A review by lpm100
The Microbiome Diet: The Scientifically Proven Way to Restore Your Gut Health and Achieve Permanent Weight Loss by Raphael Kellman

fast-paced

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Book Review
The Microbiome Diet
2/5 stars
"Sourcing is too thin and too many questions unanswered."
*******

I really do like to read books about popular health misconceptions (and give them the benefit of the doubt), and that is because later books have shown that what once was standard medical practice is COMPLETELY wrong. (Richard Atkins/ Jason Fung/ Nina Teicholz's "Big Fat Surprise"/ulcers were later found to be bacterial infections and not stress, etc.)

This reader is torn between dismissing this as Yet Another Quack treatment as opposed to realizing that this might be a physician speaking up against a medical establishment that has ossified into a position that may be erroneous. (Think about how long people thought that weight loss was a simple matter of calories in< calories out. Or that all cholesterol is bad. Or ignored insulin response. Or that all fats were / are bad.)

The notes are also extremely sparse. About 40 notes (3 ibid) over 184 pages of prose (0.2/per). 

Unacceptably thin for a book of this type.

It is interesting that a lot of these things also correspond to what has been long known.

For instance: Jason Fung would treat insulin resistance as a question of homeostasis;  Kellman treats the exact same disease as a disturbance of the microbiome creating a leaky gut.

For the record, Kellman's claim is that: 

1. Reactive foods leak through intestinal walls>>>
2. Immune system sends out antibodies>>>

3. Antibodies create cravings>>> 

4. Killer chemicals create inflammation>>>

5.  Inflammation leads to storing fat instead of burning it.

Dr Fung has one biomarker that can be reliably measured (insulin level/HbA1c) and that corresponds to a lot of things. 

By contrast, Dr. Kellman  has this thing called a "microbiome" which has hundreds of different bacteria that have not all been sequenced and we aren't sure the ways in which all these bacteria interact with the human body (leading to a lot of assumptions/ uses of the phrase "I believe").

There's also the issue that you never have the same microbiome twice between different individuals, and so getting the data is even harder for that reason.

Some things that he says are unbelievable:

"Balancing your microbiome will also help you prevent or even reverse such conditions as rheumatoid arthritis, lupus, multiple sclerosis, and other autoimmune conditions" (p.52). 

I'm not sure how Kellman could know this, because this book was published in 2015. Even papers (that I find) published a few years after that give ESTIMATES for the number of bacteria, and also no. paper. anywhere. claims to have sequenced all 2 million component genes.

Millions of people have autoimmune diseases: might not someone earlier have noticed the effect of diet on the progression of the disease?

1. There are actually many more people who go to chiropractors, and they have been in business for over a century selling the stupid notion that diseases are caused by subluxations - - shifting of the spinal column. 

And there is a chiropractor on every corner in the United States. (What makes this doctor different from chiropractic?)

2. A doctor like Paolo Zamboni had the idea that multiple sclerosis was caused by CCSVI--and what he wrote was about is thinly sourced as this.

3. Deepak Chopra is worth US$80 million with his Sokal-hoax-style interpretation of medicine.

*******
Kellman uses a bunch of terms (inulin, arabinogalactins, fructooligosaccharides, zonulin).

I've read other books like that where some author wants to reduce a large number of things to levels of ONE SPECIFIC chemical in the body. (The villain in "The Zone" by Barry Sears was "arachidonic acid." But, even a couple of decades after that book was written, it is still controversial. He's essentially saying low density carbohydrates. Nothing new.)

Kellman talks about leaky gut, and even as I look 9 years after the book was written... There is still not a good and non-invasive way to diagnose this condition. 
Other questions:

1a. Why would an extended fast not allow ine to reset the bacteria in the microbiome?

1b. (p.110). "Stress rapidly destroys many of the healthy bacteria that we need." (Okay, but how can he know that, since we don't know the totality of the microbiome. And there is no paper that is cited that says this, so how can he know?)

1c. (ibid). "The microbiome is so sensitive, that even 24 hours worth of stress can significantly change its population." But then if that's the case, then why doesn't removal of the stressor change it back? And why does it take more than one re-innoculation to make it right?

2. Why are there no fat people in China, but the rate of diabetes there is higher than the United states (12% vs 11.3%)? Do *all* of those people have disturbed microbiomes? And since diabetes is a recent thing, were their microbiomes fine up until just now?


3. If a few courses of antibiotics can disturb the microbiome, then why couldn't re-innoculation be done after every course?

4. Do we have some mechanisms of action here? Other things that I read say that the bacteria help human beings excrete more of the food as fat, and that explains weight loss - - as opposed to the leaky gut theory.

5. What is the likelihood that "leaky gut" can be a causative agent in as many things as this author says if physicians are not easily able to know enough cases to come up with a statistical relationship between that and other diseases.

6. Kellman quotes a few rat studies in his thin sourcing, but rats and human beings are not the same. (Even different of the great apes are used for studying different aspects of man.) Why not some human being studies?

7. If probiotics are available in yogurt, and they have effect, why not just eat more yogurt?

8. Is there anything more to go on than the author's belief / opinion? To make major dietary changes, I'm going to need to go off of more than just hope. (p.142).

9. Kelman asserts (p.139) that the bacteria for the microbiome can transfer genetic information between the bacteria that make it up - - and jumping genes/transposons are not unknown. But, what good gene is jumping from one bacteria to another and then,  how is that helping? 

We have no idea.

10. Why is Kellman the only one that seems to do / believe this? Why are there so few practitioners? 

His clinic has 118 reviews (average rating of 4.6) and this is in the city of New York. 

I open up a chiropractor near me at random, and he has 104 reviews in a small Midwestern City for a "practice" that has been known to be fake since the first week it was established.

Verdict: There may be something to the microbiome, but this book is not able to bring that across. Maybe that book is yet to be written after further research is done. 

Not recommended.