Viome - Microbiome Testing
Sorry for this clunky disclaimer but I need to include it...
Disclaimer: I am not intending to provide professional medical advice. Always seek the advice of your physician or other certified healthcare providers with any questions you may have regarding diagnosis, cure, treatment, mitigation, or prevention of any disease or other medical condition.
Performing "Microbiome" testing to assess gut and digestive health is a new hot trend in the world of health and wellness enthusiasts. Many people do not know about the diversity of microorganisms that live inside our gut that is called our "microbiome." Some scientists estimate that over 100 trillion microbial cells live in our gut, which is over 10,000 times the number of humans that live on Earth. Because of this staggering quantity and diversity of microbes inside us, researchers are only just beginning to understand the biological pathways that the microbiome influences. Groundbreaking scientific discoveries are elucidating connections between our microbiome and heart health, obesity, and even our brain health.
All this said I want to share a quote from Dr. Peter Attia's most recent podcast with an expert in microbiome research named Dr. Michael Gershon. The quote is from Attia: ‘
"Most of what's out there on this [microbiome] topic is utter nonsense. Commercial tests that promise miracles that don't make any sense and supplements that just don't make any sense."
The microbiome test that I review in this post is likely in this "utter nonsense" bucket in Dr. Attia's mind. I would mostly agree with Dr. Attia as this test will work no miracles, especially from a medical and clinical intervention point of view. But, I do think there is interesting value to be gleamed outside of a medical intervention perspective despite likely over-exaggerated claims. An explosion of microbiome testing companies has emerged on the marketplace with products that make bold claims about the conclusions they can draw from analyzing samples of our microbiome (yes, they test 💩). The recommendations and claims made from these services should be received with a skeptical, inquisitive mindset, but I think the tests can nonetheless provide unproven yet valuable insights on bettering our health. Much more research is needed to validate the microbiome discoveries and applications, but this field of science will surely transform our understanding of biology in the coming decades.
To see for myself, I tried a test from a company called Viome. I chose to use Viome rather than other options like Ombre (previously Thryve), Thorne, or Biohm because I had the fortune of (virtually) meeting many of the leaders of the company's management team through my job. Viome's leadership impressed me with the depth of scientific analysis that forms the foundation of Viome's testing product. To avoid too many nerdy scientific details, I hope you will trust me that Viome likely has the most sophisticated microbiome testing technology. Their recommendations are based on their advanced biological analysis methods combined with artificial intelligence algorithms. An excerpt from Viome's website helps to explain how their technology differs from competitors:
"We focus on analyzing gene expression (mRNA) to understand how you're moving closer or away from optimal health and what nutrients your body will benefit from to address signs of trouble. Because gene expression is not static like DNA, your food and supplement recommendations will change, too."
As far as I know, Viome is the only company utilizing mRNA gene expression analysis while competitors focus on the more static DNA analysis of the microbes. Important to note, these tests have not been cleared or approved by the US Food and Drug Administration (FDA), thus there is no proven clinical or medical use case as of now, and they are intended to be only a source of information for the consumer. That said, the laboratory owned by Viome is CLIA-certified to perform high complexity testing, so the robustness of scientific protocols can be trusted despite the lack of a specific clinical certification. All this said, the "scientific complexity" that I am explaining provides no guarantee that the results and recommendations produced from this test are accurate and trustworthy, but the rigor of Viome's analysis can provide a tempered level of trust.
The experience of collecting the stool, blood, and saliva to perform Viome's "Full Body Intelligence" was involved, but Viome provided very detailed instructions on how to collect each sample seamlessly. Somehow, I managed to do something incorrectly and my saliva sample was "rejected" after shipping it to Viome's lab. Because of that mistake, the results of my test will not include insights and recommendations on my "Oral Health." I will have to retest at some point and get Viome a usable saliva sample, but the results that I did receive without the saliva included have more than enough insight and recommendations to digest.
As you will see below, most of the recommendations relate to suggested diet changes as well as a supplement regimen. There is quite an overwhelming amount of detail regarding the diet suggestions, so I will elaborate on my current thinking to approach Viome's recommendations. A follow-up blog post will definitely be needed in ~6 months once I am able to get further along my microbiome optimization journey.
Here is a summary of the core elements of Viome's results:
My "Avoid" Foods
My Supplements
My "Superfoods"
My Nutrition Plan
My Health Scores
Foods Everyone Should Avoid
My "Avoid" Foods
The recommendations for my "Avoid" foods are the most interesting and surprising from the test. One recommendation--to avoid beef--is not surprising as many health professionals espouse the potential impact that red meat can have on cardiovascular health. Rather, the unexpected results are the recommendations to avoid certain vegetables. For me, arugula, beet greens, beets, bell peppers, celery, cucumbers, tomato, and watercress are on my Avoid list. Viome suggests avoiding several of those vegetables--arugula, beet greens, beets, celery, and watercress--because those vegetables are known to have high amounts of "nitrates." The test had identified "Ammonia Production Pathways" (see below) as a weakness for my Microbiome, and Ammonia is known to be a byproduct of nitrates. The science of Ammonia and nitrates is completely new to me. Evidence supports these suggestions, but no scientific consensus exists because the analysis of nitrate consumption is very convoluted. This is an example of a suggestion that I will experiment with, but I receive the recommendation with a grain of salt. That said, I am very excited to keep learning more about the Ammonia and nitrate biological pathways and come to my own conclusions over time! The other vegetables to avoid—bell peppers, cucumbers, and tomato—Viome claims to be promoters of harmful virus strains detected in my microbiome.
My Foods to Avoid
Arugula
Beef (Fatty, Grass-Fed)
Beef (Lean, Grass-Fed)
Beet Greens
Beets
Bell Pepper
Celery
Cucumber
Paprika
Tomato
Watercress
As an example, here is the description that Viome provided on "Ammonia Production Pathways" from my results reports:
I have always assumed that any vegetable is "good for me" and that a wide diversity of vegetables in my diet is undoubtedly a positive, so learning that certain vegetables may cause unintended side effects piques my interest. These recommendations may be hard to implement because I frequently eat beets, bell peppers, cucumbers, and tomatoes, but I will do my best to comply.
What makes this experimentation exciting for me is that I am still young. The tools and research validation to draw conclusions on dietary choices are in their nascency, and the underlying technology will become much more precise and proven over the years. I will have fun trying out different tactics to see if I can improve my health biomarkers, but I am in no rush to obsess over my diet while I am 25 years old and already practicing healthy habits.
My Supplements
The second main section of recommendations, Viome's personalized selection of supplements for me to take based on my microbiome, is thought-provoking. The logic that our gut's bacteria will heavily influence the micronutrients we most need makes sense, but I do not have enough conviction in these recommendations to jump on board. I also have no desire to pay $150 a month right now (the cost of their personalized supplements). Over time, I plan to continue to do personal experimentation and testing to better understand what supplements will be best for my biology's needs, but I will hold off from utilizing Viome's supplement selection right now. Perhaps, in a year or two, I will revisit these results and reconsider as I learn more and as Viome continues to optimize and validate their tests.
My "Superfoods"
The recommendations on my "Superfoods" are going to be the most exciting to implement. I am very open to trying any food, and my dietary habits ebb and flow frequently. Over the last few years, I have run many short experiments with my diet after learning about trends like "Keto," "intermittent fasting," and "plant-based" among others. No particular diet has stuck with me for long, but I am excited by the Superfood recommendations because it gives me a manageable number of diverse food options to target more deliberately.
Luckily for me, some of my Superfoods are ones that I love (see below for my list). When I cook, garlic and avocado oil are staples in my favorite dishes, and I am also a huge fan of onion, blackberries, and ginger. Incorporating raspberries and oranges more frequently into my habitual diet will be quite easy. Artichokes, anchovies, figs, and lamb, are the foods that are not common in my diet right now, but I have no hesitation in starting to grab those items at the grocery store.
My Superfoods:
Anchovies
Apple Cider Vinegar
Artichoke
Avocado Oil
Blackberry
Cinnamon
Fig
Garlic
Ginger
Jerusalem Artichoke
Kombucha
Lamb
Onion
Orange
Raspberry
Salmon (wild-caught)
Sunflower Seeds
If I follow-through with retesting myself through Viome in 6 to 12 months from now, I am very curious if these Superfood recommendations will change much. The Viome platform provides a small amount of reasoning to explain why each Superfood choice could be beneficial, but I do not assume that these recommendations should be used without question. As with all of these recommendations, I will approach them with a hint of skepticism, but I have no qualms about adding each item on my "Superfood" list to my eating routines. The risk of health downsides for this entire list seems very low.
My Nutrition Plan
In addition to the "Avoid" and "Superfood" categories, Viome also provides a more wholistic "Nutrition Plan" that recommends serving quantities, as well as 2 more categories of foods: "Enjoy" and "Minimize." The "Enjoy" foods are ones that will likely have a positive influence on my gut health but maybe less than the "Superfoods." The "Minimize" section are foods that are recommended as OK in small quantities but not in large amounts. Below is a screenshot of the very general overview for my Nutrition Plan.
My Health Scores
The "Health Scores" section of the results is an interesting, dynamic visualization that helps to simplify the plethora of results into a helpful model. I view this simplification as another set of results to be received with a healthy dose of conservatism. The 4 major health areas they outline--1) Gut Health, 2) Cellular Energy & Efficiency, 3) Immune System Health, 4) Inflammation Response, and 5) Biological Age--are obviously critically important health systems to try to optimize for overall health. I appreciate having this mental framework, and I surely will find it helpful to revisit over time, but I do not fully trust that the calculated scores for each area should be taken at face value.
I am most skeptical on the validity of the "Biological Age" calculation. I have done lots of research into the "epigenetic clock" analysis techniques that are used for these Biological Age calculations, and I believe that not enough rigorous validation exists to prove this calculation can be trusted. It is heartening that Viome's Biological Age for me matches my actual "Chronological Age" exactly, but I have no intention to lose sleep over the value for my Biological Age.
Again, I will be curious to see how much these numbers could vary over time in hopes that Viome's recommendations (and other strategies that I already practice to improve my health) will address some of the underlying score calculations. I will avoid obsessing over these numbers and simply absorb them as another interesting data point to ponder.
Foods Everyone Should Avoid
I am very glad that Viome included this final section on "Foods Everyone Should Avoid." I am decent at limiting most of these foods, but I have many lapses in discipline with several items. The hardest to avoid for me are added sugars, refined grains, and cured meats. I cherish the occasional slice of bacon or fried chicken (refined flour and hydrogenated oil), and my sweet tooth gnaws at my food desires every day. This nudge from the Viome platform to remember the detriments to health that these items bring serves a valuable reminder. We shall see how well I can circumvent the dark temptations of bacon, fried food, and sweets... To develop the discipline to avoid those foods will surely be a constant battle.
