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25:50But the other thing is you mentioned that your partner is eating fermented food. That is a lost art. 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 was a fascinating study out of Stanford University. Randomized control trial, the intervention was to add fermented food to the diet. And people that had not been 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 make it into a jungle.

26:29Give me some examples of fermented foods. And what is the fermented part? What does that mean? Well, first of all, we mentioned that 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 fruit bowl, that apple has about 100 million microbes that are a part of it. So they're already there. And those microbes have been a part of that apple's life helping it to grow from a flower to a fruit. Okay, so now these microbes, they are also involved in the life cycle of that apple.

27:11So 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 the cycle of life that's going to turn into dirt. 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 not spoil and they transform it.

27:51So if you were to take a cabbage, you know, you don't need to do anything special to this cabbage. You literally just buy cabbage, perhaps at your farmer's market. Chop it up, put it into a mason jar, pack it in there, and add a sea salt, brine solution, a salt water 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, it's acidic, 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.

28:34So this is what fermentation 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 pre -botics. Pre -botics are the parts of our food that actually feed the microbes inside of us. It's their food, pre -botics. And they are releasing new chemicals that can have beneficial effects on your body, which we call post -biotics.

29:20You find all of this in that one jar of sauerkraut. So that, to me, is a superfood. And it could be sauerkraut, it could be kimchi. 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 deals, some garlic, black peppercorns, and a couple of days later, you will have a pickle.

30:01I want to make sure I'm super clear on those three biotics that you mentioned. So pre -botics are the food for microbes. Pro -botics are the microbes themselves. And then post -biotics are the compounds that the microbes make. Is that roughly accurate? That's roughly accurate. And there's a minor caveat, which is that for these things pre -botic and probiotic, they have to have beneficial effects on humans in order to count. So we can't call it a pre -botic because it has just an effect on microbes. Sugar has an effect on microbes. That's not a pre -botic. Okay. Okay, so, and the same is true for probiotics.

30:45Now the original conception of probiotics that most of us have, it comes from a capsule. And the reason why we can call it that is because we have demonstrated through clinical studies that the specific types of bacteria, or yeasts in some cases, that you find in that capsule, have been proven to be beneficial to humans. So the pre -botic is a food, the probiotic is actually alive. And then the post -biotic 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 post -biotic. So one of the, and these can be things that are completely beneficial and good to us as humans.

31:27An example of this are the short -chain fatty acids. Short -chain fatty acids are the product of consuming fiber or resistance starches. And they come into contact with your microbes. Again, you would not be able to get these if you were sterile. Can I just drink them in a can? Post -biotics. Is there not a can of post -biotics that I can just drink? Well, so they're coming out now with supplements that are these post -biotics in some cases? Okay. And the issue that I have 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.

32:08It's not the same. So let's then talk about what happens with those. I'm assuming that the post -biotics compounds are the things that have 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 post -biotics, and these post -biotics help our body in various ways. Yes. So we mentioned earlier, we were discussing how we have this gut barrier that's key to protecting our immune system. And I mentioned that the microbes are the stewards of that barrier. It's the post -biotics. It's the short -chain fatty acids, butyrate, acetate, appropriate name, that are produced by these bacteria that builds the wall.

32:54When you want to build your wall and protect your body and reduce inflammation, you need more of this. Now, that's not the only thing that they do. Those post -biotics, short -chain fatty acids also directly affect your immune system, directly affect your metabolism, get 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 they can do that. But the point is that this is what really matters because the microbes produce these short -chain fatty acids and these short -chain fatty acids have healing effects throughout the entire body.

33:39And when we see human studies looking at fiber consumption and showing us how beneficial fiber is to us as humans, I want everyone to understand the reason why fiber is beneficial to us as humans is because fiber comes in the contact with microbes and those microbes release short -chain fatty acids. That's what's happening. Metabolism. Metabolism has 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 higher metabolism, which means they're probably going to be quite skinny.

34:14A low metabolism means I'm probably going to take longer to process my food. What is the relationship between my gut and my metabolism? And have I probably defined a metabolism wrong there? But what is the relationship? Well, metabolism is basically dealing with the currency of energy. And it is the engine that drives us as humans. And so how do these microbes affect our metabolism? Well, we have researchers Zoe looking at this directly called the predict one study. And in that, we were looking at like, what is the thing that tells me predicts what your blood sugar rate is? What are your responses going to be to this food?

34:55Or 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 detailed 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.

35:30We're, you know, in some ways we're 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 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, visceral adiposity, meaning 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.

36:16I read in your book that 60 % of poop is bacteria, which 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 gastroenterologist. If I want to know the basics of what's going on with you and your body, I need to know how you're pooping.

36:54And 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 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 Blue Pooh. 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.

37:39We could tell you 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 transit time based upon eating a blue muffin. So these things, many of these 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 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 the gut transit time.

38:23Yeah, 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 the time, whether I have a high gut, a good gut transit time, or not so good one? Yeah. So gut transit time is 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 paper was published in the journal, gut, which is the top European gastronology journal. And there's a couple of specific time points that we can use to sort of cut off these measures.

39:07The 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. So you eat these muffins, and then you basically just record when did they show up. And the average person is somewhere on the range of 24 hours or 48 hours. Typically one or two days after eating the muffins, that's when 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, what you start to see is that this is four groups and these four groups.

39:50Every 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 brings us to one of the properties of fiber that's kind of fascinating, which is that whether you have diarrhea or constipation, there's only one thing that can correct both of those. Diarrhea and constipation are both fixed with dietary fiber.

40:26It 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 trans at time to be about 24 hours or less. That being said, like as a person on healthy, if it takes two days for this to show up in their poo, no, I wouldn't characterize them as being unhealthy. But I do think that this is one of the things that we can look at. That's simple. It's nearly free and available all of us to try at home. So yeah, so you would have said that if someone's going to the toilet three or four times a day or more, then there's probably a fiber problem.

41:03There 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 the reason why I bring that up is that for a person who's low on their fiber consumption, 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 well. I was in the exact same spot 10 years ago. If I tried to eat like, you know, chili with a bunch of beans, I was not happy.

41:48So 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 microbion, and you never eat fiber, you can't expect your microbes to be good at digesting fiber. Our 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 recommend that people do this is to start low and go slow.

42:28That just means adding a little bit at a time, slowly over the course of at least weeks, if not months. And this is what allows your gut microbes basically to keep up and adjust to what you're doing. What about fecal treatment? You said that if our gut microbiome is damaged, it's not going to be great at processing the fiber. So can't I just get someone's poop who has, you know, that 60 % of their poop is the microbes and eat it or do some kind of fecal treatment where I put it in my body? So this is actually being done. Now we've been doing fecal transplants where we would take from a donor and put it into a person for an infection called C -Diff.

43:14And we've been doing this for more than 10 years. And it is fascinating. The studies with fecal transplant in humans have not been as successful as they were for the C -Diff. So we would love to say that we could treat ulcerative colitis, which is inflammatory bowel disease with a fecal transplant. Generally, it seems that we cannot, at least where we stand today. But there is something that 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 with ulcerative colitis who went into remission, meaning that their disease was no longer active after a fecal transplant.

44:09And 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 fecal 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 orally or is it some other way?

44:52Are they injecting this poop? Are they putting out their butt? What are they doing with it? There's a couple of ways. So the classic is a colonoscopy. So the way that 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 tube up the butt. The colonoscopy. Yeah. That's a tube of the butt. Okay. Yeah, that's two of the butt. Now the new technology that's been emerging in the last few years is that they can actually dry out the stool.

45:25So they wire flies 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 interesting. I'll hopefully not. I mean, I've had a couple of mega omega three capsules break and it's a nightmare. Oh, dear. Yeah. I'm not really want to be. Yeah. 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.

46:05You could just take your poop capsule every single day. God love to be the CEO of that company. That would be so fun. I mean, I think that I think that this is going to happen. You just really. Yeah. But I think we need the technology is there. The technology is there. So what do we need? We need to 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 probiotics are just one single strain. And they can't be beneficial. I'm not disparaging probiotics in any way. They can definitely be beneficial.

46:40But what we're talking about is a new future where you're actually reconstituting a healthy microbiome. And Steven, 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 there's like been this great extinction event that's taking place. Right. Where many species of animals are dying and they're gone. Microbial scientists are worried because 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 primitive environment in Africa, we have half the microbes that they do.

47:33And 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 they're creating a bank where they're collecting these poop samples from like primitive tribal people and saving 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.

48:12I don't think there'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 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. If you want my poop, you will have to pay for it. But it's going to be expensive. If you only go to the, because you're healthy, you go to the toilet once a day, it's going to be like gold.

48:46And that's the fascinating thing. Poop is on the biggest comeback in the history of comebacks right now. 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 going to have little else to do. I, you know, gosh, that is a dark disturbing vision for the future. But I could see where I could see where that's possible. I mean, I do think like it's fascinating to consider that 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.

49:20And now is the future of science. It's really so interesting. Kid 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 in 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. 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.

49:56Right. 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 resistance starches and polyphenols, all of which are pre -bottocks. And this is why when people eat more beans, they live longer with less disease. So it's kind of interesting because 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.

50:29The clonias to go get the incredible, you know, 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 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 of Jurassic Park, there's that amber with the mosquito and the needle goes in, you extract the DNA.

50:58What 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 transplants studies done in mice as well. Yeah. And what what are we seeing from nice studies? Well, okay, so we've talking about these different conditions that are connected back to our gut microbes. And part of the way that we prove this, of course, we want human research. But part of building our argument and filling in the pieces of the puzzle is like mouse research. And these mice, we have complete control and they're much more simple to manipulate.

51:42And so we have the ability to do a fecal transplant 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. I'm more than happy to point people towards the studies that I'm referring to. 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 then. And they have a different microbiome. And when you transfer human poop into mice, you also transfer the body type.

52:25Even when you feed the mice, the exact same food, the exact same number of calories. So we hear about this calories and 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 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, it's like swimming with the current at your back. It's a lot easier.

53:06You 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 fecal transplants from a person who does not have diabetes to a person who does have diabetes. And their blood sugar measures will improve in humans. We have immune studies. You can take a person who has ulcerative colitis, which we're talking about a moment ago, and transfer their poop into a mouse. And that mouse will have ulcerative colitis. We have mood studies where you could take a human who has anxiety or depression or PTSD.

53:54And transfer their poop into a mouse. And the mouse receives the mood phenotype. So basically, like, again, this 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're 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 is doing. So 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.

54:38I 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 assuming it's basically picking up some of the microbes, which are impacting the gut microbiome, which is creating a postbiotic compound, which is influencing its metabolism or something like that. 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 product of this is that those short -chain fatty acids now will have effects throughout the entire body, including affecting our metabolism, infecting our blood sugar, affecting our insulin sensitivity, infecting our blood lipids after a meal, affecting fat storage.

55:30Whether or not you turn on fat storage or whether you turn off fat storage and turn on fat burning. It really does shine a lot on this calories and calories out there. Because, yeah, I mean, there's so many people who have talked about this a few times that just think, you just have to eat below the required 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 thermogenesis, meaning fat burning.

56:01Part of it is also what you poop out. They've actually found that people who have a healthier microbiome, they poop out more calories. Okay, interesting. What do you think of the calories in calories out there? If someone comes to you and they say, I want to lose weight, Doc. And they say, I've heard this calories in calories out thing is the answer. So I'm just eating less, I mean, it not so pizza, but I'm just having less calories. I don't like that. Obviously. So to me, dietary quality is the key. There's too many examples where dietary quality. So first of all, our weight, our health is not entirely determined by our weight.

56:40Is it a major factor? Yes, it is. But there's so much more. So dietary quality study after study after study shows us the 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 it doesn't matter would be completely false and inaccurate. The idea that calories is the only thing that matters, what I do want to say is this, there is some truth to the concepts that calories matter. There's absolutely some truth to this. If you reduce your caloric intake, you will lose weight. The problem is that your body will compensate by slowing down your metabolism.

57:22And so then it puts you in a predicament where you can't continue to do this. It's not sustainable because that weight loss eventually will stop. And then 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. You go, yo, yo, and you go above where you were before. 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.

57:59So the issue is you 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 pre -bottles because we hear so much about ozemic or wagovie, which is some of glutide. We hear so much about this. And it's a GLP1 agonist. GLP1 is a gut hormone that exists within our body and it makes us feel full. We can stimulate GLP1 through our dietary choices. If you eat the right food, which is basically a hyperibiotic diet, you will activate the GLP1 and you will naturally feel full.

58:57And 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, the issue that we all have is that we eat an ultra -process diet. An ultra -process diet, number one, makes us ravenous. 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 -process diet, we overeat. And then you feel like trash. You feel like trash for a couple of hours. And that is the result of you overeating.

59:35You've thrown yourself metabolically out of balance. 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 old fashioned way. By old fashioned, I mean like prior to modern history, when ultra -processed foods came into existence. If we go back to the old way of eating, you would simply eat until you activate these hormones, things like GLP1, which is concentrated in this drug, or peptideYY. These are gut hormones that basically tell our body when to stop eating.

1:00:16Everyone's going crazy about a Zempec. I keep hearing about this drug. Elon Musk recently said he had had it. I know a few other people that have started taking a Zempec there. I would say, you know, none of them are overweight necessarily. But they're doing it because it's now been framed as kind of super drug, which can help you drop weight super quickly by making you feel satiated. What do you think of a Zempec? Well, I come back to this. So first of all, let me say that for people who need it, I'm glad it's there. I don't think that the entire world needs a Zempec in order to be healthy. Is there any side effects?

1:00:52A hundred percent. First of all, digestive symptoms, massively common digestive symptoms. But there's also long -term risks and many of which we don't simply know much about because people haven't been using the drug long enough for us to fully understand what happens if you use it. Because once you start using it, you're not going to stop. If you stop, you gain all the weight pack. 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, you know, decades. 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 Zempec?

1:01:31Yeah, I think that's the point is that if we, so if we look at our countries, the US and the UK, 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 the fiber is sexy. But I think fiber is sexy because it's so crucial and important to our health. And this is an example where this is a hundred percent true. So 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.

1:02:05The average man is getting 18 grams of fiber per day. He's supposed to be getting 38. It'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 peptideYY. 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 try consuming these foods? The average American is 10 % of their calories from plants, fiber containing food.

1:02:44What if we can 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 a professor in New Zealand. His name is Andrew Reynolds. And he compiled all of the available data on fiber. What happens when people consume more fiber? Here's what happens. They lose weight. 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 of cancer.

1:03:24They're less likely to die of cancer. Their blood pressure goes down. Their blood sugar control improves. Their cholesterol goes down. Okay. 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 into 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 middle piece. And when we're reaching for something, that's an expensive drug. It's very expensive. When we're reaching for something, it's an expensive drug.

1:04:01And 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. I 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, some adaphanil, or zemperics, etc. When I speak to them, they're very passionate that there's no side effects on all of these sort of things that I consider cheating. And I have to caveat this because there are some people who are in a situation with diabetes or other cardiovascular issues who can have their lives saved with some of these drugs.

1:04:49But for the most part, the people that I know that are consuming these drugs aren't doing it for that reason, they're doing it for vanity reasons or for performance reasons, where it's like taking a shortcut. And every shortcut, I believe, in life comes with a cost. You're talking like a doctor. You're talking like a doctor because basically what you're talking about is risk versus benefit. And the way that I think, and every other doctor thinks about their patient, is does the benefit outweigh the risk, but there is always risk in association with these drugs. And what makes me different from most other doctors, where I turn to the corner in my career, is when I start to ask the question, why are we waiting until we get to the point that we need to write a prescription for a drug, why are we waiting until that point?

1:05:31Why are we not intervening in a much earlier point, where we could transform a person's life and get them to a place where they never actually get this disease, or if they get this disease, it's so much easier for us to control that. And this is, so to me, what I come back to is basically what you're getting at, is why would we take a drug if we could change our diet and our lifestyle and actually protect ourselves? It's easier. It's much easier. Yeah, it is much easier. There's no doubt, but the problem is you pay a price for that. And the price is unobvious. So you've got an easier option, where the benefits are clear, and the cost, the risk is unobvious.

1:06:10Logical human being would take that path if they can afford it. I agree. The issue is that these are not the same things, though. And what I mean by that is that you have diabetes. Okay, like hypothetically. Yeah, I hope you don't. Hypothetically, you have diabetes. Okay, cool. We give you a drug for your diabetes. That drug covers up the issue. I can get your blood sugar down, but that's not fixing the problem. I'm not actually fixing your diabetes, right? So to me, like, we shouldn't equate taking a drug and like controlling a disease on some level, but truly what we're doing is we're just putting a sheet over the problems.

1:07:00You don't see it anymore, right? Does it result in better outcomes long term? Are you healthier as the result of controlling your diabetes with a drug? 100 % yes. No doubt. But what if we could reverse your diabetes? Diabetes, type two diabetes, which is the kinds that people acquire as an adult, is highly reversible. Most people don't realize that. Like, you don't need to be drug dependent on diabetes drugs in order to fix this issue. Take them when you need them. But let's work on the root cause. And by working on the root cause, we can actually reverse the true problem and get you back to a place where you don't need to drug at all.

1:07:37But doesn't that require a disciplined and willpower and motivation? Well, I think it requires understanding the path forward and making choices that are sustainable and that make you excited. Like, I don't, I would never ask a person to make choices that make them miserable. I'm asking people to make choices that make them feel great, make them feel energized. And yet, at the same time, actually are contributing to better health so that they can live longer with less disease and be in a position that I want to be in, which is that I want to be in my 80s and still like cutting a rug and dancing.

1:08:08Like, dance with my grandkids. So let's close off on this subject of poop. My team actually prepared some poop samples early on because I was wondering as a gastroentrologist, I wondered that if you could look at someone's poop and determine whether they have good gut health. And if you can understand what's going on in their body, just by how their poop looks because poop comes in many shapes and sizes. So what I have here is a variety of different shapes and sizes of poop for anyone that can't see. Well, look at the screen if you're listening to this podcast on Spotify or YouTube. Different shapes and sizes of poop here.

1:08:45This is a real human poop. So I'm passing that so you can play around with it. Yeah. And why does the shape and size of our poop tell us anything? Why does it matter? And how is it indicating something that's pertinent to our overall health? Well, because it goes back to what you mentioned earlier, which is that 60 % of our, the 60 % of the weight of our stool is actually microbial and origin. So if you want a window into your microbiome, look at your poop. You don't necessarily need to go and do an expensive test. I quite simply looking at your poop is one of the ways that you can tell what's going on.

1:09:18So there was a study that was done in the 90s, so long time ago. And it was less than 2 ,000 people exclusively in the city of Bristol. And it led to the creation of a chart called the Bristol stool scale. Look at that here. I'll put it on the screen. Yeah. And we're going to run through this. But before we do, I want to mention a few things real quick as the US Medical Director of Zoe. I'm proud of my contribution as a gastroenterologist as a physician to the work that we're doing there. And we not only did the blue poo study, which we've talked about already, which is that you can eat your muffins and figure out your gut transits time.

1:09:55But we also did a couple of other things. One is called the blue poo challenge, where we had over 20 ,000 people across the planet, who were basically eating blue muffins and then reporting back to us on what was going on with them. And then more recently, so again, the Bristol study was 2 ,000 people exclusively in the city of Bristol. We recently did the largest study across the entire UK on poop. And what people were doing in terms of their bomb movements. So it was called the big poo review. And we had 142 ,000 people from across the UK basically fill out a 17 question survey. And part of what we were looking at was their Bristol stool form.

1:10:35We were also looking at how often they poop. By the way, the average person poops 1 .7 times per day. And we were also looking at how it associates with different conditions. So as an example, 1 in 5 people in the UK are constipated. 1 in 6 people in the UK have diarrhea. So it's interesting to take a look at all these things. So now getting into the Bristol stool chart, the dream. That is real poop. This is the, it's lovely. This is the dream. This is where we all want to be. And this is a Bristol for the Bristol for is the classic where I come walking out of the bathroom in slow motion. And rock music is jamming and dubs are flying in slow motion.

1:11:21And I just am such a stud. So and that's after a Bristol for my wife knows what happens when I come out looking like that. It's soft informed. Okay. And it's like a sausage or a torpedo. So pretty smooth. Now when we move from a four to a three, a three is not that big of a deal. But it is getting some cracks and crevices in it. All right. So and we're moving towards constipation. Now a three, you know, a little more fiber, a little more hydration, some exercise. These are simple things that can help to get you back to a four if you're having one of these a three. But that moves us to a Bristol two where we are truly getting into constipation territory here.

1:12:02And basically this is like if you took a whole bunch of marbles of poop and jammed them together. So it still forms into something, but it looks like a pack of marbles of poop that are stuck together. So that's a Bristol two stool that's constipation. And then finally, a Bristol one is when you're having the rabbit, the rabbit pellets and they're hard. They're not easy to get out. And sometimes they're a lot bigger than this. These are small. So you would form this up into what would be like a golf ball. And that golf ball would be like a Bristol one. Okay. All right. You form it up into a hard ball like this.

1:12:43But perhaps even bigger. And it's actually hard for a person to pass this. It's so big, it's so hard that your bottom has a problem relaxing to let it out. Okay. So Bristol one and two are forms of constipation. Let's go back to the middle. We're going to start from five. The stool is soft. It's not hard. It's not lumpy bumpy. It's soft. But it's starting to break into blobs, different pieces of poop. So and we're moving towards, we're moving towards diarrhea where like just like fragments of solid stool are Bristol six. And then when it's just like or the other thing a Bristol six could be like a calpai.

1:13:27Where there's no form is just someone plopped down this formless patty. And a Bristol seven finally is straight liquid, straight liquid. And how is this puttin into a got microbiome health? What does this tell us about health? There's been now multiple studies including our work at Zoe on the blue poop study that was published in the journal God. There's not been multiple studies where basically what they found is that if you could look at which of these Bristol types you have, it does give us some insights into your gut microbiome and what's happening there. So now where do we want to be in a perfect world?

1:14:05We want to be somewhere on the spectrum of three, four or five. We ideally want to be a four. You're not unhealthy if you have a three or a five. So if this type four poop, which is kind of like a sausage, it's kind of like a smooth sausage, is optimal. How does one do that? What is tining it into a type four? What are they eating doing? Yeah, interesting question. We, one of the things that we found in the Big Poo review, which is our nationwide survey of 142 ,000 people. We actually looked at what they were eating. And we were able to find associations between fiber intake and specifically plant -based food intake and having a number four.

1:14:47So in other words, we found associations between fiber intake and basically plant -based food intake and having a number four. So basically what that means is the people that were having a number four bomb movement were consuming more legumes, whole grains, fruits and vegetables. The people who were having whether it be a type one or a type seven, they actually were quite similar in terms of their diet, which is that they actually were consuming lower amounts of fiber. Now the other thing to look at too is actually some studies have found that people who have more on the spectrum of constipation tend to have a higher fat diet, tend to typically consume more animal products, which of course are higher in fat.

1:15:31And people that are more on the loose or diarrhea side of things tend to be consuming more plant -based foods. So now you could have a very healthy diet and be having a Bristol 5. And that actually is not problematic. And the reason that you're having the Bristol 5 is because you're consuming so much fiber that actually are producing a lot of short -chain fatty acids and the short -chain fatty acids, they're like lubricants for your poop. And the gut transition time, how does that relate to these different types of poop? As you were saying that, I was thinking the one in seven, the type one and the type seven, the type one being their sort of hard nuts and the type seven being basically diarrhea.

1:16:11I was assuming that those are the poop types that would happen with a lower and a super high gut transition time. That's right. So a slow gut transit time, which is a gut transit time more than 58 hours. So again, and this is all with the blue muffins. You eat the blue muffin, it comes out 58 hours later. You are more likely to be having a Bristol 1 or Bristol 2, which is the classic constipation form. There's no way that you would have slow gut transit time and have a Bristol 7. That's not possible. A diarrhea. Yeah, a diarrhea. So a diarrhea comes out fast in these sort of hard nuts they take typically a long time.

1:16:49That's right. And the reason why this is happening, you know, so when water moves through the intestines, because a ton of water moves through the intestines and one of the jobs that our colon has, the VARGE intestine, is to pull the water out. So the more time that something spends inside the colon, the more it's actually going to do that, pull the water out. This is the reason why when we have fast transit, it's high in water. And this is also the reason why when it's slow transit, it's extremely dry. Okay, so that's the shape and size of the poop. But what about colors of poop? I've got some different colors of poop here.

1:17:25I've got some red, some blue, some black, some green, some whites and some yellows. Yes. How is color pertinent to health and everything we've been discussing? Alright, let's break this down. So first of all, why is our poop brown? The answer to that question has to do with bile. Bile is produced by our liver. It's actually involved heavily in digestion of fat. So when we, for example, eat a fatty meal, our gallbladder will squeeze. People that have gallbladder issues know what I'm talking about. You eat a fatty meal, your gallbladder squeezes, bile then mixes in your intestines with the food, and the bile helps to absorb the fat.

1:18:02That bile is what makes our poop brown. Now that becomes particularly relevant if we're talking about a white poop. People poop white? Some people poop white? No way. Yes. And the reason why a person would have a white poop is if there's a blockage that stops the bile from mixing with their intestines. On the flip side, if you are struggling to process your fat, you could have a yellow poop. So, and this could be a person who has like a pancreas issue, for example, chronic pancreatitis. And so if they're not able to digest their fat, they have a fatty poop. It may come out yellow. And one of the things that they'll notice is that there may be an oil slick at the top of the toilet bowl.

1:18:49That's fat. Oil is fat. So, all right, you've never had a green bomb movement? Any more business? That's the day of question. I have. Oh really? Yeah, there's a couple of reasons. Some are healthy, some are not. So, you could have diarrhea, like from an infectious cause. An example could be something called GRD, which is a parasite. And that'll give you a green poop. But you could also go too hard on the smoothies. I was drinking like 40 ounces of green smoothies a day and my poop would come out green. It's interesting. We're about to get into some that are really important. Before I do that, let me just mention real quick, the blue, so the blue poo.

1:19:31You could get a blue poo from eating blueberries, particularly the eat a lot of them. Or alternatively, of course, this is the blue muffin, the blue poo challenge. And perhaps what we could do in the show notes is give people the recipe for how they can go about doing that if they're interested. All right, red and black. So, we have to talk about, let's start with red. Because, of course, red we think about blood. And I have a rule, which is that if you see blood in your stool, that's not normal. And to me, that's grounds to talk to a doctor. And then there's different levels of intensity of how seriously we check it out.

1:20:12But Stephen, colon cancer, which can't present with red stool, colon cancer is the number two cause of cancer death in our countries. In the United States, 150 ,000 people are diagnosed per year. It's highly preventable. And it's shifting towards younger people. There has been a change in the last few years in terms of colon cancer, where, you know, as an example, a person of your generation, unia are pretty close, I think, but I'm a little bit older. A person of your generation is four times more likely to be diagnosed with rectal cancer during their lifetime than my parents were. And twice times more likely to be diagnosed with colon cancer compared to my parents' generation.

1:21:04So there's been this shift, and it's also affecting younger people. So my point is this, I've had patients who come to me, they go, I saw a little bit of blood in my stool. Do a colonoscopy and discover that they have a massive polyp, which is a precursor to cancer. And by removing the polyp, we just basically stopped them from developing cancer. So I take it seriously when you see a poop that is coated in red. All right, now that red may be just on parts of it, like it is here, where that's typically bright red coming from the bottom. So that would be either something in your rectum, could be hemorrhoids, could be an anal fissure, could also be a polyp in the rectum.

1:21:50But I think what I come back to is I would encourage people to get checked out, because just seeing the bright red blood doesn't mean it's hemorrhoids, don't assume that. Particularly with cancer shifting towards younger people, I think it's important to get checked out. On that point about cancer shifting towards younger people, is that because our diets are changing? I think so. I think it's the shift generationally that's taken place in terms of our diets. I also think that there's a microbiome element. The connections between the gut microbiome and colon cancer are as powerful as any type of cancer.

1:22:25And at the same time, what protects us? I think you know where I'm going to say it's the fiber and the short -chain fatty acids. And in that study that I was mentioning earlier from Andrew Reynolds, the professor from New Zealand. Actually, there was a powerful association between fiber consumption and protecting ourselves from colorectal cancer. So powerful that for every 5 grams of fiber that we increase in our diet, we are getting a significant reduction in our risk. So it's not just due to fiber or not. It's actually how much fiber do you eat and the more the better. You know what? I should mention real quick, red stool can also come from eating beets.

1:23:04It will almost always happen like literally 24 to 48 hours after you eat the beets. So don't be surprised when that's the case. You may see a little bit of red stool. Black stool can come from benign places. So an example is bismuth. So like peptobizmal. So you have a stomach ache. And then you take some peptobizmal. But the issue with this is it will actually give you black stool. So if you're having a bad stomach for a couple days in a row, it could turn black. But the other thing that turns your stool black that people need to know about is a slow GI bleed. Beleding into your stomach specifically.

1:23:42Because that bleeding is happening higher up in your intestines and then it has to pass all the way through the intestinal transit time. Because there's such a delay, by the time it gets down to your rectum, it's now black. It's not red anymore. So black stool can be indicative of bleeding. The way that we can differentiate this is when it's blood, it smells terrible. Now we go smelling our own paper. Yeah, well, you don't have to stick your nose into it. It's so clear. Like it would be so clear. Okay. Okay. When I'm in the hospital, I'll be walking through and I can literally tell when a consult is coming because I can smell this diagnosis.

1:24:20Really? Yeah. So anyway, the stool will turn black. It will smell terrible and it will be like tar. That's what makes it different than if you were to, for example, take a pepto -pismal. Q1 is often when businesses start implementing new systems and processes in hopes of creating efficiencies for the year ahead. And over the course of my career, I've learnt just how crucial having the right systems in places, one which has helped me across many of my investments is NetSuite. They're also a sponsor of this podcast. NetSuite is the number one cloud financial system through their streamlined platform.

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1:25:24That's NetSuite .com slash Bartlett. I'm really interested in this idea that we can give our gut microbiome to our kids, but also in the twin studies, they have such a diverse gut microbiome. So how much of our gut microbiome are we inheriting from our parents, our grandparents, etc. If any at all. Well, we're certainly inheriting some. And particularly when we're kids as a newborn, you're going to most closely resemble the gut microbiome of your mother. And that association and sharing is much more profound if you were born through a traditional vaginal delivery. And if you're breastfed. So that connection between mom and baby actually helps to facilitate the transfer of microbes to the baby that leads to health.

1:26:12And this is part of the reason why when you disrupt these things, which by the way I should mention, sometimes these things are inevitable. So I have three kids. They were all born by Cicerian. It's not the way that we wanted it to be, but it's what happened. You can have healthy kids who are born by Cicerian. So, but when we disrupt these things, whether it be Cicerian section or bottle feeding instead of breast feeding or antibiotics, we see downstream the same effects. Increased likelihood of obesity. Increased likelihood of allergic conditions, including food allergies and asthma. Increased likelihood of autoimmune conditions, including celiac disease and type 1 diabetes.

1:26:57So when you disrupt the developing gut microbiome in that child, you increase the risk of these things happening subsequently. And there's been some interesting studies where they will look at the microbiome. They'll look in the diaper of a child who's six months or a year old. And they can based upon that. They can predict who within the next four to five years is going to develop an allergic or autoimmune condition. So getting back to the sharing of microbes, like, yes, there is this connection between mom and child. But actually, this isn't an evolving thing throughout our life. And there's new research that I think is really important about human connection.

1:27:35And in this study, what they found is that people who shared spaces together through connection, they, number one, had a healthier gut microbiome than people who lived by themselves. Number two, they share more microbes together. So like, for example, me with my wife, we share more microbes together than I do with my siblings. And then the other thing that was kind of fascinating from this study is the strength of the relationship matters. So I think we can all agree. Sometimes relationships are in a good place. And sometimes they're in a bad place. And that's like a whole spectrum in different conversation.

1:28:17But actually where it is on that spectrum impacts your gut microbiome. They found that the couples that were sharing the most microbes were the ones that actually had the most connection in terms of their relationship. Whereas the people who were disconnected from one another, they weren't sharing so many microbes. Now you could say, like, is that because they're having less sex, could it be that they just like physically aren't even close to one another? I suppose that's all possible. But these are also people where they like they control for their diet. So it's not a dietary thing. So like I think that the, you know, the takeaway from my perspective is the power of human connection is more important in 2023, 2024.

1:29:01It's more important, more important in this moment than it's ever been. And many aspects of our life are pulling us away from this. Our devices, social media, I mean, I'm very active on social media, but let's be transparent about this. This is pulling us away from the ability to sit down with another person and look them in the eye, talk to them, have a meaningful conversation and feel connected to that person. And because you feel connected, you reap the rewards which do include better gut health. But that's super interesting because it does make a case that the people we surround ourselves with, we tend to think of psychology, right?

1:29:36We tend to think that we surround yourself with a certain type of person. It's good for your psychology if they're positive or they're negative, etc. But there's actually a case that people, the people we surround ourselves with have an impact on our physiology, our bodies, our body, our gut microbiome. And that has an upstream effect on everything. That's true, but you also can't disentangle or separate out from the fact that the positive influence of a person also really matters. Yeah. Because where you're at from an emotional perspective, and I think this is an important thing for people to understand, that where you're at from an emotional perspective does manifest in your gut health.

1:30:10And this is the reason why, for example, if a person's going to go and do public speaking and they're not comfortable with public speaking, they may just have a little bit of jitters, a little bit of nausea, or queesiness. But it can also snowball into something bigger and worse, such as full, full -due over -type cramps. Right? So, and that's many people will manifest their stress in their gut. That's an acute example, by acute, I mean, like this specific situation context that you're involved with. But what happens if your life is stress? And the answer to that question is actually very clear, because people who, for example, have childhood trauma, they will subsequently go on and be far more likely to develop digestive issues, but other gut -related issues.

1:31:01And there was an interesting study, Stephen, that was done among two -year -olds, who were adopted. And they studied the gut microbiome of these kids, and downstream they were able, basically, to identify that the fact that they came from an adopted home, even though it was before age two, like they can't remember this. Even though it was before age two, the fact that they were from an adopted home, it affected their gut microbiome, it affected their response to stress, and it also affected the way that their brain works. And they actually were able to show this through functional MRI technology, where they looked at the brain and how it was activating.

1:31:41Just because of that sort of early trauma. Early trauma. So, and not, you know, not everyone who has got issues has been exposed to trauma, but I think it's important for people to understand that if you have been exposed to trauma, this can be a very important part of your healing process. So, that's the message that I want to get out into the world, and the reason why I bring that message is because I've had people who are in my clinic, and there I could Dr. B, I do everything that you tell me to do, and I do it by the book. I eat, I sleep, I exercise, I do yoga, I do meditate, and I meditate.

1:32:18And despite that, they're not getting better. And in those relationships, what ends up happening is typically after a couple of visits, we start to get comfortable with one another, we trust one another. And when you get to that place, they will share with me something that happened to them. And then I make it clear, this is the reason why. When you heal the wound of the trauma, you actually heal the gut, and it's amazing because they're like a rocket ship, because they're doing all the right stuff, right? They're eating right, sleeping right, exercising. And the minute you take away this thing that is chaining them down, and holding them back, the minute you release those chains, they shoot to the moon.

1:32:56And it's like the greatest thing to see, and I would say that like in my clinical career, that has been the most rewarding thing above anything else, far more than like getting a person to eat more fiber. What about alcohol? I've recently quit drinking alcohol. I'm glad you did. Why are you glad I did? Well, let me be the first to say that I have not completely quit consuming alcohol. But if we remove my imperfect self from this picture, and just to look at the science, the science is actually quite clear, our gut is damaged by alcohol. So let's take a step back for a moment. If I want to clean this table, right, we're all done, we want to clean it up.

1:33:33What are we going to do? We pull out rubbing alcohol. It destroys microbes. Alcohol destroys microbes. And when we drink to the point of having a hangover, is that dehydration? Absolutely not. And I'm of the belief based upon the research that I've seen that what's happening when you're having a hangover is that you have caused significant damage to your microbiome. And this is the reason why it takes 24 hours or more for you actually to start to feel like a human being again. What you see with alcohol is disturbing. It's more than just liver disease. There are many different health -related conditions that are tied back to alcohol consumption.

1:34:16And the thresholds that we've set where we say people it's okay, like it's a moderate alcohol, if you have up to three drinks a day as a guy, or up to two drinks a day as a woman, like that to me is ridiculous. That's a lot. But the study that changed everything for me was where they actually monitored levels of something called bacterial endotoxin, or lipopolysaccharide. This is something that is not supposed to be in our bloodstream. When it is in our bloodstream, it's because there's been damage to the gut barrier. And it causes inflammation. This is the exact same thing that can cause us to get extremely sick.

1:34:56But at a minimum, it is causing inflammation in your body. And they did a study where they were basically monitoring levels of this lipopolysaccharide after alcohol consumption. And in association with blood alcohol levels. And what they showed in the study is they were parallel lines. Blood alcohol level goes up, lipopolysaccharide level goes up. Blood alcohol level turns down, lipopolysaccharide level turns down. They were the exact same thing. So when I saw that, to me, even when we're consuming minimal amounts of alcohol, we are potentially causing problems for our gut microbes. What is the brain gut connection?

1:35:41So the brain gut connection is referring to the fact that your gut's best friend is the brain. They're talking to each other right now, and they are inseparable. You can't get away from that. There's a number of ways that your gut will talk to the brain. So part of it is the release of neurotransmitters. 95 % of the serotonin in your body is produced by the gut. Serotonin is the happy hormone. It's what makes us feel energized. It's what gives us great mood. And in some ways also also gives us focus. You would think that it comes from your brain. When we treat a person with major depression, we treat them to increase serotonin levels.

1:36:24Yet only 5 % of the serotonin in your body actually is produced inside your brain. 95 % of it is produced within your gut. Serotonin can signal the brain through a nerve called the vagus nerve. The vagus nerve is like a super phone between the brain and the gut. It would be like if you were in London and I were in the United States and I had a direct line to you where I just picked this up and I go, yo, Steven, I need to talk to you. That's the way that this works. Your gut is talking to your brain directly on that phone line. So serotonin, dopamine, 50 % of dopamine, which is the reward hormone produced in the gut.

1:37:04There are over 30 neurotransmitters produced in the gut. There's also the vagus nerve that we just talked about. And then finally, your gut is producing metabolites, postbiotics. That can cross into the brain and have an effect. We mentioned this earlier. Short -chain fatty acids from fiber have the ability to cross the blood brain barrier and actually influence things like our mood, our focus. There was one study with kids where by increasing short -chain fatty acids for those kids, they actually were able to increase their focus because they were having trouble with focus. You've repeatedly talked about fiber and this thing you call short -chain fatty acids.

1:37:41In your book, you said, I believe that they're the most healing nutrient in all nature. I think that's actually true. And I also would characterize them as the most anti -inflammatory molecule that I've ever come across. And am I right in thinking we eat fiber, the bacteria in our microbiome breaks down that fiber and it produces this thing, these short -chain fatty acids. Is that it? That's... The story is just going to start it though. The story is just going to start it because the issue is that that's the simple part. These magicians that live inside of us release these short -chain fatty acids for us by eating fiber or resistant starches.

1:38:20But then those short -chain fatty acids go to work and our immune cells, our human cells have receptors to receive these short -chain fatty acids. And act upon the information that they receive. So you could think of them as a signaling molecule in the sense that your gut microbiome is not talking to your body and telling your body what it wants your body to do. So it's training it. Yeah, but it has the ability to flip genes off and on. Okay. It has the ability to turn down your immune system. So as an example, when I think about autoimmune conditions, if we were to get super into the details of autoimmune conditions, what you would discover is that we need more short -chain fatty acids to empower these specific cells called T -regulatory cells.

1:39:09And those T -regulatory cells would actually turn down our immune system and protect us. So, and it's not to say that autoimmune diseases are exclusively the result of a fiber deficiency. There is certainly a genetic component. But there was a genetic component 200 years ago, 300 years ago. And yet these conditions really weren't that much of a problem back then. So many of these conditions didn't have a name until the last 100 years. And the emergence of them, many of them have increased 500 % in the last 50 years. Why would that be? It clearly is not genetics. So it has to be related to our diet and lifestyle.

1:39:47And ultimately, when we talk about our diet and lifestyle, we're talking about our microbiome. And really, one of the most important places to start, as you say, is with the fiber. I think so. You said earlier on, we have to start slow and low with fiber. Yeah. And that's because we've got to build up those microbes that respond to the fiber and tie it into the short -chain fatty acids, right? Your gut is like a muscle. Right? Like this is the way that I want people to understand this. Your gut is like a muscle. And a muscle is capable of work. But it has limitations. And the more that the muscle has been trained, the more capable of work it is.

1:40:24So if you lift weights, you might start at 50 kilos. If we're doing a bench press, you might start at 50 kilos. And then you go to 55 kilos. And then the 60 kilos. And you work your way up. And that's the process of growing strong. And your gut works the exact same way. So if you expose your gut to food, specifically a diverse mix of different foods, you are training your gut. And your gut will become more capable of consuming those foods over time. And then you can eventually get to a point where you don't have to then restrict based upon your capabilities because the capabilities are limitless.

1:41:08Now you can eat whatever you want. And is all fiber the same? No, not all fiber is the same. Fiber is a very generic word. Fiber is like the word protein. No one would claim that the protein in a fish is the same as a protein in a bean. Yet both of them contain protein. Fiber is unique to individual plants. There are many, many different forms of fiber to the point that we don't even know how many exist. So what we know is this. It's rather simple though, right? Given that despite that complexity, it's rather simple. All plants contain fiber. Every single plant has unique forms of fiber. We do split it into two major types.

1:41:46These are again umbrella terms. These are big labels. Syable and insoluble fiber. The soluble fiber is the kind that dissolves in a drink. It disappears. You don't even know that it's there. Yet typically the soluble fiber is feeding the microbes. That's the pre -botic fiber. Insoluble fiber is the kind that's the grit. So like if you were to add it to a drink, it's not dissolving. It's going to be there no matter what. You could boil the drink. There's still be fiber in it. So insoluble fiber most of the time is not the pre -botic fiber, but it does still serve a purpose. It helps in terms of your bowel transit, which affects your gut microbes.

1:42:28It helps in terms of your bowel movements, which affects your gut microbes. It helps in terms of other things such as your cholesterol and your blood fat control. So both types of fiber, both soluble and insoluble have advantages. You don't need to worry about those individually. You just need to know that plants have fiber. Every single plant has a unique form of fiber. And every single plant will feed unique families of microbes as a result of this. You have these F goals you talk about in the book when you're recommending diets that you think people should consider. And I think it's important because this word diet is quite stigmatized, right?

1:43:04And it can lead to like disordered eating and things like that. So I think it's important for us to talk about that a little bit. But I do want to know what these F goals are. And when you use the word diet, you're not saying something that's unsustainable in short in order to have a short term. I'm saying actually the opposite. Like I want people to have abundance. In fact, if you were to ask me what is the biggest misconception that exists in the gut health space? My answer to that question would be that people are very quick to restrict and less quick to add back. So with regard to F goals, this is my general framework.

1:43:36It is not the only thing, but this is my general framework for how I remember to organize my day in terms of foods that I'm trying to seek out. Each letter represents different categories of food. So F fruit, I think fruit has been inappropriately villainized. I think fruits amazingly good for us. In fact, people that consume more fruit are less likely to have diabetes. They also lose weight. Fermented. We've talked about fermented. You can add more diversity to your microbiome by adding fermented food. We need this. G stands for greens. Greens have almost no calories, yet tons of nutrition. That's good.

1:44:16And grains. By grains, I don't mean refined grains. I mean unrefined grains. So like whole grains. So good for us. Those are gut microbiome foods, high in fiber and resistance starches. O stands for omega -3 supersedes. So that's chia -flax hemp and also walnuts. Those contain omega -3 fats. Those are healthy fats that we need more of. A stands for aromatics. So that's onions, garlic, shallots. They're delicious. They're also great for your heart. And protect you from cancer. L is legumes. So legumes includes beans, peas, and lentils. I would go back to saying like to me, this is the number one.

1:45:00The number one superfood. Because they're gut health foods and they're longevity foods. And if we look at the evidence with heart disease, cancer, stroke, diabetes, all across the board, you're going to see these produce your likelihood of having those diseases. S, when I got to S, I kind of lost my mind. Because I felt like I have more that I want to say. So let me just pack it all in. So S stands for shrooms, meaning mushrooms. Mushrooms technically are not plants. They're fungi. But they contain fiber and are incredibly good for us. So they are honorary plants. S also stands for seaweed. So most cultures don't consume seaweed.

1:45:42But like for example, in Japan, they do. And they're incredibly healthy as a result of this. It's another source of unique types of plants with unique sources of fiber. And the last is, I'm going to, in the book, I said sulfurophane, which refers to a cancer -fighting chemical that you will find in broccoli sprouts. But I want to rephrase this to say sprouts. So sprouts, to me, are superfoods. There's something magical that happens. What is a sprout, by the way, for people who are wondering? You could take any seed. And if you quite simply add water, you will unlock nature. Because basically that seed is waiting to germinate and grow.

1:46:26So when you enter this code of basically unlocking it with water, it comes to life. It opens up and out shoots this plant. And that plant is the sprout. And the sprout is tremendously high in fiber, protein, but also, there's unique chemicals that you will find in these plants. And in a disproportionate level, compared to, for example, I mentioned broccoli sprouts. Broccoli sprouts have 50 to 100 times more cancer -fighting chemical than adult broccoli has. So eating a pinch of broccoli sprouts can provide just as much benefit as eating a head of broccoli. So interesting. So if you're a parent and you follow the F -goals diet that you lay out in your book, the interesting thing I found is if you're a mother and you're having a child, you're then going to pass on some of your microbiome to that child.

1:47:21And also, I was reading about that mice study conducted that shows how the Western diet induces a loss of microbial diversity that can compound over a series of generations. Yeah, those are just the Sonnenberg studies. So just the Sonnenberg is the guy that I'm big fan of. He's out in Stanford and he actually wrote a blurb on my first book, Faber Field. And so the issue is that we want to understand microbial loss that can occur over generations because clearly our generation is different than our grandparents. And it's hard to do with humans because it takes us, like, you know, these days, 30 or more years to create a new generation.

1:48:01So, but with mice, you can do this very quickly. So he basically started off with mice with a certain level of microbial diversity. The diversity of the microbiome is a measure of the health of their microbiome. And then he saw what happened with a low fiber diet. And so basically what he saw is that if you put them on a low fiber diet, that mouse will start to lose diversity. And then it will transfer that onto its offspring. And then that offspring who's still on a low fiber diet continues to lose diversity. And transfer that onto their offspring. And so on. And what he found was that if during this process you intervene and you add back the fiber, you can actually restore on some level the diversity within the microbiome.

1:48:46You can wake them back up. They can come back. But the issue is you won't get all the way back to the starting point. So there is a certain level of loss that has taken place as a result of those choices that were occurring over generations. If your grandmother has 1 ,200 species of microbes in her gut as a child, but by the time your mother was born, she had 900, that's what your mother got. Then if your mother loses 300 species in her microbiome, now you start off with 600, half of what your grandmother originally had. Right. And at some point the loss of those species becomes problematic. Because each of those species is there with a purpose.

1:49:24We evolved to have them. And when they're absent, they're not able to do their job. And the other microbes may not be able to step up to actually do what's the job of what's missing. It's just such a great case that keeping ourselves healthy is keeping our children healthy as well. In many respects, and we also live with our children. So we're creating an ecosystem in our homes of these microbes on everything. I think that's completely true. And I also think that when we think about generational issues that exist, so in many studies they'll say, if your parents had this, then you're at risk for this.

1:50:05And we have assumed that these are genetic things. Yet much of the genetic research, much of which has been done by Tim Spukter, my partner, Zoe, much of that has not played out to prove that it is in fact genetic. I think what's happening is not just the transfer of microbes. I think it's also the transfer of lifestyle. And the lifestyle that gets transferred by generation is, if it's unhealthy, then unfortunately you're transferring along the problems that come with that. Interesting. So you're transferring the lifestyle and the microbes, which weren't able to deal with the lifestyle that caused a disease.

1:50:42So interesting. Sexual attraction is the last thing I want to talk to you about. Sexual attraction in the gut microbe. You mentioned earlier a rectile dysfunction, there's pheromones, there's all of these sort of sexual components that lead us to having a great sex life. What is the link with association between the gut microbiome and sex and erect good erections and desire and libido, if any at all? First of all, I think it's quite clear that when people are sick, which of course they have a damaged gut microbiome, when people are sick, like they're not, the libido is gone. That's a part of that territory.

1:51:18Libido is also associated with hormones. And there's a number of different hormones that our gut microbes have the ability to impact for women estrogen. There's a term that's called the astrobolome. And astrobolome sounds a little bit like microbiome because basically what we're referring to are the microbes that control estrogen levels in women. So the gut microbiome creates estrogen. It controls the recirculation of estrogen. So estrogen has this circular pattern, and in that circular pattern, it can basically be pooped out or it can enter back into the system, and the gut microbes are the gatekeepers.

1:51:58So they have the ability to actually control estrogen levels in the body on a certain level. This is the reason why if you look at estrogen -driven conditions. Breast cancer. Breast cancer, ovarian cancer, endometrial cancer, endometriosis. What you discover is that in these conditions, there's damage to the gut microbiome in all cases. So, and it provides the suggestion, not yet proven, it provides the suggestion that damage to the microbiome may be fueling alteration of the estrogen levels. The same is also true with testosterone, or Androgens, male sex hormones, which by the way, of course, all men have estrogen, and all women have male sex hormones as well.

1:52:46It goes both ways. It's just the dominance between the two genders. So there's a bacteria called clisternium syndens that's been known to basically affect male testosterone levels. And there are conditions, for example, polycystic ovary syndrome in women, that it's the imbalance between the estrogen and the Androgens that's strongly associated with the manifestation of this condition, polycystic ovary syndrome. And we suspect that the gut is central to this. So first of all, the first point is that hormonal -related issues are connected back to our gut microbes. All right, so, libido, sex, like these things obviously have a hormonal element to them.

1:53:29And this is the reason why erectile dysfunction, or I'm quite sure, not as well studied, because it's not as easy to provide, like a diagnostic label to this, but female sexual desire, I'm quite sure, would also be associated with the gut microbiome. I'm quite, I'm almost positive of this. The question that I come back to that I find to be very interesting is that the role that the microbes play in matchmaking between two human beings. Between two human beings. Making me attracted to another human. Yes. And I come back to basic questions. So now, look, I've been married for 10 years. So it's been a long time since I've been a single guy, but I think we can all relate to.

1:54:08You've been on a date. And there was something, not personality. There was something about the person, perhaps the smell that you noticed that you're just like, this is a turn off. This is not going to work. Right? Or it could be in the way that a person kisses. And these compatibility issues, I am convinced, actually come back, come from the gut microbiome, that they are in a way matchmakers, and that we're looking for good partners. I can't put my finger on exactly what that means, what makes a good partnership. But we do know that that partnership we discussed earlier ultimately has an effect on your gut microbiome, because you're going to share.

1:54:47I am convinced that sexual attraction is brought back to these things. And in animal studies, it's harder to do in humans. But in animal studies, they have actually discovered that the pheromone levels, how you smell, your sort of like, hey, attractive this hormone, is connected back to the gut microbes. So kissing is connected to the gut microbes. Phereomones are connected to the gut microbes. Sexual desire and libido and malaraction are connected to the gut microbes. I don't know where the mind exists, where it would stop. I think it's all connected. So if I want to be more attractive, do I just need to eat some sprouts?

1:55:23What are you saying here? Because is it about compatibility or is it about gut health? I think that it's very clear. So attraction is a complex thing. Of course. We all have a different take. I have friends who there's someone that they find attractive and it's completely different for me. And it's all like, that's good. I'm glad that we have a different take because variety is necessary in terms of the genetic pool. We need everyone, different people to want different things. That being said, I kind of feel like there are certain innate qualities in a person that we would universally agree are attractive.

1:56:11And those tend to be measures of health. We usually think, yeah, you're right. Yeah. Because I was going to say we think of them as physical things, right? Things we can see with our eyes typically or things we can consume with maybe our ears, jokes or humor or whittle personality or whatever. But it's completely plausible that there is invisible things. Well, I don't think that the visible things can be disconnected from the invisible things. And that's one of the messages from the show today is that even the way that you book the radiance of your skin, your youthful appearance, your body shape.

1:56:50And there's many forms of body shapes that are attractive. I'm not saying that there's only one. But these are manifestations of what's happening on the inside. Would you recommend supplements? I know you've produced your own supplement, which I have here. And I've actually been drinking as we've been talking called 38 Tara, isn't it? 38 Tara and 38 Tara, what that means is 38 trillion. So this is in reference to the 38 trillion microbes that live inside of us. And this particular product is called daily microbiome nutrition. So in this product, we are using specific ingredients at specific doses that have been clinically proven to have an effect and to have a benefit for your body.

1:57:32That includes things like improving your gut microbiome. It also means improving your bowel movements. We talked about going from a Bristol one or two or a Bristol six or seven back to a Bristol four. That's what I'm talking about right now. But also reducing digestive symptoms. So these are the benefits that we would get from regular use of a pre -botic. It's easy. It's a powder. You've been drinking it. I think it tastes pretty good. I don't know what you think. I was shocked. Yep. And it was so delicious. Yeah, refreshing. I've actually finished it all. I had it. We started the interview with it in this bottle here and it's all gone.

1:58:05Where do people find this? 38 Tara. 38 Tara is available at our website. So you come to 38 Tara, 38TRA .com. And we are launching in mid -January for the first time. We're launching in the US and Australia. So in the UK it may be more difficult to get access to. But just be aware that if there's enough of a demand, then we would serve that demand. But if I am in the UK, I can still order it. There would just be probably shipping costs instead of shipping costs. Okay. Super interesting. I've learnt so much today and it's crazy because I didn't think I had much else to learn about the gut microbiome.

1:58:42We had lots of conversations about it. But it's really inspired me. It's informed me. And it's given me a sort of actionable blueprint to start taking action in my life. And if I were just to close that out, what are the takeaway messages for everyone? Edy -wide variety of plants. Food, vegetables, whole grain, seeds, nuts, legumes. Every single one of these. Coffee. Coffee counts. Absolutely. So add more variety to your diet. Add fermented foods to your diet. Get outside and exercise. Get a good night's rest. Hug that person that you care about. Focus on human connection. Like these to me are where the priorities are at.

1:59:20Many of these things, by the way, are completely free. We have a closing tradition on this podcast where the last guest leaves a question not knowing who they're going to be leaving it for. And the question that has been left for you. When have you been happiest in your life? You may define happy in any way you like. Happiness is, I think what really matters. And we, I think we have a problem in today's world of excessively fixating on the objective things like, like, money. And losing track of the things that are less measurable. I have no clue how happy you are at home. I have no clue. I have an idea of where you're at financially.

1:59:59Yeah, this is where the essence of life is. And to me, my happiness comes from my family. It's the side of me that you wouldn't know unless you like literally where my friend in Charleston, South Carolina, and spending time with me, the real person. Right. But regardless of what you see on this camera or here on this episode, we are real people with real lives. And to me, my happiness comes from the pursuit of things with my family doing everything within my power to fight for them. And also just to enjoy time with them. That's what it's about. That's a beautiful answer. Thank you so much, Dr.

2:00:39World. You have a remarkable ability to communicate, but also you have a wealth of knowledge that is unrivaled as it relates to the issues we're talking about today. And it's really, really incredible. You're really, really incredible. And you're doing so much fantastic work for so many people because it wasn't until a couple of years ago that I learned about the gut and microbiome. And I know because I can see the data that that the society at large or on a journey of now understanding the gut more and more and the research that's coming out every year is pushing us closer to that understanding.

2:01:08And that understanding will unlock the things that we're all aiming for in our lives, which culminate in what you said there, which is happiness. So that's the work you're doing. You're increasing public happiness. And I think that's something that's an incredibly worthy mission. So I thank you for that on behalf of all the people that are listening today that got to this part in the conversation. And that don't have a means of reaching you directly. Thank you on behalf of all of us. Thank you. It's an honor to come on the show with you. And for people who want to continue that conversation, this is why I put things out into the world.

2:01:38And you can find me on social media as the gut health MD Instagram Facebook. I am on TikTok, but I think a 14 year old stole my handle. So the gut health MD underscore is how you'll find me there. But also you can come to my website, the plant fed gut .com. Sign up for my free email newsletter. That's where how I communicate the like I think the most effectively like I break down studies there. So come sign up for my email newsletter. And if you want to check out 38 Tara, you can learn more there as well. I'm going to put everything in the show notes. I'm also going to put in the show notes, which is the first time I've ever done this.

2:02:08I'm going to put the brief for this conversation in the show notes. And what the brief is it's essentially all of the research my team did and they condense it down into about 10 pages. And I think that's really important because we covered so much ground here today that someone just listening, someone who was having like a second screen experience or was doing the dishes or on the tube or whatever. There's a lot there. The 10 pages you'll find in the show notes summarise this conversation, the key takeaways and the actual insights. And this is something I'm actually going to start doing on an ongoing basis.

2:02:40Also the materials we discussed in this conversation like the Bristol Stool Chart and all of the other information that you talked about, which will pull from you after this conversation will be in the show notes, including links to find Doctor will everywhere on social media and on his website. Amazing. That sounds so cool. Can't wait to check that out. Do you need a podcast to listen to next? We've discovered that people who liked this episode also tend absolutely love another recent episode we've done. So I've linked that episode in the description below. I know you'll enjoy it.

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