FUEL YOUR MICROBIOME Through Plant-Based Nutrition | Dr. Alan Desmond X Rich Roll

every day we get out of bed and we ask ourselves what should I eat to be able to digest your food comfortably and efficiently is the essence of being a healthy human they were very very clear a healthy diet consists of Dr Alan Desmond Allen Desmond Dr Alan Desmond he's a plant-based gastroenterologist the author of the new book The plant-based diet Revolution he incorporates whole plant-based nutrition to treat your problems not just the symptoms I don't accept that concept that to build meat you gotta eat meat if we aren't able to go and enjoy our food it is such a dreadful impact on our quality of life the statistics on gut health are terrible one in 15 to 1 in 20 people in the US develop colorectal cancer in their life one in 10 Americans have type 2 diabetes that can reduce your life expectancy by seven years if you have access to all of these Foods then choosing plants first is definitely the way forward yes choosing plants choosing plants for weight management for disease prevention for longevity and even for athletic performance is indeed and is most definitely the way forward but what does that actually mean what does it look like on a daily basis I think these are questions all of us grapple with and yet even the most conscientious Among Us searching for answers are unfortunately met with more confusion than Clarity so today we Rectify that recorded during our plant power retreat in Italy last spring the very wise and articulate Dr Desmond who was just an amazing value add to that week-long experience throws down an absolutely compelling master class on how to understand build and maintain a healthy gut microbiome and why this is key to overall well-being we also bust some nutrition myths and we go really deep and practical on the fundamentals of a health the diet what to eat what to avoid how to do it how to sustain it and why this is so important to every facet of your well-being my mission with this channel is to bring you cost free the best most impactful and actionable advice to improve your daily life and to that end if you have received value from me it would mean so much if you could just take a quick moment to subscribe to this channel to share it with those who might benefit from it or resonate with the content and please feel free to engage in the comments below as for this video My Hope Is that it leaves you with the information the strategies and the protocols that you need to adopt better nutrition habits with staying power because Health isn't a diet it's a lifestyle hey everybody my name is Rich I'm Julie's husband uh I thought it would be also good for me to contribute to this Retreat on some level right thank you Alan and to kick it off maybe tell us a little bit about you know your background and the evolution of your relationship with plant-based nutrition and how it kind of became a central component in how you think about medicine treating patients and and just you know well-being in general um so I'm a I'm a gastroenterologist a gut health specialist and my journey towards recommending a plant-based diet was driven by my patients so I became I was a young doctor 2001 2002 graduated 2001 and you go through this process where you work in different Specialties so you do Nephrology respiratory medicine and when I arrived for my first job on the gastroenterology Ward I saw people who looked healthy on the outside but they were really unhealthy on the inside so there's this whole concept in Mets and variable concept of medicine that all Health begins in the gut and these are individuals who are struggling with really at the sharp end of dysfunctional gut health so in hospital with problems like ulcer colitis Crohn's disease end-stage liver disease often driven by non-alcoholic fatty liver disease and these are patients who get really really sick so there's some of the sickest patients in the hospital there's some of the patients need the most intensive support and what Drew me into gastroenterology is a specialty first of all was witnessing how much individuals quality of life improved and how much their prospects improved if you could restore their gut health and there was a few patients in particular who I watched on that Journey getting better and it was so transformative I was like I really want to work in this specialty for the rest of my career so pretty early on I was hooked on gastroenterology so that was like 2003 2004 and of course the next piece to that is I'm learning all about the procedures the medications the diagnoses and I'm explaining these to patients for the first time and I realized very early on that every patient with a digestive health problem will eventually ask you on the first conversation or the second conversation what about food doc what should I eat what should I avoid and that's a really powerful question because the patients made the connection because they've got a digestive health problem there's a straight line there for food and they're asking you well what can I eat to feel better today what can I eat to feel better in the future you just told me I need medication I might need surgery I'm going to come into your clinic for the next few years for regular checkups what can I do with food and I wanted to have evidence-based answers for that question there was one case in particular that always stuck with me and I think it kind of sowed the seed for me was when I was like the most Junior doctor on the team that was taking care of patients there's this one young man in his early 20s who was hospitalized with pretty severe inflammatory bowel disease and so he's got this Condition it's causing inflammation in his bowel we're giving him steroids and other medications to Tamp the inflammation down she's got abdominal symptoms and diarrhea he's losing weight his family are worried about him and like a lot of young people he was in he was supposed to be at University or in his first job or getting on his life but instead he's in hospital so we'd been giving him the steroid medication and the medications are great don't get me wrong the the transformative and he'd been getting steadily better for three days so the message on the Wardrobe with the attending with my boss was things are going the right way you're getting better the inflammation is reducing we're going to give you this great biologic drug we've got some great drugs from Foundry bowel disease that make a huge difference to people we're going to give you this this new drug tomorrow and we don't think you're going to need surgery so he turns to my boss and says you know I'm feeling hungry again is there anything I should eat and his mom who's there to support him kind of looked in askance to my boss and my boss said it doesn't matter eat whatever you like uh when he's got some calories in here and turned to this young man's mother and said does he like McDonald's do you want to bring him in some McDonald's because we need to uh we need to build them up a little bit and he was surprised his mum was surprised I was pretty surprised as well yeah but but I mean I'm the I'm the new kid you know I I well I've been like six years in medical school but I'm the new kid um it wasn't my my position but I was a little bit surprised and that was a missed opportunity I now know all these years later right so at that point I started looking for those evidence-based answers for my patients and around that time there was this paper published in a journal called gosh which is one of our leading gastroenterology journals it is what it says okay it's all about the latest research in Digestive Health it's called gut it was clickbaity scientists eat their studies yeah exactly they know how to suck you in so there was a paper published in gut which is the journal you're reading is a budding gastroenterologist right that's where all the new science is and there is this interesting paper and it was UK data that showed for patients for inflammatory bowel disease followed over the course of a year those who ate red meat were three times more likely to be hospitalized those who ate processed meat bacon sausage processed Meats etc etc were five times more likely to be hospitalized so even at that point I now had one answer that I could give to those patients so I started talking to my patients about that even as a very young trainee doctor and that paper the references and the mechanisms it was describing led me down some rabbit holes and then it was a very very gradual process so it takes another six years after that story for me to graduate and become a gastroenterologist 2012 until I am a gastroenterologist and on a continuing journey to give my patients evidence-based answers I would read all the journals all the Articles consume all the information and there's two consistent messages in terms of keeping your gut healthy and helping to restore your gut health it's pneumonia food is really important food really really does matter and I had learned to speak to my patients about unprocessed food avoid the junk food and eat more plants and get your protein from Plants because that supports good gut health so when I first heard the phrase Whole Food plant based in about 2015 it was like a a like a a lightning strike you know it's a whole food plant-based that's what I've been trying to explain to my patients it kind of LED on from there yeah there's there's an inherent kind of fascinating irony in the fact that the the the gut your digestive system um which is inside our bodies is actually outward facing right it is external to our bodies it is the interface between the outside world and the interior world through which nutrients pass and the idea that you know food wouldn't matter when this is the basically this is where your body meets food in the most important way seems totally insane and yet it is somewhat of a new idea over the last 10 years we've seen this explosion in not only the interest around the microbiome but also a deepening appreciation for the complexity and importance of the microbiome with respect to every facet of health and well-being and I see you as somebody who's kind of right at the center of this very important movement where the science is rapidly evolving and kind of uh coming out almost weekly with new understandings because it is so complex around uh how and why the microbiome is so important so when you were talking about the relationship between food and gut let's take a step back and explain why gut health is important to overall health that's such an awesome question I mean it shouldn't surprise us but yet it seems surprising right so I mentioned earlier you know Hippocrates two and a half thousand years ago all disease begins in the gut or if you will all Health begins in the gut so that's very very ancient wisdom okay but in recent years we've come to realize that there was so much wisdom in that ancient wisdom because we now know that not only is our gut really important for regulating our appetites not only is it responsible for absorbing nutrients it's also in many ways a control center for human biology it's the home of the gut microbiome which we can talk more about in a few minutes but that seems to be an incredibly important part of gut health and good gut health equals good immune Health there's good coronary vascular health I mean when I go to conferences now and I've been going to conferences for years talking about gut health in the gut microbiome I usually now have if it's a general medical conference I have to sit there and watch the cardiologist talk about the gut microbiome watch the neurologists talk about the gut microgram watch the endocrinologists talk about the gut microbiome and it's got to the point there's so much science coming out now that we're getting you have to be like a gut microbiome sub-specialist you know you can't read all the research you just can't there's too much coming out I was very lucky early on in my career to work for a guy called Professor Fergus Shanahan so even when I was you know around in 2004 2005 my supervisor one of my mentors was at the very Cutting Edge of microbiome research and I went down to work for him for a number of years so it's been there from the start but on a very human level food food and gut health really really matters we eat breakfast lunch dinner we think about food certainly everyone in this room thinks about food all the time and if we aren't able to go and enjoy our food it is such a dreadful impact on our quality of life every I mean people get embarrassed about gut health but look just take it for me everybody eats food everybody burps farts poops uses the toilets these are normal human functions and to be able to digest your food comfortably and efficiently is the essence of being a healthy human so we've got this concept number one that all Health begins in the gut and then we look at the state of gut health right now and it it doesn't make sense right so if to have an efficient comfortable digestive tract is human an essential human trait we look around right like you look at the United States right now the statistics on gut health are terrible so but one in five people in the U.S is living with daily gastroesophageal reflux symptoms the number one selling medication or one of them in the U.S is a acid suppressing medication to switch off a normal digestive function to try and put a lid on digestive symptoms about 1 in 15 to 1 in 20 people in the US develop colorectal cancer in their life diverticular disease is so common that people don't even refer to it as a disease anymore they refer to it as diverticulosis it's normal but it's not normal it's not inevitable there are places in the world where people don't get diverticular disease it wasn't always an inevitable part to The Human Condition yet it hospitalizes people costs the US economy nine billion dollars a year now and when again when you go and you look at the evidence for well look does food matter is the way I eat is going to help protect my gut health and keep me out of hospital so I substantially reduce my risk of colorectal cancer substantially reduce my risk of all of these problems Food Matters patients are right food really matters and how do we eat to support prevent preserve our gut health it really is I mean a whole food plant-based diet doesn't have to be exclusively plant-based how we can get into that but if you are eating the same healthy diet that we recommend for heart health and brain health and lung Health a healthy Whole Food plant-based diet you're getting I mean half your food from fruits and vegetables but a third your food from healthy whole grains you're getting your protein from healthy plant-based sources maybe a little bit of fermented food a little bit of healthy plant-derived oils and if you can establish that healthy dietary pattern and there is room for small amounts of animal products in there as an option but far less than people think then you are eating in a way that is really going to support protect and preserve your gut health for sure yeah I think I think what's the key Point here is for me at least is is agency because we can go down this microbiome rabbit hole and it's super fascinating these studies and what they're telling us of about the you know the intricacies of what's Happening inside of our bodies but what I kind of extract from all of this and and kind of Leverage in a practical way is the mutability of the gut microbiome so I had I had Tim Spector on the podcast recently but it was really compelling to hear him talk about his developing understanding of the importance of the microbiome in the context of studying Twins and trying to understand why identical twins would have different Health outcomes throughout their life thinking that this is uh emanating from from genetics right it's a it was a kind of nurture nature study as you know I'm sure you know all about this but what was discovered was the differ the differential in those outcomes really could be rooted to the differential in their gut microbiome so uh we're all very different people we look different but but ultimately the DNA that we that that we have um is almost identical to each other and yet our microbiomes if we were to sample all of that would be wildly different in this room uh but it's very responsive right when you talk about food um the the reparative uh kind of mechanism around the microbiome you know is such that if you start to treat it right you can reverse prevent like sort of set yourself on a different trajectory you can't change your genes but you can change the nature of your gut microbiome to kind of course correct wherever you're at and get on a better track which I love and when you were talking about all these diseases uh you know diverticulitis or you know it's like you think about what's causing this from you know overuse of antibiotics to environmental toxins and you know Zach Bush would say glyphosate or you know the types of foods that we're eating the ultra processed foods and and everything that's going on we're like assailing our microbiome continually and to the extent that we can like be more mindful about what that looks like and make better choices we can actually change the trajectory of our health back to that notion of agency which I think is really cool yeah it's it's incredible and you know I love Tim's research and I you know consume it voraciously and then as a clinician I've got to take all of that high level research and try to bring it to my practice on a daily basis and it's interesting because the things that help to build a healthy gut microbiome also build a healthy human so I mean when you hear uh microbiome researchers speaking they've talked about eating a varied plant-based diet getting enough sleep spending time in nature avoiding unnecessary medications I mean antibiotics are great they're life-saving but not taking them if they're unnecessary we also know from researcher Tim is involved the American gut project at eating animal products brings antibiotic looks into your digestive system and into your gut microbiome and those are practices that preserve a healthy human as well as a healthy gut microbiome and again that shouldn't surprise us right um and I know you've gone deep on the microbiome but I mean it's something that's been on my mind this is the early part of my career but should be on all of our minds I mean so the gut microbiome you've got your maybe the numbers vary depending on the latest count but maybe 60 trillion bacteria yeasts viruses and archaea living predominantly within your large bowel your colon they these bugs have been on this Earth for like two to three billion years they're far more ancient than humans we've been around for maybe 200 000 years so if you think about where the microbiome came from Rich I mean it it gets a little bit meta doesn't it because you think about this the first two primitive cells on this planet that gave rice rise to every human and every other animal on the planet when those two little cells got together they were surrounded by viruses yeasts and you know the archaea and the bacteria they were part of the gut microbiome part of the microbiome or the The Meta The Meta microbiome the microbiome right the macro the metal I've lost it the metamacro The Meta Meta macro microbiome and you know so that's incredible that that's incredible and we are still carrying those bugs with us in our digestive tract every day and we only really found out about it uh maybe 600 years ago with the Advent of microscopes you know what did the scientists do they started looking at poo under the microscope you know 600 years ago and they saw these tiny living creatures that were coming from the digestive tract they call them animal kills right like molecules little tiny little animals and it's only yeah right I wish they'd stuck with that name instead of bacteria yeast and viruses but animal kills what a lovely old name for these little bugs in our gut and then in the last 10 and 20 years and you know my former mentor like Fergus Shannon and obviously Tim Spector people like Ted Dinan uh people like Professor Tom Cotter who I'm very lucky to be working on a project with now um have led the charge on that research and thanks to the you know the Advent of the new genetic analyzes and the costs have come down and throughput has come down that we've learned so much about the microbiome in the last several years and just like one little statistic that kind of crystallizes it for me which is only like research published in the Netherlands just a few weeks ago so these researchers looking at the impact of the gut microbiome and health so they measured plasma metabolites okay so if you go to the doctor and you get a blood test so we're measuring different molecules in your bloodstream so various you know cholesterols and lipids inflammatory protein CRP you're familiar with hearing about those there's lots of other metabolites that you don't really hear about at the lab when you go to see your GP so these researchers measured everything they could measure in the plasma in their lab and determined that of the 1200 metabolites that they could measure in the lab two-thirds were directly dependent on the individual's diet and microbiome so two-thirds of the 1200 metabolites flowing through your bloodstream are determined by your diet and you've got microbiome Health compared to less than five percent determined by our genetics wow so it's no surprise that our gut microbiome and the food that we eat have such a measurable impact on our Health and Longevity great well let's let's dive into that a little bit then um let's say somebody just heard what you said and they are thinking wow I've never thought of that in that way before so first of all how do I find out the State of the Union of my you know gut microbiome I've never thought about it before so I would like to have it tested and if I go have it tested how do I do that and what should I be looking for and then sort of secondary to that we can get into kind of just best practices and protocols to improve or maintain a healthy gut microbiome yeah well I would say the first the second bit comes first okay so it'd be I think before you you start to inquire into your current gut microbiome Health you probably want to get those best practices dialed in first okay because that's you want to know the things are on point now these things we sometimes refer to as the basics but of course they're not basic anymore they're really unusual it's really difficult in the current food culture and in our current Lifestyles to actually live in a way that supports our overall health let alone our gut microbial Health even though often it's the same thing I mean when you I mean one of the key things is the diversity of plants in your diet and you know Tim was involved in the research that brought that Concept in to the public sphere so the 30 plants a week so we week right so that came from the American gut project so 11 000 citizen scientists uh sent their poop to the lab okay citizen scientists contributing to understanding the gut microbiome and one of the key findings from that paper was that the diversity and health if you've got microbiome crucially depends number one determinant depends on the diversity of plants in your diet and individuals who consume more than 30 plants per week unlock certain gut microbial benefits that other people don't get I'm sure if people have just listened to the podcasts with Tim and they're listening to this now there's repeat there okay but even in that paper fewer than one in 250 people were hitting that Mark so that's really really rare and if you look at the evidence on how much a healthy diet and lifestyle impacts Your Health and Longevity which is substantial I mean a healthy plant power diet can add 10 to 14 years of life expectancy which is incredible 10 years of healthy life expectancy which is incredible I mean who doesn't want 10 extra years of healthy life I mean that's the difference between seeing your grandchildren finish grade school and being there when they graduate University or have their first art exhibition or write their first book that's I mean that's that's powerful medicine right but when you look at all of those studies what you see is the people who are getting the greatest benefits from their diet and lifestyle in those studies are in a tiny minority because our current diet and Lifestyles just don't support Health and Longevity anymore so in order to you asked a really good question we're going to read along answer I apologize but before you embark on discovering the secrets of your personal gut microbiome I would suggest that you spend some time before you get any of those tests done um just working on your daily routine and making sure that you are eating and living to support a healthy gut microbiome so what are the things yeah yeah yeah yeah I love that um we we uh this notion of of diversity being Paramount is so interesting to me for for many reasons but as you're as you were sharing about that I'm thinking about I mean we're in Italy uh Julie and I in our family we were in Florence for a couple days before uh The Retreat started and we were going to Galleries and museums and so we have you know the David and Michelangelo and da Vinci on our mind and I'm thinking about the Vitruvian Man and the the proportions that sort of scale up in different ways in nature and when you talk about the importance of diversity in your diet as a marker for gut health this is a a truth or a notion that also appears throughout nature from the micro all the way to the macro ecosystems are healthier with diversity human populations are more robust and and healthier when we have a diversity of perspectives Etc like this is like it's sort of like uh the Fibonacci sequence right like this is like a truth um that is core and important for every component of like how we navigate the world to what we eat right so I love that idea and the Simplicity of just 30 plants a week kind of roots it in your Consciousness so you can kind of very easily reflect upon that every time you're making a food choice absolutely and that's maybe the first point or the first practice building a planned diverse diet of course a healthy Whole Food plant-based diet ticks that box and then some okay so if you're eating like a healthy Whole Food plant-based diet as you and I both espouse and promote and live you're going to be eating 60 or 70 or 80 different plants per week you know we probably had 30 to 40 plants yesterday here together eating gorgeous diverse plant-based food which did which was delicious and beautifully prepared But ultimately was pretty simple it was like pasta and tomatoes and garlic and onion and seasoning and some leaves and some other leaves and some more leaves and that really helps to build it and it's no surprise that vegans or people who eat plant-based hit that marker consistently they hit the plant-based diversity marker consistently how do we know that well we look at the dietary and intakes of plant-based eaters versus carnivores or omnivores I should say and we've known since the 1970s that about the average fiber intake for an omnivore in high income country is about 20 grams of fiber per day maybe a little bit lower than that but we've known since the 1970s that even in the UK there was Data looking dietary fiber intake in vegans and even then they were hitting like 44 grams which is a much more representative number of what we should eat for a healthy gut we've seen that validated even recently a huge study across the U.S Europe and Asia again vegans vegetarians particularly vegans get way more dietary fiber than people who are not vegan that's one of the key reasons why people who eat plant-based are less likely to develop diverticular disease colorectal cancer why a healthy diet helps to prevent conditions like inflammatory bowel disease Crohn's disease and that comes back to the diversity pieces well there's definitely an overlap there but of course I'm not blaming people who have these conditions my God as I said it's really really difficult to hit those numbers in the current food culture so that's the plant diversity aspect the second aspect is Ditch the junk I mean the junk food which now or junk food also known as junk which makes up like 60 to the calories that we consume in high income countries um so the processed chips and dips the you know the pep well I won't mention a brand but those little salami sticks that you can buy at the drugstore all of that stuff okay Slim Jims about the brand are you afraid of big slim jim yeah yeah I don't uh I don't want slim jim adding me you know coming at me you know I'll have to leave Twitter [Laughter] Foods they're junk make up 60 to the calories consumed in high income countries right now they have no business in the human digestive tract uh the modern food industry has been pumping chemicals like maltodextrin polysorbet AC carboxymethyl cellulose carrageenan lecithins these artificially produced flavor enhancers and emulsifiers into the food System since the 1950s and 60s they take stuff that isn't food and makes it taste like food makes it soft and moist and flavoursome makes it shelf stable easy to ship cheaper to produce and we we love it I mean it's it's very carefully designed to appeal to our primitive monkey brain that likes sweet things and salty things and fatty things and we love eating it but no business in the human digestive tract and then when you look at individual components of those junk foods and the mechanisms what they do to our digestive tract I'll give you an example okay so there's a there's an artificial sugar called maltodextrin it's been described in the U.S as a ubiquitous food additive I've had a lot of that in my lifetime because as an endurance athlete maltodextrin is sort of a lower glycemic carbohydrate that you can mix with water and kind of sip on throughout a very long you know sort of session so I've probably had more than a fair share of human dosage of that over the course of my lifetime oh dear so you're making me worry yeah yeah well let's talk about maltodextrin then let's talk about Rich's gut microbiome so so what we know is you're not alone in that because the average U.S citizen consumes maltodextrin three times a day because it's in almost every processed food you flip over almost any processed food and you'll see maltodextrin the slow release stable artificial carbohydrate that's made in a food in a chemical Factory this powder that's added to our food so what does it do well one of the things that it does in our gut microbiome is it promotes the growth of a bacterium called adherent in invasive E coli ah adherent invasive E coli aihc so this bug now becomes product prevalent within our gut microbiome when we consume a lot of maltodextrin for some reason that bug enjoys eating the byproducts of malted extra so why does that matter well adherent invasive E coli is just one of the components that helps to trigger the abnormal immune response that one sees in Crohn's disease so Crohn's disease can be a very devastating GI condition predominantly emerges in people in their 20s and 30s the young man I mentioned earlier in the story was on the ward with crohn's disease hospitalized about only 25 percent of people with crohn's disease say that they have good overall quality of life it's very it's very very impactful on people so it's a multifactorial illness and genetics play a part and there are other components obviously but the adherent invasive E coli has a role to play in that disease and then you add to that rich in order for that bug to cause Mayhem in your digestive tract it needs to get really close to the cells that line your gut of course the cells that line your gut have this lovely protective layer of goo called mucin that prevents abnormal interactions with pathobiomes harmful bacterium harmful bacteria but guess what the junk Foods also contain emulsifiers like polysorbate and carrageenan and lecithins that degrade raid the mucin layer okay and also we know that in a fiber deficient diet your gut microbiome isn't receiving the microbiome available carbohydrates that it thrives on so it turns to the mucin layer for food and starts to degrade it so you that allows this adherent in base of E coli to come in contact with the micropore cells in the lining of your terminal ileum and that is a key part of the development of conditions like inflammatory bowel disease well that's fascinating we're brought to you today by Roka glasses are not something you normally think about as a piece of performance gear which when you think about it is kind of insane because you can't 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basically unanimously agree that Ultra processed foods the ufps the junk has no place in in on a healthy plate right and once we depart from there though the opinions start to flare in all sorts of different directions and I'm imagining the well-intentioned person who opens up their social media on their phone or their Instagram and and they see a clip of Alan saying exactly what he just said and they scroll and then they see Dr B and he's talking about 30 plants a week Etc but then keep scrolling and there's uh Dave asprey saying how kale is is toxic and Dr gundry who's talking about lectins and why we shouldn't eat beans and then there's the carnivore enthusiasts and the liver King who are telling you do you need to eat organ meats and everything you've heard about fiber is incorrect and we need to rethink cholesterol and Etc my point being that for somebody who is in in the process of a good faith like desire to kind of understand like hey what should I do like on a very I just want just tell me like what's healthy what's not I go online everybody's saying something different these people are all crazy and it reminds me of you know that kind of famous well-known you know tobacco industry campaign where the advertising agencies understood and learned that like doubt was their product right and so I think all the con the sort of conflicting messaging out there uh sort of roots people in a certain paralysis where it's like well I'll just keep doing what I'm doing because these people you know they can't they can't get their together and agree on anything so um I'll just wait until there seems to be a little bit more clarity well will come to the carnivores in a minute because there's there's a lot to be said about that so every day we get out of bed and we ask ourselves what should I eat and my patients ask me what should I eat and some people go on social media to figure out what should I eat so that's a really really important question and food is in many ways the number one determined ever Health and Longevity and it's really really important food is powerful medicine and that's true for gut health but overall health as well we touched on that already so in 2019 one of the most prominent and long-standing medical journals in the world the Lancet medical journal very respected journals been around for centuries set up a commission and published the report to that commission and the Lancet because there's such a well-respected and high-powered Journal every now and then they will set up a commission to look at a very very important question in medicine health and nutrition and the question that they were trying to answer with this commission was what should I eat not just you not just me but the 8 billion humans on Earth what should we eat to be the healthiest possible version of ourselves and that goes for the 3 3.5 billion people on Earth who are living with diseases of excess because they're eating too many calories and too many other calories are coming from unhelpful sources it also goes for the 800 million people on Earth who are living with the health impacts of not having access to food and not having access to sufficient calories and sufficient healthy calories in their day-to-day life so for air and everybody in between what should we eat they chose 38 you know well-respected hand-picked academics from August academic institutions like Harvard and UCL Imperial around the world and ask them to go and look at Decades of scientific evidence and come back with a blueprint for a healthy diet so they published that in 2019 the report of the eat Lancer commission and they were very very clear that a healthy diet consists of getting about half your food in the form of fruits and vegetables about one third of your food from whole grains and the whole diversity of whole grains that exist by making sure the rest of your food is predominantly made up with higher protein in all plants contain protein but higher protein plants your legumes your beans your chickpeas your lentils your black beans and all that good stuff that you need to have some healthy plant-derived oils so extra virgin olive oil Etc can be added in small quantities to that healthy dietary pattern and then when it comes to the animal products as I said earlier there is a place and this is true in gut health practice but also on this big question there is a place if you have that healthy dietary pattern established for small amounts of animal products in there so water water what kind of amounts are we talking about well bacon and processed meat zero bacon processed meat ham salami sausage are probably responsible for 640 000 deaths every year on Earth predominantly driven by coronavastages cancer and complications of type 2 diabetes no dietary recommendations include bacon it's just not on the plate at all so then when it comes to red meat so your you know pasture-raised Buffalo cow lamb Etc they said yep you can have it but we would recommend based on the evidence that you would limit your consumption to about 7 to 14 grams per day that's less than half an ounce quarter of an ounce to half an ounce so that would add up to maybe one small serving of red meat per week okay and but in the body of the report they said look the safest amount of red meat to consume is probably zero but it's difficult to demonstrate harm at low levels of consumption so we've allowed this within the within the within the healthy place when it came to eggs they reckoned about a half an egg per day when it came to Fish and Chicken one to two ounces per day but it was clear reading the report that if you are lucky enough and privileged enough to live in a situation where you have access to all of these foods and not everybody does that's for sure but if you have access to all of these Foods then choosing plants first is definitely the way forward now that International Panel of experts rep reported that if they could like flick a switch and get everybody on Earth the resources and the ability and the government policies and the food structures to support that it would prevent 11 to 12 million human deaths every single year again due to preventing so many cases of various cancers colorectal cancer which I deal with all the time at work type 2 diabetes heart disease etc etc etc but also it would prevent hundreds of millions of trips to the emergency room Corner catheterizations coronary artery bypass graphs prescriptions for statins courses of chemotherapy you know colonic polypectomies which is something I do so there's that now for years as an advocate of a healthy Whole Food plant-based diet when that report came out I was astounded because it was another one of those moments where throughout that report they used the term Whole Food plant-based it's all over the report and they give resources for governments and health organizations to support their individual economy to support that way of eating so that was a real another lightning moment for me so I was like well this makes sense to me because this is how I've been asking my patients to eat this also supports really good gut health so when that report came out the meat component was actually very very low right like 7 to 14 grams but for years people have been saying to me as an advocate for a healthy Whole Food plant-based diet you know water because you mentioned carnivore for years we would be asked well what about uh paleo that was the thing paleo and obviously the paleo diet doesn't match up but what I just described it doesn't match up at a healthy Whole Food plant-based diet but it there's an overlap okay so I would look at the Paleo Advocates I think actually we agree on a lot of stuff and you agree and I agree on a lot of stuff which also agrees with the public health and epidemiology and mechanistic stuff okay so we both agree junk food is bad added sugar is bad added salt is bad junk food is out no Dairy you mean milk is for babies that's I mean that seems very clear to me you know milk is for babies humans as adults don't need to consume milk and we agree that people should have some fruits and leafy greens and a variety of plants even it was mentioned by the Paleo proponents so we're the only place we really differed was where should we get our protein so from the plant-based perspective we would say you need to get your protein from uh plants because the data shows that the more of the protein that we get from Plants the healthier we are and that goes for bowel cancer diverticities in all of those conditions whereas the Paleo folk would say oh no you should get your of protein from Mis and you know because humans are made out of meat so we should eat meat so I think basically but is is there's a corollary to that which is that that plant protein is inferior in terms of its bioavailability and in terms of its ratio of essential amino acids so I think it would be helpful to kind of speak to that question it is the low-hanging fruit where do you get your protein kind of recurring you know looping question but yet you know that question persists there are a lot of people I think that are you know either predominantly plant-based or or plant-based curious but are still kind of reticent because they're concerned about uh not just how much protein they're getting but is this the type the quality of protein that I need to maintain my muscle mass and I think you know in In fairness there is a lot of emerging science right now coming out that as we age age that we should increase our protein intake and and that it's very important to maintain muscle mass to prevent you know like you know basically like if you fall breaking your hip as you're an older person Etc uh so as you get older you start thinking about that more and I and I can see how that would push a certain individual either towards meat or back to meat because of that concern or consideration so do you have thoughts on that it's where do you get your protein I always welcome that question because it's so such an important question but of course being protein aware it doesn't mean being meat aware that those aren't the same thing so we've known for a long time that even people who eat very strictly vegan or vegetarian um without e without you know trying without taking protein shakes or whatever just ordinary folks going about their day-to-day business are getting about 70 to 80 grams of protein per day average some more some less probably the top five percent getting about 100 grams of protein per day and that comes from Canadian data from the uh Seven Day Adventists in Canada there's similar data out of Germany confirming that and lots of studies showing that you know vegans and vegetarians eat lots of protein without having to think about it too much so there's that so they're getting protein and then there's this idea that the protein that we get from meat is higher quality of protein I mean the epidemiological evidence and the health outcome evidence tells the opposite story and I'm very confident in saying that the protein we get from plants is high quality protein it is the high quality protein because the research shows us that well first of all among uh young men vegan young men don't have lower body muscle than non-vegan young men we've seen emerging data in recent years showing that if you put athletes into the gym and you put them on a high protein diet whether that high protein diet is vegan or meat based they get the same muscular gains and performance gains going to the gym you talked about muscle loss as we age now of course muscle loss when we age is more about weight-bearing exercise than it is about diet but diet is important and we saw a study published last year showing that in older folks the higher proportion of their protein calories that they get from Plants the lower their risk of age-related sarcopenia the concept that we don't get all the amino acids that we need to get from our plant-based diet is also a fallacy I mean gram for a gram you know if you eat a piece of meat if I eat a piece of my arm right now I'm going to get the perfect balance of amino acids for a human obviously but you get that from a plant-based diet too I mean even 20 years ago when the American Medical Association published their dietary guidelines for reducing cardiovascular disease they mentioned the concept of the whole protein concept so that you need to eat meat and if you don't eat meat you should have quinoa or soy because those have the full complement of amino acids incomplete incomplete sources of protein but I think it was um I can't quite remember which doctor it was but a doctor wrote to them and said that's not true and they wrote back and said and the data that the response letter was published it was Dr John McDougall wrote to them and called them out and said that's not true because all plants contain all of the amino acids that humans need to be healthy including the essential amino acids in different proportion and if you're eating a varied diet that includes fruits and vegetables and three servings of whole grains and legumes you will get all of those amino acids so if you're going to use the whole protein analogy a whole food plant-based diet is a whole source of protein and then there's the outcome data so replacing animal protein with plant protein once you've established that healthy dietary pattern that's a really smart move even replacing small amounts of animal protein with small amounts of plant protein has very significant benefits on reducing your carnivascular disease stroke type 2 diabetes etc etc so I don't accept that concept that to build meat you gotta eat meat and E and the longevity piece and the long-term Health piece is really interesting but the carnivore crowds or Advocates have taken it to another extreme right they've gone further than paleo and they're now saying that we should only ease Mis so from a GI perspective as a gastroenterologist first of all I'm just a little bit suspicious because yeah a little bit suspicious so the human GI tract produces enzymes to digest food there's three broad types there are the lipases which break down oils and fats there's the proteolytic enzymes which break down protein you've got like trypsin chemotrypsin and pepsin and then you've got this group of enzymes called amylases we were talking we were talking about this earlier before I came into the room amylases so amylases break down starch plants carbohydrates so as soon as food goes into your mouth it's exposed to amylases which are there to break down the starch and the carbohydrates yet the people who are promoting this meat exclusive way of dieting of eating or saying well actually the perfect diet for a human is like don't eat any starch it's so bad for you but it seems like our bodies are intrinsically designed to digest it and sure they will talk about the you know the mechanistic data you alluded to some of it earlier you know the nutrient profile the bioavailability this is all kind of lab based theoretical stuff and it's interesting and some of it is patently false to be honest I mean the nutrients that we get from our plants are also absorbed you know and also get into our bloodstream and people who eat a healthy plant-based diet get more fiber more folate more vitamin A vitamin C vitamin E more magnesium or more potassium in their diet than omnivores do and all of these things have tremendous health benefits but when it comes to the meat specific part to the story if you want to know what a healthy diet looks like you need to go out look at real world evidence you've got to go and pursue scientifically what does a healthy diet look like you'd and this is a whole part of medicine this is a whole science which we refer to as epidemiology has a big overlap with public health it's been around for a long time and what it tells us is that you've got to go in the real world and find out what's happening so just a little bit of background to Public Health and epidemiology so crucial to medicine it's the starting point for public health advice and if we go back to like 1855 there was this have you heard the Broad Street pump have you ever heard that story I don't think so no so we're leaving gut health temporarily but we'll come back okay so In 1855 there's a cholera outbreak in London and you know you know thousands of people are dying okay and that at the time most of the medical experts including a medical celebrity and influencer called Florence Nightingale who is a real person at United Okay so there is a real person they thought that the cholera outbreak was being caused by miasma so unhealthy air the stench from the Thames basically that's what they thought was causing a cholera but there was this young doctor called Dr John snow and he had a different Theory so his theory was that it was being caused by bad water there was a water-borne disease so he had a controversial opinion just like the the carnivores I guess okay so he went out into the real world he didn't disappear into the lab to figure out in his head how water could be causing this problem he went into the real world and he mapped out cases of Cholera in London and he found out that they were clustered around a water pump on Broad Street because people didn't have have running water then they had to go to the pump which was essentially a well and pump water that's how you got your water so he found these cases clustering around the Broad Street pump he petitioned the council to shut off the pump they said no you're crazy it's caused by miasma check with Florence Nightingale you know she'll if you uh follow her on Instagram she she let you know she let you know what's going on she's got hot takes yeah hot takes all day long right but so they said no you know your your theory doesn't stand up we already know what's caused but so he took bold action I like to think he went out in the middle of the night but what he did is he went he took the handle off the pump at the end of the cholera um the cholera outbreak in London saved lives and that was the beginning of Public Health epidemiology medicine so you go into the real world you don't just sit in your room theorizing you find out what's happening in the real world you intervene and see if it makes a difference so 25 years ago we had there's this awful condition you may be familiar with I'm sure sudden infant death syndrome very tragic condition um not something I'm a specialist in but I'm aware of the story okay so young babies found dead very awful right just awful so there was a big move to try and figure out why this was happening and 25 years ago a whole bunch of scientists did some incredible epidemiological work they went into the real world and it recorded everything about babies everything they did how they were born how they ate how they slept how their parents Asians slept their daily routine and they discovered by observing what was happening in the real world was that babies who would lay on their front were more likely to suffer this terrible illness and that gave us the back to sleep campaign 25 years ago and they encouraged parents to put their babies to sleep on their back and they didn't even know why but good epidemiology saved thousands of lives because the countries had implemented that advice sudden Foundation went down by like 78 so when we look currently when you look at the epidemiological science on nutrition and health heart disease type 2 diabetes colon cancer cluster around meat consumption in just the same way that cholera clustered around the Broad Street pump but and we have Decades of epidemiological evidence that support that and not only that we've got the mechanistic data that shows us why Mis is bad for you in certainly in excess we know about the heterocyclic amines and the polycyclic aromatic hydrocarbons and what the heme iron does increasing risk of colon cancer about the nitrates and nitrites that are added to processed meat which then combine with the bacon when you cook it to form these carcinogenic nitrous amines we know what an what the standard Western diet does that have got microbiome and how that promotes a gut microbiome environment that is conducive to disease so we've got the real world data as a starting point we've got the mechanistic data that explains what we're seeing in the real world and then we've got the intervention studies that show that you can turn it around but the carnivore Advocates just put their thumb over all of that and say that's nonsense I don't believe it why because it doesn't agree with their concept of what a healthy diet looks like beautifully put thank you for that that was a bit of a mic drop moment um [Music] foreign I think this is uh an appropriate time to open it up to all of your questions so yeah so let's let's let's open it up let's uh let's get your questions on the mic if we could though first of all thank you it's amazing to see doctors more and more doctors uh defending this and I'm it's really grateful for it um so a little bit of a personal story but I think it could be General so I think during the pandemic Ann and I we're mostly doing plant-based diet but then at the end of it or off wait to it I I got some uh health issues kind of a burnout and I ended up having very low um gut bacteria diversity so gut problems um so I truly believe on the diet but I guess there's other factors that can impact um the the gut probably the amount of alcohol that I started drinking during the pandemic while cooking um so I developed cooking skills but I guess sleep and other things what what would be other than um the diet other very important factors second question I would have is uh I kind of discussed this with you but I think it would be important to to discuss broadly uh what is being done in the medical community to even spread this word uh more thank you thanks Paula that's a great question and you I mean we've just been through this incredibly stressful three-year period for everybody and the impact that stress has on our digestive health it cannot be understated it I talk to my patients with my patients about this all the time okay so you imagine someone who's got perfect gut health like rock solid and they walk out the front door and they see the horrible car accident or they get some terrible news they find out you know something Dreadful has happened to a family member and people will react to that with nausea they may vomit they may lose their appetite they will go for they'll meet their buddy for lunch the next day and their buddy will say oh you're not eating and they say well I had this terrible thing happened to me yesterday and their friend gets it and say okay tell me about it that's your gut brain access in action that is your digestive health that is your appetite that is the peristaltic waves that run through your gut and do the do the house cleaning for your gut microbiome changing due to a 100 emotional trigger nothing else so if you imagine that you're living with 10 of that stress or 10 15 or 20 of that stress on a daily basis and you may not even recognize it it changes the gut microbial environment it changes your stool frequency it changes your appetite it changes the foods that you consume which is the number one determinant you've got microbiome so of course it matters so we talked about you know food and fermented foods and diversity and all that kind of stuff and that's those are the basics but Stress Management is really really important if we don't you know sort out the stress we're not going to fix your tummy and the data supports that um so there is a condition which a lot of gastroenterologists refer to as irritable bowel syndrome I don't use that phraseology in my clinic I call that a functional GI disorder and we try to get into what's driving it I don't think the term IBS is helpful it's way more than irritable okay having poor Digestive Health I mean we've seen data showing that people with severe IBS would give live 10 years of life expectancy to restore their gut health so it's Way Beyond irritable and I've seen so many people and patients who've been housebound and lost their jobs because of IBS but it is the term that's used in the literature okay so unexplained abdominal symptoms and we've seen data showing that mindful meditation got specific hypnotherapy are as effective if not more effective than medication and a huge adjunct to healthy dietary change in restoring your gut health so for years I've been recommending that my patients engage in gut specific hypnotherapy or mindfulness meditation and the data tells us that if we take patients with severe unexplained abdominal symptoms or functional GI symptoms that about 70 percent of them will see marked improvement with Stress Management particularly mindfulness meditation they're calming the gut brain axis and the great thing about that prescription is the side effect of profile which is better quality of life greater understanding of others etc etc so the stress component is huge and a very short answer alcohol is bad for good [Applause] great oh it's changing I mean we were talking I was talking about this outside I mean in 2014 I think uh Dr Kim Williams the most senior um cardiologist in America at the time president American Medical Association um who's in charge of setting the guidelines to help prevent and treat the number one killer cardiovascular disease made that statement there are two kinds of cardiologists uh vegans and those who haven't read the data okay and he said that he said that as a you know to stir the pot a little bit but within a short number of years the American Health the American Hearts Association had published their dietary guidelines for a carnivascular disease prevention which is incredibly important and also connected to God health of course at the godheart connection is real we could have a tmao and they've got microbiome and all that I'm sure you've heard that story before but a few years later they published their guidelines for preventing the number one killer and they said diet is really really important and we know the people sand based diet may be 50 to 60 less likely to ever develop coronary artery disease so they recognized that and recommended a Mediterranean style vegetarian diet a vegetarian dietary pattern to prevent heart disease you know in 2019 the um the American the panel in the US charge for writing the guidelines for treating type 2 diabetes Nails their colors to the mass I mean that one in 10 Americans have type 2 diabetes that can reduce your life expectancy by seven years landoon Hospital put on permanent medication you can end up in dialysis with this condition so there are guidelines now saying have done since 2019 every patient should be supported in attaining and maintaining a healthy body weight through a predominantly plant-based diet you know the research on this has come there's a paper published out of the UK just last year excuse me last week um looking at how much healthier people are if they limit their meat consumption and eat more fruits vegetables whole grains and legumes and the the title of the paper is adherence to a plant-based diet and Longevity and major comorbidities in the UK population or something like that but the phrase plant-based is right there and if you're curious that that paper showed that yes people who eat more plant-based aluminum consumption are healthier 22 less likely to die due to any cause during the 15 years of follow-up so it's really getting out there and there's and you know you mentioned the the pandemic and for me the the pandemic totally changed how I talk about food and food production and health when I speak to patients and when I speak at conferences when I talk when I'm given the opportunity like this I have a microphone in front of me so for for years is it I mean health and gut health and public health epidemiology and data brought me to recommending a healthy Whole Food plant-based diet so for years I would avoid talking about animal agriculture because I was worried well first of all it's not my very expertise and I was also a little bit worried that people would hear me talking about this and say oh yeah he said all that stuff about gut health and disease but actually he's he only cares about animals you know so he's he's biased or whatever but when we went in to the pandemic it became very clear very early on that number one the diseases that are driven by the uh you know the animal heavy uh Ultra processed food heavy standard Western dialect type 2 diabetes heart disease hypertension various cancers or suddenly even more dangerous because we already knew they were taking years off our life but now they were also major risk factors for hospitalization and death we saw that data coming out of out of China initially then we saw it in New York City when New York City was at the epicenter of the epicenter at my own experience during the code first wave as a Frontline clinician treating patients who were dying from covid very much reflected that so patients who already had these so-called pre-existing conditions which were driven in large part by our standard Western diet so there was that and then in July of 2020 so we're maybe seven months into the pandemic the UN issued a report um talking about how to prevent the next pandemic so how do we stop this from happening again and the number one thing that they said we could each do as an individual or as a nation or as a government is to step back from animal agriculture to step away from me so it's the same answer right so why is that it's because the you know the dietary pattern that requires the 82 kilograms of meats for every adult in the UK 100 kilograms of meat every year for every adult in the United States 100 kilograms absolutely necessitates that we keep 80 billion animals in conditions in cramped unsanitary unnatural conditions for their short lives before we turn them into food so their diseases have never been more able to multi multiply and develop and modify and have never had greater opportunity to jump into humans zoonotic diseases it's a very old lesson it's as old as animal agriculture 10 years ago I mean I I was on the front line during this pandemic during the swine flu pandemic 10 years ago I was there as a younger doctor helping to treat people on the itu with swine flu killed 500 million people in the first year mostly under the age of 65 came out of a pig farm more billovirus bovine more billovirus became measles when we domesticated the cow jumped into humans killed unknown millions of people mostly children let a lot of children terribly disabled throughout their lives thank God we have measles vaccination now but we still have probably got 200 000 people a year dying from measles so the mostly children so this whole zoonotic pandemic thing is a very very old lesson and the thing we can do is step away from me so rich you often say and I've obviously I'm an avid listener do you often say and you guys have heard Rich say this that you know we don't change until we hurt we don't change until there's pain and we don't change until we identify how our daily habit is driving pain so here's a question for everybody we've seven million people are dead seven million people have died so far in the covet pandemic 700 million people were affected by covid and many of them are living with long covet and all of those debilitating symptoms which quite quite honestly we don't yet have an answer for in the medical community we had to shut our businesses we had to lock up our elderly and Elderly Care Facilities the elderly relatives who survived the first wave were then condemned to you know six to 12 months of solitary confinement unable to see their loved ones we had to teach our kids to socially distance from everybody not to hug their friends not to see their teacher so the question that occurs to me now as we're crawling away out of this is have we suffered enough have we experienced enough pain to recognize that our daily habit and the way we're treating food and treating animals brought all of this on us and it's not new happened 10 years ago as well and the change needs to happen I hope that people have learned something from this um during the first two years the pandemic Global meat consumption went down for the first time in decades and I thought well that's good news that's fantastic news because maybe the standard Western doubt peaked out in 2019 and peaked out in 2020 and hopefully meat production is going to get lower and lower and lower and lower and although I mean although the you know the alternative Mis products uh may not be ideal for your gut health I mean I'm all about the whole plants I know for a lot of people they don't want to eat them but you know and they're not for me but for meat eaters maybe that's a way out I mean I think it's ambitious to think that everyone on Earth is going to stop beating Meese but everyone on Earth should stop eating animal meat great thank you well thank you gentlemen this is really informative and we're all convinced about plant-based and high quality protein that comes out of out of Plant Nutrition just kind of in a practical way real simple question um food combinations and having a healthy gut biome a couple of food combinations you might suggest that people seek out or maybe a couple of combinations to maybe avoid so that we have a little more comfortable tummy so the idea of food combination so combining Foods I don't think there's good signs to say oh I should have my beans with my rice and that sort of thing so as long as you're establishing that healthy dietary pattern that can be really helpful if you're suffering from bloating you just said make my tummy more comfortable so if you're referring to kind of bloating and excess gas and discomfort then the first thing to understand is that you know I said this earlier burping and farting and pooing that's normal that's human okay so it's normal to get a bit of gas it's normal to fart it's normal to burp that's a healthy human gut right there but if it's getting to the point where it's uncomfortable and causing distension you lean back into all of those things we talked about good sleep Stress Management make sure you're building your Healthy diverse plant-based plate plate unprocessed plant derived Foods Etc and you work on that for a few weeks and then if you're still having problems and by the way at this point you should have talked to your doctor that we haven't said that yet if you're struggling with digestive health problems please go and talk to your doctor even if they know nothing about food they're really good at detecting red flag symptoms and organizing the important tests and scans or poop tests that are needed to make sure nothing serious is going on but if you have done all that you've been to your doctor and you've had the basic tests and everything you're given the okay then where do you go I guess that's the question well often for individuals who are eating a plant-based diet well not often I think it often comes to me because I see the people having problems right I mean a plant-based diet supports good gut health but when you are running into trouble with bloating and distension there's a few things that can help so mindful eating so coming at your meal time with a bit of presence we all have busy lives we're kind of sitting at the computer on a zoom meeting kind of sneaking a sandwich in the side of our mouth now we were speaking yesterday about how we eat with our eyes you know we're talking about beautiful food here with some of the attendees but that is so true because digestion begins in the brain so even before you eat food your digestive system is kicking in so if you close your eyes right now and think of that delicious meal that you had last night you're going to start salivating your tummy is going to give a little gurgle what is that that is your digestive system preparing for food and if you were eating unconsciously you're just you know sneaking that sandwich in the side of your mouth or slabbing that protein shake in between workouts and that's your lunch you're not setting your gut up for Success you're not initiating the peristaltic waves you're not producing the enzymes to effectively digest that food that's number one I'm going to give you another tip right now that you know those uh click betty things do this one thing to improve your gut health do this one thing to improve your gut health clip that put a footstool in front of your toilet okay so so you squatty potty so humans are Apes we are designed to poop in a squatting position the the muscles and the anatomy to affect a comfortable and effective bowel movement it's incredibly complex I'm lucky enough to get to see that on on scans right so you so you can see it on a scan and when you do a colonoscopy that's one of the nice things within gastroenter is you get to look up close at the living organ that you're trying to fix with endoscopy okay okay bit icky for some people but I gotta tell you just absolutely fascinating but so humans are designed to poop like an ape to poop in a squatting position the modern flush toilet that we have in the western world has got a lot more to do with Victorian sensibility than human anatomy it looks a bit like a throne bit of a chair in fact Queen Elizabeth the first was one of the first people to have as a uh flush toilet in her house her nephew John Harrington invented it for Britain you know it was elsewhere as well the Chinese had it for years before decades Millennia before but the modern flush toilet as we know it sits you sit up straight like you're on an armchair or a high chair and you try and poo You're not set up for it so if you don't have the ability to have a Squatty Potty or squat in the woods get your knees up so put a footstool it needs to be so that your knees are higher than your waistline and you can lean forward and hug it in a little bit and you're now in a squat position and it will just slide right house [Applause] my question is for people that are sold and are deciding okay I want to change this I'm jumping in I'm going plant-based about how long can you expect effects to start taking place so we touched a little bit on the gut microbiome earlier and I can refer you back to to Rich's seven or eight other pods to go even deeper on that but so how quickly does the food that we begin to change or go microbiome so the food that so the human digestive system is incredible it is magical um we've got the surface area but size of half a tennis court in our small intestine and basically if you feed it almost anything within reason it will get to work and it will extract the proteins and the carbohydrates and the lipids and the nutrients the Magnesium the calcium and the iron and all that stuff you need to build a healthy body and repair a healthy body and what's left over what doesn't get digested by the small intestine is the residue we call it a chyme or chime in in medicine right so that gets delivered to your large bowel to your colon and now that becomes food for your gut microbiome so the gut microbes go to work on it and start to digest it and not only do they digest it they turn it into other stuff postbiotics and some of those post-biotics now become food for other bugs so it gets really complex really quick but in essence your the food that you eat affects your gut microbiome in a very real way and if you choose today to have a standard Western meal um so let's say uh steak and white potato with butter and gravy something like that okay or a Big Mac so your body is amazing it will get all the nutrients it can out of that meal to support the healthy body what's left over contains some residual animal protein contains a lot of bile because when you eat those high fat foods you have to make a lot of bile to emulsify the fat and digester and there's hardly any fiber in there there aren't any polyphenols and but you've got microbes can work with that okay they'll figure it out but the microbes that thrive on that sort of food produce predominantly unhelpful post-biotic substances so things like secondary bile acids which are carcinogenic trimethylamine which you know enters your bloodstream becomes trimethylamine oxide or and a nitrogen oxide which helps to promote coronavascular disease um not so much the short chain fatty acids which are really healthy so that's a gut microbiome environment that is conducive to chronic inflammation and disease it'll help to get you there okay but then you next day you say okay I'm going to change all that but anything like that for years so now I'm going to you know I'm gonna have the lentil burger and instead of the you know the white potato mashed up a butter and salt and cream I'm just gonna do some sweet potato and I'm gonna have that instead and I'm going to have some greens okay so now you're eating a completely different way you've got my your small intestine your digestive tract your stomach do their thing all the nutrients the fats the carbohydrates the protein the healthy plant-based protein the Magnesium the folate the vitaminated all that good stuff all gets absorbed right so now you've got a different residue for your gut microbiome from that one meal you are feeding a different subset there's a certain subset of bacteria they're now going to thrive on that residue and that residue there's hardly any bile in there because it's not a high fat meal there's no animal protein in there because you don't need animal protein there's fiber there's a diversity of fiber there's microbiome available carbohydrates it's polyphenols and now you're feeding a different subset there's a subset of bacteria that you never feeding differently and what do they produce they don't produce the secondary bile acids they don't produce the harmful hydrogen sulphide gas they produce vitamins they produce short chain fatty acids which are so many benefits for health Way Beyond gut health but in essence you're now building a gut micro microbial environment that is promotes healthy cell metabolism DNA repair anti-carcinogenesis you're building a healthy gut microbiome that is not conducive to disease those changes start after the first meal okay and we know from a study that was done in 2014 that if you take people and put them on that healthy diet you can measure the changes in their gut microbiome function within four days a few years ago there was a study done a fascinating study where they went to they got volunteers from Pittsburgh Pennsylvania African Americans who very unfortunately have a high risk of colon cancer about 1 in 15 would be that the lifetime risk and they then went to rural Africa and recruited an age-matched population of people living in rural Africa so these were people who were living and eating very differently to each other so everybody got a colonoscopy what a great study to sign up for so everybody got a colonoscopy and what they found was that in the people living Pittsburgh Pennsylvania half of them already had pre-cancerous bowel polyps fifty percent had pre-cancerous battle polyps in the people living in rural Africa they didn't find one single precancer Spell polyp which makes makes sense because colorectal cancer is very very very rare in that locality it's almost unheard of they also analyze their gut microbiome and they found that the Americans were fully stacked in terms of their bowel cancer risk so an unhealthy gut microbiome low production short chain fatty acids high production secondary bile acids and they also measured the proliferation race in the lining of the bowel and it was high in the Americans showing that the gut was having to repair repair repair repair which is a sign which is an indicator of cancer risk and of course the Africans completely opposite profile so what they did next with that study was fascinating because they just detailed everybody's diet and then they did a food swap so the Americans were now getting I think about 50 grams of fiber a day they're eating African potato salad kale they were you know it wasn't entirely plant-based but it was pretty close and what they did they did that for two weeks and the Africans had uh you know steak and mashed potatoes and hot dogs and beans and all that kind of stuff and after just two weeks they did another colonoscopy again a great study to sign up before you got to get two colonoscopies in two weeks and what they showed and they did a gut microbiome analysis as well and what they showed out in just two weeks those profiles had completely flipped so they had completely flipped so now the Africans had a had a high risk profile okay just what during the study but the Americans had a low risk profile across the board and the mucosal proliferation race went down so within two weeks 14 days you can establish that change so just think Becky what you could do in 14 weeks 14 months 14 years yeah beautiful we have time for one more question there's a lot of people who want to ask questions you guys you guys want to Duke it out okay so Alan my family is plant-based and I want my friends and family to try a more plant-based diet because I see the benefits in my family and the health benefits and I just want them to be healthier and a challenge that I've come across is sometimes sometimes people will say well I tried it and I didn't feel good or I tried it and I was tired all the time or and so I don't really that's a tough one because I don't want to sound uncaring like well you're doing it wrong just do it better or or seem like oh I don't care if you you know it's still better for you even if you're tired how do you answer that yeah that's a good question and it kind of feeds into this kind of recent concept we've had that there's the concept of Precision Nutrition where everybody should eat differently and in the Precision Nutrition piece is very interesting the science is fascinating the studies that are being published are really really fascinating um but is it better than what you said you know just you just eat a plant-based diet you know so the one of the world's leading or one most prestigious um Precision Nutrition companies just a few months or I think it was last year okay preventomics big european-wide uh company seven incredible academic institutions EU funded um looked at that okay so is there a certain way for people to eat and what they do is they take your blood and they take your saliva they do genetic testing they figure out how you handle sugar how you handle protein they measure your metabolism they measure your gut microbial metabolites in your bloodstream and they come back with your individual plan for you they've got an app called the M system it gives you meal ideas and you're told to cook like this so you might be a bit lower lower carb a bit higher protein you know if that's the Precision Nutrition thing which is kind of the ultimate a version of what you just described is it right for me so in this trial that was published last year they got 100 people who needed to lose a bit of weight and improve their insulin sensitivity Etc and they put 50 of them through this incredibly advanced multi-amix process and the other 50 they subscribed to a healthy plant-based um meal delivery service and there was no calorie restriction and they told people they supplied 60 so sent to their food and said when you're not doing the free food I want you to cook like the free food so kind of a real world sort of thing and what happened with that study is that everybody did pretty well but the multi-armic individual nutrition people didn't do any better than the people who were just told eat more healthy plant-based meals fruits vegetables whole grains legumes nuts and seeds so the the kind of outcome from that study is that the kind of Precision Nutrition Advocates still have some work to do to tell us that what they're recommending is better than just getting people to eat the foods that have been supporting a healthy gut and healthy human body for Millennia okay so there's that sort of aspects I think some people think oh I should do that program to find out what I should eat right but I think if you're embar if you are embarking on a plant-based diet for the first time there's a few things that can really help with the success of that the first thing to say is the Paradigm that we've just described 50 fruits and vegetables like one-third whole grains plenty of legumes Etc that's incredibly versatile that can accommodate any food culture any preference whether you like soft food or crunchy food Umami food or sweeter food it can accommodate so one thing you can do is okay I like I like lamb casserole so instead of switching to a kale smoothie for my dinner instead of having a lamb casserole I'm going to Google for a healthy vegan casserole which is using you know probably black beans or lentils if I like having chicken tacos I'm gonna do maybe chickpea tacos and I'm gonna just so you're not turning everything on its head you're still developing recipes that are like what you're used to eating and then you will find by rotating through these recipes oh I like that I can cook that my family like that the kids like that I mean you go to the same Journey whatever what kind of food you eat right you're looking for meals at your kids and you can both enjoy so with that by involving the kids and I'm just speaking my kids to have three kids but involving the kids in the process you will find foods that serve you serve them that you all enjoy it's number one number two get support so sometimes you can feel like you're on a lonely Furrow going plant-based and not everyone around you is on the same Journey as you in terms of learning education motivation support commitment so find a body you know in your neighborhood a friend a cousin someone you say hey I'm doing this plant-based challenge for 30 days can you join me because then it becomes fun and now you're sharing recipes and you're bringing potlucks over to each other's homes and it becomes a joyous thing it shouldn't be about deprivation and of course the other thing is that a healthy Whole Food plant-based diet is a great way to eat so if you enjoy food because the meals are naturally lower in calories so you get to eat more food so don't forget to eat more food don't be hungry you don't you you need bigger plates maybe you need two plates while you're doing this and while you're filling up those big plates I think a lot of people embarked on a healthy plant-based diet and they've still got that carb phobia ingrained so deeply and I agree that sweets and pastries and croissants and purified sugars are not good for us they should make up less than 500 for calories but the healthy whole carbs the sweet potatoes the you know the tomatoes the beans all of those healthy carbs actually serve us really really well they're very sadiating they're very good for us we know that you know plant-based populations that do really well actually eat a lot of healthy whole carbs so don't so get the carb phobia out of there so no carb phobia eat more food eat familiar food and involve some friends and make it fun awesome yeah cool thank you and for people that aren't here who are listening if they want to connect with you beyond the book um where would you like to direct those people I've only got time for one social media platform except for you I'm super busy so Instagram if you just look for Dr Alan Desmond on Instagram you'll find me there and you know through the links you can learn more about the book about the incredible online course I remembered our mutuals Stephen and David Flynn and some of the live events that I run in the UK because if you're hearing this I'd love to see you at one of those Live Events so so watch out for announcements we've got Andy ramage coming up next we can't have an episode of ritual without a shout out to Andy it's because Andy who we just had dinner with in Florence the other day told me the whole origin story behind his involvement and your kind of trajectory in the in the the plant-based medical world which is fascinating so it all ties together so it is all one right yeah yeah did you want to hear this do you want to hear that story sure why not so Andy uh co-founder of one year no beer so I was at a medical conference back in 2017 and I'd had one of these experiences that I often have at medical conferences where I was at an industry Spa sponsored Symposium and again the medications are great I prescribe them all the time but we need every evidence-based tool in the Box to get healthy so I'm at an industry sponsored medical Symposium and a very prominent gastroenterologist gives a keynote on the eight studies that we need in GI health and he didn't mention food once or diet and lifestyle once so I stood up and got the mic and said hey shouldn't we be that's amazing but shouldn't we be doing more studies and putting more funding into giving answers to that question that every single patient asks every single one of us what about food you know shouldn't we be doing that and if there was like a red button under the podium he was probably pressing it because you know I felt like I just left off a stink bomb okay so anyway afterwards a few people came up to and said hey good on you you know and then we talked I connected some like-minded gastroenterologists which was lovely but I had a phone call with Andy later that afternoon and we were talking about plant-based Andy's plant-based and he said hey you know and I told that whole story he said you should speak to Tom Hubbard I met this doctor called Tom Hubbard on the ritual retreat in Ireland and he's a plant-based doctor and I said okay cool I'll talk to Tom wonderful so I spoke to Tom fantastic lovely chap great guy and with a lot in common and then he said have you met Dr Shireen Kazam in London so she's an oncologist and she is trying to set up the first medical conference in the UK on the benefits of a healthy Whole Food plant-based diet you should speak to her because maybe you could speak at the conference and I thought wow I can get to speak at a conference this is amazing I mean I'd often been inspired by doctors and dietitians like Garth Davis and Neil Bernard and Michael Greger Juliana Heather Michelle mcmack and Brenda Davis all these people I discovered through the ritual podcast and I thought now I can we're going to do this in the UK amazing so I phoned um Shireen and introduced myself and Trina said oh yeah we're doing a conference it's going to be Kings and in London it's going to be great it'll be great if you would speak and I thought oh thank you so much for the opportunity I'll be there what I found out years later was from Shireen was that when she was organizing the conference I was the first person to say yes so I came off that call and was yes I get to speak at a plant-based conference and Shireen came off that call went yes we're going to have a conference and you know and it was so awesome and at that conference it brought together a whole community of doctors including shrink Kazam and Gemma Newman and myself with Andy Davis who visited from Australia for that conference and that was the formation of plant-based health professionals UK there was about eight of us there initially we now have over a thousand members so shout out to plant-based out professionals UK and it used to be I knew everybody's name now I know hardly anybody's name in the organization and I'm still an ambassador for that group and Shireen is doing incredible things with that group but we can draw a line from there back to Andy back to the retreat the previous Retreat you had in Ireland yeah beautiful thank you I love that yeah what a way to end it thank you it all comes back to plan power Italia the origin of it all right yeah sure something now so just to mention um it's so profound like so amazing so Tom Hubbard um we had gone to plant power Ireland we just did one retreated plant power Ireland and it was really a blast like really an extraordinary place but uh Tom Hubbard actually um uh his wife at the time uh Carmella had reached out to me and told me that he was very very ill and we had an open spot at the retreat so we had met them previously um I was in Ireland for my friend's wedding I have an Irish girlfriend who has four beautiful children and her husband promised her an Irish wedding so they had it 12 years after they were together with all the kids and she invited me to sing in her wedding and all of the kid all of my kids and me we went to Ireland so we're in Ireland and I'm posting on Instagram Rich was not able to join us and I get this message on IG came from this woman Carmel and she's like why don't you come over and I'll make you a plant-based breakfast so I kind of said well she sent me some these coordinates and I said okay you know we're on our way back to Dublin but if it works and it's easy then we'll figure it out and so we had these coordinates so we drove and we she said you know my husband Tom will meet you at these coordinates so we arrived to this location and there's this guy on a motorcycle and he says come with me and we drive through these gigantic tall like grasses like you can't see you know it's like a tunnel and we're drawing and he's driving and he stops and we pull in and we arrive and it's two sisters um with their husbands and one of the husbands is an artist from Brooklyn and they've prepared this amazing plant-based meal and we're all there and we have this amazing time and then they say wait you can't leave until we take you to the magical forest so we say okay so so we drive and drive and on the hill in the Horizon you see this Knoll of just it's like all farmland and then this just independent Forest and I had my sitar with me and I remember we pulled out and we walked into a magical fairy kingdom that is not to be described it was like trees tree beans with moss all over them I mean it was it was out of a movie it was absolutely magical and I was like I have to play my sitar and grab the sitar and we were all sort of like hanging on the trees and it was just a magical Moment Like mind-blowing Beyond and then they also shared with us that there were tunnels underneath this tree uh ecosystem that we're reaching to these sacred places I mean it was crazy so then okay cut two years later we do the plant power Island Retreat and Carmel um contacts me and she's like Tom's ill like he almost died like he's a doctor and his levels were through the floor and he couldn't figure out what's going on so I said we have an open space bring him so he comes to the retreat and uh and he's so happy to see us and he's eating our plant-based menu and the place is magical and we have this ritual Circle and Tom's also a drummer and so he brought his drum and he starts drumming and he ends up like on the table sweating like his whole body was just moving everywhere he was like a work of art in every level and he was so alive and clearly uh just feeling amazing so I sat down to next to him at dinner and he tells me that it was the first time that he felt good in like maybe a year and that he really thought that he might be leaving his body and I and this guy was just like he was dancing on the table is it crazy then he tells me you know Julie he said that time that you met me you know at the coordinates to come over to our house for the plant-based breakfast he said you know I grew up in these corn fields and I've been I've grown up there my whole life and he said you were late like you weren't there and I was waiting and waiting you weren't there and he goes and I wanted to go down to the creek and he said so I started to walk down to this Creek or streamer River and he said a black crow came and flew over my head and hit me with its wings and he said and then I I kind of walked back to the space and then you weren't there and he said and I did it again and he said the crow came six times to bat me on my head to make sure that I waited for you and uh and he said I just had to share that with you I mean this is the magical mystical undercurrent of how we're being drawn together um and so it's lovely to hear that that's how you're here yes so that's it beautiful fantastic uh what a delight um I don't know about you guys but I got a tremendous amount of value out of that experience uh Alan's book is called the plant-based diet Revolution he brought a copy here maybe you leave it out and people can peruse it over the course of that I sure will I sure will pick it up in the meantime and uh I'm sure plenty of people here are going to be tugging on your shirt tails to ask their questions that didn't get asked today so you've been very gracious with your time I appreciate it it is a blessing and an honor to have you with us this week and you have an open invitation to visit the studio sometime and we'll do round two okay I look forward to it round one was awesome so let's do it yeah cool thank you Dr Alan Desmond everybody thank you so much [Applause] [Music]

Channel: Rich Roll

Views: 106,388

Keywords: rich roll, rich roll podcast, self-improvement podcasts, education podcasts, health podcasts, wellness podcasts, fitness podcasts, spirituality podcasts, mindfulness podcasts, mindset podcast, vegan podcasts, plant-based nutrition

Id: RztiDZTuVdE

Length: 101min 15sec (6075 seconds)

Published: Mon Jul 10 2023