Leading Gut Health Expert: Follow these principles to fix your gut and fix your life - Dr. Megan Rossi

0:00Elite athletes and very sick people both coming to me, you know, complaining of the gut. and I was like, gosh, what is going on here? It just triggered something in me. I lost my sister to a medical mistake when I was really young, right? From then on, I think I had this like deep seed responsibility that if we've got the science to do better, we need to use it. Dr. Megan Rossi is a dietician and award-winning research fellow at King's College London investigating nutrition and gut health. She founded the Gut Health Doctor platform, which she runs alongside her clinic to help people better understand and care for their gut health and wellbeing.

0:32Dr. Megan co-founded gut health food brand Bio & Me, now available in supermarkets across the UK, and created Smart Strains, a range of condition-specific live bacteria products to meet the specific needs she was seeing in her clinic. Her two books, Eat Yourself Healthy and Eat More Live Well, are Sunday Times bestsellers. I'm hearing constantly plant-based diet. The plants contain fibers, the six macronutrients that we need. In an ideal world, aside from taste and preferences, should we all be vegetarian? You've got this little pet inside you, right? It's these trillions of little microbes. So if you don't feed them right and exercise them right and relax them, they can't be like your little superpower.

1:15All the different categories actually contain different types of fertilizers for your microbiome. You need all of them. Optimally, that's what we're seeing. Including herbs and spices. Exercise 100 % is a really important pillar for good gut health. and too much exercise, can it be bad for our gut? So if you're stressed up here, what happens is these nerves are like live wires, right? Literally strangle your gut. There is no scientific evidence, no clinical trial ever out there showing that taking a daily pro-back is going to help with your general gut health. If you had to compress all your knowledge into one essential advice that we should implement into our daily lives, what would it be?

2:09Dr. Megan Rossi, how would you describe the work you do? I would say that I'm a gut health researcher and a dietitian nutritionist. And then I would say I'm also an accidental entrepreneur. Accidental. I love that. Very different to you, right? Like I was listening to your story and it was very focused, whereas I never saw myself in business. Always there as a clinician to help people to discover the science. And there was just these massive gaps that was just so infuriating for me to see that kind of led me to the entrepreneurial side. That's fascinating. Walk me through the credentials that allow you or enable you to be a subject matter expert.

2:53What did you study? So I started off studying nutrition and dietetics. So back, I think, nearly 20 years ago. So I was just obsessed with food. I loved food. And then to learn that food could also do you really good, I was like, wow, this is like a magical combination, right? So I spent four years studying that. And then I graduated and was working as a dietitian in two very different settings. One was in the hospital setting with all different types of conditions. So there was people with different cancers, heart disease, kidney disease. And then I was also really fortunate to be the nutritionist for the Australian Olympic Cyclone Swimming Team.

3:29So here I was seeing two very different populations, right? Elite athletes and very sick people both coming to me, you know, complaining of the gut. And I was like, gosh, what is going on here? And I actually had lost my grandma to bowel cancer when I was studying uni and I was really close to her. So I kind of had a bit of a thing to start with the gut. Hated it. And then these, you know, my patients and clients were coming. I was like, what's going on? So that's when I thought, you know what? I need to understand more about this. And it was 2010, so there hadn't been a whole lot of gut health research come to the forefront.

3:58So I essentially threw away my early 20s of doing a PhD, looking at how we nourish the gut, those trillions of microbes, and whether that could impact the health of not just the gut symptoms that a lot of people struggle with, but systemically throughout the body, things like mental health and kidney function. And it was really that PhD that transformed my relationship with the gut and made me so obsessed and in awe of this organ, right? And I was like, wow, actually, it's just been so misunderstood. And I hated it because of my grandma. But I was like, you've been misunderstood. People haven't understood how to look after you, right?

4:36But you are so powerful. And I knew at that stage, I could improve people's lives and very real and often surprising ways by targeting the gut. So after the PhD, looked around the world because, you know, to establish my self-historic is very far away. I saw King's College in London was doing really innovative gut health research. So I begged them for a job and I'm still there a decade on doing all different types of nutrition interventions, looking again how it impacts our gut microbiome, those trillions of microbes. Yeah, that's me. Fascinating. Imagine I'm a 10-year-old and I want to understand your area of expertise from a base level.

5:13How would you describe to me? what is the gut microbiome? Yeah. So essentially you've got this little pet inside you, right? Okay. So it's these trillions of little microbes. And these little microbes are so important to whatever your health goal is, right? So maybe you want to be the smartest at school. Maybe you want to be the fastest runner or, you know, whatever your goal, these little microbes can help you, but you need to look after them in turn, right? So if you don't feed them right and exercise them right and relax them, they can't be like your little superpower. So that's how I describe it to a 10-year-old.

5:52And again, it's kind of depending on the age group. But I think it is a landmark scientific discovery that we have these microorganisms in our gut, right? So for those who are new to the space, yes, they'll probably heard about the bacteria, but we also have fungi. We've got the virus component and even some parasites, right? So all these different types of microorganisms, which you can't see by the naked eye, together make up that scientific world, our gut microbiome. And they all have different skills. And historically, we thought that, you know, things like all mental health and our hormones and vitamin production, all that sort of stuff was controlled by human cells.

6:30We didn't know about this whole other kind of organism within us. And now we're appreciating that. And it's game changing to what it means to be human and how we maximize our health and happiness. What I'm reading lately is that there is something within today's world that is severely affecting our microbiome. What is wrong with today's world? One of the main things is our diet, right? So we hear about all the time kind of this ultra-processed food movement, which, you know, historically we were like, well, this is great. It's making food more accessible, you know, cheaper, tastier. but we didn't at that stage really understand about the gut microbiome and how actually ultra-processed food typically has stamped out all of the fertilizers in food that feeds our gut microbes.

7:22So if we're going on these very heavy ultra-processed food diets, we're essentially starving that little inner pet that is so powerful to improve things like our mental health, hormone regulation, all of these sorts of things. So I think that's probably one of the biggest reasons why we're seeing poorer gut health compared to our ancestors. And then many other things like medications often, they are life-saving, right? So I'm very pro-medication. My husband's an NHS GP. But every year there's like, I think around 36 million antibiotic scripts dispensed, right? And yes, they are life-saving, but a lot of them aren't needed.

8:02So if we are eating the wrong food or taking the wrong medication, what are the potential consequences in our gut microbiome? So we're starving a little bit, but how does that affect our normal everyday life? How can I know that this is something that is affecting me? How would I feel that? Yeah, yeah. So it can show in all different areas. And I think that's what's so exciting about gut health, right? Like historically, it was like, do you have gut symptoms like bloating, altered stools? If you don't, then great, you must have good gut health. But actually, because of this whole discovery that highlights these microbes are influencing pretty much every organ in the body, that has just like skyrocketed in terms of our appreciation.

8:42So when I was writing my first book, I wrote, well, I kind of did all the different research to come up with this assessment, right, of people's gut health. Because people are always like, how do you know if you've got a healthy gut? Similar to what you're saying, right? Because like, I don't have gut symptoms. So does that mean I've got a healthy gut? I'm like, not necessarily. So I'll put it as a show note, just a link. It's a 10-question assessment, which essentially scales your gut health from 0 to 20, just to give you a better idea of kind of where your gut health sits, right? And it's things like how stressed are you, how much sleep are you getting, what medications you're on, and things like that, to kind of get an idea of more holistically how your gut health is.

9:21Does that mean, sorry to interrupt you, because you are labeling this or assessing this in 20 questions, does that mean that there are 20 factors that are the most important ones that affect our gut health? So there's 10 different questions. Oh, 10 questions. And I'd say 10 main areas, right? I mean, there's so many more. I just want to condense it down to like a, you know, five-minute questionnaire. The scoring system is up to 20. Because some points, some scores you get like two points. Just to kind of give people a little bit of a taste around and understand where their gut health kind of is.

9:56And then in clinical practice, I get them to do that baseline. then we do whatever dietary intervention we think we need or lifestyle intervention to improve that gut health. And I would get them to repeat that questionnaire just because it helps motivate people and go like, oh my God, look, I've improved my gut health. Because like you were highlighting, gut health can mean different things to different people, right? So it's kind of highlighting that. For example, there was a really incredible landmark study from some of my actual colleagues in Australia from the SMILES trial is what it was called, the Food and Mood Institute.

10:29And what they did is they had people who had moderate severe depression, right, all diagnosed. Half of them got this gut-boosting diet, so very Mediterranean. I'm sure we'll talk about what foods we should be feeding our gut microbiome. The other half got this befriending type of counseling. And they followed them. So they had either of the intervention, the gut-boosting diet, or these are really high fertilizing the microbes, keeping them very happy, all the befriending type of counseling as a nice control group to make sure any benefit of the diet wasn't because they're seeing like a dietician.

10:57They followed them for 12 weeks and they reassessed their mental health. And what they showed in the diet group, over 30 % of them had a significant improvement in their depression scores, which would have classified them as no longer clinically depressed. In the control group, that was only around 8%. What I find fascinating about that primarily is that the study went on for 12 weeks, which means that whatever we are eating, it is immediately impacting our not only gut health, but as you were mentioning, our brain's health? Absolutely. Yeah. It can within three days start to change our microbes depending on what we're feeding it, right?

11:36But I think what a lot of people probably miss, particularly in things like healthy generally, is that yes, for the four weeks you can eat really healthy. But if you go back to an ultra processed food diet, then unfortunately you're going to undo a lot of that goodness, right? So we do need to think about this as an ongoing pet to look after and not just like a quick fix. But yeah, so that's that study, I think, was the first time that gave me the confidence as a dietician to be like, wow, really nourishing the microbiome can have clinically important improvements in people's mental health. Now, I always make the disclosure when I share that study is that everyone stayed on the antidepressant medication.

12:12So anyone listening to this who's like, oh my God, I'm just going to chuck out my meds for this new eating gut boosting plan. Never, ever do that, right? It's more to highlight that as an adjunct, additional therapy can be really powerful. And certainly, you know, with the support of your prescribing medic, you know, you might actually, by focusing on your microbiome, come off your antidepressant medications if you want to. So I think it's just a really empowering area of research where, you know what, you can't necessarily change your genetics. You can't go back and be like, I should have, you know, mum should have married this person or whatever.

12:43But you can change your micros by how you treat them, which, as we're seeing, has got these far-reaching benefits in terms of our health risks. If you were to give me a split percentage of how much our genetics affect our or define our gut microbiome healthiness versus our lifestyle, what would that percentage be? Yeah, so the percentage of kind of the predictability is probably only around 10%, right, due to genetics, which again is why it's so empowering. The rest of the 90 or so percent, we're in control of. Wow. Yeah. And obviously there's going to be things outside of our control. For example, if we live in a lower SES environment, we don't have the ability to, you know, avoid so much pollution, which can impact our microbiome.

13:32But yeah, diet and lifestyle is huge. And that's, again, why I think it's so important that everyone learns about the microbiome, right? Because, you know, so many people are, you know, born with genetics and they're just like, I feel so helpless. I'm like, well, for, yeah, there are going to obviously be conditions where genetics are going to rule, right? But so many of the elements we're seeing, actually our microbiome is having a really big impact and we can control our microbiome. I feel like generally people can relate to eating unhealthy processed food and that having a negative consequences in our gut's health.

14:10But for example, myself, if I'm going through a stressy period and I can even take this back to like university or high school times in which I was maybe preparing for an exam and I was incredibly stressed, that would impact my stomach. That would impact my gut. Why? Why does, how and why does the stress impact our gut? Yeah, it's a really good one, right? Because so many people I see in clinic are like, I just want a gut boosting diet and then I'm going to have great gut health. And I'm like, absolutely, let's focus on your diet and we can help you get towards a better gut health. But if you are not exercising, super stressed, not sleeping, the other three pillars, you can't have perfect gut health, right?

14:54So exactly what you're experiencing, there is this two way communication between our gut and our brain. So that's why a lot of people refer to the gut as a second brain. So there's literally hundreds of millions of nerves that connect the two, and it's called scientifically the enteric nervous system. Enteric. Enteric nervous system, yeah. So if you're stressed up here, what happens is these nerves are like live wires, right, literally strangle your gut and can, you know, change the movement of the gut, how you absorb nutrients, and obviously impacting your microbes as well. So absolutely, it's one of the, I think, biggest causes that I see in clinic of why people are having direct gut symptoms is because often up here is strangling the gut.

15:38So no matter what they eat, it's just not having that same beneficial impact. What do you think is more effective? To follow a preventive plan so that doesn't happen in the first place or a reactive plan? Yeah, I mean, prevention is always going to be the best. No one wants to go through periods where if they get to the level of having really bad gut symptoms, in clinic, often it means that they have to go on this restrictive diet for a period of time, then we start to reintroduce. It's a lot of work to kind of retrain their gut to handle healthy foods and not have those symptoms. So a lot of people probably have heard of irritable bowel syndrome, So it's a gastrointestinal disorder where essentially that communication between your gut and your brain is dysregulated.

16:27So, you know, foods that often stimulate a lot of our guts like chili and fat, you know, caffeine, when you have IBS, that's hyper exaggerated. So you can get really bad gut symptoms. So if you develop IBS, which, you know, there's many different causes or increased risk factors. For example, if you are stressed chronically, often university students go through really intense periods. A lot of them can then come off the back of that with IBS. And then we can, you know, help manage the IBS, but it takes quite a number of years to get them back to having no symptoms. Whereas if you prevented that really strong period of stress, which I know is really difficult, but doing things like diaphragmic breathing and really relaxing the gut through stressful periods, then actually you kind of avoid that chance of having to get IBS.

17:19I'm in a stage in my life in which myself, but also many of my friends, they want to have kids or they're going to have kids. And one of the topics of conversations almost in these days in every single dinner is how can we increase our chances of having a baby? And a subtopic of conversation is how our gut health can impact our hormonal imbalance. And then by definition, perhaps our chances of having a baby. How does our gut health impact our hormones and then by default our ability to have a baby? So this whole gut hormone connection is incredibly fascinating, right? So we spoke about kind of the gut brain axis.

18:03There's all of these axes. The gut hormone one is one that I think is really starting to take off in terms of the research. So what we've discovered is that certain types of microbes are really important in regulating and kind of recycling different hormones. So one of the strongest areas of research is with estrogen, right? And so really important in a lot of female-related conditions as well as things like fertility. So what happens is our body produces estrogen. When it gets old, it gets dumped into the gut. Now, the gut is this nine-meter-long digestive tract, right? Now, often that estrogen would just kind of get, you know, pooped out essentially, right?

18:40But there's a group of microbes called the estrabilone, which turn that inactive estrogen to active estrogen. And that helps then recycle the estrogen throughout the body. And the same actually goes with things like testosterone and other sorts of sex hormones. We're discovering our microbes actually are quite important in kind of regulating that to some extent. So absolutely, I think when it comes to things like, you know, different hormone-related conditions, endometriosis, PCOS, as well as things like fertility, the research is really starting to go, okay, let's delve into this. And how can we help people who may have, you know, these different issues by targeting on their gut health and their nutrition?

19:21We'll get into the solutions very shortly. But a lot of people also, they want to understand, and I include myself in that basket, what are they intolerant to when it comes to food? should we be doing that? Is that actually affecting just how we digest but not necessarily our gut microbiome? Yeah, so I think it's a really important one, right? So food intolerances can cause people a lot of gut distress but they are different from food allergies, right? So food allergies involve the immune system where, you know, for example, a peanut allergy people can have struggles breathing or, you know, certain other types of allergies where, you know, they might get skin rashes and stuff like that.

20:08So if it's an allergy, you need, you know, it's really important to get diagnosed, to remove that because you don't want to have this ongoing inflammation throughout your body, right? When it comes to food intolerances, you know, there's many different types. It could be lactose, so milk sugar intolerance is quite common, particularly in certain types of ethnic backgrounds. You know, some people have intolerance to gluten, although the kind of frequency of that is a lot less common than actually what the general public have perceived that to be because everyone thinks gluten is the enemy. Is it not?

20:40No. So it's a protein, right? And if you have celiac disease, which is an autoimmune condition where your body thinks that gluten... Gluten is a protein. Yeah. Yeah, yeah. Fascinating. I know a lot of people are like, yeah. So, I mean, it's got a lot of roles in end foods, which we'll go into. But essentially, if you have celiac disease, which is around 1 % of the population, then you need to cut out all gluten, right? Like even a crumb of ran using the same toaster as someone can cause this ongoing gut inflammation and there's a lot of negative consequences of doing that. So it's really important to rule out celiac disease.

21:15And I should probably note that half a million people are living in the UK with undiagnosed celiac disease because they're like, bit of bloating must be IBS, right? So it's really undiagnosed. So it's so important before you start cutting out foods and playing with your diet, go to your doctor, get checked for celiac disease, a really simple blood test. But do that before you cut gluten out. Because if you cut gluten out, then you can get a false negative and you can still have celiac, right? So that we kind of went on a bit of a tangent, but then there is this other category called non-celiac gluten sensitivity.

21:45So this is thought to probably only affect maybe like four to 6 % of the population where they don't have celiac disease, but there seems to be some issue with gluten. Their body's just not working with them. And again, it's this area of research, which we're still trying to understand. But a lot of people like I would see in clinic who've got non-select gluten sensitivity, i.e. gluten tolerance, they can still have small amounts of gluten and it's fine. They just find maybe having too much. So there are different types of food intolerances, which can be more affecting people's quality of life.

22:17So for that reason, it's important to get on top of them, right? But there is crazy myths out there around all these food intolerance tests. And it's really unfair that they can exist despite having no science behind them. In fact, the World Immunology Organization has literally said that some of these tests, like the IgG-mediated test, is not valid for diagnosing food intolerances. What is the IgG test? So it's a play on IgE. So IgE is a blood test that certain types of allergies, you measure it and you're like, yes, you've got an allergy to this, right? So it sounds very similar. But actually, the IgE is more of a measure of like tolerance that you've had it in your diet.

22:59So often, you know, people come to see me in clinic who've gone online and had these IgG tests or they've sent hair samples away, all there's so many different ones on the market. And they've come with these lists of like, you know, 20 safe foods, all the other foods are like apparently intolerant to, and there's just no science behind it. Like it's fraudulent, right? So the way that we, you know, diagnose a food intolerance in clinical practice is kind of this three-arm method, right? So you would record all your, what you eat and your symptoms for, you know, a week or so. And then you would, if you see that there is a correlation, for example, milk sugar, so milk products, you would restrict out that food for, again, depending on what it is, maybe like one to four weeks, if it's like less common in your diet.

23:48And then it's really important, the third step is to reintroduce. That's the third R, to make sure it's not just a chance finding if you feel better during that period. If you don't feel better, then reintroduce it, right? So that's a way in clinical practice that I would work with someone to just kind of diagnose a food intolerance test. Now, the only one where there is a valid test is for lactose intolerance and get like a breath test. But it's so, lactose intolerance is the easiest food intolerance to diagnose. It's as simple as like, you know, getting a cup of milk, 250 grams of milk, have it skimmed so the fat is not the issue.

24:22Have it all in one sitting over maximum 10 minutes and then if you get symptoms within the next four or so hours such as bloating or altered stools, then it's probably likely you've got lactose intolerance. But still, you can have small amounts of lactose, right? And even your microbes with learning actually can help digest lactose and those who are lactose intolerant and help them be able to consume more lactose-containing food. So yeah, there's this whole world of food intolerances. But I think the take home, because I know I did a lot of rambling there, the take home is very much like don't fall trap to all these food intolerance tests.

25:00If you think there is a food that you are struggling with that do see a dietitian or nutritionist to get advice around going through that three-hour process, Or my first book actually goes through that three-hour process for lactose and gluten, which you can easily do at home in quite a safe way. Are there different severities of intolerance? Meaning I have a mild intolerance to lactose, which means that I can drink a little bit of milk, but not too much. Or intolerance is intolerance and that's it. No, absolutely right. You can have different levels of it, right? The same with things like histamine intolerances, where some people can have small amounts, But actually, if they have it over their threshold, then they'll get symptoms.

25:42And we'll get that threshold from the clinical test. So it really, again, going through that three-hour process, finding out when we reintroduce how much you can have without having it be tipped over for you. And if I'm intolerant to a particular type of food, but maybe I really like it or its nutritional values are great, can that unbalance the fact that I'm intolerant to it? So should I be eating it because I'm not allergic? Yeah, yeah. So this is a really good one, right? So it's something that I definitely recommend. For example, if you are lactose intolerant, then I still say try have small amounts of lactose in your diet.

26:27So you can actually have around 12 grams of lactose. So like 50 grams of 50 mils of milk three times a day. So kind of space it out because it gives your gut that ability to digest it more. And like I was alluding to before, if you slowly start to increase more lactose, some people's microbiome actually can help digest the lactose. Because with the lactose intolerance, one of the main issues is that you don't have the enzyme to break down lactose. So the enzyme is called lactase enzyme. So as you get older, often that lactase enzyme doesn't kind of grow in your gut anymore as efficiently. So then a simple assumption would be that as we grow older, we should consume less lactose.

27:09so that is yeah one of the arguments and particularly in some cultural groups um where you know i think it's asian and african heritages the frequency of lactose intolerance is like 90 right so it's really high but of course there's you know benefits to um you know things like kefir for example like fermented dairy um for for gut health benefits and actually fermented dairy breaks down some of the lactose so it usually contains around 30 less lactose than a cup of milk, for example. But what we're, again, learning is that you can train your gut microbiome. So even though you don't have the lactase enzymes as much anymore, you can train your microbes to kind of develop those enzymes to break it down for you.

27:52So you can then still get things like, you know, the calcium and those biopeptides from the kefir by slowly teaching a microbiome to help digest that lactose for you. Fascinating. So we can get rid, potentially, we can get rid of some intolerances if we gradually introduce a particular type of food into our diet and our microbiome would learn from that and how to digest it and how to use it effectively. Absolutely. Yeah, yeah. Fascinating.

28:24You mentioned the immune system several times. I read that 70 % of our immune system sits in our gut. Now, going back to the analogy of pretending that I'm 10 years old, in fact, please pretend that I'm 10 years old for the entire of the episode. Can you describe to me what is the immune system and what is its purpose and why 70 % of our immune system sits in our gut? Yeah, so I like to think of the immune system kind of like your own little personal army, right? That's going to help protect you from all of the different bad viruses. Remember, not all viruses are bad, but all the baddies kind of out there and the germs and those sorts of things, right?

29:02So your immune system is really important. And then if we think about the immune system, it's kind of different layers to it. So you've got the physical barrier. It's kind of like the first line. And that's like in your gut lining, which is that nine-meter long tube, you've got this mucus layer, right? And that kind of physically prevents some of the baddies from getting from your gut into your blood system. So there's a mucus layer. Then there's something called the innate immune system where essentially that's kind of the immediate. it. So if your immune system, there's all these cells in your gut, because actually that's other than your skin, your gut is how things get from your gut, from your, you know, this hollow tube into your blood system.

29:41So it's one of the biggest gateways that the baddies can get into your body. So that's why 70 % of the immune system lives there, right? Because it's really kind of high highway for where all the baddies could get in. So it's really important. So that kind of innate immune system is where, you know, it'll immediately sense something's bad that's kind of gotten, you know, through the mucus layer, through that barrier into kind of closer to the immune cells. And that will result in things like inflammatory markers being produced, which then tries to kill the baddies. And then you've got this third layer, which is called adaptive.

30:14That's more like the secret agents, right? So you've got these secret agents that are more like trained specialist to kill specific types of baddies. So you've got these three different layers to your immune system, right? And like you said, 70 % of the immune system is living in the gut. And what's so important we've discovered is that actually the gut microbes, because remember, we've got these trillions living in the gut right next to the immune system, are so important for training the immune system as we age. Particularly in the first, you know, thousand days of life, It's thought to be really important for the microbes to kind of tell the immune system what it should react to.

30:52The first thousand days of life. Of a baby's life. Yeah, yeah. And what it shouldn't. So what should a parent do in those first 1 ,000 days? Yeah, so what we've seen that, I mean, if you can, I was fortunate enough to grow up on a farm. We see that kids who grow up on a farm or with furry pets seem to have, you know, more trained immune systems. And that's because they're exposed to more different microbes. So they've got more diverse microbes, which can then teach their immune system more effectively. And there's this whole area of the hygiene hypothesis, right? So it's thought that, you know, in the last 20 or 30 years, we've probably become a little bit too overly hygienic.

31:33And therefore, we're sterilizing everything. And we're not allowing our kids to get exposed to microbes, which are important to, you know, develop their microbiome. And if we expose an adult to the same stimuli at later stages of their lives, the microbiome won't be able to adapt as well. Probably as well in terms of, you know, training their immune system. Because it's thought to be at the very start where the immune system is kind of set in its place. Fascinating. So kids are neuroplastic, but also the immune system in our gut is, it has a lot of plasticity. Much more than when we're adults.

32:11Yeah. Yeah. Now, that's not to say that if you have a bad initial, if you're on loads of antibiotics or for whatever reason, don't write off your gut health and like, oh, my immune system is terrible. I've had the worst start. There's still things that you can do. But exactly as you said, it is kind of the best time if you can intervene. I feel like a lot of people after this episode, if they have gut problems, they're going to blame it on their parents when they were young. You gave me these foods and you didn't give me these other foods. Yeah, I mean, but it's kind of a little bit like IBS. A lot of people who kind of had trauma or loads of antibiotics when they're kids have a high risk of getting IBS.

32:51Let's continue talking about diets. What do you think about very niche specific diets like the keto diet, the paleo diet? My brother, my twin brother is right now following the keto diet. And anytime he follows any new diet, he shares so much knowledge and information and data about it. and he's incredibly deeply convinced that that's going to be the diet that will change his life. I'm a bit more democratic than that. I don't think everything is black or white, but I would like to get your opinion. Yeah. So, I mean, like you said, there's many different diets out there. Now these, you know, the keto where they go really high fat, they cut the carbs.

33:28And, you know, paleo, they don't have things like legumes and whole grains, right? What we know is that plants essentially feed our gut microbiome. So when we think of plants, there's what I call the super six. So there's six different categories of plants. So you have your whole grains, so things like your barley and your rye, your oats. You've got, I'm not going to put you on the spot and tell me what the other ones are. You've got your fruit, you've got your veggies, you've got your legumes, so things like your chickpeas, your butter beans, you've got your herbs and your spices, and you've got your nuts and your seeds.

34:01Right? So all the different categories actually contains different types of fertilizers for your microbiome. You need all of them. Optimally, that's what we're seeing. Including herbs and spices. Yeah, because they've got different types of these polyphenols, these different types of plant chemicals, which are thought to do different things and feed different microbes. So if you just, you know, even though blueberries are considered a superfood, if you just ate blueberries and that was it, you would starve the microbes that love the quinoa and the microbes that would love the nuts, for example.

34:31So actually, again, what we're seeing in the research is that people eat more different types of plants across the Super 6 have better gut health because essentially they've fertilized more different types of microbes. And just like an army or a sports team, right, you want to have as many different skills within your little ecosystem because it's going to look after you. And if a body comes in, you've probably got the weapons within this whole network to look, you know, to protect you, right? So if we think back to the keto and the paleo diet, they're cutting out some of these super six, right?

35:05Now, I don't want to dismiss them because I, again, see in clinic, but some people just swear by them, right? And what I would say is why there's two main reasons why people feel good on them in the short term anyway. I think the long term as well, we start to see the cracks appear and probably they might start to get higher risk of things like heart disease and things, you know, five, 10 years down the track, depending on how old they are. But in the short term is that, yes, these diets actually cut out ultra processed foods, right? And everyone's going to feel better if you're reducing down your ultra processed foods.

35:40So that's one reason it gives people a really strict guidance on what they can eat. And therefore they're not going to have the croissant. They're not going to be tempted by the birthday cake, right? So that's one reason why people are like, oh, I feel so good. I'm like, yeah, you could feel that same kind of goodness if you went on a Mediterranean gut boosting diet and didn't have the ultra processed foods. But they've been convinced because it's more of a restrictive diet that it's the keto element and it's the paleo element of why they feel better. So that's one. And then the second reason, people with these functional gut disorders.

36:15So it's the umbrella term that describes things like IBS and functional bloating where structurally everything is normal, but functionally something is out, like that dysfunction between the gut and the brain. So the gut is not moving right and the hormones are affecting how the different enzymes are released and those sorts of things, right? So we have those functional gut disorders like IBS. Now, if you have them, we come back to those loose wires in the gut, really sensitive. So when you eat healthy foods, like some of the super six, things like your chickpeas and your butter beans, which actually are prebiotic, which essentially are fertilizers that feed your microbes.

36:59So they have these really good stuff in them, essentially. They activate the gut a little bit because when the bacteria eat these prebiotics or fiber, for example, which is in all our plant foods, it breaks it down and produces amazing... Fiber is in all our plant's food? Yes. Yeah. So that's one of the reasons why plants are so beneficial is it's got all these different fibers in it. Right. And when the microbes break down the fiber, they produce different chemicals, things like short chain fatty acids, which, you know, do things like help regulate our appetite, you know, help with our immune system.

37:34So it's so beneficial. And that's why fiber is associated with so many health benefits. So we want the fiber, but when the microbes break down the fiber, they produce a little bit of gas. It's just a natural thing that happens. So if you have this underlying sensitive gut, right, and you add the fiber to it from the plant foods, then you're going to get a little bit of gut disturbance and you're going to feel, oh, I just don't feel great. Right. And that's because your gut is kind of hyperactive. So a lot of people going on the keto diet are cutting out the plants and the paleo diet cutting out a lot of these plants and they're like, my gut feels so much better for it.

38:10I'm like, Like, yes, I understand because you're taking out the triggers, but it's kind of like going to the gym. You need to think of your gut, if you've got a sense of gut, kind of like this big muscle, right? So if you've got, you know, you want to essentially accomplish a marathon, right? So you would never just run the marathon. I mean, you could, but you would be in absolute agony. You would train. You wouldn't train, right? So you need to train your muscles to do the marathon slow and steady, right, to get to that ultimate goal because you're training your muscles. Same with the gut. If you have a baseline sensitive gut, instead of just loading all these plants because you've heard this podcast and like, oh my God, Megan saying plants are good because the fiber, I'm just going to load it.

38:54You're going to have a very sore gut because you've got this gut sensitivity. You've got that extra fiber being broken down, the gas being released and stuff like that. But that doesn't mean you should cut it all out and go on a keto diet or a paleo diet, right? Because that's just kind of like a band-aid, you're taking out the trigger. So what you need to do kind of like the marathon is slow and steady, start to increase the amount of fiber and train your gut to be able to digest it more efficiently because we know there's so many health benefits, right? Whereas if you keep on these keto and paleo diets and kind of have this band-aid approach, yes, you're not going to have to go through the training process, but you're never going to get the benefits of having high fiber diet or running that full marathon.

39:35What are some fiber rich foods? Yeah. So like I said, all of those super six, those six different categories all contain different types of fibers, right? So - Well, there are different types of fiber. There are different types. Yeah. So everyone thinks, oh, fiber, that's why I'll just take a fiber supplement. You know, in clinic, people are like, I'm busy. I'm just going to take one of these drinks, which got all my fiber in it. I'm like, yeah, but the thing is there's close to a hundred different types of fiber and they all feed different types of microbes, right? So when someone's like, okay, just tell me what are my top three foods I need to eat?

40:08I'm like, that would reduce down your microbial diversity and not be beneficial. You need to think, you know, across the day, have I had my super six today? And if you come towards the end of the day and it's like, you haven't had your legumes, you're like, okay, even if I'm getting Indian takeaway, I'm just going to add a can of mixed beans in, done. And then I'm going to get those sorts of fibers. And if we want to get to the next level, So you think of plants, there's a super six categories. They all contain different fibers, but they also contain different types of plant chemicals called phytochemicals.

40:42People have heard things like polyphenols. So that, you know, it's why red wine and dark chocolate have been associated with health benefits because of the polyphenols. Now, polyphenols, most of them can't be digested by human cells. The whole thing of polyphenols is to get in the lower part of the gut where those microbes live and they can break down the polyphenols to produce these smaller chemicals which can then get from our gut into our blood system. You mentioned the Mediterranean diet. Yeah. It's been good for our gut health. Yeah. What's the Mediterranean diet? Yeah. So it's probably one of the most well-studied diets in terms of health benefits, right?

41:18And essentially it is a diet, you know, full of those super six, things like your extra virgin olive oil. So it's really high in your fibers, but also in those phytochemicals and those polyphenols. And I was just thinking, I probably should have said at the very start, when we have this nine meter digestive track, right, our gut health, things like when we eat protein and most carbs and fat, it gets absorbed higher up that nine meters, right? So we get from our gut into our blood system to feed things like our muscles and our brains. Now, the thing about fiber, which is why it's so unique, is that human cells don't have the enzymes to break it down.

41:57So kind of like lactose intolerance, right? We don't have the enzymes to break it down. We don't have, everyone doesn't have the enzymes to break down fiber. So fiber gets malabsorbed through most of the digestive system and it makes its way in the last 1.5 meters of that nine meters where most of our microbes live. And they are the ones who have the enzymes to break down the fiber. So fiber is not food for humans. It's food for our microbes. It's fertilizer for them. So that's why we're starting to, and we've always known people who ate more fiber, lived longer, were happier, lower health risks.

42:34We never really understood why until we discovered the microbiome. We're like, because that feeds them. That's the fertilizer. That's kind of the missing link. So yeah. You've also mentioned prebiotic. What's the difference in between a prebiotic and a probiotic? Yeah, so prebiotic, literally one letter, which just makes it so difficult because they're literally opposite things. So prebiotic is a fertilizer for the microbiome. So I mentioned before about things like legumes, so chickpeas, butter beans, they're really good sources of prebiotics. So many prebiotics, they just make the microbes grow even faster or certain types of anti-inflammatory microbes.

43:13So prebiotics are through the super sex, right? So you're having the super sex, you're going to get enough prebiotics. Now, probiotics, P-I-O-biotics, are these live microorganisms, which when you have them in adequate doses, confer a health benefit. So actually, they're quite different because they're kind of like the live microbes and the fertilizers. They're actually quite different things. And I did my PhD in probiotics. I'm very passionate about that space because there are just so many myths around probiotics. People are like, oh, I'll just take a probiotic off the shelf and I'll be having good gut health.

43:49I'm like, that's not how probiotics work. They are very kind of like medications. They're very specific. Each different type of probiotic is called a strain, a different type of bacteria. It has a different function in the body. Like some microbes are really important for training the immune system. Others are really important in helping with your hormone regulation. So each different strain of probiotic, and that's why it's quite a scientific thing, has a different purpose and you need to give it a different dose for a different reason. It seems to me that when people feel like they're depleted from either prebiotics, probiotics or nutrients like fiber, they take supplements to off-balance that depletion.

44:30What do you think of this? So I, again, understand why marketing claims are so convincing, right but so many of the beneficial chemicals in plants mother nature has hanging over us right we can't make a lot of these you know in in the factories so a lot of these phytochemicals that i mentioned we we just don't know how to make right they we can only get them from plants and often plants are so ultra processed in a lot of these supplements like you know the drink powders and stuff, that those spider chemicals have been damaged and broken. So I totally understand why people are like, I need more fiber.

45:07I'm just going to take a supplement. But you're not going to have those same health outcomes if you were to get that fiber from the super six, right? Now, that's not to say that I would never recommend a fiber supplement. But like I said, there's many different types of fibers. And for example, if you struggle with constipation, which is very common, that actually there's really good scientific evidence for psyllium husk fiber. You add it to some warm water in the morning or to your porridge, and that can really help with laxating. So it's for a specific need state, would I recommend a specific type of fiber?

45:41It seems to me that everyone should become vegetarian. I mean, I'm hearing constantly plant-based diet, the plants contain fibers, the six super like types of super plants with all the macronutrients that we need. in an ideal world, aside from taste and preferences, should we all be vegetarian? So I would say we should all include oily fish as well. So if you could have all the plants plus oily fish, I would say that's probably the best combination in terms of optimally feeding your microbiome. So we don't need steak and chicken. We just need fish and veggies. In terms of, I guess, the specific nutrients, you know, we can get the protein from the fish and we can get it from the kefir, you know, to feed the muscles.

46:32We can also get the iron from plant sources. Yes, it can be more challenging to get iron from plant sources, but if you combine plant source iron, so from legumes, for example, with some vitamin C, such as a tomato, that can increase your body's ability to absorb that iron. Now, I'm very pro everyone, including whatever they want in their diet. Like I eat chicken and some meat, but very small amounts. And so I'm just being quite a purist in terms of actually, if we think of where the science is at for optimal gut health, it's your plants, it's your fermented dairy, and it's your oily fish. So you wouldn't need the other meats.

47:10How does an ideal day of nutrition look like for you? So breakfast, lunch, and dinner. Well, you know, it really does change. But like, you know, for example, this morning I had my Biome Potter porridge. So it's got the like 15 different types of plants in it. Got some like dried carrots in it, chia seeds, all of that sort of goodness. And then I usually have a, you know, some fresh fruit, whether it's like a handful of blueberries. And actually blueberries contain a polyphenol, which is thought to help increase the blood flow to your brain. So if I've got something like an interview or something stressful, I need to like be on my game.

47:43then I often have blueberries to kind of increase that blood filtration. And that's polyphenol. And that's one of the polyphenols is kind of the... What other fruits have polyphenol? So all of your bright colored, you know, fruit typically contains different polyphenols. Red wine is one of the common ones, dark chocolate. Yeah, not to say have red wine because obviously it's got the alcohol component in it, right? So that's one people like, oh, should I have red wine? I'm like, well, it's got polyphenols, but also it's got alcohol, which have too much. It'll make your gut lining leaky, which means things that normally should stay in your gut and you kind of poop out can get from your gut into your blood.

48:19So it makes it a little bit more likely to have inflammation. So it's kind of pros and cons to everything. All right. So if I drink alcohol, my gut will get inflammation. Yeah. So, again, it depends how much. So I'd say any more than one serve of alcohol does make your gut lining a little bit more leaky. Now, obviously, when alcohol is out of your system, the leakiness closes up, your gut barrier gets strong again. But yeah, it's very much dose dependent on how much alcohol you have. Have you followed any food trends like bone broth? So, for example, I live in London, very close to Whole Foods.

48:53And every time I go to Whole Foods, they are promoting a different superfood. One of the latest ones is bone broth. What do you think about bone broth in particular? And then food trends or like superfood trends in general? Yeah. So when it comes to bone broth, there's just, there sadly is no science for gut health, even though that's the number one thing why it's marketed, right? So it's based, you know, the myth is based on the fact that it contains gelatin, which is a derivative of collagen, right? And everyone's like, oh my God, collagen mad. But collagen is like, you know, protein again, you get a lot of the amino acids from other types of protein, like your fish and your fermented dairy and things like that.

49:31And then, so that's kind of why people associate that, but there's never been a human clinical trial showing that bone broth is going to help improve your gut health, right? And in fact, in clinic, often what I've seen, if people are making their own bone broth and they're not skimming the fat, it can lead to increase in their kind of bad cholesterol. So I'd say caution, you know, how much of these saturated fats you're getting from the bone broth. But where I see people like, oh my God, it's so good for my gut. It's coming in. And it's kind of that mindset again, is if you have that sensitive gut, because bone broth doesn't contain fiber, right?

50:04So it's not going to stimulate those nerves if you've got that sensitive gut. So again, it's kind of like that band-aid approach. You're kind of starving your microbiome with the fiber, but it's not triggering that sensitive gut. So you feel good in the short term, but in the long term, you're making yourself kind of more sensitive to fibers when you start to reintroduce them. So if you enjoy the flavor of bone broth, go for it. But the health outcomes is not what you've been led to believe, unfortunately. Good. You just saved me some future money. How does exercise influence our gut health? And are there any exercises that you recommend more for us to practice than others?

50:46Yeah. So in terms of exercise, there's been studies showing the independent of diet, which I think is important because often when people exercise more, they start to eat healthier because it's just that positive mindset. But they've shown that independent of dietary changes. exercising more can increase your microbial diversity. So remember, we spoke about microbial diversity means the different types of microbes in your gut, which can be a bit of a surrogate measure of your gut health, right? More different microbes, lower risk of a lot of chronic conditions. So exercising absolutely is a really important kind of pillar for good gut health.

51:17And one of the studies showed that it was a moderate intensity exercise three times a week, was able to achieve that. But again, I think it's whatever exercise you can do long-term, right so if you love doing weights as long as there's a bit of you know heart rate elevation as well then i think that's probably going to impact your microbiome in a positive way if you like kind of more of the yoga element then again i'm sure that will impact your microbiome in fact there was one study um looking at uh people with ibs and they followed this gut directed yoga flow and i showed that that significantly improved their their symptoms of altered stools and stomach cramps and bloating as well.

51:56So we know that, you know, yoga actually can have this additional kind of benefit. So exercise 100 % is a really important pillar for good gut health. And too much exercise, can it be bad for our gut health? Yeah, I'm happy you raised that actually, because things like high intense, like HIIT sessions, which I love because I love the de-stress and like, you know, the endorphin rush after. But if you've got a sensitive gut, then that can kind of add fuel to the fire. Because what happens in these high intensity and even marathons, right? So I guess that's the opposite. But if it's high intensity or if it's really long duration, what happens is the blood kind of moves away from the gut and that can leave your gut kind of a bit starved from blood and oxygen supply and make your gut a little bit leaky again.

52:41But again, we think, okay, the benefits of doing a marathon outweigh kind of the potential short-term gut negative effects. A lot of people who run And marathons find that it can take up to a week for their gut to feel normal because actually it's quite inflamed after. And obviously, if you've got a baseline of a sensitive gut like IBS, then that can exacerbate that even further. Is it safe to assume, again, maybe this is a very naive way of thinking, but if I see a very fit person, a man with a six pack, would it be safe to assume that he's got health, his gut microbiome is very diverse, very healthy.

53:21And if you see a fat person, he has a very terrible gut microbiome. Absolutely not. That is not a safe assumption because yes, obviously there's one element where there is this gut metabolism connection, right? So people who are in a healthier body weight are more likely to have better gut health because our microbes, again, are really important regulating things like our appetite hormone. So when it breaks down fiber, it can produce or activate the production of things like GPL1 hormone, the active, the target hormone for a Zempic, the weight loss drug. So we know that having a healthy microbiome is important for weight metabolism, but we know also that, you know, in the short term, you can obviously just cut down your calories, get that six pack and have a really unhealthy gut microbiome.

54:06And, you know, I see in clinic, a lot of like CEOs, high performing people kind of have followed that. They're just having the shakes and like, I'm looking good. And yeah, in the short term, they might be like, I'm thriving, but five, 10 years, I can confirm it's downhill from there. Because there's kind of this rebound effect. If you starve your microbiome, then actually that gut metabolism connection can actually, you know, kind of become more dysfunctional. But if, I mean, there's a lot of, I'm not sure if it's research, but definitely there's There's a big talk around fasting and intermediate fasting.

54:44And that's in a way starving ourselves, right? Our microbiome or at least our gut. Is that bad for us? Yeah. So fasting is a really interesting one. And what we see is that absolutely everyone should fast. Not everyone. You know, if you have diabetes or pregnant or that sort of stuff, you need to be cautious of how long you fast. But between 12 and 14 hours. So overnight fasting is really good to kind of give your gut that rest. allow the salts to turn over and kind of refresh, right? And then obviously, as you mentioned, there's all different types of fasting. You've got time restricted where you might reduce down your eating window to six hours in a day, or you've got like the five and two diet where two days you really go low calories, the five days you eat what you want.

55:29And then obviously the extended fast of like the two, three day fasts. And I would say we have convincing evidence that if weight management, weight loss is your focus, then yes, fasting is, you know, it's a no-brainer, right? In reducing down your calories, it will help you lose weight. I guess you have to be careful of the rebound effect of that. If you start to kind of, you know, increase your eating hours, then you're likely just to regain it and maybe some more because it's interrupted the gut metabolism connection. Can you follow intermediate fasting for your entire life? Yeah, a lot of people do and it works for them and they feel good on it.

56:07So I would definitely, you know, one-to-one in clinic would never say you can't do that. I would say caution though, right? So if you are doing these intermittent fasting, it's really important that you're still getting your 30 grams of fiber a day, which if you're really restricting down kind of your eating window or how many calories, it can be quite challenging to get. And again, this is based on animal studies, but what they've shown that animals like mice who are starved of fiber, the microbes start to eat away at the food, at the mucus lining, which then makes it kind of more expose that gut lining and the immune cells are more likely to get triggered and have inflammation.

56:43So I think we need to be careful of the impact that these fasts could have on starving the microbiome, which kind of needs to be fed fairly regularly. And also, again, this is anecdotal evidence, but in clinic, you know, a lot of people who've come to me following long fasts, two, three days, they feel great doing it. A lot of them are reported really high energy, but when they start to reintroduce food, they find that the fibers, the plant foods, make them feel a bit more bloated and uncomfortable. And that's the same kind of analogy of the gym, right? So essentially you don't go to the gym, you're not getting any pain, and then you go do a really hard session again and your muscles can't handle it and you feel awful.

57:26Yeah. So that's another kind of watch out. And you can work your way through that. Again, like if you're going along fast and you feel that you slow and steady, increase your fiber again. You don't just go back to your normal way of eating. So there's ways around that, retraining your microbiome. But again, it's that danger factor of people being like, I ate this high fiber meal. I feel awful. Therefore, I've got an intolerance to fiber. I can't have it. I have to go keto. I have to go keto. And you're like, well, actually, again, that's a Band-Aid effect. So in the long term, that might actually do more harm because we know all of these benefits of having fiber throughout the rest of the body.

57:59I think that the primary reason why people either start working out or do intermediate fasting or follow a particular diet is first because they want to look good and then second because they want to feel good. But I think the first one is to look good. And once drugs like Ozempic have been introduced, I think this has been profoundly confirmed because so many people are taking this drug or drugs. What do you think of drugs like Ozempic? Look, it's a really interesting topic. And I am very much like there is a role for it, right? So for the people who have struggled with their weight, and we're talking, you know, obese BMI categories where they haven't had the confidence to go to the gym.

58:49They try to eat well and they do it for three days and they're just so unmotivated, right? So I've seen it be really helpful for those people in the short term to get to a body weight where they're like, okay, I can start going to the gym. I feel motivated. I'm going to eat really well. And for those people, it can be life-changing, right? It can reduce type 2 diabetes. It can be really effective if they change their lifestyle as they start to feel better. You've said two things there that are very intriguing for me. So you're categorizing people first according to their ability to lose weight.

59:22Are we talking about five kilos that they need to lose? Is that the category of people that you're referring to or very severe obese people that they need to lose 20, 30 kilos? Yeah, so I would say their BMI category should be 30 plus. In fact, I think that's probably the NHS requirement in terms of, don't quote me on that, it is a, you know, it might be, I know there is a, you know, a requirement in terms of who can actually get a Zempic, right? So if you are in the healthy BMI category, you know, lower than 30, then you aren't eligible to get it, right? Because they don't want people to misuse it and be like, oh, I just don't like this little hip fat and therefore I'm going to lose a little bit extra weight, right?

59:59It's people who have a BMI in the obese category who are really struggling to get that lower to a healthy level and then have the healthy benefits. And the second thing that intrigued me is you mentioned that people should be taking this drug for a short period of time. What is a short period of time? Yeah. So again, you know, I'm not prescribing this because I'm not a medic, but it really comes down to the individual's response and how long. but, you know, maybe up to six months depending on how much weight they're able to lose, right? Because we don't want people getting to, you know, from a BMI of 35 to a BMI of 19.

1:00:40You know, that's not healthy, right? So we want to make sure that they get to a place where they then can maybe lose the final one or two kilos through diet and lifestyle. And they feel motivated and encouraged to do that. But then there's obviously the abuse of it, right? where people are like, yeah, because how it works essentially is that people just have no appetite. So like I can't stomach a whole meal, but what I'm going to do in my very small, you know, size of meal is just have half a Mars bar and then have half a croissant and have really low fiber, you know, really awful kind of low nutrient diets and they become malnourished.

1:01:17So even though they physically look like they're bigger, you can still be malnourished and be in a bigger body, right, by not getting all your micronutrients, as well as obviously not feeding your microbiome. So it's those people who do it in a very unhealthy way which find they get stuck on the drug because as soon as they come off it, they've kind of harmed their gut metabolism connection because their microbes are all destroyed and therefore they feel really hungry because their microbes help regulate appetite because I haven't fed them the fiber. And that's a really negative approach to the drug and a negative use of it.

1:01:49So I know that was a long ramble in terms of what's my thoughts on it, But I think there's pros and cons to everything.

1:02:00We've discussed extensively about our gut health. We deep dive into the different factors that affected and the potential solutions. How do these differ in gender, men versus women? Should we all, so if we split the conversation into the factors that affect our gut health and then the solutions that we should be practicing, should both men and women follow both? A really good question. And I guess we haven't really elucidated the full extent of that. There is arguments to say that males should probably have slightly more fiber in their diet. So the recommendations is 30 grams of fiber. and actually in some countries, I think it's the US, they actually give different recommendations for males and females in terms of the amount of fiber.

1:02:52But I think we don't, I'm not convinced there's enough scientific evidence to say that males need to eat more of something or less than something. I think there's probably a lot more nuances than that. And that's what I think excites me as a scientist around the microbiome is like we're constantly learning new things. You know, you've just raised a really good research question. Like we need to investigate that, right? So there's just ongoing, really stimulating questions that, you know, keeps us going. You are a multifaceted person, faceted person, because you're not only a doctor, a researcher, but you're also an entrepreneur.

1:03:27So today we have in front of us two, some of the products from two of the companies that you founded. One of them is Smart Strains and the other one is BioMe. I think we should start with Biome because I believe it's the first company that you founded. So if you were to give me the elevator pitch, what is Biome in a nutshell? Yeah, look, my first baby, nearly six years old. I would say I could give 95 % of people all the knowledge they need for good gut health, right? But if they don't have convenient, gut-loving, tasty foods available to them, they're not going to have good gut. Yeah. Right? So I saw that in clinic all the time.

1:04:12And obviously, that's why I went on social media. I was giving all this information. But people are busy, right? So essentially, that's where Biome is the solution to that. It's delivering or making good gut health deliciously easy. All right. So we have a range of products here. So I can see the kefir, which I'm going to give it a go. Yeah.

1:04:34Do you have a favorite product or a best-selling product? Yeah. So, I mean, this was the first baby on the market. So, our super seedy and nutty granola. Okay. And it's still probably one of the best sellers. So, in terms of, I guess, the food portfolio, we've got the ambient range. So, that's things like our granolas, our mueslis, our porridges, our bars, our porridge pots. That's very nice. And the concept behind the ambient range, essentially just adding as many different types of those plants. So like our granola is often contained around 15 different plant points per bowl. So it contains things like carrots and extra virgin olive oil and those sorts of things, which a lot of people wouldn't suspect.

1:05:15It's also no added sugar. And for me, that was really important because we don't need to be adding sugars into our food to get something delicious, right? That's what fruit comes in. Because yes, it's got the sweetness, so it's got some sugar, but it's also got the fibers and polyphenols, which helps satisfy our microbiome. So all our ranges is always no added sugar because we get the sweetness from whole fruit. And then we've got the fermented dairy range. So we've got the kefir drinks and the kefir yogurts. And again, it's based on the fact that there is convincing scientific evidence that fermented dairy has got all these different health benefits to it.

1:05:52And it's not just the fact that they contain billions of live microbes and many different strains compared to competitors. is. But what happens to make kefir, for example, you have some milk and then you add the microbes to it. And then those microbes start to break down, not just the lactose, that milk sugar, but also they turn some of the proteins into bioactive peptides, which are thought to have these additional health benefits. So yeah, it's a really exciting space to be in the fermented dairy. I've had the pleasure of consuming your products for two reasons. The first one is because my fiance already, she buys this at home.

1:06:30But then the second one is because I was once walking by Whole Foods and they were giving samples of some of your new products. And I really like that your face is on almost every packaging. And I looked at the face and I was like, this face looks familiar. And then I remembered it because the team already invited you to come to the show and we were with the research back. And your team were incredibly helpful, but also knowledgeable because I sometimes feel like when someone is giving samples, you know, they hire very young people that they don't really care about what they're doing. And also they don't really know what they're giving you.

1:07:09And especially in the food and beverage space, probably the unique selling proposition are in this day and age, the nutritional value. So ask them a thousand questions and probably you can already tell that I'm a very curious person. So I was really stressed testing them. I love that. I love it. Yeah, yeah. And they gave me fantastic answers. We even took a picture together. They gave me some samples to take home, which was fantastic. So yeah, we are great consumers of your brand. So thank you for helping our gut microbiome. Oh, thanks. I mean, honestly, the team, what I've learned about entrepreneurship is the team makes a brand, right?

1:07:43Like our Biome team is like a family. And we're very small. Like people don't realize we've only got like 15 team members, right? but they're just so passionate. Like our WhatsApp group on weekends is so busy. And a lot of people are like, oh, no, you shouldn't be contacting work. But everyone is just so passionate about it because they all know that we are legitimately the best for gut health in the market. So they're really proud in that. So yeah, it's a really nice feeling. So thank you for that feedback about the team. I'll definitely let them know. One thing that also struck my attention as an entrepreneur is how they spoke of you.

1:08:20They spoke very highly of you from an admiration perspective, but also from a respect point of view. And I think that that's a great test that can determine how good of a leader a person is within their company. So my compliments to you on that, because that's not easy. And definitely you should keep doing what you're doing because it's working within your team. That's great to hear. Thank you. I've got an amazing co-founder, John Walsh, as well, who is definitely key to ensuring that team bond, which I think is, yeah, it's absolutely vital, isn't it? It is. Let's talk about your latest company, Smart Strains.

1:08:55My new baby? Your new baby, yeah. So this was, it's, you know, very much this huge passion within me. So I think I highlighted before that I did my PhD in pre-bikes, right? So I've always loved and been really intrigued by how powerful different types of bacterial strains are for doing different things. And certainly in my PhD, you know, I was very fortunate to get the Dean's Award for Contribution to Science, where we discovered, along with many others, that different strains of bacteria are doing different things, right? So we need to get very focused on that. And that's why, obviously, in our gut, we want all the different types.

1:09:31So when it comes to probiotics, you know, there is these international probiotic guidelines out there, right? So it's not just me as a scientist saying this. All the scientists agree, which is a very rare thing, I think, in the research world, that scientists are all saying the same thing. and they're all saying that probiotics are very strain specific and dose specific. So the way I like to explain in clinic is if you have iron deficiency, I'm never going to go give you a vitamin D and expect your iron to improve, am I? They're different nutrients, right? That is the exact same thing with probiotics.

1:10:03Each strain does different things. In fact, there is no scientific evidence, no clinical trial ever out there showing that taking a daily probiotic is going to help with your general gut health. To help with your general gut health, as we covered, it's the super six and the fermented dairy. That's where the clinical research is highlighting. But again, that's not to say that probiotics don't work. I found in my PhD and many other research clinical trials and all the clinical trials backing these, they show that they can, but they are very specific. So you need to take the right strain, i.e. the right type of bacteria at the right time, for example, if you go on antibiotics or for your immune health or for your vagina microbiome, for a colicky baby in the right way.

1:10:44And that's the right format and the right dose. So it's very specific and clinical. So when I opened the gut health clinic, so I've got a team of gut specialist dietitians, seeing patients in clinic after I moved to the UK, still working as a research fellow, just in the evenings on Harley Street, because I wanted to make sure that my research maintained relevance, right? So I wanted to keep seeing patients as a dietitian. And what I was seeing is like people would come in with these, you know, going on antibiotics, for example. And I'd be like, oh, I know that there is these international health authorities all saying the guidelines around, we should give this strain of bacteria at this dose for this duration.

1:11:21So I was aware of these guidelines, right? I was like telling the patient that, like, what brand? I'm like, there literally was no brand that translated these clinical authority guidelines into the products, right? People, all the products on the market were just like throwing in random strains and just saying, you know, it's good for your general health. And I was like, oh my God, it just triggered something in me. I lost my sister to a medical mistake when I was really young. Right. And I, from then on, I think had this like deep seed responsibility that if we've got the science to do better, we need to use it.

1:11:57So I think that's what triggered smart strains is because like, I didn't want to have another business. I'm like, I've got Biome, but I was like, there is this huge gap in the market. And I actually went to a lot of the brands and was like, look at the clinical guidelines. This is what they're saying for this, for antibiotics, for someone on antibiotics, they need to take this particular strain. You're giving them the wrong strain. You're giving people the vitamin D when they've got the iron deficiency in this setting. So you need to change that. Like that's quite fraudulent, right? We've got these guidelines and they're like, oh yeah, we've just done it this way.

1:12:28And they just, they wouldn't change their formulations. I'm like, I don't even want a cut of this. Like just make it so I can, you know, help my clients. And yeah, I was just like so frustrating. A couple of years trying to convince businesses to be like, these are literally the answers and no one would have a bar of it. So I was like, I'm going to have to, I'm going to have to do this. Like I can't sit knowing that people are not getting the benefits of probiotics that I know they can achieve when they follow the clinical trials, right? And in fact, we did a survey and it showed that although 50 % of people have tried a probiotic, it was around eight out of 10 reported no significant benefits, right?

1:13:07So even from a business perspective, yes, you might have to go through a bit of structural change, but people are becoming skeptical of probiotics because they're not working. So if they were smart, they would have listened to me and be like, okay, we want to deliver the results that people you know, when they come back. Anyway, so I finally met a company who, you know, saw the guidelines, believed in it, were like, gave me full control, Nordic Pharma. And yeah, that's smart strains for you. So it seems to me, and correct me if I'm wrong, but the short term version of how your company differentiates from substitute or similar products is that you are offering a tailored or a specific strain according to a specific need and in the right quantity.

1:13:51So it's like if Nike, when Nike started producing different running shoes for different running conditions. So off-road or on track. Fascinating. I love that analogy. It's exactly it. Yeah. And because that's the way we need to use probiotics if we want to benefit. Otherwise it's literally just a waste of your money. I found a very interesting common denominator in between both of your companies, both of your brands. They were both born from a real need that you had. So on one hand, you wanted to consume products or you wanted people to consume products that were healthy for your gut microbiome, but that they were tasty and that didn't exist.

1:14:31And then on the other hand, you wanted to be able to recommend your clients the appropriate strengths, but that wasn't available in the market. So these are clear gaps. And these are gaps that you initially identified, which is fascinating because also part of our show is to interview great entrepreneurs cross sector. And right now there seems to be a clear distinction so far in between men entrepreneurs and women entrepreneurs. So it seems that men entrepreneurs, mostly they identify a gap in the market that they're not emotionally attached to. They just feel like there may be a financial gain and it's very much logic driven.

1:15:12And then women entrepreneurs, they identify a gap in the market because they would either be the perfect consumers for that particular product or service, or because someone within their environment, it could be, as you said, it could be probably an experience from a family loss, unfortunately, or within your practice, your professional experience. You need to recommend this to your clients, but they physically themselves felt this gap and they believe in it so much that they need to see it or they need to develop and design a company around that gap, which I find fascinating. So thank you for producing this.

1:15:45I think the aim of both of them is quite helpful and needed. and I'm all about wellness. So I personally will consume, will continue consuming Biome and will identify maybe after this, the show I can ask you which particular product from SmartStrain should I be consuming? But definitely I can already see two of them that my fiance would like to consume. I have a final question. If you had to compress all your knowledge into one essential advice that we should implement into our daily lives, what would it be? I would say, it's a very good question, at every meal, think about what's on your plate that's going to nourish that inner pet, right?

1:16:34If you look after them, they absolutely will look after you. So it's just changing that mindset instead of being like, oh, I'm going to have a cheat day. Be like, no, because this amazing community, like have your chocolate bar, but then have a handful of nuts, right? At the same time, don't be had this all or nothing approach because if you really want the best out of your microbiome, you need to feed them every time you feed your human cells and your taste buds. I'm definitely going to remember that on my next cheat meal. Thank you so much for coming. Thank you so much for educating me, my team, and all of our audience.

1:17:07I think the work you're doing as a researcher, as a doctor, and as an entrepreneur, and I'm pretty sure soon as a mom too. I'm already a mom of two, so this is the third one. I know, it's a bit chaotic at my end. When I said you're a multifaceted person, probably that was an understatement. You're a superwoman. But thank you so much for coming and sharing all your knowledge and experience with us. It's been very revealing. And I look forward to doing this perhaps in a year from now because probably you're on your next baby from a professional perspective but also from a personal point of view.

1:17:40But thank you, thank you so much. It's been a pleasure. It's been a pleasure for me too. Thanks for having me. Thank you.