OOO: Eat Shit!
The Human Microbiome & The Promise of Fecal Transplants
Welcome to Startup ROI! I’m Kyle O'Brien, an early stage deep tech investor — alongside
— and community builder based in Paris, France. I write what I see. These days, it’s mostly explorations into various categories of interest including:The Future of Computing
Blockchain Infrastructure (Privacy & Encryption)
Frontier Health
I enjoy taking complex topics and reducing them into accessible articles and top-notch memes. I also throw bangin’ dinner parties for cool people in tech and venture — sign up here and never miss a meal again.
What does OOO mean to you?
It’s that time of year again: summer holidays. Last year I wrote about August in France, a decidedly different experience than summer holidays in my home country. I’m still often ridiculed for my hyper-capitalist American indoctrination (by comparison) and subsequent difficulty taking real vacations. The French, however, will draft an out of office message and effortlessly walk away from their workstation without a second thought. I’ve tried to adopt this policy, but can’t say I’m a true convert.
There’s an existential darkness to the stereotype contrasting the work attitudes of Europeans and Americans, which is perhaps what makes it so funny. Over time I’ve learned that the month of August should be dedicated to strategic planning to avoid the constant bombardment of OOO messages when attempting to do any outreach whatsoever. When every auto-response feels like a personal affront — a digital reminder to politely fuck off — it’s best to stay in your lane and do what you can to prepare for the barrage of back-to-work messages in September.
Due to the frequency with which I receive these automated responses, they started to take on imagined connotations. Each out of office reply had its own flavor, its own insult hidden within the carefully crafted response template:
A Sales Rep in the UK felt like a “cheerio, wanker”
A German founder implied “auf Wiedersehen, punk”
A French VC was a clear “eat shit, putain de merde”
These were all figments of my imagination, of course. A humorous game to pass the time weeding through my inbox. But it got me thinking. If everyone is going to tell me to eat shit, maybe I should dedicate some time to a subject that’s been in my research backlog for a minute: fecal transplants.
Shit Sandwich
In the US, there’s a common approach to giving tough feedback that is appropriately called the “shit sandwich.” If for example, a subordinate did a relatively poor job on a project, you might be inclined to correct them. But we Americans are delicate, so you can’t just make a critique and walk away. You’ve got to deliver it in a neatly packaged format that leaves everyone happy. Here’s how it works:
Say something positive about the employees work (The Bread)
Outline what they did wrong and why (The Shit)
Explain how they can improve it and reassure them that they are up to the task (The Bread)
We nest the negative feedback within to slices of all-American white bread (positive affirmations). It’s easier to digest, it feels less like a personal attack and ideally the receiver can make improvements to their work since they were spared a demoralizing conversation with their boss. This is the type of shit sandwich that I’m accustomed to; however, it is not the one we will be discussing today.
The Human Microbiome
Today’s health conscious consumer, no doubt, has heard of the “gut microbiome” — the home to trillions of microorganisms like bacteria, fungi and viruses co-existing in our digestive tracts. We know comparatively little about this flourishing ecosystem, but research in the area has put forth some astonishing findings.
When you think of “gut health” the first logical conclusion is that good maintenance equates to good digestion. This makes sense. In fact, it’s where much of the early research in the field has gone. C. difficile, a chronic, gastrointestinal illness caused by bacteria was successfully treated with fecal transplants from healthy sources (now available in pill form — see above).
The next layer of inquiry will reveal that poor gut health may lead to consequences outside of this precise region (most people encounter this via hangover and attempt to counteract by drinking an unreasonable amount of probiotics). This is evident by the onslaught of direct-to-consumer metabolic health and supplement business online today. Pre-biotics, pro-biotics, balancing your gut, boosting your metabolism — all promises to improve your overall health by way of treating your gut microbiome.
The frontier research in this category, however, extends the hypothesis beyond local gut health and overall physical health into the realm of gene expression, mental health, drug responsiveness, cardiovascular health and event autism spectrum disorder. This is where ordinary healthcare meets the boundary of sci-fi-adjacent. The mysteries and unimaginable scale of the universe exist inside of us as much as they do beyond our galaxy. Early forays into this micro-verse (the gut microbiome) seem to indicate there is much to be discovered.
If you want to go down a real rabbit-hole, I suggest watching this talk given by Dr. Susan Lynch. She articulates details around the microbial soup in which we all live and breath and the co-evolution of our species with theirs. To keep with the space metaphor, there appears to be “microbial dark matter” — yet undiscovered or invisible, that has serious implications on our health. A discovery, that if unlocked, could change the face of modern healthcare.
Early research suggests that the microbiome plays a larger role than we anticipated regarding overall health, inheritability of disease and potential treatments. The vastness of this microscopic landscape is overwhelming and the fact that it changes over time, with age and dependent on your region and diet only serves to add another layer of complexity to the equation.
In studies with mice, researchers at UCSF inserted microbiota from an obese mouse into a healthy, germ-free mouse. The result? The mouse became obese. This suggests that microbiota can induce phenotypic variations in target subjects. It also suggests the heritability of certain pathologies via the same mechanism.
The gut microbiome is highly dependent on region, age, diet and geography. Dr. Lynch even mentioned a study in which microbiota differed in babies depending of if they underwent vaginal birth or a C-section (or the sun roof as she put it!). The chart below highlights the variance in gut microbiomes among three regions. Bacterial composition in the gut differed between Americans and the two indigenous populations. One contained bacteria ideal for digesting plants; the other, skewed heavily in favor of bacteria specific to decomposing processed sugar. Can you guess which is which?
More and more research is emerging on the “gut-brain axis” and how our metabolic and digestive health may be linked to mood, mental health and even psychiatric disorders. There is still so much to discover here. The Human Microbiome Project might be the one of the biggest healthcare unlocks since the Human Genome Project. And if anything, recent advances in AI might be poised to handle some of the complexity surrounding the data processing at such scale. It’s a field I’m more and more curious about and hope to see some incredible findings in the coming years.
Ancient Medicine, Modern Wellness
Ever since Antonie van Leeuwenhoek laid eyes on what he dubbed “animalcules” in the pond water under his microscope, we’ve furthered our exploration of the hidden microscopic world around us. The pursuit of science fosters discoveries that lead to step changes in humanity’s quality of life and ultimate potential. There are records from ancient China whereby doctors developed “yellow soup” for gastroinstestinal disease (early fecal transplants). While the merits of its safety and efficacy are doubtful, these medicinal pioneers recognized something in the gut before it could be explained with science. Powerful technology, modern research standards, and the willpower of research scientists around the world makes for substantial upside.
I, personally, hope to see advances in the space. With a mapped microbiome, accurate testing and precision medicine we could go a long way to treating and preventing major health issues. Imagine a toilet that samples waste after your “morning constitutional” and gives prescriptive measures regarding your daily diet or detects early signs of something as severe as cancer. Take that Toto!
Until then, we don’t know shit…