2.4. Outcome Measures
PROLIFERATION, SKIN CONDITION, DISEASES
The primary outcome was a composite of adverse health outcomes, defined as new symptoms or diseases leading to self-reported negative impacts on their activities of daily living including hospitalisation, absence from work, and medical consultations.The collection of adverse health outcomes commenced from the time the subjects were enrolled in the study. Secondary outcomes were changes in quality of life and gut microbiota composition. We examined whether study subjects had improvement in quality of life regarding their sleep quality, skin appearance, and mood three months after the intervention. Three questions were constructed by a public health professional and pilot tested by an epidemiologist for face validity. These questions included: in the past three months, (i) was your sleep quality better, worse, or similar; (ii) did your skin condition appear younger, older, or similar; and (iii) was your mood better, worse, or similar? We also measured the restoration of gut dysbiosis, defined as improvement in gut microbiome composition and diversity, and the proliferation of a beneficial bacteria genus (i.e., Bifidobacterial and other short-chain fatty acids producers).