BETA - How do I know the diversity of my gut microbiome? What testing can be done?

It's unfortunately a difficult answer because there is no FDA approved test that we could say is validated and you just do this test and you know whether your microbiome is healthy or not. There are lots of companies out there selling microbiome test kits. The question is how accurate they are and these have not been again validated or approved in studies or things like that. So it's a bit hard for us to know whether they're truly as accurate. So that's the main challenge with those tests. What I think is that the studies show that higher microbiome diversity is associated with better overall health and then we know certain foods or things are associated with better microbiome diversity. So I think if we can just make those changes that kind of is probably the best as what we know currently. We do these tests at MSK but for research purposes we don't have a clinical test that we can do for patients as of yet. It's a stool test. So we ask patients to provide a stool sample at the time we want to test it. Another issue with microbiome is it changes very fast. So if you eat something over the last few days that's very different from your typical diet your microbiome is going to reflect what you did in the last few days not what you did over the last year potentially. So there is some inherent stability of what's similar to each person but there is a lot of variation based on what we do in the days before we take the sample as well. It's very fascinating to know that human bodies composed more of bacterial cells or microbial cells as compared to human cells. So for example we have about 38 trillion bacterial cells in our body as compared to only 30 million human cells. So we are actually more composed of microbial cells than human cells. This area of research is really quickly evolving in the past decade or so if you would and that's mainly with the advent of technology. So previously we did not have very fine techniques to identify the species of bacteria or determine their function or the kind of proteins that they produce in the gut and things like that but now we do. So there are two things. So one of them is shotgun metagenomics and the other one is 16S ribosomal RNA sequencing and so that helps us. Those are the two tests that we use to evaluate stool samples and what that helps us is to know the individual species of bacteria that line our gut and also proteins, the kind of proteins that they produce or short chain fatty acids, so the metabolites if you would that they produce. And we know that there are some bacteria that are good bacteria for us and some that are not considered good and so the research has shown basically that it's better to have a more diverse type of gut microbiome and so having a different mix of good and bad bacteria with predominance of like the good bacteria is healthier as compared to having only a few types of bacteria in the gut. So having a Dr. Shah always uses this analogy but having a forest with different types of trees and plants and shrubs and animals and like a different diverse sort of an environment is better than a plantation with just one particular type of trees or plants. So think about the gut microbiome in a similar way that having diverse bacteria lining the microbiome is found to be healthier and protected towards cancer risk and we all know the diet is the biggest modulator of the gut microbiome and so changes in the diet, be it small changes, gradual changes are going to produce more sustainable changes in the gut microbiome. That may in the long term prove to be beneficial and protective for you to prevent cancer and so the recommendation currently is to include 30 different types of plant foods in your diet and that has shown to have that kind of ideal diversity in the gut microbiome that we would like to see.