Dhru Purohit Show - #262: The Radical Healing Properties of Broccoli Sprouts and Sulforaphane with Dr. Jed Fahey

Episode Date: January 31, 2022

This episode is brought to you by Pendulum and Vivobarefoot. Sometimes, a lot of big benefits can be found in quite a small package. Believe it or not, this is very true for broccoli sprouts.   In the world of nutrition, people have known for a long time that the sprouts of cruciferous vegetables and legumes are powerhouses of valuable nutrients. The secret to the health benefits of this remarkable food lies in the bioactive compound sulforaphane, which is generated in high concentrations when broccoli sprouts are consumed. Over a thousand published studies have identified sulforaphane as one of the most potent food-derived molecules of our era, and that some truly remarkable health benefits that can be accessed through its main source, broccoli sprouts. This week on The Dhru Purohit Podcast, Dhru sat down with Dr. Jed Fahey to talk about the healthspan-promoting power of broccoli sprouts, and how sulforaphane shows promise as a therapeutic agent against a wide range of diseases including autism, cardiovascular disease, diabetes, among others.  Dr. Fahey is a nutritional biochemist with an extensive background in plant and human nutrition and phytochemistry. Dr. Fahey was an Assistant Professor at Johns Hopkins Medical School, where he directed the Cullman Chemoprotection Center, a leading center for the study and development of plant-based protective agents. He held faculty appointments in three departments at Johns Hopkins Schools of Medicine and Public Health where he conducted laboratory and clinical trials, taught graduate courses, and mentored students since 1993.    In this episode, we dive into:    -The most underrated food that most people are missing in their diet (6:47) -The health benefits of broccoli sprouts (9:53) -The benefits of sulforaphane (12:03) -The dangers of low levels of sulforaphane in the body (18:38) -How our gut bacteria makes use of phytochemicals (30:42) -The best way to make and eat broccoli and broccoli sprouts (36:17) -The quantity of broccoli sprouts you need to eat to receive the benefits (46:01) -Autism research and the neuroprotective compounds of broccoli sprouts (1:07:21)  -The role the gut microbiome plays in the manifestation of autism (1:19:13) -The fever effect and autism study  (1:21:13) For more on Dr. Jed Fahey, follow him on Twitter @jedosan, and through his website https://www.jedfahey.com/.  This episode is brought to you by Pendulum and Vivobarefoot. Pendulum is the first company to figure out how to harness the amazing benefits of Akkermansia in a probiotic capsule. To receive 20% off your first purchase of Pendulum’s Akkermansia probiotic supplement, go to Pendulumlife.com and use code DHRU20. Vivobarefoot footwear is designed to be wide, thin, and flexible—as close to barefoot as possible. They promote your foot's natural strength and movement, allowing you to feel the ground beneath your feet. Vivobarefoot is offering 20% off your first order at vivobarefoot.com/DHRU. Hosted on Acast. See acast.com/privacy for more information. Learn more about your ad choices. Visit megaphone.fm/adchoices

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I know you're going to love these shoes as much as I do. I've been recommending them to everyone I know. Check them out. Welcome to the Drew Perot podcast. Each week we explore the inner workings of the brain and the body with one of the brightest minds in wellness, medicine, and mindset. This week's guest is Dr. Jed Fahey. Dr. Fahey is a nutritional biochemist with an extensive background

in plant and human nutrition. and phytochemistry. Dr. Fahey was an assistant professor at Johns Hopkins Medical School, where he directed the Coleman Chemo Protection Center, a leading center for the study and development of plant-based protective agents. He held faculty appointments in three different departments at Johns Hopkins School of Medicine and Public Health, where he conducted laboratory and clinical trials, taught graduate courses, and mentored students since 1993. On today's podcast, we've invited Dr. Fahey to come on and talk about one of the most underrated superfoods of all-time broccoli sprouts and their ability to support the detoxification process in our body, support our body's natural ability to detoxify, and increase our overall immune resilience. If you're curious about actual clinical trials and what they've shown around which superfoods work and which superfoods work and which superfoods,

Superfoods don't work, today's episode is for you. I hope you enjoy. Dr. Jed Fahey, welcome to the Drew Proa podcast. It's an honor and a pleasure to have you here. I want to jump right in, starting off with the basics. Would you say, and if you don't say, please correct me, that broccoli sprouts could be one of the most underrated foods that people are missing from their diet. Now, I know you don't love the term superfoods, and you're really not about highlighting any one particular thing. It's really just a larger approach to our diet.

That being said, with the amount of evidence that's out there on broccoli sprouts, would that be a fair statement? Yes, I think. So thanks for having me. Good morning or afternoon or evening, wherever you are. I know where you are. And yes, I think that's a fair statement. I think all sprouts would be a good, you could consider all sprouts of sprouted seeds to be a food that people are missing because they're so convenient, so easy to make, so easy to make anywhere you are really, any climate, but certainly in the U.S. and all of the climatic zones, because you make them. in your house. I mean, you make them wherever you have a temperature suitable for a living.

You know, the sprouts have gotten a bad name or got a bad rap, I should say, 25, 30 years ago when there were some outbreaks in commercial sprouts. But for the home sprouter, this is something that can be done. And it is especially, I think, useful for people of limited means, because all you need is the seeds and you have fresh vegetables. That said, yeah, broccoli sprouts have a special phytochemical or a compound in them present at very low levels, but it's a very potent health-promoting or health span extending compound. And we can talk about all those terms later. But we developed broccoli sprouts in the mid-90s, mid-1990s because of their very special.

special and unique characteristics in really protection. At the time we thought protection against cancer, that certainly has been underscored with many clinical studies. I should say it has been, we're getting closer to being able to wave our hands and say, yeah, it prevents cancers. But there's a lot of work that's been done on it, nothing negative. And over the years, we and many other. have found protective effects against a variety of other chronic diseases, which again, we can

talk about and even therapeutic effects against some of those conditions. And before we get into exactly what those mechanisms are, what those key compounds are in broccoli spouts, you mentioned cancer. You said there's a few other areas where there's deep interest and also existing research. Give us a couple of those bullet points that are there. it comes to the potential health benefits as related to either disease conditions or just overall well-being. Yeah. So, I mean, the whole overall well-being thing we should cut out and talk about a little more in a minute. But in terms of, because I don't want to ramble on forever without, you are interrupting me with some specific questions. But in terms of the overall effect, the

overall effects and specific compound, I'm sorry, specific conditions, there is fairly dramatic, I think, anti-diabetic activity, for example. And that's been shown in a clinical trial. We did, the lead on that study was in Sweden, and that was published a few years ago. So there is even clinical evidence. There's also a study in Iran, out of Iran, that shows clinical evidence. A lot of preclinical and laboratory work, though. It appears that it may be cardioprotective, may be helpful against a variety of cardiovascular conditions. Asthma, I think the sort of two big modes of action that people that may resonate with your audience. not specific disease, but mode of action, are antioxidant and anti-inflammatory.

And it is clearly, sulforaphane from broccoli spreads, clearly have those activities. And those activities lead into a discussion of a whole variety of diseases, including, or condition, including neurodevelopmental and neurodegenerative conditions, such as autism, Parkinson's, MS and schizophrenia, perhaps, all of which have been the subject of clinical attention. You mentioned a term, and I'd love to start off with establishing the definition of some of these key terms that are here. You mentioned sulfurophane. Talk to us about what it is and what it does in the body and why it's important. Yeah, it's critical to define terms, especially when a scientist like me, who's been deep in the weeds on a subject is trying to talk to a Morley audience.

So sulfurophane is a small molecule, a compound smaller, certainly smaller than proteins. It's about the same weight as a sugar molecule. But sulfurophane is a compound that's also called a phytochemical. It's derived from a compound also present in broccoli. and I have to tell you about that mechanism because it's important actually in terms of bioavailability and delivery. But sulfurophane is where the pedal meets the metal, where the rubber meets the road in terms of health effects. And this small molecule is present or its precursor is present in plants like broccoli, mostly broccoli, not all cruciferous vegetables, but at very low levels. So in a plant, you've got your macronutrients, you know, carbohydrates, fats, and proteins,

those make up and fiber make up the bulk of the mass of any plant tissue and water. And then you drop down and you've got vitamins and minerals, right? And everybody knows about them. And then even less prevalent, so smaller amounts, you have phytochemicals. And they are the things that give all plants really color, odor or smell, taste. So they're in large part responsible for all those characteristics of plants, as well as for fighting off predators. And those predators are typically bugs, insects, worms, or fungi or bacteria that would eat them.

And of course, you and me and all of. other human beings are, unless you don't eat any plants, are also predators. And so some of these, especially the taste effects, either send us away from them. We either hate broccoli or maybe we love it, or they may attract us to those plants. So sulfurophane is one of them. And we and many others have identified huge numbers. of mechanisms, many mechanisms in which it works. Now, you talked about broccoli sprouts,

and broccoli sprouts don't have sulfurophane directly in them, from my understanding of your work. There's a precursor that's in them, though, that triggers the production of sulfurane in the body. Can you explain that to our audience? Yes. So the plant itself, the cells of the plant, contain

each of the cells really contains a vacuole in a plant which is a bag of juice, a bag of sap, if you will, water and dissolved stuff. And it has cytoplasm. That's the jelly-like stuff that fills the most of the plant or some of the plant cell, depends on which cell. And it has a nucleus and is a membrane in a cell wall. That's sort of the basics.

And in that bag of sap, you find these compounds called glucosinolates. And those are the precursors of one glucosinolate in particular, glucoraphon. Names aren't important, but that's a precursor of cell forophane. Why is it a precursor? It's precursor because in the rest of the cell, the cytoplasm and various membranes, you have a protein or an end. enzyme associated with those membranes, happens to be called myrosanase.

Again, the name doesn't matter. But when any predator busts the plant cell, chomps it, you know, liquefize, destroys it as a bacterium, or you chew a raw vegetable as a person, you're breaking plant cells. And when you break them, you're breaking that balloon, that bag of juice. juice in the middle, letting the precursor glucoraphrenin come in contact with the enzyme that's in the rest of the cell or other parts of the plant tissue. And a very rapid reaction happens to convert glucoraphon to sulforaphane. And it happens so rapidly that if you're, for example, if you're eating the best example,

I use this a lot in sort of trying to represent what things look like. is you chew on a red radish, more daikon, Japanese radish, or really any cruciferous vegetable, but when you chew on it, you first get a cool, crunchy sensation, and within 15, 20, 30 seconds, it gets hot, right? Same thing happens if you chew on a wasabi root, but I'm not recommending it. You get this heat. That is what you're doing in your mouth is your breaking open plant cells that have these glucosinolates and you're allowing maracinase to react and convert that precursor to a bioactive

compound in the same family as sulfurophane. All cruciferous vegetables have this set of reactions. broccoli happens to be one of only a few and really the only common human food that makes sulfurophane. It's present in some rangeland weeds out in western U.S., but it's not, you know, they're not important in human food. So all of this is to say that the plant is sort of loading the gun to fight off predators and the trigger doesn't get pulled. until the predator hits it. So I often find that a good way to help people understand the importance of a particular molecule compound ingredient inside of the body is to talk about what happens when we don't have it.

So if I could place you inside of a human body to help people understand, what would happen to us if we did not have enough sulfurophane and our levels got extremely, extremely low? Talk about some of the cascading events that would take place. Yeah. So I think first you have to sort of step back and think about stress of all kinds, I mean, physical and mental in people's lives and ask ourselves if there's anybody who truly doesn't have any stress in their lives. And, you know, there's not, there's nobody like this.

that, I think, that are truly stress-free. So going with the assumption, so if you were truly stress-free, I think you might be able to get away with a diet of just the macros and the vitamins and minerals and no phytochemicals. I mean, that might be possible. And indeed, I don't like to call out brands, but there's some. something called Soylent, which is, which was made by some, you're probably familiar with it. Yeah, I'm very familiar with it.

Made by some people who wanted to stay at their computer terminal 24 hours a day and didn't like the idea of eating or probably exercising. And this was just, I was just sort of adding in the macros and the known required vitamins and no phytochemicals. And some people actually lived on that exclusively. for, I know, at least a month. I haven't followed the literature for quite a while. So if you have no stress, zero stress,

you probably could live on that or survive on a diet like that. But all the rest of us have stresses that come in and blast us, whether they be physical or mental or both, usually. And they vary. And to most of those stresses, probably all, result in oxidation stress, oxidant stress in the body, and inflammatory stress in the body. And those stresses manifest all over various organs and in different ways. But what we know about sulforaphane, I hope I'm not going too far off the question you asked,

but what we know about it as well as a variety of flavonols, flavonoids like coarsatin, like curcumin from turmeric, I should say quercetin from typically apples and onions are good sources of that, and sulfurophane, and a whole host of literally thousands of phytochemicals like them, present in low concentration, but potent in whatever mechanism they fit into. Those do things that help to modulate the stresses on the body. or to upregulate protective enzymes. And this is the big thing that we started looking at. Actually, when I joined Paul Tallade's group in 1993,

he and Yushin Zhang, an MD student, he was a physician and he was getting his PhD. They discovered sulforaphane in heads of broccoli, market stage broccoli. They published it in 1992, and this was a big deal. It was on the front page of the New York Times, so it got lay public attention as well as scientific attention. And it was a big deal because they showed how protective it was in a cell culture system and how it upregulated cytoprotective, or it turns out later these were identified as antioxidant,

enzymes. And then we discovered, once I joined a group, that this compound sulforaphane was present in even higher concentrations in broccoli sprouts, very high concentrations, and in seeds. Which actually came from a little bit of a mistake, right, that whole process, which we can talk about a little bit later on, but I thought it was fascinating. Yeah, yeah, let's talk about the most, Well, it wasn't a mistake. It was an effect of the season and the place. But let's come back to that. But you asked, what did you ask, sir?

Yeah, I was saying that basically if we didn't have enough of this compound, so ferrephine in the body, what would be some of the cascading effects that somebody might notice? And you were talking about, you know, the protection layer and mechanisms. Right. Right, sorry. So if you didn't have sulforaphane, you'd be fine as long as you had a variety of other phytochemicals probably. Sulforaphane would help because it's such a potent antioxidant and cytoprotective compound,

meaning so let's take the antioxidant first. As a side effect of living in an oxygen-containing atmosphere, When we respire, and everybody does, and especially when we respire at high rate of physical exertion, aerobic exercise, we generate reactive oxygen radicals. We generate things which are reactive and which can actually do damage. So, as with everything, too much is not good. Too much exercise, I believe, is ultimately going to be shown to have some negative effects on longevity. and joint health and so on. But I'm talking Iron Man ultramarathoning type too much.

Certainly most people need more activity in this country. Anyway, you generate these compounds, and you need to be able to neutralize them if you want to protect the tissues or the brain, which is, of course, a tissue. And one way to do that, and this is how sulfurophane, I would say sulforaphane's probably most relevant,

mode of action is to upregulate antioxidant enzymes. Sulforaphane upregulates a whole host of enzymes, something on the order of 3 to 5 percent of the total cellular proteins are actually controlled by the nuclear transcription factor that sulfurophane triggers. So sulforphine or other compounds could activate it. And this is. these enzymes are upregulated, they stay high, their activity stays up, if you will, for a period of hours to days, in some cases even weeks. And so it's very different than taking vitamin C, for example. And with vitamin C, you take it, you ingest it, it spikes in your blood and in your system.

The molecules of ascorbic acid vitamin C are used up. in fighting oxidants and then they're gone. And so your levels go up and they come down very rapidly, certainly within a day, within a couple of hours, they spike and come down. The same thing happens with the levels of sulforaphane in your blood. It spikes and it comes down. But in the process, so it's not a direct antioxidant. It doesn't act like vitamin C. So in the process, it upregulates this whole host of protective enzymes and anti-inflammatory enzymes and so on.

And they stay active while cell foraphane is literally chucked out of the cells. It goes in, it's recognized as a foreign substance, it turns on the defenses, and the cells throw it back out actively. So if you have none, you know, you'll live. Our argument, those of us and there are many of us now in the world, thank goodness, who sing the phytochemical song, we think that sulforphane and other like phytochemicals, other similar phytochemicals, sulforphine happens to be our champion, enhance health span. So they, you know, you look at two people born at the same time, even identical twins, living different lifestyles.

One, a healthy lifestyle, protective foods, a lot of phytochemicals, sulforaphane regularly. And the other one is a couch potato, does an exercise, and so on. And these studies, unfortunately, haven't been done because they're so long term and so costly. but certainly most, I think most scientists and most aging experts would agree that the couch potato who eats steak and potatoes, it will, you know, they both were born, they both survived, and quality of life was theoretically good at birth and for a few years, and then into their 20s and 30s and 40s and 50s and 60s, quality of life, as per actuarial, and U.S. statistics, quality of life will decline. The bad twin, if you will, will get multiple, probably multiple chronic diseases.

In fact, many people in this country have four or five concurrent chronic conditions when they die. And let's assume they both die at the same time. Let's pick age, I don't know, I want to be optimistic. Let's pick age 90, although the couch potato almost certainly won't make it that long. But by the time the couch potato dies, he or she is going to be in really sad shape. You can name the, anybody can name the litany of chronic diseases that they may have. We think that the phytochemical enthusiast who exercises and eats well and doesn't smoke and all that is going to have a quality of life that plateaus sometime in, you know, early childhood and stays high. And on their

90th birthday, they just won't wake up. But damn, that's the run that I want to have. And, you know, I wanted to go to 100 or 105, but that's not too realistic still yet. But so when we talk about health span, sorry for the long-winded answer, when we talk about health span, it's not lifespan. lifespan may or may not be increased ultimately. There's a lot of their seniletics and a lot of work that people are doing on it, but that's not what we're talking about. Phytochemical ingestion like sulforaphane, I strongly believe, enhances health span and will enable the consumer, whether it be through food or good food and supplements,

to live a better life, healthier life. It's a well said. Talk to us about the role of the gut bacteria in this whole process. Where does it fit in when it comes to making use of these phytochemicals that we want to be looking at, including more of in our diet? Yeah. That's a great question. And not nearly enough is known about those effects.

However, you know, when I started out in the science world, when I started my training, of course, the gut microbiome was completely unknown and uninvestigated. Now it's the field that I wish I had been in, but it was too late for me to jump on. Well, I didn't jump on that boat because I think that's where the action is and where some just stunning advances have already been made and will continue to be. In terms of phytochemical interactions with the gut microbiome, I'm going to not pretend that I'm an expert on microbiome research and leave, I'm sure you have had or will have other guests that can talk about effects of changing ratios of one type of bacterium to another. or in the popular press, it's frequently represented as the good bugs and the bad bugs.

But, you know, probiotics and prebiotics all play into gut health, certainly very strongly, as do phytochemicals. What's not very clear, for example, with sulfurapine, but I'm aware that there's some work that's being done on it, and hopefully it will be published soon, is how much does. was sulfurophane itself, when taken in, or the precursor of glucoraphidin, how much, or does that effect either the composition or the actual number of any of the species in the gut? So that's one question. The hints are that it probably does, and it depends obviously on how much you eat and how often you eat it because if it has a stimulatory effect on some organisms in your in your gut,

mostly large intestine, but stomach where we've done some work on helicobacter, but stomach and certainly small intestine are also important in this. So you look at the options. What could sulforphine do? It could kill or suppress bugs. It could stimulate or, you know, enhanced the growth of bugs. We just don't know the answer, but we're pretty certain that one of those effects will be seen when the proper studies are done. Then you look at the precursor of glucoraphinin, because if you eat, for example, raw or, sorry, cooked broccoli or broccoli sprouts, which aren't that really palatable, but so you're, you're not, you, you eat a cooked cruciferous vegetable like broccoli, the precursor is what you're going to be

ingesting. And then what do you count on? You count on, actually, we haven't talked about this, but that enzyme I mentioned, myrosanase, is present in the gut microbiome of everybody, unless you've been attacked with a course of preoperative antibiotics and taking a fleet of. dynamo and you just completely wiped out your gut flora. But most healthy or even unhealthy people have bacteria with myrosanase activity in their guts. Therefore, the next question, we talked about sulforaphane. What if you're delivering either through supplements or food,

glucosinolates like glucosanin? Since everybody has myrosanase, then wouldn't it be interesting if you could enhance those critters from that big population of bugs, bacteria in your gut, that have myrosonase, so that you would increase bioavailability of sulforaphane. It's unlikely that glucoraphon would have a deleterious or an inhibitory effect on those bacteria, but it's likely that the myrosonase in some of those bacteria could help accelerate or decelerate that whole conversion. Then, so, I mean, those are the sort of direct effects, but then, you know, I think there's this whole question of indirect effects,

again, stimulating or not those populations that would come, one would guess primarily from other things in the food that contain sulforaphane, in other words, broccoli or broccoli sprouts. And if you deliver it as a supplement, you probably have less opportunity. You certainly have less opportunity for those sorts of effects. But it's not to say that's not a good way to get sulfurophane if people don't or don't want to eat broccoli. And then there's the whole, well, let me stop there. Those are sort of the main overview, I guess, to answer your question.

Well, you mentioned something about cooking broccoli. And a lot of people, you know, they're like, I love, I love broccoli and they'll, they'll nuke it, char it, you know. And really, the question becomes, of course, broccoli sprouts having a lot more of the active compounds that you've researched that support all the health benefits. But talk to us about the best way to actually make and eat this food, both in the sense of broccoli and in the sense of broccoli and in the sense of, of broccoli sprouts. I think that naturally people first think that, great, I'm just going to go cook a bunch of broccoli and get the same exact amount of benefits. But it doesn't seem that that leads to exactly the same benefits as focusing on maybe

eating it raw or lightly cooking it. Yeah. You know, this question, I think has been the answer to this question or the discussion about, the answer to this question I think has sort of given an exaggerated importance to this whole idea that you should, you know, you should add mustard seed or some other source of myrosanase to make sure you convert all the glucoraphon into sulforaphane. And there are a lot of podcasts that have sort of gone off on a tangent about that. It's not wrong.

it sort of overshadows the idea that all of those of us who really espouse or favor a plant forward or a predominantly plant diet are trying to get to people. And that's, in so many ways, it doesn't matter what the hell you eat plant-wise, vegetable-wise, fruit-wise. It just matters that you do it and that you replace, you know, ultra-processed food. middle of the store, thank you Michael Pollan and Marion Nessel, all the stuff in the center aisles of the store, that you don't focus on that and you focus on the periphery, the produce aisles especially. That's by far the most important message that I would like to convey to people and because phytochemicals are important. And yes, I think it would be great if you

liked broccoli and ate it raw or cooked. Doesn't matter. You're still going to be getting the precursor of glucoraphon. It will still have an effect. If you like cooked broccoli and hate raw broccoli, go for it. Don't worry about it. And you're going to eat 100 grams or hopefully more. And you're going to get a quantity of sulfurophane ultimately that will be helpful.

I should mention my friend and colleague Tom Kensler and I actually published two papers earlier this year. Of course, you'll have them in your show notes, but one on phytochemicals and one on this whole conundrum of bioavailability with broccoli, and is it the sprouts or the seeds or the supplements that are better? And the question isn't really answered yet, but we know that people, people, ourselves, certainly a big part of these clinical studies, have shown effect of both, not both, but of pure sulforaphane, of pure glucoraphene, delivered, of a combination of glucoraphonin and myrosinase. And these are all in supplement or, you know, isolated, semi-purified extracts, and certainly of whole sprouts and whole broccoli. So, I mean, again, backing up from that, you asked about how best to cook it or deliver it. If you lightly steam it or microwave it gently and don't just boil the hell out of it,

yes, you will preserve most of the glucoraph. You will not leach it out in the pot liquor or the water that you, that are, you know, in the bottom of a pot. Because you won't be breaking a lot of cells and just leaching it out. Glucoraphon is very water soluble. And, you know, if you follow the sort of dogma that people do when they talk about not losing all the vitamins in vegetables, that sort of applies to. So, you know, if you want to put it in soup, soup, soup or stew, you're retaining whatever leeches out there. So that's cool. You know, if you cook it more, if you bake it, as you say, or grill it or really cook it until it's soft and mushy, you're still going to be getting the glucoraphon as long as you capture the pot liquor, what's left in the bottom.

I would argue it won't taste as good. If you try to do that with sprouts, well, you would never grill sprouts. I can't imagine how that would turn out, vaporize them. But, you know, if you cook them well, they're going to get sort of the texture is just gross, I think. So let's back up then to fresh stuff. Fresh broccoli, it's a no-brainer. Some people like it, some don't. You typically would not eat as much fresh broccoli.

as you would cooked broccoli because chewing it or masticating it is energy consuming. I mean, it just takes a long time to do that. It's like eating a tough steak. So I don't, so you would get less probably, but you would be getting the myrosanase in an active form. And the argument we don't have an answer to is, you know, it's clear that when you eat the cooked stuff, the glucoraphonin is going to go through here, through here, they anthropomorphize here, go all the way down, and it probably won't be cleaved until it gets to your upper large intestine where those bacteria are that have the same enzyme. If you think of eating the raw stuff

and you chew it and the enzyme and the substrate are present in your mouth, I gave you the example of fresh radishes and how fast that reaction happens. So sulforpein becomes available in the large intestine, the bowel, in the cooked example, but in the raw example, it starts happening up here. And then it's going to be available in the esophagus and probably, the stomach, but we know there's not much absorption of sulforaphane from either of those two places. We also know that it will, sulforaphane will survive, as will glucoraphane, a trip through the stomach. We also know that it's a quite potent antibiotic against the helicobacter pyloroi,

which causes ulcers and can lead to stomach cancer. We know it's active there, but it probably won't be absorbed into the system until it hits the small intestine. And the thing we don't know much about is how much absorption is there in the small intestine versus the large intestine. Does it survive the rest of that trip or does it get taken up? Does it go into antihepatic circulation or not? So there are clearly kinetic, pharmacokinetic differences in how the raw versus the cooked vegetable works in terms of bioavailability. And the answers to those things will come in time. I mean, people are looking at things like that with model GI systems, fake gastric systems, if you will,

and with animal studies and with clinical studies. Let me stop for a second, and I've tried to address your question. You know, I haven't given you a magic recipe for what you should do. No, but I think that people want to hear about, people want to hear about all those layers that are inside of there. And I think that what you did, what I got away from my question to you, which was, you know, if we overcook it or how should we be eating it, should be focused on raw, is like, look, just get it in. And, you know, you probably don't want to char things because charing comes with their. their own, you know, carcinogenic effects on just food in general. Anytime you see black char that's there, especially people like to char broccoli and,

you know, and get that. In the case of sprouts, you really can't char those, you know, and you can't grill those. So I find that just a little bit of light olive oil, a little bit of seesaw, adding on top of my salad. But it does beg the question, and I know this is another area for debate, but people always looking for guidance. between sprouts and of course supplementation that's out there of companies, which is a whole discussion in itself,

people are always looking for guidance in terms of how much do I have to have to take advantage of the benefits? Now, you've shared in the past that there's a lot of variables that are there. And to your best knowledge that you can share here, if people are looking for that minimum viable dose, what's the best guidance that you could offer the audience? So when Paul Tallay and I decided to take our findings in the mid-90s about broccoli sprouts and try to push them out there, we formed a company with his son, Tony, and the goal of that company was to, I'm going to tell you a short story, but it relates to your question.

The goal or the objective or the business mission of that company was to sell fresh broccoli sprouts and to get them out into the public. And so long story, very long story short, we started doing that, producing, and Johns Hopkins was a co-investor in that company, by the way. The university was. So this was a very, you know, above board effort. and we had, I think, 13 copackers around the U.S. and then in Japan and a couple of other countries, making broccoli sprouts, packaging them with uniform labeling, and having those sprouts tested for glucoraphon levels by labs that the company trusted.

So point number one, there's so, much poor analytical science going on in the nutraceutical phytochemical commercial space. So one must be careful of that. So we were selling broccoli sprouts. And at about that time, the time the company was formed and we got started, there were quite a number of foodborne illness outbreaks in sprouts, not broccoli sprouts, but alfalfa sprouts and I think clover and dicon sprouts, Japanese radish. So one of the big partners that we thought we were going to have,

which was the holders of the Jolly Green Giant fresh brand, pulled out because they were afraid of sullying their brand name if there were to be a foodborne illness outbreak. And the company ultimately wound up, making supplements and still makes the supplements, and I actually consult for them now. I had to pull away from them because of conflict of interest with clinical trials at Hopkins, but now that I'm retired, I consult for them. It's brassica protection products, or they make something called True Brock,

which is high glucoraphate an ingredient for other supplements, for direct-to-consumer supplements. they don't sell direct to consumer. I say that because Paul and I and those that were involved with this company at the time had to address this question of equivalency. When you look at the epidemiologic literature, it's very clear, and this goes back to the mid-70s when the first studies came out, It's clear that those people who are avid or strong or big consumers of broccoli, actually of cruciferous vegetables in general, but of broccoli specifically,

are at lower risk, have a lower relative risk or odds ratio for getting a variety of cancers. And we were all about cancer protection at the time. We still are, you know, we still are, but there are a lot of other conditions that have, that have sort of piled on for which cell forfein is effective. So if you look as best you can, the data is always squirrely with dietary records. But if you look at N. Haynes and other dietary records, the Harvard Health questionnaire and so on, you see an epidemiologists, not us, saw that those who ate all, lot of broccoli had these reduced cancer risks. And in fact, bringing it down to specific numbers,

a study that I remember from 1978, Graham, I think was the first author, Graham, showed that the relative risk of colorectal cancer was halved in people who ate two servings of broccoli, 200 gram servings of broccoli a day. Then they were, and that's, you know, that's dual That's impressive. And most of that, we would assume, was cooked broccoli. So Paul and I had to take that, the amount of glucoraphon present in, say, two servings a day, and convert that to, oh, broccoli sprouts are much higher in glucoraphon. So what would that equal in terms of broccoli sprouts?

Well, it's a couple of ounces. And a couple of ounces is about a half of one of those. clam shells, the four-ounce clamshells that you see sprout sold in in the grocery store. And then when the company wound up by necessity turning to supplements, the question is, okay, how much, you know, how much glucoraphid and how much supplement? And it's, I honestly don't remember the exact number. It's, I have it written in all sorts of places. It's something like 50 milligrams of glucoraphnein, but I should, hopefully, by the time, time you come out with this and have show notes, I can give you a more precise statement.

No, I think that sounds about right. My wife takes it on a regular basis and has found that, that, and I know that you guys sell to like different, the company sells to different brands. I think the particular product she takes is the Thorne product, the Thorne product that has the sulfurane inside of there and that orders from a true block. And they have something called Crusera SGS. Right, right. And she started taking it because she noticed that it helped her a lot when she would be gearing up for her menstrual cycle and reducing the symptoms of PMS. And she's heard a lot of different experts that have been on this podcast talking about the importance of having a lot of those cruciferous foods because of the sole ferrofen inside of there.

inside of your diet to help, as I understand it, in the process of maybe removing extra estrogen towards the end of the phase of the cycle, which seems to, at least anecdotally right now, be helpful with women who experience more painful periods. So I know that's the one that she takes in that particular product. Yeah, you know, we have heard that from many corners. and also things like fibromyalgia that seem to preferentially affect women. There's clearly an involvement with the hormone axes. It's not as well studied, I think, as some of the other effects,

but in breast cancer, the signs are very good that there's an effect, and it seems to be preferential. I can't remember if it's estrogen-resistant or non-estrogen-resistant or women who have certain genotypes. So there are interactions there. I'd like to go back to the previous question for a second, though, and say, you know, you started, I'm not sure if you, I can't remember if you exactly asked it this way,

but your question sort of tiptoed around the question Well, should I eat it as a food or should I take a supplement? And that is a question that a lot of people ask. And I think the way I look at that is that if you go on the assumption that a lot of people don't eat broccoli because they don't like the taste. And certainly a huge number of people like probably 99.something percent of the country don't eat sprouts because they're not very available. They don't last on supermarket shelves. They don't want to spread on themselves, and they don't like the taste or texture. Then you have to say, okay, well, some people are going to get the benefit by eating the stuff, sulfurophane.

But most people or many people, probably the majority of, I would say the vast majority of people in this country won't get that benefit. So is supplementation appropriate then? And I think the answer is, yeah, I think it's appropriate. The conundrum there is that, first of all, supplements are expensive, and one of the reasons they're expensive is that to make sure you're delivering what you say you're delivering, you as a manufacturer have to do a lot of testing, and that's expensive. But there's an enormous amount of garbage out there, supplements that just don't meet spec, don't do what they say they do, don't have what they say they have in them. And it's extraordinarily easy to fool most consumers, including me.

I mean, you get a pill that has a powder in it unless you test it yourself, or unless you know through certificates, certificates, through channels, through having it tested yourself which will never happen or through the reputation of the seller the company you know you know that a lot of people are getting garbage in their in their supplements so that's the conundrum you know they're expensive and the reason they're expensive is testing's required so many people you know so many companies are sort of like pop up you know whack-a-mole pop-up companies that show up pretty produce garbage, maybe eventually get shut down, or maybe customers sort of lose interest in them

when they realize the things that we're supposed to happen aren't. And then they go away and they come up with a different brand name. That's a huge problem with supplements. But I do think there's a very strong place for supplements in the American panacea. More difficult to – sorry, I know you want to ask another question, but is more difficult to – It's more difficult to see that happening in a lot of less well-off countries in the world. And certainly in a lot of areas of this country that are food deserts where people can't, you know, can't afford the basics to get them supplements unless it's somehow subsidized.

It's hard for me to see how that might happen. Yeah, I do both. I have the supplement form that's out there. And again, I know there's access question. And I really enjoy broccoli sprouts. I really enjoy putting them on my salad. Every day for lunch, I have my big, I call it big fat salad. You know, there's healthy fats that are in there.

I do eat animal protein. I am very plant forward in my diet, but I do have animal protein that's there. And my go-to for lunch is often, I'll make, from a distributor over here, we get, pasture-raised chickens, either whole chicken, we'll cook the chicken together, me and my wife early in the week, you know, break it apart with all the different parts, you know, keep those proteins available for us to be able to add quickly to our lunch. I'll add in a ton of, I'll add in like butter lettuce. For me, like an incredible salad is a lot of layers.

So I like crunchy stuff. I like softer stuff. I like some pumpkin seeds inside of there. And then I'll put a big dollop of broccoli sprouts on top, maybe some fermented foods that are there. And it's probably, if I think about it in terms of dosage-wise, it's at least in that big salad and there's avocados and olives and other things like that. There's probably at least four to six servings of vegetables that are inside of there, like total cup servings of vegetables and fruit, if you think about avocado and sometimes maybe some berries. and broccoli sprouts are like the perfect add-on to it.

Then I put in a little bit of sea salt on top of that. And they just, I don't know. It's like once you start cleaning up your diet, your palate changes, and you crave these foods. Just me talking about right now, my mouth is watering. And I'm like, I can't wait to have lunch later on and have my broccoli sprouts. Drew, are we twins? I do the same thing, exactly. Although I'm almost exclusively fish and shellfish, not chicken, but anymore.

I used to. But I do exactly the same thing. And my wife eats differently. And so frequently she'll have something more sort of traditional. And I'll just grab all the veggies out of the fridge and make a salad exactly as you described. Except the thing that I lament is that in Maine here where I live, In the summertime, we have great farmers markets, and I can get locally grown Red Diccio, the bitter red leafed lettuce-like substance.

And I love that. That's great in salads. And, you know, it goes away at about this time of the year unless you get it from California shipped in in the supermarket. But, yeah. And for yourself, if you throw on some broccoli sprouts, is it stuff that you've grown at home? I mean, we won't go into all the. processes of growing sprouts and everything like that, you've done a lot of really great sort of

stuff and put PDFs together with individuals like Rhonda Patrick that are out there that we can link to in the show notes. But will it be what you grow at home or even for you? Do you notice that, you know, sometimes like you don't feel like growing it. So if a local farmer's market is selling it and somebody's doing it, it's just easier to pick it up. Or do you actually enjoy the process and you like growing it and using your own sprouts? I probably shouldn't say this, but For 20 years, I never have, I'd never buy broccoli sprouts from anybody else or any sprouts from anybody else. Part of it is, part of it honestly is just fear of the way they've dealt with them and treated them.

I'd say the biggest part is just available, regular availability and the fact that so often sprouts get really skanky looking after they've been in the supermarket for a few days and the produce managers typically don't do a good job of rotating them out because it costs them a lot of money. But I do enjoy making sprouts and I typically have four jars going at one time and usually lentils and clover and broccoli and fenugreek. Fenugreek is the best. If you haven't tried that, got to. It's wonderful. One more question for you about your salad. How many grams or how many teaspoons of curcumin or turmeric do you throw in there? You know what?

I actually don't love adding like raw turmeric to my salad. I'll typically in the morning because I do enjoy eating having breakfast, especially in a day where I have to tap a lot more into my cognitive powers. I find like having breakfast in the morning does really well for me. And so I typically will make a more savory breakfast. because I'm always mindful and we're doing a lot of education on blood sugar, metabolic health. I don't want to have my blood sugar spike and go crazy in the morning. So for me, what that often looks like is I'll make a breakfast skillet.

And so in that skillet, I'll have a bunch of different veggies that I'll lightly cook. And that's where I'll add in my turmeric and some of the other spices that are there that are quite often used in my tradition and background from the Indian culture. So I don't use it a lot in my big salads, my big fat salads, although we did invest in a company a few years ago called Primal Kitchen. And they do have one of their dressings that has turmeric. So sometimes I'll toss in a little bit of turmeric dressing on there. Yeah. Interesting. I don't do it for breakfast, but there's a more practical reason.

I'm a really sloppy eater. And it seems with salad, when I was working, when I was working, having to show up cleanly pressed for at Hopkins to teach, you know, I would invariably splash some whatever contained the turmeric on whatever I was wearing. And, you know, it's not too cool to show up full of yellow spots. So, and I was too proud to wear a bib. So, so I eat at the end of the day. Has your family been so around broccoli sprouts that, like, I find that when somebody's so into something, you know,

our family, they should be naturally into the things that they're interested in. I'm always curious, you know, does your, is your family into it or is it,

oh, that's, you know, Jed's thing, you know, like sometimes when you're so close to it, you don't realize

the true power that, that something has. So yeah, I'm very curious what it's like in your family. So, um, they,

they, they, they buy, into it. My wife does eat broccoli sprouts when I make them. And my son is a big fan of them. And we, I can't speak from my daughter-in-law because I haven't given her the third degree on it, I guess. But I know both myself and my wife and my son, who lives just about 10 minutes from us, I'll take a supplement, a glucoraphid and sulforaphane-containing supplement. And we have our favorites based on what I know.

I sort of have an inside track on knowing because I know that the product that the company we started sells is what it says it is. And I know, and it's available on their website, what supplements their product goes into, and I know that they don't sell to fly-by-night companies. You know, I sort of, I know what supplements to avoid. You know where to get the quality. Yeah. And we can link to that.

We can link to that in the show notes where there's that list. We mentioned Thorne. I think that's on that list. And there's a few others that are out there. A lot of the trusted brands, the doctor's brands, you know, that we often talk about on this podcast are great ones. So we'll have the link to that in the show notes. I think that would be great because as we touched on or I touched on earlier,

unfortunately you as an individual consumer don't, I mean, you can't get every bottle or every lot of a supplement you buy tested to verify phytochemical content. There's just, you know, it costs 150, 100 and a quarter, $200 a pop for just a single phytochemical analysis, there's no way a consumer would want to or could afford it. So you've got to trust someone. You've got to go with some recommendations. And my friend Chris Dodomo is, he's at the University of Maryland. He's given lectures to my class before classes at Hopkins and talked about some of the certifying agencies. So there are ways that a consumer can be, get some comfort knowing that the specific product or the company that they're

looking to buy from is decent, you know, isn't a fly-by-night company selling garbage. For sure. You know, going back to the family conversation, you know, one of the areas that you've been involved in is looking at the role of some of these compounds that we've been talking about in relation to autism. And I thought it'd be just really nice to talk about that briefly because parents, even if they don't have a child that's on the autism spectrum, parents are often thinking about the neuroprotective properties of all these different compounds when it comes to their kids. So what do you know about, well, let's first talk about your work in the space with autism research. And I think that's ongoing and it's continuing.

by some other folks that are there. But also, too, is, you know, what are your recommendations for broccoli sprouts for kids, either recipes or sort of usages? And then is there any guidance that you or anybody else that you could point our audience to when it comes to potentially including supplementation for kids? Yeah. That's a difficult one. And, you know, I'm not a pediatrician and I'm not your doctor and all of those qualifications.

but I'm not a physician, which I think was made clear. It's a tough one because I think you and I would both suggest that all kids from the get-go or from as soon as they start eating solid foods should be coaxed or forced, I guess, is a better word if you're a two- or three-year-old, to eat fruits and vegetables. to the exclusion, perhaps, even of some other things. So I am starting with the end of your question. But so, you know, I think that's a given. And should broccoli, for example, should broccoli sprouts be part of that?

That's a little iffy, more iffy because the very young and the CDC has, or the FDA, I guess, has, no, CDC, sorry, has had a guidance out for many years, that the very young, very old and the immunocompromised should not eat sprouts because of the risk of foodborne contamination. So, you know, very old. Just to interrupt, just to interrupt for a second. Yeah, yeah. Largely that seems to be from my perspective, and again, completely disagree with me, if you do, it seems to be related to the mass production of sprouts and going back to what

you had shared before. But generally speaking, if people are growing it at home, or if you are. are more familiar with the person that's growing it at the farmer's market and you actually have a relationship and you can ask questions and other things, it's crazy that that would be the recommendation, and some people just follow it blindly when there's plenty of other things like food additives and other stuff that, you know, there should be stronger recommendations on, but, you know, the CDC or FDA or any other governing bodies haven't come out as strongly on, you know, saying why by those things, ingredients that are banned in other countries for their impact on

the development of kids and brain health, you know, would be allowed it. So it just feels a little bit, it feels a little bit well, it's well-intentioned, but it's not nuanced enough, in my opinion. So I completely agree with you. No pushback necessary. We're on the same page. I think, sorry, I've got a barking dog behind me. I think, I mean, I completely agree with you. However, most people don't make their own sprouts. So, you know, so that's the catch there. But where I was going with that is I think, you can make a good argument for, you know, weight appropriate, obviously weight appropriate dosing, but for starting to supplement young children.

And that's a very unexplored, unexplored area. So, you know, if you're not going to give a kid, if a kid doesn't like broccoli or doesn't like vegetables, let's say, and you're not going to, if you're not going to give them broccoli sprouts for whatever reasons, would it be appropriate to supplement with a sort of multi-component nutritional supplement that might contain flavonoids, might contain glucoraphidin, might contain, you know, probiotics and prebiotics. I think it would be very appropriate, but it, you know, those recommendations are, I think, not going to happen for quite a while because I think the clinical, the clinical, the compelling clinical trials showing safety and showing that it's not going to screw up a kid's development. I don't think those have happened. I mean, I, we have a two-year-old and a five-year-old granddaughter. I don't think I would really twist my son and daughter-in-law's arm to give them anything but, you know, the standard pediatric vitamins until, you know, maybe they're five, six, seven, eight years old.

Just because there's a lot we don't know about the effects of those things early on. In our case, if the kids are getting a good diet, then I think don't mess with it. But when you start to get into the 6, 7, 8, 9, 10-year-old age range, the kids are in school, you know, just food availability obviously changes a bit. I think it's very much worth considering. And that leads into the first part of your question that we drifted from a little bit, but that's the question about autism. Well, autism starts to develop.

It's usually first able to be diagnosed at about two. So the developmental process leading to it does start early. To sort of put some parameters on that, should remind the audience that the rate of diagnosis or the diagnosis of autism or a kid being on the autism spectrum disorder has gone up steadily and remarkably over the years and the latest was a 2018 report and it just came out about I just saw it about a month ago The data was from, last complete set of data was from 2018, and it was that one in 44 kids aged eight have, are on the spectrum. They pick age eight, I believe, to catch the time of diagnosis,

but not to, you know, which is, again, about two, but not to go out too far in age. And I didn't make those rules. But that's, you know, that's, that's over two percent. That's, that's, that's phenomenal. It's huge. There are a lot of, I think there are a lot of diagnosticians who would argue that, you know, many of us, probably a quite large percentage of the population is somewhere on the spectrum. And, you know, we've all got our problems. We've all got our idiosyncrasies. We've all got our mental issues of some sort or another that could play into being, quote, on the spectrum. but the rate of diagnosis is very high.

So, you know, if you start, and I should say then, you know, if the diagnosis is at 2, well, how do you address your question about dose and when do you start or a question we both were discussing? And I think you have to also consider maternal diet, it and the perinatal period in the mother. And there is good evidence. One of my former students has published two or three papers looking at that. So, again, I tend to drift from your questions, but since you don't crack the whip too hard,

then I feel like I'm allowed. But I want to go back to your question about our studies with autism. Yeah, and before you chime in, I will say that there's some functional medicine pediatricians, MDs that have been on the podcast in the past. And also we have also functional medicine doctors at our own clinic at the Ultra Wellness Center in Massachusetts with Dr. Mark Hyman. We have a few people that do see kids over there, Dr. Liz Boehm and a few others. And like a lot of these things, and when it comes to, you know, supplementation other aspects, especially with a child with like something diagnosed.

You know, if you, if people look for a forward leaning doctor who's willing to look in the literature and also, you know, clinical trials is one set of data and clinical experience is another set of data, right? There's another, there's another aspect of clinical experience. And so if you find a doctor that's forward thinking that can work with you and your family and your child, then, you know, they're often a lot more comfortable in making certain recommendations because they have the long clinical track record and they know what's generally regarded as safe. And they also know that, you know, all interventions have a risk, but they also have a reward. So in some instances, something could have a huge reward.

And many of the kids that have come to the clinic at the Ultra Wellness Center and other functional medicine doctors that have been in this podcast, It's very common that a lot of kids on the autism spectrum have severe gut issues, almost always. There's usually a gut component. So not saying specifically sulfurophane, but just any heavy gut intervention seems to be a big part of the treatment process to at least alleviate some of the symptoms. And there's been many well-respected people, highly credential that have been on this podcast that have gone into that. and we can link to some of those show notes that we've done in the past. I'm excited.

I haven't seen those particular podcasts, but I'm excited to hear that. And I assume you may be aware there were a couple of studies that had really spectacular, I think, and very interesting results modifying the gut microbiome of kids with autism. And I think it was a three-year, it was a two-year. it was a two-year follow-up on patients in the first study, and then they published essentially similar information with a three-year follow-up, or maybe it was three-and-four. I can link you to those papers, and one of the principles in those studies gives a good talk. I've heard some of his lectures, tried to get him to come and lecture to my class, all of whom were very interested in

hearing about it. But yeah, so the gut microbiome plays a huge role in manifestation of autism. I believe, I mean, again, I'm not a neurologist. I'm not an autism expert, but that's what the published evidence seems to be saying. And, you know, we'll never get to your question, but two other points to make there. What is that, you know, I think everybody knows, a lot of people talk about the fact that their genetic component to autism. Sure, absolutely there is. And the Simon's Foundation and a lot of other groups are studying the genes that are typically

mutated or changed, altered in kids who are expressing symptoms of autism. there's no question that's an effect. But let's not forget epigenetics, the ability of food and environment to modify the effects of genes. And that's, you know, even if there were no direct effects of something like sulforaphane on autism, that transcended the effects of those genes, this is an important thing to remember that epigenetics, the express. of genes differentially is key and it's influenced by food and diet and stress and all sorts of other things. So, yeah, let me go back to our studies just briefly because we keep alluding to them and

I should make it clear what we know and what we think we know and what we don't know. Do you want me to start with the heats, the, the, the, the, the, the, the, the, the, the, the fever effect part of the story? Yeah, that's great. It's a great place to start. Yep. Okay. So back in the early, about 2011, 2011, 2010 or something, Dr. Andrew Zimmerman, who is a neurologist

and pediatric neurologist was at the Mass General at the time, came to Paul Talley and me and said, look, you guys have shown that sulfurane modulates heat stress in cells. The heat shock proteins and cells have a lot to do with protein folding and maintaining protein structure and integrity in periods of stress, of temperature stress. This is a well-known phenomenon now in biology, has been for a long time, actually. well-known and central part of, you know, how biology operates. And it was shown that sulforaphane modulated that effect. So it upregulated the heat shock proteins.

Dr. Zimmerman, Andy, came to us and said, look, we've done a study. It was published in 2007. Koran, C-U-R-R-A-N was the first author. we've done a study codifying or showing the following. People who study, look at autism, people who have autistic, physicians who have autistic patients have long observed that when some kids with autism get a fever, a febrile illness, their temperature goes up,

their behavior becomes more normal. They lose some of their characteristics. autistic behaviors. And as soon as the fever goes away, those behaviors come back. And he said, I wonder if that's not something having to do with the heat shock protein or the heat shock response. So their paper made sort of quantified this effect. It had been observed by others before Zimmerman.

And so we all sort of sat down and said, geez, let's do a clinical study because that's testable. We did that study. It was published in the Proceedings of the National Academy of Sciences in 2014, Singh, S-I-N-G-H as the first author. And what we did is we gave a sulfurophane rich extract of broccoli sprouts that I made out in Oregon at a big freeze-drying company or a placebo. and we monitored classic or standard autistic behaviors using the scales that physicians who do this sort of thing use. And so it was the mass general team at the Luria Center, actually. So physicians experienced with these evaluations, and there were some parent ratings or caregiver ratings.

These are all young men, age 13 to 30, as I recall. And of course, autism is a male predominant condition, four and a half times more male children than female wind up being diagnosed with it. And we took blood samples and verified that those on the sulforaphane extract were getting it, and those that were on placebo didn't show signs of it in their urine, so they weren't cheating. Bottom line is we had dramatic changes in behavior, improvements in various components of autistic behavior as measured on a variety of subscales. Over time, the first time that they were brought back in for evaluation after the baseline, the time zero, was four weeks, and then 10 weeks.

and then I think 18 weeks. So the improvements were very noticeable and significant in some cases after a month and then the other time points. And then they all went on placebo for or went off the intervention for a month and came back in. And most of those metrics were back to baseline, some significantly, some not. So the unfortunate part of that study is that because of the way recruitment was done and because of the actual makeup of the population we got, we didn't have enough power, enough statistical power, or a good enough spread of fever responders and non-fevor responders to make any conclusions about whether those who had a fever response

responded better to sulforaphane or not. That's a shame, but But the other effects that were seen were so I think dramatic is a fair enough word that it fostered follow-on studies. And I should say that we then had a follow-up paper in 2017. Lynch is the first author in which we observed those subjects in that study for up to three years after the intervention was stopped. And of course, everybody wanted to know, Doc, where do I get some of this stuff? But since it was made by us and quality controlled by us at the university at Johns Hopkins, we couldn't. We couldn't.

It wasn't just ethics. We just couldn't. So we ultimately had to break down. We didn't at first want to do this, but we saw the wisdom in doing it and share with them the names of some of the companies. We talked about this earlier. we knew made decent supplements that had what they say they had. And so for up to three years or four three years, most of those subjects wound up taking a sulforaphane supplement, whether they had been subjects that showed an effect or not, their parents gave them supplements. And some of

the anecdotes that we reproduced in that follow-up paper were just remarkable. I won't say unbelievable because they weren't unbelievable, but they were really remarkable, sustained effects. And so that wasn't the kind of paper I usually am like to, and I'm used to publishing because it was all anecdotes, but still supported further work. So we've been involved with about six, I think now, five or six follow-up studies around the world. the biggest one being in China. Results of that one haven't yet published, but they showed effects. And with Dr. Zimmerman, we just published our follow-up, done at the Mass General Hospital,

with boys and girls much younger and using a dietary supplement as a source, because we couldn't keep making this for clinical studies ourselves. And there was much less of a pronounced effect, but the most interesting thing we found, and this is the data I'm closest to, was an effect on mitochondrial function. And mitochondrial biogenesis and mitophagy probably are involved. So we're starting to get some clues as to how this might be happening, although there's a lot of wobble in the sort of robust, of the clinical observation still. And that's sort of natural for this kind of a trial.

Absolutely. I need to take a breath, so you need to ask another question. Well, I think it's good that these things are happening. And it really gives hope to, especially parents and families who feel like they're not really sure exactly what to do, right? And it does seem that that, when you layer in things, because obviously, because it's a clinical trial, you have to look at one isolated specific component that's there. And in this instance, you're looking at these compounds, frown, and broccoli sprouts, but that you add in these other layers that have also some data behind them. And a lot of doctors with clinical experience recommend, like, significantly lowering, you know, sugar intake.

Potentially, in some instances, looking at if, you know, if a child has a wheat sensitivity, separate from a gluten intolerance. So you start layering all these different things that are on there, and you can start to see how some parents that are courageous enough to go on that journey and find the right team to surround themselves with, start to notice some significant differences for their children, which is a beautiful thing.

And like I said, we'll link to a few podcast episodes that we've done on this topic in the past. Chad, while we have you here for a few more minutes, Anything else that you'd like to give light to or talk about as we wrap up the conversation? You know, I haven't thought about a proper answer to that question in the context of this podcast. I think, you know, I enjoy going outside my comfort zone and my area of expertise. I frequently try to do that to keep myself honest. I think one of the things that bothers me about sort of where a lot of the discussions on not just supplementation go, but on integrative medicine go, is to this, to the whole insurance and medical care kind of problem, let's say, in this country and really around the world.

But, you know, when we talk about supplementing, I already made my pitch that, you know, people in food deserts and people of less means have trouble affording supplementation. In fact, they have a lot of trouble affording fresh fruit and vegetables of decent quality and availability of them. But, you know, the same thing goes to this whole question of integrative medicine and functional doctors. you know, I absolutely, even, even me with, you know, decent means and a good full-time job at university wanted to, many years ago, switch my medical care over to a functional medicine doc, or an integrated medicine doc, and insurance just doesn't bloody well cover it. And, you know, I had a growing family at the time, and I certainly putting them and me all with a functional medicine doc.

And I'm sorry, I confuse the two terms, sometimes functional and integrative, but, you know, thousands of dollars out of pocket for visits and comprehensive lab tests, which are great. So the whole issue of affordability and insurance coverage is just, it's awful because certainly it excludes people

of limited, means from that sort of attention, which is really what we all need, especially as we are growing up developing instead of a seven and a half or a 15-minute session where a doctor checks off a list. And I'm not demeaning. I've helped in the education of many allopathic physicians at Hopkins. And it's a, you know, it's a wonderful system. And boy, if I need major surgery, that's where I want to go. But the whole cost issue makes it so prohibitive from sitting down with a doc for two or three hours and going through my friend Bob Browntree has talked with me about this, sitting down for two or three hours and going through all the systems with

you, getting a major dossier of labs that you can compare to five years down the road or whatever. So that's a real drag, and I don't have a solution, but I would love, if I can be part of the solution, I'd like to be. I think part of that, though, is the whole issue of educating allopathic physicians, the bulk of our doctor workforce, if you will, in food as medicine. and the use of food and diet. And I'm sure you're, I know you're well aware of this, but, and I don't know the statistics as of today, but, you know, most medical students are lucky if they get a few hours or a week of nutrition training in their entire medical education. That has changed.

There's Tulane University, I think, and some others. are gradually starting to develop actual full whole courses on nutritional medicine for docs and to give them an appreciation of how to cook and how to eat what kind of recommendations to make other than just saying eat more fruits and vegetables, you know, don't eat as much sugar. So that's got to come and, you know, tell me how I can help. I've tried to help instituting such courses or a such course at Hopkins, and I think it's coming. I've worked with my friend Chris D'Amow at the University of Maryland on that. And I think one of the things he and I have both observed is a lot of times it's the new generation of medical students that are driving those changes because they come in and I say, WTF, you know, I need some of this in my curriculum.

them change it you old you know white-haired old men that are running the system um so anyway they're listening to podcast they're you know working out they're following people like uh you know many of the people who's podcast you've been on before and i think that it really starts with education you know nothing education of the early adopters the early adopters throughout history have been the people that ultimately helps something go mainstream. So when that education comes, and previously, you know, if you wanted to go and find, you know, some material about, you know,

this underrated superfood, you know, called broccoli sprouts and exactly the way that it worked, chances are, unless if, you know, Dr. Jed Fahey got a book deal around it that was really consumer-focused, most people are not going to be able to come across it. But now because of podcasts, YouTube videos, education, it's more likely that these things spread.

I know there's many young physicians, that listen to this podcast here and people that are in institutions, and that groundswell is building up. And, of course, then we need to operationalize it and turn it into an actual thing. You know, I know at the Cleveland Clinic Center for Functional Medicine, where my business partner, Dr. Mark Hyman, is the head of strategy and innovation. They even started a residency program over there. And they had the first two physicians a couple years ago go through that and they're slowly expanding out there further so that these students who do actually have and young physicians who do have an interest in this area can actually see the practical aspects.

So it's slower than both of you and I would want. And it's extremely cost prohibitive, as you've mentioned before when it comes to the patient. But through more education, more conversation, more showing people and letting them know. that this world that we're all living in, that it has incredible amounts of suffering that have come from these lifestyle diseases, it doesn't have to be this way. And there's another alternative. But like is said in the beautiful quote, you know, we must be the change that we want to see.

So as we all start to adopt these things and start to go to holiday parties and gatherings and school board meetings and other places and start talking about what we're doing, how we feel, how it's made a difference for us, that information starts. spread. And I'm very hopeful, but there's a long way to go for sure. Indeed. Indeed. If you have time for one other sort of parting thought, I just ask all of us to think about the rest of the world, too. And when I say the rest of the world and the predominant mass of population in the tropics, and when you think about everything we've spoken about and poorer tropical countries, functional medicine, less possible,

dietary supplements, less possible, although certainly China and Japan they're taking off, and just availability of medical care much worse. So would you think that someone in Sri Lanka or the Philippines or Malaysia would be able to reliably buy, say, broccoli sprouts or grow them themselves. I think not so much, plus it's not in their palate. You know, that's not what they're used to. But for, I think, one of the sort of translational thoughts that comes out of a lot of our work, and my getting my doctorate in the School of Public Health at Hopkins really sort of help focus me in this direction, too, is that there are other plants,

edible plants similar to broccoli since we've been talking about that, that grow in the tropics, that do beautifully in the tropics and that have these compounds, these glucosinolates that produce compounds like sulforphine. Moringa oleophera, the horse radish tree or the drumstick tree, happens to be one that I've spent a lot of time with. And that's, you know, all of the stuff we've been talking about really can be replicated. We can have this whole conversation. It could have been about, almost, about Meringa. There's a lot less published work on it. There's a lot fewer high-quality clinical trials on it. But this is the kind of thing that could be implemented or recommended or pushed in many of those tropical countries especially. So we have to not just think

that broccoli is the only game in town or broccoli sprouts. I think we really have to, as human beings interested in not just the fate of rich Americans, but all those in the world, we have to think about what are some of those alternatives that could be replicated in other parts of the world, and they exist. And we just need the energy and the money to help move them there. Yeah, it's well said, and I think it's a great concluding point. And it's a reminder that when we focus on getting ourselves healthy, because we have to start with us and we start to feel good, it allows us to have the energy, the focus, the will to think

about giving love and attention to everything else that matters in our life. And as you go deeper down that rabbit hole, we start to realize that a big part of what matters is helping people that are less fortunate than us. and that's really the, you know, one of the end games, especially after we've set up our own family and our own home and taking care of the basics that are there and make sure that everybody that we're immediately responsible for is as healthy as they can be within the degree that's possible. Now we have to really be thinking about everyone else. Dr. Jed, this was an incredible conversation.

I appreciate you coming on and talking to us about your work, your research, and how this, food that's that's super underrated can be easily grown at home and can start improving people's diets and lifestyles, potentially their cognition, the anti-cancer properties as well, that all can start today. And it's a very simple process. So thank you again for being on the show. Really appreciate it. Thank you so much.

I enjoyed it. And we will carry on. And I loved your closing thoughts. And if there's one take home that people should take away from this podcast, It's what you said at the very end, I think. So take care of others, less fortunate than us. Absolutely, absolutely. We'll have all the links and everything that you mentioned in the show notes and the link to your website and everything where people can follow along with your journey.

Who knows what you'll be up to next? Who knows?