Translator: Rhonda Jacobs
Reviewer: Peter van de Ven When I was just a little boy
when I used the toilet, my mother taught me to wash my hands, and when I flushed
and I looked at what was going down, I'd go, boy, you'd better
wash your hands, you know? And I had this little puppy,
you know, this little dog, and when I saw what came
out of his body, and if I stepped in it, I'd go, boy, I'd better wash my hands. And my mother taught me all about germs
and how bad they were, and you should always
wash your hands, and I believed her. And then I grew up
and I went to medical school, and we had the microscope. And we looked at these bacteria, and we heard these stories
about how they caused these epidemics, and people dying all over the place,
and then antibiotics came aboard, and now we could actually stamp out
these epidemics of these bad germs. And then, all of the sudden,
I started hearing about the good bugs, and I go, "What's that?" And as we began
to look at the actual genetics, this was the breakthrough that allowed us to actually understand our microbiome, particularly in our GI tract, because when I was just
looking at them through a microscope, it was very limiting. You could only see just certain kinds, but now that we could
actually genetically look at this - this all started about ten years ago,
and many of you are familiar with this - when they started looking
at the genetics of the human, what are the genes? How many genes? What are the genes that we have? Through incredible research,
it became apparent that we actually had, like, 26,000 genes. And I thought, wow, that's really cool, and everybody was studying the genes
and this was really wonderful, until they started studying
the genes of a rice plant. The rice plant had 46,000 genes. What's that?! You know, I mean, we're only 26 ... and they're 46?! And so this was very humbling to say that the rice plant
was more sophisticated than humans. So then about five years ago
everybody got busy, and they started to do
the genome of the bacteria that resides inside of our body. Guess how many genes there are there. 100,000 genes. And so we began to look at,
what are these bugs? Who are these? What are these? So there's, like, 100 trillion of them. When we think of cells of our body, our biome describes
90 percent of all the cells. We're only ten percent. So we just heard how wonderful it is
to look at the astronomy and be humbled. I would suggest we probably just need to
look inside of us and really get humble because "the other" is way beyond this. So these genes are incredible -
there's about 1,000 different varieties, and then when we look
at the species and sort of like that, it's incredible how diverse this whole environment,
this whole biome is, and just resides in some
just humble you and me. Well, okay, let's team up with our bugs. So we're 26,000 and they're 100,000. Wow, now we can trump the rice plant, (Laughs) so we better stay joined with them. So we begin to do - what actually
does this biome do for us? So we first think of fermentation -
talk about a microbrewery, you know, right here
in our right colon, right here, these bugs are actually fermenting
because this does a lot of good things, and they produce about the equivalent
of a can of beer every day. And, yeah, that's true.
(Laughs) And so, of course, we handle it
quite nicely and so on, we don't get tipsy with that much. And so in this process of fermentation, some very important things are created;
they're called short-chain fatty acids. These short-chain fatty acids
are critical to our immune system. So if you breed a little mouse
that has no biome, this little creature is very vulnerable
to infections and so on. And so in many ways,
this is quite dramatic, and we wonder, where does
this biome come from? Because the little human,
when he's just inside the uterus, he doesn't have a lot of bugs - this has been kind of coming
in question here, like, right now - but so far, we've always thought of it
being kind of sterile inside there. But when this little child
goes through the birth canal and is breastfed, that is where
the microbiome starts. This is critical
to the life of this child, and our C-section babies
and our babies that don't get breastfed, this is very difficult, so now, in modern places
and hospitals that understand this, if the little child has to
be born by C-section, a vaginal swab is actually taken
and placed in the child's face and mouth so that they can actually become
a mirobiome-positive creature, otherwise the immune system
would not develop. So this is very, very vital, so that's kind of the positive
side of the fermentation. But there's a negative side to this,
and this is where - remember all these cells, these thousands
of different kinds of bacteria - like most of life, it's about a balance, and when they are not balanced,
we call it a dysbiosis. When that begins to happen,
we find that it starts causing diseases. You know the word
"irritable bowel syndrome"? Some of you may actually have it - you know, diarrhea,
constipation, abdominal cramps, all these kind of things. You know about colitis,
you've heard of people that have colitis. These kinds of things
are when there is a dysbiosis, there's an imbalance
between the good bugs and the bad bugs. Also, we're beginning to understand that a lot of the - what is called -
autoimmune diseases, such as rheumatoid arthritis,
multiple sclerosis, these kind of things may indeed be associated with an imbalance
in our microbiome. So another things that our bugs do
is they harvest calories. Now, if you're starving to death, and you're having to eat
a lot of grasses and grains, and things that have a lot of fiber, your body can only absorb
a certain number of calories, and we can't absorb, normally,
any calories from fiber. Fiber just goes down to the biome, and the biome actually
will harvest from the fiber, will actually harvest an extra
10-15 percent of the calories from that food we've eaten. This is how humanity has survived
very, very severe circumstances. But just as there's a positive,
there's also a negative. And we find when we look at this whole
obese area, people who are overweight - Anybody have any deficit of calories?
Lunch looked pretty good, didn't it? So we're not living in a cave anymore
and we're not starving. So this good thing
can then become a bad thing, particularly if we tend towards
these particular kind of bugs, they're called Firmicutes -
it's a big family group - and they harvest extra calories, so when we actually look at the biome
of people who are overweight or people who have diabetes, they tend to have a lot more
of this Firmicutes family. Are you following me? Do you see where this is starting to lead? What if we begin to change the biome to a more balanced biome
for people that were overweight? Ha! You know how
this is going to go, don't you? And the studies are already
being done in mice, (Laughs) but you know, there's a lot to this. So this study came out
about two years ago - it was a fascinating study - because they took
these skinny, little mice and they just gave them
an artificial sweetener, and sure enough, the little, skinny mice
became fat and became diabetic. So then the obvious
scientific question is, did the artificial sweetener change
the metabolism of this little mouse, or did it change the microbiome? Guess what? So they did this elegant study - if you think of fecal
transplant as elegant - and they took other little, skinny mice, and they just did a fecal transplant
from the heavy mouse that had diabetes, no artificial sweeteners, and that little, thin mouse became obese,
and overweight, and diabetic. So you begin to see how this science
is beginning to progress. And a third area
that I think is very critical is what we call the gut-brain axis. And when you look at animal studies, you can take, again,
these little germ-free mice, and when they're born,
they're kind of autistic. You know, they don't kind of hang out
with their puppy brothers and sisters, and they don't eat well,
and they don't do things well, and they're kind of autistic. But if you then transplant
normal mouse biome into these little guys, they become normal, they just kind of hang out
with each other and so on. You can see where this
is going, can't you? (Laughs) And sure enough it's already happening. So in Europe, there's some beautiful studies
that are being done on humans. Here in America, there's some people
that on the side are giving probiotics, you know, probiotics
have the microbiome in them - probiotic enemas - to autistic children,
and actually seeing some development. I have not seen good
randomized controlled trials, but where there's a little smoke,
there definitely can be some fire. Now in the human studies,
one of the things that we want to know - so we already know
that the gut affects the brain, but we also want to know,
does the brain affect the gut? And sure enough, when we find people
that are under high stress - of course, nobody here in the audience,
I'm sure ... high stress ... you know ... that must be someplace else - but under high stress
the biome actually changes. And what we find
is that there's a breakdown. So inside the gut there's
a nice little layer of mucus - so you have all this bacteria
and here you have your gut wall, and then this first layer of mucus,
there is no bacteria, it's a barrier. The next layer is another layer of mucus
that does have bacteria in it, and under stress, those mucus layers
begin to break down, and antigens from the bacteria
actually penetrate into the muscle wall and therefore into our circulation. So this barrier is broken down. And there's a great deal of study
that's going on now to even look at microbiome
and Alzheimer's. Alzheimer's is now
being called diabetes type 3, because we know
that those high insulin levels, those high sugar levels,
all these things may well be contributing. So at first I thought,
well, this is a little fringy, but when I began to see
that we have neuroscientists that have linked together - 30 neuroscientists
in the Scientific American just published an editorial saying we need to take another look
at Alzheimer's disease in relationship to the biome. So let's kind of think about
how we can feed this biome. What are the nutritional features
that we can do to help our own biome? So, first of all, we have the refined
carbohydrates and the processed foods. You're probably aware
that of the 600,000 foods that are manufactured in America today,
72 percent of them have added sugar. That did not happen by accident. Sugar is addicting. That processed food is beginning
to actually alter our biome to make us less and less healthy. So obviously,
I teach my patients to just - when they go to a grocery store, just shop around the periphery
where they have real food - well, except for the deli maybe - but real food, don't go into that sinister middle section
unless you need toilet paper or something. But that's where
the real food is, is there. Eat real food, because
that's what our body is set up for. And then eating our vegetables,
and a lot of the fermented vegetables, so your kimchi, and your sauerkraut,
and your kefir, and your yogurt, all of these natural biome foods
should be part of our everyday diet. And when we think about
eating some healthy fats like avocados and walnuts
and these kind of things, that's very important
to create a healthy biome. And the biome needs protein, so good quality protein
can be a very important feature. Well, I like to think about the lifestyles
in addition to nutrition that could help our biome. And believe it or not,
our gut bugs have a circadian rhythm. They have a night and day rhythm
just like we do. And there are scientists
that are doing research on the circadian rhythms of bacteria. And so when you don't sleep,
your bugs don't sleep, and they need sleep. (Laughs) So it's really important to have that kind
of lifestyle where you get sleep. And believe it or not, exercise also stimulates
a healthy balance of the microbiome. You begin to see a trend here, don't you? So, then the one that I thought
was just scary, horrible is that our use
of antibiotics in America - 70 percent of all the antibiotics
that are used in America are used to feed the animals from which we get our eggs
and milk and meat and so on - 70 percent. Why do they do that? Because you give antibiotics
to an animal and it gets fat faster, and it goes to market quicker. So 70 percent - ever wonder why
we're getting more bacteria resistance? And think of all of you - you know,
the first time you get a sniffle - "I've got a cold.
Oh, I've got to get rid of this. Oh, I better call my doctor and ask
for a Zipac or something," you know. "Quick, a Zipac!" Every time you treat
your viral infections with an antibiotic, as in bacterial, it changes your biome. So if you do need antibiotics, be sure and follow up
with your probiotics, your kefir, your sauerkraut, your kimchi,
whatever you prefer. You've got to repopulate your bowel
if indeed, you have to use antibiotics. So, gut bug cultivation. (Laughs) You know, we should
start a primer on this, you know, there should be something like, "Gut Bugs for Dummies"
or something like that. So first of all, we have to respect them. You know, they're 90 percent
of who we are - all of our cells; they're there. And certainly, we want
to take good care of them, we want to make sure that they get
the proper sleep, the proper exercise. And if you have happy bugs,
you're going ot be a healthy person. Thank you very much. (Applause)
