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Issue #67 (May 2020)

From the Editor

We don’t normally talk about drugs in NERD, since our jam isn’t drugs, but nutrition and supplementation. But sometimes we make mention of drugs when comparing their efficacy to the stuff we normally cover. And since we’ve made the ERD to NERD transition, we’ve also mentioned drugs that touch on the realm of nutrition to some degree, like in Issue 65, where we discussed Palforzia in NERD News. Palforzia is essentially powdered peanut allergen, and significantly lowers the risk of severe allergic reactions to peanuts in children who already have peanut allergies.

In this issue, we continue that trend in our most recent installment of Safety Spotlight, where we discuss an interesting meta-analysis of possible drug interactions with cruciferous vegetables like broccoli and Brussels sprouts. But sometimes there are studies that don’t quite make the cut for a full-on NERD article because they’re a little too far outside of Examine.com’s wheelhouse. But I’m going to indulge myself and use my soapbox here to briefly mention one that was published this month in Nature[1] because I found it so cool. And while the study covers drugs, it also touches upon a couple of topics that interests many of you: the gut microbiome and obesity.

At this point it’s pretty clear that the composition of people’s gut microbiome is associated with obesity. But, being an avid NERD reader, you’re probably all too aware that correlation does not necessarily mean causation. However, chaining together correlations can sometimes generate some interesting hypotheses.

In this case, the authors knew that one pattern of the gut microbiome called Bact2 was correlated with higher inflammation and looser stools in people. This particular cluster of gut bugs is characterized by having relatively high numbers of Bacteroides (a gut bug that can cause big problems if it escapes the intestines, but isn’t thought to cause a ruckus if it stays put), low levels of the usually common and harmless Faecalibacterium, and a low bacterial cell density. They also knew of something else that is associated with high inflammation and looser stools: obesity.

Putting two and two together, the authors suspected that if they looked, they’d find that people’s guts microbiomes would look more like Bact2 as their BMI increased. When the authors looked through some databases, they indeed found this correlation, but it wasn’t super strong. When they looked more closely, they found a possible factor that explained why: people who were taking statins had a lower-than-expected prevalence of the Bact2 pattern, and so were diluting the correlation. The correlation in people who weren’t taking statins was stronger.

While the authors emphasize that their study was observational, it generates an interesting hypothesis: that statins could somehow be affecting the gut microbiome, which may be part of the mechanism by which they lower cardiovascular disease risk. While this is all just correlation, it’ll be interesting to see randomized controlled trials exploring whether small molecules like statins influence the gut microbiome, and how their effects (if any) compare to dietary changes, prebiotics, and probiotics.

Gregory Lopez, MA, PharmD
Editor-in-chief, Nutrition Examination Research Digest

See other articles in Issue #67 (May 2020) of Study Deep Dives.