The Microbiome Doctor: Doctors Were Wrong! The 3 Foods You Should Eat For Perfect Gut Health!

30:24So the first point of the eight was being mindful about what you eat. second was eat 30 different plants and that's that was the basis of our our zoe product the daily 30 which has 34 mainly freeze-dried whole plants in it and we've recently added some more so we added some seaweed some algae and some kombucha in there so they're rare ingredients we've got seven different types of mushroom that you wouldn't normally have it's worth me saying that I'm an investor in Zoe. And let me take a look. So you just, you take this out and you sprinkle it on top of your food typically. Yes, you add it to food.

31:07And it's, so it's different to most of the other sort of supplements you might see. It's not instead of food. It looks more like food than most of the common supplements out there that look like green powders. We did a big trial of this with about 340 people, comparing it to a probiotic and a dummy one. And over six weeks, you get really quite dramatic improvements in your gut microbes with eating this. So you really push up the good bugs and squash out the bad bugs about several times more than you would get just by having a traditional probiotic. So this fertiliser approach does seem to work.

31:56And this is the study where we also showed the improvements in mood after a few days, which surprised me because I wasn't even thinking about that when we planned the study. So the key reported findings in that study were a gut microbiome improvement, an average increase of five points in their zoe gut microbiome score, digestive system 70 percent of people reported improvements in overall digestive systems symptoms um and it increased fullness by 41.5 percent satisfaction by 21.6 percent and energy by 43.3 percent and reduced hunger and desire to eat versus the meal alone about half reported increased energy and 45 percent reported improved happiness in the main study So we weren't expecting that.

32:50That was my point, really, on these. Because we thought it would just be gut. It was like, okay, do I get to the toilet more often? Is it improving my gut microbes? And so it was a real bonus to see these brain effects. And did you do stool tests on those people to see the change in the bugs in their stomach over that period? Was it six weeks? It was around six weeks, yes. Yeah. And what did you see change in their gut bugs? So we've got a new scoring method for gut bugs, which we published last month in Nature. And so we used to talk about diversity. And on previous podcasts, I think we've talked about diversity, which is the number of different species.

33:32But we've got a better way of looking at that now, which is to take 100 most important bugs that change with diet that everybody's got, because we're all different. It's very hard to compare your bugs with my bugs, because we're in share 20%. So this looks at 100 common bugs that we've both got, 50 good and 50 bad. And what we want in an intervention is to see the good bugs that are associated with good diet and good health outcomes, good blood tests are going up, and the bad bugs associated with inflammation, poor diets, and bad health outcomes are going down. And that's exactly what we saw. we saw a change in roughly 40 of these microbes with the prebiotic the daily 30 whereas with the probiotic which we know works from other studies we saw only a change in about four or five of the bugs okay so was it so they both worked but the the prebiotic was working better than the probiotic which has sort of changed my mind about what's more powerful so prebiotic being what and probiotic being what?

34:41Prebiotic is like a fertilizer for gut microbes. It's giving them food. Yeah. So in an indiscriminate way, because we're giving a wide variety of foods. In these 34 plants, each of them has hundreds of chemicals. So there's thousands of different things for them to feed on. Whereas a probiotic, we used lactobacillus rhamnosus, which is a well-known one that's been studied in hundreds of trials. It's a live microbe that lives generally in foods like yogurt and things like this. In a concentrated form, in a capsule, you give that and it improved the gut microbiota much less than the... So prebiotic gives them food, probiotic actually just puts bugs in there?

35:27It puts bugs in there. And we used to think it was like a seed. So fertilizers and maybe seeds. But we now know that that bug will never really seed in your gut microbiome. And so the science and our thinking has changed. We think the probiotic is really tickling your immune system as it's going down. Okay. So it's probably working higher up in the small intestine, which is further up in the gut. Where is the gut? Yeah, so most people, if you ask people to point to the gut, they always think of their stomach. Yeah. That's not your stomach, you see. They're the intestines. So your stomach is up here.

36:14It would take away your liver. If you imagine we've got a body here, a mouth, food goes in there through the esophagus, which is a tube that leads to the stomach. and this is the stomach here which is highly acidic and that leads into the duodenum through a little valve and that is where food starts getting mushed around into little balls and it goes into the small intestine here which is badly named because the small intestine is really the largest bit of the gut and it's endless coils of guts. There are lots of crypts. There's little nooks and crannies everywhere. And so the surface area is really huge.

37:03It's several tennis courts if you laid it out, just one in one human. And that's because that's where most of the nutrients get absorbed. They get extracted from the food and absorbed that way so that all the trace elements and things we're recycling. We're like a recycling factory. And then from the small intestine, it then goes into the large intestine, which is also called the colon. And that's where most of the gut microbes are. So 99 % of the gut microbes are in that final part, the large intestine, which is a couple of meters long and varies widely between people. and this is the spot where fiber goes, things that hasn't been digested in the early part of the gut and that's because the microbes mainly feed off fiber.

38:02And so that's where they do the good. They convert that fiber into products such as short-chain fatty acids which are the really beneficial chemicals that are good for our immune system. And it's important to realize that across both the small and the large intestine, you've got huge amounts of nerves. You've got what's called the enteric nervous system, which is our second brain. And it was actually the first brain to be formed. So when we were little embryos, we started as a little tube. And the nervous system that formed around our intestine was actually the first brain of our body. And in a way, we devote the second one on our head as a bit of an afterthought, which is quite a fun way of thinking about it.

38:50But it just shows how important the nerves are in our gut to the way we function. And as we were talking earlier about this connection between the two. And there's also immune cells. So 70 % of our immune cells are in the gut, most of them in the large intestine, but also in the small intestine. So our immune system is here and a huge amount of our nervous system is here. Why? Presumably the bugs are all through the body. They're everywhere. So they're also in your, yes, I should point out we're covered in bugs. So every bit of the human body has some bugs in it. The second biggest place where we have them is in our mouth.

39:32So the oral microbiome in our saliva and in our teeth and our gums. And that's why poor hygiene, if you're not flossing properly, you're double the risk of getting dementia as well, interestingly. There's a real link between microbes here that if they're eating plaque and other stuff that you're leaving around in your gums, gets inflamed. That creates an environment where nasty microbes that love inflammation live. And for reasons we don't know, they seem to pass from your mouth into your brain and trigger inflammation in the brain, which then increase your risk of dementia. If you're not flossing.

40:17Yes, this is really new science showing that just how important these getting the right bugs in the right place and avoiding the ones who are in the wrong place really is. Why do we need these bugs? Why didn't evolution design us so that we could just do all this stuff without the need of these little workers, these little bugs in our bodies? It seems super weird to me that, you know, you think of the human body as being this one organism, but actually it appears to be many millions and millions and millions of organisms. Well, you've got a sort of human-centric view of the world, Steve. True.

40:51We evolve from microbes. We are one. We used to be one. We used to be one. And it turns out that most of our bodies are remnants of microbes. Microbes obviously fuse to cause human cells. So that was the whole origin of how multicellular creatures came together. The single-celled microbes, some of them fused to do that. Others stayed as single cells. There was always this link between the single-celled guys and their multicellular ancestors, if you like. And so as we co-evolved into more complicated beings, the two were always together. And it turned out that, again, as we're formed as embryos, the gut is the first thing that this tube is the first thing that comes out of the design system.

41:53And it's designed to have microbes in it that serve a crucial purpose in training our immune system to recognize what's out, what's harmful, what's beneficial. And it's also shown to be crucial for our brain development. But it is fascinating when we start thinking about our origins and think of it that, you know, we essentially start as microbes because also we don't think of our body, you know, we've always historically thought of, you know, God's creation, this body had nothing to do with anything else. We were the masters of the universe. And I think it's quite humbling to realize that so much of us comes from microbes.

42:32And I learned something recently that also blew me away is that all our cells have these powerhouses in them called mitochondria. And it turns out they do much more than just supply batteries for the cell. They're fighting inflammation. They're important for gene expression. They're good for metabolism. And it turns out the origin of these things is little microbes that got trapped in our bodies. They are essentially microbes that were good at making, creating energy. and at some point in our distant past we fused our multicellular microbes that were going around doing stuff. They said all we could do was some more energy and so by chance they fused with these energy microbes and slowly and slowly became incorporated into our bodies so that we now have these mitochondria all over our bodies whose ancestors are also microbes.

43:37And we have them in every cell of our body. Yes, we do. And they're turning out to be quite crucial as well in brain health. Do you spend much time wondering, or have there been periods in your life where you've wondered about the meaning of all of this and why there's living organisms? Because there doesn't appear to be a great need for living organisms. You know, you could just have rocks and water on these planets. I don't know why you need humans necessarily as it relates to the contribution we make to the environment. Well, I think as soon as you add life, whether it was plant life, I mean, you're thinking perhaps of animal life.

44:18But, you know, things like lichen on rocks were one of the first forms of life. and something that needed to get energy, nutrients from the rock, and then they, for some reason, just wanted to survive. And I think that's the point, that life is about getting enough nutrients so you can keep living or pass your genes on to someone else. It's that concept. Once that was started, maybe it was lichen, Everything else came from that. And that could have just been a chance event. So, but I, you know, it is always humbling, humbling to think that, you know, we've probably come back from some lowly point like this as we emerge from rocks and water.

45:14But, yeah, philosophy is not my strong suit, but I just get so much pleasure from finding new facts that are all around us. And I think it's fascinating that we've spent so long as humans looking up at the stars, whereas looking inside us at things like microbes and their origin is, to me, far more exciting. And maybe explanatory as to, like, you know, we're looking at the stars inside France. Yeah, we look at the stars, so where do we come from? You know, what about the Big Bang, all this kind of stuff? Whereas actually studying what's in ourselves and where do they come from, we could learn a hell of a lot more about ourselves.

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47:37And so I signed up for both of those offers and I'm now an investor. and a huge partner in a company called Whisperflow. You have to check it out. Whisperflow is four times faster than typing. So if you want to give it a try, head over to whisperflow.ai slash doac to get started for free. And you can find that link to Whisperflow in the description below. So that was the second point of the eight, which is eat 30 plants. And so a daily 30 is an easy way to do that and a tasty way to do that. What's the third one? I go for eat fermented foods and try and get three portions of ferments in your diet every day.

48:17Every day. And I wouldn't have said this three years ago because the science wasn't really strong enough to support this. But a study three years ago by a group in Stanford of 28 people showed they gave them five portions a day for about a month and showed that you can get a reduction in blood inflammation levels about 25 % in that time compared to a fiber diet. and that blew me away because this was the first really good study in this therapy because there have been lots of studies but they're not good quality. Suddenly someone doing daily bloods, they looked at 20-odd proteins in the blood and suddenly you've got this link between a food and directly affecting inflammation in the blood which, as we've been talking about, has big knock-on effects on the brain and the rest of the body.

49:18That's like kimchi and stuff like that. Fermented food is any food that's been transformed by microbes into something better, which means it tastes better, it's more complex, it lasts longer, so you don't need a fridge. That's why our ancestors did it. And it's been chemically transformed and is generally more nutritious. Give me some examples. So, yoghurt from milk. All you're doing is adding... Zero fat. Zero fat Greek yoghurt. Oh, I never have zero fat Greek yoghurt. Why do you want to drink that? I don't know. I was just... No. No? That means it'd be heavily processed. You don't want that.

49:59But there's still good microbes in it. And, you know, all you're doing is transforming something rather average like milk, which adults don't really need. It's not particularly beneficial milk. And just by adding the microbes to it, you make it something healthy for the body. And that's now been shown by these kind of studies. What do you mean by what's wrong with this zero fat Greek yogurt? It says zero fat, so that sounds like it's... Well, we need fats to live. So fat is good. And in fact, just a few days ago, the USDA have changed all their guidelines, which used to be about saying don't have fat and have low-fat products, to saying actually fat is good.

50:46All that advice we said in the past is wrong. So why do they label things zero fat still? Because public still believe they're healthy. And the companies that make them save money by having zero fat. They replace the fat with starchy, artificially made fillers, basically. So it's usually more sugary by having zero fat in it. But if it says zero fat, it's a sign it's unhealthy. You should avoid it. So what are those fermented foods then? You were going to say you said... Well, shall I just give you a quick list of all of them so people know what I'm talking about? So we've got yogurt. We've got cheese.

51:25And virtually every cheese has live microbes except American cheeses. The more artisan, the bigger the number. Milk kefir, which is like a super yogurt, often has 10 to 20 types of microbe in it. The krauts. So I think of the 4Ks. So we've done kefir. The kraut is like a sauerkraut. So we've got fermented cabbage. Cabbage is pretty boring on its own. You ferment it, the tastes are amazing. And it has these health benefits. Then you've got kimchi, which is a spicy kraut and the staple diet of Korea, and they're pretty healthy. And even if it's got salt in it, people who have kimchi have lower blood pressure than people who don't have kimchi.

52:11And I love kimchi. Now, I hated it at first, but I'm now a real addict. Then you've got kombuchas. You see those in most supermarkets and stores. That's fermented tea. And the good ones can have 30 or 40 of these. There's another type, water kefir, which isn't as popular, but I think we're going to see more of it. Tibicos is the other name for it. It's grains with lots of microbes in it, a bit like milk kefir, but with fruit added. And then you've got all the misos you get in Japan, miso soup, miso paste, tempehs, all these ferments. around the world there's hundreds of different ferments in nearly every continent has their own type of ferment.

53:00In Africa there's all kinds of fermented beers and porridges and of course we've got these are the live ones but they've also got lots of dead ferments. Obviously bread is a dead ferment. Everyone makes sourdough. Then you've got wines and beers. And interestingly, again, very new science, dead ferments actually have some health benefits. So I used to be very dismissive of products like kombuchas that you would see in stores in America that say lightly pasteurized. And I'd say, well, that's a load of rubbish, be nothing good about that. But it turns out that even dead microbes, when you do a randomized trial, have some benefit for the host.

53:47You're looking a bit sceptical. But these against placebo studies, and there are enough of them now that you definitely believe it. I know some of the researchers, they were surprised, but it's genuine. Why is that? What's going on? We think, again, if you go back to the vaccine discussion we were having, it looks like, although it's not alive, the microbe still has a cell wall and it has proteins in the cell wall. So it's like the debris of these dead bodies that you're ingesting. We think they're tickling your immune cells as they go through the small intestine. Okay. And it's giving a signal to your immune system to calm down, reduce inflammation.

54:37That's our best understanding of what this phenomenon is about. So live microbes are best, but it looks like dead microbes, which are called postbiotics or zombie biotics, are probably also good for you. So I think all fermented foods, even those that I would have dismissed three years ago, are probably good for us. And that's really the best way to reduce your inflammation levels. We did a big study in Zoe of, we asked 9 ,000 people who were Zoe members who weren't taking ferments to try and see how they get on taking three ferments a day, how do they feel. I think about 3 ,000 dropped out, didn't fancy it, but nearly 6 ,000 continued and did the two weeks taking it after a one week run in period.

55:35and around half of them noticed improvements in mood, energy and had less hunger. So anyone out there who hasn't tried this, I think it's a great simple way to see what you can improve just by changing what you're eating and going for some of these ferments that you might not have thought about. What's number four? Number four is pivot your protein. At the moment, proteins, all in the news. Everyone wants to have more protein. Big controversy about whether you need more. Most studies showed 90 % of us are getting enough protein. It probably doesn't do too much harm other than it's really hard to get lots of protein in your diet.

56:17And most people are focusing on eggs and meat when they think about protein. So what I think people should focus on is there are many other sources of good quality protein, like beans, like legumes, like mushrooms, like whole grains, like quinoa and pearl barley instead of rice. That if you're thinking about it, you can get your protein and get your fiber because 90 % of us are deficient in fiber. And if you want to look after your gut microbes, you really need to be giving them the fiber. Otherwise, you're starving them just by having a protein drink. Next one, which one are we now? Number five.

56:55Number five is think quality, not calories. The whole idea of assessing food by calories is wrong. We've discussed this in the past. You should never really go for low calorie products. You should go for ones that are whole foods, that have their initial structure in them, that have all those original nutrients. So it's all focusing really on high quality foods that haven't been tampered with. Why not calories? Because it's not a good way to assess food. Calorie-restricted diets have been shown for the vast majority of people not to work. And we know, particularly through GLP-1 drugs, that as you restrict your diet and calories, your hunger signals go up.

57:47And hunger is the main driver of obesity. so all you're doing is losing some weight short term long term it will bounce back as your as your body does that so calories should be ignored on any labels really you should be looking to get high quality food that supports your gut and that's an important change in mindset for many people but the next point is is the crucial one which links to that which is avoiding high risk processed foods. because they damage your gut and your body in a number of ways. The first obvious one is that they have lots of additives and chemicals to transform them into something edible.

58:34And those ones, things like emulsifiers, preservatives, gums, colourants, flavourings, artificial sweeteners, are all things made by the food companies to trick your body into thinking these are tasty, and they often are. but they will damage your gut microbes who in their billions of years of evolution have never come across these products because they don't exist in nature in that form so like the cereal bar i have here yes so this has got flavored fillings whatever that means glucose syrup glycerin, wheat, fruit juice concentrate, vegetable fibre, natural flavourings, oatmeal and soya. Well, this one doesn't look too bad.

59:32I'm not quite sure what a flavoured filling is, though. Flavoured filling. What about this? Was that cornflakes or something? Cornflakes, yes. So they would be something I would regard as highly processed and probably a moderate risk. At Zoe, we've created a new scale because in the past, we'd have grouped all of these together as the same. But I think we now need to think of these as zero, mild, moderate, high risk, depending on whether they have them. What about this? That would be high risk, okay? Because this is designed by the people that make them. It's got preservatives in it. So this will be the same in a week's time, right?

1:00:16We can still be playing with it. It's not going to change or get moldy. It's got emulsifiers to keep it together. It's got extra sugar in it. It'll have a really amount of salt in there probably and sugar and I've got some fat in here. So it'll be hyperpalatable. What does that mean? That means that you can eat a lot of it before you get full. So it makes you overeat. For anyone that can't say we're talking about white bread, just normal white bread that you'd probably get in the supermarket. Yeah, and it's got a special structure that's different that also means that it takes very little chewing.

1:00:58So you put this in your mouth, you don't really have to chew it. It's like baby food. Whereas a real bread made with high fibre, it takes several chews to get it down to you. So there's lots of features of these foods that alert you to them being unhealthy. So not only the ingredients which are bad for your gut microbes and disrupt them, the additives, you've got the fact that it makes you overeat. So a lot of those potato snacks and things you get, they just dissolve in your mouth. They're designed, you can eat them so fast. Is there a good bread or a preferable bread? Yeah, there are. There's not many.

1:01:40Things like rye breads and spelt breads, ideally sourdoughs, the German-style breads, the Scandinavian breads, they're pretty good for you because they still have the whole grain intact. And that means it's got the nutrients. It also means it's harder to eat them quickly. And they fill you up. If you eat this bread, it just makes you hungrier. I used to have this all the time when I was a junior doctor. every ward had toasters and cheap bread courtesy of the NHS. And you eat them, they give you a little kick, but you just feel just as hungry an hour later having eaten, you know, four of them. And I think this is the problem many people don't realise, that this food is not only making them sick, making their gut microbes sick, but it's actually making them overeat.

1:02:31And studies show it makes you overeat by about 25%, which really adds up every day of your life. A lot of people, including me, have gone through their life thinking that because when they eat this stuff, they get stomach pains and sometimes they have gas or they'll have like, I don't know, toilet-related issues, that they are gluten-free. Like they are gluten intolerant or whatever. I was one of those people. I thought, because if I eat this, if I was to eat this piece of bread, I'd feel it for the next two days. So I assumed I was gluten-free. But when I think we spoke last time, you told me that almost nobody is gluten intolerant, has a gluten.

1:03:11What's the term? Gluten intolerance? Gluten intolerant. Yeah. But that's not necessarily. When you test them, yes, directly. I mean, there are some, but most people who think they are are not. and that's because generally when you eat a sandwich in the US or the UK you're getting crap bread, a terrible filling, all kinds of other additives and chemicals which are probably disagreeing with you. So when you give up eating sandwiches you might feel better. So roughly up to 30 % of people believe gluten is a problem for them but only 1 % actually need to strictly avoid it? I think it's a great example of we love to have a simple solution.

1:04:01So gluten came in, said, right, everyone can think about gluten. Let's just get rid of that and all our problems are solved. Rather than thinking, what are all the other things in a cheap bread sandwich that you might be reacting to? It also could be the emulsifier that is gluing that bread together or is in the mayonnaise that you're having. It could be some of these colorants that are making the bread white or making that sauce bright yellow that you might be intolerant of. The more things that these manufacturers add to these foods, the more likely there is one that is disagreeing with you and your favorite sandwich suddenly becomes your worst enemy because, you know, they're just created by brilliant scientists to all they care about is you find it irresistible and keep eating it.

1:04:58If you eat the healthy stuff, you don't have these problems. What about these almonds? Some walnuts in there as well. What do you think of almonds? I love almonds. They're good for you. Lots of studies showing they're good for your cognition, even some mild effects on other aspects of brain health and mood. These are good for gut health. They've got all kinds of really good fats in them. These omega-3s and et cetera are in nuts. So they're a fantastic snack that do fill you up and generally recommend them. Probably more data about walnuts than almonds for brain health that I've read about. So there are studies that people take a lot of walnuts, they help.

1:05:45But I I think the idea shouldn't be there's only one type of nut that you should eat that's going to help your brain. We should, again, go back to this concept of diversity. And so mixed nuts really are your best way of helping your brain health by eating these things. And we used to demonize nuts because they had fat in it. Certainly when I was, you know, 20 years ago, you can't have peanuts and nuts. They're really bad for your heart. Now we've totally reversed this. And I just think it just shows how much has changed in this field in a relatively short time. What's number seven? So number six was avoid high risk processed foods.

1:06:26Important when you're picking food to try and get as many colours on your plate as possible, because that's a sign that they contain these chemicals called polyphenols. Natural colours. Yes, exactly. Not the blue colours you get that you really want to avoid, which are bad for you. So natural colours are a sign that these foods are good for you. So we're talking bright berries. We're talking raspberries, blackberries, strawberries. We're talking rosololo lettuce. We're talking about cabbages that are purple. We're talking really all those bright colours because they contain chemicals that are from this family, broadly called the polyphenols, which act as fuel for your gut microbes.

1:07:18and that allows them to then in turn produce things like short-chain fatty acids and keeps them healthy. So it's a sign from nature that we're eating these foods and it's a signal that our ancestors knew. And the other sign, which we can't tell from looking at it, but we get to know, is bitterness. So bitter plants tend to be much healthier than bland ones. That's the broccoli story. That's why extra virgin olive oil is so good for us, why coffee is also good, why red wine and dark chocolate. It's those polyphenols in there that are really giving us our microbes a boost. And the eighth one, last but not least?

1:08:11Last but not least, give your gut a rest. Fast? Yes, so time-restricted eating. And this has been shown to help your gut recover in a proper circadian rhythm. It's a bit like getting a good night's sleep for your gut. So we all know the benefits of sleep for us, but we often disregard our gut. Many people have a late night snack, a kebab going home from the pub or whatever it is. It's completely the wrong thing to do for your gut health. 12 to 14 hour overnight fast, trying to restrict your eating time to 10 hours, really has been shown to have metabolic advantages for you and improves your gut lining.

1:08:59So it's less likely to leak and cause inflammation and allows the cleaning team in your microbes to come out and clean up your gut. The number of studies now showing that it does have these metabolic advantages, but I'm not pushing it so hard these days because we did do another massive citizen science study with Zoe with over 100 ,000 people doing this. We asked them to do 14-hour time-restricted eating. A third gave up. They said, I can't do this. I feel too hungry all the time. I need to be snacking something like almonds. a third loved it and they're still doing it two years later and a third was sort of yeah i'll do this sometimes i feel better on it so i think there's a personalized element to it but if you can do it it is really important and i would urge even the people that find it tough if you can avoid that unhealthy late night snack that can have a really big impact on your gut and your brain you know every once in a while you come across a product that has such a huge impact on your life that you'd probably describe as a game changer.

1:10:10And I would say for about 35 to 40 % of my team, they would currently describe this product that I have in front of me called Ketone IQ, which you can get at ketone.com as a game changer. But the reason I became a co-owner of this company and the reason why they now are a sponsor of this podcast is because one day when I came to work, there was a box of this stuff sat on my desk. I had no idea what it was. Lily and my team says that this company have been in touch. So I went upstairs, tried it, and quite frankly, the rest is history. In terms of my focus, my energy levels, how I feel, how I work, how productive I am, game changer.

1:10:47So if you want to give it a try, visit ketone.com slash Stephen for 30 % off. You'll also get a free gift with your second shipment. And now you can find Ketone IQ at Target stores across the United States, where your first shot is completely free of charge. If there's anything we need, it is connection, especially in the world we're living in today. And that is exactly why we created these conversation cards. Because on this show, when I sit here with my guests and have those deep, intimate conversations, this remarkable thing happens time and time again. We feel deeply connected to each other.

1:11:20At the end of every episode, the guest I'm interviewing leaves a question for the next guest, and we've turned them into these conversation cards. And we've added these twist cards to make your conversations even more interesting. And there are so many more twists along the way with the conversation cards. This is the brand new edition. And for the first time ever, I've added to the pack this gold card, which is an exclusive question from me. But I'm only putting the gold cards in the first run of conversation cards. So get yours now before the limited edition gold cards are all gone. Head to the link in the description below.

1:11:53You've become more open to keto in recent years. Yes. I would say I'm keto curious you're keto curious what's made you keto curious because I don't think you I don't think you were very keen on keto before no I think when we discussed it I was pretty anti it you know but reading about the brain how important metabolism of the brain brain energy is and doing more research has slightly changed my mind because what we discovered how amazing it is for childhood epilepsy. It is still used as the main treatment for drug-resistant childhood epilepsy. The keto diet. The keto diet. So for people who don't know, what we're talking about here is you're changing the energy supply of the brain from glucose to ketone bodies, which is a switch that we've always had in evolutionary terms when we couldn't get food.

1:12:58So after about two days of not having food, we used up our glucose reserves, we used it up from our muscles, and you switch to this other form of energy. And it's a survival mechanism. But what it tends to do is reset the brain. And so in epilepsy, that's what they think. It's a bit of a, like rebooting your computer. Epilepsy is rather strange because, and it used to be thought of as a mental illness, as I said, because you can get hallucinations, delusions, it's associated with depression. All the same, you can have all the same symptoms you get in all mental illnesses, interestingly. And it can be cured by keto.

1:13:46So that made me curious as to what else is going on. So in theory, some of the other mental health issues could be improved by keto. At the moment, there isn't sufficient good evidence. There's lots of anecdotal stories, studies of seven patients, open label, not convincing enough for me to say, let's do it. But I think definitely worth doing some real studies, but also suggesting that even if you don't go as far as keto just by improving the metabolism and what how the brain is getting its energy could be really important i think um the interesting thing about the ketogenic diet um as someone that kind of cycles in and out of it i actually i showed you earlier i have this ketone monitor on my arm which is monitoring my uh ketone levels at all times and connected to my phone um i think the interesting thing is in uh in the world we live in where there's a lot of food noise as they call it.

1:14:45Everywhere you go there's temptation to eat something bad. You're going down the high street there's takeaways and junk food stores and stuff like that. What I think keto does which you're probably never going to see in a study I don't know if you would is it helps the craving it like dampens the food noise. So this is part of why I think cycling in and out of it it's quite useful for me because it means I have several moments in the year where my cravings for like this junk food, some of which we have on this table, just appear to vanish for a while, even if it's just for a week or two weeks or three weeks or four weeks.

1:15:21And that allows me to kind of reset and kind of take back control of the steering wheel. Whereas it's very easy, especially in modern life when you're working really hard or you're traveling, you've got sleep disruption to get into that exact spiral we talked about where you get like cravings for sugar and then you eat sugar so you feel a bit more tired and you lay down a bit more and then you're not you miss the gym and then you kind of you have the same like downward spiral um keto continually snaps me out of the probability the chance of that how long for that probably the longest i've done it is maybe six weeks or eight weeks but even get even doing it for let's say one week for me will then mean the preceding four, eight weeks are much healthier in every regard.

1:16:10So even when I come off it, I'm much healthier. You know what I'm saying? That's what's interested me, because I think being on a long-term keto diet is never going to work, right? It's just too brutal, and it's incompatible with keeping your gut happy. So to me, that's, I mean, very few people can tolerate anyway. As you know, it's tough. If we can come up with a regime that every three or every six months, you had a few days of going into keto, just enough to reset your body and your brain. And at the same time, you protected your gut, say, by taking daily 30 or other things that weren't going to get you out of keto, but could keep your gut in the right place.

1:16:58Then I think we could potentially have something of practical use for brain health issues. And I'd love to do more. I'm planning at some point later in this year to test myself, see if I can do a week of keto whilst keeping my gut microbes happy. Have you ever done keto? Not properly, no. If you've done a 24-hour fast for a colonoscopy, you are just about getting into keto at the time you're doing it but you're not you've got other things to worry about about going to the toilet to distract you i think this is really it because we talked about how holistic the whole picture of the body is and how it's so interconnected and how the brain is so connected to the gut and all these things and there's something about doing the ketogenic diet which just it feels like i get control back in a way that then has this bigger holistic effect on my life, my ability of everything in my life, like my ability to articulate myself as a podcaster.

1:18:01I heard actually Jorogan say the same thing. I heard him say that words to the effect of the fact that when he's in ketosis, it's so profound, his ability to articulate himself and think as someone that does four-hour podcasts that he would almost stay in it forever just for that particular cognitive benefit of like mental clarity. And I always say to my team that when I'm in the kitchen, don't diet, I feel like I'm looking at the world like this, like everything's high definition. And my mouth and brain are like, I always say my mouth and brain are connected suddenly. Yeah, well, I've had other people say this, that they do get this sort of clarity, which could be a more exaggerated way of fitting that benefit of a long overnight fast.

1:18:38when you come in after 14 hours without eating and you're doing a podcast like this, yeah, I definitely do feel better than if I'd had a big English breakfast just before. But I think the danger is that, you know, if people disregard their gut microbiome and do this, any advantage would be wiped out so quickly by the problems of what's happening to your immune cells and everything else in your body. So if we can find this intermittent middle way while you can still look after your gut, then I agree that would be cool. But I couldn't find any good data on this apart from anecdotes of, you know, fanatics who will obviously say it's great for their patients but without any control group because it must be a big placebo effect as well.

1:19:31It's very hard to not have a placebo effect when you're doing that, when you're struggling so hard to do things. As I say, people get keto headaches and as you go into it, people say it can be quite rough. So you can't double blind yourself. But I think it is fascinating that in the same way that reversing type 2 diabetes improves your mental health, it makes sense that if you're switching energy levels in the brain, you could also do things. And let's not forget things like ECT, still an effective treatment, that's a brain reset. Sometimes, you know, we may end up going back to the old era of psychiatry, where, you know, before we got into this obsession with neurochemicals, to have this holistic view, which I think is really fascinating.

1:20:23And when you did that brain scan, you found that you're in the highest 20 % for levels of environmental microplastics in your blood. Yeah, that was a bit scary. They divide the microplastics into two groups, depending on the dimensions of them. I was concerned, was I eating a lot of microplastics? It turned out that the higher levels I had were actually the smaller ones that you get through your lungs, which probably means a life having lived a life in London you know six decades in London probably wasn't very good for getting all this dust and and and things in there that was a bit of a worry that's probably because I cycle around London a lot in the last 30 years have you changed anything in that regard I still cycle I don't like wearing a mask I know I sort of probably should and I've put a new water filter in my home to take out some of these chemicals and at least some of those plastics.

1:21:28I'm still not totally convinced on how bad they are and the science, I don't think really we've resolved that issue yet. But it's something I'm looking at closely and I think if there's something easy you can do, I try and avoid plastic containers, I try and avoid plastic bottles and I think that's good for the planet as well. Is there a way to take these microplastics out of our body once they're in there? Anecdotally, they say things like plasmapheresis. You know, you can go to a spa in LA and get your plasma taken out and filtered and put back into your body. This is from your blood. But I don't think there's any real clinical trials that satisfy me that would be worth.

1:22:12and they cost, I think,$10 ,000 a go. So it's not a cheap process to have that done. So wait and see. But at the moment, yeah, it's a worry. But I think there are other things in the environment that are probably worse. You know, dust, pesticides. Is it better to have organic food rather than worry about plastics? We don't know the answer to these problems. How is your views on GLP-1s like Zempec and Wagovia, whatever it's called, these injections and I think now tablets people are taking for weight loss, how is your views on those evolved? Are they good, bad and different? They're going to be a part of our life anyway.

1:22:55So they're going to transform medicine and obesity in a way we can't imagine at the moment, especially now this year that the pills are available. And it's coming off patent in many countries. so it'd be much cheaper. I think for people who really need them, they're an incredible drug. The only problem is you can't really come off them, so they're pretty much for life. My first worry is that a lot of people take them without supervision and they are not told to change their diet. I'd love people to go take the drugs, their hunger signal gets switched off, They can then be mindful about their food.

1:23:40They could do something like, you know, have the Zoe app or some other educational program to change their food habits forever in that window of opportunity. And that, I think, is where we should be doing. And that's been completely ignored at the moment. Virtually nobody's getting that lifestyle advice as well as the drug. And so they're failing, they're going back in it, they're, you know, yo-yoing, and they're getting the worst of the world. The other slight worry we need to keep an eye on is the long-term effects on the brain. So far, the data suggests that it does reduce your chances of getting dementia, even beyond, you know, reversing diabetes.

1:24:29So it looks like it's brain protective, probably because it might have anti-inflammatory effects. It reduces things like gambling and addictions. So we don't really know how it does that, but if it takes away some of those drives, those basic drives to say, I like to take risks, I like to take drugs, I like to smoke, I like to gamble on horses, is it in some way changing you as a person long term in that you might be less good as an entrepreneur, for example? So that is something I think that's really interesting to follow. But in general, I think from a public health perspective, this could save health systems hundreds of billions long term.

1:25:25And we ought to be taking it much more seriously and integrating it into holistic and educational advice. And as it relates to brain health, you also have a sauna routine as part of your brain health regime? Yeah, I've been impressed by some of the science coming out of this and the fact that I quite enjoy it, just actually enjoy it from a hedonistic point of view. So I try and have a sauna twice a week if I can do that, ideally with a cold plunge afterwards but the science isn't sure whether that makes a big difference it's like just a workout for your your blood vessels in your body and your brain so um i think that the science is quite compelling and yeah it makes me feel good which um it's always should be part of anyone's health routine something you enjoy doing is always easy and And regular socialising is part of your brain routine.

1:26:23Yeah. If you look at the happiest long-lived populations on the planet, they've all got really good social lives. They are always dining with friends, going out. Often that does involve a little bit of alcohol in most of these societies, but that doesn't seem to adversely affect them. The idea of having a key group of core friends you see regularly, I think is really good for your mental and brain health. And loneliness has got to be one of the worst things for your brain health. So really important to maintain your good friends. What is the most important thing as it relates to brain health or overall health that we haven't talked about that we should have talked about?

1:27:08I think we haven't talked about early life experiences and stress. What, trauma? Yeah, so one thing, and we haven't talked about talk therapies, and conventional treatments. So if you look at all these brain diseases, virtually all of them, if you go back in time, if you've had emotional, physical, sexual trauma in early life, you're much more likely to have brain diseases later in life. And this is across all of them. Again, coming up with the idea that they're all related in some way. And so we've moved on from the Freudian idea that the mind is different from the brain. If you take this holistic idea, how does this fit into this inflammatory metabolic theory of brain health?

1:28:06I think it now does because they've done studies showing that following trauma or stress, you can trigger your immune system to be permanently raised. So again, you get this consistent stress that the thermostat doesn't go down to baseline. so you have a period of a year a terrible period as a kid they do tests later in life they'll find your inflammation levels and your blood are raised from people who had a nice gentle quiet childhood and I think this is starts to link all these different components together and these cross all these early life traumas you see the same thing in people with chronic pain chronic back pain, fibromyalgia, irritable bowel syndrome, epilepsy, schizophrenia, everything.

1:29:10But it doesn't really matter where the source of the stress was. It's caused some physiological problem. So I think that is really interesting so that we could pick up people who, if we had better tests of that stress and inflammation, we could start to help those people earlier on before the brain started to struggle. And I think that's really interesting. And, of course, we want to do most to reduce the problem in the first place. They've also done studies on talk therapies. So, obviously, psychiatry is compartmentalised into the talk therapists and the drug therapists. and there's quite a lot of evidence that talk therapy does reduce inflammation levels and help your immune system so just in the same way possibly that talking to friends has that effect so talking to your therapist long term will reduce your stress and you can see that in blood markers as well the whole thing is starting to come together that all these different ways of treating it can be working through similar pathways that look so different through the fact that we've got so distracted by Descartes, Freud, treating the brain as something so different to the rest of the body.

1:30:37We have a closing tradition on this podcast where the last guest leaves a question for the next, not knowing who they're leaving it for. And the question left for you is, what are you uncontainably excited about? I'm uncontainably excited about the idea that we can dramatically improve our lives and our health just by making the right food choices. this is really driving me to talk about it so much to do the studies to do the science to spread the word because you know we're seeing all the time the dramatic effects and i was talking about the tv program was doing with these you know these these families that are really suffering it just shows you what you can do if you start treating food like you would treat medicine you you know, taking it really seriously and experimenting with it and noticing those differences.

1:31:42And, you know, I get the feedback all the time because the books and the media, people are telling me how their lives have been transformed. And so that feedback keeps me excited on this topic. And so I've never had that in my career before. And it's super exciting. It's really hard though, isn't it? And this is, I guess, the part we don't talk about much, which is the psychological part of, you know, what some might call discipline. In the world we live in, where you go into like, I don't know, a gas station or a petrol station or whatever you call it in different parts of the world, and the options are very ultra-processed.

1:32:21And you live a stressful life. You're on your phone all day. You're getting your dopamine fried by watching short-form videos back to back to back to back to back. You may be, you know, people are lonelier than ever before. so making the right choices when we're controlled by our neurology and our hormones and how we feel is is often easier said than done so even in the case of that family that you met do you think much about the psychology part of like discipline when it comes to making the right choice and is there any advice there on how to be more disciplined with our food choices or do you just think that knowledge is power in this regard?

1:33:02Well, knowledge is power, but it's not the only thing. You need tricks. We're fighting a food environment. You know, multi-billion dollar industry wants us to eat this crap food. Your gas station, they're being bribed to fill their everything around you with the worst foods. The worse the food, the more they pay the supermarkets to have it in a point where you're going to buy it. So you need to have tricks to counteract that. And not going to a supermarket is often one way to avoid doing that. If my house was filled with crap food, I would probably be snacking in it. I find it really hard to throw stuff away.

1:33:47You know, you go to workplaces and you see people with piles of biscuits and M &Ms there. They should be banned. So there are certain things you say we need to fight back by changing the rules a bit. Just like you wouldn't have, you know, glasses of vodka in an office for people to just have a swig if they fancy it. You shouldn't have candies and sweets and these things in the current environment where, you know, we're fighting a battle. Like, you know, they used to have cigarettes that were free everywhere. You forget. And they changed that environment. So the cigarettes are now really hard to get at.

1:34:26that makes it easier for people to fight the habit. And we often beat ourselves up because we think of ourselves as being weak. Because of this, we think ourselves being like ill-disciplined because we end up reaching for the wrong things. But it is really, really hard. And it's really, really hard. Even, you know, I sit here all day, every day, speaking to people that are experts on these subjects. And you'd think that would mean that I made perfect decisions because I've probably interviewed more people than the average 99.999 % of the population on this subject. but I'm a human with emotions and hormones and life to deal with and and so even I have to regardless of how much I know about this stuff now I still have to like give myself the best possible chance by thinking proactively about my environment my food environment at home and even like in the car and even at the office like I have to think really proactively put systems in place to avoid the possibility that I get really really hungry really really late at night and my only options are shit, for example, you know, which has been a big change.

1:35:25And it's forming habits. And that's the other thing. So it's, yes, you've got knowledge, then you've got these tricks, tricks to avoid often the worst offenders. And then you've got to come up with these new habits that you make that are going to break the old ones. So, you know, rather than reaching for your breakfast cereal in the morning, you've got a different one ready to go and often we've found that if you can change that first meal of the day it becomes a lot easier because that's the one you're mainly in control of and realize when the other risky events are tim you've written many many books i'm going to link them all below this is the the newest one i know you're working on one specifically about the brain but i'm very excited for that one but this is the newest one called ferment um unsurprisingly a number one bestseller yet again um but there's a whole stack of books here the diet myth the science behind what we eat, Spoonfed Why Almost Everything We've Been Told About Food Is Wrong, and this book, which has been extremely successful, The Food for Life Cookbook with 100 Recipes, created by Zoe.

1:36:28I'm going to link all of them below for anyone that wants to check them out. And thank you so much, once again. Been a pleasure, as always. You've kept my audience very, very healthy, and they're very appreciative of that. I remember just the amount of people that come up to all over the world and cite the conversations we've had in the past and how that's been the thing for them that has helped them to change their life. And it's pretty remarkable. It's really remarkable how many people you must have fundamentally caused to create different food and dietary decisions through the work you've done yourself, through the books, through Zoe.

1:37:02And that's a really special thing. So thank you on behalf of all of them. Hopefully we can do millions more. I hope so.

1:37:12if there's anything we need it is connection especially in the world we're living in today and that is exactly why we created these conversation cards because on this show when I sit here with my guests and have those deep intimate conversations this remarkable thing happens time and time again we feel deeply connected to each other at the end of every episode the guest I'm interviewing leaves a question for the next guest and we've turned them into these conversation cards. And we've added these twist cards to make your conversations even more interesting. And there are so many more twists along the way with the conversation cards.

1:37:45This is the brand new edition. And for the first time ever, I've added to the pack this gold card, which is an exclusive question from me, but I'm only putting the gold cards in the first run of conversation cards. So get yours now before the limited edition gold cards are all gone. Head to the link in the description below.

1:38:13Thank you.