In this episode, ISAPP’s current President Prof. Maria Marco PhD and past President Prof. Dan Merenstein join the podcast hosts for a conversation about highlights in biotic science from the past year. Prof. Marco points out a paper published in Nature Microbiology, the result of an ISAPP discussion group exploring whether diet may be a confounder of biotic effects in clinical studies. The group concluded that scientists should work with dietitians to include data on participants’ habitual diet in future studies on biotics – particularly with on prebiotics. These efforts will help scientists establish causality and understand the basis of individual responses to a biotic intervention. Prof. Merenstein highlighted conversations in 2024 around the role of probiotics in the neonatal intensive care unit (NICU), including ISAPP’s panel on this topic at the annual meeting in Cork, Ireland. Although US regulators have recently warned against the use of probiotics for preterm infants in the NICU setting, the data overwhelmingly points to benefits and this may eventually drive regulatory change. Prof. Marco added that a take-away from ISAPP’s panel was that parents of preterm infants should be included in the decision-making around whether to use probiotics. The guests talked about Prof. Merenstein’s recent appointment to the National Academy of Medicine and his rigorous approach to primary care research. Further highlights in the science this year were ISAPP’s papers exploring evidence for probiotics restoring an antibiotic-disrupted microbiota, and evidence for the benefits of probiotics in healthy individuals – both of which found a lack of conclusive evidence to answer these questions. Many gaps exist in the knowledge around biotics, gut microbiota, and health – for example, another paper this year found that the abundance of microorganisms in a fecal sample is a confounder of microbiome-disease associations. And finally, beyond the scientific advancements, conveying the scientific concepts to the general public requires careful consideration and dedicated effort.