Gut Intelligence

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Part
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Gut Intelligence Market Overview

The gut intelligence market has recently allowed consumers to become more aware of their gut flora concerning their health by implementing various innovations such as microbiome testing, personal nutritional recommendations, probiotic advancements, and AI technology. Consumers are generally aware of their gut intelligence but are lacking reliable sources of information to improve their health.

Services & Innovations

  • Viome is a company that sequences the gut microbiome from a very small stool sample.
  • Biohm is a probiotic supplement business that offers gut microbiome tests.
  • Thryve is a health-tech company based in the San Francisco area that can provide a microbe population make-up report and dietary and supplement recommendations.
  • DayTwo is a company in Israel that applies research on gut microbiomes and machine learning algorithms, delivering a personal nutritional recommendation to minimize blood sugar spikes.
  • A team at the Wyss Institute for Biologically Inspired Engineering at Harvard has created a human-organs-on-chips technology to model intestinal inflammation and overgrowth of bacteria, allowing scientists to analyze how gut microbes contribute to the immune system and investigate IBD.
  • Synbiotic Health, a Nebraskan company is developing a combination of beneficial gut bacteria and the fuel that feeds them, or an advanced prebiotic and probiotic supplement.
  • An app using AI technology called Atlas allows consumers to take images of their food and receive personalized meal scores and lifestyle recommendations/changes in return.

Consumer Survey

  • In a recent survey, over 60% of the respondents believed their gut health had a large impact on their overall health.
  • Only 40% were able to pinpoint signs such as severe gas, bloating, and stomach pain regarding their gut being unhealthy.
  • According to a survey, 46% of people said that they are unsatisfied with their knowledge of their gut health.
  • The internet is the second most used source of information for gut health, coming before both nutritionists and pharmacists.
  • 60% of the women surveyed said that they had been diagnosed with digestive issues and 50% diagnosed with IBS at some point in their life. Of those, two-thirds adopted a new diet without any recommendation of a healthcare professional.
  • One in three people surveyed take additional supplements during the winter months to maintain a healthy immune system, because of 70% being in the digestive tract, but 24% did not consider how to otherwise maintain a healthy immune system.

Culture

  • From Russia to the Middle East, fermented foods have been consumed for digestion regulation and boosting immune health for centuries.
  • The Hazda people of Tanzania observe microbiome cycles throughout the year, eating more meat and fruit in dry seasons and honey and berries in wet seasons, which isn't seen in the standard Western diet.
  • In Bulgaria and Central Asia, nomads carried milk in animal skins, unintentionally discovering how to ferment and preserve food, subsequently creating yogurt.
  • In the Caucus Mountains back in 10,000BC the creation of kefir was discovered.
  • Filmjolk is sour fermented milk that has been drunk in Norway and Sweden since the ninth century.
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Part
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Gut Intelligence Companies

Viome, Biohm, and Thryve are some companies that offer testing kits to check the volume of bacteria being produced in an individual's gut and offer appropriate food recommendations that help to increase their gut intelligence.

1. Viome

Brief description of the product:

  • Viome offers two products, including a gut intelligence kit and a food sensitivity kit, that offer comprehensive information on the gut microbiome from a minimal stool sample kit. The microbiome consists of microbiota, such as bacteria, fungi, protozoa, and viruses, that live on and inside the human body.
  • Viome's gut intelligence kit helps to locate bacteria in the digestive system.
  • Customers take a swab of the stool sample, which is mixed in a solution, and then it is shipped back to the Viome lab.
  • Viome then provides a breakdown of the functioning of these bacteria and determines whether it is harmful or helpful for the body.
  • The other kit, which is a food sensitivity kit, helps to examine the tolerance of 40 different foods and presents recommendations to customers on the types of food to avoid.

How it helps people to improve their gut intelligence:

  • Viome identifies and quantifies gut bacteria to examine live organisms. Based on the gut microbiome, the company provides personalized nutrition recommendations.
  • The food recommendations are sent to customers through the Viome app, which is also available for tablet and computer.
  • The diet and lifestyle recommendations also helps to improve gut intelligence among people by controlling the functioning of all gut microbiome, such as bacteria, viruses, and fungi, that are present in the gastrointestinal tract. The recommendations allow the customer to minimize the production of harmful metabolites, which is the intermediate end product of metabolism, and to maximize the production of beneficial ones.
  • As per customers' reviews on Amazon, users are delighted with the Viome gut intelligence testing kit, as they can measure the activity of all bacteria, fungi, and viruses present in their stomach. Many customers rely on the Viome app that offers appropriate recommendations to improve their health.

2. Biohm

Brief description of the product:

  • Biohm is a company that checks customers’ gut microbiomes by offering a Biohm test kit.
  • The testing kits work as a home kit that takes a stool sample for analyzing the number of microbiomes, which is a form of bacteria, fungi, protozoa, and viruses that live on and inside the human body.
  • The testing kits analyze the DNA in the stool sample and extract the type of bacteria present in the stool.
  • The kits help to provide insights into the ways the microbiome is changing.

How it helps people to improve their gut intelligence:

  • Biohm provides a testing kit that helps in determining the number of microorganisms available in the gut.
  • The Biohm testing kit gives a clear picture of the volume of cultures (i.e., good bacteria present in the gut). The company shares the testing result with Biohm's nutritionist, who immediately provides an appropriate recommendation as per the customer's health.
  • To increase gut intelligence, nutritionists primarily share three types of recommendations, including specific dietary advice to improve gut’s microbiome, particular recommendations on lifestyle adjustments, and specific supplements to add in one's daily routine.
  • As per customers' reviews on Trustpilot, users find it beneficial to purchase the kit, as it provides ways to correct their imbalances with the help of a nutritionist's advice.
  • Customers find the kit helpful in curing digestive problems and improving affected tissues.

3. Thryve

Brief description of the product:

  • Thryve provides a gut health testing kit that provides species-level identification of bacteria present in the gut.
  • Like other kits on this list, customers collect a small swab sample of stool using toilet paper and then send it to the Thryve's laboratory.
  • The company prepares a report and sends it back to the customer, which is used to cure digestive problems and improve the level of energy.

How it helps people to improve their gut intelligence:

Research Strategy

To identify some companies that are offering products and services that help people to understand gut disorders, we commenced our search through news articles and health magazines, such as Nutrishatives, Ben Greenfield Fitness, and PC Magazine. The sources mentioned information on some companies that offer testing products to assist individuals in comprehending their gut disorders. Additionally, we looked for customer reviews on the company's products in sources such as Amazon, DNA Testing Choice, and Trust Pilot to get an idea of how these products help to increase the gut intelligence of consumers. Thus, all the relevant information has been added and presented in detail.

Part
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Part
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Gut Intelligence Hypothesis

There is evidence to show that a moderate number of people are aware of their gut health and have some form of gut intelligence, attributed possibly by recent research that connects the brain and the gut. An overview of the findings is as follows:

GUT HEALTH

  • Seventy million Americans are living with a chronic gastrointestinal condition.
  • It may be challenging even for doctors or health professionals to recognize inflammatory bowel diseases such as Crohn's.
  • More than half within the US population living with gastrointestinal conditions are not seeking help.
  • Seventy-two percent of Americans experience gut discomfort such as bloating, pain, gas, and diarrhea at least once a month.
  • According to a survey by Megafood, 40% of respondents are able to tell that they have issues with their gut health simply from telltale signs such as gas, bloating, and stomach pain.
  • It is often easy to tell when the gut microbiome is out of balance from these symptoms.
  • There is evidence to suggest that individuals may downplay their IBD symptoms as something trivial such as a minor stomach bug when it comes to the workplace.

GUT-BRAIN CONNECTION

  • In Traditional Chinese Medicine, the connection between the gut and the body's organs "has been recognized for thousands of years."
  • Ninety percent of dopamine and serotonin production begins in the gut.
  • Major neurotransmitters associated with the brain such as nitric oxide, glutamate, norepinephrine, and enkepalin are released by the gut.
  • With approximately a hundred million nerve cells in the GI tract, the nerves in the gut communicate with the brain, "relaying the health of the gut."
  • The enteric nervous system may trigger big emotional shifts that is experienced by those coping with IBS and bowel problems.
  • Despite new evidence coming to light about the mind-gut link, there is still more to be uncovered.

RESEARCH STRATEGY

We have looked hard data to either prove or disprove the hypothesis of gut intelligence. We have searched for this information mainly from credible health and medical sources such as WebMD, ScienceDirect, PubMed which we then cross-referenced with credible news articles and media outlets such as Time, APNews, CNN, BBC. We also scoured through health blogs and surveys relating to gut health in order for us to get an overview of what people understand about gut health in general.

From the information available as a result of our search effort, we are able to deduce that a moderate number of people are aware of gut health, especially in recent times with new evidence of the brain-gut connection, with doctors and researchers going as far as labeling the gut colloquially as the second brain. From studies linking the brain and the gut, we can hypothesize that listening to the body's subtle signs when it indicates that something is wrong has some scientific basis.

We then searched for publications and studies released by organizations covering gut health such as the Crohn's & Colitis Foundation to search for evidence on whether people are ignoring their gut when it comes to IBD symptoms. Evidence as provided above suggest that people with GI symptoms may not seek help from a health professional. We theorize that while people do have some form of gut intelligence, they are unable to discern whether their gastrointestinal issue could be a sign for a bigger problem. This is further compounded by the fact that even health professionals, with their vast expertise, are unable to sometimes correctly recognize the symptoms.



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Part
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Top Regions for Gut Intelligence

Traditional Chinese Medicine (TCM) has promoted gut intelligence for thousands of years and texts reveal TCM practioners understood the importance of listening to the gut when assessing a person's mental and physical health. TCM promotes gut intelligence through a traditional approach to food, herbal remedies, and acupuncture. India has a high level of gut intelligence and lately have been studying the unique gut microbiomes in the country to better understand other diseases such as the increasing prevalence of diabetes in the country. Information regarding China's and India's promotion of gut intelligence is provided below.

China and TCM

  • Thousands of years ago, Traditional Chinese medicine (TCM) discovered the linkage between gut health and all the body's organs and people's mental state. Recent research proves the connection between the gut and brain is stronger than previously recognized and bacteria found in the gut can affect mood, cognition, and behavior, and researchers are starting to consider the gut to be "the second brain".
  • TCM practioners assess a patient's gut health as part of their primary examinations and treat the mind and body of patients, a practice believed by some to be neglected Western doctors and causing patients to continue to suffer. Western medicine is just now starting to realize the importance of how much the gut influences the mind and emotions.
  • The Chinese traditional conception of the gut refers to the spleen and stomach. TCM views the body as a whole with 12 main energy channels (meridians) that run through the entire body. Traditional TCM texts reveal that practioners thousands of years ago recognized connections between cognitive symptoms and gastrointestinal conditions.
  • TCM uses herbal remedies to address intestinal bacteria, and some herbs cause it to become more active, help detoxify harmful substances, and increase other beneficial bacteria functions. The best Chinese herbs for gut health are the Schisandra fruit, astragalus, and goji berries. Studies are proving that some ingredients such as Reishi mushrooms that have been used by TCM for thousands of years have health-promoting properties such as reduce obesity, alleviate inflammation by modulating gut bacteria.
  • TCM promotes gut intelligence by encouraging traditional eating habits, acupuncture, and Chinese herbal medicines. TCM's approach to food is described to represent " the wisdom of thousands of years of human discovery" untainted by modern industrialization and changes to the human diet. The right food is "critical" for good health because of the complex interactions between food and the trillions of microbes and cells in the human body, called the energetics of food.
  • TCM practioners recommend mind-body exercises such as yoga and meditation to alleviate stress that can aggravate digestive disorders.
  • Many of the foods recommended promoting gut intelligence are beneficial for the spleen which also has complex interactions with the gut bacteria and is considered part of the gut in TCM.

India

  • Studies of rural and urban Indians have diets that are more similar to tribal groups and those of their ancestors, and also exhibit lower incidents of lifestyle diseases. India has been making "promising developments in next-generation probiotics, fecal transplantation, personalised diet", and other regimes to manage other diseases, controlling malnutrition, healthy aging, and behavioral concerns.
  • Research of the microbiomes in India are focused on how to manage the microbiome and gut health to better understand and address the increasing prevalence of diabetes in the country. Distinct patterns of microbes have been connected to conditions and diseases such as atherosclerosis and psychological disorders.
  • Indians promote gut intelligence and gut health and are the leading producers of probiotic functional foods are Mother Dairy, Amul, Danone Yakult and Nestle India, and the products include lactobacilli and bifidobacteria. The level of gut intelligence in this area can be evidenced by the popularity of the wide range of products they create such as yogurt, curd and dietary supplements".
  • The diets and environmental factors have been identified as reason that Indians, specifically those that live in rural areas, have gut intelligence and intestional health. Differences of the microbiomes of Indian in different regions reveal that food and environmental exposure shapes the gut microdome. An example of this is analysis of gut microbiomes in Ballabhgarh have an abundance of genes that play an active role in xenobiotic substances like due to exposure to industrial and agricultural chemicals such as fertilizers.
Part
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Part
05

IBD Messaging: Humira, Stelara, Entyvio

Humira's messaging focuses on personal achievement, while Stelara focuses on greatness and obtaining predictability and control. Entyvio stresses how people's guts don't let them do what they want to with the day.

Humira IBD Messaging

  • Taglines: "Reimagine Impossible" and Body of Proof.
  • What they say about themselves: Humira stresses personalized attention, emphasizing that the resources on their website are "one-on-one" and "designed with you in mind." The company provides "ambassadors" that act like assistants for each patient, ensuring that they "don't go it alone."
  • On social media, Humira is also promoted through the use of personalization (i.e. first names), for example, "We make medicines for patients like Jennifer, Barry and others. Learn more about our commitment to them." Likewise, the company talks about how one patient, Maya, conquered IBD through "determination"; "Being a kid with #IBD wasn’t easy for Maya, but that didn’t stop her from living life fully," they say on Twitter.
  • The brand also stresses safety, and discussing the potential benefits and risks of taking the medication with a doctor first. The television ads repeat the word "proven" and "proof", and try to create confidence in the consumer that the biologic will definitely be effective.
  • How they say it: Humira uses language that addresses the patient directly (i.e. second person), particularly parents of children — the target consumer for the drug.
  • Humira is careful to use a cautious tone (i.e. steering away from false promises), with language like "HUMIRA may be right for your child" and "HUMIRA is not right for everyone." The language used is also serious, technical, but accessible.
  • Humira's messaging emphasizes the various illnesses it can be used for. Over the past year however, it has been criticized for doubling its prices in a market that it has a monopoly over.
  • In 2018, AbbVie (the brand's company) spent almost $490 million on marketing Humira — making it number one for pharma ad spend. The figure doesn't include social media advertising. Fortune describes its marketing as "über-aggressive."
  • The television ads for Humira, in a similar way to its social media posts, stress personal empowerment, with positive imagery of happy, young people doing and achieving things, and language like "I can fight (disease or condition)".

Stelara IBD Messaging

  • Taglines: Though Stelara doesn't appear to have a formal tagline, its advertising stresses "It's time to take back control" "Stelara works differently" and "Remission can start with Stelara."
  • What they say about themselves: Stelara's messaging emphasizes overcoming the unpredictability of IBD. The brand's company, Janssen, talks about Stelara in terms of its trial outcomes and its unique treatment abilities. Company spokespeople stress how the biologic is "delivering treatments for patients who have limited therapeutic options." Marketing for Stelara makes it clear that it is for "“more than just a bathroom disease.”
  • How they say it: Stelara's television marketing is accompanied by grandiose music, giving it a serious and powerful tone. The imagery is of people doing vague, but great and mighty things. The language and tone of Stelara's marketing is more serious — less joyful — than Humira's.

Entyvio IBD Messaging

  • Taglines: "Relief and remission within reach" and "When your head says one thing ... But your gut says "not today.""
  • What they say about themselves: Entyvio also stresses the lack of control one has with IBD, and then how it "acts directly in the GI tract." The brand's marketing emphasizes how it can be used for "long term relief." Entyvio differentiates itself from competitors like Humira by saying it is the "only GI-focused biologic."
  • On Facebook, Entyvio emphasizes the "it happens to anyone" aspect of IBD, with the slogan "With people like you." Their social media posts are focused on healthy recipes, as well as on other resources like discussion guides and app-based support.
  • How they say it: Entyvio's marketing uses more toned-down imagery than Humira and Stelara, with a person quietly walking about inside (but craving some hiking), and eventually getting time in the outdoors and having adventures. There is a more down-to-earth tone in their television spots, which is matched by their social media accounts. On Twitter, they talk about "Real talk on UC and CD."
Part
06
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Part
06

IBD Messaging: Xeljanz, Simponi, Cimzia, and Zeposia

Zeposia, also known as Ozanimod, is a prescription medicine used for treating multiple forms of sclerosis, and ulcerative colitis. Xeljanz utilizes comparison-based messaging for its ulcerative colitis drug.

Xeljanz

  • A recent article from FiercePharma highlighted that Xeljanz is using use-messaging, which is built "around the ease of use of a pill for patients versus injection or infusion used by most competitors." The same is also reflected on the official website of Xeljanz, where their tagline says, "NEEDLES — ESSENTIAL FOR THE CACTUS, BUT MAYBE NOT FOR YOU."
  • The website states that "XELJANZ XR is the first and only FDA-approved, once-daily pill for adults with moderate to severe UC in whom tumor necrosis factor (TNF) blockers did not work well enough or cannot be tolerated."
  • The brand utilizes comparison-based messaging, where the brand is comparing its product to most of its competitors' products and is highlighting the fact that its product is easy to use and isn't painful, unlike its competitors' products.

Simponi

  • As per the official website of Simponi, "it is the only injectable treatment for moderately to severely active ulcerative colitis that is taken every four weeks after three starter injections."
  • The tagline used for addressing the UC audience or the UC patient group is "Explore the injection experience SIMPONI® has to offer." The brand addresses its core UC audience with statements like "Start changing your UC picture," this statement is accompanied by a picture that includes names of all the symptoms that are accompanied by ulcerative colitis such as diarrhea, bleeding, cramping, and others.
  • The brand also claims that "Simponi is indicated to both control symptoms and begin to improve the appearance of the intestinal lining for moderately to severely active adult UC patients who have not responded well to certain other UC medications or find it necessary to continue taking steroid medications."
  • The messaging is pretty impactful since clinical studies back each of its claims. Additionally, product messaging is attempting to touch the pain points of the UC patients and is presenting its product as a reasonable solution to all these problems (for instance, their UC page). One of the most important elements of their messaging is comparing their product to their competitors' products. The official website offers a comparison between Humira and Simponi on points like treatment frequency, impact on symptoms of UC, and others. These comparisons mainly highlight that Simponi is an effective solution to ulcerative colitis.

Cimzia

  • Cimzia is a drug that has been approved by the FDA, the official website of Cimzia highlights the brand tagline, which is "plan for fun, NOT FLARES." The brand also directly addresses its IBD audience and comforts them with statements like, "It's time to change your view with less focus on your Crohn's disease."
  • An official press release from the company stated that "CIMZIA® is indicated for reducing signs and symptoms of Crohn's disease (CD) and maintaining clinical response in adult patients with moderately to severely active disease who have had an inadequate response to conventional therapy."
  • The official website also puts forth claims like "CIMZIA is the only biologic treatment of its kind for adults with Crohn's disease" and "CIMZIA is a biologic, meaning it is a drug derived from living sources that copy the effects of substances naturally made by the body's immune system."
  • Additionally, the website also states that "as an injectable treatment, CIMZIA treats Crohn's disease where it starts, inside the body."
  • The messaging used by Cimzia is mainly targeting its audience by presenting the product as a unique and one of a kind solution to treating Crohn's disease. The messaging highlights the pain points of the target audience, for instance, the tagline, "plan for fun, NOT FLARES."

Zeposia

  • Zeposia, also known as Ozanimod, is a prescription medicine used for treating multiple forms of sclerosis, and ulcerative colitis. This drug is still undergoing clinical trials and has not yet been approved by the FDA for commercial purposes, but Celgene, the company which owns the rights to the drug, is expecting the drug to be approved in 2020.
  • The official website has no information about the drug, and it just prompts that the drug will be out soon.
  • Executives from Celgene, and Bristol-Myers Squibb, which is the parent company and has recently acquired Celgene, have issued public statements about Ozanimod such as "Ozanimod is the first-in-class remedy for inflammatory bowel disease."
  • BMS has also said several other things about the drug, but these statements were issued in public by their investor document. According to the document, "Ozanimod has the potential to expand pre-biologic treatment in Inflammatory Bowel Disease." BMS also stated that the drug has shown "promising efficacy and remission rates in Ph 2 TOUCHSTONE study."

Research Strategy

For providing detailed insights around the messaging being used by Xeljanz, Simponi, Cimzia, and Zeposia for addressing their IBD audiences, we utilized several renowned industry publications, news, and media sources, and the official websites of these brands. For Zeposia, we were able to provide limited information about their product messaging, mainly because the drug is still undergoing the clinical trial process and has not yet been approved for commercial purposes. We also searched through a variety of mainstream publications such as Pharma Times, Fierce Pharma, Global Pharma News, and market sources like MarketWatch, and these sources highlighted some statements from BMS, which is the parent company, about the drug and its impacts on IBD patients. Since these statements were officially published on several popular and mainstream media publications, we believe that these could be considered as product messaging initiatives.
Part
07
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Part
07

Gut Intelligence Survey Questions

1. Do you believe that your gut health and brain health are connected?

  • Because of new evidence that the gut and brain are connected and the enteric nervous system triggers emotional shifts in those living with gastrointestinal conditions, this question could delve further into the hypothesis of whether people listen to their gut when suffering from anxiety, depression, and memory issues.

2. Do you know if an unhealthy gut affects other parts of your body or not?

  • Research shows that having good bacteria in the gut is good for a person's physical health. An abundance of bad gut bacteria can cause heart and/or kidney issues. This question aims to assess the number of individuals that are knowledgeable in the importance of gut health and its connection to overall health.

3. Have you put off seeing a doctor about gut-related issues because of a busy lifestyle, insurance issues, etc.?

  • Over 50% of the United States population suffers from gastrointestinal issues but do not seek help. This question would assess why individuals are not seeking help, as there is limited information on the reasoning behind it.

4. If you have gut-health issues, do you not seek out medical attention because of embarrassment?

  • A study done in the UK showed that only 15% of people said Chron's Disease and Ulcerative Colitis were acceptable reasons to call in sick. This question would help achieve a higher understanding of the stigma around having a GI disorder and may help explain why some are living with an unmanaged disorder instead of getting medical treatment.

5. When viewing IBD medication commercials, like Humera/Stelara/Entyvio, do you resonate with the messages of not being in control or being held back by gut health issues?

  • This question aims to see if IBD commercials resonate with an undiagnosed person. If yes, it would be safe to assume that they may have an undiagnosed condition.

6. Have you ever purchased a service from companies such as Viome, Biohm, Thryve, DayTwo, etc. to more understand your gut health?

  • If an individual uses a service from companies that measure microbiomes, it would be safe to assume that they have a high sense of gut intelligence because of taking an action to improve their gut health.

7. Have you heard of or are you interested in Traditional Chinese medicine and their beliefs and practices regarding gut health treatment?

  • By asking this question, a 'yes' could equate to a higher sense of gut intelligence because it shows they are knowledgeable in the practice of taking care of their gut health and the importance of doing so.



Sources
Sources

From Part 06