Leading Gut Health Expert: These Foods Are Damaging Your Brain and Body - Dr Tim Spector

0:00These new categories of foods, they make you overeat by about 25 percent. Wow. Or five or six hundred calories per day. What would you say to someone that counts calories? There's a 95 percent chance you're wasting your time. We're probably more microbe than we are human. We can't live without them. They do many of the things that we've given up doing, producing vitamins and brain chemicals. Dr Tim Spector is a world-renowned doctor and professor of genetic epidemiology. known for his research on nutrition, the microbiome, and personalized health. He has led some of the world's largest research studies, co-founded Zoe, and is the best-selling author of The Diet Myth, Spoonfed, and Food for Life.

0:37Most of us in the Western world have a slightly raised immune system. We're slightly in an inflamed state. If you have a powerful gut microbiome, you can de-stress that system. I want to keep my microbes happy. I would have f***ing plants a week as a goal. Different ones. Have f***ing fermented foods a day. Remember that inside you are 100 trillion microbes begging you to make the right choice. What should a healthy day of eating look like?

1:09Well... Dr Spector, who are you and what do you do? Oh, that's a tough question. Who am I? I have trouble describing myself. So I normally take people on a journey of who I was to who I am. So I think of myself as a medical doctor, first of all, who sort of went slightly reluctantly into medicine, following my father's advice, and did as little work as possible to become a doctor. Then I found I quite enjoyed some bits of it, particularly the research bits. ended up doing a subspecialty called rheumatology which is arthritis and bones and got a consultant job at a prestigious hospital in London called St Thomas's Hospital and then started to get a bit bored and I'd taken some time out to do research and in epidemiology and had always an interest in research but it was hard to get a solid job that way so I seized the opportunity in 1993 to start a twin research program I just thought this would be a really cool thing to do I'd learned about twins being exciting and so the idea of studying lots of identical twins lots of non-identical twins you know nature of inertia it was no one else was doing it in the UK and I always wanted to do things that were novel and so got that going when I was still quite young it was very hard to raise the money to do that but I managed to do it and did that for 20 odd years taught myself genetics and then got into discovering genes and became very successful at doing that getting more money big big department very successful but then I started getting a bit disenchanted with genetics it wasn't going to solve all the problems of the world as we'd hoped it would and was looking around for other things to do and got into the gut microbiome and that happened at exactly the same time as I had a personal health crisis a mini stroke as I was skiing in Italy and those two events sort of discovering that the microbiome was really interesting and my health crisis basically gave me another yet another change of career and so I said I'm really going to start looking at the gut microbes and nutrition and that led me to write a book on nutrition and start a whole new area which was really new to me and And then I was doing nutrition, gut health.

4:36And then in 2017, I met two entrepreneurs at a talk. And we founded a company called Zoe, which is a personalized nutrition company, a gut health company. and really got into the sort of business side of this and how we could use industry and investors to get much more data and get more science and really change the lives not just of a few people but of millions of people through this new science. So I haven't answered your question at all, But I'm a sort of multidisciplinary scientist, doctor, who's curious about everything. I found I've got a skill for writing and talking to the public. I, like you, have never liked having a boss.

5:45So I always fought with my bosses. and that's partly why I always wanted to be in charge of whatever I was doing. And I'm sure if I hadn't gone into medicine, I would have also been an entrepreneur, interestingly, because a lot of people don't realize this, but if you're an academic in medicine and you're not doing teaching, your job is to be like a scientific entrepreneur. you live or die as a professor by how many grants you get and that's like whether people will give you money to do a certain project so essentially you're pitching ideas to these very reluctant investors and convincing them of your success every time to give you more of this stuff now it doesn't make you rich but you still get the same bean counting rewards and ego trips and sort of medals and all this stuff that an entrepreneur who be get the money side of it does do so it's very much a similar ego boost when things go well and it's extremely disappointing when things don't go right so I'm at an interesting point in my career where I'm doing both I'm doing the scientific stuff still I'm still producing really high quality papers that I couldn't have dreamt of doing with hundreds of thousands of people that would have cost tens of millions of pounds to do and I'm also involved in marketing and commercial aspects of the company and strategy and things like this, which I also find fascinating and I'm enjoying.

7:32So I'm, yeah, I'm a sort of scientific businessman, presenter, writer. Yeah, I'm, you know, I'm loving it. There's probably five different episodes that I was counting that I would love to have with you based on the entire journey of your professional career. but for the purpose of this particular episode I want to focus on everything that is related with the gut microbiome. Now the average person and I include myself in that basket I don't think we know very well what the gut microbiome is because nobody taught us that at school surely not at a deep or technical level. So in your own words how would you describe what the gut microbiome is so all of my audience can understand it the gut microbiome needs to be thought of as a virtual organ so you need to stop trying to visualize these hundreds of trillions of microbes inside your gut and think of them collectively as a community of these tiny little beings that are like chemical factories they're like mini pharmacies they are through the hundreds of genes and thousands of different genes they have they're converting food into other chemicals that supply our body so So mini pharmacies is the way to think about our gut microbiome.

9:11And there are as many of the cells in our body as there are these microbes. So we're probably more microbe than we are human. And we've co-evolved with them because we can't live without them. And they do many of the things that we've given up doing through evolution or we never were able to do in terms of producing vitamins and brain chemicals and lots of other stuff. And essentially, you can break down their functions into three main groups of things that are most vital for our body. One is metabolism, which is basically our energy balance, how we keep all the cells in our body roughly running at about the right speeds.

10:01they're not burning out they're not going too slow and that controls our weight and our appetite and general turnover of things then you've got our nervous system so most our second biggest brain is in our gut and our microbes always talking to those nerve cells and there's a big channel between our gut and our brain called the vagus nerve. And 80 % of the traffic is from our gut to our brain, not from our brain to our gut. Oh, wow. So essentially, that's how the brain knows what's going on in the body is through what's happening in our gut. And our gut microbes, through the chemicals they produce, are essentially telling our brain what's happening, what our environment is.

10:52and the third thing is the role in the immune is immunity now immunity is all about these white cells that control how our body reacts to things how it heals itself how it fights infections how it fights aging how it fights cancer so essentially it's our repair mechanism and we now know that our gut microbiome controls the immune cells so 70 percent of our immune cells in our body are in the lining of our gut as well so as well as most of our nerve cells it's full of immune cells and they're talking to the microbes all the time the microbes tell our immune system you know how calm or stressed to be whether they should be gearing up for action or they should be calming down at night and rest.

11:47And this is a crucial function because most of us in the Western world have a slightly raised immune system. We're slightly, what we call, in an inflamed state. Our immune system is slightly stressed. And if you have a powerful gut microbiome, you can de-stress that system. You can reduce the signals going to the immune cells so that the body is not under immune stress, it's not inflamed, and that also has links to the brain. so through these three mechanisms the immune system metabolism and the nerve system they basically control our it's like a control system for regulating our body these thermostats that are telling us whether things should go up or you dial it up or down and it turns out that this is a crucial link between what we eat and our health this is the control mechanism that determines how our outside environment and the food interacts with our body.

12:57What are the factors that contribute to the inflammation in our gut microbiome? There are many factors, but the number one is probably the quality of the food that we eat.

13:14so the if you have highly processed foods that contain chemicals like emulsifiers like glues like artificial sweeteners like flavorings chemicals that we're not used to eating artificial sweeteners come from the petrol industry so you know they're not part of our normal diet. All these things will cause irritation for the gut microbes. They send signals to the lining of the nerve cells and the immune cells saying, something wrong here. You know, they send threat signals out to raise the level of inflammation. So that's one way that happens through the bad food they're eating. And others, you can get it just from overload of sugar and fat so if you have a huge sugar dump uh you know you drink three colas or whatever it is um or huge bowl of white rice your body will have a sugar spike that then sends your microbes sense that and they send signals triggering inflammation similarly if there's too much fat in your body three hours after a meal in some people that will send again an inflammation spike so there are a number of different mechanisms we also know that just outside stress can also cause inflammation in the gut so it's a two-way process they've done lots of interesting studies with mice where you can you can have stress a mouse make it really anxious change its microbiome and give that microbiome to an unstressed mouse and that mouse will become anxious and it will change its microbes.

15:09And you can do the reverse and you can reverse some of this stuff with antibiotics. So we're realizing that the microbiome is both, it senses what's going on, but it also can produce things like anxiety and stress through certain microbes working harder than others. and producing certain of these chemicals. So it's, but it is complicated, but it's important to realize that this immune system is really crucial to our health. And it's only the last few years we've realized this, that we need a really good functioning immune system that reacts to injury, but then goes down to really good baseline levels to have a long and healthy life.

15:58If we don't, we're not going to be able to deal with repair systems. We can't stop aging as well. We can't fight early cancers. And we get mental health problems. So this link between food, gut microbes, immune system is becoming more and more important. Let's tackle the three enemies that you just mentioned one by one. So you've said bad foods, I would imagine this is referring to ultra-processed foods, glucose and fats, and then stress. When you're referring to bad foods or ultra-processed foods, so how would you define those so anyone can understand, well, this is ultra-processed food and this is not, or this is bad and this is good?

16:46It's not as easy as it sounds. And I think we're in danger at the moment of calling everything an ultra-processed food and being unable to eat 50 to 60 % of all food in the UK. Interesting. So there are colleagues of mine who are on record as saying we shouldn't be eating any of these foods, but that's because they have a very loose definition of an ultra-processed food, which came from scientific research epidemiology which is population style work where people just had to have a nice simple definition and their simple definition was if it's got any additive in it added to it that wasn't sort of naturally there it's a process it's an ultra processed food so So some of them will be clearly bad, like most breakfast cereals, most potato chips, you know, cakes, ready meals, where they've changed many things.

17:52and others will be very simple and all they've done is added some ascorbic acid to it which is you know like vitamin c and under that definition it would be called the same so we've reached and zoe we've recently recategorized all these these foods into four grades so zero risk mild moderate severe risk based on what the food companies are trying to do to change the food so that you eat more of it okay so understanding what the food companies are doing is crucial to understanding what foods to avoid so knowledge really is power here because the the worst ones and the ones which is about 25 % of them are ones that have all of these attributes.

18:46They have additives in them that we know are harmful to health. So these are chemical additives, special glues, emulsifiers, whatever. They might upset your microbes. They might have direct effects on your body, might give you allergies, all kinds of stuff like this. then you've got food is hyper palatable have you heard that phrase before no so hyper palatability means that it's designed to override your normal fullness instincts so these especially created by the food industry by and they they employ the very best food scientists to come up with a combination of particularly salt sugar and fat in in combinations that are they call the bliss point which light up a bit of your brain create this sort of surge of dopamine and reward center that overrides when you're your belly feeling full so you don't you don't get the normal defense mechanism so these foods are artificially manufactured that's why many uh mueslis for example have added salt so they've got sugar in it but you add salt you got fat uh you know the typical biscuit is obviously a mixture of um salt uh sugar and fat together which you wouldn't find in nature and this is what they do and they're continually trying to tweak these with other additives and sweeteners and things like this to make it perfect to override your normal defense mechanisms then you've got the structural element so that they're designed to be when you put it in your mouth you don't have to chew it right it just dissolves uh and you just so whilst you're you're eating something in front of the tv mindlessly watching you will finish this huge bag without really any effort um this is the the structural integrity has been taken away so there's no cell walls there's nothing there to stop you eating huge amounts of it most breakfast cereals like that And what's the purpose of that?

21:08That is so you can eat large amounts very quickly and you don't feel full. So you overeat. And the final one is that you have quite a high calorie density for the weight of it, which is similar that they're trying to make them light and easy. But they don't want you spending a long time to consume those calories because if you spend too long on it, again, your body will feel full as it's supposed to. They're trying to override the normal human responses to food. And this is why these new categories of foods have done so well to make people overeat. And studies have now shown that they make you overeat by about 25 % or 500 or 600 calories per day if you had the equivalent food in this form rather than in its original form.

22:06So it's trying to understand, when you're trying to avoid those foods, it's really important to understand what the food companies are trying to do. So you've got the antidote. And the antidote is knowledge and power, the ability to look at the back of a label or use an app like we have on Zoe so you can just scan it. It will tell you what the risks are. the front of the packet won't tell you because that's just full of bullshit about high in protein low in calories you know low fat all misleading messages high in vitamins but they're obscuring the fact that actually what they're doing is making you overeat even when you you're full so that you'll be eating all kinds of crappy food without even thinking about it and that that's what we should be fighting about and that's about 25 percent of the food that we eat which means that we can still carry on eating the other 25 percent which i think are minimal risk and we shouldn't worry so much about the different food categories or high risk food categories that you've just mentioned would you classify them as ultra processed foods or are they just bad food from a terminology point of view ultra process doesn't have a scientific meaning that has a public perception yeah but there isn't really the only definition was this one used for population studies so it wasn't meant for an individual to make those choices it was meant for scientists to do research and say okay people who eat ultra processed foods have 20 more cancer or people who eat these general foods which were easy to categorize because it was any additive right it was like you put anything in there that they only had four categories of food you know one were like fruits and vegetables which are whole foods then they had condiments then they got things like butter which is processed food then everything else that had an additive to it to change its texture or its colour or anything was called ultra-processed.

24:23So that meant that essentially most of this whole category was called ultra-processed food. But within that, there's a huge range of harm. Some had additives that are completely safe. Some would have 10 additives that are extremely bad for you. And some would have these hyper-palatability, making you overeat, others didn't. So that's why we've come up with this new way of thinking about food. But you've got to realise that most food, you know, perfectly healthy cheese is processed. Once you've added a microbe to milk, it's processed. And it's not bad. That cheese would not be bad for us. No. Correct.

25:11So it's really understanding how this food is made and what it's been designed for. Adding a preservative, you know, like salt or something to keep it from going rotten longer isn't necessarily a bad thing, but it could be classed as being ultra-processed in this categorisation. So we need to improve our understanding of what good and bad foods are. I think that's really where we're going with this, that on the one hand, we shouldn't dismiss them, but on the other hand, we shouldn't say that everything in this category should never be eaten because then you alienate a lot of people who quite enjoy having a biscuit with their tea once a week.

25:58It doesn't mean they're going to become obese or get cancer because of that. Let's test my understanding. So in a nutshell, what you're stating is that food companies, they can be harmful for two different reasons. On one hand, because the ingredients of that particular food are overstimulating us. So we overconsume, right? So we eat more than what we should be eating. And then the second reason why, or the second, let's say, negative consequence from the same type of food companies are the particular ingredients or chemicals that are within these foods that they are just on isolation, regardless of how much weight of them, very bad to us, to our nervous system.

26:51They create inflammation. They could start potentially a future cancer and so on and so forth. So these are the two reasons why. So overconsumption of food and then the negative consequences of some of the ingredients that these food companies put into these foods. And some of them are put in there not to make us eat more, but because they're cheaper. So that's why the food companies really loved the last 20 years where we've been attacking fats. Because if you remove natural fats from food, you can replace it with cheap starches. and so that which come out as cheaper if you can avoid anything from animals or natural places and replace it with semi-synthetic products like modified starches just to fill it up then that's a cheaper product so their profit margins go up and it if that starch happens to be not very healthy for you that's that's a byproduct they're not doing it intentionally they're just doing it to be cheaper.

27:55So every time that something says it's low calorie, they will swap sugar for artificial sweetness for chemicals. And every time they make it low fat, they will swap that for starches and they to make it taste okay or have some mouthfeel like real fat does, they then have to add all kinds of other chemicals to it so that it tastes similar to the consumer. So your advice to me would be the following, right? So let's say I have two choices, full-fat cottage cheese and low-fat or fat-free cottage cheese. You would always advise me to choose the full-fat cottage cheese for health. Interesting.

28:40Okay, let's talk about the second contributing factor that creates inflammation in our gut microbiome. So the consumption or overconsumption of glucose and fats. Now, I think the bigger question that I have here is not necessarily to understand what are glucose dense or fat dense types of food. But most importantly, what does high quantities look like? So you've mentioned white rice before. How much white rice do I need to eat for that inflammation to happen? That's very personalized. So when we did our original study, the PREDICT1 study, which was the largest single experiment of giving everyone the same food, we gave 1 ,000 people, mostly twins, because we thought there'd be a genetic component to this, an identical muffin.

29:40Muffin was made with lots of sugar and vegetable oils, flour, and there was giving identical people identical meals there was a tenfold difference in the blood sugar level afterwards and tenfold difference in the blood fat level afterwards so in ask your question we'll give you and i this you know if we both had the same bowl of rice we'd have a different metabolic response to it. So you might be able to tolerate it better than I could, but in general, rice is not very good for us because it has hardly any fiber. And so it's mainly the starchy sugar in the inside of the rice that comes straight into your bloodstream and gets really rapidly into your blood and the rest of your body.

30:38And that, but the amount and the speed it does that will vary between people. And we think that's partly because of our gut microbes being different and a small extent due to our genes. Do the results of these glucose spikes as an aftermath of the consumption of foods like rice vary depending on what we have eaten prior to that product? So if I'm eating something before eating the rice, would that impact my glucose? What would you recommend us to eat if we want to eat the starches or something with glucose? Well, it's actually, even what you ate the night before will impact how you eat something the next day.

31:18So everything is sort of correlated, which makes it really complicated and hard to give precise advice. But if you like eating rice, and many people do, it's important to eat it with a lot of fiber. protein and fiber will reduce your subsequent sugar spikes if you have them so again it's i believe it's all about focusing on everything that's on your plate rather than trying to reduce things to is this ingredient good or bad so a smaller part of rice with 10 different plants on a vegetable curry, for example, could be perfectly healthy. A large amount of rice and, you know, just a bit of chicken is not going to be very healthy.

32:13So, but again, if you swapped the rice for another grain that has much more fiber in it, that will protect you from getting those sugar spikes because it's much harder for the sugar to come out of the rice into your bloodstream and cause problems or trigger inflammation. And so things like bulgur wheat, things like pearl barley will have a very different effect than that plain white rice. And yet most people would think of white rice as a healthy option because it's associated with Asian food and generally Asian diets are seen as more healthy. But it's all about what you put on the plate. The combination.

33:04It's the combination. It's the total amount you're getting in your gut. Because your microbes don't mind really, you know, which spoon you have first. By the time they get it, they're just getting a big mix. So we don't have to deconstruct it too much. We've just got to say, okay, there's so much fiber in there, I can throw in a bit of white rice, it doesn't matter too much. Or, you know, you might be someone who's, you know, like me, had a test and will know how you respond to rice with a glucose monitor or through a gut microbiome test. And we can now test your gut microbes to know whether you're going to have a sugar spike or not with 80 % accuracy.

33:51so it's really quite cool that some of the new science is showing we can have a pretty good guess about where you're going to fit in that tenfold difference amongst different people and some people like my wife can you know happily eat croissants for breakfast every day without a sugar spike and i can't and even if she doesn't get a sugar spike does that mean that that croissant is healthy for her? Is it good for her? A croissant is still a croissant. It means it's not going to have an immediate effect on her. For me, it would cause a sugar spike, then a sugar dip. I would feel hungrier later in the day and it might affect my mood.

34:37For her, she probably wouldn't have that short-term effect, but if she only ate croissants, then overall her long-term health would suffer so i think there's a difference in the short term and the long-term consequence of some of these foods which is personalized but probably long-term you know i don't think anyone could exist just on eating croissants as much as some people would like that yeah and you know and i still if i'm in you know a fantastic hotel in the south of france and you've got the breakfast they bring down to the croissants, every now and again, yeah, I'll have one. But it's got to be a good one, though.

35:20Nothing worse than a bad croissant. Let's talk about the third factor that contributes to inflammation, stress. So what are some, let's call them stressors or external factors that can cause us to stress, particularly in the gut microbiome? well uh we know from uh lots of animal studies that just putting people in social situations that are stressful if you isolate an animal or you put it in a cage with a bigger animal it will get stressed and that will cause inflammation in the animal and that inflammation will then start to change the gut microbes. So we're surrounded by stress all the time.

36:09A short amount of stress is fine, but there's a certain point when that stress gets too hard to be coped with. So in a way, we need stress in our lives. A little bit of stress is good, too much is bad. so the constant stress uh you know poor relationships um this stress also from our environment from pollution um some people believe that microplastics pesticides can cause low-level stress as well so stress i'm used that in a very sort of general term about and these are tend to be stressors to our immune system so social and environmental even exercise we were talking before we recorded about you know not overdoing exercise and there's there's quite a lot of evidence that people who do over do exercise do cause an enormous amount of stress to the body and it's it's about getting the balance right small amount of stress is good recovery good if you're stressing too much as many professional athletes do they can get inflammation and they can get a lot of gut problems and long-term health problems so it's this is really what we're talking about stress but um it's very interesting that i i'm sort of researching my new book now which is about the brain and nearly all the mental health problems the brain health problems we have have very common risk factors and they often start early in life you know traumatic childhoods stress as a child or really bad infections as a kid relationship problems and that seems to reset some hormones in the body causing too much cortisol and stress that leads to inflammation that changes your gut microbes that then affects your brain and everything gets reset at that level and this seems to be a common thread through through many many problems is there are often common risk factors for many of these seemingly very different conditions and problems that may all be related.

38:42I want to go back to food, particularly to the topic of calories. I myself, as I was sharing with you earlier, for I would say a long period of time, not anymore, but for a long period of time, I was counting calories in order to optimize my physical performance at the gym or I do various other different sports and I compete in some of them. what would you say to someone that counts calories there's a 95 chance you're wasting your time the the clinical trials have been done on calorie counting to to lose weight generally show that you can do it short term but 95 of people cannot do it long term i'd also say that you're fooling yourself if you think you can do it accurately.

39:36Even trained nutritionists cannot do it accurately. Labels on foods can vary by 20%. 20 %? Yes. So a lot of these calorie counts were, you know, they were nearly a century old when they were. Jesus, sir. But like a lot of companies became widely successful due to how many calories they have per 100 grams of that particular product. That's probably their main unique selling proposition. Many of them, when they're tested, are not actually accurate. But there's nobody checking them. But also, you can have a product like almonds. and you have a huge difference between the calorie amount in the whole almond, you know, a ground almond or a almond flour.

40:37They're all essentially almonds. They'll all have a single calorie count. But they'd be about a 25 % difference between the different forms of the almond because when it's totally crushed up, as you would get in most highly processed foods, all the cell walls are open and you can access every bit of the oil and the fat, whereas in the whole almond, as you're eating it, a lot of it, you're not actually ingesting all those fats that they're passing through the body and you're not absorbing them. So the whole science of calorie counting is flawed. And the other, you know, I'd remind you of this original experiment we did with this identical muffin, which has obviously the same calories every time.

41:31A thousand people got a very, you know, one in three people got a really big sugar spike and a sugar dip. those people eating the same identical muffin some people had a sugar dip after it and those people ended up eating more for the rest of the day okay so they would eat another 400 calories on average if they had a sugar dip after eating that food so if you think of calories as the only important thing you're missing out all these the way the calorie is delivered will have a huge much more important role in how your body reacts to it than the actual count so it's it it's really so old-fashioned that it should be thrown out and there's hardly any nutritionists or nutrition scientists that believe in calorie counting anymore.

42:32It's just these multinational companies that have promoted it, starting with Weight Watchers and all these other ones that have tracking and people who make tracking apps for people who like to track things are giving people something to do. But the reality is it just doesn't work and it doesn't stack up scientifically. I think in order for us to understand this better, we would need to bring it to a base fundamental level. What is a calorie in simple terms? A calorie is a unit of energy that was devised a long time ago whereby you basically burn the food

43:22and the heat that comes off from burning it you calculate how much that heats up some water in the surrounding tube so it's it's a slightly complicated idea but it's it's you put a set amount of that food in a set amount of water you heat it up very rapidly it's all burnt off and you see how much that water has increased its temperature and it's essentially if it you know one calorie is one one's a change in one centigrade uh of that water and that's how they've calculated it for 100 years so this means that at some point there was an organization or an institution that burned absolutely every single ingredient in the world and then they put that in in a catalog or somewhere yeah for us to really That's right, yes.

44:16Interesting. There's an American who did this. Was his name Calary or something? At water. He didn't get the term. But it was a nice idea, and it's accurate, but it's only accurate in the context of that very small experiment. it's it's not telling you how your body uses that calorie and what else and how you can change the structure of that in your body in a realistic way so your body is not the same as a calorimeter it's not a it's not a furnace and what is the difference in between a calorie that comes from protein and a calorie that comes from fats are they the same they're the same yeah i mean they have a different calorie density um so things like fats have more calories per gram in it than um than than say protein which you know has has less in it but it that's just uh there's no there's no difference in in in the energy you get out of it and is there a place in our lives for us to care about calories at all i used to think so i think it's only if you're you're you're being tricked into eating into having something that you you're being told is healthy and you know in tiny writing you see that it's got you know 600 calories or something and you think you're having it as a health drink that might be it but nowadays that's quite unusual because normally they'd reduce the calories they know that customers look at that and they'd be adding all kinds of artificial sweeteners in and looking at it that way but i i don't think it's it's actually very useful unless you're have an eating disorder and uh you know this is the whole science of nutrition started after the second world war when millions of people were starving across europe and Asia.

46:33And it was designed that this is the minimum amount of food you need to give people in order for them to be relatively healthy. It was never, and that's why vitamins came in. You needed these vitamins. We had this RDA about how many vitamins you needed. It was to avoid major problems it was never you know what's the maximum you can give to someone or uh what's uh you know how much vitamins is there an upper limit to it it was always you know this is what we should be giving people who have you know terrible malnutrition after you know in a war zone so that's why nutrition is taken until this moment to deal with that and it was mainly dealing of people starving, not as we are now with a third of the population obese.

47:28Fascinating. You've mentioned something that I think at least in Spain it was a big deal. You've said that sometimes we consume something thinking that it's healthy, but then science tells us otherwise maybe down the line. And I think this was the case of, correct me if I'm wrong, orange juice for example in spain when i was growing up like every morning every single kid in spain needed to have an orange juice before going to school because otherwise you wouldn't be getting your vitamin c and i don't know a bunch of other different things that you would be needing and then many years down the line they're telling us that it's just you're only drinking sugar effectively and it's very bad for your teeth because it has tons of acids what are other food examples that we may perceive as them being healthy, but the science is telling us that they're not?

48:18Orange juice is probably the best example because everyone, it was around the world, right? It wasn't just Spain. It was definitely here as well. I used to give it to my kids. My mom used to give it to me, you know, and we'd be absolutely sure this was the best stuff. And of course most of it was made in the south of spain um i think uh things like breakfast cereals generally that's because they have lots of vitamins on the packet many people think they're giving their children healthy produce um and giving them vitamins therefore that's generally good i think people think milk is very healthy and there's really not much evidence that it is very healthy um it's probably good for growth and certainly helps speed up growth but there's no evidence it's good for your bones or uh anything else in life and you probably don't need it as an adult and that's why most of the world doesn't drink milk um well i guess uh things muesli was another one you know it was a promoted as a massive health granolas and mueslis uh are super healthy you know 95 of them are very unhealthy why because of the sugar it's usually the amount of sugar and um they have salt in them and um all sorts of extra ingredients and fake fake fruit you know fake strawberries and everything they can do to cut costs um and i think um and we touched on earlier low fat all low fat products low fat yogurts low-fat spreads there was a even though you used to get low-fat cheeses people used to think were healthy and they're much worse for you than actually the full-fat ones much worse so what should a healthy day of eating look like well we've come up with a sort of list of overall guidelines for healthy eating which for me correlate with your gut health because as you probably guessed by now i'm a bit obsessed with the gut and microbes i want to keep my microbes happy i want to have as many good microbes as i can i don't want to have room for bad microbes i really believe that that's crucial for my my health well-being my mental health so what i want to do i want to i want to have 30 plants a week uh as a goal different different ones okay not the same so it's not just eating spinach uh 30 times it's you know and it's every every type of plant and that means people have got to understand what a plant is it's it's a fruit it's a vegetable it's also a legume a bean it's a nut it's a seed it's a herb it's a spice thank you for clarifying that because i was thinking immediately about vegetables and i was thinking i don't think i know 30 different vegetables well i'm drinking a vegetable here now uh it's fermented bean called coffee and coffee is a health food which we used to think was unhealthy We now know it reduces risk of heart disease, and that's because it's good for your gut microbes.

51:54It has fiber in it, it has defense chemicals. And that's the second general rule is to eat the rainbow. Have brightly colored plants on your plate so that you're ingesting these healthy chemicals, defense chemicals called polyphenols, which are a source of energy for your microbes as well as helping your body as antioxidants. So that's the second sort of rule. I'd say the third one would be have three fermented foods a day, because fermented foods are a crucial part of our diet that many of us have forgotten, particularly in the UK. It's a sort of lost art. And we know that fermented foods are really important for your immune health.

52:45What are fermented foods in simple terms? A fermented food, and I've just written a book on this, so it's fresh in my mind. A fermented food is a food that's been transformed by microbes into something better. and by better I mean it preserves for longer so it doesn't go rotten as quickly in in the air so you may not need a fridge that's why it was used in the past it's tastes better it's more complex it's more interesting than the original you know to look at the difference between milk and cheese or grapes and red wine and the third is that it's healthier than the original so generally microbes will increase the number of chemicals there they'll increase the number of nutrients and because it's then a substrate for living microbes they will have this powerful effect on your body so that's why we all need to know more about fermented foods and why the latest science didn't used to be quite as as much of a promoter of fermented foods because it was sort of yeah they're sort of good but the science wasn't really there but the science has really caught up the last few years and if you have regular fermented foods you will reduce your inflammation level by about 20 25 percent should we eat them every day every day it's little and often and i think um three portion three small portions is what we should be aiming for so don't wait up till the end of the week to have a giant bowl of sauerkraut you should be having small amounts added to your food regularly or small shots this is this is the way to get the fermentation into your body and it we think they act not by colonizing your gut microbes but by tickling the immune cells in your intestine.

54:49So what are some good examples of fermented food so anyone could buy in a supermarket? Well, they're probably buying them already. So yogurt is what I guess the fermented food most people eat. Full fat, I would imagine. Full fat, Greek yogurt, avoid the artificial fruits and flavorings. You can add your own at home. Don't have ones with sweeteners. Don't have ones with vanilla. um just the pure one then cheese of course and nearly every cheese except the american ones that come out of a tube or a that look like plastic will look like plastic all the others are do have microbes in them and are good if you can get raw milk cheese they're the best raw milk cheese um unpasteurized uh they will have extra microbes in them rosh wash rind cheeses particularly you know you see those camembert would have a fungus sprayed on the outside they're extra good blue cheeses they have a fungi each each of the veins in the cheese is blue because that's they've injected a fungus and they're all good.

56:04Then you've got milk kefir, which is like a super yogurt, often have about 10 to 12 different microbial species. That's a fermented milk. You've got water kefir, tibikos, which is made from different grains, quite common in Mexico. Really good kombucha, which is fermented tea and you can now get in lots of fancy restaurants with michelin stars now they're making their own kombuchas getting vintage kombuchas and they're they're excellent you've got the whole range of krauts so sauerkraut which is basically cabbage salt and microbes nothing else, really simple to make. And then you've got all the different varieties of that, beetroot krauts, and then the kimchi, which is the Korean version with spices on top of that.

57:06Then you've got all the Japanese ones, all the fermented soybean products. So soy sauce is a fermented product, natto, fermented bean sprouts. Then you've got tempeh, from indonesia the list goes on and then you've got all the african porridges and and beers then you've got the dead microbes as well so they're the live ones but you've also got dead mike dead products which i used to think we had no value at all but the latest science shows that even when you've pasteurized some of these microbes they can still have a beneficial effect on your body. So that's good news for people who have bought the cheaper products, which tend to be pasteurized.

58:02Kombuchas in cans, for example, generally have no live microbes, but might still be giving health benefits. You've mentioned that we need to consume 30 different types of plants. Now, it is clear to me that there are different types of fermented food. Do we need to consume most of the tabs that you've mentioned or the regular person would can get away with the benefits just from cheese and kefir and yogurt is that enough well it depends what you're aspiring for um at the moment the the average person the uk has about two ferments a week so what we're saying is we want to get to be having about 20 so it's a tenfold increase 20 types different types 20 occasions.

58:49It doesn't have to be 20 types, no. You know, I have a lot, myself, I have a big variety, but I started slowly. When you start these foods, they're a bit strange to many people. They're often a bit sour. They can be a bit bitter. They can have some funny smells. They can be gassy. So a bit like having your first beer as a kid, you don't like that first one, but you keep going. And I was like that with kimchi. I don't know when you had your first kimchi, but it's kind of strange, you know. It's a bit spicy for me. My partner introduced me to it. But it's not something you immediately say, oh, I love this, right?

59:29You've got to have it. And then I now love it. Yeah. But I was in South Korea for a medical meeting and they were serving it at breakfast and I just couldn't take it. The smell was too much for me at breakfast. So, and sometimes, you know, some milk keffirs can be very strong. Some goat milk ones can be overpowering. So I think aim for three a day and build it up slowly. Some of these strong tastes you can mix in with other foods. So I tell people who are trying to get used to kimchi or getting their kids to eat kimchi to mix it with, say, cream cheese. um i tell people to mix milk kefir with yogurt so that you're just diluting it as your first as you're having it lots of ways you can do this more gradually interesting without going hardcore and you know but the whole point is it shouldn't it should feel that these are additions to your food and your plate they're making the food more interesting and so i add stuff to my food not just for the health benefit, but because I love that, you know, that taste.

1:00:41I make my own miso and I never use stock cubes. I prefer the umami taste of real miso in all my cooking now, and I can't go back. So generally I'm doing this to add flavor and taste. And in a way, there's a secondary health benefits. And I think that's a much more positive way to think about it.

1:01:10So we've spoken about 30 different plants, fermented foods. What else should we be eating sort of on a daily basis to feed our gut microbiome? I think really you've encompassed, once you've got your 30 plants, you're going to be getting enough fiber. The only other thing I would say is, as a protein source, we don't think about beans and legumes. enough and uh we're obsessed driven by the you know the u.s influencers and uh you know gym bros telling us we've got to eat more steaks and raw eggs um beans and legumes are a fantastic source cheap source of high quality protein and also fiber you're getting double benefits of having all that stuff so we don't eat nearly enough beans and legumes in this country you know and that's everything from chickpeas to lentils to all the different types of bean mushrooms are another important source of protein as well mushrooms are a whole other category they're not a plant they're not an animal they're a kingdom of their own the fungi i think there are enormous benefits of eating more mushrooms.

1:02:33And we know that they have a completely different cell wall to plants and we can start cultivating many more microbial species if we have those as well. And that's why we added mushrooms to our daily 30 mix. We've got eight different mushrooms in there because it's quite hard to get that variety in your normal diet. but so beans lentils mushrooms and then um that's probably all your microbiome really needs i think if you throw in a little bit of fish and a little bit of meat that keeps them happy and our studies when we compared vegans vegetarians and omnivores showed that on average the vegan is has the best gut on average followed by the average vegetarian followed by the average omnivore who was the lowest but if you look within the groups the top one percent of the very top best people are omnivores who eat a little bit of meat and fish but have a hell of a lot of plants they they seem to have the most complete gut microbes so if you know if you've got no ethical or uh moral concerns about having small amounts of fish and meat that's probably optimum for your gut health oh there's so much that i want to unpack from that but i want to simplify i want to simplify with one question so does that mean that we should all in an ideal world be vegetarian or ideally vegan because we're serving better our gut microbiome or Are we just looking at the gut microbiome in isolation when it comes to its benefits and not thinking about maybe other systems or components of our body that perhaps are being served better through an omnivore diet?

1:04:32I think if you look at the gut microbiome, you're seeing it represents the state of your body, all your organs. It's a pretty good indicator of how you're doing. We've now got data on 300 ,000 people. And the health of the gut microbiome, we can relate that to all the health outcomes, whether it's your blood pressure, your blood cholesterol, your diabetes level, how much body fat you've got, cognition level, et cetera. And it's also related to the diversity of plants in your diet. So the more different plants you've got, the healthier you are. So I don't think there's a mismatch between your gut health and some other process in your body.

1:05:24It's there as this signaling organ. So it really knows what's going on. It's getting messages from the brain. It's getting messages from all your organs in your body. and so the results tell us that you know eating a large amount of plants a small amount of meat and fish is probably the optimum but the key is the number of plants right so people who eat a lot of meat and fish and not much plants are going to do much worse than the average vegetarian so that's why we on average you see the vegans beating the vegetarians beating the omnivores but if you look within the groups if you can and you you move you sort of break down this group so say you know i don't know how to identify myself because i mainly eat plants but i also eat meat and fish i just don't eat them very often and nothing like i used to and so that's where i think the sweet spot is and it's probably what reflects are passed you know we didn't have access to regular meat it was an extra bonus and we need a small amount of it having a lot more doesn't help your gut microbes and if we need to convince a gene bro as you've mentioned earlier what would you answer to the following question how does a unit of protein from originating from a an animal source compare to a unit of protein originating from a plant?

1:07:02There's no essential difference. Meat is a more balanced source of protein. So you get all the essential amino acids to build other muscle and protein when you eat meat. Whereas if you eat plants, you have to eat a variety of plants in order to get that right same combination. But essentially, if you are eating a variety of plants, If you only ate baked beans and that's all you did, you wouldn't get the right balance of amino acids. But if you eat beans and you eat rice and you eat grains and you have broccoli, you don't have any problem. So there's no essential difference that way. And many elite sports people are complete vegans.

1:07:54they just have to have a wide variety of plants. So what you're saying is that protein is protein regardless of where it comes from. The difference is that you may need a different variety of plants or even more plants from a volume, from a quantity point of view to hit a protein intake rather than if you consume that protein from animals. Interesting. I want to shift slightly the conversation to maybe two terms that a lot of people, including myself, think of them as a bit more technical. I've heard numerous times about the benefits or the purposes of a prebiotic and a probiotic, but I never really understood what they are.

1:08:39What are they? Well, let's define them first of all. So a prebiotic is like a fertilizer. it's the food that microbes eat okay so plants are a prebiotic and a probiotic is a live microbe that either lives in a capsule in a in a health store or it lives in food in a fermented food oh so fermented foods have probiotics and that feeds our gut microbiome correct and prebiotics are more more microbes that no they're not microbes they're the food for microbes they're the fertilizer okay so they're the they're the and there are some products like say sauerkraut which are a mixture of both there's a cabbage plus the microbes that live on the cabbage that are that you're eating so you're eating both a fertilizer and a microbe um so and then there's a um there's a a new category called postbiotics okay which are dead probiotics so probiotics means alive live bacteria right live bacteria and postpartics are when they're killed by pasteurization or heat treated and no longer alive now the reason we talk about it is because they've done many scientific experiments now showing that they can still have benefits to humans so you've got a kombucha can it's been pasteurized dead microbes um you can or a kefir and it still has benefits to your immune system okay so that they're the three categories of of products we now have um we think that postpartics aren't quite as effective as um pre as probiotics because probiotics have live and dead microbes naturally because microbes have a life cycle they turn over they die and um the uh but this is new and i three years ago i would have said this is rubbish don't buy anything that's pasteurized but there's now good evidence and that's why in in our prebiotic mix so we have a prebiotic mix this daily 30 that we developed for zoe that we were interested to test because people ask people often ask me what's better a probiotic or a prebiotic what's more powerful and no one's really known uh mainly that we focused on probiotics and that's what most people know prebiotics there was never any money in it they're just plants you know the big companies weren't really interested in it.

1:11:44So there wasn't much science done. And we tested in 350 people our pre-biotic mix of 30 freeze-dried plants versus a probiotic, which one of the leading ones called a lactobacillus rhamnosus, which has been shown to be beneficial for things like depression, and another arm of 120 people with just taking dummy prebiotic as breadcrumbs. And we did this really well-controlled study, and both the probiotic and the prebiotic had an effect on the gut microbes, but the effect of the prebiotic was 10 times more than the probiotic. it's shifted nearly all the good microbes upwards so and we saw bigger changes in symptoms in mood and energy than in the probiotic so they both work but based on that our study which is the largest one done to date it looks like we're better off feeding all our microbes than trying to select one seed because i think the way to think of it is if the prebiotic is a fertilizer a probiotic is like a seed and fermented foods are better than a single probiotic that you buy on a chemist probably because they have many more species you you know you you can get some kefirs and kombuchas that have 30 or 40 species whereas you can't really get that many in a probiotic and they might interfere with each other.

1:13:30So because of that experiment, I've changed my view. And I think really prebiotics and food and 30 plants a week is the most powerful thing we can do for our gut health. So what you're saying is that the average person with this information about prebiotics and probiotics, what we should do is just eat more plants. if you can yes that's as important you can do that naturally do that naturally as a base if you want to add more to it you know take some of these uh these supplements but that's the core element of what we should be doing and and it's the diversity that counts so in the past we just said just have more fiber here's this artificial fiber you can have inulin made from chicory root or something but that's just one fiber source so that's not as good as having 34 different types of fiber so i think it's it's got more complex as we understand we need this diversity but that's also good because you know diversity means more plants it's more fun to look at it's more fun to cook it's more fun to enjoy rather than us having a sort of Star Trek-type concoction of just one magic ingredient.

1:15:00What do you think about this? What are your thoughts on supplementation? In general, well, 95 % of supplements are rubbish. There's no science behind them, or they've been proven not to work. And the other five? And yeah, there are some supplements that have been shown in trials to work that do have some biological sense. But most people probably don't need them. So the ones that do work are things like vitamin B12 for people who don't eat much meat or have some issues. Vegans might need B12 or some folic acid as another one that is really important in pregnancy, proven to stop many neurological problems in children.

1:16:01And there's increasing evidence that that's important in cognition in your brain as you get older. So I now take folic acid. I studied vitamin D for 30 years and it's the most common promoted drug for bone health. It has absolutely no effect on bone health and actually might be detrimental and cause increased falls. But it strangely might have some impact on preventing diabetes. So trials have shown that it might work in a completely different way. so it might reduce by a few hours the length of a cold and it might reduce your risk of diabetes but a few other ones like omega-3 is a very common supplement people take only likely to work if you are deficient in omega-3s if you never have fish and your blood levels are particularly low then it might be helpful but most people are taking it probably don't need it and or it's it's probably low quality anyway and many of these are very low quality products not regulated and a lot of these new ones for aging and things are also rubbish things like uh the ones that nad plus and uh all these infusions you can get in in los angeles glutamates and all this i've had the founder of nad plus on the show there's no evidence in humans that it works brilliant in mice and if you're a mouse if you're a mouse definitely yeah if you're mouse all supplements work and what about creatine because every time every time i open a a wellness magazine or or social media for that matter we're constantly being told especially in the last year or so that creatine is something that we should all eat regardless of our age gender and the type of or the amount of physical activity that we do in our everyday lives yeah i i was interested in this and so i did look at all the research and um there is uh definitely consistent evidence that if you take creatinine and you exercise at the same time you can increase your muscle mass above a placebo but it's not that impressive i don't know i think it was about 1.7 percent of muscle is that the only benefit of of taking creatine the other ones are less clear there's a suggestion that it might improve cognition as you get older but it's suggestive rather than sure at this stage so so it it definitely has an effect on muscle it may have an effect on cognition um whether the whole population should be on creatine um i think is unclear you know and again a lot of the products don't actually contain any creatine or they're inflated with other stuff um i tried it for a while i started adding it to my yogurt but it filled me up and made me rather nauseous.

1:19:41I really found it rather strange, this tasteless powder. So I'm looking for a more natural way to get my creatine. If I was convinced on the data about brain function, I would take it. So I'm keeping an eye out on the latest research. i'm not that impressed i don't care about one percent of my body my muscle mass really i don't think i'm going to notice my one percent by improvement in my biceps at the moment let's talk about other other wellness trends or fitness or food trends what are your thoughts on diets like the keto diet? The keto diet is not supportable by most people. You have to have 70 % fat in your diet.

1:20:36You have to have, I think it's less than 25 grams of carbohydrates. It's really tough to sustain it, and many people feel very sick on it. So only a small minority of people can do it. Those people say they feel better, they get some mental clarity. So I've spoken to a lot of people about it. And there are a few illnesses that can be cured by keto diets. If you have childhood epilepsy, just going on a keto diet will cure 50 % of them. So it clearly has real effects. but long-term, it's a disaster for your gut microbes because essentially most people on keto diets ignore fibre, ignore plants. They're obsessed with proteins and fats, and where short-term they might feel better, long-term it's a complete disaster.

1:21:40So I expect they'd have much higher rates of all other diseases going forward. so I don't think it's a long-term solution for most people I think what is interesting is there are some whether every three months if you did say a few days of keto that could work I think there's some tiny studies that suggest it might they're just having a little reset every now and again, whilst the rest of the time looking after your gut health, that might work. So I'm open to that. But there are these, also these fasting mimicking diets, if you've heard of these ones, where for five days, between three and five days a month, you go on a low calorie special diet that is supposed to trick your body to think it's in famine and switches something in your brain that acts as another reset.

1:22:53And there's some good clinical trials showing that can help you metabolically and help your blood sugar levels. So in the future, there could be some sort of combination of these things that, you know some sort of intermittent keto might reset your brain and your body a little bit but long-term keto is i think is a disaster what are your thoughts what are your views on the different forms of fasting well obviously that fasting mimicking one was is looking quite promising because that's the one with data lots of people who talk about fasting don't have any data they're saying going on these really long fasts um there's no real data to show they they help i'm against people who do long fast because there's quite a lot of evidence that more than say 48 hours your microbes will start will start starving to death and they start eating away at your gut lining um so that at first they eat the mucus layer but then after a while there's they go through and through and it gets thinner and thin and they start causing damage to your gut which will end up with problems of leaky gut etc so i'm not a big big favor of lengthy fasts um i don't think 5-2 diet works that was a big trend about 10 years ago all the evidence shows that has no real benefits for weight loss um i do think the time restricted eating is useful and it's something i do intermediate fasting well intermediate fasting is a very global term for many types of fasting obviously it's all intermittent because if you're fasting all the time you'd be dead you know you're um uh nobody's really fasting it's a bit silly really isn't it permanent fasting is the yes um so i think time restricted eating is the latest form of intermittent fasting but as i said five two is another their variants of it or 48 hour fasts or this um fasting mimicking diets they're all part of this uh pattern um so i think just eating differently one day a week doesn't really help um but if you constrict the time you eat the you eat the same but you eating say in 10 hours rather than in 14 hours we believe that works we did a big study a pragmatic study of a couple hundred thousand people with zoe and showed that a third of people love it and they're still doing it two years later.

1:25:39A third hated it, couldn't do it because they're snackers and they don't like, they're hungry when they wake up in the morning. And a third is sort of somewhere in the middle. So it's not for everybody, but the people who can do it do see metabolic benefits and they get less hungry, less bloating and can sort out a lot of problems. So I believe that these sort of mild time-restricted eating means you cut out late night snacks, you give your gut a rest. To me, it makes the most sense rather than these other more extreme ones which haven't been proven yet. I think at least the people that I talk to follow different forms of fasting for different reasons.

1:26:21But one that usually ends up being the common denominator is to lose weight. what would you advise when it comes to losing weight so what's the best advice in in that in that space i'm not sure these fasting regimes help you lose weight so i wouldn't go into it saying i'm doing this because i've got to lose 10 kilos all i gotta do is stop eating every second day and i'll be fine your body is cleverer than you are and it knows that if you're stopping eating calories your calorie restricting in some way it has a defense mechanism to stop you doing that and it does that by slowing down your metabolism making you more tired and it will increase the hunger levels so every day your hunger level just gets ramped up and up until eventually you crack and that's why you know calorie restricted diets don't work long term they only work short term and you bounce back beyond it so that is that's and we've discovered with the zempic like drugs how important appetite signals are.

1:27:40It's not really about metabolism. It's about what can you do to control the appetite. So all the things I've been talking about, why gut health is so important and processed foods are so bad, a lot of it is about appetite control and signaling to your brain and your gut and getting that right. And we've seen the huge power that just by switching off the appetite signal, people can lose you know 20 percent of body weight um seemingly effortlessly when you know the last 50 years of calorie controlled diets have failed miserably uh so we have these wonderful drugs showing us that this is the crucial mechanism so picking foods that fill you up picking foods that don't make you hungry picking foods that don't give you a sugar spike don't give you a fat spike this whole concept of personalized nutrition understanding more about the food you're eating all become more crucial and if you do that you change the quality of the food you're eating you avoid this bad stuff you you eat within these restricted times you know you will lose small amounts of weight but over a long time period nobody without these drugs is going to lose weight, massive amounts of weight short term.

1:29:05But if you take the long term view, then just changing what you eat can make a big difference.

1:29:15What are your views on these drugs, like Ozempic? I think they're the biggest medical breakthrough of my whole career. A positive breakthrough. Yes. They could change the life of hundreds of millions of people and change the economies of countries like the UK, change the health service if they're used right. Obesity is our number one health problem. So who should take it? People that are obese or anyone that just wants to drop some weight? No, they still have risks associated with them. There's a one in a thousand chance of a really serious side effect.

1:30:04And you have to take them for life, pretty much. Huh. So it's a bit like taking a blood pressure tablet or a statin, both of which we know save lives. These looking like they would save more lives than statins or blood pressure tablets. but you have to be prepared to take them for life and what we should be doing is what we're not doing the moment is combining taking these drugs with lifestyle changes with educating people about food with using this time when your brain is switched off your appetite is switched off so you don't have this drive to eat junk food you're not going to demolish a bag of chips or pringles mindlessly or go to you know go to mcdonald's or have enormous amounts of pizza this is the perfect time to change to a gut-friendly diet which will permanently alter your taste buds and everything else and if we combine these two approaches then it you know it would make such a difference to our world we live in.

1:31:16But who should be prescribed this drug? At the moment, from what we know on the safety profiles, you should have a BMI of 30 or more, or I would say a BMI of 25 with some medical problems. If you're not in that category, you're in this social world where the risks outweigh the benefits and we don't know all the effects on the brain as an entrepreneur you should know that one of the one of the effects of these drugs is to reduce your addictions so you reduce smoking cocaine addiction gambling and if you think about it gosh you reduce gambling so does that mean that your personality is no longer going to take as many risks so these are things we don't know fully but they should be little warning signs that these are these are powerful drugs that have really beneficial effects if you need them but if you don't really need them we don't know enough about those brain effects yet before I would say to you, you know, you want to lose five pounds, therefore take it for a month.

1:32:41No, I wouldn't. That's a very interesting new angle to discuss about those end picks. So not necessarily through the lens of losing weight, but through the benefit of dropping an addiction, which I think is equally important and perhaps not discussed when it comes to these types of drugs. It's, you know, people in the addiction field, you know, dealing with alcoholism, for example, find it's the most effective thing that they've seen. And you start thinking about all these additional benefits to the drug, you can see why it's such a blockbuster for public health terms. But you need to take it for life.

1:33:23Everything suggests that's true. I mean, obviously there's 100 new types of these drugs coming along, possibly in combinations and things. They might be able to get low dose effects down. But I think the best people could hope to do is take the drug, you know, change your lifestyle, improve your gut microbes, change your taste buds so you don't want sweet, you know, sweet things. You don't want processed foods anymore. or get your act together, then you might be able to reduce the dose and have it intermittently or whatever. But there's virtually nobody who manages to get off these drugs and without the appetite going back up and changing the way they eat again.

1:34:12So it doesn't term, you know, nothing permanently stops your appetite because it's so crucial for humans to have hunger signals. I want to address the topic of portion control and appetite, but for the people that will not be taking drugs that cause NPIC, how should we define that what we're eating is enough? Should we listen to how we feel? Because also that varies, right? There are some days that I didn't necessarily work out more physically-wise or I didn't have a more stressful day from a work point of view. But yet there are some days for no reason that my appetite is higher and I want to eat more.

1:34:58So I don't know when to define that enough is enough and to know that I am maybe overeating. Well, I think you've got to listen to your body, but you mustn't always do what it says.

1:35:13So I don't know if you've noticed, if you travel a lot and you're sleeping badly and you're jet lagged, you want food, right? Your body is saying, feed me, feed me, feed me, right? And you know that you don't need food. You've been doing nothing. You're sitting on an airplane. You haven't spent any calories. So you know your body's wrong, but at the same time, you want to be able to sleep, so you have to do something about it. so i think it's listen to your body but don't be ruled by it we know that what you ate last night will determine your appetite the next day so if you had a bad meal you know your signals will be raised in the morning we know that if you only got five hours sleep your food choices in the morning not only you'll be hungrier but it'll be saying give me carbs, give me lots of fatty foods, right?

1:36:12It won't be asking for vegetables. So it's telling you the wrong thing. And so you need to listen to that, but also understand what your body is trying to do and not be ruled by it. I think that's important. But realize that, you know, some people are ruled by their appetite and others aren't. You know, we're all different. And it's very hard to know what someone else's appetite signal is telling them. So we're very judgmental about obese people and say, oh, you've just got no control. But we don't know how strong their appetite signals are. And I don't think until Zempi came along, we didn't realize how they can just switch and become like skinny people.

1:36:59Yeah. Who aren't, we know in every population in the world, there's perhaps 20 or 30 % of people that never get fat. you go to the Gulf states where most people are obese. They're drinking, you know, sodas and eating terribly. But amongst all those obese people, there'll be a group of skinny ones that just don't get those appetite signals. Yeah, but I think we all have this one friend that can eat whatever they want. sugars fats starches um anything and they just must have an incredibly high metabolism because they don't seem to put on weight does that mean that even though from the outside they're not putting on weight internally they're healthy these very small group of people we all think what you've suggested but the evidence doesn't suggest that there's huge differences in and our metabolism one person to another so you know it could be that they're not actually eating that much you just perceive them to be eating but when they're not with you they're not eating very much at all really they're not waking up hungry in the mornings you know they have different patterns to you so you know we used to think that we could explain a lot of this by huge variations in metabolism you're a fast metabolizer you're a slow metabolizer you know and we'd all blame ourselves oh it's my fault you know i'm useless metabolizer but it all seems to be controlled by the brain rather than by metabolism and or when i was researching genetics of obesity it turns out that you know most of the genes for obesity are in the brain or in the immune system.

1:38:59They're not controlling metabolism. So I don't have all the answers, but I do think that some people are protected and it's probably they just don't, they can eat for fun or whatever, but they don't get the same drives that some people do, you know, in that morning. So, oh, I'm starving, you know, I really must eat something. They maybe don't get that. I think you're so right because, yeah, We don't spend every single day with this other person. And you're probably right. They're just maybe eating less than what we think. Yeah, it's very hard to know what is going on in someone else's brain. What are your thoughts on alcohol when it comes to our gut health, but also our general health?

1:39:47Are you a person in simple terms that is pro-alcohol consumption, against alcohol consumption? somewhere in between well i'm trained as an epidemiologist which means i look at population health and in in general uh alcohol is bad there's no getting away from it it's a risk factor you know it's a mild neurotoxin um but most of the planet drink alcohol because it's pleasurable and uh you know even our monkey ancestors still you know many of them still like fermented drinking out and eating alcohol so it's it's part of our dna in a way um and i i think we shouldn't i'm controversial amongst my colleagues because i i i won't most It's easy to condemn alcohol completely and say nobody should have any alcohol.

1:40:50We should ban it, make it unaffordable. Certainly very big in America, that opinion. But I look around the world and I see many healthy populations, whether they're in Spain, Italy, Mediterranean countries, Japan, where they enjoy sake and shoyu, to enjoying small amounts of alcohol in social settings, and that seems to have some health advantages. And I think, you know, one glass of alcohol a day for most people, particularly if it's like a red wine and not a spirit, or, you know, a bottle of beer is perfectly fine. I did some back of the envelope calculations for my book because I'm quite happy to say I have a glass of red wine five or six nights a week occasionally have a week or so where I don't drink I drink less than I used to I'm a doctor remember most doctors were taught to drink heavily worked out that the risk of me having a problem due to drinking one glass of wine is the same as me commuting by car for an hour a day in terms of health risk and so we wouldn't tell people never drive a car it's it's it's very small that's my point so if you're having one zero but it's very small So if you're having a glass of wine six times a week, is that, as you said, it's not harmful to us, which I have a few questions about that, but before those questions.

1:42:45So if that same person, instead of having those six units of alcohol, six units of, or six glasses of red wine in six days, if that person is having those six glasses in one day, does that have a different impact in our bodies from a negative point of view? Is it worse? uh yes so they've done studies of of binge drinking which is what young people do nowadays is you know they would all have that on a friday night yeah and then that has uh according to the epidemiology evidence it is is much worse for you than having um a regular drink drinking spirits is not good for you at all i mean the reason i pick i pick wine is that We actually did a study of about 5 ,000 people looked at their drinking habits and their gut health.

1:43:38And the only alcohol that was beneficial for your gut microbes was red wine. That's because it's grapes and polyphenols. And when you drink it, you can taste a bit like an olive oil. You've got the tannin in there. So it is quite natural. So that contrasts against the alcohol and gives you the modest benefit for the gut, but maybe negative. So it's good for the heart and the gut, maybe negative for other things. And it sort of balances out. Yeah, so that's what my next question is going to be about. So in your next book, you are researching the connection in between the gut and the brain and how everything that we consume and we eat is impacting our brain's performance.

1:44:29When it comes to alcohol, my understanding was that alcohol, it's literal poison to the brain. It impairs so many of our different neurological circuits, but also it hijacks our dopamine system, which then by definition we have a dopamine low which makes us also sad aside from impacting our memory, our focus and many other cognitive functions. What do you think about this? Well, I think it's all true but it all depends on the dose. It depends on the dose, okay. So lots of things in small dose are fine and in large amounts are terrible.

1:45:12It's a bit like saying if you smoke one cigarette a year is that are you likely to die probably not right um 20 cigarettes a day yes um you know uh if you drive a car you know for a living um and you're on on the road you know every every waking day of your life your risk of having being in a car crisis is greater than even an occasional one. So it is all proportional. And I think that's what people want to black and white answer, but there isn't necessarily one. I think there's still advantages, you know, again, from these historical studies of centenarians, et cetera, the ritual of alcohol in human society is very strong.

1:46:10So meeting as groups, meeting friends, getting around, whether it's a small beer or a glass of wine, which you see in Spanish villages and whatever, is extremely important for the benefits. And it's not due to the alcohol. It's because they're there and they get these benefits from being in a group and a community and a bonding. and i think i think it is so integrated to that that um which maybe they care less about in the u.s than you know um in europe uh but we mustn't always take one thing apart and say yes that's evil therefore you cut it out because if that's part of all this other stuff that's very beneficial then maybe we should just yeah okay in moderation it's fine so i'm happy i've looked at the data if I have, you know, five glasses of red wine a week, I know it's probably good for my gut health and any extra risk is minute.

1:47:13I would have to, you know, really, I'd have to live to be a thousand before I'd sort of see any major side effect of it. You know, but at the same time, people who say there's no such thing as a safe level of alcohol are also correct but there's also no safe level of driving you know and we we don't criticize that or no safe level of walking on a pavement because someone could crash into you you know um that you know there's no safe level of walking in london because you're gonna get pollution um no safe level of uh breathing because i guess the bigger question would be then what purpose is alcohol serving us in comparison to driving so driving is taking us from point a to point b but alcohol is serving the socializing purpose right and then the question would be can we satisfy that purpose without this drug um quite possibly yes and then in an ideal world if we're able to do that then then that's the perfect scenario, right?

1:48:24Yeah, and things are changing. You know, the last 10 years, we've seen zero alcohol beers become really good from being terrible. And, you know, I drink a lot of low alcohol beers now. And if you go to the pub with friends or, you know, with my cycling mates in Spain, you know, it doesn't matter if I get a Tastada Zero, you know it's it's acceptable so i think this will change things as these products and i i'd love to see a really good uh low alcohol red wine they haven't invented one yet um to go with your food you know and you know you know you're a chef you know the importance of um what wine can add to a meal um and i i think you know enjoyment is another part of this we shouldn't lose the sight of the fact that it gives great enjoyment to lots of people and um uh you know let's keep working at it but yeah if someone comes a lot like like the beer i think the beer has revolutionized you know um a lot of drinking and um realize you can get satisfaction without the alcohol so i think it is changing but i'm just i'm you know old school and um uh i still you know was brought up my father was a wine connoisseur i love wine um you know it's it's part of my culinary experience dr specter you are the co-founder of a company called zoe for those who don't know what the company is what is it it's a science nutrition company it's also a a gut health company that we believe is sort of leading the gut health revolution our goal is to improve the health of millions of people through tools to guide them to eat better So we have a number of products that we've been developing through research in the last eight years.

1:50:45So we have an app that people can use as a tool that uses AI and photos of your food to track what you're eating, give you scores based on your personalized responses so that you can reduce sugar spikes fat spikes reduce inflammation just nudging you towards a long-term healthy way of eating it tracks how many plants you're eating ferments etc we also have a gut test which is the most advanced in the world, which we've done on a third of a million people now, to say what's the state of your current gut health and how we can use that data to personalize some of the food scores in the app. We also have products like the prebiotic fiber of 32, 34 plants, and we're having others in the pipeline, all of which we test in proper randomized trials rather than just using marketing.

1:51:55And the idea is we're currently in the US and the UK. We're moving into Europe this year. And really, we also have a big successful podcast, the biggest nutrition podcast in the world, which is free, telling people all the latest science about what's happening in the field of nutrition. so what's the name of the podcast so my audience can also follow you zoe science and nutrition and we feature you know real scientists talking about their research and how this can impact the practical aspects of of food and nutrition and lifestyle so we're trying to through all these ways of working, get people to eat in a more healthy way that is driven by science and get people to understand food more.

1:52:56And that's really what our aim is. What is the greatest discovery that you've made while building Zoe from a scientific point of view?

1:53:10Well, there have been lots. I mean, Zoe is very unusual because we've actually published 70 papers, which is a lot. And in the top ranking papers in the world, like Nature and Nature Medicine, that is like winning the Oscars. We also did a lot of work in COVID. So as COVID came on, we were developing the food app and then we switched to help people record their symptoms and we made all kinds of amazing discoveries about the virus, but I guess everyone wants to forget about COVID. I think I'll list a few discoveries. So the first was that we all respond very differently to the same food. No one had ever said that before.

1:54:00So that was a revolutionary moment in nutrition history that that meant we could personalise it. That meant that you could predict how people respond to foods, how you and I are different. Second thing we know is that the gut microbiomes of us all are very different. So you and I only share maybe 20 % of our gut microbes. You and your twin only share 25 % of your gut microbes. It's really tiny compared to everything else in our bodies. And so that makes us very unique in our responses to food. uh i think we we showed the first times these sugar dips no people in the past had only focused on sugar spikes not sugar dips and showed that that is then linked to extra hunger and explains a bit why junk foods cause people to overeat as well it's not just the contents of the food it's the response of the body that tricks it into thinking it needs more or you know it needs to compensate for that for that dip as if that dip is like you know a bad night's sleep or something else um i think the effects on the brain i mean we've done about four very large studies all of them showing that the first things people notice when they improve their gut and their diet is their mood and their energy improve.

1:55:33And I think that, for me, has been the biggest sort of aha moment in the last few years and why I really wanted to start writing more about the brain, et cetera, and realizing how important the gut is pivotable. And we always thought the brain used to rule the rest of the body. Now I think the gut tells the brain what to do. And sometimes it gets it wrong. And that's why we end up depressed. and anxious and stressed and if we can understand that we can all feel better are the different responses from different people eating the same types of food a result of nature or nurture they are if by that meaning genes or environment they are predominantly environment and random factors so as you know my background is in twin research so that very first study we had 650 twins there because we wanted to see the genetic effects because i was sure that'd be a big genetic effect and it turns out it's very minimal it's only about 25 for sugar response and five percent for fat response so it's nothing really to do with our our genes and that is a really empowering message because that means that we all have the ability to change ourselves our responses through our diets and environment and our lifestyle which i think is um very powerful because in the past we said nothing more you can do just blame your parents you know now we can change ourselves we can change our bodies.

1:57:21What would you tell these parents that right now they are deciding what to give their kids for breakfast, lunch or dinner? I tend to read my books and yeah not make the same mistakes that you know I made with my kids and that nutrition is probably the most important thing any parent can teach their kids. Not only what to eat but you know how to enjoy it, how to eat socially how um to decide what's good um you know how to cook foods themselves so they you know they'll know for the future and it it's something that i'm really passionate about we should be teaching in in schools uh it's a total disgrace that we don't and uh you know the most powerful thing you know parents can do is to is to give people the right food habits and in many cultures in the world still do that but many cultures like in the UK have lost it and what does that look like for a kid breakfast lunch dinner well the current one is terrible I mean you know mainly ultra processed foods they'll have breakfast cereals they have orange juice they go to school they get given a whole box of snacks that they don't need so they're having high protein chocolate snacks getting crisps they then have a terrible school lunch often not sitting down and they might you know have some fast food on the way home and then you know a microwave dinner in the evening and have had no fresh vegetables or plants all day.

1:59:10Why should we be sitting down while we eat? Our body needs time to appreciate what we're eating. And so we've evolved to sit down and eat communally and have time. And it takes about 20 minutes for our body to realize that what's going on and and when when to be full and so time is is is crucial for us both to savor what we're eating so we don't eat like dogs we can actually taste the flavors and appreciate it but also to allow us at the time to know when we're full and we've eaten enough when we're eating in front of the TV, when we're walking, when we're eating standing up, driving in a car, one in five meals in the US are eaten in a car.

2:00:11We're not getting any of these normal signals. And it's getting worse and worse. So we need to get back to teaching kids this is the way to eat. And, you know, Mediterranean countries still do it. It's very important, you know, but it starts at school. And many of our schools no longer have tables to eat. They've done away with the dining room. It's very sad. Devastating, yeah. I was in Japan recently, and it's quite interesting. They have a lot of snack food in Japan, but they have lots of cultural rules to mean that nobody eats food while they're walking. You don't eat it while commuting. And you don't take snacks to school.

2:00:59And every meal at school is prepared partly by the kids. They clean up, they sort everything out. And, you know, it's a very formal affair. and there's a nutritionist in every school. French schools are similar as well, making sure that, understand the formal process of the meal. Dr. Spector, my final question to you has now become a bit of a tradition on the show as our closing question. And I would like to think that is the most important question. If you had to compress all your knowledge into one essential piece of advice that we must implement in our daily lives, what would it be? I would say every time you put something in your mouth, remember that inside you are 100 trillion microbes begging you to make the right choice.

2:02:06And if they're happy, you'll be happy. Thank you. I really, really, really enjoyed our conversation for so many reasons. But the primary reason is because, as we were discussing earlier, I believe that there are very few topics that act as a common denominator across every single human in this planet. And I try to pick up those topics and then bring subject matter experts of those topics into the show So they can, on one hand, simplify the area of expertise so we can all understand. And then, on the other hand, provide us with valuable tips that we can implement in our daily lives, regardless of how much money we make or where we live, right, in a very democratic way.

2:02:48And I cannot think of a more mainstream and democratic and common denominator topic than food. So I've really enjoyed our conversation. I'm going to implement so many of the tips that you've shared with me. And I'm very hopeful that this will also help my audience. And I'd like to have the opportunity of having this conversation again, perhaps in a year or so, because I know that this industry, the food industry, the world of food is evolving constantly. And perhaps maybe what we agree today that is very healthy in a year and a half from now, we discover that it's not healthy and we need to revisit that topic.

2:03:28but thank you so much and for our audience we will leave a link to all the different books that Dr. Tim Spector has right now published which if my memory serves right there are five different books right now right available and there's a sixth coming so we'll make all of them available across all of the different podcast platforms and yeah thank you so much it's been a great pleasure