The Rich Roll Podcast - Optimize Your Gut to Fight Disease With Tim Spector
Episode Date: May 22, 2023As Hippocrates said, food is medicine. But what food specifically for which person? Under what particular circumstances? And when? Thanks to some astonishing breakthroughs in medical technology, scie...ntists are at the threshold of prescribing food to sidestep disease, predict diagnostic outcomes, promote longevity, and enhance well-being on a highly individuated basis. The era of personalized medicine is upon us. And at the tip of this revolution is today’s guest, Dr. Tim Spector. Arguably the world’s leading authority on the cutting edge of microbiome research, Tim is a globally-renowned epidemiologist and geneticist. He is also the bestselling author of several books, including The Diet Myth, Spoon Fed, and his latest work, Food for Life, an in-depth, scientific breakdown of what and when to eat, and ways we can all improve our own personal nutrition. This is a fascinating conversation that will leave you reframing the importance diet plays in your life—and what the near future holds for better health for all. Show notes + MORE Watch on Youtube Newsletter Sign-Up Today’s Sponsors: Seed: seed.com/richroll ROKA:  http://www.roka.com/ Squarespace: Squarespace.com/RichRoll Caldera Lab: http://calderalab.com/richroll SriMu: http://srimu.com/rrp
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The 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 to prescribe 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
that builds this community in your gut.
Only recently we've discovered are like mini pharmacies.
Awarded the distinction of Order of the British Empire.
Tim is also the bestselling 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, let's acknowledge
the awesome organizations that make this show possible.
awesome organizations that make this show possible.
We're brought to you today by recovery.com. I've been in recovery for a long time. It's not hyperbolic to say that I owe everything good in my life to sobriety. And it all began with
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Okay. 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.
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 Bolzewicz,
friend of the podcast, who's sitting right over there right now, who accompanied you.
But today is a particular honor because as Dr. B insisted I make clear, you truly are the world's leading authority in this field
at the cutting edge of all this fascinating emerging science
that's creating a new way of learning
about how our bodies work,
how they operate in the world.
And it's very exciting.
So not only are you somebody who's innovating new research,
you are also pioneering this fascinating field
that I wanna learn more about
that we're calling citizen science,
which we're gonna 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 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.
So very excited.
And my journey has been a bit of a long one.
So I-
We got time.
Plenty of time.
Okay, so, cause I'm old so that's what makes makes
one's career longer um i started life as a doctor went to medical school and got interested in
epidemiology which is a study of populations uh but there was no real jobs in that so I trained as a rheumatologist studying bones and
joints and made my way up training and that in London in medical schools and on the way I did a
master's 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 only really after in about 30 years ago that I changed tack from purely rheumatology
and I started what's called the Twins UK project,
which was setting up this twin volunteer system across the UK,
which now has 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 at the time no one knew much about.
And the whole idea of the twin study
was this nature of inertia debate.
And it was 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 genetic.
So we found that back pain was three times more genetic
than breast cancer.
Interesting.
And also to interject here,
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 of 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 diseases.
So that was the time we were living.
And it was also just as the genetic revolution was starting.
So we were starting at gene markers, et cetera.
But it took the first 10 years was really convincing people
that there was a genetic component to common diseases.
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 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 if you had a model that worked,
you might as well study all the interesting stuff you can,
not be stuck 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 that differential, right?
What aspect of their nurturing or their environment
is compelling one to 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 how did that kind of evolve out of studying these pairs
over so many years?
Well, I think I eventually got out of my system
that everything was genetic.
So I was telling everyone everything's genetic.
It turns out that 50% is the, of every,
you name any disease, 50% roughly is genetic.
And that got a bit dull.
It's not a very satisfying answer.
No, it wasn't.
And it was useful because we 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 one be depressed one wouldn't so
i was suddenly 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 a living in a different environment to us uh what happens to them it's like your own little
controlled 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
don't know 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, 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 in 20 odd years
of studying them
that 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 what we thought
was this randomness of disease,
but importantly also changed my perception
about how food works as well
and why in a way the whole of nutrition advice
had been so muddled and confused
and seemingly with poor science
because we'd assumed everyone behaves the same.
Once that food goes into you,
it's gonna 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.
Cause I think it can 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 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 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 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 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 sort of mind boggling the complexity of it.
But I think it's becoming clear that,
yes, there are lots of different strains and microbes
and trillions of them.
But the thing that does bind them in common
is they are essentially mini pharmacies.
They are taking a food as their sort of consumables
and pumping out all kinds of chemicals
that are unique to us 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 microbe,
but the products they make, the chemicals.
And that's the essential, 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 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 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 75, 80% of the microbes
that are in there,
which is pretty, you know,
we wouldn't have believed that possible.
Yeah, yeah, yeah, that's unbelievable.
10 years ago, and the cost has come down
from $5,000 a sample to less than $100 a sample
in 10 years. So 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 in all kinds of areas, not just in nutrition, but in
pharmacy and fighting disease 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, our colon. And the microbiome really refers to the genes of those
microbes, should technically be called the microbiota, But we just use them as microbiome because I'm not fussy about words
and everyone now understands that.
So there are some dispute about how many there are,
but there are certainly trillions,
maybe 100 trillion or so,
roughly the same numbers of cells in our body.
Most of them are the ones we know about are bacteria,
but there are 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're 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 are 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, et cetera, et cetera,
fights infections.
And they also produce lots of chemicals
that might go to our brain,
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?
Infinite things.
But this idea that our immune system
really resides in our gut is kind of a shocking revelation. Like I always understood 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 this is where we're producing all these cells.
Yeah, this is why, yeah, this is.
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, we gotta get rid of parasites and all this stuff.
These are plaguing the human 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, our powerful drugs can get rid of this incredibly complex system. I think it was medical hubris that says that,
our powerful drugs can get rid of this stuff.
We're fighting the West, the world.
We know that microbes have killed lots of people in history,
infectious diseases were vitally important.
We survived them.
Therefore, we can beat them and antibiotics,
sterilizing creams,
keeping people away from dirt.
This is the way we're gonna 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's it's only-
Absorb nutrients and-
Some people still believe that, right?
But you know, particularly the toxin bit,
but the not realizing it had such major implications
as a vital organ for us.
And I think it was, you know, few people guessed at it.
And even the, you know, you go back to the days of 100 years ago,
Metchinkoff and Pasteur talking about yogurt.
They thought it worked because it deputrified the body,
you know, got rid of those toxins.
They couldn't still imagine that it was feeding
other microbes inside there.
So I think we just had a blind spot to it.
Some people believe the ancient Indian art,
you know, understood 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,
couldn't grow them.
And this has been part of the problem.
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 revelations that have emanated out of looking at twins
through this lens?
Oh, it's hard to pick highlights.
Because there was some revelations at the time,
they might seem rather dull now.
Like I was saying, back pain is highly genetic.
Might not surprise people now to say,
but other ones were, one of the first to look at fat distribution was highly genetic.
So whether when you put on weight,
whether you accumulate it in your belly or your bum,
really strongly genetic.
And you can see that in families.
It's sort of obvious.
We showed for the first time that cataract wasn't just
was something you inherited as well um we looked at um early risk factors for melanoma found that
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 genetics than anything else.
And so you can divide people into those groups.
And twin studies helped us with that.
And we did some fun stuff.
We found sense of humor wasn't particularly genetic.
Political views were.
So your right-wing views or your left-wing views
have got 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 you can quantify it reliably and get the similar answer. So it allowed us to
look at sexuality as well. And we were the first to look at the genetics of female sexuality. And so you can study any personality or trait in that way,
as well as things like the microbiome, epigenetics,
which, you know, again, has some genetic influences,
and even things like vitamins.
So people are 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 our vitamin D levels
are gonna be due to differences in our genes.
So what's normal for you, isn't gonna be normal for me.
And how does epigenetics play into that?
From my understanding, epigenetics basically means
the potential for genetic expression.
And also this idea that we're 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 seems like a sticky wicket and very complicated to kind of understand.
And there's a certain aspect of it that's sort of mystical in terms of like the inheritance of
like ancestral trauma and things like that. Like how does that play into how you think about this
and study populations?
Well, I wrote a book about this
called Identically Different, which nobody read,
but I think it was a great book, but you know,
as often the way.
And went into a bit of this and a bit theorizing about it.
And it's been called soft inheritance.
So it's an inheritance.
We think it's an evolutionary adaptation that allows in times of stress or famine or some emotional stress to just switch the genes on or off in a way that takes you on a different path to some extent. And the general belief is that
it takes so long to change your genes normally
that your whole family would have been wiped out by that time
you'd made that switch.
But if this allows you to,
I don't know, there's a temperature change
so it 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 so 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 in when i was looking at, I did interview lots of identical twins
who went through stress, for example.
And it was quite remarkable that, say, a very major family breakup
or something when the teenage twins, one, for example,
responded by overeating and got very obese
and the other one had an eating disorder and ended with anorexia.
So they were acting in response to a stress,
but very differently,
probably because in theory,
the genes were switched and doing something.
But there was something in our evolution
that allows us to have these switches
and make you depressed or happy and these things.
So I think in response to stress, it does make some sense.
And there are lots of stories about after the war,
Dutch hunger famines,
whole populations having these stresses,
which for several generations had effect on their mental health
or others due to these change in 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 as often the case.
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.
It's gotta be so frustrating to see,
amazing kind of dramatic results in mice studies
and not be able to replicate that in humans.
I mean, that seems to be kind of like the recurring theme
across all areas of science.
Millions of scientists have been frustrated.
That's why I didn't get that Nobel prize.
You know, humans just don't behave like mice.
It's very annoying.
Right, and the mice studies are what, you know,
generate a lot of hyperbolic headlines
in terms of breakthroughs.
They still do.
It creates a lot of consumer confusion.
And they still do.
And it's similar in the microbiome.
It's not very, it's not different.
And there were, you there were some misleading studies
in the early days of the microbiome
that just exaggerated the potential effects in humans.
So I think they were accurate,
but from mouse studies,
you can't really get an idea
of the scale of the effect in humans.
You don't know if it's trivial or it's really large.
And I think that's the other sort of problem
about extrapolating.
And, you know, we're not rodents
and we have very different lives
and we eat different things.
And so, yeah, more and more,
you know, we realized
that a lot of these mouse studies were flawed.
And of course you can do unlimited number of mouse studies.
You know, you 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 know, whether it failed or not,
you're going to write it up because it's important.
So you're starting to develop this, you know,
growing sense that the microbiome
is playing a much more crucial role
than previously imagined.
And 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 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 I got in touch with a colleague who I met at a meeting,
Ruth Lay in Cornell, and 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 father of the microbiome, Jeff Gordon,
and who based in St. Louis.
And Rob Knight was another one of his proteges.
And he learned that I was really interested in this.
I was doing the big twin study
and told me about his project,
which he just started,
the American Gut Project,
which was a citizen science project
getting Americans to sign up,
basically donate money
in order 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,
British public were up for this as well.
And so we got together
and under the banner of the American Gut Project
and did this and led to a paper
where the UK Inc. provided about a third of the subject.
So relatively, it was more popular in the UK
given the population density and uh
but together we did a great paper um which how many were in that how many were in the study
there were 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 nutritional eating habits, fiber, and health,
and showed that these clusters, that, you know, measures of gut health,
which is then we used something called diversity.
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 populations tend to still be, they were slightly heavier,
slightly less diverse microbes compared to the British.
But the key bit of that paper was it was the one that found that 30 plants a week
was the sweet spot for maximum diversity.
And that study still hasn't sort of been bettered many years later.
And it'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 ate 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, nuts and seeds and to some extent, herb mixes and spices.
It didn't matter whether you had a little bit of meat,
little bit of fish, you were vegan, vegetarian, whatever,
your gut health was still optimal.
And I think that still resonates with me
that it's not about 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 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 a nice simple rule that means
you don't have to be too strict about 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, colorful polyphenol rich foods.
It's nice, you know, the fermented foods,
we know are good as well,
avoiding ultra processed foods, et cetera.
But that to me is still number one.
And I think that's been a good,
a really good way of communicating it also to the public
about understanding why I feed your gut microbes,
you do it by eating right.
And if you do that,
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, you're crowding it out.
Yeah, I mean, and it's an easy rule to follow.
It's flexible, it's doable.
It's easy to wrap your head around what that means.
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 are your colleagues sort of 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 weren't like you're a nutter,
like you've gone off the reservation.
Well, I mean, there was-
People were saying-
There was awareness in 2014, people,
it wasn't like, you know,
people were talking about the microbiome.
There was an interest then, not like now.
There was, but a lot of people thought it was a passing fad
that like a lot of these new science,
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 just a few years, flash in the pan,
a few fancy mouse studies,
you know, there's a few anecdotes of fecal transplants
that were successful, it would all fall over.
And most of my colleagues in the UK
were not keen on it at all.
And so the countries varied about whether they supported it 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 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 US 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 actually pay for our research. And that really got it going.
So that was really where we were, you know, up until the time when I realized I wanted to do the next stage.
And I was giving a talk about the microbiome.
And that's when I met these two guys
came up to me and said,
we'd like to form a company.
And with all the trouble I'd been getting money academically,
I said, aha, this could be my big chance.
But I'm warning you guys,
the science is very expensive
and there's no quick results the way I wanna do it.
I don't wanna do a marketing led project
with smiling MDs and a stethoscope on the front page.
It's gotta be serious science.
It's gonna 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 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 you could use that to predict everyone's response.
And so give people a real idea of what they should be eating.
And came out of this idea that, you know, there isn't one single diet that suits everybody.
And all these studies like that of Christopher Gardner, the diet fit study where they competed high fat versus high carb diets
and both did well, no winners or losers,
but within the groups, massive differences.
And at the same time, an Israeli group had come out
with a study showing that CGMs,
continuous glucose monitors,
were able to also predict responses to food.
So suddenly the idea was there to combine the microbiome
with these new devices on the market
to suddenly have a quantitative way of really telling people
how they respond to these foods. 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
but luckily managed to convince these guys it needed 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 um studied uh at my
hospital st thomas's and and a group were also studied in Mass General, given identical foods at the same time,
and then all their bloods studied,
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 gave us the nextDICT study. Right. And that, you know, that as well,
that gave us the next revelations, if you like.
So having known that the microbiome
was different between people,
there were two other big aha moments there
when we first looked at 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.
There was also a tenfold difference
in their 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 even 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 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,
certain variables that distinguish individuals
can be 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 solid guidelines in terms of do's and don'ts.
So that gets into the sort of citizen science aspect
of the conversation that I wanna get into,
but there were so many things in what you just said
that I wanna tease out gradually.
The first being just the realization that gut health, the microbiome in so many ways
holds this key to unlock so many things
that have befuddled scientists for so long.
And there are a few things as complicated as nutrition.
And certainly it's something that is so hotly debated
and it appears that it's so difficult to arrive
at any kind of consensus around,
and you talk about this 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,
this is your DNA, this is your genetic makeup. And you can say,
well, you know, 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 right? And trying to understand how to kind of maneuver
around that 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 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 for everything, right?
You're eating crow now.
And hope that, as you said,
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 getting myself down a bit about it.
And so it was so empowering really to realize that yeah we're 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,
you know, this study, 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, me personally, in a few days. So unimaginable to change your genes in that way.
So I think suddenly, you know,
me personally, 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 big, hard problem, right?
Well, we were starting from, yeah, a very fair base.
Yeah, it's like this,
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 protocols
or means of diagnosis and recommended therapies.
Yeah, no, it's tough.
And I think we mustn't, again,
realize that we know more than we do.
And so we are just at the tip of this discovery.
The microbiome sequencing is just getting to the point now
where we're discovering all kinds of new elements
to our gut microbiome.
Like, you know, we've discovered this parasite.
There's in one in four, you know,
one in four British people have this parasite
called blastocystis.
And it's only in one in 20 Americans.
And if you have it, if you went to see your GP,
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 problems and whatever.
You know, better kill it.
Let's get it out.
But it turns out that if you've got it,
you are healthier, you're skinnier,
you've got less visceral fat,
your blood lipid levels are lower,
your blood pressure's lower,
and it's a sign of super good health.
And so we're discovering that this parasite
actually probably eats other microbes
that are 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.
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 third world countries,
100% of the populations have blastocystis
and modern living has wiped it out.
And, you know, we 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 fascinating.
This is just one element of all these, you know,
we know nothing about the fungi, the parasites,
the viruses, the phages that are doing all this stuff as well.
So let's, you know, we can't get ahead of ourselves.
We've got to stick to the basics as we learn
and understand that, you know,
we're all got different makeups
and different bugs inside us
that could be doing different things.
Right, the insane complexity of all of it
seems like a perfect dynamic
for introducing the tools of,
the emerging tools of artificial intelligence
because they're so good at crunching massive data sets
and dealing with complexity at this kind of scale.
Has there been any inroads with these kind of emergent tools
and how they might apply to this field?
Well, we think we've just about got to the level.
So we've now got, we've been looking at our latest paper
at 50,000 stool samples from the US and the UK,
people who've taken the ZOE tests.
And with those numbers,
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're doing this on a small level
with our studies at the moment
that's allowed us to work out
what we think 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.
So 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 associated with all these good health outcomes
and associated with these healthy foods
as well.
So it's the link between the foods, the microbes
and the health outcomes.
Right, right, right, right.
But you need these big data sets,
like we did in genetics before you really start
to get 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 those big data sets,
introduces this idea of citizen science.
And I wanna get to personalized nutrition,
but I don't think we can really talk about that
until we kind of discuss the impact
and the potential impact of what this whole emerging world
of citizen science is
and the kind of advent of these technologies
by dint of Zoe and, you know,
other kind of things that are out there
that are allowing you to run, you know,
incredible, incredibly detailed experiments
at a massive scale
unprecedented in the history of science.
Because, 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
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 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 kind of data analytics
and the power of the results
that you're seeing to create predictive outcomes
and again, like diagnostic tools.
Yeah, and I think it's a real game changer in science
because in a very short period of time,
we've built up the largest microbiome database in the world.
We're now doing microbiome sequencing in the world we're now uh
doing 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 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 so slow,
you can do this in real time and get these results back.
And I think my eyes were open to this.
You know, we'd started Zoe, but then a pandemic hit and um 2020 and obviously everything all our clinical studies
stopped on the twins and so while cycling home from in london i had the idea of uh asking
repurposing the the sort of zo app, which was based for nutrition,
to understand COVID and get COVID symptoms, et cetera.
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 went live, totally raw, full of bugs,
and thought it would flop, but at least we'd done our bit.
And we had a million people downloaded it in 24 hours.
Wow.
So one of the biggest sort of health outcomes. How'd you manage that?
Social media.
Everyone shared it, said this is a great idea.
It was the first day of the lockdown in the UK.
And we launched it a week later in the US.
And within two weeks, we had 2 million and then we eventually got to 4 million people
using this app at a time when there was,
people wanted to unite to do something.
And the government was useless.
You couldn't go and see your doctor. You know, you were told to stay at home. You couldn't go and see your doctor.
You know, you were told to stay at home.
You couldn't get tested.
So it just struck a chord.
And we were told no one over 60 is going to use an app, right?
That was the other thing they say, well, you know,
technology is not for oldies, you know.
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
loss of smell, for example,
was being reported by a third of people
who had all these other symptoms of COVID
or tested positive.
Right, so that's the origin of how it was determined
that loss of smell was the thing, right?
It came out of that originally.
Clinicians noted it in Italy.
So they were saying, it's strange, I've got, you know,
ENT people were saying, I think this seems,
something must be happening here, but they couldn't tell,
couldn't do a proper study.
So 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 the UK was the slowest to change, but interestingly, because they
hadn't done the study themselves. But 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 looked at skin.
We asked people to send pictures
of their skin rashes with COVID.
I think we got 30,000 pictures.
Wow.
And she formed an Atlas that, you know,
people could see around the world.
We, there was COVID tongue.
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, $5 million and five years to do
where we asked a million people
to fill in a diet questionnaire
in the US and UK and look to
their severity of COVID they got, you know, a year later. And with that data, we clearly showed that
diet quality was one of the biggest factors in determining how you were likely to die or to
stay in hospital,
have really serious COVID,
a link with the immune system and nutrition.
So this is all done at the speed of light.
We were writing papers in a few days.
Yeah, shocking.
I mean, so 4 million people,
how many people are on the app now?
We have about, still about 300,000 still logging daily.
And we've, but we've, so it's three years on now.
It's obviously come down from the millions that were doing it.
But we've repositioned it into a health study app.
So we've got consent to study more than just COVID.
And we're now using it to do other lifestyle factors.
So we realize its potential.
And so we, for example, have 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 appetite, their weight,
any other factors we wanted to,
and got this launch really fast.
And amazingly, most people,
and they could do the fasting whenever they wanted.
So we were also looking,
it's a way of looking at not just does it work,
but how practical is this?
Because you have these tiny studies done on 10 people,
handpicked volunteers from Stanford.
I mean, what can you really extrapolate from that?
They're not generalizable.
That's meaningful.
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 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 of them were less bloating, mood improved.
And interestingly, appetite didn't go up
because we were 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
at very little cost
in such rapid time
really means, for me,
this really is the future
of how we can particularly do subjects
that don't get the funding.
You know, the sort of studies about
who's gonna give you big money to do meditation
or yoga or five minutes exercise
or going to bed earlier or, 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, you get the aficionados who tell you, yes, you know, the dedicated gurus 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 that people, you know,
because we're told like intermittent fasting works better
if you do your fasting later at night.
So you don't eat after say 5 p.m.
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 can't adhere.
It's like diets, right?
Completely pointless if you can't stay on it long-term.
So finding out that only about a quarter of people
in the UK prefer to do their fasting late at night,
I have an early meal and then 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 purist idea
that this is the only thing that people should do.
What's replicable and sustainable.
And if you do that, then are you eating it?
You're probably eating dinner at six or seven
as opposed to 10 at night.
And what's the implications of that?
But the real power it seems comes in
when you layer on top of that,
all kinds of other sort of biometrics
from heart rate variability,
the glucose monitor that's showing
how you're metabolizing your food,
resting heart rate, metabolic rate,
all these things with these kind of devices now
that all establish a matrix of variables
that you can then compare and contrast
to draw a 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, I think that's the next phase.
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 inputs and then
rework some of this data. And we want to also, with people doing the paid Zoe program,
Also, with people doing the paid Zoe program,
also start having some of these interventions as well.
So that 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 gonna do better?
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,
the more you can do it.
And everything we've seen is people are super willing to take part.
Even if they've been paying money,
they like the idea of being in these large experiments as long as you give them you feed back 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've done the study,
people want to know how they got on,
how they compared to other people.
And this is what we have to start to do much better
than we've done in the past.
But I think it's really exciting.
I wish we'd discovered this 20 years ago.
Well, these things happen when-
Wouldn't have been possible.
Yeah, the technology has to be robust enough, right?
And to your point, we are at the very beginning of this.
I mean, I think there's privacy concerns,
there's other kind of issues
that need to be kind of properly navigated,
but it is exciting.
And I think it answers a critical question 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, et cetera,
and everything that's going on, you know, on your platform, but like, why does this matter?
going on 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 medicine
versus the promise or the hype?
And how close are we to kind of bridging that gap
between our aspiration and what we're actually capable of providing
the interested consumer.
Yeah, there's certainly plenty of critics
of personalized nutrition, which is what we're 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.
Remember the blood type diet?
Yeah, exactly.
That was a fantastic example, that's right.
So there's been a lot of rubbish.
But the new era of personalized nutrition,
A, we've published peer reviewreviewed papers in Nature Medicine,
high-quality journals to show
there are these big individual differences that are real.
We have performed a randomized controlled trial
of unpersonalized approaches,
standard US advice versus people doing the Zoe program.
Unblinded the results, but I'm looking at it.
I'm very confident they're going to be good.
So the randomized controlled trial is the best way to tell whether it's better than, you know, uniform advice.
to tell whether it's better than uniform advice.
And I think the other reason is that as soon as something's personalized to you,
you're much more likely to take, 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 likely.
Your level of belief is so much higher.
And if that's backed up by science,
then 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 is absolutely the future.
And I think, you know, yes, we won't be able to sort out all the future. And I think, you know, yes,
we won't be able to sort out all the problems.
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 glucose and for lipid levels
and assessing how much those people need,
I think we're doing a pretty good job now.
So, and, you know, I think the studies will show
that people feel better.
Anecdotally, the people were saying they felt better
and the randomized controlled trials
actually are saying the same thing.
And I think the bit we've always been forgotten
about nutrition, which we didn't know,
is things like energy.
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 a 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,
your triglycerides hanging around your body
which means you get less inflammation.
We're seeing that in everything we do
is this report of I feel more energy.
Right.
And I think that's really important.
So it's not just about weight
and the sort of external stuff.
It's finding out what foods make you feel good.
And you know this from running.
Yeah, of course, of course.
People do this by trial and error.
That the average non-sports person
has to rely on other tricks to do it
and may not have thought about it
in the same way as a performance athlete.
One of the diagnostic tools that you're using for this
is the continuous glucose monitor.
And that, you know, I wanna talk more broadly
about metabolic health in general
and how that relates to the microbiome.
But with respect to CGMs,
there's a lot of squabbling around that as well.
There's a certain kind of subset
of the type one diabetic community
that seems unhappy with the fact
that this is available to consumers more broadly.
And, 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
an undue fixation on CGM metrics alone paints an incomplete picture of what you should or should not be eating, et cetera.
And there's kind of the whole biohacker community around it
that's drawing conclusions that aren't necessarily
completely solid because of an over-reliance
on that variable over kind of a matrix
of complimentary value.
So can you talk a little bit about the benefits
and perhaps the limitations of the use of a CGM?
Like I've used it, I found it to be super interesting.
I drew a lot of kind of non-intuitive conclusions
about my lifestyle habits and certain foods
that were contributing to spikes and valleys, et cetera.
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.
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 like you 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.
10 years ago, you wouldn't have dreamt this would be possible.
And we think that within five years,
you know, most of the smartwatches might actually have
some capability to do this as well.
So it's not going away.
Like any new technology,
it's gonna be misused by some people
or overused or overhyped, et cetera.
And yeah, certainly for the type one diabetics,
there was a time when they were run out out of supply so they couldn't get it
and I absolutely
understand why they were angry
people just doing it for fun
when they're risking
fatal hypos without them
so they're incredibly useful but
they are
a complaint against Zoe
was that they weren't very reliable.
We did a study where we gave 300 users one on each arm
and looked at those,
and they worked out really pretty well
for the purposes we're using it.
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 and 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 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 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, you reach some wrong conclusions. And
one of the common ones is that the only way to eat is to have a completely flat.
Right. You eat a hundred percent fat diet. Like you're going to have an awesome curve, right?
It's going gonna be flat.
Exactly, you just put ice cream on everything
or whatever it is and you know,
you just cream on everything, you sort it out.
And clearly that's wrong.
And that's why something with Zoe,
we see it's just one of these three tests really.
It's one part of your score is your glycemic score,
but we need to know how you handle fats.
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 fats 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 is reasonable to use these.
And I think they are a great educational tool
to show people that some of the common things
they were eating,
like their standard sliced loaf bread,
which they thought was super healthy,
is giving them this massive spike,
what mine looks like if I had supermarket bread. And certain fruits, for example, that
they thought was 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 that 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 also can think about your fats you've got
to think about how good that food is for your gut microbes and accept that you will all yeah you can
still have some sugar spikes every now and again.
It's normal, that's physiology.
Let's not get obsessed about it.
But seeing it in real time is kind of cool.
And that's a glimpse, I think, of the future.
You know, 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, let's say you have a CGM,
you see your blood glucose go up, it goes down.
Why is this important?
What is metabolic health?
And why should we be paying attention to this
in the first place?
These spikes in sugar and or triglycerides
are part of normal physiology.
So, our body's designed to do that way.
But if there's too many of them
and the spikes are too prolonged,
you either get a buildup of...
So the sugar spikes will create rise in insulin,
which can start getting insulin resistance,
and long-term you might end up more likely to get diabetes,
pushing you towards pre-diabetes, et cetera.
And the buildup in triglycerides
are particularly related to inflammation.
You get inflammation in the blood vessels.
Over time, that stress builds up,
and again, heart disease and other metabolic problems.
So 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,
this sort of low-level stress in the body.
And other studies have shown that people who have um 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 a sugar dip so one in one in three men one in three
women one in four uh men after a carby say breakfast or or lunch three hours later we'll
have a dip below baseline and you say okay that's not to worry about but we we followed
a large number of these people and it turns out they report being more tired.
They don't know what their result,
they were blind to their result.
They were more tired, they were more hungry
and they overate by about 300 calories that day.
So these sugar dips,
which you get from highly 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 dips.
So some people are 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
a robust, healthy microbiome in turn
help you maintain a healthy metabolic sort of profile?
We don't know is the true answer, but we do know that all the epidemiology studies
show that people with poor metabolic health,
so with type two diabetes, with obesity, with high blood pressure,
with autoimmune disease, inflammation,
all have low diversity microbes,
poor ratios of good to bad bugs.
So there's a clear association there.
And then you can do 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 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 both cause and effect relationships.
So we don't understand exactly how they do all this.
There's so many chemicals involved, so many microbes involved
that we don't yet know the details,
but we do know that there's these very clear associations
and that you can improve metabolic health
sort of dramatically in a lot of animal models
by improving the microbes
or things like fecal transplants in mice
and things like this.
Right, so in other words,
if you are getting indicia
that you're having some level of insulin resistance,
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 a leap or is that?
No, I think that's general for most of the chronic diseases
that are raised 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 all these other stress hormones.
And 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 impact of those diseases.
So these haven't been studied
in big enough nutritional trials yet,
but everything points to that is the direction
we should going in it.
So far for most of these diseases,
they don't seem to be very specific microbes
that are involved.
It's more the general community 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 beneficial or pro-inflammatory
and itself producing more of the problems.
That's fascinating.
And as this continues to scale up,
obviously you'll continue to learn more.
Yeah, and Christopher Gardner,
I know you're probably gonna be talking to him soon,
did a really neat study where gave intensive amounts
of fermented foods to volunteers
and looked at their inflammation and immune levels
over the next few weeks.
And they showed 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 basic mechanisms
that are important to so many chronic diseases.
And yet most doctors never suggest these as treatments.
They always reach for the prescription pad.
It's amazing how fast that is too.
Yeah, exactly.
How mutable it really is.
That was the surprising thing that it just,
it was four weeks of intensive meal deliveries.
So they knew, you know, they were getting this stuff
and then they had four weeks
where they were just trying it on their own,
but it was, 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 shocking as well.
Cause we've just said, oh, well, that's just yogurt.
That's not real treatment.
You know, that's hippie stuff.
You know, we don't believe in that, but these, you know,
luckily they did a huge range of blood tests
and microbe tests.
So yeah, in a few weeks you can really change
your gut health and influence disease.
And I think that's the message
and this whole mess about why medicine,
why food really is medicine.
And we should come back to that,
not start saying, well, you have to be a nutter
if you say that.
Yeah. Did Hippocrates you say that, you know?
Did Hippocrates actually say that or is that apocryphal?
We don't know.
I haven't seen his original text,
so, but it's nice to think he would have said it.
I like to believe that as well.
The other kind of really exciting, interesting field
where we're seeing a lot of exciting developments
is at the intersection of the microbiome
and cancer research, right?
So explain a little bit about what's going on with that,
specifically with respect to melanoma
and to some extent, even lymphoma, right?
Yeah, well, 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,
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,
ageing and cancer have got this sort of close link.
We've never really realized how important it was
until these immunotherapy drugs come along,
these so-called checkpoint inhibitors,
which have been sort of game changers for many people
with some of these solid tumors,
particularly melanoma,
but to a lesser extent, kidney and lung and some prostate,
that you're using these drugs to boost the immune system
to attack the cancer cell and get round its defences.
And so mortality rates were sort of 95%
and these drugs have really changed it.
So they've halved, doubled the survival rate
in these particular conditions.
It doesn't affect most cancers, but these ones.
And what we've seen is that there were some early studies
showing that the microbiome might have a role in this
and that the state of the microbiome was important
because it was interacting,
because as I mentioned, how important it is for the immune system.
And you want a really powerful immune response
in order to fight that cancer for that drug to work.
So there are a few early studies of this
suggesting this might be the case.
And we got together with a UK charity
and got a consortium of other cancer centers in the UK and the Netherlands and we got
several hundred melanoma cases end stage these are people with terminal sort of metastatic cancer
going through their 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 the good to bad ratio, loss of diversity.
And we also looked at their diets and it was the lack of fiber
and positive aspects of those that followed more Mediterranean diet
had like double the rate of success of survival.
And these figures aren't trivial.
It's not a tiny amount.
If real difference between double your chances of success of reaching 12 months.
Wow.
And yet, how many patients know the importance of this?
Yeah, it's interesting.
How many oncologists discuss diet in such a powerful way?
And there's been some studies for chemotherapy
haven't been very clear or very large,
which is where you just sort of try and kill all the cells.
And there are some hospitals like, I think it's Sloan Kettering or MD Anderson,
where 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 you-
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 gonna get obliterated, right?
So to culture it and be able to supplement
or kind of have a way of repairing that as you go along
would seem to be kind of crucial and obvious.
Yeah, and I think we're all gonna be storing microbiome
when we think we're at our healthiest,
which is always hard to know.
Yeah, well, trust me,
I'm gonna 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 turbocharge 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 CART therapy is very complicated using T cells.
And the microbiome again is proving crucial
in those lymphoma just like a type of leukemia.
So I think we're gonna see more and more of this.
And 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 diet is
and gut health because medics are still not being taught anything about 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 patients saying-
Because what is the rationale?
I think it comes to the days when
at some point in chemotherapy,
you are very vulnerable to infections.
And so you have very few white cells 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 micros.
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 far as I know that, you know,
they've never killed anybody who isn't,
who's got a few, you know, decent white, some white cells.
Yeah, so paint the picture of what the future
in your mind looks like from a personalized
medicine perspective and a diagnostic
and treatment perspective when you're able to perform,
really dialed in specific citizen science
and data crunching to create really powerful tools
to treat better in a more bespoke way.
I mean, what does that look like?
And you did, like I'm imagining how far in the future. Well I'm imagining- How far in the future are we talking?
Well, maybe like 10 years from now and 50 years from now.
Like I've had futurists on here.
I've heard, like I think what's happening in terms of-
I can't go beyond 10 years, I'm sorry.
Well, like there's a lot of interesting breakthroughs
and developments in scanning and early detection
and all of these things that I think are really powerful
in terms of catching things early on.
Like so much of what we perish from is avoidable and all of these things that I think are really powerful in terms of catching things early on.
Like so much of what we perish from is avoidable if we could have caught it earlier.
And kind of the technology is getting to a point
where we're gonna be able to detect these things so early on
that we can deal with them in a really facile manner
before they become problematic.
But-
That's early treatment. Yeah, early know, before they become problematic. But that's early treatment.
Yeah, early treatment, right.
And what you're talking about is just another piece
in that broader puzzle in terms of like where medicine
and healthcare are heading, but you know,
what does it look like from what you're seeing?
Well, I'd love to see more about prevention
rather than sort of early treatment
and reverse the major threat to the Western world,
which is our poor diet,
which is essentially killing us
and giving half the population of the US,
you know, diabetes and obesity.
It's an insane statistic.
And so, you know, ultra processed food
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 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 increasing number of diseases
with expensive MRI scans.
We actually gonna do something
at a population epidemiology level to say,
these foods they're like,
they couldn't have cigarettes in the 1970s.
They should have health warnings on them,
not health promotion benefits to say,
this is healthy because it's got some vitamin D.
Iron or whatever it is.
Yeah, fortified with vitamin C or D or K.
There should be a warning that says,
if it comes with some health advice, it's bad for you.
That would be a good sticker um so i'm 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.
We know all the major smartwatch manufacturers are moving towards this.
They'll have laser devices that will be able to pick up different blood measures in you in real time.
These will be fed back through algorithms in your phone.
measures 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 people's?
You know, which artificial suena,
if you have to have one, you know, would you have?
This 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 through the food jungle,
point us to say what ideally we should be eating,
keep us logged about 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
relative to where our last night's sleep was.
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 this is an evolving science
and if everyone is part of a giant citizen science project,
then everyone benefits.
And I think that's my vision of the future
is that we will have this sort of benevolent companies.
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 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 it in the new book.
I think this is definitely the future,
but it's also understanding what the foods we're eating
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 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 by calories and by 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,
they're fake food.
But because they have the right macronutrients on the label,
they get a nice tick and we're poisoning ourselves.
So I think, you know, we haven't really changed in 100 years
our basic concept of how to discuss nutrition properly.
And 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 muddying the water on it.
So the fact that they, 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 by its 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 food.
And that's totally clear.
Like the example I gave you in the Zoe study
of people giving an identical calorie muffin.
I gave you in the Zoe study of people giving an identical calorie muffin.
And some people react to that in a very different way and get a sugar dip and will 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 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,
what's a whole plant food,
not these foods that are made
in a way to falsify real food.
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 we can go into the whole thing
about why calorie counting diets
fail the vast majority of people.
It will work for a few weeks,
then your body just readjusts
and bounces back the same way.
Exercise for most people does the same
because your body adapts to that exercise.
We're not just furnaces,
we're finely tuned machines that change.
So these are concepts that have just stayed
because of the market,
the force of the calorie counting diet market,
the force of the food industry trying to sell 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, there's sort of an arms race also,
because as the public becomes increasingly
more and more aware of 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 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 human frailty and weakness accounts for the rest.
So it's sticky to like-
Well, I've got no, I don't really have a beef with foods
that are obviously unhealthy, but super tasty, right?
But when something is wrapped up in all this healthy packaging
and is sold to you as a healthy, low calorie,
low fat alternative, that's criminal.
It's like dressing up cigarettes as healthy
because they're low in,
like it used to be low tar or low nicotine.
Therefore they're fine.
Right, yeah, 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 gonna get rid of them,
but let's have them
with health warnings. Let's have them with a tax that reflects the huge burden on the taxpayer that
all these foods are costing us. So it's hundreds of billions of dollars a year just because 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 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.
I mean, I agree with you completely,
but then it becomes a question of political will
and kind of penetrating the battalion of lobbyists
who are very invested in the status quo.
Yeah, most countries have this problem.
While we're all getting diabetes and becoming obese
and dying of chronic lifestyle illnesses.
There will be a point when the country
just won't be able to afford it.
The healthcare system is broken.
So it becomes a national security issue, honestly.
Like it's a really huge problem
and yet it continues to persist and metastasize,
which is disturbing, but perhaps we can, you know,
pivot to a more optimistic or helpful conversation around
like how to guide people towards those better choices.
I mean, we all know more fruits and vegetables, nuts, seeds,
you know, that's the kind of thumbnail. But for 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, you avoid and what to invest in?
Well, there's a lot to avoid.
But in writing the book, there were some surprising findings that I found that things that are relatively cheap aren't always unhealthy.
So things in cans.
many studies have shown that some canned tomatoes can have higher nutrient levels than fresh tomatoes for example get a can of beans they're just as healthy as
getting your 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 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 source,
it doesn't have an artificial source in it, it's gonna be true as long as the source it is it doesn't have you know an artificial
source in it it's going to be really good for you so that that was a surprising finding for
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. And there's a big difference
between some artificially created 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 unfortunately, the vast majority of ready meals
that you buy have large lists of ingredients in them
that you 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 going to 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 no fiber, very little 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.
And that, so to my mind,
it's an educational way of thinking,
but realizing there are some things that look quite similar
that actually are still very good for people,
but they're not eating.
Yeah, your dietary perspective and recommendations,
although very plant focused and kind of plant centric
are not ideologically sort of driven
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 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 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, 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 light?
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 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?
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 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 a little of this.
But all the science suggests
that actually lightly cooking food is the optimal.
So lightly steaming your food breaks down the structures,
allows the nutrients 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 freezing stuff,
even microwaving is fine.
Before I researched the book,
I was, oh, I'd got rid of my microwave.
I thought this is terrible.
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,
if you say a baked potato in a microwave,
it's much more efficient for climate change to use.
From an energy expenditure perspective.
It may not taste as good.
I still struggle with the idea of like having a microwave,
but go ahead.
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 not be so obsessed with my prior beliefs.
So structure of food's important.
How you cook it's important.
What you cook it with.
So just combining foods together
will change their nutrient value as well.
So a lot of these Mediterranean dishes
which 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 10 minutes before you use it
actually trebles the amount of
these really beneficial nutrients in the garlic
that otherwise would get broken down.
So 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.
Obviously, cooking stuff close to plastics,
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
is also important.
And I think the other thing 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, were animals, you know, injured?
What's the ethical basis of that?
Or what's a lot of,
there's a lot of new stuff about child slave labor,
for example, chocolate and coffee
and various other tropical things
that we need to be aware of.
But 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 wanna buy something nice
and you're trying to work out all of,
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 use, etc.
So it makes obvious sense to cut that out.
So I switched to oat milk,
which 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
fat, mild sugar mixture for a much higher sugar, much more refined product,
meant that if I was having regular oat milk, for me, it'd be bad. Other people might be fine,
but that would be better for the planet if we all switched to oat milk. But it would
probably cause more, 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 week?
Are you going to, how do you freeze them enough?
And where do you get the nuts from?
So it starts to ask a lot of questions.
We don't have all the answers,
but I think it made me think,
and I want people who read the book
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 purchase of food that you make
is a vote for the world that 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 product that we, 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 manufacturing
and distribution of this?
You know, what was the 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 impossible to put all that on the consumer
and expect them to like really be able to make
an informed decision,
especially when the larger food companies
are doing their best to obscure
any kind of transparency around that.
Well, 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
that gives you an environmental index.
And obviously the Zoe program is designed so that you get your general Zoe score.
And I've got my scores in the book for various things,
which is a combination of the three.
So we're thinking 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 have it as a major factor could actually
have that but it is so complicated it would need it does need algorithms and an app you can't
it is so complicated.
It 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,
what's the difference?
And also labeling is not reliable.
All the obscurant language around labeling,
you think you're buying something
that was grown in a certain way
and it most likely wasn't.
And that opens up a conversation around, you know,
a different, you know, a different component
of the microbiome, which is the sensitivity
of our, you know, larger microbiome,
not just to the foods that we're eating,
but to environmental toxins, the air that we breathe,
the personal care products that we use,
skin cream, shampoos, et cetera,
and not for nothing, the pesticides that find their way
onto the foods that we're eating,
that we're not even aware we're consuming,
whether we're washing them or not.
And there's a spectrum of harm associated with that.
But 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 all have 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 level.
Because it's just blowing around in the wind
from the neighboring farm and finds its way
into the soil 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, or meat.
You get a whole bunch of other stuff.
But you know, so it's,
but you obviously compensate by, you're eating lots of plants and vegetables, think you're, so it's, but you obviously compensate by eating lots of plants
and vegetables, think you're doing the right thing.
But if it's not organic,
you are actually ingesting more glyphosate.
And I certainly realize there are also certain types
of plant where you get many more.
So if you like oats,
and I know Americans love their oatmeal in the morning,
think it's a healthy food.
It has really high levels of glyphosate when the people have tested breakfast cereals
because oats and rye, to dry them out,
they'd spray it out as a way of harvesting it quicker.
So used 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 suggestion it increases
lymphomas and there are some there have been some court cases on that um they've done some
mouse studies that show that uh it does affect the gut microbiome because these chemicals were designed
so they didn't affect human genes.
So they're not supposed to interact with human genes,
but they're supposed to kill plant genes
and as collateral damage,
they take out quite a few of our microbial genes as well.
So we are seeing disruption in the gut microbiome
due to glyphosates.
And animal models have shown
that they do produce abnormal chemicals.
Now, that's really all we know at the moment.
So there's nothing definitive,
but it's 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 mortality levels over the next 10 years.
So there's enough for me to worry about.
I'm also worried about microplastics.
I think we don't understand that.
And we do know that they do get into our gut
and can cause disruption in our gut microbes as well.
And they're also enough if you eat a lot of fish,
because you think fish are healthy
and they go into that in the book.
You're gonna be eating.
And if you go to a nice non-sentient fish like mussels
and say, okay, I can eat those.
They're great, they're really healthy and nutritious,
but they've got a lot of microplastic in them
because they suck it out of the sea.
So we're sort of screwing up our planet slowly.
So all these good things we're having a problem with.
But so, you know,
I think there is pretty clear evidence
that these pesticides, et cetera,
and are bad for newborn babies
and pregnant women
and increase,
they've done some small scale studies.
Evidence for the whole population isn't yet definite,
but certainly if you can afford it,
then definitely go organic is my advice.
And unfortunately in most countries,
it's still more expensive and that's a problem.
But I do worry about that.
But having said that, it's still better to eat vegetables
and not worry about the pesticides
than 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 harm with respect to that.
If you're budget conscious about
what's the most important
food group to be organic versus conventional.
But yeah, but for your breakfast cereal
in the US is one of the biggest sources.
Well, you should just get rid of that.
Exactly. Cross it off the list.
We can agree.
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.
What is your thoughts?
A big piece of, let me preface this by saying,
I think 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, and that the level of that 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,
eating a diet that's high in fiber,
that is high in prebiotics and fermented foods,
which are probiotics, et cetera.
And with that, what is your response
to this growing 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 very enthusiastically
sharing their anecdotal experience with this.
Well, 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, and I also get people saying,
I've been on a carnivore diet for two years, I feel great.
What are you talking about?
You need all these plants.
We do know that people who don't eat plants, a variety of plants,
have less diverse gut microbes. Their microbial health is generally poor, which means they will
have a poorer immune system. And so my worry about the carnivore diet is that it may work short term,
they might feel better.
And not everybody,
I know some people who really can't tolerate
those levels of meat or fats.
And we know there's individual variations.
There are some people who can tolerate it
and for a short while will feel better,
might lose weight,
might feel they're getting,
you know, they're feeling stronger, et cetera.
And I think that's genuine.
But long-term, they're gonna 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 Hadza hunter ancestors
through antibiotics, through poor foods,
through ultra processed foods, et cetera, et cetera.
So they're gonna 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, et cetera, is going to be used up.
So whenever they have a problem, they're going to 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.
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 about five or six years ago
and saw firsthand what these hunter-gatherers in Tanzania,
what they actually eat.
And, you know, I ate exactly as they did.
And, you know, I was filled up at about 10 o'clock
with baobab porridge,
which is this, it just falls off the trees
and you mash it up with a bit of water.
And that's your huge high fiber mass.
You can't stop farting after that.
You know, you're just so full of fiber.
You're eating berries.
Then at lunchtime, you'd have,
the women would dig up tubers,
which are like, you know,
ancient yams,
like a sort of form of sweet potato.
And that would be 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 found any.
But the large periods of the year,
they'd be having no meat.
And most of their calories would come from the carbohydrates.
And if there's honey around, they didn't want meat.
They just went for the honey.
They stopped hunting completely.
They just satiated themselves on the honey.
So people have a very different perception
of what our ancestors were actually doing.
And the majority of their food was plant-based 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 the Hatha is, for people that don't know,
an African traditional hunter-gatherer tribe
that has been able for the most part
to maintain their lifestyle and their traditions
amidst a rapidly kind of encroaching developing world.
And they have the most robust microbiomes
because they have a very robust environment
and extremely diverse amount of plant life
on which they sort of persist and exist, right?
But it feels like there's a deadline on that.
I don't know, when were you there?
Like the world is encroaching on them, right?
And some of their traditions are beginning to erode
and their dietary habits 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 pastoralists moving in.
And of course, 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. For, everybody wants to study. I have a guy coming in tomorrow who went down and lived with them also.
Yes.
For different reasons, but yeah.
So yeah, I mean, you know,
hopefully they will survive a bit longer,
but they're sort of running out of room.
And they are the last true hunter gatherer tribe really
in Africa.
And, 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 counterintuitive to what we believed.
In fact, they don't burn many more calories than we do.
And, you know, 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 doing it a lot better
than we are.
Exactly.
And you don't see obesity, 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 ripe old age,
but 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 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 otherwise, you know, we're not eating healthily.
And so, you know, it is this last chance to see
how we did evolve.
I think they've been there for, you know,
at least 15,000 years or in that similar sort of environment,
which is, you know, where we're supposed to evolve from,
you know, around the equator.
So, yeah, it's a pity.
But, yeah, we've learned a lot from them.
I certainly did.
My microbes actually-
You tested before and after, right?
Yeah, and I was eating everything they had.
So the baobab, the yam, but one day it was porcupine was on the menu.
So, you know, which is not something you get regularly
and various other animals that I had no idea what they were, but they all got thrown on the menu. So, you know, which is not something you get regularly and various other animals
that had no idea
what they were,
but they all got thrown
on the barbecue.
But you were surrounded
by animals and dirt
and they're the microbes as well.
So I think part of this
is also the environment
that we've lost
as we've moved into cities,
everything's sterile.
You know, we're not,
we need to go back to hugging trees
and getting back to nature.
And that's why gardeners have better microbes
than non-gardeners.
You know, I think we also realize it's external
as well as what we eat as well is important.
But yeah, my microbes improved
by about 30% in diversity while I was there.
But when I got back on airplane food on the way back,
by the time I got back to London,
it had gone straight back to where it was.
Did you keep that culture though
and store it for future proliferation?
Yeah, I wouldn't have got through security.
Yeah, I mean, that conjures up the next thing,
which is the future of fecal transplants. Like it does seem like there's something interesting there.
Like if you can, 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.
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.
It is the number one treatment for a couple of conditions, mainly really bad infections
and something called recurrent C. diff, clostridium difficile. You get recurrent diarrhea 30 times a day,
usually caused by antibiotics overuse.
That is 90% of the time cured by a single transfusion
of a healthy donor stool sample.
But there are not many other conditions
where it's shown to be nearly as effective.
And the early hope that it would be a cure for obesity
has been shown to be false.
So you can't take someone's skinny feces
and put them into an obese person and make them skinny.
Doesn't work.
But isn't there, there's some indicia around cravings though,
isn't there with this or no?
There are autoimmune diseases.
Well, it does work in a proportion of people
with ulcerative colitis, which is an autoimmune disease.
So that's the other hope because there's at least one
disease where I think it's about one in four or one in five people have remission.
So it's like 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 pretty good.
But it doesn't work for other related conditions.
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 actually
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 it's not looking as hopeful as it was
perhaps 10 years ago to be 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 stool sample,
and they gave that to people who'd failed immunotherapy
and were about to die.
And a reasonable proportion of them 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 improve them.
So I think we're still finding our way
and 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 Magi-Mix
and serve up that soup
or they should be specifically looking for certain microbes
or you should be artificially producing these 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 hope and 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 storing up the people who successfully fought off cancer
against the odds and worked out what it is about those microbes
that are so good at helping that person's immune system.
Yeah, that's interesting.
Yeah, it's a nuanced game as we say,
but I think we were misled
because a lot of people thought it was a cure for obesity.
Right.
That a lot of people were doing this on the internet
and had some very bad results.
Another source of confusion
surrounds the importance or lack thereof
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 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 kefir's,
it'll say, it has this and that in it,
but what is the pasteurization process?
Like do these cultures persist through the manufacturing
and distribution process of these foods
such that they have any kind of viability
once they're consumed.
So lots of questions there. I think the first one is I think to build a healthy gut microbiome,
you've got to get the diversity of plants in there as your number one. That's number one.
If you don't eat plants, I don't think 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 as they're passing through, they stimulate the other microbes to produce helpful chemicals.
We don't exactly understand that because,
to produce helpful chemicals.
We don't exactly understand that but we know that the microbes, for example,
in kefir or yogurt, these lactobacilli,
they're designed to live in 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, for reasons we don't still understand,
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 current idea of what they do.
And obviously 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, 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.
And as you get some exotic French ones,
which often illegal in the US
because they're too dangerous.
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 chilies.
And there may be 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.
So, and the kombuchas are similarly complex,
often between 10 and 30 different microbe species.
But how do you tell that?
So you want to study, so little and often is the rule.
So there's no point having a big once a week feast.
You want to have a small little shots.
And I think the study is 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 I was in a store with Will.
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 the date, how long its shelf life is.
If it's live, it's not going the date how long its 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 whether 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 um 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.
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 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, if you take the end of a kefir,
if it's live, you pour it into a glass of milk,
within 24 hours, that should have turned into
kefir. So there are ways of actually doing your own little practical experiments to work this out.
But it's a real problem for the consumer at the moment. There isn't anything to protect you.
Right. Like the consumer shouldn't have to do that, you know, to figure this out. Like 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 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 have to put up with a little bit of sugar,
not too sweet, rather than having artificial chemicals,
which will have a negative effect 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's a study that you talk about
with respect to COVID and kind of outcomes around,
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.
And I think a lot of consumers struggle
to kind of make sense of that world.
Yeah, to cover the COVID stuff first, we did a, again, a survey of consumers struggle to kind of make sense of that world. Yeah, to cover the COVID stuff first,
we did, again, a survey of about a million people
and looked at their COVID outcomes
and whether we're taking vitamin supplements or probiotics.
And virtually none of the vitamin supplements
had a consistent effect on preventing COVID.
Right, the omega-3, the D, what else did you look at?
Like, because there was a whole lot about like,
if you're on D, you're gonna be in good shape.
Vitamin C, garlic tablets, 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 for someone in gut health, I'm biased to say, well, that looked like a good result for me.
Right, I'll put that one in the book.
But a few years ago, we did a meta-analysis for the British Medical Journal and looked at all the evidence for probiotics.
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 normal people they are useful there's some evidence that in neonates, early young children and 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 shown to work in,
if you have, for example, some GI infections,
in balance, they do work.
There's some evidence they work in mild depression in randomized controlled trials.
So there are a few examples where,
and this irritable bowel syndrome is another common,
there's some evidence they work a bit in these conditions.
Now, many people don't work at all.
It's not totally consistent.
And a lot of this is probably because each probiotic is different.
They're protected by patents,
so 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 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 there are some new microbes like Accomansia, for example,
is a bug that has been shown to reduce blood glucose levels in trials
and actually works just as well dead as it does alive.
And it's a very common feature 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 I'm not giving you a very clear answer,
but I think it's, I still think you're much better off
taking your probiotics as food than as supplements.
Yeah, of course.
Because you're getting a bigger mix.
Yeah, of course, of course.
And I appreciate the kind of respect for the complexity
and nuance of all of this.
Like, you know, our human brains want that clear cut answer.
Do this, don't do that.
Yeah. Give me the top.
And you're like, ah, 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?
Six years.
Yeah, so.
I realized why no one else had done it.
And it's almost in this day and age,
a courageous act to like dip your toe
into the world of nutrition and make a statement,
you know, because, you know, it is so difficult
to provide kind of any actionable, you know,
guidelines around it because the science is, you know,
is in many ways so inconclusive
and there's so many variables that come into play,
like, you know, in terms of,
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 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
healthier choices for themselves,
beyond the 30 kind of plants a week,
what are some other principles that you could share?
Because at the end of the chapters,
you do kind of like bullet point,
like 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 don't eat beige. Don't eat beige.
Yeah, go colorful.
That's the title of this podcast.
Go bitter.
Many bitter things are actually good.
One reason coffee's so healthy for you
is it's got full of polyphenols
and I recommend coffee over orange juice
anytime as a health drink.
It should be in the health section.
Dark chocolate's another surprising one. Cook with extra virgin olive oil rather than any other oil.
Don't believe all this nonsense about-
Heating points.
Yes, all that stuff, that's all rubbish.
The way you eat is also important.
So we've talked about what to eat,
but 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 overnight,
so your gut is rested just as the hunter-gatherer tribes did.
They're not nibbling snack bars or protein bars at night.
They're resting just as they're sleeping,
giving that full circadian rhythm,
real chance to real synchronize.
So I think that's an important part.
So there's reducing the snacking time,
less meals,
giving yourself at least 12 hours overnight,
ideally 14 is a good way for your gut
to repair itself and enhance.
Eating more slowly.
We all eat too fast.
I think one in five American meals are consumed in the car.
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 something something new as 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, our microbes don't like that.
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. Try and 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 always think about your food.
Now, again, in these food choices,
if you care about the planet,
really think about those food choices you're making.
Cause 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 what is kind of on the near horizon for Zoe
and the research that's going on there that has you excited?
Well, in general, the study that will never be done
would be a massive randomized control trial
of ultra processed food against real food
and pay people to do this.
Why can't we do that?
Because-
Who's gonna fund it?
Who's gonna fund it and-
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.
But that's what we need to shake this up.
So far, the study has been limited to a few weeks.
And that's where I think I would,
if all the money in nutrition do that study,
that would change our system and show how bad it is for us.
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.
You know, should they be worried about giving,
we're trying to move towards giving people real-time advice
about what they should be eating.
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 they improve their gut microbiome,
what does it look like on retest
and how their gut microbes are tested
and the results are looking really good on that.
Because no one's managed to do that yet so far.
And so using the gut microbiome
is a pretty good sort of like a 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.
I think we're going to start doing these citizen science projects
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 got intermittent fasting.
All these lifestyle interventions,
I think would be really exciting.
And we 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
as new probiotics and prebiotics
because they've never been discovered before,
but they have really big effects.
In our data now, we see these huge effects
of these microbes that don't even have names yet.
And so if we can harness them,
they could be super powerful medicines as well.
So yeah, there's sort of too much to,
I'm a kid in a sandpit, but it's full of toys
and it's a fantastic time to be doing science.
Yeah, yeah, well, I can tell it lights you up
and it's a really fascinating new kind of emerging field.
Like if I was a young medical student,
this would be where I would wanna, you know,
be focusing on right now
because you're at the very beginning of something
that clearly is only gonna grow
and become kind of more integral
to all aspects 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 it was great to talk to you today.
So thank you.
Appreciate it. It's been fun.
Yeah, it was good.
If you wanna learn more, pick up Tim's book,
"'Food for Life, The New Science of Eating Well."
You can check out the Zoe app.
Joinzoe.com. Yeah, joinzoe.com.
And any other places you wanna direct viewers and listeners?
Follow me on Instagram.
People still do that.
They still do.
I think they still do.
You're not on TikTok?
I wouldn't admit to it.
There we go.
No, no, I'm not on TikTok, I can't.
I haven't got the patience or technology for that.
Yeah, how's Dr. B doing?
Is he doing a good job?
Should we give him a review right now
while he's sitting right here?
Yeah, no, he's- You gonna fire him?
No, he's nine out of 10, nine out of 10.
He just needs to bring more sunshine
to the venues when he lives.
Yeah, good, man.
Thank you.
Well, come back again
and share with me more about what's happening.
I'm sure it's changing all the time, right?
Oh, yes.
Yeah.
Cheers.
Thanks.
Peace.
Play it. plants.
That's it for today.
Thank you for listening.
I truly hope you enjoyed the conversation. To learn more about today's guest,
including links and resources
related to everything discussed today, visit the episode page at richroll.com, where you can find the entire podcast archive, as well as podcast merch, my books, Finding Ultra, Voicing Change in the Plant Power Way, as well as the Plant Power Meal Planner at meals.richroll.com.
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Peace.
Plants.
Namaste.