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Vandeputte et al1 recently reported a strong effect of stool consistency—as measured by the Bristol Stool Scale (BSS)—on the composition of the gut microbiota in 53 healthy females. This work potentially has a large impact on future microbiome studies as it suggests that such studies may need to be corrected for BSS scores. However, the generalisability of their study is not immediately evident as it did not include a replication cohort and was limited to females aged 20–55 years.
We analysed gut microbiota in relation to BSS in LifeLines-DEEP, a large population-based cohort.2 From 1126 LifeLines-DEEP participants, with both males (n=454) and females (n=672) aged 18–81 years (table 1), the BSS score was recorded for seven consecutive days and a fresh-frozen stool sample was collected in the same week. We calculated the average stool type of 7-day records for each participant. Stool DNA was isolated using AllPrep DNA/RNA Mini Kit (Qiagen; cat. #80204), and subsequently we performed 16s rRNA gene sequencing using forward primer …