[ed note: Michael Jorrin, who I dubbed “Doc Gumshoe” a few years back, writes for us about health and medicine a couple times a month. He does not typically cover the investment side of medicine, but, as today, he often digs into the health “teasers” and hyperbole that we all see along with the investment teasers. He chooses his own topics, and has agreed to our general trading disclosures.]
The definite answer to that provocative question is “maybe.” I come to that emphatically ambiguous position as a result of having dug around in response to yet another lengthy presentation to which Travis alerted me. I’m going to try to spare you the tedious repetitive build-up in the spiel, and just give you the highlights (so to speak), which run like this:
“Hi, my name is Anthony Turner. And in just a moment, I’m going to share an incredible true story with you.
“A story about how a 390 pound morbidly obese man, who just 3 months earlier had collapsed to the floor in agony, heart failing, sweat pouring down his face, fighting for breath as he lay on the floor on the verge of death, not only survived this ordeal … but was able to quickly and easily shed 142 pounds in just 90 days, transforming his health and adding years to his life expectancy in the process.
“This is the story of how a man who doctors had warned would be dead inside 6 months, stunned the medical community, and forced doctors with decades of experience and knowledge of the human body to rethink everything they thought they knew about losing weight.
“And remarkably, he did it without calorie counting… without gastric surgery… without starving himself… without medication… and without following any kind of diet AT ALL.
“In fact, this man was able to effectively ‘trick’ his body to melt away fat on a daily basis, without cutting out ANY of his favorite foods.”
The presentation then goes on to repeat essentially the same story again and again and AGAIN … always with the same conclusion, which is, in case you didn’t get it the first time or the second time, that you can lose huge amounts of weight without pain or inconvenience. The food goes in through your face as usual, but the fat doesn’t then accumulate at those inconvenient locations where you wish it wouldn’t.
Fairly early on, the spiel gives you a quick peek behind the curtain, but then goes on to explain, in serious terms, that the information you are about to receive has been divulged by a courageous individual who is defying the serious threats brandished by the pharmaceutical industry and the medical establishment so that the miraculous weight-loss protocol should remain secret and not threaten the cash flow to those greedy entities. Here are some more snippets:
“This game-changing discovery, which has already made headline news in the Guardian, USA Today, the Scientific American, and The Washington Post, is cast-iron proof that your weight gain has NOTHING to do with calories….
“NOTHING to do with your metabolism…Are you getting our free Daily Update
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“NOTHING to do with what time you’re eating…
“And incredibly, NOTHING to do with how much you eat, despite what the mainstream media and the medical profession has been telling you.
… And is instead all down to a nasty ‘fat-building’ bacteria residing in your gut that is not only resulting in you gaining weight, but is also making it literally IMPOSSIBLE for you to shed that weight, and achieve the lean and toned physique that you want.
“But what’s really going to make you angry is that there’s a very simple solution to the problem –
But it’s currently being suppressed by the greedy multi-billion dollar pharmaceutical industry who are doing everything in their power to keep this discovery hidden from the public, for reasons I’ll reveal very soon.
“I have already been physically threatened and had 4 separate lawsuits filed against me in order to stop you from learning the truth about why you’ve found it such a struggle to lose weight, even when you do everything right.
“So I urge you to read this page while you have the chance, because there are no guarantees that it will still be here tomorrow, or even in a few hours from now.”
Mr Turner, the narrator of this epic, doesn’t seem to be in too much of a hurry to reveal the very simple solution to the problem in spite of the implied threat that his page may not still be there in a few hours. First he has to put in a few testimonials from people who have achieved phenomenal weight-losses, and then he has to tell his own story – yes, he’s the guy who weighed 390 pounds and lost 142 pounds in 90 days. Then just a bit more about the efforts by Big Pharma to suppress “the truth.” And then, finally, the secret – except that it’s not so secret.
Let’s start with the grain of truth: as by now all you well-informed citizens of Gumshoe Nation are aware, we humans are hosts to a large number of microbes, most of which dwell in our intestines. The number has been estimated to be as high as 100 trillion. Yes, that’s TRILLION, with a T. Most of these do neither good nor harm; the scientific term is “comensal.” Some of them, however, provide considerable help by assisting with the digestion of our food; that relationship between our microscopic guests and ourselves is termed “symbiotic.” Another beneficial function that some of those micro-organisms perform is to keep the population of their evil compatriots in check. That function sometimes is affected for the worse when we take antibiotics. The antibiotics kill off large numbers of the beneficial bugs, and resistant bacteria such as Clostridium difficile rapidly multiply to take their place.
This huge population of microbes in our gut is our microbiota, and it includes not only bacteria and fungi, but another, less known phylum of microbes called Archaea. The relationship between our microbiota and obesity has been the subject of a great deal of research. PubMed lists, at last count, 1466 published papers that discuss that subject.
However, the particular “nasty fat-building bacteria” that Mr Turner referred to are members of a bacterial phylum called “Firmicutes.” Here’s his revelation:
“… one Sunday morning, I came across an old online article in the Washington Post that changed everything.
“It was titled ‘Scientists Link Weight to Gut Bacteria’, and it referenced a study that had taken place back in 2006.
“Apparently, researchers at The Center for Genome Sciences at Washington University in St. Louis, had discovered something incredible – a direct and irrefutable connection between weight gain and the levels of certain types of bacteria in the gut.
“According to two separate studies, which were published in the peer-reviewed journals Nature in 2006, and Science in 2009, it was found that obese mice had high levels of a bacteria called Firmicutes, and a lower level of a family of bacteria called Bacteroidetes.
“In lean mice, the opposite was true.
“And even more amazingly, the same results were found in humans.
“The research team studied 4 sets of twins, where one twin was obese, and the other was of a normal, healthy weight.
“In each set, the obese twin had higher levels of the ‘fat-building’ bacteria, Firmicutes, and a much lower level of Bacteroidetes, while in the lean twins, it was the reverse.”
So far, Mr Turner is staying in the general vicinity of the facts. The first paper did indeed find that the balance between Firmicutes and Bacteroidetes was linked with obesity in mice from the same litter. As he stated, the mice with a greater Firmicutes to Bacteroidetes in their gut tended to be fatter. The reason postulated by the authors of the paper makes intuitive sense – the Firmicutes are better able to harvest nutrients from the contents of the mouses’ digestive systems, and, all other things being equal, the mice do not convert all of those nutrients to energy and therefore store them as fat, exactly as we would. The paper is under the name of PJ Turnbaugh et al (Nature. 2006;444(7122):1027-31) of the Center for Genome Sciences at the Washington University School of Medicine in St Louis.
That first paper went on to report another bit of interesting evidence, which was that if the lean mice were colonized with the biota of the fat mice, lo and behold, the lean mice started to put on weight. That observation goes some way to bolster the cause-and-effect relationship between the Firmicutes/Bacterioidetes balance and weight gain: weight gain could be induced by tipping the balance in favor of the Firmicutes – at least in mice. But note – the gain in weigh, and the change in the balance of the gut microbes, was triggered by diet, not the other way around.
By the way, the origin of “Firmicutes” has nothing to do with being firm and cute. The so-named bacteria have a firmus cutis, or strong skin.
The second paper mentioned by Turner, also under the name of PJ Turnbaugh (Nature. 2009;457(7228):480-4), is a good deal more cautious with regard to that cause-and-effect relationship. It doesn’t go much further than to describe the association, based on observation of pairs of female identical twins. That study, to be fair, did not include colonizing the fatter twin with the biota of the leaner twin. It was not interventional, but observational. But the study did report a great deal of variation in the microbiota of the subjects, and was very conservative about the strength of the association.
Here’s where the Turner narrative turns into something like a thriller.
“I wasn’t lazy.
“I wasn’t gluttonous.
“I didn’t have a slow metabolism.
“I was just that I had more fat-building bacteria than naturally lean people.
“Amazingly, it was nothing more than bad luck that I was as heavy as I was – and wasn’t able to shift the excess weight.
“I literally couldn’t – it was impossible.
“Unless I was able to increase my levels of the slimming bacteria residing in my gut, and reduce my levels of the bad, fattening bacteria.
“But how could I do that?
“I was desperate to find the answer.
“My life literally depended on it.
“So I searched online for further study results and treatments based on the research.
“But I couldn’t find anything. I couldn’t understand it.
“Surely, if these scientists had discovered that obesity is caused by an excess of Firmicutes in the gut, and lean people had more Bacteroidetes, then they would have created a simple treatment, like a drug, for example, to address the imbalance.
“It would be the biggest single cure for obesity ever developed.
“It would be breaking news all over the world, and would save hundreds of millions of lives within a matter of weeks.
“But there was nothing. Why?
“I had to find out…
“So that afternoon I got on the phone to the Center for Genome Sciences at the Washington University School of Medicine, in St Louis, Missouri, to see if there was anyone there that could help me.
“And this is where things got really sinister…
“The lady on the phone was as nice as pie at first, but as soon as I mentioned the weight loss studies back in ‘06 and ‘09, she cut me off.
“I called back, only to be cut off again.
“Eventually I managed to speak to someone else, who told me that they had no record of these studies, or the researcher’s names that I gave them, and that I must have been mistaken.
“I couldn’t understand what was going on.
“Over the next few weeks, I wrote emails, letters and made hundreds of calls, desperately trying to get in touch with anyone involved with the original trials to find out what had happened to all the research – and why it had hit a dead end.
“5 weeks passed – and I’d had nothing back.
“Not even an acknowledgement of my letters or emails.
“I’d all but given up hope, and resigned myself to the fact that I’d probably be dead in the next few months.
“I might have a couple of years if I was lucky.
“Then completely out of the blue, I received an email that changed everything.
“It was from an anonymous Gmail account, and the sender had written just one single sentence.
‘Anthony’, it said. ‘I was a researcher on the gut bacteria studies at the Center for Genome Sciences. I’m willing to talk. Call me on…’
“The email was signed Dr David Forrest, and he gave a phone number for me to contact him on.
I couldn’t wait a single second to find out about what he had to say, so I called the number immediately.
“What followed was the signal most important conversation of my entire life.
“Dr Forrest explained that he was a co-researcher on both the mice and human trials, and his team had been absolutely amazed at what they’d found.
“They knew that they’d finally discovered the Holy Grail of weight loss…
… The real reason why certain people put on weight, and others didn’t, despite eating similar diets – and they were excited about developing a revolutionary weight loss drug.
“The team were expecting to be lauded for their discovery, and talk of Nobel Prizes was everywhere.
“This was big, and they knew it, Dr Forrest said.
“But then something strange happened.
“Their request for further funding was denied – their research lab was shut down, and the entire team was reassigned to other projects.
“‘Why would they want to stop the research?’ I asked Dr Forrest. ‘Surely if they produced a drug, it would pretty much end the obesity epidemic overnight?’
“‘Exactly!’ replied Dr Forrest, and that’s why it was shut down.
“What do you mean?” I asked, confused about what I was hearing.
“‘Well,’ said Dr Forrest, ‘what most people don’t know is that Big Pharma fund most of the major research institutions, and they were funding us at the Washington University School of Medicine.
But when we stumbled on this discovery, they got scared, and threatened to pull all of their funding if we continued with the research. The University couldn’t afford to lose all of that money, so they were forced to go along with it.’
“‘But why?’ I asked…
“‘Think how much money Big Pharma are making from the obesity epidemic’, said Dr Forrest.
‘You’ve got literally thousands of different drugs treating obesity-related conditions like heart disease, stroke, type 2 diabetes, hypertension, high cholesterol, Osteoarthritis, kidney failure, liver problems, gallstones, neuropathy, and a whole lot more. Big Pharma are making hundreds of BILLIONS every year from obesity.'”
Okay, I hope you were able to stand the suspense. Here are a few tiny facts that spoil Mr Turner’s spinning the tale of a dire plot. First, regardless of threats from Big Pharma, the Center for Genome Sciences at Washington University is far from discontinuing research into the relationship between the microbiota and obesity. Those same authors of the studies cited by Turner have continued to do research in that area and have published several papers. Dr Jeffrey I. Gordon, the lead author in those papers has also been quoted extensively on the subject of the balance between Firmicutes and Bacteroidetes as it relates to obesity. (Contrary to what one might suppose, the most prominent author in academic papers is often listed last, so although the paper is cited as P. J. Turnbaugh et al, J. I. Gordon is the senior author and head of the research project.)
Second, the subsequent research, while confirming the relationship between a gut population high in Firmicutes and obesity, in no way demonstrates any avenue to reversing obesity by tinkering with those microbes. It has been shown with a high degree of confidence that altering the diet will quickly change the microbiota, at least in mice. One mouse study showed that in a mouse population that had been kept lean for several weeks through a low-fat, low-sugar diet, a switch to a high-fat, high-sugar diet altered the balance of the microbiota from Bacteroidetes to Firmicutes in a single day. But there was no evidence that altering that balance prospectively would make the mice leaner or fatter. In each case, the triggering event is a change in diet. This study also came out of the Washington University Center for Genome Sciences.
A third pinprick in Turner’s narrative is that there doesn’t seem to have been any Dr David Forrest at the Washington University School of Medicine. And although PubMed comes up with over 400 papers with “D Forrest” listed among the authors, if one adds “obesity” to the search term, the result is Zero. Of course, Mr Turner may have made up the name to protect his real source from assassination at the hands of evil Big Pharma.
Without exception, the papers I have looked at in this connection don’t come anywhere near proposing a weight-loss protocol based on changing the balance of the microbiota. So, is Turner’s spiel pure horsefeathers, or is there really some hope that research along those lines will eventually produce useful results?
Eventually, if one suffers through Mr Turner’s spiel, he throws out a hint as to what the actual means of achieving the miraculous weight loss might be. Here’s what he says that Dr Forrest did:
“… he went underground, and began to put together a natural weight loss program designed to reduce Firmicutes, and increase Bacteroidetes in the human gut.
“During his research, he discovered that a high-fiber diet was key.
“According to one study he found, published in the Nature Immunology Journal, children in Burkina Faso, in Africa, were shown to have a diet very high in fiber, and consequently had much lower levels of the fattening bacteria, and much higher levels of the slimming bacteria.
“Dr Forrest also found that increasing a person’s levels of Prebiotics, which are non-digestible carbohydrates in the form of dietary fiber, helped to nourish the friendly “slimming” bacteria, and helped them grow in numbers.
“And the good news is, prebiotics can be found in natural foods like garlic, onions, asparagus, beans and bananas, amongst other things.
“According to Dr Forrest, over the next few years he developed the ultimate list of fat-burners –
“Completely natural ingredients proven to regulate gut bacteria, and redress the balance between the fattening gut bacteria, and the slimming bacteria.”
How exactly this sorts with Turner’s opening salvo, in which he explicitly states that this 390 pound morbidly obese individual lost 142 pounds in 90 days “without following any kind of diet at all” is beyond me to figure out. In fact, what Turner is touting is definitely a diet – a diet that stresses prebiotics. Some of the “foods’ (I use the term loosely) containing prebiotics are chicory root, Jerusalem artichoke, dandelion greens, garlic, leek, onion, wheat bran – all of them to be eaten RAW and DRY. The benefits of prebiotics as a way to nourish beneficial bacteria in the digestive tract have been widely discussed, and “Dr Forrest” can’t claim to be in on the ground floor of this trend. As to weight loss, wouldn’t you figure that if you fill your stomach and digestive tract with stuff that is non-digestible, you would feel quite full, and not inclined to gorge? You might as well eat sawdust.
However, since prebiotics mostly don’t have much in the way of the nutrients that we hungry humans need to survive, we have to eat something else. Is Turner suggesting that so long as we eat the requisite amount of prebiotics, we can eat whatever else we want? I doubt it. I have not read any of the three books that Turner is selling – Dr Forrest’s “Fat Burning Bible,” Dr Forrest’s “Foods that Make You Fat,” or Dr Forrest’s “False Friends.” But I would be flabbergasted if Dr Forrest told his disciples that they can go back to eating a high-sugar high-fat diet. It’s the high-sugar, high-fat diet that quickly changed the balance between those two gut bacteria populations back to predominantly Firmicutes. In the case of the mice that had been mostly Bacteroidetes, the switch to Firmicutes took place in about one day.
A thorough review of the subject, “Impact of the Gut Microbiota on the Development of Obesity,” by John K DiBaise MD, of the Mayo Clinic Division of Gastroenterology, suggests that altering the bacterial balance in obese individuals may not be all that easy:
“… A very recent report showed that short-term alterations in nutrient load induced rapid changes in the gut microbiota in lean, but not obese, humans. Specifically, in lean individuals, increases in nutrient load resulted in an increased relative abundance of Firmicutes (and a corresponding decrease in Bacteroidetes) and increased energy harvest. Interestingly, this relationship was not observed in obese subjects, suggesting that the microbiota of obese and lean individuals respond differently to changes in the caloric content of diet.”
We shouldn’t accept that as definitive, but it certainly casts serious doubt on the prospects of effecting significant weight loss just by changing the balance between those two classes of bacteria. The wrong sort of diet can alter that balance in the lean individual in such a way that it will tend to make him or her fat. But it may not be so simple to alter the balance in the fat individual so that he or she quickly and easily loses weight.
That same DiBaise paper tentatively examines a number of other options for weight loss, including probiotics, fecal transplantation and gastric by-pass surgery, without arriving at clear conclusions. The answer we’re left with is that there doesn’t seem to be an easy answer.
As our mothers and their mothers before them knew, the food in your belly went in through your face, and that’s what makes you fat. Weight-loss schemes that don’t rely on eating less fat-making food are usually pipe-dreams.
* * * * * * *
I can’t resist a comment on Dr Forrest’s mention of those slim children in Burkina Faso who subsisted on a high-fiber diet and consequently had much higher levels of “slimming bacteria.” A young woman whom we know spent a couple of years in Burkina Faso, and she reported that she was hungry all the time, as was everybody else. It wasn’t that she didn’t have money to buy food. It was just that there wasn’t much food to be had, regardless of the money. She lived in a very small village, but when she had a few days off, she went to the capital, Ouagadougou. There wasn’t much to do there, but at least she could get enough to eat.
So it’s no wonder those children in Burkina Faso are so slim. So is everybody else. The reason they have high levels of Bacteriodetes and low levels of Firmicutes is because they don’t get enough to eat. They’re not slim because of the balance between those two bugs – it’s the other way around.