What’s more important: probiotics or prebiotics? And where can we best get them?
How to Become a Fecal Transplant Super Donor
Below is an approximation of this video’s audio content. To see any graphs, charts, graphics, images, and quotes to which Dr. Greger may be referring, watch the above video.
“Virtually every day, we are all confronted with the activity of our intestine, and [it’s] no surprise that at least some of us have developed a fascination for our intestinal condition and its relation to health and disease.”
“Over the last years, the intestinal microbiota [our gut flora] have been identified as [like] a fascinating ‘new organ’” with all sorts of functions. Well, if the bacteria in our gut make up like a whole separate organ inside our body, what about doing an organ transplant?
What would happen if you transferred intestinal bacteria from lean people into obese people? Researchers figured that “rebalancing the [obesity-causing] bacteria” with an infusion of gut bacteria from a lean person might help. Now, they wanted this to be a placebo-controlled study, which for drugs is easy: give a sugar pill. But, when you’re sticking a tube down people’s throats and transplanting feces, I’m thinking, what do you use as a poop placebo—a poopcebo, if you will? Both the donors and the subjects brought in fresh stools, and the subjects were randomized to either get the donor stool, or get transplanted with their own collected feces. That was the placebo; you get your own back.
Okay. So, what happened? The insulin sensitivity of the skinny donors was up around 50; that’s a good thing. High insulin sensitivity means low insulin resistance—the cause of both type 2 diabetes and prediabetes. The obese subjects started out around 20, and after an infusion of their own feces, they stayed around 20. But, the group of obese donors getting the skinny similarly started out low, but shot up to near where the slim folks were.
It’s interesting; not all lean donor stools conveyed the same effect on insulin sensitivity, as some donors had very significant effects—the so-called super-fecal donor, whereas others had little or no effect. Turns out this “super-donor effect” is most probably conveyed by the amounts of short-chain fatty acid-producing intestinal bacteria in their feces, the food bacteria that thrive off of the fiber we eat. The short-chain fatty acids produced by fiber-eating bacteria may contribute to the release of gut hormones that may be the cause of this beneficial improved insulin sensitivity.
“The [successful] use of fecal transplantation has recently attracted considerable attention,” not only because of its success, but its capacity to prove the cause and effect relationship—that the bacteria we have in our gut can affect our metabolism. But, within a few months, the bacterial composition returned back to baseline; so, the effects on the obese subjects were temporary.
We can get similar benefits, though, by just feeding what few good gut bacteria we may already have. Say you have a shed full of bunny rabbits. Feed them pork rinds, and they all die. Yes, you can repopulate your shed by infusing new bunnies, but if you keep feeding them pork rinds, they’ll eventually die off as well. Whereas, even if you start off with just a few bunnies, if you feed them what they’re meant to eat, they’ll grow and multiply, and soon, you’ll be full of fiber-eating bunnies.
Fecal transplants and probiotics are only temporary fixes, if we keep putting the wrong fuel into our gut. But, by feeding prebiotics, such as fiber, which means “increasing whole plant food consumption,” we may select for, and foster the growth of, our own good bacteria.
However, such effects may abate once the high-fiber intake ceases. Therefore, our dietary habits should “include a continuous consumption of large quantities of high-fibre foods” to improve our health. And, if we don’t, we may be starving our microbial self.
Please consider volunteering to help out on the site.
- Swaminath A. The power of poop: patients getting ahead of their doctors using self-administered fecal transplants. Am J Gastroenterol. 2014 May;109(5):777-8.
- Udayappan SD, Hartstra AV, Dallinga-Thie GM, Nieuwdorp M. Intestinal microbiota and faecal transplantation as treatment modality for insulin resistance and type 2 diabetes mellitus. Clin Exp Immunol. 2014 Jul;177(1):24-9.
- Vrieze A, Van Nood E, Holleman F, Salojärvi J, Kootte RS, Bartelsman JF, Dallinga-Thie GM, Ackermans MT, Serlie MJ, Oozeer R, Derrien M, Druesne A, Van Hylckama Vlieg JE, Bloks VW, Groen AK, Heilig HG, Zoetendal EG, Stroes ES, de Vos WM, Hoekstra JB, Nieuwdorp M. Transfer of intestinal microbiota from lean donors increases insulin sensitivity in individuals with metabolic syndrome. Gastroenterology. 2012 Oct;143(4):913-6.e7.
- Konstantinov SR, Peppelenbosch MP. Fecal Microbiota Transfer May Increase Irritable Bowel Syndrome and Inflammatory Bowel Diseases–Associated Bacteria.
- de Vos WM, de Vos EA. Role of the intestinal microbiome in health and disease: from correlation to causation. Nutr Rev. 2012 Aug;70 Suppl 1:S45-56.
- Baty V, Mougin B, Dekeuwer C, Carret G. Gut Health in the era of the human gut microbiota: from metaphor to biovalue. Med Health Care Philos. 2014 Nov;17(4):579-97.
- Shen Q, Zhao L, Tuohy KM. High-level dietary fibre up-regulates colonic fermentation and relative abundance of saccharolytic bacteria within the human faecal microbiota in vitro. Eur J Nutr. 2012 Sep;51(6):693-705.
- Tuohy KM, Conterno L, Gasperotti M, Viola R. Up-regulating the human intestinal microbiome using whole plant foods, polyphenols, and/or fiber. J Agric Food Chem. 2012 Sep 12;60(36):8776-82.
- Possemiers S, Bolca S, Verstraete W, Heyerick A. The intestinal microbiome: a separate organ inside the body with the metabolic potential to influence the bioactivity of botanicals. Fitoterapia. 2011 Jan;82(1):53-66.
- Kim MS, Hwang SS, Park EJ, Bae JW. Strict vegetarian diet improves the risk factors associated with metabolic diseases by modulating gut microbiota and reducing intestinal inflammation. Environ Microbiol Rep. 2013 Oct;5(5):765-75.
- Tilg H, Moschen AR. Microbiota and diabetes: an evolving relationship. Gut. 2014 Sep;63(9):1513-21.
- Kaji I, Karaki S, Kuwahara A. Short-chain fatty acid receptor and its contribution to glucagon-like peptide-1 release. Digestion. 2014;89(1):31-6.
- Kellow NJ, Coughlan MT, Reid CM. Metabolic benefits of dietary prebiotics in human subjects: a systematic review of randomised controlled trials. Br J Nutr. 2014 Apr 14;111(7):1147-61.
- Tosh PK, McDonald LC. Infection control in the multidrug-resistant era: tending the human microbiome. Clin Infect Dis. 2012 Mar 1;54(5):707-13.
Icons created by Mourad Mokrane, Luis Prado, Renee Ramsey-Passmore, Alexander Smith, Creative Stall, Gan Khoon Lay, Jamison Wieser, and Gregor Črešnar from the The Noun Project.
Image credit: Newtown graffiti via flickr. Image has been modified.
Video credit: Avocado Video
Below is an approximation of this video’s audio content. To see any graphs, charts, graphics, images, and quotes to which Dr. Greger may be referring, watch the above video.
“Virtually every day, we are all confronted with the activity of our intestine, and [it’s] no surprise that at least some of us have developed a fascination for our intestinal condition and its relation to health and disease.”
“Over the last years, the intestinal microbiota [our gut flora] have been identified as [like] a fascinating ‘new organ’” with all sorts of functions. Well, if the bacteria in our gut make up like a whole separate organ inside our body, what about doing an organ transplant?
What would happen if you transferred intestinal bacteria from lean people into obese people? Researchers figured that “rebalancing the [obesity-causing] bacteria” with an infusion of gut bacteria from a lean person might help. Now, they wanted this to be a placebo-controlled study, which for drugs is easy: give a sugar pill. But, when you’re sticking a tube down people’s throats and transplanting feces, I’m thinking, what do you use as a poop placebo—a poopcebo, if you will? Both the donors and the subjects brought in fresh stools, and the subjects were randomized to either get the donor stool, or get transplanted with their own collected feces. That was the placebo; you get your own back.
Okay. So, what happened? The insulin sensitivity of the skinny donors was up around 50; that’s a good thing. High insulin sensitivity means low insulin resistance—the cause of both type 2 diabetes and prediabetes. The obese subjects started out around 20, and after an infusion of their own feces, they stayed around 20. But, the group of obese donors getting the skinny similarly started out low, but shot up to near where the slim folks were.
It’s interesting; not all lean donor stools conveyed the same effect on insulin sensitivity, as some donors had very significant effects—the so-called super-fecal donor, whereas others had little or no effect. Turns out this “super-donor effect” is most probably conveyed by the amounts of short-chain fatty acid-producing intestinal bacteria in their feces, the food bacteria that thrive off of the fiber we eat. The short-chain fatty acids produced by fiber-eating bacteria may contribute to the release of gut hormones that may be the cause of this beneficial improved insulin sensitivity.
“The [successful] use of fecal transplantation has recently attracted considerable attention,” not only because of its success, but its capacity to prove the cause and effect relationship—that the bacteria we have in our gut can affect our metabolism. But, within a few months, the bacterial composition returned back to baseline; so, the effects on the obese subjects were temporary.
We can get similar benefits, though, by just feeding what few good gut bacteria we may already have. Say you have a shed full of bunny rabbits. Feed them pork rinds, and they all die. Yes, you can repopulate your shed by infusing new bunnies, but if you keep feeding them pork rinds, they’ll eventually die off as well. Whereas, even if you start off with just a few bunnies, if you feed them what they’re meant to eat, they’ll grow and multiply, and soon, you’ll be full of fiber-eating bunnies.
Fecal transplants and probiotics are only temporary fixes, if we keep putting the wrong fuel into our gut. But, by feeding prebiotics, such as fiber, which means “increasing whole plant food consumption,” we may select for, and foster the growth of, our own good bacteria.
However, such effects may abate once the high-fiber intake ceases. Therefore, our dietary habits should “include a continuous consumption of large quantities of high-fibre foods” to improve our health. And, if we don’t, we may be starving our microbial self.
Please consider volunteering to help out on the site.
- Swaminath A. The power of poop: patients getting ahead of their doctors using self-administered fecal transplants. Am J Gastroenterol. 2014 May;109(5):777-8.
- Udayappan SD, Hartstra AV, Dallinga-Thie GM, Nieuwdorp M. Intestinal microbiota and faecal transplantation as treatment modality for insulin resistance and type 2 diabetes mellitus. Clin Exp Immunol. 2014 Jul;177(1):24-9.
- Vrieze A, Van Nood E, Holleman F, Salojärvi J, Kootte RS, Bartelsman JF, Dallinga-Thie GM, Ackermans MT, Serlie MJ, Oozeer R, Derrien M, Druesne A, Van Hylckama Vlieg JE, Bloks VW, Groen AK, Heilig HG, Zoetendal EG, Stroes ES, de Vos WM, Hoekstra JB, Nieuwdorp M. Transfer of intestinal microbiota from lean donors increases insulin sensitivity in individuals with metabolic syndrome. Gastroenterology. 2012 Oct;143(4):913-6.e7.
- Konstantinov SR, Peppelenbosch MP. Fecal Microbiota Transfer May Increase Irritable Bowel Syndrome and Inflammatory Bowel Diseases–Associated Bacteria.
- de Vos WM, de Vos EA. Role of the intestinal microbiome in health and disease: from correlation to causation. Nutr Rev. 2012 Aug;70 Suppl 1:S45-56.
- Baty V, Mougin B, Dekeuwer C, Carret G. Gut Health in the era of the human gut microbiota: from metaphor to biovalue. Med Health Care Philos. 2014 Nov;17(4):579-97.
- Shen Q, Zhao L, Tuohy KM. High-level dietary fibre up-regulates colonic fermentation and relative abundance of saccharolytic bacteria within the human faecal microbiota in vitro. Eur J Nutr. 2012 Sep;51(6):693-705.
- Tuohy KM, Conterno L, Gasperotti M, Viola R. Up-regulating the human intestinal microbiome using whole plant foods, polyphenols, and/or fiber. J Agric Food Chem. 2012 Sep 12;60(36):8776-82.
- Possemiers S, Bolca S, Verstraete W, Heyerick A. The intestinal microbiome: a separate organ inside the body with the metabolic potential to influence the bioactivity of botanicals. Fitoterapia. 2011 Jan;82(1):53-66.
- Kim MS, Hwang SS, Park EJ, Bae JW. Strict vegetarian diet improves the risk factors associated with metabolic diseases by modulating gut microbiota and reducing intestinal inflammation. Environ Microbiol Rep. 2013 Oct;5(5):765-75.
- Tilg H, Moschen AR. Microbiota and diabetes: an evolving relationship. Gut. 2014 Sep;63(9):1513-21.
- Kaji I, Karaki S, Kuwahara A. Short-chain fatty acid receptor and its contribution to glucagon-like peptide-1 release. Digestion. 2014;89(1):31-6.
- Kellow NJ, Coughlan MT, Reid CM. Metabolic benefits of dietary prebiotics in human subjects: a systematic review of randomised controlled trials. Br J Nutr. 2014 Apr 14;111(7):1147-61.
- Tosh PK, McDonald LC. Infection control in the multidrug-resistant era: tending the human microbiome. Clin Infect Dis. 2012 Mar 1;54(5):707-13.
Icons created by Mourad Mokrane, Luis Prado, Renee Ramsey-Passmore, Alexander Smith, Creative Stall, Gan Khoon Lay, Jamison Wieser, and Gregor Črešnar from the The Noun Project.
Image credit: Newtown graffiti via flickr. Image has been modified.
Video credit: Avocado Video
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How to Become a Fecal Transplant Super Donor
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Content URLDoctor's Note
The microbiome is one of the most exciting research areas in medicine these days. For more information, see, for example:
- Bowel Wars: Hydrogen Sulfide vs. Butyrate
- Putrefying Protein and “Toxifying” Enzymes
- Microbiome: The Inside Story
- What’s Your Gut Microbiome Enterotype?
- How to Change Your Enterotype
- Paleopoo: What We Can Learn from Fossilized Feces
- Egg Industry Response to Choline and TMAO
- Is Obesity Infectious?
- How to Develop a Healthy Gut Ecosystem
- Microbiome: We Are What They Eat
- Effect of Sucralose (Splenda) on the Microbiome
- The Role of the Gut Microbiome in Autism
For more on healthy sources of prebiotics, check out:
- Prebiotics: Tending Our Inner Garden
- Gut Dysbiosis: Starving Our Microbial Self
- Resistant Starch and Colon Cancer
- Gut Microbiome: Strike It Rich with Whole Grains
- How to Keep Your Microbiome Healthy with Prebiotic Foods
In 2023 I released new fecal transplant videos: Fecal Transplants for Ulcerative Colitis, MS, Depression, Bipolar, and Alcoholism and Fecal Transplants for Aging and Weight Loss.
If you haven’t yet, you can subscribe to my videos for free by clicking here. Read our important information about translations here.