SINGAPORE - If you have ever wondered why you feel down all the time, why you have indigestion or why you have a foggy brain, the problem might be with your gut.
AMiLi or the Asian Microbiome Library, a Singapore start-up, has been working to map the gut microbiome of people living here, by appealing to them to donate their poop for research.
Now, it is offering a service where members of the public can have their gut microbiome analysed, using a scoop of poop.
A dietitian will then give them advice on what lifestyle changes they can make to improve their mood, think more clearly, have better heart and liver health, and improve their digestive wellness, among other things.
There has been a lot of buzz in the last few years about the human gut microbiome. The gut microbiome is the genetic material of the trillions of microbes in the human body. With advances in science, researchers and scientists can look at how these micro-organisms in the gut are linked to disease.
Dysfunction in the microbiome has been associated with autoimmune diseases such as diabetes, rheumatoid arthritis, muscular dystrophy and multiple sclerosis; gastrointestinal problems such as Crohn's disease and irritable bowel syndrome; and other conditions such as eczema, anxiety, obesity and autism.
Research in Asia has lagged behind the West, and a group of doctors and researchers here started AMiLi last December to catch up and to give their peers data relevant to people from this part of the world. The start-up is headed by Dr Jeremy Lim, AMiLi's co-founder and chief executive.
It started by appealing to Singaporeans and those living here to contribute their poop, to add to the databank for the library, or, in the case of very healthy people with "premium" poop, to contribute samples that can be processed and used for fecal microbiota transplants. In Singapore, this procedure is used for treating severe cases of C. difficile infection. The bacterial infection can result in the perforation of the colon or sepsis. The transplant introduces healthy bacteria into the patient's gut.
But these transplants can be used to treat more than just C. difficile infections.
Dr Lim says: "We are working with various academic institutions to conduct research into the different potential applications of fecal microbiota transplants, such as inflammatory bowel disease and irritable bowel syndrome."
Early bird sales of the AMiLi Bio+Me Gut Microbiome Test have started. It costs $129 until the end of the year or for the first 1,000 kits. After that, the price is $229. People can order the kits from bioandme.asia. There are instructions on how to activate an account and submit a stool sample to AMiLi to be analysed.
Dr Lim says microbiome sequencing has been offered in the United States and Europe for a number of years and the reference data is based in large part on Caucasian data. "We wanted to offer in Singapore, and Asia more broadly, a test based on global as well as Asian data with recommendations tailored to the diets and lifestyles in Asia," he says.
In the second quarter of next year, AMiLi will roll out a subscription plan for people who want their gut microbiome analysed regularly. Prices are not available yet.
Dr Lim says: "The gut microbiome is highly dynamic and responsive to changes in lifestyle, environment and diet. Testing one's microbiome every three months is a great way to track any changes in the microbiome, as well as to see the effects of diet and lifestyle changes people have made."
Ms Bibi Chia, principal dietitian of Raffles Hospital Singapore, is also AMiLi's nutrition adviser. She and her team will look at the results of the test and give recommendations on how individuals can boost the performance of their gut microbiome.
She says: "Your gut is also associated with the production of neurotransmitters that influence your feelings, mood and affect your brain function. The Think Well category measures the levels of certain neurotransmitter-influencing microbes that are important to your mental health.
"The Live Well category looks at the pathways that your microbes take to produce chemicals that impact your heart, gut and liver health. And the Feel Well category measures your microbiome's efficiency in breaking down nutrients and producing short-chain fatty acids, which are important compounds that help us produce, store, and use energy."
For example, the Think Well part of the report measures the production levels of GABA or gamma-Aminobutyric acid, and serotonin. These are neurotransmitters which regulate sleep and anxiety. Up to 90 per cent of these neurotransmitters are made by good gut bacteria such as lactobacillus and bifidobacterium.
"Low levels of these bacteria might correlate to a lower production of neurotransmitters and will result in a lower Think Well score," she says. "The dietary recommendations we make in such a scenario will focus on boosting the levels of GABA- and serotonin-producing bacteria."
Doctors say there are practical reasons for knowing about one's gut microbiome.
Dr Juanda Leo Hartono, consultant at the National University Hospital (NUH), Singapore's Division of Gastroenterology & Hepatology, says: "In the future, it may be possible to use the gut microbiome as a biomarker, to identify or predict the clinical course and severity of disease, the response to a particular treatment, and the complications of treatment.
"Having the ability to predict these will allow a more tailored, personalised, form of medicine."
Dr Tan Poh Seng, a gastroenterologist in private practice, says gut problems such as irritable bowel syndrome, constipation, acid reflux and gastritis are common among Singaporeans, and older people are more prone to developing diverticular disease, colon polyps and colon cancer.
He says: "I am interested in offering the Bio+Me Gut Microbiome Test to some of my patients, to better understand their gut microbiome and how I can use this information to improve their gut conditions."
But the test is not necessary for most people for now.
As a 2018 paper led by United States-based researchers in the Clinical Gastroenterology and Hepatology journal concluded: "Although there is great interest in the microbiome, there is still a long way to go before microbiome-based diagnostics become a routine part of clinical care."
Dr Alex Soh, consultant at NUH's Division of Gastroenterology & Hepatology, notes that gut microbiome testing is currently not routinely performed in the clinical setting.
He adds that in the future, when the link between the gut microbiome and certain health conditions is more well-established, allowing personalised targeted therapeutic interventions to be made available, it will become clearer which groups of individuals would stand to benefit from having their gut microbiome analysed.
Still, people here who have had their poop analysed by AMiLi say they have a better idea of their health status.
Retiree Eddie Goh, 66, says: "I was a little sceptical and curious about what a poop sample can tell about the body's state of health."
He says the results tallied with two other medical studies he took part in. "My fairly good overall results gave me more motivation to continue with my present lifestyle and dietary habits," he says.
It is the genetic material of the trillions of good and bad micro-organisms that live in your gut. The bacteria digest food and help absorb and synthesise nutrients from food.
Beyond that, the gut microbiome affects a person's quality of life too - his physical and mental health, mood and longevity. Phrases such as "gut instinct" and "butterflies in the stomach" come from how closely tied the brain and gut are.
Advances in science have allowed scientists to look at the genetic sequence of the gut micro-organisms and see how they might be linked to conditions such as irritable bowel disorders, obesity, autism, diabetes, depression and cancer.
Stress, illness, the overuse of antibiotics, obesity, ageing and a poor-quality diet can throw the gut microbiome out of whack or cause it to lose diversity. At the same time, dietary and lifestyle changes can improve the diversity of the gut microbiome.
https://www.straitstimes.com/life/how-to-tell-if-youre-healthy-get-a-scoop-of-your-poop-analysed
A version of this article appeared in the print edition of The Straits Times on December 2, 2020, with the headline 'How to tell if you're healthy? Get a scoop of your poop analysed
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My Comments...............from Sim Ching Tong
How to tell if you're healthy? Get a scoop of your poop analysed
This in an article published in The Straits Times on December 2, 2020.
Gut microbiome or normally refer to gut flora in a simple term.
Gut problems such as irritable bowel syndrome, constipation, acid reflux and gastritis are common among Singaporeans, and older people are more prone to developing diverticular disease, colon polyps and colon cancer according to Dr Tan Poh Seng, a gastroenterologist in private practice.
Think Well : Production of neurotransmitters that influence your feelings, mood and affect your brain function.
Live Well : Producton of chemicals that impact your heart, gut and liver health.
Feel Well : Breaking down nutrients and producing short-chain fatty acids, which are important compounds that help us produce, store, and use energy."
Production levels of GABA or gamma-Aminobutyric acid, and serotonin. These are neurotransmitters which regulate sleep and anxiety. Up to 90 per cent of these neurotransmitters are made by good gut bacteria such as lactobacillus and bifidobacterium.
It's important to maintain a balance gut microbiome or flora in our gut by dietary or lifestyle changes.
Shuang Hor Lactoberry with 2 types of multicoated probiotics : Bifido Bacterioum Lactis (L-form) and Bifido Bacterioum Longum (L-form) are good to provide the wellness of GI tract.