OPTIMIZE YOUR GUT to Fight Disease: New Science of Eating Well | Dr. Tim Spector X Rich Roll Podcast

the whole of nutrition advice had been so muddled and confused it's not about you know that one thing that you do or you don't do it's about the holistic view what can you get on your plate if three quarters of it's filled with a giant steak there's not much room for your plants food is medicine we are now at the threshold do prescribed foods to sidestep disease predict diagnostic outcomes and enhance well-being on a highly individuated basis and at the pointy tip of this revolution is today's guest Dr Tim Spector Professor Tim Spector Professor Spector medical Professor Tim Spector many consider you to be the leading expert on gut health and diet Tim is a globally renowned epidemiologist geneticist and author microbes are these microscopic organisms this builds this community in your gut only recently we've discovered are like many pharmacies awarded the distinction of order of the British Empire Tim is also the best-selling author of several books including the diet myth and his latest food for life is an in-depth scientific breakdown on what to eat when and why to improve our own personal nutrition in this episode we expand upon my many past conversations about the microbiome we talk about the importance of plant diversity in one's diet we talk about the Environmental implications of food systems and consumer food choices the future of food microbiome science and plenty more before we dive in this episode is brought to you today by Roca now I get asked fairly consistently about the very stylish spectacles you always see me wearing on the show well the answer is Roca I love them everything Roca makes is designed for high performance all their glasses and sunglasses are super light with premium Optics these are the Hamilton frames but Roca has tons of great Styles none of which will ever slip off your face no matter how much you sweat I'll be sharing a bit more about Roka later but right now let's get into it with Dr Tim Spector this one is appointment listening enjoy well Tim it's a delight to have you here today thank you for coming uh as I mentioned to you a few minutes ago I've had the privilege and the pleasure of Hosting many conversations about the microbiome about gut health over the years including the good Dr B will bolsowitz friend of the podcast he's sitting right over there right now who accompanied you but today is a particular honor because as Dr B insisted I made clear you truly are the world's leading Authority in this field at The Cutting Edge of all this fascinating emerging science uh that's creating a new way of learning about how our bodies work how they operate um in the world and it's very exciting so not only are you somebody who's innovating new research uh you are also pioneering this this fascinating field that I want to learn more about that we're calling citizen science which we're going to get into but I think the best place to begin is just to understand what got you interested in this field kind of the origin story behind this and kind of defining our terms uh with respect to you know what we're talking about when we're talking about gut health in the microbiome okay well it's great pleasure to be here big fan of the podcast um so very excited and my Journey's been a bit of a long one so I we got time plenty of time okay so um because I'm old so that makes makes months career longer um I started Life as a a doctor went to medical school and got interested in epidemiology which is a study of populations but there was no real jobs in that so I trained as a rheumatologist studying bones and joints and made my way training in that in in London in in medical schools and on the way I did a masters in epidemiology that was still interested in that side of why diseases happen in populations this sort of detective in me that wanted to find out why things happen and I when I did my um three years research and my thesis in in that whole area and it was early really really aft in about 30 years ago that I um I change tack from purely Rheumatology and I started What's called the the twins UK project which was setting up uh these twin volunteer system across the UK which now is 15 000 twins in it and has been running out for 30 years so that was the largest of its kind in the world where we were intensively looking at these twins as they were getting older and looking at a whole range of disease and obviously started with bones and joints which are the time no one knew you know much about and the whole idea of the twin study was this nature of inertia debate and it was really a really cool time to be doing that because many of the diseases we thought were purely due to Aging for example ended up having a big genetic component and many things that we thought were genetic ended up not being particularly jacked so we found them back pain was three times more genetic than breast cancer interesting and also to interject here uh you know the the state of science with respect to what we understood about genetics in 1992 is very different than it is today yeah it's hard to believe how much our opinions have changed and how you know the scientists and doctors at the time have had these fixed views about everything was degenerative it was just everything was wear and tear and your body just wore out and that was a common thing for anything to do with aging and the idea there were these big differences between people really wasn't really considered so it it was really quite exciting to be able to write these pivotal papers to disprove a lot of you know clinical nonsense that had been talked about and and why some disease were given more priority than others because they're more exciting they're sexy diseases others were sort of dull aging disorders so that was the time we were living and it was also just as the sort of genetic Revolution was starting so we were starting at Gene markers Etc but um it took the first 10 years was really convincing people that there was a genetic component to common diseases at up to that point really only been the rare ones that people had focused on or the sort of exciting ones so that was a cool time and I came out of my little field of you know osteoporosis and arthritis and back pain into all the other common chronic disease of aging and that led us to publish all kinds of fascinating work and made me realize that I if you had a model that worked you might as well study all the interesting stuff you can not be stuck in a in a specialty like most of my colleagues remain so from what I understand I mean obviously when you're studying twins it's fascinating to see a difference in outcomes between two different people that share the same genetic makeup and then trying to figure out like why those what's driving those that differential right what aspect of their nurturing or their environment is you know compelling one to you know become ill and the other one to remain healthy but was there some sort of epiphany along the way that triggered this Fascination that led you into the microbiome or you know how did that kind of evolve out of you know studying these pairs over so many years well I think I eventually got out of my system that everything was genetic so um I was telling everyone everything's genetic it turns out that 50 is the out of everything you name any disease 50 roughly is genetic and that got a bit dull because I and it's not a very satisfying no answer it wasn't and it was useful because we you know then went on to find genes but as it turned out they weren't that useful either other than maybe for long-term drug targets and things but for me I started looking more closely at why identical twins who were basic genetic clones and lived the first 18 years of their life completely together ended up often dying of different diseases so the aging process was different there was no real genetic base of longevity it was very small one would die of cancer the other one wouldn't one would get autoimmune disease the other one wouldn't want me depressed one wouldn't so I'm starting to intrigued why we were seeing this when you know all the previous stuff was showing it was quite it seemed to be genetic and yet the identical twins which this perfect model of these it's like you know all of us have this shadow person that can be doing in it living in a different environment to us uh what happens to them it's like you all own little control study and so I was fascinated by this and I was then determined to try and look and see what were those factors was it gene mutations that were different between them turned out that wasn't the case I looked at something called epigenetics which is where you can switch genes on and off with chemical signals did that for a few years only small differences that couldn't really explain these big effects and it was then it was about um yeah 2000 about just over you know 11 years ago that I came across the microbiome and said let's test this in twins and that was really Epiphany because I found that identical twins had very different microbes and it was the first time I'd in you know 20 odd years of studying them I'd found something really different in identical twins and suddenly I said wow that's that's kind of that is really cool because why should they be different and yet if they are different that could explain why we we all get different diseases slightly what we thought was randomly because of this whole new organ in our bodies that is behaving very differently in all of us and essentially producing lots of different chemicals so I think it was an aha moment both for realizing you know this what we thought was this randomness of disease but importantly also changed um my perception about how food works as well and why that why in a way the whole of nutrition advice had been so muddled and and confused and seemingly with poor science because we'd assumed everyone behaves the same once that food goes into you you know it's going to behave the same way in everybody and suddenly knowing that even identical twins they only share maybe a quarter of their microbes means that in response to the same food they're all going to respond very differently so that was the theoretical moment when I said aha this could be really interesting I'm going to spend you know the next at least decade working on this rather than all these other areas which I could work on to try and get to the bottom of it because I think it could be much bigger than just looking at a few microbes right so it is quite a watershed moment or a paradigm shift to realize or or to kind of reflect upon this conventional perspective which is our genetic makeup is what differentiates us and it becomes this predictor of a variety of things but in reality the genetic differences like we're much more genetically similar than we are different right and that's a very you know set number of variables it's still incredibly complex but it feels very simplistic in comparison to the diversity of the microbiome and understanding that maybe a better way to look at it is through the differences in in you know these trillions of microbes that are dramatically different from one individual to the next irrespective of similarities in their genetic makeup like and using that as a lens and then trying to to sort of wend that or tie that to certain outcomes as a predictor seems like an impossible not to untie because of the infinite number of variables involved yeah it's it's sort of mind-boggling the complexity of it but I think it's a it's becoming clear that yes there are lots of different strains and microbes and you know trillions of them but the thing that do does bind them in common is they are essentially mini pharmacies they are taking the food as their sort of consumables and pumping out all kinds of chemicals that are unique to us and our and our system and in completely in different amounts and so there is a certain amount of redundancy in these microbes but the difference and I think that the key difference is not so much the micro but they're the products they make the chemicals and that's that's the essential uh for me the big difference is understanding food and nutrition not as macronutrients or these rather old-fashioned ways of looking at it but in in in in chemicals that we are converting one set of chemicals as food by our microbes into these other chemicals which have massive effects on our immune system our brains and our bodies and our health and I think as complex as the microbiome is it can be simplified by understanding those those chemicals and this whole science of metabolomics which is a study of studying these metabolites so I don't think it's an impossible scenario at all and luckily because of the genetic Revolution we have the tools now to measure our microbiome incredibly accurately and actually uncover you know 75 80 percent of the of the microbes that are in there which is pretty you know we wouldn't believe that yeah yeah that's unbelievable ten years ago and the cost has come down from five thousand dollars a sample you know to less than a hundred dollars in in you know in 10 years so it's it's been an incredible journey and you know we're just really scraping the surface of what we know about these things but they have huge potential um in all kinds of areas not just in nutrition but in sure Pharmacy and fighting disease and and everything else because of this all these incredible chemicals they're producing all the time that we co-evolved with so before we even go any further it would probably be good to just Define what you mean when you say the microbiome like what are we talking about specifically in general terms the microbiome is the term we use for the community of microbes microorganisms that live in our bodies and we generally refer to the 99 that live in our lower intestine are colon and the microbiome really refers to the genes of those microbes should technically be called the microbiota and where you just use them as microbiome because I'm not fussy about words and everyone now understands that so these there are some dispute about how many there are but they're probably they're certainly trillions maybe a hundred trillion or so roughly the same numbers of cells in our body most of them are the ones we know about are bacteria but they're also these other related species called Archaea and there are fungi and yeasts and there are viruses five times as many viruses as bacteria that feed off them called phages which also have a role in health and there are even parasites that virtually all of us have to some extent in our guts and some of which turn out to be beneficial as well so it's this whole Community a bit like an ecosystem that is living within us and it best considers a virtual organ stick them all together they weigh about two kilograms same as your brain and they basically as I said these mini pharmacies pumping out chemicals which send signals all over a body but particularly to all the immune cells the majority of which our immune cells are actually lining our gut and so they interact with those immune cells on a constant basis signaling whether to be aggressive or be passive and modifying them tuning them up and down that helps fight aging helps fight cancer sorts out allergies etc etc in fact fights infections and they also produce lots of chemicals that might go to our brain um responsible for serotonins and many other Pathways in the brain as well so it affects our mood and obviously our metabolism and how we digest food amongst others right like so many things right things but this idea that that our immune system really resides in our gut is kind of a shocking Revelation like I always understood that our immune system originates in our bone marrow and you know this is where we're producing uh yeah this is what yeah this is and and and and and why is it that we didn't begin to really even put these pieces together in a methodical way until I don't know the early 2000s like it seems like you kind of got into this around 2011 right like this is all extremely recent because prior to that conventional wisdom was sort of like you know parrot we got to get rid of parasites and all this stuff this is these These are plaguing the human and body and at some point somebody figured out like actually we're living symbiotically with all of this and this is crucial to every facet of health and we're still it feels like in the very early beginning stages of trying to understand the true and vast implications of this incredibly complex system I think it was medical hubris that says that you know our powerful drugs can get rid of this stuff we're fighting the West the well we know that microbes have killed lots of people in history infectious diseases you know were vitally important we survived them therefore you know we can beat them and antibiotics sterilizing creams um you know keeping people away from dirt this is the way we're going to conquer our sort of our fears and I think it was a blind spot to realize that the gut health really was important and for so long just regarded that the intestine is a tube to get rid of toxins right and that sits nutrients some people still believe that right but you know particularly the toxin bit but the um not realizing it had such major implications as a vital organ for us and I think it was you know a few people guessed at it and even the you know you go back to the days of 100 years ago mitchinkoff and uh Pastor talking about yogurt they thought it worked because it deputified the body you know got rid of those toxins they couldn't still imagine that it was feeding other other microbes inside there so I think we just had a blind spot to it some people believe the Indian ancient Indian art you know understood the what the sort of core of the gut to health and so ancient Chinese and ancient Indian did know but of course they couldn't see these microorganisms uh couldn't grow them and uh this has been part of the problem you know we right Medical Science just couldn't see them until genetics came along and so over the course of the 30 years under which the twins UK research has been ongoing there's been like a thousand research papers that have come out of this what are some of the the revelations that um have emanated out of looking at twins through this lens oh it's hard to pick highlights I think because there were some Revelations at the time they seemed might seem rather dull now like I was saying you know back pain is highly genetic uh might not surprise people now to say you know but um um other ones were one of the first to look at that distribution was highly genetic so whether when you put on weight with you accumulate it in your belly or your or your your bum uh really strongly genetic and you can see that in families it's sort of obvious um we showed for the first time that cataract wasn't just that was something you inherited as well um we looked at um early risk factors for melanoma found that um because everyone talks about melanoma they're always talking about sunshine which is a really overrated risk factor for melanoma it's actually highly heritable about whether you have these lots of moles you have light skin and lots of moles much stronger uh genetics than anything else and so you can divide people into those groups and twin studies helped us with that and we did sort of fun stuff we found sense of humor wasn't particularly genetic um political views were so your right wing views or um your left-wing views have a quite a strong heritable basis interesting as does belief in God have a heritable basis so there's nearly anything that you can quantify you can study in this way if it's if you can quantify it reliably and get the similar answer so it it allowed us to look at um sexuality as well and we're the first to look at the genetics of female sexuality and so you can study any personality or trait um in that way as well as things like the microbiome um epigenetics which you know again has some genetic influences and even things like vitamins so people always talking about oh my vitamin D level is low well we were the first to show how that was strongly heritable and that there are certain genes so 50 of the differences between say are vitamin D levels are going to be due to differences in our genes so what's normal for you isn't going to be normal for me and how does epigenetics play into that from my understanding epigenetics basically um means uh the potential for genetic expression and also this idea that um that were were kind of storing genetic information passed on from our ancestors that is perhaps latent but given the right set of circumstances could be expressed like how you know that that seems like a Sticky Wicket and very complicated to kind of understand and there's a there's a certain aspect of it that's that's sort of mystical in terms of like um the inheritance of of like ancestral trauma and things like that like how does that play into how you think about this and and and and study populations well I wrote a book about this called identically different which nobody read but I thought it was a great book but uh you know as often the way and went into a bit of this a bit theorizing about it and it's it's been called Soft inheritance so it's an inheritance we think think it's an evolutionary adaptation that allows in times of stress or famine or some emotional stress to just um switch the genes on or off in a way that takes you on a different path and to some extent and the general belief is that it takes so long to change your genes normally that you know your whole family would have been wiped out by that time you'd made that switch but if this allows you to add a there's a temperature change so allows you to switch so you gain more weight or just the fact that your family might all be switching their genes so that they end up more different they're not all going to be wiped out by the same environmental stress or infective agent makes some sort of sense so but it just lasts for a couple of generations and then Fizzles out so it when I was looking at it I did interview lots of identical twins who went through stress for example and it was quite remarkable that say you know a very major family breakup or someone that teenage twins one for example would responded by overeating and got very obese and the other one had an eating disorder and with anorexia so they were acting in response to a stress but very differently probably because the in theory you know the the genes were were switched and doing something but there was something in our there's something in our Evolution that allows us to have these switches and make you depressed or happy in these things so I think in response to stress it does make some sense um and there are lots of stories about um after the war Dutch hunger famines um whole populations having these stresses which for several Generations had effect on their mental health or others due to these changing genes so it's a lovely it's a nice Theory but it's been really hard to prove it in humans mice it sort of works quite well is often the case um and you can change Mouse hair color for example just by giving them different vitamins and things switching them epigenetically or giving them alcohol or whatever can't do that in humans so it's got to be so frustrating to see you know amazing kind of dramatic results in my studies and not be able to replicate that in humans I mean that seems to be kind of like the robber Curry theme across all areas of science millions of scientists uh have have been frustrated so that's why I didn't get that Nobel Prize you know that so humans just don't behave like mice it's very annoying right and the my studies are what you know generate a lot of hyperbolic headlines in terms of breakthroughs it creates a lot of consumer confusion and they still do and and it's similar in the microbiome it's not not very it's not different and there were you know some misleading studies in the early days of the microbiome that just um you know exaggerated the potential effects in in humans so they were you know I think they were accurate but they just from Mouse studies you can't really get an idea of the scale or the effect in humans you don't know it's trivial or it's really large and I think that's the other sort of problem about extrapolating and uh you know we're not we're not rodents and um we have very different lives and we eat different things and uh so yeah more and more you know we realized a lot of these male studies were flawed and of course you can do unlimited number of mouse studies you know you've got labs well-funded labs they can afford to slaughter thousands of mice and they don't necessarily report every experiment they do right and that's the other problem which human trials they take so long to do you you know whether it failed or not you're going to write it up because it's uh it's important yeah today by Roca 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 perform at your best if you can't see well the Geniuses at Roka basically rebuild eyewear from the ground up no matter how active you are or how much you sweat these things never slip or fall off your face they're super durable they look awesome and they've got tons of super classy modern styles to choose from I've been rocking rokas for about four years at this point I love them I'm a big fan of the Hamilton style in gloss black that's this Frame right here as well as clear or I guess they call them vintage on the website and if you want to try them out for yourself you can do that right now and unlock 20 off your order with the code Rich Roll at roca.com or you can click the link in the description below okay back to the show so you're starting to develop this this you know growing sense that the microbiome is is is playing a much more crucial crucial role than than previously imagined and and you know this sort of leads you into the American gut project and the British gut project so talk a little bit about like how that came together and and what that was all about and kind of what you discovered as a result of that well so when back in 2011 there was no one really doing microbiome research in the UK and most of it was going on in the US so um I got in touch with a colleague who I met at a meeting Ruth lay in Cornell and we we did all the microbiome testing in her lab there and she was linked with this group that had all worked with this really the the father of the microbiome Jeff Gordon and um based in San Luis and Rob Knight was another one of uh his Protege and uh he learned that I was really interested in this and I was doing the big twin study and uh told me about his project which he just started the American gut project which was a citizen science project uh getting Americans to sign up basically donate money you know to pay for their own microbiome testing and I said I was really keen on doing this in the UK and I think we could you know the British public were up for this as well and so we got together and um under the banner of the American gut project and did this and led to a paper where the UK I ain't provided about a third of them the subject so relatively it was more popular in the UK given the population density and uh but together we did a great paper how many were in the study they're about um 11 000 I think it was in the end um which doesn't sound much at the moment but it will it was the biggest study done to date clearly showed a link between uh nutritional eating habits fiber and health and showed that these these clusters that you know measures of gut health which is then we used something called diversity um the more diverse the species the healthier you were and the less likely you were to obese or have diabetes and so this was common to the British and the American populations American populaters tend to still be they were slightly heavier slightly less diverse microbes compared to the British but the key bit of that paper was that it it was the one that found that 30 plants a week was The Sweet Spot for maximum diversity and that's that study still hasn't sort of been bettered um many years later and it and it's that's been a bit of a mantra for me in the books that I write for the public about trying to educate people about what to eat and I think what was really important about the study is that it showed as long as you at 30 types of plant and that's including nuts and seeds and to some extent herb mixes and spices it didn't matter whether you had a little bit of meat a little bit of fish you were vegan vegetarian whatever your your gut health was still optimal and I think that still resonates with me that uh it's not about you know that one thing that you do or you don't do it's about the holistic view of that what can you get on your plate clearly if you've got a big if three quarters of it's filled with a giant steak there's not much room for your plants right so the top level rule just being diversity of plant life in your diet on a the most consistent basis possible is producing the diversity in that gut microbiome ecology that is going to be you know the sort of front lines of keeping you healthy yeah and it's it's a nice simple rule that means you don't have to be too strict about right anything else because if that's your number one rule then everything you know follow yes it's nice to have you know the rich the colorful polyphenol rich foods it's nice you know the fermented foods uh we know are good as well avoiding Ultra processed foods uh Etc but that to me is still number one and I think that's been a a good you know a really good way of communicating it also to the public about understanding so they want to feed your gut why feed your gut microbes you do it by eating right and if you do that you know you can't really have Ultra processed food it's very hard to get you're crowding it out yeah you're crowding it out yeah I mean and it's it's an easy rule to follow it's flexible it's doable it's easy to wrap your head around what that means um and it's withstood the test of time because that project was like 2014 right when you were doing that so I'm curious about how that was received at the time like we're all talking about the microbiome now was that the case back then how were your colleagues sort of you know receiving this pivot in your career and this focus on this new science at a time where this was just emerging well it didn't have any of the public impact that it has now so the newspaper they were like you're a Nutter like you've gone off the reservation well I mean there was there was awareness in 2014 people it wasn't like you know people were talking about the microbiome there was an interest then um but a lot of people thought it was a passing fad that like a lot of these nuisance I think you know as soon as something comes up a lot of Grants follow it money goes there it's hyped up because you write a grant to Hype it up that's how you get your money and then it all comes crashing down again and a lot of people thought that the microbiome was you know just a few years flashing the pan a few fancy mouse studies you know there's um a few anecdotes of fecal transplants that were successful it would all fall over and most of my colleagues in the UK were were not keen on it at all and so the countries are varied about whether they support or not and the UK certainly didn't and that's because a few powerful people in science just said this isn't going to work it's rubbish we've got to stick with genetics it's the only way and also the nutrition uh the nutrition uh sort of profession didn't embrace it at all either they felt threatened by it and didn't approach it so pretty much on my own doing this often with U.S collaborators or overseas collaborators and getting maybe commercial money and we used the citizen science funding actually to get a lot of our work done where we asked the public to to actually pay for their our research and that that really got it going so that was that was really where we are we were um you know up until uh the time when uh I realized I wanted to do the next stage and I was giving a talk about the microbiome and that's when I met uh these two guys came up to me and said we'd like to form a company and um with all the trouble I'd been getting getting money academically um I said aha this could be my my big chance but you know I'm warning you guys you know the science is very expensive and no there's no quick results you know the way I want to do it I don't want to do a marketing LED project um with you know smiling MDS and a stethoscope on the front page it's it you know it's got to be serious science is going to cost you several million before we get going so I thought I'd never see them again but they came back a few weeks later with the money and so that's where the company Zoe was born right and the the kind of operating principle behind that and the studies that you wanted to pursue were What specifically at that time well we wanted to really test the idea that you could use the microbiome and other blood tests to personalize food choices and nutrition that there was sufficient variability between people that um you could use that to predict everyone's response so give people a real idea what they should be eating and came out of this idea that um you know there isn't one single diet that suits everybody and all these studies like that of Christopher Gardner the the diet fit study where you know they competed high fat versus um high carb diets and both did well no winners or losers but within within the groups massive differences so and at the same time an Israeli group had come out with with a study showing that cgms continuous glucose monitors um were able to also predict responses to food so suddenly the idea was able to combine the microbiome with these uh these these new devices on the market to suddenly have a quantitative way of really telling people how they respond to these foods and but the only way to do that wasn't in theory was to actually do a really big experiment to prove it and see if it worked so it was a big gamble at the time um but luckily managed to convince uh these guys that need to be done and the study was a thousand people giving a thousand people mainly twins because I still believe there was a genetic component then um who were studied at my hospitals and Thomas is an and a group were also study it in um Mass General given identical Foods at the same time and then all their bloods studied you know and work up for 24 hours and then for two weeks onwards and it was that experiment which was the largest of its kind that really was the basis for everything else we've done since then and that was the predict study right and that you know that is what that gave us the next Revelations if you like so having known that the microbiome was different between people um there were two other big aha moments there that when we first looked to the data one was when you give people an identical muffin there was at least a tenfold difference between normal people's response in sugar and Insulin to that muffin at identical time of day in laboratory conditions so that was well pretty amazing uh there was also tenfold difference in there triglycerides their blood fat levels six hours after that meal so everyone clears fat at a very different rate and up to that point no one had ever thought to him look because we only take fasting levels which aren't very informative and that really meant that we had the basis of a big enough variation to build algorithms to predict how people would do based on those sort of Baseline standard tests right so so it provides this like sort of starting base to try to begin to understand the nature of personalized nutrition and lifestyle habits and the variations you know between people and how those you know certain variables that distinguish individuals uh can be uh you know valuable information in terms of how people respond to certain foods or don't and when you start to scale that up with massive data sets you can extrapolate from that valuable information to provide um you know solid guidelines in terms of do's and don'ts right so that gets into the sort of Citizen science aspect of of the conversation that I want to get into but there's so many things in in what you just said that I want to tease out gradually the first being just the realization that gut health the microbiome in so many ways holds this key to unlock you know so many things that have befuddled scientists for so long and there are a few things as complicated as nutrition and and certainly it's you know something that is so hotly debated and you know it appears that it's so difficult to arrive at any kind of consensus around and you talk about this in in your books but what's really kind of empowering and fascinating about the microbiome is its mutability like when you look at genetics you come with a you know this is your DNA this is your this is your genetic makeup and you can say well you know my my dad got this or my grandfather got this I have a genetic predisposition to this and perhaps there's some mutability around the epigenetic piece but there's not that much that we can do about it but with the microbiome there is this mutability right and trying to understand how to kind of maneuver around that you know mutability and kind of push it in certain directions becomes the Vanguard of this whole new kind of horizon of Science and Discovery yeah I mean for me it was a revelation because you know I was a geneticist I've been finding genes I've been telling everyone that it's all a genetic basis just blame your parents right and how you're eating crow now and and hope that as you said you know take this magic potion to tweak your epigenetics and you might you've got a chance of doing it but it was a pretty depressing talk and I was sort of you know getting getting myself down a bit about it and so it was so um empowering really to realize that yeah you know identical twins have very different microbes and they respond differently to the same Foods you know we had these identical twins one would have a good fat response the other a bad fat response and the only thing we could find different was their microbes so the fact that you know other studies before us um you know the story um some out of UCSF had shown just by changing from vegan to meat-eating diets in four or five days you can switch your gut microbes you can do this stuff in a few days so unimaginable to change your genes in that way so I think suddenly you know because I was really energized to say this is really important and that small changes to your nutrition can have massive effects you know via your gut microbiome if we get it right and so everyone needs to know much more about gut health and the microbiome and treat it you know just as you would look after it like you would your heart right and getting it right is hard that's a that's a big hard problem right it's starting from yeah it's a different place yeah it's like this I I feel like you're kind of cresting this hill where for many years it's been about trying to understand the nature and the complexity and just the general landscape in which the microbiome operates and now we're in this kind of transitory period where it's about applying that understanding into kind of tangible you know protocols or or means of of diagnosis and and recommended therapies yeah no it's it's um uh it's tough and I think we mustn't you know again realize that we know more than we do and so uh we are just at the tip of this discovery you know the microbiome sequencing is is just getting to the point now where we're discovering all kinds of new um elements to our gut microbiome like you know we've discovered this parasite there's in one in one you know one in four British people have this parasite called blastocystis and it's only in one in 20 Americans and and if you have it if you went to see your GP uh he'd probably say look it up and say okay we've got to get rid of this guy you know it's been shown to cause diarrhea and bloody you know problems and whatever you know better kill it let's get it out but it turns out if you've got it you are a healthier you've you're skinnier you've got less visceral fat your blood lipid levels are lower your blood pressure is lower and it's a sign of super good health and it's um you know and so we're discovering that this this parasite actually probably eats other microbes that are uh increasing your fat levels so it's sort of wow it's a sort of predator of other microbes that we still don't understand which ones and having this effect so and it turns out all our ancestors had this blastocystis parasite and if you look at all the data whether it's modern day you know hunter-gatherers or most of their world countries 100 of the populations have blastocystis and modern living has wiped it out and you know they even see big differences between you know MidWest America and California there's you know where healthier people are it's a sign of healthy diets and Healthy Living it's uh it's fascinating this is just one element of all these other you know we know nothing about the fungi the parasites the viruses the phages that are doing all this stuff as well so uh let's you know we can't get ahead of ourselves we could just stick to the basics as we as we learn and understand that you know we've all got different makeups and um different bugs inside us that could be doing different things right the insane complexity of all of it seems like a a perfect um Dynamic for uh introducing the tools of the emerging tools of artificial of artificial intelligence because they're so good at crunching massive data sets and and dealing with you know complexity at this kind of scale has there been any inroads with these these kind of emergent tools and how they might apply to this field well we've we think we're just about got to the level so we've now got we've been looking at our latest paper at 50 000 uh still samples from the US and the UK people have taken the Zoe tests and with those numbers that's that's that's where you start to get this real power and so we're just starting that Journey now to try and understand it and link that with the health outcomes but in a way we are we're doing this on a small level with our with our studies at the moment it's allowed us to work out what we think are a healthy microbiome looks like in most people so what's the sort of key ingredients of a healthy microbiome which has been quite elusive um so we you know we've got a list of good and bad microbes that's getting bigger and bigger that we find if you get that ratio right that's that's right that's associated with all these good Healthcare Health outcomes and associated with these um healthy foods as well so it's the link between the foods the microbes and and the health outcomes right right right right but you need these big data sets you know like we did in genetics before you really start to get uh the clues out that you know if you're dealing with just hundreds of people it's just we have too much variation to be able to deal with it right and and those big data sets you know introduces this idea of of Citizen science and you know I want to get to personalized nutrition but I don't think we can really talk about that until we kind of uh discuss the you know the impact and the potential impact of of what this whole emerging world of Citizen science is and the the kind of Advent of these Technologies by Dental Zoe and you know other you know other kind of uh things that are out there that are allowing you to run you know incredible uh incredibly detailed experiments at a massive scale unprecedented in the history of science because um you know will and I were chatting the other day and he was telling me like listen in testing or in science historically you can have a small population of people people that you kind of control and you can get very detailed information out of them or you have population studies that are very general and basic because you lack that level of detail and control and now because of these technology platforms and you know in particular what Zoe is doing you can get both you can get the best of both right which opens up a whole new world of you know kind of data analytics and the power of of the results that you're seeing to you know create predictive outcomes and and again like diagnostic tools yeah I think it's it's a real game changer in science because you know in a very short period of time we've built up the largest microbiome database in the world without uh doing G you know microbiome sequencing on two and a half thousand people a week and doubling that very soon because in a way people are paying for those tests themselves and they're all signing consent forms to say they agree to share that data for science so that you know it's not just lost as it would be in any normal medical clinic or uh private facility or whatever so it's all going back into a large database that we you know we've published I think Zoe's published like 40 papers now on this kind of data so it is a whole new phase I think of science so rather than waiting five years to get a NIH Grant or um so slow you can do this in real time and get these results back and I think my eyes were open to this um you know we'd started Zoe but then the pandemic hit and um 2020 and obviously everything's all our clinical studies stopped on the Twins and so while cycling home in London I had the idea of uh asking repurposing the the sort of Zoe app which was based for nutrition to understand covid and get covered symptoms Etc so it was a bit of a wild idea but my colleagues George and Jonathan loved it the whole company loved it and so in five days we built this app which um went live totally RAW full of bugs you know and thought it would flop at least we'd done our bit and we had a million people download it in 24 hours so wow one of the biggest sort of how did you manage that social media um everyone shared it so this is a great idea it was the first day of the lockdown in the UK and uh we launched a week later in the U.S and within two weeks we had two million and we eventually got up to four million people using this app uh at a time when there was people wanted to unite to do something and the government was useless um you couldn't go and see your doctor you know you were told to stay at home um you couldn't get tested so it it just struck a chord and we were told no one it was over 60 is going to use an app right that was the other thing to say well you know technology is not for oldies you know they have to you've got to send them a web page or you know or a questionnaire prove that wrong you know we had people in their 90s doing this um and it it absolutely took off and so it became the number one tool in the UK for knowing out where outbreaks were happening and what was going on and we learned also what the new symptoms were which were not what we were told from the original Chinese uh variant and so just in real time we were seeing uh as people reported on the app rather than old-fashioned science of questionnaires and you know waiting a year to validate the paper and whatever in real time we got a system worked out with the team at Zoe So that we knew that um loss of smell for example was being reported by you know a third of people who had you know had all these other symptoms of covert or tested positives right so that's the origin of of how it was determined that loss of smell was a thing right it came out of that originally the clinicians noted it in Italy so they were saying it was strange I've got you know ENT people were saying I think the scenes something must be happening here but they couldn't tell couldn't do a proper study so um it was a combination of having that real data in millions of people and we presented it and you know suddenly who and all these other countries around the world changed their criteria it was it was the UK was the slowest to change but interestingly because they they hadn't done the study themselves but um that was that was a wake-up call about how fast this new way of doing science with new technology with apps citizen scientists working together could do so much and we did lots of other stuff um that I'm really really proud of the team for doing as well as the other symptoms we found delirium in old people was a sign children got very different symptoms we we looked at skin we we asked people to send pictures of their skin rashes with covert we've got 30 000 pictures wow um and she formed an atlas that you know people could see around the world um we 've some it was covered tongues so people were sticking their tongues out taking pictures you know and suddenly people felt engaged for the first time they were doing something and I think it was really important we did a study that would have taken you know five million dollars and five years to do where we we asked a million people to fill in a diet questionnaire um in the US and the UK and and look to their severity of covert they got you know a year later and with that data we clearly showed that dark quality was one of the biggest factors in determining uh how you were likely to die or to stay in hospital have really serious covert a link with the immune system and nutrition so this is all done at the speed of light we were writing papers right in a few days yeah shocking I mean so four million people how many people are on the app now uh we have about still about 300 000 still logging uh daily and we've but we've it's so it's three years on now um it says obviously come down from the millions that were doing it but we've repositioned it into a health study app so we've we got consent to study more than just covid and we're now using it to do other lifestyle factors so we realize it's potential and so um we for example I've just finished a study on intermittent fasting so we've got 140 000 people to agree to change their method of eating to eat in a time-restricted eating window of 10 hours and we repurposed the app and and gave them so they could fill this in and tell us how they were doing in terms of their mood their sleep their appetite their way to any other any other factors we wanted to and uh got this launch really the fast and amazingly most people and they could do the fasting whenever they wanted so we're also looking it's a way of looking at not just does it work but how practical is these you know because you have these tiny studies done on 10 people mm-hmm hand-picked volunteers from Stamford I mean working you know really extrapolate from generalized meaningful yeah so it was really cool to see how many people managed to do it and I think it was about 80 or something managed to do it for at least three weeks at least you know five or six days a week of just eating in a 10-hour window and you know we're still writing up the paper so I can't give you all the um the details but it was super encouraging because the people that did manage to do that 10 hours you know reported all kinds of benefits on some of their GI Health you know many less bloating uh mood improved and interestingly appetite didn't go up because well told well if you and there were differences between men and women differences in different ages but the fact we could do this massive study um at very little cost uh in in such rapid time really means for me this it really is the future of how we can particularly do subjects that don't get the funding you know the the sort of studies about who's gonna who's gonna give you big money to do meditation right uh yoga right right right um five minutes exercise or um going to bed earlier or uh you know cutting back on alcohol or you know just seeing what are the practical cold showers you know who knows you know these things you get you know that you get the aficionados who tell you yes you know the dedicated Guru say if you do this it always works all anecdote what about the real you know the person on the street how good useful is it for them how easy is it to do fascinating the people you know because we're told like intermittent fasting works better if you um you you do your fasting later at night so you don't eat after right right yeah like that 10 hour window when is that 10 hour window and what are the age of these people and what are the foods that they are eating when they break their fast there's all kinds of variables and then beyond that there's adherence issues and are these people even being honest with what they're reporting none of these things are useful if you come in here it's like diets right completely pointless if you can't stay on it long term so finding out that you know only about a quarter of people uh in the UK preferred to to do their fasting late at night I you know have an early meal and then uh most people it was easier in their lifestyle to like delay or skip breakfast and that's just really useful to know that saying well actually for most people even if it's not quite as good biologically they can keep probably keep that going for years so it's much better rather than this purest idea that this is the only thing right people like what's what's replicable and sustainable uh yeah and if you do that then are you eating it you're you're probably eating dinner at six or seven as opposed to ten at night and what's the implications of that but the real power it seems comes in when you when you layer on top of that all kinds of other uh sort of Biometrics from hurry variability the the the the glucose monitor that's showing how you're metabolizing you know your food resting heart rate you know metabolic rate all these things with these you know kind of devices now that all you know establish a matrix of variables that you can then compare and contrast to draw you know a more more kind of intelligent conclusion from just I feel better or I slept better but well actually if I look at this you were your Deep Sleep Number increased or your REM went up or it went down yeah that's the next phase I think is to having shown this works at a sort of crude level is to try and get people to input you know either automatically or semi-manually some of these these inputs and then rework some of this data and we want to also with people doing the Zoe the paid Zoe program also start having some of these interventions as well so that you know you know every every wave of different week might do a different intervention so we can actually see well can you personalize some of these lifestyle things well can you predict who's going to do better are you is there a certain cold shower person is there a certain early fasting person can you predict who they are as well so I think the more you can combine these things together with these interventions as opposed to just observation um the more you can do it and everything we've seen is people are super willing to take part you know even if they've been paying money they they like the idea of being in these large experiments as long as you give them you feedback the data so in the past researchers like myself have been grabbing all the information you can and then five years later you get a little you know a note saying thank you we published it in nature you know you pray for God what it was right thanks for your help now it's very much you know you've done the study people want to know how they got on how they're compared to other people and it's this is what we have to start to do much better than we've done in the past but I think it's I think it's really exciting I wish we'd discovered this uh 20 years ago well these things happening yeah the technology has to you know be robust enough right and I you know to your point we are at the very beginning of this I mean I think there's you know there's privacy concerns there's other kind of issues that need to be kind of properly navigated um but it is exciting and I think it answers um a critical question uh that that I'm sure gets posed to you from your critics around like okay so you're making these breakthroughs and you're trying to understand you're understanding better what's happening with the microbiome Etc and everything that's going on you know on your platform but like why does this matter like how are we translating this into anything actionable like what is the reality of personalized uh medicine versus the promise or the hype and you know how close are we to kind of uh um bridging that gap between our aspiration and you know what we're actually capable of of providing you know the interested consumer yeah there's a plenty of critics of personalized nutrition which is what you know grew into as opposed to Medicine I mean because that's in a way the personalized medicine has been discussed before particularly with regard to genetics and genetic testing and things like that and selecting drugs on a basis of those things we won't remember the blood type diet yeah exactly a fantastic example that's right um so there's been a lot of rubbish yeah but the the new era of personalized Nutrition a we've we've published you know peer review papers in nature medicine you know high quality journals to show there are these big individual differences that are real um we have uh performed a randomized controlled trial of sort of unpersonalized approaches you know the standard U.S advice versus uh people doing the Zoe program um who have unblind to the results but I'm looking at it I'm very confident they're uh they're going to be good so the randomized control trial is the best way to to tell whether it's better than you know uniform advice um and I think the other the other reason is that as soon as something's personalized to you you're much more likely to take um believe it I think that's what we've shown in all of these all these citizen science ideas that if you can make it this is your response it's not just the average response it's not like everybody you know who goes on this diet does well we know that you respond to this you will do it so your adherence to it is much more like your your level of belief is so much higher and if that's backed up by science then um I think you know it's inevitable it's going to happen so these critics yes we need to do these big studies we need to do the randomized controlled trials these critics are generally you know hanging on to the past and old style nutrition and they will be dropping off this this is absolutely the future and um I think you know yes we won't be able to sort out all the problems um you know we're a long way from I don't know working out exactly how much protein every individual has because we don't have ways of measuring protein response in the body and things but you know for for glucose uh and for lipid levels and and assessing how much those people need I think we're we're doing a pretty good job now so um and you know I think the studies will show that people um feel better anecdotally where the people were saying they felt better and the randomized control trials actually are saying saying the same thing and uh I think the bit we've always been forgotten about nutrition which we didn't know is things like energy um it's never really been asked before in nutrition trials you know what's your mood and energy like when you change from say a high fat or high low or you know whatever it is you switch around to something that suits you and you don't get these spikes in your sugar or you don't get this you're triglycerides hanging around your body which means you get less inflammation we're seeing that in everything we do is this this report of I feel more energy right and I think that's that's that's really important so it's not just about weight and uh you know the the sort of external stuff it's it's finding out what foods make you feel good and well you know this from running you know yeah of course of course people do this by trial and error yeah that the average non-sports person in hasserole and other other tricks to do it may not have thought about it in the same way as a performance athlete right um one of the diagnostic tools that you're using for this is the continuous glucose monitor um and that you know I want to talk more broadly about metabolic Health in general and how that relates to the microbiome but with respect to cgms um there's there's a lot of squabbling around that as well there's a certain kind of subset of the type one diabetic community that that seems unhappy with the fact that this is available to to Consumers more broadly and I you know I believe that that comes from perhaps an affordability or access perspective there's another kind of contingent of people who don't like it because they think that uh you know kind of uh an undue fixation on CGM metrics alone paints uh you know an incomplete picture of what you should or should not be eating Etc um and there's you know kind of the whole the whole like biohacker Community around it that's drawing uh conclusions that aren't necessarily completely solid because of an over Reliance on on that variable over kind of a matrix of of complementary values so can you talk a little bit about um the benefits and and perhaps the limitations of the use of a CGM like I've used it I found it to be super interesting um I I drew a lot of you know kind of um non-intuitive conclusions about my lifestyle habits and certain foods that were contributing to spikes and valleys Etc but I think without adequate education it's very easy for a consumer to perhaps adopt less than Savory dietary habits because their sole focus is on like flattening that curve we agree on that um so you know for anyone who hasn't tried it they are an amazing educational tool about how your body works okay so it's it's like you'd suddenly do this amazing science experiment on yourself and seeing how your body's reacting in real time which is kind of you know it's amazing really you ten years ago you wouldn't have dreamed of something possible and and we think that within five years you know most of the smart watches might actually have some capability to do this as well so it's not going away um like any new technology it's going to be misused by some people or overused or over hyped Etc and yeah certainly for the type 1 diabetics there was a time when they run out of Supply so they couldn't get it absolutely understand why they were angry people just do it for fun when you know they're risking right you know fatal hypos without them so they're incredibly useful but the um they are a complaint against uh Zoe was that they weren't very reliable we did a study where we gave 300 users uh one on each arm and looked at those and they they worked out really pretty well for the purposes we're using it um we've also looked at whether you know compared to standard blood tests they are do they add anything to just taking a baseline blood sugar and insulin level on a hba1c and by looking at over your two weeks your time in range and the Very glycemic variability You can predict who's unwell or not better than those Baseline tests so there isn't we've shown there's a clear Advantage even in normal people to having them as a predictive tool there are lots of ways of misusing them I I agree that if you don't have a clear program with it that puts it into some context you would you know using it just as a toy uh you reach some wrong conclusions and one of the common ones is that the only way to eat is to have a completely flat uh right you eat a hundred percent fat diet like you're gonna have an awesome curve right you just be flat exactly you just put ice cream on everything yeah whatever it is and you know you just just cream on everything you sort it out and clearly that's wrong and it and that's why starting with Zoe we we see it's just one of the of these three tests really it's it's it's one part of the your score is your glycemic score but we need to know how you handle fats uh and that's why the Zoe test has a blood spot and your six hour triglyceride test see how much is hanging around and of course your gut microbes and those you know we need a more holistic view of it rather than getting obsessed about that one increment of it because you have to if you are going to control your blood spikes for sugar you've got to make sure that you're not giving yourself too much fats you're tipping that so your your fat to hang around the blood you're going to get atherosclerosis and inflammation and also the foods you're eating are also good for your gut microbes so if you have a more holistic view of it then I think it it it it is reasonable to use these and I think they are a great educational tool to show people that some of their common things they were eating like their standard sliced loaf bread which they thought was super healthy is giving them this massive Spike which you know what mine looks like if I had Supermarket bread and certain fruits for example that they thought were super healthy and like me you know bananas you know which I used to take as my standard every single day fruit not particularly good for me I think these are things are useful because they start making you think about food in a different way and I think but out of context I think they can be dangerous to some people but if you think about it you're also getting about your fats you've got to think about how good that food is for your gut microbes and except that you will or yeah you can still have some sugar spikes every now and again uh it's normal that's physiology let's not get obsessed about it but um seeing it in real time is is kind of cool and that's a glimpse I think of the future you know they'll assume someone will invent a lipid test in real time and it'd be on your watch soon so you'll be able to see how these right all of these different readings about what's happening in real time within your body I think it's inevitable which is interesting and fascinating but like a real basic question here is like why should we care about this like we see you know let's say you have a CGM you see the you know the the your blood glucose go up it goes down why is this important what is metabolic health and why should we you know be paying attention to this in the first place these spikes in sugar and or triglycerides are part of normal physiology so you know our body is designed to do that way but if there's too many of them and the spikes are too prolonged you either get a build up of so the sugar spikes will create rise in insulin which can can start getting um insulin resistance and long term you might end up more likely to get diabetes pushing you towards pre-diabetes Etc and that build up in triglycerides are particularly related to inflammation and you get inflammation the blood vessels over time that stress builds up and again heart disease and other metabolic problems so it's the idea is that if you can calm that down so you're not having as many of those spikes in a day then your inflammation levels are lower and we've shown that they are related to blood inflammation markers you will reduce your risk of many common chronic diseases most of which are related to some extent to what we call chronic inflammation the sort of low level stress in the body and other Studies have shown that people who have are prone to these sugar spikes end up long term with more diabetes and heart disease so there are there are sort of links you can make epidemiologically we also know that some of these big spikes we showed there's something called sugar dip so one in one in three men one or three women one of four men after a car be say breakfast or or lunch three hours later will have a dip below Baseline and you say well yeah that's not willing to worry about but we we followed a large number of these people and it turns out they um report being more tired uh they don't know what they was out they were blind to their result they were more tired um they were more hungry and they over ate by uh about 300 calories that day so these sugar dips which you get from higher refined foods and carbs are actually making you overeat as well so they over time will make you gain much more weight than someone who's not having these uh these steps so some people even more susceptible than others and what is the relationship between metabolic health and the microbiome like how does a robust healthy microbiome in turn help you maintain a healthy uh you know a a healthy metabolic you know sort of uh profile we don't know is the is the true answer but we do know that uh all this epidemiology studies show that people with poor metabolic health so with type 2 diabetes with obesity with high blood pressure with autoimmune disease inflammation all have low diversity microbes uh poor ratios of good to bad bugs so there's a clear Association there and then you can do voice studies in mice to show a cause effect relationship of these sort of inflammatory microbes that are maybe producing chemicals that are making the whole problem worse so it's a bit of a vicious circle so the microbiome reacts to meta people with poor metabolic Health end up getting unhealthier microbes but we also know that having unhealthy microbes makes you more likely to also have poor metabolic health so it's it's it's a you know it's both cause and effect relationships so we don't understand exactly how they do all this um there's so many chemicals involved so many microbes involved that um we don't yet know the details but we do know that this is very clear associations and that you can improve metabolic health so dramatically in a lot of animal models by improving the microbes or uh things like fecal transplants and mice and things like this so right so in other words if you if you are are getting indicia that that um you're having some level of insulin resistance um the immediate kind of first thing to do would be to make sure that you're getting 30 varieties of plants in your diet like improving the quality of your microbiome which in turn may have some positive impact on buttressing against that insulin sensitivity is that is that a leap or is that no I think but that's a that's general for most of the chronic diseases that are relates to inflammation so yes we know that people who have poor metabolic Health have pro-inflammatory microbes they have species that actually Thrive off you know the stressed cytokines and and all these other stress hormones and if you can if you can change those and get some of the good guys in there instead and drive down the bad ones you can reduce some of the the impact of those diseases so these haven't been studied in big enough nutritional trials yet but everything points to that is that is the direction we should go in it so far we for most of these disease they don't seem to be very specific microbes that are involved it's more the general Community is is all changed so it's just the environment has just shifted and it could be something subtle just by changing the pH of the gut just a fraction makes a big difference between it being in a beneficial or pro-inflammatory and itself producing more of the problems that's fascinating and you know as this continues to scale up obviously you'll continue to learn more right yeah you know um Christopher Gardner I know you're probably going to be talking to him soon did it really a neat study where gave intensive amounts of fermented foods to um to volunteers and looked at their inflammation and immune levels over the next few weeks and they showed one one arm was given just fiber and the other one was given fermented foods and both groups improved to some extent but the one that had the biggest immune impact and reduced inflammation was the fermented foods group so we know we can change in just a few weeks quite a lot of these these basic mechanisms that are important to so many chronic diseases and yet most doctors never suggest these as treatments they always you know reach for the uh the Prescription Pad it's amazing how fast that is too yeah how mutable it really is that was the surprising thing that it just uh it was it was four weeks of intensive meal deliveries um so they knew you know they were getting this this stuff uh and then they had four weeks where they were just trying it on their own but it was um uh you know the results really were very striking and that's what it had a really big impact but no one had done those studies before which is so shocking as well right right right because we just said oh that's just yogurt that's not real treatment you know that's uh that's hippie stuff you know we don't we don't believe in that but these you know luckily they did all as a huge range of blood tests and and microbe tests so yeah in a few weeks you can really change your your gut health and influence disease and I think that's that's the message and this whole mess about why you know medicine might why food really is medicine and we should come back to that you know not start saying well that you have to be a Nutter yeah you know did did Hippocrates actually say that or is that apocryphal uh we don't know I I haven't seen his original text yeah but uh it's nice to think he would have said it I I like to believe that as well um the other uh kind of really exciting interesting field where we're seeing a lot of exciting developments is in at the intersection of the microbiome and cancer research right so um explain a little bit about what's going on with that um specifically with respect uh to melanoma and to some extent um even lymphoma right yeah but it all comes down to this new approach to cancer which is to realize that it's actually an immune problem rather than a sort of mutation problem um because we're all getting micro cancers all the time and our immune system if it's healthy is picking them off before they get too big and so that's why the immune system aging and cancer I've got this sort of close link we've never really um realize how important it was until these immunotherapy drugs come come along these so-called checkpoint Inhibitors which have been sort of game changers for many people with some of these solid tumors uh particularly melanoma but to less extent kidney and Lung and some prostate that you're using these drugs to boost the immune system to attack the um the cancer cell and get round its defenses and um so you know mortality rates were sort of you know not 95 percent and they've these drugs have really changed it so they're sort of half you know they've halved doubled the survival rate in in the in these particular conditions it doesn't affect most cancers but these ones and what we've seen is that the there were some early studies showing that the microbiome had might have a role in this and that the state of the microbiome was was important uh because it was interacting because as I mentioned how important it is for the immune system uh and you want a really powerful immune response in order to fight that cancer for that drug to work so a few early studies of this suggesting this might be the case and uh we got together with a UK charity and got a Consortium of um other uh cancer centers in the UK and the Netherlands and we've got several hundred melanoma cases end stage these are people with terminal sort of metastatic cancer going through that immunotherapy and saw how they did over a year and it turned out that the state of their gut microbiome at the beginning was one of the biggest predictors of whether they would survive or not and as expected it was you know the good to bad ratio loss of um diversity and we also looked at their diets and it was the lack of fiber and positive aspects those that followed more Mediterranean diet had like double the rate of success of survival and you know these these figures aren't trivial it's not a tiny amount if you know real difference between double your chances of success of reaching 12 months wow and yet how many patients know you know the importance of this uh yeah yeah yeah it's interesting how many oncologists discuss uh diet as in in such a powerful way and um there's you know there's been some studies in in for chemotherapy I haven't been very clear or very large which is you know this where you just sort of try and kill all the cells um and there's some hospitals like I think it's um Sloan Kettering um or OMD Anderson where they they actually if you're going through chemotherapy they will take a sample of your gut microbiome and they'll store it in freezers you have your chemotherapy then they give it back to you as a booster and so and they've got data that improves survival as well so I mean that makes perfect sense it's common I mean you're saying it's immediately what I thought of like no matter how robust and great your microbiome is if you're going into chemo or radiation it's going to get obliterated right so to culture it and be able to you know supplement or kind of you know a lot you know have have a way of repairing that as you go along would seem to be kind of crucial and obvious and I think we're all going to be storing our microbiome when we think we're out our healthiest it's always hard to know yeah well trust me I'm going to get into fecal transplants like we yeah we should all we should have Banks where we're where we're storing this stuff at our healthiest right so you know when we Face some kind of Crisis we have the ability to kind of Turbo Charge our our microbiome and in turn our immune system so that we can meet whatever we're facing in the best way and as you said there's some other examples in lymphoma some called heart therapy is very complicated uh using T cells and the microbiome again is proving crucial in those uh yeah lymphoma just like a type of leukemia so I think we're going to see more and more of this and I I'm I think the cancer area is one that the public can really relate to and this might be finally the barrier that gets it across to the medical profession how important uh diet is and diet and gut health because Medics are still not being taught anything about this this whole area and nutrition is still sidelined as a minor thing but if we can show how important it is in cancer then hopefully everyone will be convinced and the word will get out but cancer patients are traditionally told to avoid fermented foods right they are yeah they certainly are in many places and I get lots of complaints from from patients saying um because what is the rationale I think it comes the days when at some point in chemotherapy you you you are very vulnerable to infections and so you have very few white cells to to fight infection and so they're worried about introducing bugs and obviously at that nadir in your treatment you don't want to be given large amounts of microbes but for the vast majority of people most of the time these fermented foods could actually be saving their lives so there's a lot of misinformation out there and that um we need to you know get oncologists and and doctors up to speed on on this this new area and it's moving very fast but fermented foods are really good for your immune system and as far as I know that you know they've they've never killed anybody who isn't who's got a few you know decent white some white cells yeah so so paint the picture of of what the future in your mind looks like from a personalized uh medicine perspective and a diagnostic and treatment perspective when you're able to perform you know really uh dialed in specific citizen science and you know data crunching to you know create um to create really powerful tools to treat better in a more bespoke way I mean what does that look like and you do like I'm imagining how far well maybe like you know 10 years from now and 50 years from now like I've I've had futurists on here I've heard you know like I think what's happening 10 years I'm sorry well like you know there's a lot of interesting breakthroughs and developments in scanning and early detection and all of these things that are I think are really powerful in terms of catching things early on like so much of what we perish from uh is avoidable if we could have caught it earlier and you know kind of the technology is getting to a point where we're going to be able to detect these things so early on that we can you know deal with them in a really fast all manner you know before they become problematic uh but that's really true yeah that's yeah early treatment right and and what you're talking about is just another piece in that in that broader puzzle um in terms of like where medicine and Health Care are are heading but you know what is your what does it look like like from what you're seeing well I'd love to see more about prevention rather than sort of early treatment and reverse you know the major threat to the Western World which is our poor diet which you know is is essentially killing us and uh giving half the population the US you know make diabetes and obesity and it's an insane statistic and so think about it you know Ultra processed food is is the number one killer in this and the studies are clearly linking Ultra processed foods and microbiome dysfunction and we've just let it happen you know we just let all these chemicals come into our food system uh without a proper testing and the science is now showing that many of these emulsifiers that glue stuffed food together the artificial sweeteners the sugar alcohols all these things that you see in Ultra processed foods have a negative effect on our microbiome so you know I'd like to see a future where we're not just fighting and ever an increasing number of diseases with with expensive MRI scans we're actually going to do something at a population epidemiology level to say you know these Foods they're like they come to cigarettes in the 1970s you know they should have health warnings on them not um uh health promotion benefits to say yeah yeah this is healthy because it's got some vitamins iron or whatever it is yeah fortified with vitamin C or D or should be warning says if it comes if it comes with uh some health advice it's bad for you you know that would be a good sticker um so I I'm really into prevention and I think we're gonna we're gonna see that the tools for you know rather than trusting in doctors that individuals are empowered to do this themselves I think this is the way it's going to happen and we've seen already you know how these devices are changing people's lives just in the last few years the glucose monitor there'll be the lipid monitor um we know all the major smart watch manufacturers are going to moving towards this they'll have laser devices that will be able to pick up different blood measures in in you in real time these will be fed back through algorithms in your phone and you know the vision of companies like Zoe is to also tell people not only what's happening to their body in real time but what they're eating in real time so with the complexity of the ultra processed food it's very hard to know what you're actually eating how bad is it how many of these chemicals are bad for you are you the one in three people that reacts to carrageenan you know which is an emulsifier that will glue your microbes together but not other peoples you know which artificial sweetener if you have to have one you know would you have this per level of personalization can only be so complicated you need apps and advice to be able to do it to guide you through it so I think we'll be using these devices to find our way uh through the food jungle point us to say what ideally we should be eating keep us logged about how that you know how well are we doing in our 30 plants a week hints of new things to try and telling us when we should be taking our exercise um relative to where our last night's sleep was um everything should be optimized but also not just making us robots but making us more intelligent more educated about what we're doing so that we realize you know this is an evolving science and it and if everyone is part of a a giant citizen science project then everyone benefits and I think that's that's my vision of the future is that we will have this sort of benevolent um companies who like there'll be a group of people who can pay for all these tools but that information will pass to the people that can't pay for them and they will get predicted scores that are free and um we'll we'll move to a time when this is possible so realizing that you know as we talk about cancer yes you can have an MRI scan that can detect that cancer early but wouldn't you be better to know how to boost your immune system so that your immune cells do it beat that cancer before it seemed detected by the MRI scanner and rather than rely upon the food pyramid that's the result of a political process to have a personalized food pyramid that is specific to you and you alone which is what you talk about in the new book yeah I think this this is definitely the future but it but it's also understanding what the foods we're eating and you know and moving away from this old-fashioned idea of calories well let's talk about that like it's a good segue into the new book but let's bust a few diet myths right like macros calorie counting like come at me like I I know you got a lot to say about this kind of thing they exist but you know their importance has been massively hyped and the idea you can describe food buy calories and buy macronutrients has been exploited to the nth degree by the food companies and that's why they can sell us all these products with these Health claims on them when we know they're rotten they're artificial you know they're just they're fake food but because they have the right macronutrients on the label they get a nice tick and we're we're poisoning ourselves so I think you know we haven't really changed in a hundred years uh basic concept of how to discuss uh nutrition uh properly and it we're only just starting to get into this discussion of what Ultra processed food is and the different levels of food processing which the food industry doesn't want us to discuss because the last thing they want is some definition that they would have to apply to so they are keeping money in the water on it so the the fact that they you know the companies um you know discuss this in the book you know love the idea of calories they love calorie things on menus and they're describing food bites as if you can tell if it's food good or bad by its calorie count and its fat content it's complete nonsense there is no real correlation and there are good and bad fats and there is good and bad calories Foods you know we need to be focusing on the quality of of food and that's totally clear um like the example I gave you in the Zoe study of people given an identical calorie muffin and some people react to that in a very different way and get a sugar dip and we'll overeat by 300 calories later in the day others won't if you describe food purely in terms of that all calories are equal and you just gave everyone these bad bad foods you wouldn't know that that this is what this effect they're having on mood and energy and everything else so smoke screen that we just need to get rid of and we need to start talking about quality of foods and what's Whole Food you know what's a whole plant food not these foods that are made in a way to falsify real food you know they're they're they're designed to reformulate actual food using fake ingredients extracts and I think that's you know no one denies that calories exist but you know we can go into the whole thing about why calorie diet calorie counting diets failed the vast majority of people it will work for a few weeks then your body just readjusts just as uh and bounces back the same way um exercise for most people does the same because your body adapts to that exercise you know we're not just furnaces we're finely tuned machines that change so these are Concepts that have just stayed because of the the market the force of the calorie counting diet Market the force of the food industry to undersell us worse and worse food with more and more Health claims and I think the science is now out there to show how sort of irrelevant they are and how they are just a smoke screen yeah it there's sort of a an arms race also because as the public becomes increasingly more and more aware of the the ills of ultra processed foods at the same time the giant conglomerate food companies are getting better and better and better at dialing in palatability and The Addictive nature of these foods with the exact recipe or combination of salt sugar and fat to kind of light up the dopamine centers and make it impossible to just have one so it creates this this sort of compulsive relationship with Foods we know are not good for us and yet we find ourselves powerless to deny right so education takes us to a certain place and you know human Frailty and weakness uh you know accounts for the rest so you know it's it's sticky to like I've got no I don't really have a beef with foods that are obviously unhealthy but super tasty right um but when something is wrapped up in a in in all this healthy packaging and is sold to you as a healthy low calorie low-fat alternative that's you know that's criminal um it's it's it's like dressing up cigarettes as uh as healthy because they they're low in like used to be low tar or low nicotine therefore they're fine right yeah that's that's sort of the Tobacco Company version of greenwashing it makes us just feel a little bit better about that purchase you know making that purchase exactly so you know let's have we're not going to get rid of them but let's let's have them with health warnings let's have them with the tax that reflects the huge burden on the on the taxpayer that all these foods are costing us you know so it's hundreds of billions of dollars a year um just because of we're eating these foods and why should the taxpayer be basically paying for all this when the food companies are making all the money and you know and they're getting massive subsidies to do it and whereas anyone producing whole plants and fruits is not getting those same subsidies right it's wrong right right I mean I agree with you completely uh but then it becomes a question of political will and kind of penetrating the you know the Battalion of lobbyists who are you know very invested in the status quo so well well while we're all getting diabetes and becoming obese and dying there will be a point by the country you just won't be able to afford it you know the Health Care system is broken so it's it is and it's a national SEC it becomes a national security issue honestly like it it's it's a really huge problem and yet it continues to persist and and metastasize which is disturbing but perhaps we can you know pivot to a more optimistic or or helpful uh conversation around like how to guide people towards those better choices I mean we all know more fruit more fruits and vegetables not seeds you know that's the kind of thumbnail but for the the the conscious consumer who's just going to the supermarket and shopping for their family and is on some level of budget what are some of the kind of guiding principles about what to avoid and and you know what to invest in well there's a lot to avoid um but in writing the book there were some surprising findings that I found that things that are relatively cheap that aren't always aren't always unhealthy so things in cans um many Studies have shown that some canned tomatoes can have higher nutrient levels than fresh tomatoes for example um you get a can of beans they're just as healthy as getting you know dried beans and doing them yourself and they're often extremely cheap really good source of protein most frozen vegetables and berries are also highly nutritious and really good for you and cost virtually nothing so um we tend to think of anything frozen or in cans or in packaging is all the same but it's absolutely not true as long as the sauce it is it doesn't have you know an artificial sauce in it it's going to be really good for you so that that was a surprising findings that many of these these products you can get out of season frozen berries for example out of the freezer really good for you um nuts and you know there's nothing wrong with nuts as a snack um and there's a big difference between some artificially created um snacks like I don't know you know things like Pringles which have very little potato in them they're actually made of all kinds of a composite of other things versus some Artisan potato chips that you can get that only have potato and olive oil or sunflower oil so there are some surprising ones in there but uh unfortunately the vast majority of ready meals that you buy have large lists of ingredients in them that you can't wouldn't find in your home and they're the ones that will cause you problems they will make you overeat and they will be bad for your gut microbes and I think that's a really important educational message that needs to get out there is that it's not about the fat it's not about the calories it's the fact they have this really harmful effect on your immune system and you're gonna eat more and more of them so they might be cheaper but you're gonna they're made for a purpose so that you'll be overeating your family and you will put on weight and have all these other diseases so I think it's this education about what's wrong with certain foods that are you know Ultra refined have the fiber vadal nutrients get into your bloodstream quickly don't fill you up and they're just plain wrong we weren't designed by Evolution to eat them right that so to my mind it's it's an educational um way of thinking but realizing there are some you know things that look quite similar that actually are still very good for people but they're not eating yeah um your dietary perspective and and recommendations although very plant focused and kind of plant-centric are not ideologically sort of driven and and they're not super strict in that regard they're more like this is what looks like the science supports and this is what I'm you know advising you to do and not do and an added wrinkle on top of that that I found really interesting in the book is addressing not only um how the food is prepared like have you cooked it is it better to eat raw or this is stuff I've thought about often like should I eat this vegetable raw or is it better cooked is it better to like what happens if you overcook it am I destroying all the nutrients in it and then also how is the food packaged what is the impact of you know food that's wrapped in plastic and particularly if you end up like heating that food up while it's in the plastic and you kind of address all of these which I think are you know kind of common questions we all think about but maybe don't pay enough attention about so can you kind of unravel some of that uh well it's a lot to unravel yeah I mean there's it is I mean you can read the book but like maybe some sort of general principles around that yeah well I think a little bit comes down to understanding a bit more about the structure of food and um cooking changes the structure of food so yeah there was a common misconception that raw food is better for you and the raw food movement is led a lot of this and but all the science suggests that actually lightly cooking food is the optimal and so lightly steaming of food breaks down the structures allows the nudes to come out without destroying some of these vitamins and nutrients and these polyphenols we talk about these defense chemicals that are in all plants that are really rocket fuel for our gut microbes that are really what we should all be trying to get more of that definitely aren't in Ultra processed foods so understanding the structure of food and how you're cooking is really important understanding that you know freezing stuff even microwaving is fine before I researched the book I would sell and I got rid of my microwave I thought this is terrible you know so um but it turns out that actually it doesn't destroy nutrients in any way it's actually good and it's much better for the planet so in terms of the energy used you know if you say a baked potato in a microwave it's much more efficient for climate change to use from an energy expenditure taste the idea of like having a microwave but go ahead but well I was like you you know but in a way having researched the book I've said well if I care about the planet I should use both of these tools you know and um and not be so obsessed with uh uh my prior beliefs so structured food's important how you cook it's important what you cook it with so just combining Foods together will change their um their nutrient value as well so a lot of these Mediterranean dishes would use olive oil and garlic and onions you know collectively they actually produce many more healthy chemicals together than they do when you have them alone chopping up your garlic uh 10 minutes before you use it actually trebles the amount of um these uh really beneficial nutrients in in the garlic that otherwise would get broken down so there's all these kind of funny weird stuff about structure of food is useful for people to know in everyday life about how to cook things um yeah obviously cooking stuff close to Plastics and and you've alluded to some of this you know the problem of microplastics is something we should be aware of we don't really know enough about it except there's lots far too much plastic around and so limiting the plastic that's close to our food um is also important um and I I think the other thing I I realized is that no one had really written a book before that looks at all the different food groups and first takes health then takes the ethics so you know where animals you know engineer what's what's the what's the ethical basis of that or what a lot of there's a lot of new stuff about child slave labor for example chocolate and that and coffee and various other tropical things that we need to be aware of and also finally the big other area is the environment sure and it was a bit of an eye-opener because it's quite hard often to balance these three things when you're making you're going into a store and you want to buy something nice and you're trying to work out all of you know to get all three perfectly aligned at the same time is kind of tough and so particularly when it comes to something like artificial milks so I found that really interesting because I'd experimented with cutting out dairy milk and the main reason for me to cut out Dairy is because of its harmful effect on the planet when you calculate how many cows and methane and land land use Etc so it makes obvious sense to cut that out so I switched to oat milk which you know I didn't mind the taste of it seemed quite good but then I put a CGM on me while I was drinking oat milk and I saw it shoot up so suddenly I've swapped what was this reasonably healthy um fat mild sugar mixture for a a much higher sugar much more refined product meant that if I was having regular oat milk it would for me it'd be bad other people might be fine but it would that would be better for the planet if we all switched to open them but it would probably cause more um have some disease consequences as well so there are lots of examples of how tough it is to balance some of these things and you know are you going to get them from Mexico every every week are you gonna how do you freeze them enough and and where do you get the nuts from so it starts to ask a lot of questions not we don't have all the answers but I think it it made me think and I want people to read the book to to think about food in a very different way because the food choices we make every day are the most important choices we make for our health and probably also for the planet yeah 100 I mean every every purchase of food that you make is a vote for the world you know that that you know will be right so it would be great if there was some kind of metric or carbon score or some numerical value that we could attribute to each food you know sort of product food product that we buy that would kind of tally like what is the carbon footprint of this you know what went into the the manufacturing and distribution of this you know what was the the um amount of like water and acreage and you know all of that and you know were animals killed in this or like you know so it's it's impossible to put all that on the consumer and expect them to like really be able to make an informed decision especially when the large larger food companies are doing their best to obscure any kind of transparency around that but there are academics who have produced scores and we're working with them at Zoe and we do have a sort of beta score for all the common foods it gives you an environmental index and obviously the Zoe program is designed so that you you know you get your a general Zoe score and I've got my scores in the book for various things which is a combination of the three but so we're we're thinking uh sometime in the near future of adding in that fourth score which would be the environmental impact score so that people who wanted to prioritize environment above health or habit as a major factor could actually have that but it is so complicated it would be that does need algorithms and an app you can't retain all of this stuff in your head knowing if that avocado comes from Mexico or it came from California you know what's the difference or you know and also labeling is not reliable it could you know all the all the the obscurant language around labeling you think you're buying something that was grown in a certain way and you know it most likely wasn't and that opens up a conversation around you know a different um you know a different component of of the microbiome which is the sensitivity of our of our you know larger microbiome not just to the foods that we're eating but uh environmental toxins the air that we breathe the personal care products that we use Skin Cream shampoos Etc and not for nothing the pesticides that find their way onto the foods that that we're eating that we're not even aware we're consuming whether we're washing them or not um and there's a spectrum of of harm associated with that but you know how do you think about that and have there been studies done to give us a real grounded scientific sense of the harm or lack of harm like what is the level of concern that we should have around that well in researching the book I mean obviously looked at things like glyphosate and herbicides in particular because I was wanting to look at exposures that nearly everyone has had and the problem with this kind of study it's pretty hard to find people who haven't been exposed because whether you live in a rural area and there's lots of spraying around you or you eat a lot of vegetables or you eat breakfast cereal we are going to be glyphosate coursing through our veins all of us have glyphosate and yes the Studies have shown that if you have organic food it has a fifth of the glyphosate levels of non-organic food but you're still getting some so everyone's exposed to some love because it's just blowing around in the Wind from the neighboring farm and finds its way into the soil of the Arc of the organic farm and obviously as I start to eat more plants I get a bit more nervous about this because you don't get glyphosate on beef for example or you know um or meat you get a whole bunch of other stuff but but you know so it's but you obviously compensated by you're eating lots of plants or vegetables would think you're doing the right thing but if it's not organic you are actually ingesting more glyphosate and uh I I said whereas there are also certain types of plant where you get many more so if you like oats and I know Americans love their oatmeal uh in the morning think it's a healthy food um it has really high levels of glyphosate when people have tested breakfast cereals because oats and Rye to dry them out they they spray it out this way of harvesting it quicker so use for different purposes so I have a real problem with something that we're ingesting every single day of Our Lives what effect that has on our bodies now the science isn't the epidemiology isn't conclusive there's a suggested increases lymphomas and there are some there have been some court cases on that um they've done some mouse studies that show that it does affect the gut microbiome because these these chemicals were designed so they didn't affect human genes so they don't not supposed to interact with human genes but they're supposed to kill plant genes and they and as collateral damage they take out uh quite a few of our microbial genes as well so we are seeing disruption in the gut microbiome due to glyphosates and they animal models have shown that they do produce abnormal chemicals now that's really all we know at the moment um so it's nothing definitive but is sufficient to worry about and there have been epidemiology studies such as one in France where they compared a group of people having organic foods regularly versus non-organic foods and found big differences in cancer and um and mortality levels over over the next 10 years so there's enough for me to worry about um I'm also worried about microplastics um I think we don't understand that and they we do know that they do get into our gut and can cause disruption in our in our gut microbes as well and um they're also enough if you eat a lot of fish you know because you think fish are healthy and they go into that in the book you're going to be eating and if you go to a nice non-sentient fish like mussels uh and say okay I can eat those they're great they're really healthy nutritious but they've got a lot of microplastic in them because they they suck it out of the sea so we're sort of screwing up our planet slowly so all these good things um we're having a problem with but so you know I I think there is pretty clear evidence that um these pesticides Etc and uh are bad for newborn babies and and pregnant women and increase they've done some small scale studies evidence for the whole population isn't yet indefinite but certainly if you can afford it then definitely go go organic is my advice it's it and unfortunately in most countries it's still more expensive and that's a problem but yeah I do worry about that but having said that it's still better to eat vegetables and uh not worry about the pesticides to not eat the vegetables and the fruits yeah and you can go to the environmental working groups list of The Dirty Dozen there's a spectrum of of harm with respect to that if you're budget conscious about what what's the most important food group to be organic versus conventional but it yeah but for your breakfast cereal in the in the US is one of the biggest uh sources well you should just get rid of that of that don't just cross it off the list have a health warning like a cigarette packet and then say yeah if you have this at your own risk you can't sue us if you get cancer um what is your thoughts a big piece of let me preface this by saying um I think I think you know the scientific consensus is pretty clear that if you want that you want a healthy microbiome that having a robust and healthy microbiome is so crucial to so many facets of health and we're only uh and and that and that the level of that um relationship and importance is only growing as more science is coming out and a key component to maintaining the robustness of that ecology is a diversity of plants in your diet you talked about 30 plants a week um eating a diet that's high in fiber uh that is high in prebiotics and fermented foods which are probiotics Etc um and with that what is your response to this growing uh enthusiasm around what's being called the carnivore diet which is a diet that is if not exclusively meat is almost entirely meat based there's a lot of people particularly on the internet who are espousing the benefits of that saying how much better they feel how it helped them resolve whatever kind of chronic ailment they had and this seems to be more than a fad at the moment like there's a lot of people who are um very enthusiastic enthusiastically uh you know sharing their anecdotal experience with this well the good the good side of it is generally these people are not having Ultra processed foods agreed so they are doing some good in that where uh and I I also get people saying I've been on a carnivore diet for two years I feel great you know what are you talking about you need all these plants um we do know that people who don't eat plants a variety of plants have less diverse gut microbes their microbial health is is generally poor which means they will have a poorer immune system and so my my worry about the carnivore diet is that it is it may work short term they might feel better and not everybody I know some people who really can't tolerate those those levels of uh meat or fats and we know this is there's individual variations there are some people who can tolerate it and for a short while we'll feel better might lose weight might feel they're getting you know they're feeling stronger Etc and that I think that's genuine but long term they're going to be causing harm to their system their immune system because they're not nourishing those gut microbes they're you know the average American has you know only half the microbial species of say that has a hunter ancestors through antibiotics through poor Foods or Ultra processed foods etc etc so they're going to be denuding that even more and so that means their Armory of chemicals that they can use to fight infections to help negotiate their energy balance their metabolism Etc is going to be used up so whenever they have a problem they're gonna they're gonna be in trouble they just won't have the tools to be able to deal with it and have an immune system that I think is going to be wanting for most people I'm not saying there are some rare individuals who might be able to get by for longer than others without this problem for in general it's a problem and I think the other misconception is this is what our ancestors ate I mean I spent a week with the hadza tribe um about five or six years ago and saw it firsthand what these hunter-gatherers in Tanzania what they actually eat and you know I exactly as they did and you know I was filled up at about 10 o'clock with Baobab porridge which is um this this just falls off the trees and you mash it up with a bit of water and that's your huge high fiber Mass so you can't stop farting after that you know you're just so full of fiber using berries then at lunch time you'd have the women would dig up tubers which are like you know uh ancient yams I guess a form of sweet potato and that would be um lunch and then the guys would go out and do a bit of hunting and on top of that they would bring back some meat if they if they found any but the large periods of the Year they'll be having no meat uh and their most of their calories would come from the carbohydrates and if there's honey around they they didn't want meat they just uh they just went for the honey they just uh they stopped hunting completely they uh you know just satiated themselves on the honey so it's people have a very different perception of what our ancestors were actually doing and the majority of what their food it was was plant-based uh and carbohydrate-based it wasn't a high protein high fat diet and they have the healthiest gut microbes they don't get chronic diseases they never get cancer all these things that we've now developed as part of the West so so the hutter is for people that don't know uh an African traditional hunter-gatherer tribe that has been able for the most part to maintain their lifestyle and their Traditions amidst a rapidly and kind of encroaching developing world and they have the most robust microbiomes because they have a very robust environment and extremely diverse uh amount of plant life on which they you know pers they they sort of persist and exist right um but it's it's it feels like there's a there's a deadline on that uh what I don't know when were you there like it like it's the world is encroaching on them right and some of their Traditions are beginning to erode and their dietary habits are are starting to kind of shift as a result of that yeah which is awful the area they're in is getting squashed by people cutting down trees around them and posture lists moving in and of course you know they've got all these researchers around them now right everybody wants to study I have a guy coming in tomorrow who went down and lived with them also yes uh for different reasons but yeah uh so yeah I mean you know hopefully they will survive a bit longer but it they're sort of running out of room and uh they are the last true hunter-gatherer tribe really in um in Africa and uh but I think it's really important we do learn the lessons from them and we've learned so much about sleep and exercise and calorie burning and all these amazing things that have gone counter-intuitive to what we we believed we thought you know um the fact they don't burn many more calories than we do and you know um and they're not you know they're not running all the time either you know and they're happier and they're more connected to their community and their neighbors and their family members and I think for the most part anybody I know that's had any contact with them said you know basically they're they're happy they're doing it a lot better than we are exactly and there's you don't see a Beastie you don't see diabetes you know and they die when they fall out of trees or they get hit by animals so you know it's not they don't live to a ripe old age but um they don't really have a concept of age and it was just interesting and you know it was fascinating to see them you know I asked them when do you have breakfast and they didn't have a word for breakfast so this is again you know an invention of perhaps Kellogg's that we all have to have breakfast and uh otherwise you know we're we're not um eating healthily and so you know it is this last chance to see how uh we did evolve and I think they've been there for you know at least fifteen thousand years or in that similar sort of environment which is you know where are we supposed to evolve from you know around the Equator so um yeah it's it's a Pity but um yeah we've learned a lot from them and I I certainly did my microbes actually um uh you tested before and after right yeah so uh and I was eating everything I had so the bear bab the yam but you know we one day we it was porcupine was on the menu so you know um which is not something you get regularly and various other animals that I had no idea what they were but they they all got thrown on the barbecue but you were surrounded by animals and dirt and um they're the microbes as well so I think part of this is also their environment that we've lost as the soil the cities everything sterile you know we're not we need to go back to hugging trees and um uh Getting Back To Nature and that's why gardeners have better microbes than non-gardeners you know I think we also realize it it's external as well as what we eat as well it's important but um yeah about microbes um improve by about 30 percent in diversity while I was there but when I got back on airplane food on the way back but you know by the time I got back to London it had gone straight back to to where did you keep that culture though and store it for future uh proliferation I yeah I wouldn't have got food security yeah uh yeah I mean that that conjures up the next thing which is is is the future of fecal transplants like it does seem like there's something interesting there like if you can one the more we learn about the microbiome and the more we figure out how to kind of cultivate a very bespoke ecology for a particular individual the idea of these fecal transplants seems to be a really good idea I think it's a great idea and but I would say that The Hope and hype we had 10 years ago hasn't played out as much as I would have hoped um it is the number one treatment for a couple of conditions mainly really bad infections and something called recurrency def Clostridium difficile you get recurrent diarrhea 30 times a day usually caused by antibiotics overuse that is 90 of the time cured by you know a single uh transfusion of a healthy donor uh stool sample but they're not many other conditions where it's shown to be nearly as effective and the early hope that it would be a a cure for obesity has been shown to be false so you can't take someone skinny skinny feces and put them into a an obese person and make them skinny doesn't work um but isn't there there are some in disha around Cravings though isn't there with this or no there are autoimmune diseases well it it does work in a proportion of people with alternative colitis which is an autoimmune disease so that's the other hope because there's at least one disease where um I think it's about one in four or one in five people have remission so they it's like there's you know there's no sign of the disease after it which is pretty much as good as the drugs the medicines the immunotherapies that they're given which is is pretty good but it doesn't work for other related conditions um other autoimmune conditions doesn't seem to work nearly as well so we don't really understand what it is and it it could be that you know the microbiome of the host the person who's you know the sick person has to be so bad there's literally nothing there in order for the new microbes to colonize and take over and if it's too stable it's really hard to gain a hold plus the fact we haven't matched up the donor and the recipient very well and we don't know what the magic factors are so I think there's still time to do it but I think uh it's not looking as hopeful as it was um perhaps 10 years ago to be you know the Cure All For Everything But the exceptions to this are in cancer where they've done a couple of cases of people who survived metastatic melanoma responded very well to immunotherapy and they took their their stool sample and they gave that to people who'd failed immunotherapy and were about to die and a reasonable portion were rescued wow so there could be very specific cases for people who have very bad microbes where they just need that extra shot to to improve them so I think we're still finding our way and um trying to get around this idea that because we're so different it's very hard to come up with a sort of one-size-fits-all solution and they don't quite know whether to get 10 donors and put them all in a you know a magic mix and uh and serve up that soup or they should be specifically looking for certain microbes or you should be artificially producing these um fecal transplants and there are trials going many trials going on artificially to look at it but so I think cancer is the one area of the most open excitement and going back to the idea I think in the not too distant future everyone's going to be storing their stool sample maybe to use when they have cancer treatment give themselves the best chance and you know storing up the the people who've successfully fought off cancer against the odds and worked out what it is about those those uh microbes that are so good at helping that person yeah yeah yeah it it's um a nuanced game as we say but I think we're misled because a lot of people thought it was Secure for obesity right that a lot of people um were doing this on the internet and had some very bad results um another uh source of confusion uh surrounds uh the importance or lack thereof of of fermented foods we talked about the 30 plants a week thing I think there's a lot of people who think as long as I'm getting some fermented foods in my diet on some kind of regular basis I don't have to worry as much about the 30 plants a week or the diversity of of the foods that I'm eating how important is the fermented food piece and then on top of that how do we know that the kind of cultures the fermented cultures that are in these foods are actually efficacious we were talking about kombucha before the podcast or in these yogurts or these kefirs it'll say you know it has this and that in it but you know what is the pasteurization process like do these cultures you know persist through the manufacturing and distribution process of these foods such that they have any kind of viability once you know they're consumed so lots of questions there the um I think the first first one is I think to build a healthy gut microbiome you've got to get the diversity of plants in there as your numbers number one if you don't eat plants any amount of fermented food is going to really help you because the probiotic microbes in the fermented food don't actually stay in your gut very long they pass through and they as they passing through they stimulate the other microbes to produce helpful chemicals we don't exactly understand that because but we know that the microbes for example in kefir or yogurt are these lactobacilli they're designed to live in yog milk and yogurt not in your intestine long term so they pass through and they have to have a sort of collateral effect on that environment they just the reason we don't still understand they they make them produce better chemicals we discussed this Pharmacy idea they're sort of boosting the pharmacy to produce those chemicals for you is the is the current idea of what what they do and obviously the the greater the diversity of the microbes that are doing that the better your chance of it working that's why kefir has more microbes than yogurt uh perhaps 10 times more different species it's a more complex fermented food and cheese you know often has only two or three microbial species unless you get some exotic French ones which often illegal in in the US because they're they're too dangerous um and then you've got things like kimchi where the fermented food is you've got the microbes which are eating the cabbage and the garlic and the and the chilies and there may be maybe 30 different microbes in there including yeast and fungi and the difference with those Foods is that they're also Prebiotic because you're also eating the plants that are nourishing the microbes so they will probably hang around a bit longer than say just your kefir or your yogurt or your cheese ones um so and the kombuchas are similarly complex often uh between 10 and 30 different microbes species um but um how do you tell that so you want to study it's a little and often as the rule there's no point having a big once a week Feast you want to have a small little shots and I think studies suggesting that if you can get three small portions a day that's probably pretty ideal of different types of these fermented foods and how do you tell what the best products are it's really difficult we were discussing kombuchas and you know I was in a a store with will we were we were looking at some of these range great range of kombuchas in California but some of them just at the bottom just say oh gently pasteurized right so it's dead so probably if it's a little use although there is some evidence there are some microbes that do work when they're pasteurized but I don't think these ones have been proven to work and so checking whether it's been pasteurized checking its um the date how long it's shelf life is if it's if it's live it's not going to have a really long shelf life and so you pick up a kombucha you want to see where there's any sediment in the bottom is there something like a mini blob in there that's that could form and like and similarly other products if you're taking kimchi or sauerkraut make sure it's not in vinegar it's actually live and it says live microbes on it hasn't again make sure it hasn't been pasteurized even gently and the ultimate test is probably to try some of these either get a brand you really know and can trust and if you don't know them test them you know you can you can take the sediment of a kombucha and if you put that into a bit of tea and sugar and leave it for a week you'll know whether it's real or not similarly yeah if you take the end of a kefir um if it's live it should you pour it into a glass of milk within 24 hours that should have turned into kefir so there are ways of of actually doing your own little practical experiments to to work this out but it's it's a real um uh problem for the consumer at the moment there isn't right like the consumers shouldn't have to do that you know to figure this out like we we shouldn't have to run our own experiments to validate whatever's on a label or isn't and beware of artificial sweeteners as well in in a lot of these products because we know they're harmful for the gut microbes as well so you're doing some good and some bad you might you know have a better put up with a little bit of sugar not too sweet rather than having artificial chemicals which will have a negative effect on the on the gut microbes and what about a proper probiotic not as a replacement for a healthy robust diverse diet but as something as sort of a cherry on top in the book there there's a study that you talk about with respect to um uh covid and kind of outcomes around uh you know populations that were on a probiotic versus not on a probiotic so where's your thinking around that because there's also a lot of Confusion And there's a wide spectrum of products out there um and I think a lot of consumers struggle to kind of make sense of that world yeah it would cover the covered stuff first we did a again a survey about a million people and looked at their covert outcomes and whether we're taking vitamin supplements or probiotics and actually none of the vitamin supplements had a consistent effect uh on preventing the omega-3 the D what else did you look at like because there was a whole lot about like if you're on a team you're going to be in good shape vitamin C garlic tablets um um multivitamins but the one that looked like it had the biggest effect was actually regular use of probiotics this was an observational study so it's full of potential biases and flaws but you know it for someone in gut health and I'm biased to say well that that look looked like a good result for me um right I'll put that one in the book but um we did a few years ago we did a meta-analysis for the British medical journal and looked at all the evidence for probiotics um and there's absolutely no evidence that if you're healthy probiotics prevent you getting disease okay so for the healthy person to take them regularly probiotic capsules or or however you take them uh no clear evidence for healthy nor people they are useful there's some evidence that in um chill neonates early young children and El the elderly they can be beneficial so there's some randomized trials that show they are some are good in preventing infections or other problems they also are have shown to work in uh if you have for example some GI infections in Balance they do they do work there's some evidence they work in mild depression in randomized control trials so there are a few examples where in this this irritable bowel syndrome is another common there's some evidence they work a bit in the in these conditions now many people don't work at all it's it's not totally consistent and a lot of this is probably because each each probiotic is different they're protected by patents so um they can't be used by other companies and our individual microbes are very different as well so it's not surprising there's this big difference so although we can say that many of these conditions probiotics work I can't say which one you should take because the studies have included lots of different ones so it's but I think we're in a stage now where we're moving to the second second stage of probiotics there's some exciting ones that have come out of this new science because all these ones are very old we're talking about all the ones you see out there but um there are some new microbes like acamancia um for example is a bug that is shown to reduce blood glucose levels in Trials and actually works just as well dead as it does alive and it it's it's a very common feature in in the new in all the new microbiology we're seeing so I think the next generation are going to be much better and much more designed for human health than these old ones which have just been around on some company's Shelf with a patent for a long time so it I I'm not giving you a very clear answer but I think it's um I still think much better off taking your probiotics as food than as supplements because yeah because you're getting a bigger mix yeah of course of course and I appreciate the the the the the the you know kind of respect for the complexity and Nuance of all of this like you know our human brains want that clear-cut answer don't do that yeah give me the top and uh you're like uh not so fast you know even with each one like everything in this book like you know there is that layer of complexity that I think when you read it you begin to understand like why it's so hard to even tackle this subject to begin with like you how many years did you spend writing this book like yeah so I realized why no one else had done it and it's a it's almost in in this day and age a courageous act to like dip your toe into the world of nutrition and and make a statement you know because you know it is it is it is so difficult to provide kind of any actionable you know guidelines around it because the the science is you know is in many ways so in inconclusive and there's so many variables that come into play like you know in terms of and and the personalization you know aspect of it that is emerging that makes it even harder to say you should do this and not do this right but we do have to end this podcast so maybe we could do that with if there are any kind of concrete you know rules or or recommendations for the person who's you know brand new to the idea of the microbiome even being a thing and who's grappling with the idea of making you know healthier choices for themselves um you know beyond the 30 kind of plants a week what are some other principles uh that you could share because at the end of you know the chapters you do kind of like bullet point like here's some here's some kind of clear takeaways that I think would be helpful so top of mind you know what sits atop the kind of most important of those well we've covered some of them so obviously eating the rainbow is you know the colors are there for a reason and they're actually really good so you know don't eat beige yeah the only beige yeah go colorful um that's the that's the title of this podcast many bitter things are actually good um you know one reason coffee is so healthy for you is it's got full of polyphenols and you know I recommend coffee over orange juice anytime as a health drink should be in the health section uh dark chocolates another surprising one cook cook with extra virgin olive oil rather than any other oil don't believe all this nonsense about um heat heating points yes um the um the way you eat is also important so um we you know we've we've talked um about what to eat but uh time restricted eating we've discussed we didn't discuss that actually has a really big benefit on your gut microbes so all the studies show that if you leave a big gap um overnight so your your gut is rested just as the hunter-gatherer tribes did you know they're not nibbling uh snack bars or protein bars at night they're you know they're resting just as they're sleeping giving that full circadian rhythm real chance to real synchronize so I think that's that's an important part so there's reducing the snacking time less meals giving yourself you know at least 12 hours overnight ideally 14 is a good way for your gut to to repair itself and enhance um eating more slowly um we all eat too fast a one in five American meals are consumed in the car you know it's difficult to have a leisurely meal in the car um just you know wait do like the Mediterranean countries you know just don't have snacks wait and have a proper meal you know make it a social good occasion enjoy the food um and uh you know learn to try something new every uh every week you should be aiming for something something new is extra so part of this 30 plants is to discover new things you haven't eaten and you know get your taste buds to try something something new all the time and introduce that to your family and make make food something exciting rather than a chore because we all get into these ruts in our choices we find something we like and we think it's healthy we have the same thing well that you know our microbes don't like that we you know they like to be tested all the time so I think it's all about an adventure experimenting find out whether you're someone who does well you know with this long overnight fast and not snacking or whether you are someone who does need to eat there are different people are you an early morning person a late morning person try skipping breakfast try changing your breakfast for you know from a high carb one to a high fat one see how you feel trying to just think about how your body's working don't accept that everything's the same for everybody and I think the more we can all experiment and understand our bodies the better we get to understand food and live with it and and always think about your food now again in these food choices if you care about the planet really think about those those food choices you're making because as an individual it is the number one thing we can all do to save our planet beautifully put I really appreciate it final Thing Before I Let You Go would be around the kind of science that you would like to see being performed right now like what is the study that hasn't been done yet that you feel is most important to be conducted and and you know what is kind of on the nearer Horizon for Zoe and the research that's going on there that has you excited well in general the study will never be done would be a massive randomized control trial of ultra processed food against real food and pay people to do this uh you know why can't we do that because uh who's gonna fund it who's going to fund it and uh we already know the answer though irrationally the ethics board would probably say it's unethical to randomize one arm to the American diet and the other arm to a healthy diet um but that's that's what we need to you know shake this up so far the studies have been limited to a few weeks and uh you know we that's that's where I think I I would you know if all the money in nutrition do do that study that would um change our system and show show how bad it did for us um the Zoe studies are it's evolving all the time and introducing all kinds of new features and giving people personalized feedbacks on whether they're Dippers or not um you know should they be worried about giving we're trying to move towards giving people real-time advice about um what they should be eating uh we are just starting retesting so this is a really exciting time people can see if they've reduced their sugar Peaks and their fat Peaks and then improve their gut microbiome what does it look like on retest and how they've got microbes are tested and the results are looking really good on that and because no one's managed to do that yet so far and and so using the gut microbiome is a pretty good sort of like your dental checkup that you go to every six months or so to say how am I doing when I'm experimenting it's quite hard to know um I think we're going to start doing these citizen science projects Within within the Zoe product so that we'd love several thousand people to start you know go on fermented foods for a month and see what the difference is others um got intermittent fasting um all these lifestyle interventions I think would be really exciting and we you know want people to join in this big community so there's a lot there's so much stuff going on as well as feeding back these new insights into the microbiome maybe getting some of those microbes into as new probiotics and prebiotics because they've never been discovered before but they have really big effects in our in our data now we see these these huge effects of these microbes only have names yet and so um if we can harness them you know they they could be super powerful medicines as well so yeah there's there's sort of too much to uh I'm you know a kid in a sand pit but it's full of toys and um it's it's a fantastic time to be doing science yeah yeah well I can tell it lights you up and uh it's a really fascinating uh new kind of emerging field like if I was a young medical student this would be where I would want to you know be focusing on right now because you're at the very beginning of something that clearly is only gonna grow and and and become kind of more integral to all aspects of of of of of human health and planetary Health too so it's really exciting and I think the work you're doing is really important it's inspiring and uh it was great to talk to you today so thank you appreciate it it's been fun yeah it was good um if you want to learn more uh pick up Tim's book food for Life the new science of eating well you can check out the Zoe app zoe.com and uh any other places you want to direct viewers and listeners uh follow me on Instagram uh if you people still do that and they still do I think they still do you're not on tick tock uh I wouldn't admit to it there we go no no I'm not on Tick Tock I can't I haven't got this with the patience or technology for that yeah how's Will how's Dr B doing is he doing a good job should we give him an a a a review right now while he's sitting right here [Laughter] yeah good man thank you well uh come back again and uh share with me more about what's happening I'm not sure it's changing all the time right oh yes yeah cheers thanks peace

Channel: Rich Roll

Views: 601,370

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: nop0-lZy9cM

Length: 161min 23sec (9683 seconds)

Published: Mon May 22 2023