Can consuming your own poop's microbiome help you lose weight?

Can consuming your own microbiome from your feces help you maintain weight loss? A new study published in the journal Gastroenterology seems to have proved that it can. 

Researchers form the Ben-Gurion University of Negev (BGU) have discovered a solution to the problem that anyone familiar with dieting and losing weight has encountered - regaining lost weight after a diet.

Yet, the answer to this widely experienced phenomenon isn't one that many people might jump right on however, as it requires people to consume frozen microbiome capsules derived from their own feces. 

 

One might ask why someone might chose to do such a disgusting thing?

“It is well known that most weight-loss dieters reach their lowest body weight after 4-6 months, and are then challenged by the plateau or regain phase, despite continued dieting,” explained Dr. Shai. a member of the School of Public Health. 

In light of this, researchers explored whether preserving the optimized personal microbiome from fecal transplants after six months of weight loss helps maintain weight loss by transplanting back the optimized microbiome during the subsequent expected regain phase; a process called autologous FMT.

The answer to the solution was theorized and tested in an unprecedented 14-month clinical trial in Israel, in which Prof. Dr. Shai; BGU Ph.D. student Dr. Ehud Rinott and Dr. Ilan Youngster from Tel-Aviv University collaborated with a group of international experts from US and European research institutes.

During the trial, abdominally obese or high cholesterol participants in Israel were randomly assigned to one of three groups and were told to follow general healthy dietary guidelines, a Mediterranean diet or a green-Mediterranean diet. After the initial weight-loss phase of six months,  a period in which weight begins to plateau or be regained, remaining eligible participants were were provided a fecal sample that was processed into aFMT frozen opaque and odorless capsules.

During the initial six months, all groups received a free gym membership and physical activity guidelines. Both Mediterranean groups consumed 28g a day of walnuts which contain containing 440 mg polyphenols, and the green-Mediterranean dieters further consumed 3-4 cups of green tea in addition to being provided with Mankai, a specific duckweed aquatic strain consumed in a green shake, further providing them with 800mg/day of polyphenols.

Polyphenols were given under the theory that they better optimize the microbiome for an aFMT procedure. Polyphenols are known for their prebiotic effect, "which might underlie the polyphenols’ contribution to the prevention of weight-regain" the study states, a theory tested in a complimentary study on on mice.

After six months, 90 participants remained eligible and were randomly assigned to the groups that received 100 capsules containing their own fecal microbiota or placebo, which they ingested until month 14.

Ultimately, the diet that induced the largest significant change in the gut microbiome composition during the weight loss phase was the green-Mediterranean diet. While the 90 participants lost 8.3 kg (18.2 lbs.) on average after six months, only in the green-Mediterranean diet group did aFMT limit weight regain from only 17.1%, vs 50% for the placebo.

During the "14-month human trial including 90 participants, green Mediterranean/high polyphenols diet was the only lifestyle strategy that induced a significant change of the gut microbiome composition during the weight-loss phase, potentially optimizing the conditions for aFMT, derived from the maximal weight loss phase," the study reads. 

However overall, the study found that participants who lost weight on a healthy diet and were then fed capsules containing fecal material collected during the diet period for months after the six month turning point of maximal weight loss, regained less weight than participants given placebo tablets, "by modulating the intestinal microbiota. A plant-based diet in participants or a  Mankai diet (in mice) produced the optimal fecal microbiome for preventing weight regain," the study read.

“This study is the first of its kind to prove in humans that preservation of an 'ideal' gut microbial composition can be used at a later time point to achieve metabolic benefits,” says Dr. Youngster, director of the Pediatric Infectious Diseases Unit and the Center for Microbiome Research at Shamir Medical Center. “Using the patient’s own stool after optimization is a novel concept that overcomes many of these barriers. It is my belief that the use of autologous fecal microbiota transplantation will be applicable in the future for other indications as well.“  

Furthermore, green plant-based diet such as Mankai, better optimizes the microbiome for the microbiota transplantation procedure. This potentially optimizes the conditions for the aFMT, collected during the maximal weight loss phase. The Mankai duckweed aquatic plant is being grown in Israel and other countries in a closed environment and is highly environmentally sustainable - requiring a fraction of the amount of water to produce each gram of protein compared to soy, kale or spinach.

Ultimately the researchers concluded that aFMT, collected during the weight loss phase and administrated in the regain phase, might preserve weight loss and glycemic control and is associated with specific microbiome signatures. High-polyphenols, green plant-based or Mankai diet better optimizes the microbiome for an aFMT procedure.

"The nutrition-microbiome axis has been proven in this study as high polyphenols diet, and specifically, Mankai, a protein-based plant and dietary fibers could ideally optimize the microbiome in the weight loss phase, to induce potent microbiome to recall the flora of germs related to regain attenuation and improved glycemic state after transplantation," Professor Omry Koren, at Bar-Ilan University who led the complimentary study on mice.