Gut microbiome testing: What can it reveal about your health? | Profs Tim Spector and Nicola Segata

microbes are connected with our brain through chemicals through neurotransmitters that are produced so there is a connection between our gut in our brain so yes they actually produce the neurochemicals to make these key differences between us being happy and sad depressed or anxious we're only just discovering all those intricacies there so yes they're key to virtually all the bits of our body and we ignore them an apparel welcome to Zoe science and nutrition where World leading scientists explain how their research can improve your health thank you Nicola and Tim thank you for joining me today and I'm very excited that Nicola has flown over especially for this so why don't we start as we always do with our quick fire round of questions uh and Nicola we designed this especially to be really difficult for professors so the rules are you can say yes or no or maybe or if you have to a one sentence answer but no more are you okay with that sorry yes fantastic all right and we'll we'll alternate so starting with you Tim if I didn't have a gut microbiome would I die no but you'd have a pretty miserable life Nicola can I improve my gut microbiome yes you can there are several ways to do that and we are going to learn them fantastic Tim could altering my gut microbes prevent or even treat disease absolutely Nicola have you discovered gut bacteria that are linked to Good Health that weren't even known to science a year ago yes many actually it's amazing we're definitely going to talk some more about that so this is definitely a Cutting Edge podcast Tim do you see a future where everyone has their gut microbiome tested absolutely all right and then finally for each of you what's the biggest myth that you often come across about the gut microbiome and sort of gut microbiome testing um I think that it's that you can diagnose specific diseases with it and I think that's probably the commonest one most people um think it's they criticize it because it's not particularly good at diagnosing a particular type of disease whether it's diabetes or heart disease or cancer or whatever and that they're missing the point really it's it's it's a much better tool at understand your General Health your immune health fantastic yeah for me the myth is that the microbiome can tell you everything it can tell you everything but only when connected with the other health measures of your body got it so it's in both case you're saying it's giving you this really big Insight but it's not sufficient on its own yep yep hi I love that you're here listening to this it means a lot to me and to the whole team who puts such a lot of hours into this podcast each week we release the show for free without ads to help millions of people improve their health with cutting-edge science in return all I ask is that you help us by hitting the Subscribe button thank you and on with the show [Music] brilliant so look let's start at the very beginning and you know Tim why should we care about the microbes in our gut at all well although it's not a question of life or death they are pretty much crucial for so many processes in our body and I think what we're realizing is just how crucial they are for our immune system because we've assumed that okay microbes are there to digest our food which is true they have thousands of chemicals that our body doesn't have itself in order to break down food and extract the nutrients we know that from Mouse experiments if they take away the microbes make them sterile those mice have to eat like 30 or 40 percent more every day just to stay alive because they don't have those careful processes so life would be a struggle but I think it's the new science is telling us that the immune system is the key to why we need a gut microbiome to be healthy because seventy percent of our immune system is in the lining of our guts and that's interacting with our microbes so our microbes are essentially mini pharmacies pumping out chemicals that are interacting with all those cells as immune cells and that's priming them so they know whether to attack things or to defend things or just to get it right when it goes wrong that's when you get food allergies that's when you get autoimmune diseases that's when you don't detect early Cancers and that's when you don't repair some of the processes of Aging so increasingly you know we're expanding our view of what the microbiome does from a rather limited idea of oh it helps break down food and it's quite useful for our energy balance and our metabolism to a much broader idea of what they will really do which is we're starting to see in some areas like cancer and immunotherapy etc etc so I think that's why everyone needs to know about the gut microbiome and everyone really needs to know that it's not just about how we break down food it's absolutely crucial and that's you know explains a lot of the western epidemics of chronic disease that as we've lost our gut microbes over the last 50 years we've also gained all these diseases all these allergies all these immune problems and we're you know facing this pandemic of ill health so I understand the gut microbes we can get back on track and really start to get back to our original where our set point of health and to do that we need a healthy set of gut microbes and I will actually also add the brain because there is the gut brain axis microbes are connected with our brain through chemicals through neurotransmitters that are produced and so there is a connection between our gut and our brain so even more functions yes they actually produce the neurochemicals to make these key differences between us being happy and sad depressed or anxious and we're only just discovering all those intricacies there so so yes they key to virtually all the bits of our body and we ignore them at our peril I always love hearing Tim and Nicola talk about this because you come away just thinking how amazing it is and how important it is and of course how you know new it is as well and I think we can explore a bit today sort of the things that that people are coming uh starting to understand um before we do that just can you help us understand like how many different bacteria and other microbes are there in our gut well nickel I might have a different number to me because everyone you ask can't really give you an exact figure for this but they're in total numbers there are hundreds of trillions okay so there of bacteria but they're also another related species called archaea which we don't talk about much because we don't know as much about them then we've got five times as many viruses little mini viruses called phages which eat the bacteria and within all that lot we've got fungi we've got yeasts and we've even got parasites which you know we're starting to find are of great interest and some of them are even healthy so we've got this Menagerie if you like it's like a a jungle out there of lots of predators eating each other controlling each other struggling for survival whilst we're um you know little ones big ones uh fat eating ones protein eating ones sugar eating ones uh fiber eating ones and they're all in this these ecosystems struggling for survival and as they eat the food they're pumping out all these incredible chemicals that are used by our body our immune cells and you know our health so it's it's you've got to try and envisage this as this this living community of microbes working together and totally dependent on the food that we give them and I think that's that's really important which sets their environment and if we get that wrong that environment shifts and those populations shift just like you know if there's no rainfall in a forest or you spray pesticide all over it you're going to get a very different environment everything from the tiny insects to you know the the Lions and the the big beasts they're they're all all inside inside our gut and everyone has a very different Community we're all totally unique and Nicholas done this work on not only the S the species but also the The Strain So within each species there are subtypes called strains where just a little tweak of the the DNA makes it quite different have a different function and so we're seeing even greater diversity than we imagined because of the new these new techniques yeah so there are probably thousands of different species in each of us now but not all are the same so me and you team may we may have only maybe 30 40 percent of the species in common and as you said these strains that count is is like covet now we know there are many different variants and the covet has been around three three years more or less our gut microbes are around since hundreds of thousands of years and so they have us spread a huge amount of different variants and is very likely that you and me they don't we don't have even one variant in common so very very diverse very different we've all got isn't it true that we've all got some variant of a bug that literally nobody else has exactly 10 000 people or something we know that our human genome is unique but our human microbiome is even more unique there is really you know personalized to each of us it's amazing so you're saying that if I think of your jungle analogy you we might all have an orangutan inside us but actually it's a completely different variety of orangutan like you know the one that might be in Indonesia and one that's you know I don't think they have one in Africa my analogy has broken down but you're saying that actually when you really go down to understand it really each of these is is different even though at the high level description of it as a title does look different they are different they eat different the food they they produce different chemicals so very diverse within the same species amazing so I think we're getting a picture of like this incredible complexity and also um I love this jungle analogy and the idea that the food we're eating might be a bit like pouring pesticides or I'm thinking a bit about Brazil you know burning parts of it down or you know it's a slightly scary analogy you've also said up there Tim um I do want to talk a bit about testing um in this context because you know I think most people listening to this they're used to this idea of maybe regularly testing their blood pressure when they're going to their doctor or or probably use the idea of having you know things tested in their blood regularly like their cholesterol all these sort of things these have become completely normal for maybe like 100 years right in uh in the west I think most people are not used to the idea of measuring their poo right that seems like quite radical why would we want to measure our microbiome well there are a number of reasons I mean the first is that if if I get a sample of say your microbiome and a sample of your DNA and I do sequencing on both I can tell much more about your current state of health from your microbiome than I can from your DNA and this is came from me as a ex-geneticist okay so I've totally changed my views on that so the microbiome really says what's your current state it doesn't necessarily predict you know 50 years time like like DNA might but it gives you much better idea of your current health and also an idea of your the state of your diet whether your diet is appropriate for your microbes and whether it's pro-inflammatory or anti-inflammatory I think one question though that I think I immediately had when we first started talking about this um probably six years ago I think many people have is around whether this can change because there's one thing which is hey I've got this measure like my DNA it tells me some things which often feel a bit depressing right like it's saying hey I've got these high risk for uh you know getting breast cancer for example and that's especially you know sort of is a bit depressing if you feel you can't do anything about it and um one things that was exciting I think about the the idea of the gut microbiome is the idea that it might actually be able to change and we actually did a um where she asked our community on social media um uh a question in in preparation for for this podcast about how quickly they thought uh somebody can change their their gut microbiome and we had many thousands of responses and interestingly 50 said they thought that you could change the gut microbiome within a week 31 within a month and 18 uh it would take six months so like to what extent can we change our microbiome and what is it the latest science tell us about how quickly you can start to see a change I think they are all right actually okay well done everybody there are multiple scales now so uh what I eat today will change my microbiome tomorrow for sure but it's also what I had for the last 10 years that are changing in a more radical way the microbiome they have today so it's a combination of the short-term diet and the long-term diet and also the lifestyle and that is what is really exciting though because is the fact that we can change our require you at multiple levels and the challenge here is to understand in which direction we need to move it which microbes we need to improve and which food we need to improve certain microbes this is the real challenge today and it's only with big data actually a lot of information from a lot of microbiomes or the people and health information and diet information that we can you know and study everything together and pinpoint what which are data producible changes that we see and we can then tell people to do and the the other point I think is that if your your gut is in a bad way then actually by radical change to say you're on a junk food meat diet and you change to a vegan diet you see dramatic changes within five days and the opposite is also true so I think there are these extremes that if you have a very poor diet or a very good diet and you you swapped the extremes you will definitely see effects within a few days and that's been proven uh with with some very carefully done studies it's harder to change someone who's on a really good diet to improve them than it is to improve someone who's has a very poor very non-diverse uh inflammatory diet so I think there is this variation these time scales we've talked about but there's definitely a large proportion of the gut microbiome that is very changeable very amenable and very unlike your genes which you know you really can't do much about at the moment apart from just blame your parents and I've blame them for a lot already so and I think there are two levels here no because one thing is that with our food we can increase or decrease the microbes that we already have but we can also acquire new microbes and the microbes then can colonize ourselves depends on what we eat so uh but you know if I change my diet today I cannot immediately acquire new microbes I need both aquarium microbes and finding the right uh food for for them so again it's a combination of two and not to always say the same thing but it's more complex than what we currently appreciate also and only with the big data we can really understand it more I think one of the things I've discovered over the last six years is always these things are more complicated as you get deeper into them than they appear on on the outside and Tim's smiling here because I think that's the history of uh of his career um I actually have my own personal experience here which which is quite fun so I first had my microbiome tested in 2019 so uh four years ago as part of the very first Zoe and predict study and at that point I hadn't made any changes to my diet I thought I've been eating pretty healthily I subsequently discovered it really wasn't that healthily but I thought so and I scored 52 out of 100 in terms of the um uh the Zoe um uh gut microbiome score which is basically completely average in the UK so sort of 50 is sort of sort of the average score um I've had it tested repeatedly since then at the end of last year I scored 78 which put me in the quarter of people thank you so I'm very proud about that um but I think what's interesting is I was able to make make a really dramatic change in my microbiome over those four and a half years and it clearly took time to achieve this and so you know in my own you know particular example it wasn't a sort of transformation that happened uh in a week I wasn't eating a sort of an all-junk food diet but I clearly also was not eating you know I've made very big changes with Zoe um I know we have very little data of people's microbiome over time because actually almost nobody was having their microbiome tested properly with this this thing we'll talk about in a minute the shotgun sequencing but you know we've got two of the world experts on the microbiome in the room right now do you do you think that might be typical what would you what would you guess you really need to change the environment in your garden to make new uh strains uh finding the the new home so yes also because I think we need to think about the microwave as an average no because uh we cannot really measure every minute of our microbiome for a lot of reasons so it's the average of what you ate in the last year and and I think uh that's really the time frame we we need to test ourselves on you know every six months or so we should see the Improvement if we are changing our diet if we change it tomorrow we see a difference sorry if we change today we see the difference tomorrow but then we change again and again so it's really probably over a few months that we can see the improvements and yeah you did greater and uh I think you did some you know substantial in your diet then yeah so I think aren't you a bit slow Jonathan you should have sped it up a bit you know four years come on you can do better than that so I think um you know I may not have been the perfect student so if you'd followed my advice you'd have definitely improved in six months and I think that's what really we should be seeing for the for everyone who isn't sort of really high I think that goes back to the point the better your microbiome is the more stable it is the harder it is to make it better or worse because it's such a really tight-knit Community it's working so well together it fights off other guys and doesn't like to uh to change whereas if you've got an unstable one it's not very diverse it's inflammatory those are those the people that can really improve dramatically and pray in less than six months so I think we're going to see an interesting picture here and of course you know coming back to this is you know unlike everything else in the body we're also unique that just because it hasn't changed doesn't mean anything wrong you might be someone that needs a longer time frame some people will change faster Some People Change slower just like we react to drugs in our microbiome at much different speeds as well and and to be clear it wasn't that nothing happened for four years I want to be clear there was a sort of a sort of steady Improvement through this period I've been testing more frequently more recently as the costs have come down a lot it was seemed quite expensive to start with but now it's um it's got much cheaper which is fantastic um so there was a sort of steady Improvement through this but what's interesting is like it's continued and it's been step by step and probably has followed behind some of the impact I felt in terms of energy and things like this were very fast sort of losing some of these slumps so it's interesting that there's definitely um there's something here that's taking quite at some period of time and other things we were seeing sooner and I think this matches up to some of the latest data that the two of you have been looking at right there's some unpublished data um that we'll be coming out in a paper soon I'm sure looking for the first time at what happens with repeat measures of people who are um uh following in this case the Zoe advice can you can you share a little sneak peek for the listeners about what that's um what that's showing uh yeah I can I can start off Nicola can uh add the details but um essentially we took people who'd adhered to an improved diet so they were eating towards uh gut healthy foods more fiber more polyphenols more fermented foods less junk Foods Etc and we got improvements uh after about between three and six months about over 80 percent of those people uh improved their Global scores and of course lots of changes in individual microbes which may or may not be significant but we'd managed to Nicola's team got together this this score that summarized these changes and so really for the first time we're now confident we've got a scoring system that works to monitor people's change over time and no one's managed to do this yet it's very interesting the literature there's a whole dearth of these these problems because it is so difficult to summarize not only the complexity of the microban but also this incredible interperson individuality but I think Nick and his team have finally cracked this and uh by looking at you know the 50 uh healthy bugs 50 bad bugs that ratio that is proving really consistent for us and I think we've we've suddenly um got these exciting results which mean we can start testing you know we know what success now looks like so therefore we can start to work out what works best for for which people and how we can tweak Our advice because until that point we were floating a bit in the dark yeah yeah and as we were seeing uh people with a bad starting score improve the best so over 90 percent of those without not great score improved it more than those that were already are in the score yes and that in a way 90 is like a minimum because there's a bit of error in those in those results so it's probably we're capturing virtually everybody who who started with a low score and then adhered to a gut-friendly diet so I think that's that's fantastic news for the whole field really because we just haven't had that sort of clarity before which means that we've now got a way of monitoring how our gut is doing over time I think it's safe to say we were quite excited this is the First Data started to come back about where these personalized advice is really starting to work so we will definitely talk more about that at the point that the the paper is ready um I'd love to talk a little bit more about the test because there'll be lots of people listening to this who either haven't done it or even they have really they have no idea what's really going on behind the scenes um could you maybe start I mean maybe Tim start with like what you do as just uh you know as it were a patient a a customer in terms of the um gut test and then nickel I'd love for you to sort of explain the magic behind behind the curtain after that but let's say I've got this box I'm sitting at home to him probably there are a few people thinking oh this sounds a bit scary what happens next yeah so you get this you get this box with some instructions and it has pictures of toilets in it and uh various um other bits that all sound a bit icky but basically all these tests and the Zoe test in particular gives a way of collecting your stool sample so there's a little uh sheet that comes out that you put over your toilet uh you you do your normal business and leave a bit of this in this sort of paper that's covering the the toilet which allows you to scoop out a lot a bit like there's a little spatula and you put that into and how much because people might be thinking minute amounts so we're talking yeah less than a sort of thing fingernail amount a tiny uh you don't you hardly need any because there's so many billions of microbes in in a in a millimeter of this stuff you just say you don't don't have to to fill the tube or anything it's just a minute amount forensic type amounts you put in and you basically put into this tube which has a medium in it which preserves that preserves the DNA so that when it goes to the lab it doesn't matter if it's waste waste a few days or not before it say it goes to Nicola's lab and then that that's when the sequencing Starts Now what we've noticed is we've been doing this for uh about over a decade and we started with our our volunteers the UK twins who always the guinea pigs for all these things I can tell you when they first heard they had to collect their own poo samples they were pretty shocked and they said this sounds very icky so um and so you know and you ask people I never look at my poo I never looked never turned never turned back you know always just flush and go and so this is a new thing for many of them but as each year has gone on the acceptability has gone up from about 40 percent to about 95 percent so I think people are now used to this idea in this country and in other countries probably in Italy um this is quite normal I remember when I was working in France and Belgium patients were always showing me their poo I didn't want to see it but you know this is very cultural that's interesting in Britain and the USA I think we have a bit of a problem but we're overcoming it we realize it is just like like a urine sample a blood sample saliva sample I mean I would just say at a personal level uh it is definitely a lot easier than changing a nappy or a diaper so anyone who's ever had to do this that is so much worse for picking up your dog's poo totally as well that's right so I think but it's interesting you know I think it does time so you know we're all um brought up I think as small children that sort of poo is a bit is something that you're sort of like it's a bit all a bit icky as you say Tim and so I think um uh there is something that one has to get over and then I think um you know that fits into a lot of this this is going to be talking about something that's actually very important this is going to be commonplace and I think everyone knows if up I think it's over 60. they get a standard colon cancer test now from the NHS where you do the same thing on the stool test really to look for blood in the stool it's very crude measure compared to the microbiome but it's it's a similar thing and I think people now realizing this is part of normal Health prevention so I'm not worried that you know it we're going to continue that aversion to it so that's that's where we are the pot go you close the pot put it in an envelope and then it goes off to Nicholas lab and he's going to tell us we have to do a simple thing which is not simple is reconstructing the jungle so having a picture of the Jungle and you know there are several ways you can could do that in the past they were trying to isolate grow single microbes but this is inefficient and is not giving you the jungle it's giving you the single uh animals and in a cage so it doesn't yeah so in the past we've only got one percent we earned one percent or less of all the microbes in us we we thought because we could see them grow we ignored over all the other ones exactly yeah the 99 you know five five but isolated they were also in a cage so they were not representing what they were doing the jungle so what the Revolution was DNA sequencing and what we do on the sample is to uh um free the genetic material of all these animals or all these bugs in in this in the sample and then we try to read it but these machines negotiation sequencing they are called They Carried only little pieces of the genetic code so not the full Genome of the microbes so we need We The Machine will give us a lot of very small readings of the DNA and at that point we have a big computational computed issues which is reconstructing the puzzle of each single animal so the Genome of an animal of a microbe is the solution of the puzzle and we have little pieces but it was called shotgun sequencing so I used to basically into tiny pieces and then someone has got to put this massive jigsaw puzzle exactly but but it's more difficult than that actually because uh all the pieces of the of the of the puzzle are scrambled together so we first need to understand which pieces which little pieces of DNA are coming from one microbe and the other microbe and then we need to reconstruct the genome so yeah it's a long story I just tell people this is a really hard kept busy my love for the last 10 years yeah and it was nice because at the beginning we were only able to say you know a big division of microbes like like animals no we have mammalians in this sample and now we can say you know we have these specific animal actually this subtype or strain of animal and this was only done by improving the methods we can develop to look at that with the computer so 10 years ago this this would cost at least five thousand pounds a sample to do okay so and a bit like the genetic revolution in humans which you know the reverse one cost a billion or something the cost has come down so sort of halved every year yeah so that it's it's a few hundred pounds now so but it's even less you know it's an incredible and we're getting so much more than we were and still most people who are offering microbiome testing are using a very crude method which is called 16s which uh which is looking only at one gene micro server 500 5000 genes more or less each of the microbes and these initial testing that we were also using about 10 years ago it was looking at only one Gene and looking at the differences in this Gene that are characterized in different microbes but this will not tell you anything about what is the Machinery of this microbe to degrade as per specific nutrient or something so is giving a bit of diversity analysis so on an idea about how many microbes are there but as you were saying is more important to understand which micro which subtypes of microbes you have you have rather than how many you've got this far which means you know more about the gut microbiome than 99.5 percent of the population congratulations now perhaps you're wondering how your microbiome is doing as part of becoming a Zoe member you receive an at-home test that will reveal your exact gut bacteria to help improve your unique gut microbiome I do this regularly and it's had a massive impact on my energy levels my cravings and my mental clarity our latest scientific breakthrough means we now offer the most advanced gut health test in the world so if you've been thinking about joining Zoe now's the time to do it head to zoe.com podcasts to learn more and even get 10 off so you can start your journey to Better Health today right back to the interview so it is amazing and it continues to be computationally definitely by far the most complicated thing that um uh you know we're doing at Zoe and that I think that I've really seen actually in this whole sort of um medicine um sort of human biology space in terms of data it's extraordinary now having said all of that to him um some people claim that with a microbiome sample alone you could deliver high quality personalized advice and I know that you know you you said you don't believe that's currently possible you know part of the reason that at Zoe we don't just do a microbiome sample but we also get all this other information like sugar and blood fat can you explain why why that is because it's listening to you it sounds like this is so important like why isn't it enough well it's only 10 years ago I thought it would be the case that by now we would have enough information that we'd be able to say yes you know you're going to get Alzheimer's disease you're going to have heart disease you need to avoid this food you need to do this and it's turning out to be a different tool to the one we envisaged so as as I said earlier it's not really a useful diagnostic because in a way it's so complicated there's lots of different ways for those microbes to work so we just don't understand all of this yet correct you've got to if you if you yes there's this jungle but um all the animals are able many of the animals are able to produce say the same chemicals so you might have a different balance of microbes that are producing different sets of of or the same sets of chemicals and in one person a different set of microbes producing exactly the same so you know serotonin or whatever it is or another one that might predispose you to cancer so we haven't yet sorted anything out that level of detail we'd need to predict uh individual disease so that's why at the moment it's much better test of the overall function of say the immune system or our metabolism then it is predicting individual disease now I think that we're going to see as we move from identifying the microbes to identifying their functions that could be a step change so once we perhaps use uh you know a artificial intelligence or other sort of major Computing factors to work out this combination of microbes what what chemicals could they produce and are some of those maybe carcinogenic then I think we're going to be a position where we could do that in the future but absolutely now for the next couple of years we're not going to position that on its own it's going to be that useful so that's why we've found that um you know yes we know we we can give up what what a healthy one looks like an unhealthy one looks like we want to improve that but it's using these other tests like we did Zoe like with the your your blood sugar response to individual foods and your lipid testing are better predictors say of cardiovascular and so we put all of these things and each component says I guess what you're it's we're still going to take a holistic approach I think it's going to be some time before the microbiome on its own could ever do that job and we need to understand much more about all the chemicals that they're producing and how we manipulate them if you like but you know there are some areas like cancer and things where a has been doing some work on that that we're getting sort of close to be able to say so people their response to drugs and things like this you know knowing what their microbes look like can you tell us anything about that Nicola yeah I think um for certain diseases a specific diseases for example colorectal cancer the our microbiome can tell us something directly but something more you know complex like cardiometabolic Health we need to contextualize the microbiome so it can be the same microbiome can be a very good microbiome compared to what you eat or a bad microbiome compared to what you eat so we need steel to contextual the microbiome with respect to what you eat with respect to your cardio metabolic readouts and we need to take these these into account our microbiome is an ecosystem but is inside a bigger ecosystem which is provided by our body and by also the environment we are all in and it's complicated by the fact that it's also the reflection of the environment so if you're eating badly you might have a pro-inflammatory microbes because you're eating badly um or if you have an inflammatory disease they might be responding to that and so there's a mixture of cause and consequence in our microbes that needs more sorting out before we can just say oh yes you're going to get that so having made this big disclaimer that you can't just rely on your microbiome to give all your results and I think Tim you've often said to me you know as a doctor there's actually very few tests where you would say that's the only test you use to paint a picture is that is that fair yes hardly any yes so it's part of the story I think people listening is like okay okay enough with the disclaimer tell me what I can expect so what's the information that I I could expect to get back and how can I make sense of it so this is actually something that's that's useful for me well what we can say is whether you have the right microbes um so when we did the our first holiday we with Zoe it was 2019 we had the by at that time the biggest study more than one thousand dividers and we identify 15 bacteria that were strongly associated with the good outcomes and with good the diet and on at the same time 15 Instead at the opposite side so they were bed bugs let's say but now we expanded everything just before we move on that was the paper that you then published in 2021 in nature medicine right so exactly we'll put the links in the show notes if people want to see that and that was I remember saying that actually the biggest study in the world of um uh gut microbiome and these sorts of Health markers that had ever been done exactly which to me syndic sorry it was like it's only a thousand people um and again I think we talk about this a lot on the show it gives you a sense of sort of how small historically most of these studies are because they're very expensive and there hasn't really been the been the funding so that was sort of 2021 uh are we in the same place today well in a couple of years I think we made the giant steps forward because is at least 50 000 now tests and uh way more diverse from all viewpoints and also in the meantime thanks to these data and other data with this cover many new microbes microbes that don't have a name because microbiology is never really cultivated them in the lab so we have identifiers we have some nicknames let's say that are not official microbiological needs because they don't exist so just to make sure I've understood that you are finding through your data like these microbes that no one ever knew existed they've never been grown outside of like the human guts they haven't got names correct it's not like being an astronomer and suddenly discovering exactly instead of a new star we discovered a new genome a genome of a bacterium which is so different from all the other bacteria that needs to have a new species needs to be a new species you could have totally totally amazing new functions that we don't know about yeah so you know Stars you know roughly what they they do but this is actually more exciting because it's like discovering some totally new unknown Factory that is producing a chemical you've got no clue what it does and Nicholas team are fighting hundreds of these that weren't previously discovered I love this idea that you know because I think sometimes you feel like all the explorations got really hard right you know like my children are like oh I'd like to discover something new and like well you know people have been all over the world they've never seen everything and here you're saying well actually inside your gut you're literally just carrying around with you is this huge amount of undiscovered species indeed to two years ago we were seeing only 50 of the microbiome because uh for 50 of our data we couldn't make any sense of amazing so half of them had no idea but now we are around 80 percent that we know so only 20 percent of what we still call the microbial dark matter with a big name so that's huge the unknown has fallen from 50 to 20 yeah exactly and let's not forget that we haven't even discussed uh looking at the viruses yeah and fungi which are harder to look at right yeah picking up a few parasites which I'm will probably talk about in another podcast which are really exciting but there's this whole world there that we're just uncovering and so you know just in in a few years we've managed to to find another 30 percent of uh the what previously unknown microbes and that's incredibly exciting from a scientific perspective if I'm listening to this you know somebody think about doing a test you know what is that so what's this complexity what does that mean for me so at the end it means that we move from 15 good bucks to 50 at least good bucks so 15 to 50. 15 to 50 years so we enlarge much more uh the the a number of bacteria that we really think are great for us and are associated with good food and uh good cardio metabolic health so this is the key have we done the same for the bad 50 bed bugs there of course we could have chosen 55 or 50 but more or less these huge expansion the number of specific types of bacteria reasons to say like these are actually associated with good health and these are exactly there is the one associated with coffee for example coffee drinker they always have much higher bonuses of a certain bacterium and you know is that bacterium associated with good health as well uh partially yes so it's not that within our 50 good bugs because it's not particularly good but is to pinpoint one single Association and you may say you know food is a simple coffee is a simple food well it still have a lot of it still has a lot of different fibers and there is one micro particularly good in in so this is this example coming back to the I just want to make sure that that I've understood it so come back to the Jungle like we all know I think sort of from being thinking about you know like the zoo or something right all the different animals have to have different food you can't feed the lion and the gorilla are on the same food and so this is the same analogy here where you're saying this bacteria really loves the particular fibers that come from coffee and it sort of does a better job of eating them you don't see it if you're not a coffee drinker you don't see it no it's like you know that's it if I'm not getting bananas like I can't even live I can't live off anything else so it only likes this fermented Coffee Bean that some people eat and others don't so I think that's a really brilliant example of how specific our foods are and how important our food choices are to our health and are to us getting a diverse you know set of gut microbes that are really beneficial and this is why you it's it's so interesting to understand which bacteria you have in the associations with food because you should be able to end up there for giving really specific advice to somebody saying you know here are the 15 gut boost of foods specifically for you right now for the ones you know the good bugs or the low because you can really use exactly over time we can get that title link um and it's no good just eating one generically healthy food because it's a bit like your jungle example that you're you're not never going to get that bacteria for the coffee if you're not having a coffee we're not saying everyone has to drink coffee yeah we're not changing the coffee habits here but if you connect it with nuts and seeds or specific vegetables for example that is much more relevant no and you know this is real so you believe in this individual bacteria are really linked to individual Foods or groups of bacteria associated with groups of foods and we are seeing that and some are the changes that we also observe when we as we were saying before we retest someone in six months so we see that there is association with eating more of a vegetable and increasing the bacterium that we sold should have increased and and that's and that's why these there is this level of personalization in the diet that is aware of the composition of the microbiome particularly regarding the 50 good and 50 bed bugs so in the future we're going to get really good at telling people exactly what they need to eat to improve these particular sets of microbes we think you know it's an okay job at the moment but it's going to be so much better as we get more and more data and what about because we touched on this on one of our previous podcasts what what about when you go to people who are still living sort of a traditional lifestyle so not uh eating all of our processed food you know not with Modern Sanitation how does their you know got microbiome score look yeah we studied it quite a lot and it's very different it's very different they have much more fiber degrading bacterial complex fiber degrading bacteria and a microbiome that is really more known the dark matter the part that we cannot explain is bigger because it is less studied and this is a very interesting because we can see the differences with our microbiome but another intriguing thing is that we went back in time also so with some studies and some collaborators we look at the microbiome of people of 5000 years ago from mummies actually we sample the gutter microbiome of mummies these fossilized boosts they're called coprolites and we can get a microbiome profiles out of there and guess what they are very similar to the current what we call non-westernized populations and these healthier microbiomes is non-westernized populations Nicola I would say generally yes but also in this case we need to contextualize now so we need to understand why these defenses are there because it's not only diet it's sanitation for example so you know we have to be careful with pathogens of course how many different just to get a sense because I think um you know Nicholas a good scientist I know it's always hard to pull you on this but I think when you look at this on a slide it's slightly terrifying um and makes you feel like what you have is incredibly stunted compared to sort of what we've lost a lot of our microbes haven't we we lost Michael so people say up to a half is that right probably yes so whatever difference that you can see in our population people eating completely different vegans let's say and and and non-vegans these uh difference is smaller than our difference with with the no westernized populations like Tim is very proud of his microbiome you know it's really good but um you know that's comparing to people like me um and it's a bit I think I mean my analogy is a bit like you know you're really good at running because you're in your like your little village and you run around you're really fast and then you arrive at the Olympics and you realize that these people are not 10 faster like twice as fast as you is this is sort of the analogy that I've understood is that yeah I think there are things that the team cannot digest and other people in those population can probably digest I definitely wouldn't in a race with the hunter-gatherer tribes I think I'd my gut would lose but you know but I think for practical purposes we're building a database for Journey the Western World so that people know importantly they can judge what is the health of their gut you know on a on a scale not to ten where do they sit what is the room for improvement and they can see the effect of illnesses of changes in diet of medications all these things are going to be really important as we realize they're all interrelated and so people have just ignored their their gut health because we haven't had a good test of it but it's a bit like you know having tests when you take drugs for example many many of the medications people take like proton pump inhibitors for acid reflux or um even things like antidepressants or painkillers can have effect on your gut microbes that could be adverse so having a check every six months of how that particular bit of your body is like having a blood test to see what your liver is doing in response to these drugs so I think we're going to see this much more as a routine test that everyone's going to want and gives them a goal to aim at to say okay like you did like you know I'm gonna you start at five out of ten I want to you know get up towards seven or eight out of ten over the next uh couple of years and I think this is really important this is a fan it's like not trying to it's like trying to control blood pressure you couldn't measure it you just roughly say okay hopefully people no one will die of a stroke but suddenly you know we've got this intermediate measure which I think everyone can start to use and as more people do it the price will come down and it will become common every commonplace we'll realize it's actually much better than doing a blood test just for your Baseline cholesterol or these things that we routinely do in our Health Service that actually have rather little use compared to these major insights so some people will be listening to this and saying you know that's really great but you know I can't get this for free for my health service today I can't afford to buy um this product today um and so therefore I'm obviously not going to get sort of this personalized advice but I think the good news is we don't have to say well there's nothing you can do could we talk about like what's the actionable advice you would give to somebody listen to this saying I'd really love to improve I really love to improve my good bugs I really love to shrink my bad bugs you know what's the key advice that you would um you would would give both of you well I've got five Simple Rules really to improve your gut health which I've talked about before but it's good just to remember them first try and eat a diverse range of whole plants and we think at the moment the optimum is around 30 plants we're doing some other studies to see if that's still true now with these new tests but 30 different plants a week is what people should aim for not problem if you don't always make it but aim to get it right up currently people have about five on average right so there's a long way to go second is eat the rainbow trying it colorful plants because of the polyphenols these defense chemicals in them which are microbes eat and as a source of energy which we didn't know that before and that includes all kinds of bitter Foods as well extra virgin olive oil for example nut seeds dark chocolate um and our our coffee we mentioned then fermented foods when we talked about that that's another podcast I think that having regular small amounts regularly of fermented foods has been shown to improve your gut microbes and improve your immune function so dampens down those inflammatory microbes and fourthly give you give your gut a break we've talked about time restriction eating if you can eat within a 10 hour window or if you can't do that a 12 hour window at least you give your microbes a rest overnight that helps them that make them more efficient and finally don't poison them with too many chemicals from Ultra processed foods because Ultra processed foods have a negative impact on your gut microbe in ways we're still understanding but things like sweeteners emulsifiers preservatives etc etc so they're they're my five rules and of course there are other ways you know I mean the environment aren't there of course yeah these are the great general rules now but I I think in addition that the challenge is to understand what it personalizes to you and that that is what we are trying to get from the data because maybe for you the best is 30 for some 30 different uh you know vegetables for others maybe 20 or 40. so that is the personalized uh part of it that can add a big added values to to to that so can I wrap up with a cup because we had a lot of questions from the community I think we've managed to answer some of them I want to pick a couple that we haven't um hit here that were specific since I've got both of you which is um rather special to have you physically in in the room here um so one question was like how rapidly can I damaged my microbiome I mean a lot of questions saying like I've gone on holiday I've eaten really terrible food for a week lots of all the things that Tim tells me I shouldn't done you know have I wrecked my microbiome will my bad microbes have doubled during this period in a week like how worried should people be well I think uh um you should be very worried if you go on holiday and then you get sick and you have to take antibiotics for example that will ruin you know the most the most of it um otherwise I think uh you know we all go on holidays and we need to eat differently so it's not a huge problem if it is for for a week or so because there is this uh dynamics of the microbiome you can then go back anything in general if you travel on holidays and you have a diversity or food whatever you are it's also going to improve so um I think there is this memory of the microbiome that unless you continue with antibiotics or very wet food for a long time is unlikely you will disrupt it completely the caveat might be if you go on a junk food holiday and you only eat junk food for say like 10 days and you have zero fiber no diversity having the same meal and this is the experiment I put my son through a few years back when he was a student so for 10 days he had only chicken nuggets or a Big Mac and Coca-Cola and he lost 30 or 40 percent of his diversity in that time and I'm afraid to say still hasn't regained it so I think so the caveaters don't go on a purely junk food zero fiber uh holiday because it may your microbes may take much longer to recover and my takeaway from this is um and it's one of the things I think that that um you and Sarah and other people talk a lot about um Zoe is like it's fine to have treats it's fine to add some stuff on top so in the sense in the holiday like by all means have your pizza and your ice cream but you'd like to make sure you're still having some food through this it's going to sort of support your microbiome because it's sort of it sort of makes sense right if you starve them for 10 days and they all they like reproduce very fast right Nicholas like once an hour or or something like this right you can see that's a lot of generations with no food which I guess I I sort of think of well that's quite different right than saying okay I'm going to give a lot of stuff that's maybe good for my bad microbes but I am still providing some food for the good guys and we'll we'll get them back after the holiday is that a sort of practical way to that's like be my practical approach to Holiday now yeah give them a minimum diet and but in a way for people should be relaxed if you've got a healthy gut microbiome you can afford more leeway than someone who's got a really sick microbiome and I think that's the that's the key if you've built up you've been very good you've built up your gut microbes well you can have the odd Excursion with junk food and you'll bounce back but if you've got a really poor one and you go overboard then you're really in trouble but yeah and I think the funny thing is that I also have found my tastes have changed a lot so interestingly like what I want to eat on holiday I still definitely want gelato that comes out quite often on these podcasts but there's a lot of junk food that I used to eat that actually now sort of seems quite disgusting um having switched away from it for a planter and you realize you sort of got addicted to this stuff and I know we'll talk about that on another podcast final question because this came up interesting was like the top question um is there any data about whether taking painkillers regularly can negatively impact the gut microbiome well we know as dee mentioned that probably the two main worst medications are proton pump inhibitors and and antibiotics but all the others are are not not positive for the microbiome for sure so I don't think we have a lot of data from uh Zoe on painkillers but also from other studies we see that they are not good for sure not the level antibiotics and protopant Inhibitors but definitely something to keep an eye on so pretty some people you know if they have heartburn which is a type of pain they take these these drugs which Sue that pain but they change the acidity of the gut and actually increase your risk of other infections and we're only slowly discovering this for painkillers we know that um you know they've studied paracetamol quite well and we know that the reason they don't work in some people is just because they don't have the right microbes so it's quite possible that some of these side effects people might get might also be related to the gut microbes we simply don't know enough but we do know that at least 50 percent of all the drugs people take are interacting with your gut microbes in some way and we have to be a bit cautious that you know all of them could be doing damage or interacting in some way so it's an area we need to do much more research on stuff but the example I did it was just because there are very few examples that are documented and that so you know with the variety of drugs that we can take and the divest of our microbiome it's another line of reserves that should keep us busy I think Nicola you feel like this your career is set for the rest of your years I feel like this yeah absolutely and you know we did some work on on cancer therapies and immunotherapy and certainly the the state of your gut microbes is probably the number one factor that determines whether you're going to respond uh to immunotherapy and cancer and so increasingly I think this you know when people are put on drugs Physicians are going to have to learn more about the gut microbiome and take that into account and as we start to balance as to balance these things up because it really in some cases is a is a matter of life and death yeah but partially it's because we cannot really measure our immune system is difficult and there are no good measures immune system and because the microbiome is connected with the immune system reading the microbiome may be a way to reading the immune system at least indirectly amazing Tim and Nicola I could keep going for hours but I know I need to wrap up thank you very much I'm going to try and do a quick summary of uh of what we covered so that we started with this wonderful analogy that the gut microbiome is like a jungle and you've got all of these different species that are interacting with each other and then you know this latest information that our microbiomes are even more different than we had realized a few years ago because it's not just that they look really different at the species but when you get down to like the exact strains so the exact type of animal so almost everybody is completely unique we then talked a bit about how the microbiome changes and I think the consensus was um you can see these very Swift changes in just a few days but in general if you're trying to make a sort of long-term Improvement in health so making it much better probably you'd expect to see that in four to six months but the data is still quite early and there's gonna be some exciting new stuff published and then hopefully continuing to get it better steadily than uh over years we talked a bit about how microbiome testing actually works and why you know the latest science and what Zoe is doing is with his shotgun sequencing the incredible complexity of trying to piece together what's going on and the way that you know just in the last couple of years we've gone from only understanding 50 of the microbes to I think you said about 80 percent of the the microbes today which still means there's another 20 that we have no idea um what they are and as a result of this and the scale of the data and this is I think where Zoe's research has really been able to be at the Forefront of scientific research which is which is really fun that with Now sort of 50 000 of these test results you've been able to move to now discovering sort of 50 of these good bugs linked to Good Health 50 of these bad bugs linked to poor health and able to create a sort of score that allows you to understand that in the same way that we might get a blood sugar score or a cholesterol score um that we're starting to understand the links with individual foods and you gave This brilliant analogy that you can tell whether or not I drink coffee just by looking at my poop and it's not because you're looking for coffee grains it's because you're looking for a microbe that you will only find if you're eating coffee and the belief is that there are these sets of microbes that are linked to all sorts of specific Foods so over time you know you'll really understand that you know you're not eating particular sorts of beans or cabbages or whatever it is and that could really help you to get back towards the healthier gut which it sounds like the really healthy gut is these people live in a non-western lifestyle but for for normal people I think we all aim to have Tim's gut that's like my my ambitious level and you know what are the things you need to do and then I think we wrapped up with um sort of some some key advice if you're listening about what what you could do and and and Tim sort of push this down sort of to this this really simple rules of you know eat 30 diverse whole plants trying to eat the rainbows lots of different colors and bitterness fermented foods which is something I think we will definitely come back to in the future um restricting the amount of time you're eating so at least 12 hours where you're not eating and lastly avoiding these Ultra processed foods and I think we have this rather terrifying story from Tim about how he for some reason got his son rather than himself to eat Kentucky Fried Chicken for 10 days and apparently that wiped out 30 of his micro dogs McDonald's McDonald's Kentucky Fried Chicken McDonald's I'm sorry um because that's obviously much better to be sued by McDonald's um for 10 days and lost 30 of their diversity and I think you said that was 10 years ago uh getting on for that nearly yeah and it still hasn't all come back yeah so slightly scary there um but the good news is you can eat you know you can enjoy yourself on holiday just make sure you're still providing like that core nutrition to all of these microbes and think about you know the ice cream on top rather than just swapping it all out and um you know so it's not that you can never eat any of these things but you've got to make sure you're supporting the microbes you got it nailed it amazing thank you both and I think we uh are definitely going to come back to a bunch of these topics and I think we're also going to record some more in-depth material for some of the Zoe members to go and talk in more detail about some of these upcoming uh you know new discoveries and how we can deliver them thank you great fantastic job Jonathan as always he's been very very cynical now thanks both of you bye thank you Nicola and Tim for joining me on Zoe science and nutrition today if you want to understand the health of your gut microbiome and access tools to improve your gut health then why not try Zoe's personalized nutrition program you can learn more and get 10 off by going to zoe.com podcast as always I'm your host Jonathan Wolfe so he cites nutrition it's produced by yellow hewings Martin Richard Willen and Tilly fulford see you next time [Music]

Channel: ZOE

Views: 156,772

Keywords: zoe, zoe podcast, gut health, ultra processed foods, tim spector, gut health diet, ultra processed foods documentary, ultra processed food, jonathan wolf, gut microbiome testing, zoe health score, nicola segata

Id: RAzCWMfgy7A

Length: 65min 21sec (3921 seconds)

Published: Thu Sep 21 2023