Gut microbiome testing: What can it reveal about your health?

26:07Yeah, so you get this box with some instructions, and it has pictures of toilets in it and various other bits that all sound a bit icky. but basically all these tests and the zoe test in particular gives a way of collecting your stool sample so there's a little sheet that comes out that you put over your toilet you do your normal business and leave a bit of this in this sort of paper that's covering the the toilet which allows you to scoop out that a bit like there's a little spatula and you put that into and how much because people might be thinking like that. Minute amounts. So we're talking less than a sort of fingernail.

26:50You hardly need any because there's so many billions of microbes in a millimeter of this stuff. So you don't have to fill the tube or anything. It's just a minute amount, forensic type amounts you put in. And you basically put into this tube, which has a medium in it, which preserves the DNA so that when it goes to the lab, it doesn't matter if it's wasted a few days or not before it, say, goes to Nicola's lab. And then that's when the sequencing starts. Now, what we've noticed is we've been doing this for over a decade. And we started with our volunteers, the UK twins, who are always the guinea pigs for all these things.

27:30I can tell you, when they first heard they had to collect their own poo samples, they were pretty shocked. and they say, oh, this sounds very icky. And you ask people, oh, I never look at my poo. I never turn back, always just flush and go. And so this is a new thing for many of them. But as each year has gone on, the acceptability has gone up from about 40 % to about 95%. So I think people are now used to this idea in this country. And in other countries, probably in Italy, this is quite normal. I remember when I was working in France and Belgium, patients are always showing me their poo. I didn't want to see it, but it's very cultural.

28:10That's interesting. In Britain and the USA, I think we have a bit of a problem, but we're overcoming it. We realize it is just like a urine sample, a blood sample, saliva sample. I mean, I would just say at a personal level, it is definitely a lot easier than changing a nappy or a diaper. So anyone who's ever had to do this, that is so much worse. Or picking up your dog's poo as well. as well. That's right. But it's interesting. I think it does tie into the stuff. We're all brought up, I think, as small children, that poo is something that you're sort of like, it's all a bit icky, as you say, Tim.

28:42And so I think there is something that one has to get over. And then I think that fits into a lot of this idea that we don't talk about something that's actually very important. This is going to be commonplace. And I think everyone knows if they're, I think it's over 60, they get a standard colon cancer test now from the NHS, where you do the same thing on the stool test, really to look for blood in the stool. It's a very crude measure compared to the microbiome, but it's a similar thing. And I think people now realizing this is part of normal health prevention. So I'm not worried that, you know, we're going to continue that aversion to it.

29:19So that's where we are. You close the pot, put it in an envelope, And then it goes off to Nicola's lab, and he's going to tell us. Tell us what happens next, Nicola. We have to do a simple thing, which is not simple. It is reconstructing the jungle. So having a picture of the jungle. And, you know, there are several ways you could do that. In the past, they were trying to isolate, grow single microbes. But this is inefficient, and it's not giving you the jungle. It's giving you the single animals and in a cage. So it doesn't really work. So in the past, we've only got 1 % or less of all the microbes in us.

29:54We thought, because we could see them grow, we ignored all the other ones. Exactly. The other 99, you know, 5%. But isolated, they were also in a cage. So they were not representing what they were doing in the jungle. So the revolution was DNA sequencing. And what we do on the sample is to free the genetic material of all these animals, of all these bugs in the sample, and then we try to read it. But these machines, negotiation sequencing, they are called, they can read only little pieces of the genetic code, so not the full genome of the microbes. So the machine will give us a lot of very small readings of the DNA, and at that point we have a big computational computer issue, which is reconstructing the puzzle of each single animal.

30:42So the genome of an animal, of a microbe, is the solution of the puzzle, and we have little pieces. It was called shotgun sequencing. Shotgun sequencing, yes. So you used to basically explode it, blow it all up into tiny pieces, and then someone has got to put this massive jigsaw puzzle back together. Exactly, but it's more difficult than that, actually, because all the pieces of the puzzle are scrambled together. So we first need to understand which pieces, which little pieces of DNA are coming from one microbe and the other microbe, and then we need to reconstruct the genome. This is a really hard data science problem, right?

31:20That is what kept busy my lab for the last 10 years. Yeah. And it was nice because at the beginning, we were only able to say, you know, big division of microbes, like animals. We have mammalians in this sample. And now we can say, you know, we have this specific animal. actually this subtype or strain of animal. And this was only done by improving the methods we can develop to look at that with a computer. So 10 years ago, this would cost at least 5 ,000 pounds a sample to do. Okay, so, and a bit like the genetic revolution in humans, which, you know, the first one cost a billion or something, the cost has come down sort of halved every year.

32:05So that it's a few hundred pounds now. Even less. And we're getting so much more than we were. And still most people who are offering microbiome testing are using a very crude method, which is called 16S, which Nicola can explain. Which is looking only at one gene. Microps have 5 ,000 genes, more or less, each of the microbes. and this initial testing that we were also using about 10 years ago, it was looking at only one gene and looking at the differences in this gene that are characterized in different microbes. But this will not tell you anything about what is the machinery of this microbe to degrade a specific nutrient or something.

32:46So it's giving a bit of diversity analysis so an idea about how many microbes are there. But as you were saying, it's more important to understand which micro, which subtypes of micro you have, rather than how many. So it is amazing. And it continues to be computationally definitely by far the most complicated thing that we're doing at Zoe and that I think that I've really seen actually in this whole sort of medicine, sort of human biology space in terms of data. It's extraordinary. Now, having said all of that, Tim, some people claim that with a microbiome sample alone, you could deliver high quality personalized advice.

33:21And I know that you said you don't believe that's currently possible. Part of the reason that at Zoe, we don't just do a microbiome sample, but we also get all this other information like sugar and blood fat. Can you explain why that is? Because listening to you, it sounds like this is so important. Why isn't it enough? Well, certainly 10 years ago, I thought it would be the case that by now we would have enough information that we'd be able to say, yes, you're going to get Alzheimer's disease, you're going to have heart disease, you need to avoid this food, you need to do this. And it's turning out to be a different tool to the one we envisaged.

34:03So as I said earlier, it's not really a useful diagnostic because in a way, it's so complicated. there's lots of different ways for those microbes to work. So we just don't understand all of this yet. Correct. Yes, there's this jungle, but many of the animals are able to produce, say, the same chemicals. So you might have a different balance of microbes that are producing the same sets of chemicals. And in one person, a different set of microbes producing exactly the same. so serotonin or whatever it is, or another one that might predispose you to cancer. So we haven't yet sorted anything out that level of detail we'd need to predict individual disease.

34:52So that's why at the moment, it's a much better test of the overall function of, say, the immune system or our metabolism than it is predicting individual disease. Now, I think that we're going to see as we move from identifying the microbes to identifying their functions, that could be a step change. So once we perhaps use artificial intelligence or other sort of major computing factors to work out this combination of microbes, what chemicals could they produce, and are some of those maybe carcinogenic, then I think we're going to be a position where we could do that in the future. But absolutely now, for the next couple of years, we're not going to be a position that on its own, it's going to be that useful.

35:41So that's why we've found that, you know, yes, we know we can give what a healthy one looks like, an unhealthy one looks like. We want to improve that. But it's using these other tests, like we do at Zoe, like with your Your blood sugar response to individual foods and your lipid testing are better predictors, say, of cardiovascular. And so we put all of these things, each component is, I guess, what you're saying. We're still going to take a holistic approach. I think it's going to be some time before the microbiome on its own could ever do that job. We need to understand much more about all the chemicals that they're producing and how we manipulate them, if you like.

36:23But, you know, there are some areas like cancer and things where, and I know Nicola's been doing some work on that, that we're getting sort of close to be able to say. So people, their response to drugs and things like this, you know, knowing what their microbes look like. Can you tell us anything about that, Nicola? Yeah, I think for certain diseases, specific diseases, for example, colorectal cancer, our microbiome can tell us something directly. But something more complex, like cardiometabolic health, we need to contextualize the microbiome. So it can be the same microbiome, can be a very good microbiome compared to what you eat, or a bad microbiome compared to what you eat.

37:05So we need still to contextualize the microbiome with respect to what you eat, with respect to your cardiometabolic readouts, and we need to take this into account. But our microbiome is an ecosystem, but is inside a bigger ecosystem, which is provided by our body and by also the environment we are all in. And it's complicated by the fact that it's also a reflection of the environment. So if you're eating badly, you might have a pro-inflammatory microbes because you're eating badly. Or if you have an inflammatory disease, they might be responding to that. And so there's a mixture of cause and consequence in our microbes that needs more sorting out before we can just say, oh yes, you're going to get that disease.

37:51So having made this big disclaimer that you can't just rely on your microbiome to give all your results, and I think, Tim, you've often said to me, as a doctor, there's actually very few tests where you would say that's the only test you use to paint a picture. Is that fair? Yes, hardly any, yes. So it's part of the story. I think people listening are like, okay, enough with the disclaimer. Tell me what I can expect. So what's the information that I could expect to get back and how can I make sense of it so this is actually something that's useful for me? Well, what we can say is whether you have the right microbes.

38:21So when we did our first study with Zoe, it was 2019. We had at that time the biggest study, more than 1 ,000 individuals. And we identified 15 bacteria that were strongly associated with good outcomes and with good diet. and at the same time, 15 instead are the opposite side. So they were bedbugs, let's say. But now we expanded everything. Just before we move on, that was the paper that you then published in 2021 in Nature Medicine, right? Exactly. We'll put the links in the show notes if people want to see that. And that was, I remember you saying, Nicola, actually the biggest study in the world of gut microbiome and these sorts of health markers that had ever been done.

39:02Exactly. Which to me seemed extraordinary. It's like, well, it's only a thousand people. And again, I think we talk about this a lot on the show. gives you a sense of sort of how small historically most of these studies are because they're very expensive and there hasn't really been the funding. So that was sort of 2021. Are we in the same place today? Well, in a couple of years, I think we made the giant steps forward because it's at least 50 ,000 now tests and way more diverse from all viewpoints. And also in the meantime, thanks to this data and other data, we discovered many new microbes. Microbes that don't have an A because because microbiologists never really cultivated them in the lab.

39:40So we have identifiers, we have some nicknames, let's say, that are not official microbiological names because they don't exist. So just to make sure I've understood that, you are finding through your data like these microbes that no one ever knew existed. They've never been grown outside of like the human gut. They haven't got names on it. It's amazing. So it's like being an astronomer and suddenly discovering that there are all these planets. We discover a new genome, a genome of a bacterium, which is so different from all the other bacteria that needs to have a new species, needs to be a new species.

40:14And could have totally amazing new functions that we don't know about. So, you know, stars, you know roughly what they do. But this is actually more exciting because it's like discovering some totally new unknown factory that is producing a chemical. You've got no clue what it does. and the NICLA and his team are finding hundreds of these that weren't previously discovered. I love this idea that, you know, because I think sometimes you feel like all the explorations got really hard, right? You know, my children are like, oh, I'd like to discover something new. And you're like, well, you know, people have been all over the world.

40:45They've been able to see everything. And here you're saying, well, actually inside your gut, you're literally just carrying around with you is this huge amount of undiscovered species. Indeed, two years ago, we were seeing only 50 % of the microbiome because for 50 % of our data, we couldn't make any sense of. Amazing. So half the microbes, you had no idea what they were. And now we are around 80 % that we know. So only 20 % of what we still call the microbial dark matter with a big name. So that's huge. The unknown has fallen from 50 % to 20%. So it's an enormous reduction. Yes, exactly. And let's not forget that we haven't even discussed looking at the viruses and fungi, which are harder to look at.

41:25We're picking up a few parasites, which we'll probably talk about in another podcast, which are really exciting. But there's this whole world there that we're just uncovering. And so, you know, just in a few years, we've managed to find another 30 % of what previously unknown microbes. So incredibly exciting from a scientific perspective. If I'm listening to this, you know, somebody think about doing a test, you know, what does that mean? So all this complexity, yes. What does that mean for me? So at the end, it means that we move from 15 good bugs to 50, at least, good bugs. So 15 to 50? 15 to 50, yes.

42:01So we enlarge much more a number of bacteria that we really think are great for us and are associated with good food and good cardiometabolic health. So this is the key. And have we done the same for the bad bugs as well? Exactly, 50 bad bugs there. Of course, we could have chosen 55 or 50, but more or less, these represent... The number of specific types of bacteria that we can say, like these are actually associated with good health and these are associated with bad health. There is the one associated with coffee, for example. Coffee drinkers, they always have much higher bonuses of a certain bacterium.

42:35And is that bacterium associated with good health as well? Partially, yes. So it's not within our 50 good bags because it's not particularly good, but it's to pinpoint one single association. And you may say, you know, coffee is a simple food. And well, it still has a lot of different fibers. And there is one micro particularly good in using that. And so this is this example coming back to the, I just want to make sure that I've understood it, sort of coming back to the jungle. We all know, I think, sort of from thinking a bit like the zoo or something, right, that all the different animals have to have different food.

43:08You can't feed the lion and the gorilla on the same food. And so this is the same analogy here where you're saying this bacteria really loves the particular fibers that come from coffee and it sort of does a better job of eating them. You don't see it. If you're not a coffee drinker, you don't see it. It's like, you know, that's it. So that's like if I'm not getting bananas, like I can't even live. I can't live off anything else. So it only likes this fermented coffee bean that some people eat and others don't. So I think that's a really brilliant example of how specific our foods are and how important our food choices are to our health and are to us getting a diverse set of gut microbes that are really beneficial.

43:52And this is why it's so interesting to understand which bacteria you have and the associations with food, because you should be able to end up therefore giving really specific advice to somebody saying, you know, here are the 15 gut booster foods specifically for you right now, for the ones, you know, the good bugs or the low, because you can really believe that over time we can get that tighter link. And it's no good just eating one generically healthy food because it's a bit like your jungle example that you're you're never going to get that bacteria for the coffee if you're not having any coffee we're not saying everyone has to drink coffee we're not changing the coffee habits here but if you connect it with nuts and seeds or specific vegetables for example that is much more relevant no and you believe this is real so you believe that these individual bacteria are really linked to individual foods or groups of bacteria associated with groups of foods and we are seeing that and some of the changes that we also observe when we as we were saying before we retest someone in six months so we see that there is association with eating more of a vegetable and increasing the bacterium that we thought should have increased and and that's and that's why these there is this level of personalization in the diet that is aware of the composition of the microbiome, particularly regarding the 50 good and 50 bad bugs.

45:14So in the future, we're going to get really good at telling people exactly what they need to eat to improve these particular sets of microbes. We're doing, you know, a sort of okay job at the moment, but it's going to be so much better as we get more and more data. And what about, because we touched on this on one of our previous podcasts, what about when you go to people who are still living sort of a traditional lifestyle so not eating all of our processed food you know not with modern sanitation how does their you know gut microbiome score look yeah we studied it quite a lot and it's very different it's very different they have much more fiber degrading bacteria complex fiber degrading bacteria and a microbiome that is really more unknown the dark matter the part that we cannot explain is bigger because it is less studied.

46:02And this is very interesting because we can see the differences with our microbiome. But another intriguing thing is that we went back in time also. So with some studies and some collaborators, we look at the microbiome of people of 5 ,000 years ago from mummies, actually. We sampled the gut microbiome of mummies, these fossilized pools that are called coprolites, and we can get microbiome profiles out of there. And guess what? They are very similar to the current what we call non-Westernized populations. And are these healthier microbiomes, these non-Westernized populations, Nicola? I would say generally yes, but also in this case we need to contextualize, no?

46:43So we need to understand why these differences are there because it's not only diet, it's sanitation, for example. So, you know, we have to be careful with pathogens, of course. And how many different, just to get a sense, because I think, you know, Nicola's a good scientist. I know it's always hard to pull you on this, but I think when you look at this on a slide, it's slightly terrifying and makes you feel like what you have is incredibly stunted compared to sort of what nature intended. We've lost a lot of microbes, haven't we? We lost microbes. So people say up to a half, is that right? Probably, yes.

47:11So whatever differences you can see in our population, people eating completely from vegans, let's say, and non-vegans, this difference is smaller than our difference with the northernized populations. Tim is very proud of his microbiome, you know, it's really good. But, you know, that's comparing to people like me. And it's a bit, I think, I mean, my analogy is a bit like, you know, you're really good at running because you're in your little village and you run around really fast. And then you arrive at the Olympics and you realize that these people are not 10 % faster, they're like twice as fast as you.

47:43This is sort of the analogy that I've understood. Is that? Yeah, I think there are things that the team cannot digest and other people in those populations can probably digest. No, I definitely wouldn't. In a race with the hunter-gatherer tribes, I think my gut would lose. But I think for practical purposes, we're building a database for generally the Western world so that people know, importantly, they can judge what is the health of their gut on a scale 0 to 10. Where do they sit? What is the room for improvement? and they can see the effect of illnesses, of changes in diet, of medications. All these things are going to be really important as we realize they're all interrelated.

48:32And so people have just ignored their gut health because we haven't had a good test of it. But it's a bit like having tests. When you take drugs, for example, many of the medications people take, like proton pump inhibitors for acid reflux or even things like antidepressants or painkillers can have effect on your gut microbes that could be adverse. So having a check every six months of how that particular bit of your body is like having a blood test to see what your liver is doing in response to these drugs. So I think we're going to see this much more as a routine test that everyone's going to want and gives them a goal to aim at to say, okay, like you did, You start at 5 out of 10.

49:17I want to get up towards 7 or 8 out of 10 over the next couple of years. It's like trying to control blood pressure. You couldn't measure it. You just roughly say, okay, hopefully no one will die of a stroke. But suddenly, we've got this intermediate measure, which I think everyone can start to use. And as more people do it, the price will come down and it will become commonplace. will realize it's actually much better than doing a blood test just for your baseline cholesterol or these things that we routinely do in our health service that actually have rather little use compared to these major insights.

49:56So some people will be listening to this and saying, you know, that's really great, but you know, I can't get this for free for my health service today. I can't afford to buy this product today. And so therefore I'm obviously not going to get sort of this personalized advice, but I think the good news is we don't have to say, well, there's nothing you can do. Could we talk about what's the actionable advice you would give to somebody listening to this saying, I'd really love to improve my good bugs. I'd really love to shrink my bad bugs. What's the key advice that you would give both of you? Well, I've got five simple rules really to improve your gut health, which I've talked about before, but it's good just to remember them.

50:31First, try and eat a diverse range of whole plants. And we think at the moment, the optimum is around 30 plants. We're doing some other studies to see if that's still true now with these new tests. But 30 different plants a week is what people should aim for. Not a problem if you don't always make it, but aim to get it right up. Currently, people have about five on average, right? So there's a long way to go. The second is eat the rainbow, try and eat colorful plants because of the polyphenols, these defense chemicals in them, which our microbes eat and is a source of energy, which we didn't know that before.

51:09And that includes all kinds of bitter foods as well. Extra virgin olive oil, for example, nuts, seeds, dark chocolate, and our coffee we mentioned. Then fermented foods. We haven't really talked about that. That's another podcast, I think, but having regular small amounts, regular fermented foods has been shown to improve your gut microbes and improve your immune function. So dampens down those inflammatory microbes. And fourthly, give your gut a break. We've talked about time-restricted eating. If you can eat within a 10-hour window, or if you can't do that, a 12-hour window at least, you give your microbes a rest overnight.

51:52That helps them. They make them more efficient. And finally, don't poison them with too many chemicals from ultra-processed foods, because ultra-processed foods have a negative impact on your gut microbe in ways we're still understanding, but things like sweeteners, emulsifiers, preservatives, etc., etc. So they're my five rules. And, of course, there are other ways, you know, the environment, aren't there, of course? Yeah, these are the great general rules, no? But I think, in addition, the challenge is to understand what it personalizes to you. And that is what we are trying to get from the data because maybe for you, the best is 30, for some 30 different vegetables, for others, maybe 20 or 40.

52:37So that is the personalized part of it that can add a big added value to that. And can I wrap up with a couple? We had a lot of questions from the community. I think we've managed to answer some of them. I want to pick a couple that we haven't hit here that were specific. I've got both of you, which is rather special to have you physically in the room here. So one question was, how rapidly can I damage my microbiome? And we had a lot of questions saying, I've gone on holiday. I've eaten really terrible food for a week. All the things that Tim tells me I shouldn't have done. Have I wrecked my microbiome?

53:14Will my bad microbes have doubled during this period in a week? How worried should people be? Well, I think you should be very worried if you go on holiday and then you get sick and you have to take antibiotics, for example. That will ruin, you know, the most of it. Otherwise, I think, you know, we all go on holidays and we need to eat differently. So it's not a huge problem if it is for a week or so, because there is this dynamics of the microbiome, you can then go back. And I think in general, if you travel on holidays and you have a diversity of food, wherever you are, it's also going to improve.

53:51So I think there is this memory of the microbiome that unless you continue with antibiotics or very bad food for a long time, it's unlikely you will disrupt it completely. The caveat might be if you go on a junk food holiday and you only eat junk food for, say, like 10 days and you have zero fiber, no diversity, having the same meal. And this is the experiment I put my son through a few years back when he was a student. so for 10 days he had only chicken nuggets or a big mac and uh coca-cola and he lost 30 or 40 percent of his diversity in that time and i'm afraid to say still hasn't regained it so i think so the caveat is don't go on a purely junk food zero fiber holiday because your micros may take much longer to recover and my takeaway from this is and it's one of the things i think that you and Sarah and other people talk a lot about at Zoe is like, it's fine to have treats.

54:53It's fine to add some stuff on top. So in the sense in the holiday, by all means, have your pizza and your ice cream, but you'd like to make sure you're still having some food through this. It's going to sort of support your microbiome because it sort of makes sense, right? If you starve them for 10 days and they all, they like reproduce very fast, right? Nicholas, like once an hour or something like this, right? You can see that's a lot of generations with no food, which I guess I sort of think it was, well, that's quite different, right? Than saying, okay, I'm going to give a lot of stuff that's maybe good for my bad microbes, but I am still providing some food for the good guys and we'll get them back after the holiday.

55:30Is that a sort of practical way to, that's like being my practical approach to holiday now? Yeah. Give them a minimum diet. But in a way that people should be relaxed. If you've got a healthy gut microbiome, you can afford more leeway than someone who's got a really sick microbiome. And I think that's the key. If you've built up your gut microbes well, you can have the odd excursion with junk food and you'll bounce back. But if you've got a really poor one and you go overboard, then you're really in trouble. And I think the funny thing is that I also found my tastes have changed a lot. I still definitely want gelato.

56:04That comes up quite often on these podcasts, but there's a lot of junk food that I used to eat that actually now sort of seems quite disgusting having switched away from it for a plant and you realize you sort of got addicted to this stuff. And I know we'll talk about that on another podcast. Final question, because this came up interesting, it was like the top question. Is there any data about whether taking painkillers regularly can negatively impact the gut microbiome? Well, we know, as Tim mentioned, that probably the two main worst medications are proton pipe inhibitors and antibiotics. But all the others are not positive for the microbiome for sure.

56:43So I don't think we have a lot of data from Zoe on painkillers, but also from other studies we see they are not good for sure. Not at the level of antibiotics and protopartinibitos, but definitely something to keep an eye on. For painkillers, we know that they've studied paracetamol quite well, and we know that the reason they don't work in some people is just because they don't have the right microbes. So it's quite possible that some of these side effects people might get might also be related to the gut microbes. We simply don't know enough, but we do know that at least 50 % of all the drugs people take are interacting with your gut microbes in some way, and we have to be a bit cautious that all of them could be doing damage or interacting in some way.

57:29So it's an area we need to do much more research on. But the example I did was just because there are very few examples that are documented. And so, you know, with the variety of drugs that we can take and the rest of our microbiome, it's another line of research that should keep us busy. I think, Nicola, you feel like your career is set for the rest of your years, I feel. I still have a bit of work to do, yes. Yeah, absolutely. And, you know, we did some work on cancer therapies and immunotherapy. And certainly the state of your gut microbes is probably the number one factor that determines whether you're going to respond to immunotherapy and cancer.

58:08And so increasingly, I think when people are put on drugs, physicians are going to have to learn more about the gut microbiome and take that into account as we start to balance these things up. Because it really, in some cases, is a matter of life and death. Tim and Nicola, I could keep going for hours, but I know I need to wrap up. Thank you very much. I'm going to try and do a quick summary of what we covered. So then we started with this wonderful analogy that the gut microbiome is like a jungle and you've got all of these different species that are interacting with each other. And then, you know, this latest information that our microbiomes are even more different than we had realized a few years ago, because it's not just that they look really different at the species, but when you get down to like the exact strains, so the exact type of animal, sort of almost everybody is completely unique.

58:58We then talked a bit about how the microbiome changes. And I think the consensus was, you can see these very swift changes in just a few days. But in general, if you're trying to make a sort of long-term improvement in health, so making it much better, probably you'd expect to see that in four to six months. But the data is still quite early, and there's going to be some exciting new stuff published, and then hopefully continuing to get it better steadily than over years. We talked a bit about how microbiome testing actually works and why the latest science and what Zoe's doing is with this shotgun sequencing, the incredible complexity of trying to piece together what's going on and the way that just in the last couple of years, we've gone from only understanding 50 % of the microbes to, I think you said about 80 % of the microbes today, which still means there's another 20 % that we have no idea what they are.

59:49And that as a result of this and the scale of the data, and this is, I think, where Zoe's research has really been able to be at the forefront of scientific research, which is really fun, that with now sort of 50 ,000 of these test results, you've been able to move to now discovering sort of 50 of these good bugs linked to good health, 50 of these bad bugs linked to poor health, and able to create a sort of score that allows you to understand that in the same way that we might get a blood sugar score or a cholesterol score, that we're starting to understand the links with individual foods. And you gave this brilliant analogy that you can tell whether or not I drink coffee just by looking at my poop.

1:00:28And it's not because you're looking for coffee grains, it's because you're looking for a microbe that you will only find if you're eating coffee. And the belief is that there are these sets of microbes that are linked to all sorts of specific foods. So over time, you'll really understand that you're not eating particular sorts of beans or cabbages or whatever it is. And that could really help you to get back towards the healthier gut, which it sounds like the really healthy gut is these people living a non-Western lifestyle. But for normal people, I think we all aim to have Tim's gut. That's like my ambitious level.

1:01:01And, you know, what are the things you need to do? And then I think we wrapped up with some key advice if you're listening about what you could do. And Tim sort of pushed this down to this really simple rules of eat 30 diverse whole plants, try and eat the rainbows, lots of different colors and bitterness, fermented foods, which is something I think we will definitely come back to in the future, restricting the amount of time you're eating. So at least 12 hours where you're not eating. And lastly, avoiding these ultra processed foods. And I think we had this rather terrifying story from Tim about how he, for some reason got his son rather than himself to eat Kentucky Fried Chicken for 10 days.

1:01:43And apparently that wiped out 30 % of his micro-diversity. McDonald's. We don't have trash. I don't want to be sued by Kentucky Fried Chicken. McDonald's. I'm sorry. Because that's supposed to be much better to be sued by McDonald's for 10 days and lost 30 % of that diversity. And I think you said that was 10 years ago? Getting on for that nearly. And it still hasn't all come back. Yeah. So slightly scary there. But the good news is you can enjoy yourself on holiday. Just make sure you're still providing that core nutrition to all of these microbes and think about the ice cream on top rather than just swapping it all out.

1:02:17So it's not that you can never eat any of these things, but you've got to make sure you're supporting the microbes. You got it. Nailed it. Amazing. Thank you both. And I think we are definitely going to come back to a bunch of these topics. And I think we're also going to record some more in-depth material for some of the ZOE members to go in and talk in more detail about some of these new discoveries and how we can deliver them. Thank you. Great. Fantastic job, Jonathan, as always. He's being very cynical now. Thanks, both of you. Bye-bye. Thank you, Nicola and Tim, for joining me on Zoe Science and Nutrition Today.

1:02:51If you want to understand the health of your gut microbiome and access tools to improve your gut health, then why not try Zoe's Personalized Nutrition Programme? You can learn more and get 10 % off by going to zoe.com slash podcast. As always, I'm your host, Jonathan Wolf. Zoe Science and Nutrition is produced by Yella Hewins-Martin, Richard Willen, and Tilly Fulford. See you next time.

1:03:18I'll leave you with one final thought. What if there was one simple habit that when repeated could change how you feel for the better? I'd like to tell you about something that I do daily for my own health. It's called Daily 30, the gut supplement developed by our scientists here at Zoe. Daily 30 is made of over 30 hand-picked plants, including seaweed, fungi, and different types of fiber. It's a source of plant protein, omega-3, and vital minerals. You simply add a scoop to any meal once a day to support your health and increase the plant diversity in your diet. And unlike synthetic supplements, Daily 30 actually tastes great.

1:03:57It's designed to be enjoyed, because when a habit brings you joy, you're far more likely to stick with it. So next time you feel like your plate is missing extra plants, do yourself a favor. Try Daily 30. It's a delicious and healthy habit that you'll feel good about, and one that your gut will definitely thank you for. By the way, whenever we talk about Daily 30 as a good source of fiber, we're required to say that it contains four grams of total fat per serving. Obviously, that's all amazing healthy fats from plants. So order yours today at zoe.com slash daily30. See you next time.