A suboptimal microbiome, particularly a deficiency in Akkermansia, can reduce the effectiveness of healthy interventions and increase susceptibility to negative effects from unhealthy interventions like non-nutritive sweeteners.

“if your microbiome is suboptimal which we can Define in a number of ways but let's use one very specific example if you are completely deficient in or woefully deficient in acromania it is harder for you to have a favorable response to a healthy intervention and or you may be more susceptible to the downside of a less healthy intervention so on the one hand you may be more impacted negatively by something like non-nutritive sweet nerves”