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EXCELLENT
(and semi-bleak) @AGA_Gastro commentary on probiotics
Probiotics are...
Misunderstood
Over-hyped
Under-studied
Mis-regulated
BUT (if done right
) have lots of potential
Article highlights
(1/8)
#GItwitter
@rabritton @AmerGastroAssn https://twitter.com/amergastroassn/status/1278394199998685184
(and semi-bleak) @AGA_Gastro commentary on probioticsProbiotics are...
MisunderstoodOver-hypedUnder-studiedMis-regulatedBUT (if done right
) have lots of potentialArticle highlights
(1/8)#GItwitter
@rabritton @AmerGastroAssn https://twitter.com/amergastroassn/status/1278394199998685184
2/8
Probiotics come with BIG promises
BUT Prob
Almost ZERO high-quality human trials
Prob
Strain matters
Some Ecoli are good
Some Ecoli are bad
Same species not = same function
Strain not always advertised in probiotics
Makes systematic reviews V hard
Probiotics come with BIG promises
BUT Prob
Almost ZERO high-quality human trialsProb
Strain mattersSome Ecoli are good
Some Ecoli are bad
Same species not = same function
Strain not always advertised in probiotics
Makes systematic reviews V hard
3/8
Your gut bacteria are a stable little family
They may be toxic like some Thxgiving dinners
But they’re family NONETHELESS and stick together, in their own complicated way
And like some boyfriends you brought home for the holidays, most probiotics WONT LAST
Your gut bacteria are a stable little family They may be toxic like some Thxgiving dinners
But they’re family NONETHELESS and stick together, in their own complicated way
And like some boyfriends you brought home for the holidays, most probiotics WONT LAST
4/8 Prob 
You are a unique little snowflake
And so is your gut
You have different flora than your neighbor!
Probiotics interact (prob a lot) with your native bacteria
So why would it be
one size fits all?
You are a unique little snowflake
And so is your gut
You have different flora than your neighbor!
Probiotics interact (prob a lot) with your native bacteria
So why would it be
one size fits all?
5/8
And let me throw some political drama in the mix
(Prob 
)
Probiotics are regulated as a FOOD (yum yum
), not a DRUG
So no need to
specify strain
specify AMOUNT of bacteria per pill
submit validation of label claims to FDA
run rigorous clinical trials
And let me throw some political drama in the mix
(Prob )Probiotics are regulated as a FOOD (yum yum
), not a DRUGSo no need to
specify strainspecify AMOUNT of bacteria per pillsubmit validation of label claims to FDArun rigorous clinical trials
6/8
It costs > $2 billion and 10 years to get a drug to market
So why would probiotic makers go thru that?
ESP when, as a food/diet supp, they are allowed to make vague claims like “improves digestion”
It costs > $2 billion and 10 years to get a drug to market
So why would probiotic makers go thru that?
ESP when, as a food/diet supp, they are allowed to make vague claims like “improves digestion”
7/8
Ok ok ok
Before the probiotic mafia comes to my house and makes me eat yogurt
Great @AGA_Gastro review on probiotics found mod-to-high evidence that certain probiotics prevent necrotizing enterocolitis!
https://twitter.com/trott_nick/status/1290626968392740864
Ok ok ok
Before the probiotic mafia comes to my house and makes me eat yogurt
Great @AGA_Gastro review on probiotics found mod-to-high evidence that certain probiotics prevent necrotizing enterocolitis!
https://twitter.com/trott_nick/status/1290626968392740864
8/8
IF WE CAN
use fancy tools 
to ID the specific microbial/function deficits of an individual or narrow dz phenotype
create bacterial consortium that play well w the complex environ of your native bugs
actually test them
Probiotics may have a
future
Fin
IF WE CAN
use fancy tools to ID the specific microbial/function deficits of an individual or narrow dz phenotypecreate bacterial consortium that play well w the complex environ of your native bugsactually test themProbiotics may have a
futureFin
