Do you find the Viome test is helpful, and how do we utilize it in practice?

Chris: I think the biome methodology and technology is sound, and I think it does represent the future of microbiome testing, so this is the next level. We had 16S DNA PCR technology through American Gut​ and ​uBiome​ for several years, and now the methodology that ​Viome​ is using is certainly the next level there because you’re sequencing all of the RNA in the samples. It can go all the way down to the species and strain level, so it’s a much more complete view of what’s in the gut than the 16S DNA PCR technology provided. On the other hand, I think some of the limiting factors right now are that we don’t actually know yet what a healthy individual microbiome is. We know a lot of the research is focused on populations and patterns they observe within populations, so we can make certain inferences from that, but more and more the thinking is that each person’s microbiome is kind of like a fingerprint. What might be healthy in one microbiome is not necessarily healthy in another microbiome. This applies not only to individuals but even populations. For example, in the Hadza hunter-gatherer population that has been studied, their levels of bifidobacteria are pretty low, and that really contradicted some ideas about that in Western populations low Bifidobacteria actually corresponds to poor health, but that’s not the case in the Hadza hunter gatherers. I think there’s still a lot to learn about what an individual healthy microbiome is. Then with Viome, a lot of the recommendations that are made, from the basis of the test results, are things that we could just recommend that our patients do anyway like consume plenty of fermentable fiber and things that are restorative for a healthy microbiome. I think it’s a stretch to say that, “Oh, you’ve got this certain kinds of bacteria, and, therefore, you should eat more protein or less protein.” I don’t think the science is there yet. While I applaud their methodology, I think the clinical recommendations are being made from that methodology or are not sound.