0:00 [Music] what I have here is a variety of different shapes and sizes of poop yeah what does this tell us about our health well if your poop looks like this to me that's grounds to talk to a doctor Dr will gtz world-renowned gut health Doctor Who has a wealth of information on how we can improve our gut health through food and lifestyle changes we are currently living through an epidemic of gut health issues and if we want to be healthy humans we absolutely need a healthy gut microbiome in order to accomplish that so let's break this down first of all microbes are visible on your thumb there are as many microbes as there are people in the UK really and gut microbes play a critical and essential role in controlling whether or not you suffer from depression because 95% of the happy hormone is produced by the gut it controls your cognition your
0:46 memory your energy levels your gut is the place where you are making decisions and study after study after study shows us that when people eat more not only do they empower the gut microbes but also they lose weight they're less likely to die of heart disease less likely to be diagnosed with multiple different types of cancer no way yes what about alcohol the science is clear when we drink to the point of having a hangover is that dehydration absolutely not the issue is you have caused significant damage to your microbiome but the gut is forgiving and the choices that you make today within 24 hours will have an effect on your microbiome I want people to eat a diet where they can eat as much as they want without restriction and still achieve their weight goals and this is completely possible by consuming a diet that's quick one this is really really fascinating to me on the back end of our
1:32 YouTube channel it says that 69.9% of you that watch this channel frequently over the lifetime of this channel haven't yet hit the Subscribe button I just wanted to ask you a favor it helps this channel so much if you choose to just subscribe helps us scale the guest helps us scale the production and it makes this show bigger so if I could ask you for one favor if you've watched the show before and you've enjoyed it and you like this episode that you're currently watching could you please hit the Subscribe button thank you so much and I will repay that gesture by making sure that everything we do here gets better and better and better and better that is a promise I'm willing to make you do we have a [Music] deal Dr will if someone's just clicked on this conversation and they they're deciding whether to listen or not what
2:18 would be the pitch to those people what's the benefit if they stick around welcome to a uh what I sincerely believe will be a life transforming conversation for you because the issue is that we are currently Liv living through an epidemic of gut of gut health issues um if we look across the board this is everywhere and it's not just you know uh digestion this is so much more than that we need this now more than ever because ultimately if we want to be healthy humans which to me is one of the highest goals that we should hold for ourselves if we want to be healthy humans we we absolutely need a healthy gut microbiome in order to accomplish that what's your sort of academic professional background oh gosh where do we begin um so uh I graduated from Vanderbilt University uh
3:04 with a chemistry degree that was my college and um I went to Georgetown which is one of the top medical schools in the country I um spent three years at Northwestern as a as uh Internal Medicine resident I won the highest award that they give while there then I was the chief medical resident and I spent four years training as both a gastron neurologist in the hospital and also working on clinical research so I didn't expect when I finished all this that I would be continuing to publish papers at any point in my life in the future but now in my work with Zoe as their us medical director I've been heavily involved in clinical research again you mentioned a big GW there gastro enologist what is that uh we are the
3:51 specialists in terms of basically like the intestines the gut so if I were to summarize it I would say guts and butts guts and butts yeah the conversation around the gut microbiome and the gut generally has exploded really since what a 200 2006 2007 time before then I mean to be fair with you I think as far as I'm aware and I'm not that close to doctors or hospitals or research I've only started hearing about the gut microbiome in the prevalence that I have in the last two years yeah three years what is the central misconception that most people have as it relates to their health that guy that looks into the mirror and goes I don't like what I see here I don't feel good that's C up they they're bloated they've got gut pains the current sort of line of
4:37 thinking will say it is X but there's something that you believe it is what is that well I think that all of these things ultimately con connect back to our gut microbiome and I think that's the piece of the puzzle that's been missing this entire time you know there's it was sort of this black box if you eat well you will improve your health if you do this you will improve your health um what we were missing was the understanding that all of those choices ultimately impact these gut microbes and by impacting these gut microbes you can actually transform the physiology within your body gut microbes yeah what is that gut microbes is my nerdy way of talking about these uh microorganisms that like you can't see them right now but they're there they're you know if you hold up your thumb
5:24 literally on your thumb there are as many microbes as there are people in the UK really and they cover our entire body from the top of our head to the tip of our toes every single external part of our body is covered with these microbes but the main spot is actually deep inside of us which is our colon the large intestine in that spot you can find 38 trillion now these when I say microbes it's referring to the fact that they're microscopic and they're alive it's mostly bacteria um in addition to bacteria could also be fungi could be parasites could be viruses but we have 38 trillion of these mostly bacteria focused and concentrated within our colon so when we talk about the gut microbiome are really referring to them how did they get there
6:10 so you started in your mother's womb MH and evidence these days would suggests that you're already starting to come into contact with these microbes but um but for the most part you haven't really met them yet until the water breaks and in that moment for the first time you are exposed to the world and the world is covered in microbes everything that's alive everything has a microbiome could be a plant could be an animal could be an insect could be us so when Mom's water breaks these microbes then enter into the uterus and you meet them for the first time but you are particularly exposed to them as you pass through the birth canal and this is basically like Nature's Way of being like hello welcome
6:57 to the world and meet your partner ERS that'll be with you for the rest of your life and they're here to help you and they will make you healthier and this is the result of co-evolution that goes back over a billion years we have been evolving and which is crazy because humans have only existed for three three or four million years but these microbes were the first life on the planet and all life evolved with these microbes and things like for example our immune system is the product of evolution that started a billion years before humans even existed we always think of ourselves as one organism but you're making the case that I'm maybe 36 trillion or whatever you said organisms in one and we would call you a super organism and that sounds
7:44 like a Marvel character which is cool and we'll take that but that's actually completely true because the issue is that if we withdrew these microbes from you if you were like hypothetically you know we could talk about the Bubble Boy from um the 19 1970s where they actually did this they tried to have a child live in a sterile world because he had a specific immune deficiency so their thought was if we keep him separate from all the bacteria then he'll never have a problem but the issue is that there are consequences there are consequences to living without microbes because we need them so and through this process of co-evolution literally from the very first human we grew to trust them and we trusted them with things that are critical important to us and
8:30 our success as humans and we allowed them to integrate into our physiology in a way where once again if we don't have them we're in trouble and that includes things like digestion breaking down our food which to me is like that's the essence of life like you can't get energy into your body without this and they help us to accomplish that but they also train our immune system you know we talked a moment ago about what happens when you're born and that's the very beginning of training your immune system and during those first three years of life life it has a massive impact on whether or not you develop allergic issues autoimmune issues down the road they affect our metabolism our research at Zoey has overwhelmingly shown that they play a critical and essential role in controlling for example your blood
9:15 sugar your blood fat response after a meal they affect your mood um literally your energy levels uh whether or not you suffer from depression your cognition your memory your ability to focus all affected by these microbes they affect our hormones so in women conditions like endometriosis polycystic ovary syndrome associated with damage to the gut microbiome in men erectile dysfunction which I mean to be honest is not talked about enough um perhaps because we've stigmatized this but this the guys that have this issue this is like the most important issue to them and so when you think about all these things whether it be digestion our immune system our
10:00 metabolism our hormones our mood our brain health like to me this is um uh an overview of everything that matters for human health from my perspective as a medical doctor and is my microbiome different to yours do we all have different sort of jungles inside of us we are all different and this is one of the things that makes us actually profoundly different so to be honest it's it's this is mindblowing if we looked at your genetic code and my genetic code even though clearly we are different people we our genetic code would be 99.99% the same it's a small part of our genetics that is different between us as
10:46 humans but our microbiome these 38 trillion microbes that are living inside of us they can be completely different so as as a classic example let's pretend that you have a twin brother identical twin brother brother mhm all right so you share the exact same genetic code you share the same mother for the vast majority of cases you would have shared the same childhood and largely the same upbringing in food and things like this and our research shows that only about 25% of your microbes would be shared even though you come from the exact same place you would be 75% or more different so you and I it's hard to say exactly like if our diet was you know quite similar then we would have a more similar microbiome but it still would be more different than the same and how much then so I've got twin we've got completely different micro gut
11:31 microbiomes these sort of um microbes that live inside our bodies how much of our microbiome can be Associated back to disease and things like that in your view what percentage of disease do you think links back to the gut microbiome well it's hard to say globally right it's hard to give an exact number um you would have to I think go condition by condition to say but what I would say is this my you know the reason that I became very interested in this as a gastron neurologist is that I was convinced and I continue to believe this to be true that every person that walked through the door to see me had a gut microbiome problem right people with iral bowel syndrome Crohn's disease ulcer of citis
12:18 celiac disease acid reflux go down the line every single one of these when we study them we discover that they have gut issues but the other thing if you expand that one of the things that I would always do you know I'm about to go see a patient I'm going to walk into the room and you take the chart off the door right you hear if you're the patient you hear that you're in the room and you hear the chart come off the door and the doctor flips it open and what do I do I take a look at their medical history and when you when you look what you see is a laundry list of conditions that have been associated with damage to the gut microbiome so they're here to see me for their digestive problem like iral bowel syndrome but when I take a look I see that they have hyper lipidemia high blood pressure type 2 diabetes history of major depression
13:04 uh they may have autoimmune condition right so and then it starts to implicate these different systems that like we have not classically associated immune like autoimmune issues or metabolic issues or cognitive issues or mood issues we haven't classically Associated those things with the gut microbiome yet they are and so to me do I need like for that particular patient do I need a poop test to tell me that they have a damaged gut absolutely not it's already clear and what's the relationship between our gut microbiome and our immune system I was reading in the introduction to your book that 70% of the immune system is is the gut yeah the um the walls of your intestine are actually the home of your immune system we classically would think of the
13:52 bone marrow as being the place where the immune system exists that's not true that's where the immune the immune cells are born there but then they basically immigrate out and then they take up residence and live within the walls of your intestine and by the way this makes complete sense from an evolutionary perspective because our gut is actually the most vulnerable part of our body this is where we come into contact with the outside world your skin you may think of that no your skin is a wall your gut is the place where actually you are making decisions do I absorb and allow this into the body or do I reject and keep it outside and in order to help facilitate that yes we need our immune system there but the other thing that we need is we need a barrier we need something to basically um uh section off
14:37 the inside of the intestines and keep things separate so what we have is called the epithelial layer and this is quite humble like given how important this is in our body it is just a single layer of cells that are being held together by this kind of cement called tight junctions they stick together on one side is 70% of your immune system on the other side are 38 trillion microbes and when this barrier breaks down this is how things that are inside your intestines can get access to your body um get into your bloodstream potentially cause a whole body infection and then the immune system is forced to react and when this is like we have an infection that's really important we we
15:24 this is why we have an immune system to protect us in that setting but what's happening in the 21st century what started in the 20th century is chronic inflammation and chronic inflamation is the result of a broken barrier when that gut barrier breaks down now we are giving access to our body to things that aren't supposed to get access and the result is that the immune system stays perpetually active because it is constantly trying to clear stuff out because the barrier is broken and for those who are wondering so Dr B then how do we how do we fix the barrier not to put the question into your mouth Stephen but please do the answer is the microbes the answer is the microbes
16:09 because they are the stewards of the gut barrier they help to repair it every three or four days you actually completely transform and recreate your gut barrier so it's not the one that you were born with it's the one that you developed in the last three or four days and you will turn that over and when it turns over we need these gut microbes to help us to form a strong gut barrier so because it's constantly turning over this is where the microbes come in and they're and they're critically important again the microbes when you when you reference microbes you're talking about the bacteria the yeast the parasites the viruses that exist in our in our guts and how long do they live for you said they turn over in three days does that mean that they live for three days typically so the uh the gut barrier turns over every 3 days yeah yeah so and those are human cells so those are not the microbes okay so those are your
16:56 human cells keeping the the microbes separate from your immune system and your body MH um these microbes they are um turning over like literally every 20 minutes they're dying every 20 minutes so well not necessarily dying replicating replicating okay right and so if we think about this if we had if you had one microbe in your intestines right now and we feeded something whatever it may be good thing bad thing whatever 24 hours from now that microb will have spawned at least a new microbes so if you think about the power that exists there to amplify choices starting with one and ending 24 hours later with a thousand it's crazy there's this really interesting sort of
17:41 reframing in the introduction of your book which is really simple but it does cause you to I think it's a really powerful frame to Think Through about what we eat and how we eat which is where you say that um each of us consumes an average of 1.3 kg of food per day keeping the math simple that's 475 kilos of food per year meaning we'll consume about 36,300 kilos of food during our lifetime and in contrast to the couple of milligrams of medicine that we take it really makes you realize that food is in fact the medicine that we're feeding our body at all times we think we sort of compartmentalize food over here as this energy source that quenches hunger and then we have medicine over here to fix stuff yeah but in fact you're doing
18:28 36,000 kilos of food in your lifetime so that the thing that's having the biggest sway on your medical your sort of physiological health and your your your gut health is of course the food the food is the medicine well I think that there's two important takeaways from that because there was a study actually that changed my life in 2014 that came out um this was published in the journal Nature which is literally the top journal on the planet and um uh the author was Warren David from Duke University and you have to understand if we go back this is almost 10 years ago go in this moment we didn't know if food changed microbes in humans we didn't know this this is new information we knew it in mice but it's not the same mice are not humans um so what they did to try to prove this is they put people on uh diametrically
19:15 opposed diets so a completely 100% plant-based diet versus a completely 100% animal-based diet it was only a 5-day study which is interesting because within 5 days you can actually see massive results and the key one of the key takeaways from this study is that the choices that you make today within 24 hours will have an effect on your microbiome in that study when they changed a person's diet 24 hours later you could already see things underway shifting so now the other thing to keep in mind here is that I think is really important is the gut is forgiving I mean to a degree you can only beat it up so much but the gut is forgiving so this doesn't mean that there are foods that
20:01 are on the table and off the table everything is on the table but what we want is we want to create a weight or a disproportionate consumption of those high quality foods because when we do we are lifting these microbes up explain that process of food and the impact it has on the microbes so is it like watering certain microbes is that a way to think about it in simple terms these microbes are as alive as you and I are Stephen and and we need to eat um if I don't eat I get quite hangry and they do too and but it turns out that the reason that they took up residents because they could have been anywhere they could have stayed inside soil or lived on a plant or something like that they chose to live inside of you and the reason why they are inside your colon is because they get access to nutrition you do that
20:49 for them you go out you find food and you deliver that to them whatever goes into your mouth whatever it may be it will come into contact with these microbes and they will consume it and and this becomes their energy source because they are alive they need energy so but the choices that you make impact which microbes get to eat so not every single microbe likes kale not every single microbe likes sugar but there are some that like sugar and some that like kale and when you make these choices whatever it may be those choices ultimately are going to feed specific families of microbes lift them up and allow them to thrive so when we talk about you know improving dietary quality and you hear me talk about this
21:35 in fiber fueled which is a message that I started sharing publicly back in 2018 um and the book came out in 2020 or if you listen to Tim Spector who published the paper that I'm about to talk about um the science is clear the way to lift the microbes up is by eating a variety of plants now in Tim spectre's paper that originally came out it's called the American gut project but by the way the British gut project was a massive and critically important part of the study in that study um you have to understand the magic number that they came to was 30 a lot of that had to do with just the technique that they were using to measure it doesn't mean that 29 is bad and 30 is fantastic it's all on a spectrum 30 30
22:23 different plants per week mhm yeah 30 different plants per week so the key is we want varieties of plants and every single plant's Choice ultimately is fuel for a healthy gut microbiome so that's fruits vegetables whole grains seeds nuts and legumes it's not just veggies it's not just kale and to me like one of the things that I've always tried to do whether it be as a medical doctor or as an author I want to meet people where they are so like if it were if I were Consulting with you I want to know where you stand right now and then we're going to set realistic goals because so for a person who's eating 10 different plants per week which which by the way is more than I was eating 10 years ago to go to 30 instantly that would be quite hard and when it's hard it's more likely to become unsustainable I would go from 10 to 15
23:09 and when you hit 15 I would be celebrating how many plants does the average person eat in the Western World America the UK Europe do you know uh I believe in the American gut project the number was around 10 to 15 for the average person it was a minority of people that were hitting 30 per week and that's the it's interesting when I I did my Zoe test I got my results back and it did say that I had quite a narrow gut microbiome in comparison to my partner and I was thinking about this I was like you know whenever we go somewhere whenever we go to a restaurant she orders new things all the time and if you look at our fridge it's like tahini and this and all this like all these plants especially in the top part of our fridge it's all like fermented stuff she eats like she's a like a rabbit or she
23:54 just eats anything and she eats diverse food food and she orders new things and then there's me yeah I like what I like and if I go to a restaurant anyone that's been to a restaurant with me like three times could order for me because they know um until I got my zuro results back and it was it was pretty alarming cuz she had her my crbs were like a like the Amazon rainforest nice and mine were like you know I park at the End of the Street H you know I think that it's important to start with food that you like yeah we're all like that what you described but the issue is finding that motivation to push yourself to me this is the this is the piece of the puzzle like again this was a black box we didn't know anything about the gut microbiome we just had like nutritional
24:39 ideas being tossed at us now this is filling in the gaps where it's like hold up no nutrition affects the microbes the microbes affect us as humans now we can connect those dots and to me I find this very empowering and motivating to know that that exists and to know that those choices every single meal is an opportunity to follow this concept and add more diversity to your plate but the other thing is you mentioned that your partner is eating fermented food that's is a lost start people have not been consuming fermented food in the western world and the research is quite clear and standing out at this point that actually there um was a fascinating study out of Stanford University randomized control trial the intervention was to add fermented food to the diet in people that had not been
25:25 consuming fermented food and what they found eight weeks later is that they had increased the diversity within their gut microbiome what does that mean if your microbiome is the park at the End of the Street adding fermented food we can we can make it into a jungle give me some examples of fermented foods and what is the fermented part like what does that mean well uh first of all we we mentioned that all all life on this planet has a microbiome so there was an interesting study where they analyzed the microbiome of apples and discovered that when you eat an apple like you just grab an apple off the uh out of the fruit bowl um that Apple has about a 100 million microbes that are a of it so they're already there and those microbes have been a part of that Apple's life
26:10 helping it to grow from a flower to a fruit okay so um now these microbes they are also involved in the life cycle of that Apple so when the Apple goes to spoil the microbes are the ones doing that in fact I would argue that when food spoils I actually find that reassuring if food doesn't spoil we should be concerned the microbes are helping to facilitate that spoilage that takes place and that's because the Earth is taking it back it's this it's the cycle of life that's going to turn into dirt right now fermentation is where we actually grab that process and we control it almost like a magician we're shaping it and what we're having is we're empowering certain microbes to protect that food so it does
26:58 not spoil and they transform it so if you were to take cabbage um you know you don't need to do anything special to this cabbage you literally just buy cabbage perhaps at your farmers's Market chop it up put it into a mason jar pack it in there and add a sea salt brine solution a saltwater solution and you basically put this into you know a nice cool space give it a week you will have sauerkraut sauerkraut is not salty cabbage it's tart it's bitter uh it's acidic um it's delicious when you make it yourself it is completely different than the sauerkraut that I grew up on that came from a can which was soft and disgusting so this is what fermentation
27:45 is it's transformation the microbes specifically bacteria and yeasts are transforming the food for us and when they do this they also are eating so because they eat they grow stronger and they multiply so you are creating a food that is high in microbes which we could call probiotics it has been transformed to unlock the nutrition which we could call prebiotics preotic are the parts of our food that actually feed the microbes inside of us it's their food prebiotics and they are releasing new chemicals that can have beneficial effects on your body which we call call postbiotics you find all of this in that
28:32 one jar of sauerkraut so that to me is a superfood and it could be sauerkraut it could be kimchi uh pickles like pickles are not meant to be a vinegar thing by the way vinegar is the product of fermentation but pickles were never meant to be hey add cucumbers and some vinegar and call it a day cucumber true pickles are meant to be that you take the cucumbers you don't skin them you allow the microbes that are on the surface to do their job and you put them into a saltwater solution with some you know some dill some garlic black pepper corns and a couple days later you will have a pickle I want to make sure I'm super clear on those three biotics that you mentioned so prebiotics are the food
29:18 for microbes probiotics are the microbes themselves and then postbiotics are the compound that the microbes make is that roughly accurate that's roughly accurate and there's a minor caveat which is that for these things Prebiotic and probiotic they have to have beneficial effects on humans in order to count okay so we can't call it a Prebiotic because it has just an effect on microbes sugar has an effect on microbes that's not a preotic ah okay okay so and the same is true for probotics now the original conception of probotics that most of us have it comes from a capsule right and the reason why we can call it that is because we have
30:03 demonstrated through clinical studies that the specific types of bacteria or or yeasts in some cases that you find in that capsule have been proven to be beneficial to humans so the Prebiotic is a food the probiotic is actually alive yep and then the postbiotic is not alive that's a compound that's produced by the things that are alive that's right and the key with all of this is the postbiotic so one of the and and these can be things that are completely beneficial and good to us as humans an example of this are the short chain fatty acids short chain fatty acids are the product of consuming fiber or resistant starches and they come into contact with your microbes again you
30:49 would not be able to get these if you were sterile can I just drink them in a can postbiotics is there not a can of postbiotics that I can just drink well so they're coming out now with supplements that um are these postbiotics in some cases okay and uh the issue that I've taken with them and I've actually discussed with some people within the supplement industry let's not assume that that's going to do the exact same thing that eating a high-fiber diet is going to do it's not the same so let's then talk about what happens with those I'm assuming that the postbiotics um compounds are the things that have the health all the health benefits so the reason why the gut microbiome is so healthy the reason why these microbes are so beneficial is because they produce postbiotics and these
31:35 postbiotics help our body in various ways yes so we uh mentioned earlier we were discussing how we have this gut barrier that's key to protecting our immune system and I mentioned that the the microbes are the stewards of that of that barrier it's the postbiotics it's the short chain fatty acids butter acetate proprionate that are produced by these bacteria that builds the wall when you want to build your wall and protect your body and reduce inflammation you need more of this now it's not that's not the only thing that they do those postbiotic short chain fatty acids also directly affect your immune system directly affect your metabolism cross the get
32:22 into your bloodstream pass throughout your entire body cross the blood brain barrier they have the ability to actually get access to your brain and can affect your brain and we could talk about different ways that that they can do that but the point is that this is what um really matters because the microbes produce these short chain fatty acids and these short chain fatty acids have healing effects throughout the entire body and when we when we see human studies looking at fiber consumption and showing us how beneficial fiber is to us as humans the Reon I want everyone to understand the reason why fiber is beneficial to us as humans is because fiber comes into contact with microbes and those microbes release short chain fatty acids that's
33:09 what's happening metabolism metabolism is the I've been learning a little bit about metabolism recently when people think of metabolism they think of the speed in which I process my food so people in society say I've got a high metabolism which means they're probably going to be quite skinny a low metabolism means you know I'm probably going to take longer to process my food what is the role between the relationship between my gut and my metabolism and have I def I've probably defined metabolism wrong there but what is the relationship well metabolism is basically dealing with the currency of energy right so and it is the engine that drives us as humans and so how do these microbes affect our metabolism well we have uh research at Zoe looking at this directly called the predict one
33:54 study and in that we were looking at like what is the thing that tells me predicts what your blood sugar response is going to be to this food or your blood fat response after a meal and when you start to line these things up they're individually different they're not the same but if you look at both of them the gut microbiome plays an essential and critical role in each so in other words if we know what your gut microbes are then that empowers us to be able to understand why you have high blood sugar why you have low blood sugar now if we want to get super nerdy and detail into the weeds a little bit of how this is actually happening it does come back in many ways to these short chain fatty acids they're not the only thing we're you know in some ways we're
34:41 reducing it a little bit too much so I just want to be clear to everyone there's other things going on too but these short chain fatty acids they have the ability to basically activate certain receptors and cells that will basically like allow us to have more sensitivity to insulin to reduce fat storage to enhance fat burning so at the end of the day when we think about these sort of measures of metabolism because there's certain things blood sugar response blood fat cholesterol levels um uh visceral OB visceral osity mean meaning like fat that exists around our stomach when you look at all these things the gut microbes play an essential role in regulating every single one of them and the short chain fatty acids tend to be the key I read in your book that 60% of poop is bacteria
35:29 yeah which would just blew my mind yeah and I think that this is an important conversation to have because we have stigmatized poop we're not allowed to look in the bowl we should be looking in the bowl and the reason why is because if I were a cardiologist I would come over and I would check your pulse I would listen to your heart and those Vital Signs would allow me to have an idea of how you're doing in terms of like just on a basic level your cardiovascular health all right I'm a gastrologist if I want to know the basics of what's going on with you and your body I want I need to know how you're pooping and what your poop looks like because 60% of it is microbial in origin because it is not just the excrement of your food what your poop looks like
36:17 allows me to have insights into your gut health and we've actually proven this we've actually proven this at Zoe because what we found we did a study called um blue poo and we fed people blue muffins it had a blue food dye and basically it's quite simple you eat the muffins and then you wait to see when they show up in the toilet bowl and based upon that time which is basically your gut Transit time how long it takes for the blue dye to pass through your intestines we could tell you um what's going on with your gut microbiome we could talk about cardiovascular risk we could talk about visceral fat all quite simply tied to your gut
37:03 Transit time based upon eating a Blue Muffin so these things many of these um things that you and I are discussing today whether it be the gut connecting to our metabolism our immune system or whatever it may be we can connect them back to these simple measures like what does your poop look like or um or how long does it take for you to have a bomb movement the gut Transit time that's super fascinating I do want to talk about poop as well but um the gut Transit time yeah that's the time it takes from a muffin to go from my lips to the toilet bowl yes and is a high gut Transit time better than a low one and what is determining whether or I have a high gut a good gut Transit time or a not so good one yeah so gut Transit time is a
37:49 um uh a personal measure of the health of this entire digestive system the reason why you do the blue dye by the way instead of like eating beets or something like that is that the blue dye we have like clinically validated this so this this paper was published in the journal gut which is the top European gastron neurology journal and there's a couple specific time points that we can use to sort of cut off these measures um the first is 14 hours if you are less than 14 hours that is very fast the other is 58 hours if you are more than 58 hours that's very slow all right so you eat these muffins and then you basically just record when did they show up and the average person
38:36 is somewhere on the range of 24 hours or 48 Hours typically one or two days after eating the muffins that's when you you start to see this and those are both considered to be normal now if we were to break these things out into less than 14 hours more than 58 hours or you know these two sort of Peaks at 24 and 48 we what you start to see is that this is four groups and these four groups every single one of them is a little bit different in terms of their gut microbiome a little bit different in terms of their gut diversity and we can make associations between these things and what people are eating so the high fiber consumers are all showing up in the middle which means normal and the low fiber consumers are the people that are showing up on the outside and it
39:21 brings us to one of the properties of fiber that's kind of fascinating which is that whether you have Di diarhea or constipation there's only one thing that can correct both of those diarrhea and constipation are both fixed with dietary fiber it helps to normalize our stool bring it back to the middle so in a perfect world where do we want to be we want to generally be pooping about once a day so you want your gut Transit time to be about 24 hours or less um that being said like is a person unhealthy if it takes two days for this to show up in their poo no I wouldn't characterize them as being unhealthy but I I do think like this is one of the things that we can look at that's simple it's it's nearly free and um available all of us to try at home so yeah so you you you would assert that if someone's
40:07 going to the toilet you know three or four times a day or more then there's probably a fiber problem there's May well be a fiber problem and if they're you know they're sort of chronically constipated it's also probably a fiber problem at the heart of it generally speaking yes now I will say that fiber is not as simple as I wish that it was and and the reason why I bring that up is that for a person who's low on their fiber consumption um and they may suffer with these issues increasing fiber is hard for them and many people don't feel well if they go too hard too fast when they do this it folds them over they feel unwell I was in the exact same spot 10 years
40:52 ago if I tried to eat like you know chili with a bunch of beans I was not happy so I prefer to stay away from that so the point that I'm trying to make about this the reason why people struggle with fiber is because we are 100% reliant on our gut microbes to digest our fiber for us we don't have the enzymes to break them down to break down fiber the gut microbes are doing it so if you have a damaged microbiome and you never eat fiber you're you can't expect your microbes to be good at digesting fiber are microbes they learn and they get good at the stuff that we allow them to practice so when we start to add more fiber the way that I recommends that people do this is to start low and go slow that just means
41:38 adding a little bit at a time slowly over over the course of at least weeks if not months um and this is what allows your your gut microbes basically to keep up and adjust to what you're doing what about fecal treatment you said there that if our gut microbiome is damaged um it's not going to be great processing the fiber so can't I just get someone's poop who has you know that 60% of their poop is the the microbes and eat it or do some kind of feal treatment where I put it in my body so this is this is actually being done um now we've been doing feal transplants where we would take from a donor and put it into a person for an infection called C diff and we've been
42:24 doing this for more than 10 years and it is fascinating the studies with fot transplant in humans have not been uh as successful as they were for the C diff so we would love to say that we could treat ulcer of colitis which is inflammatory bowel disease with a fecal transplant um generally it seems that we cannot at least where we stand today but there is something interesting that we found in one of the studies on this topic which is that there was one study where again these studies are small like we need bigger studies to really fully understand this there was one study where they did have a couple of people
43:11 on with all sort of cus who went into remission meaning that their disease was no longer active after a feal transplant and they asked the question what was unique and they found they all had the same donor so what we think is that there's probably specific donors for specific diseases that could actually potentially fix those issues because at their root they are gut issues I think that the future of feal transplant is very promising but the complexity of figuring out who are these donors like could I be a good donor for some specific disease that I don't even have myself and don't know anything about possibly and this is what we have to figure out and how do these poop transplants happen is it
44:00 orally or is it some other way are they injecting this poop are they putting up their butt what are they doing with it there's a couple ways so the classic is a colonoscopy so the way that I always I would always administer it is that the patient comes in for a colonoscopy they're completely asleep they're not aware of anything that's happening and during the procedure I basically release this stuff it's a liquid it's not as gross as it sounds so that's a CH up the butt the colonoscopy yeah up the butt yeah let Tobe up the butt now the new technology that's been emerging in the last few years is that they can actually dry out the stool so they liliz it and put it into capsules you have to take a ton of capsules in order to do this but this is an alternative choice is like you could start taking this what I think would be
44:45 interesting breaks well hopefully not do you know what I mean I've had a couple omega omega 3 capsules break and it's a nightmare so oh dear imagine trying to get that sh on my te we want to be um what what we're transitioning towards like the past was this big event you had to come in get a big procedure colonoscopy well to do that repeatedly is simply not sustainable that's not realistic now what we're entering into is the possibility that you could do this every day you could just take your poop capsule every single day God love to be the CEO of that company that' be so fun I mean I think that I think that this is going to happen we just need really yeah but I think we need the the technology is there the technology is there so what do we need we need to
45:31 identify who are the proper donors for this and we need to run the clinical trials to prove that it will work but to me this is a super probiotic because it's not just you know most probotics are just one single strain um and they can be beneficial I'm not disparaging probotics in any way they can definitely be beneficial but what we're talking about is a new future where you're actually reconstituting a healthy microbiome and Stephen on this topic real quick it is fascinating because some of the people who are in this space they're worried about the way the world is going in terms of microbes right so there's been this concept that perhaps you've heard about where which is that um there's like been this great uh Extinction event that's
46:16 taking place right where many species of animals are dying and um and they're gone microbials scientists are worried cuz the same thing is happening on a microbial level so if you were to compare our microbiome as westerners to a person who lives in a more uh primitive environment in Africa we have half the microbes that they do and so what these scientists are doing is they're saying what if those microbes that you find in those people what if we need them what if we evolved and they're required for us so so they're creating a bank where they're collecting these poop samples from like uh primitive tribal people and saving
47:04 them in the event that it turns out that the only way back is to actually take the poop from these people and create super probiotics that would help to reconstitute our microbiome I'm so compelled by this idea that there's going to be this range of supplements in the future that are just like poop capsules I don't think it'll be supplements though I think it'll be completely regulated well what I mean by that is there's a difference in regulation between supplements and um Pharmaceuticals and I don't think they'll have any choice but to regulate this on the same level that you would a drug because in my head I have this idea of you know if this really takes off people with great poop are going to be you know expensive dude I think my stock is rising to be honest with you want some of your poop all right if you want my poop you will have to pay for it but
47:50 it's going to be expensive if you only go to because you're healthy you go to the toilet once a day it's going to be like gold um and that's the fascinating thing poop is on the biggest comeback in the history of comebacks right now maybe maybe that's where we live in a post AI World maybe that's the currency we trade in you know what I'm saying because we're gonna have little else to do so I you know gosh that is a dark uh disturbing vision for the future but I could see where I could see where that's possible I mean I I do think like it's fascinating to consider that what what we once disparaged as completely worthless has turned into the powerful treatment that doctors are administering in the hospital to treat the uncurable infection and now is the future of science it's going to be so interesting
48:35 could like you know change the class system in the country that you know like upper class could just be people with the best poop and then lower classes if you've got like a really narrow gut microbiome and your poop is useless you can't sell it to anybody well it's kind of fascinating that you say that because the issue is that if you look at the microbiomes of countries that are less developed than the US and the UK um you know they they they have less money which the result of this is that they eat a more basic diet which often is based upon whole grains and legumes right like that's the essential like beans and rice is like the essential diet yet these things are actually so good for our gut microbes like to me legumes are the least talked about food that we should be talking about because they're high in fiber they're high in
49:21 resistant starches and polyphenols all of which are prebiotics and this is why when people eat more beans they live longer with less disease so it's kind of interesting cuz like popper food cheap food is the food actually that is the best for us because it feeds these microbes lazy westerners are going to get on a boat like they did Once Upon a Time the Colonius to go get the incredible you know they the the gold and the Diamonds and whatever else they it's claimed that they stole from Africa and they're going to get back on that boat and go over there and start stealing poop I think that that I could definitely see that happening there has actually been fights over when they they discover um uh prehistoric poop like fossilized poop there's fights over who gets to control that because if you think about it's like Jurassic Park right in the beginning Jurassic Park there's that Amber with the mosquito and the needle goes in you extract the DNA
50:08 what if we could extract the DNA from prehistoric poop and study that and potentially use that the poop studies that have been done really compelled by them because I hear that there's been a lot of sort of poop transplant studies done in in mice as well yeah and what what what are we seeing from those studies right okay so we were talking about these different um conditions that are connected back to arot microbes mhm and part of the way that we prove this of course we want human research but part of building uh our argument and and filling in the pieces of the puzzle is like Mouse research and these mice there it's we have complete control and they're much more simple to manipulate and so we have the ability to do a fecal transplant
50:54 even potentially from a human to a mouse and then see what happens and so let me take you through a couple of examples of what we have seen in clinical studies and I'm more than happy to point people towards the studies that I'm referring to um classic study they took identical human twins so again we were talking about this in the beginning of the of the episode identical human twins same genetic code and in this case one was obese and one is thin and they have a different microbiome and when you transfer human poop into mice you also transfer the body type even when you feed the mice the exact same food the exact same number of
51:43 calories so we hear about this calories in calories out concept which by the way we could talk about if you want to but it's not perfectly true and this is showing you the complexity that exists your microbiome impacts how you work with those calories the mouse that uh receives the obese microbiome it's like swimming against the current the microbiome is making it basically so that that Mouse absorbs all of those calories and then the thin mouse mouse um it's like swimming with the current at your back it's a lot easier you consume the same number of calories you don't gain any weight that's just metabolism by the way we have studies also diabetes can be transferred we have studies in humans where you can actually do a feal transplants from a person who does not
52:29 have diabetes to a person who does have diabetes and their blood sugar measures will improve in humans we have uh immune studies you can take a person who has all sort of cidus which we were talking about a moment ago and transfer their poop into a mouse and that Mouse will have all sort of cidus we have uh mood studies uh where you could take a human who has anxiety or depression um or PTSD and transfer their poop into a mouse and the mouse receives the mood phenotype so basically like again this
53:17 uh needs to be studied more in humans we are more complicated you can't just cure diseases like this by transferring poop among humans yet but when it comes to mice where they are less complicated it's very clear that the microbiome plays a central role in these conditions because you can transfer the condition using human poop and take me on a journey of what that poop's doing so I I get the skinny poop from a skinny twin and I put it into a mouse the mouse gets skinny or I get the obese twin I take the obese twins poop and I put it into a mouse the mouse gets obese what's going on in that mice's body to make it obese I'm I'm assuming it's basically picking up some of the microbes which are impacting the gut microbiome which is creating a
54:03 postbiotic compound which is influencing its metabolism or something something like that you could eat the so if you have a microbiome designed to produce short chain fatty acids you and I could eat the exact same meal but the person who has the microbiome designed to create short chain fatty acids will get more short chain fatty acids and the and the product of this is that those short chain fatty acids now will have effects throughout the entire body including affecting our metabolism and affecting our blood sugar affecting our insulin sensitivity infecting our blood lipids after a meal affecting fat storage whether or not you turn on fat storage or whether you turn off fat storage and turn on fat burning it really does shine alert on this calories in calories out thing because yeah I mean there's so
54:49 many people I've talked about this a few times that just think you just have to eat below the required amount amount of calories for your body and you'll lose weight but in that example it proves that there's this other process going on that's going to determine I guess is it how many of those calories go through or is it just how your body processes that energy part of it is part of it is thermogenesis meaning fat burning yeah part of it is also what you poop out okay they've actually found that people who have a healthier microbiome they poop out more calories ah okay interesting what do you think of the calories and calor out thing if someone comes to you and they say I want to lose weight Doc and they say I've had this calories in calories out thing is the answer so I'm just eating less I'm eating lots of pizza but I'm just having less calories
55:37 I don't I don't like that obviously so to me dietary quality is the key um there's too many examples where dietary quality so first of all our weight is our our health is not entirely determined by our weight is it a major factor yes it is but there's so much more M so so dietary quality study after study after study shows us that dietary quality is crucial to the health of our microbiome and also to our Global Health our longevity and our risk for disease so to pretend that that doesn't matter would be completely false and inaccurate um the idea that calories is the only thing that matters what I do want to say is this there is some truth to the concept that calories matter there's absolutely some truth to this if
56:23 you reduce your caloric take you will lose weight the problem is that your body will compensate by slowing down your metabolism and so then it puts you in a in a predicament where you can't continue to do this it's not sustainable because that weight loss eventually will stop and then you will uh your appetite signals will grow so much that you will start to overeat and then when you overeat not only do you gain the weight back you rebound yo-yo you yo-yo and you go above where you were before wow and the problem with this is that when people lose weight they don't just burn fat they lose muscle mass like all weight loss is associated with a loss of muscle mass when you gain the weight back the muscle doesn't come back you're just getting fat so so the issue is you
57:10 end up less healthy than when you started to me what I want is I want people to eat a diet where they can eat as much as they want without restriction until they are full and still achieve their weight goals and this is completely possible by consuming a diet that's high in prebiotics because we hear so much about uh OIC or wovi um which is seml semaglutide we hear so much about this and it's a glp1 Agonist gp1 is a gut hormone that exists within our body and uh it makes us feel full we can stimulate GL lp1 through our
57:56 dietary choices if you eat the right food which is basically a high Prebiotic diet you will activate the glp1 and you will naturally feel full and the result of this is that in the process of actually activating your normal satiety signals you will consume less calories satiety signals are basically hunger signals hunger signals so basically yeah so the issue that we all have is that we eat an ultr processed diet an ultra Ultra processed diet number one makes us ravenous right like We Can't Stop we want it so bad number two it doesn't activate those fullness signals and so the result is when we eat an ultra processed diet we overeat and then you feel like trash you feel like trash for
58:41 a couple of hours and that is the result of you overeating you've thrown yourself metabolically out of balance right don't we all love the meal that tastes great but you eat until you're full and you stop and actually feel energized and don't need to take a nap or drink an energy drink to compensate for what you just did and that happens when we do this the the oldfashioned way by oldfashioned I mean like prior to modern history when ultra-processed Foods came into uh existence if we go back to the old way of eating you would simply eat until you activate these hormones things like glp1 which you know is concentrated in this drug or peptide YY these are gut hormones that basically tell our body when to stop eating everyone's going
59:26 crazy about a zmek I keep hearing about this drug I think Elon Musk recently said he had had it and I know a few other people that have um started taking a Zac there I would say you know then none of them are overweight necessarily yeah um but they're doing it because it's now been framed as kind of super drug yeah which can help you drop weight super quickly by making you feel satiated yeah what do you think of his MC well I come back to this so first of all let me say that for people who need it it's I'm glad it's there um I don't think that the entire world needs OIC in order to be healthy is there any side effects or 100% 100% first of all digestive symptoms um massive uh massively common digestive symptoms but there's also long-term risks and many of which we
1:00:12 don't simply know much about because people haven't been using the drug long enough for us to really fully understand what happens if you use because once you start using it you're not going to stop if you stop you gain all the weight back so once you start using it you're basically committing to however old you are you're going to be doing this for years on years if you know decades um we don't know what happens after a couple of years isn't it kind of skipping a step in the process of developing the gut microbiome taking a zek yeah I think that's the point is that if we so you know if we look at our countries the US and the UK um there's a major fiber deficiency and I don't think you know I realize I'm out there pounding the drum on this but I don't think this is talked about enough perhaps because people don't think that fiber is sexy but I think fiber is sexy because
1:01:00 it's so crucial and important to our to our health and this is an example where this is 100% true so uh 95% of Americans are deficient in fiber the average woman is getting 15 grams of fiber per day she's supposed to be getting at least 25 in the US the average man is getting 18 grams of fiber per day he's supposed to be getting 38 that's a massive massive deficiency and the issue is that the fiber is what actually empowers the gut microbes by the way through short chain fatty acids the fiber is what empowers the gut microbes through short chain fatty acids to release these gut hormones like gop1 and peptide y y so my thing is this because again like our health is not determined exclusively by our weight balance there are other things other than that why don't we cons
1:01:47 try consuming these Foods the average American is 10% of their calories from Plants fiber containing food what if we could make that 30% or 50% I think that we would see a massive difference there was a study that was done it's one of my favorite studies of all time by uh uh professor in New Zealand his name is Andrew Reynolds and he compiled all the available data on fiber what happens when people consume more fiber here's what happens they lose weight uh they are less likely to have a heart attack they're less likely to die of heart disease they're less likely to have a stroke they're less likely to be diagnosed with diabetes they're less likely to be diagnosed with multiple different types
1:02:32 of cancer they're less likely to die of cancer um their blood pressure goes down their blood sugar control improves their cholesterol goes down okay like that's sitting there for us available all we have to do is make the dietary changes and again what happens in that process is you consume more fiber it comes in the contact with your gut microbes they release short chain fatty acids and they have healing effects throughout your entire body so to me I agree with you I think that we're missing this um this middle piece and when we're reaching for something that's an expensive drug it's very expensive we're reaching for something that's an expensive drug and it has a very real risk of side effects and it also has risk in the sense that we just don't know what happens after you take it for a couple of years um I I
1:03:19 don't understand why we would do that when think of the benefits that I just listed by simply increasing your fiber intake I have so many conversations with my friends about various drugs that they're taking performance drugs mfil
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