The gut-brain axis, separated from the marketing

The gut-brain axis is real. Almost everything sold on the strength of it is running years ahead of the human evidence — with one large exception.

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Cabbage fermenting into sauerkraut in a glass jar.
User:Greg G · CC BY-SA 3.0 · Wikimedia Commons

The short version

Fibre has large, consistent, dose-dependent effects on hard outcomes and almost nobody eats enough of it. Probiotics have small and inconsistent effects on mood. Microbiome testing services have essentially nothing. The gap between those three statements is the whole story of this field.

Strong

Fibre is the finding that holds up

Dose-dependent reductions in all-cause and cause-specific mortality across meta-analyses. Most Europeans eat about half the recommended intake.

Weak

Do probiotics affect mood?

Meta-analyses find small effects on depression and anxiety symptoms, in trials with real quality problems.

Mechanism

What the axis actually is

Vagal signalling, microbial metabolites and immune pathways — most of it characterised in rodents.

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