The Rich Roll Podcast - The Gut Health MD: Dr. Will Bulsiewicz On Optimizing Your Microbiome (In A Pandemic)

Episode Date: August 10, 2020

We are living in a moment of compounding collective stress---personal, pandemic, economic, civic, and political. This trauma and tumult comes with side effects both physical and psychological.  How do we take care of our bodies during this incredibly stressful moment? Furthermore, how do we buttress our immune system to combat the virus? The answer, we are increasingly coming to understand, begins with the microbiome. In fact, you might be surprised to learn, the gut is home to 70% of our immune system. To glean a better understanding of what that means, I convened with Dr. Will Bulsiewicz, a lauded gastroenterologist & gut health guru whose life’s work is devoted to better comprehending the microbiome and the crucial role it plays in all facets of health, from brain function and hormone balance to weight management and everything in between. Affectionately known as 'Dr. B', Will is a graduate of Georgetown School of Medicine and a former chief medical resident at Northwestern Memorial Hospital and chief gastroenterology fellow at the University of North Carolina Hospitals. In addition, he received his Master of Science in Clinical Investigation (MSCI) from Northwestern University and a certificate in nutrition from Cornell University. He's authored more than twenty articles in the top American gastroenterology journals and his New York Times bestselling book, Fiber Fueled: The Plant Based Gut Health Program For Losing Weight, Restoring Your Health, and Optimizing Your Microbiome, is a must-read primer on why gut health is so crucial--and everything you need to know to optimize it. Since the beginning of the pandemic, I’ve lamented the mainstream media's lack of attention to caring for our immune system. So today we dive in. This is a conversation about all things microbiome and gut health. The mechanisms behind it and latest research findings. We discuss our epidemic of dysbiosis (lack of gut biome balance) and its relation to a litany of chronic diseases that unnecessarily plague too many.  We explore the gut-brain connection. The paramount need to increase the biodiversity in our bodies and our environments. And (sorry carnivores) why fiber is king. In addition, in this time of excessive sterilization and sequestration, Dr. B provides practical takeaways on how we can improve our gut flora and optimize our immune system, without putting ourselves and others at risk. And finally, we talk fecal transplants. Because, let's face it, I can’t have a gastroenterologist on the show and not ask about that. It was an honor to to converse with Dr. B--a fresh, new mind making big waves on the plant-based, microbiome scene. Passionate, empathetic and whip-smart, I enjoyed every minute. And I promise you will walk away from this episode armed to take your health to the next level. Note: I first came across Dr. B's work by way of his many appearances on my friend Simon Hill's wonderful Plant Proof Podcast (which you should all check out). The pandemic prevented an in-person exchange, so this conversation was recorded remotely a few months ago. Apologies in advance for any audio issues. We did the best we could. The visually inclined can watch it all go down on YouTube. And as always, the podcast streams wild and free on Apple Podcasts and Spotify. Enjoy! Peace + Plants, Rich

Gut health has never been as important as it is right now. There is a direct connection between your gut microbiome and the strength of your immune system. Our gut is where we are actually interacting with the things that we choose to put in our mouth and swallow down, basically indicating that we trust it enough to include it. And our gut is where our body is basically interacting with it. It's our place of most vulnerability. And for that reason, it becomes imperative that we take care and nurture a healthy gut microbiome. We're a super organism. We are carrying life within us. And they're a part of the story. And yes, they are completely capable of altering the cravings that we have. And it's important because it also means that

if you change the microbiome, you will change your cravings, you will change your taste buds. You can't separate the two. Your brain's best friend is your gut. If you have an unhealthy gut, it is going to affect your brain. And if you have a healthy gut, you have a brain that is being optimized. That is Dr. Will Bulsiewicz, everybody. And this is The Rich Roll Podcast. The Rich Roll Podcast. What is going down, people? Welcome to the show where I think we can all agree that we are collectively dealing with a fair degree of stress at the moment, personal, pandemic, economic, civic, political.

It's a traumatic time. And I think with that comes a few side effects, implications, both physical, emotional, as well as psychological, which I think should serve as a reminder that it really is crucial that we all take care of ourselves right now. Our bodies, our immune systems

during this period of tumult, of upheaval, of uncertainty. And so much of how we do that, as we are increasingly coming to understand, begins in the gut. To help guide us to a better understanding of what all of that means, I have enlisted the good Dr. Will Bolzewicz. Dr. B, as he is affectionately known,

is a lauded gastroenterologist and gut health guru whose life work is devoted to better comprehending the microbiome and the crucial role that it plays in all facets of health. Dr. B is a graduate of Georgetown School of Medicine. He was a chief medical resident at Northwestern Memorial Hospital and chief gastroenterology fellow at the University of North Carolina Hospitals. He's authored more than 20 articles in the top American gastroenterology journals and his New York Times bestselling book, Fiber Fueled, is a must-read primer

on why gut health is so crucial and basically everything you need to know to optimize it. This conversation is packed with not to be missed, mind-blowing health and nutrition epiphanies. It's all coming up in a couple of few. 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 treatment and experience that I had that quite literally saved my life. And in the many years since, I've in turn helped many suffering addicts and their loved ones find treatment.

I've in turn helped many suffering addicts and their loved ones find treatment. And with that, I know all too well just how confusing and how overwhelming and how challenging it can be to find the right place and the right level of care. Especially because, unfortunately, not all treatment resources adhere to ethical practices. It's a real problem. problem. A problem I'm now happy and proud to share has been solved by the people at recovery.com who created an online support portal designed to guide, to support, and empower you to find the ideal level of care tailored to your personal needs. They've partnered with the best global behavioral health providers to cover the full spectrum of behavioral health disorders, including substance use disorders, depression, anxiety, eating disorders, gambling addictions, and more. Navigating their site is simple. Search by insurance coverage, location, treatment type,

you name it. Plus, you can read reviews from former patients to help you decide. Whether you're a busy exec, a parent of a struggling teen, or battling addiction yourself, I feel you. I empathize with you. I really do. And they have treatment options for you. Life in recovery is wonderful, and recovery.com is your partner in starting that journey. When you or a loved one need help, go to recovery.com and take the first step towards recovery. To find the best treatment option for you or a loved one, again, go to recovery.com. Okay, Dr. B, since the beginning of the pandemic, I've been lamenting the lack of mainstream attention to caring for our immune system. Well, what does this have to do with gut health?

Well, it turns out everything because 70% of that very system actually lives in our microbiome. Not only are these two things, immunity and gut health, not separate, they are inextricably linked. So today we're gonna break it all down, the mechanisms of the microbiome, the latest research behind it, this epidemic of dysbiosis or lack of gut-biome balance that we are experiencing,

and its relation to a litany of diseases. We talk about the gut-brain connection and the paramount need to increase biodiversity both in our bodies and in our ecosystems at large. And finally, why fiber is king. In this time of excessive sterilization and sequestration, Dr. B gives us some really great ways that we can continue to support our gut flora and optimize our immune system without putting ourselves and others at risk.

Oh, final thing. We also talk about fecal transplants. I mean, you know, come on, I can't have a gastroenterologist on the show and not talk about that, right? In any event, Dr. B is the new mind making big waves on the plant-based microbiome scene. He's passionate, he's empathetic, he's super smart. I really enjoy talking to him and I think you guys are going to get a lot out

of this one. Final note, I really did want to get Will on the show in person. I was quite impacted by not only his book, but his several appearances on my friend Simon Hill's Plant Proof podcast, which all you guys should check out. But alas, the pandemic prevented that, and this was recorded remotely and some time ago at the end of May, in fact. So apologies in advance for the audio quality. Final, final note, if this conversation leaves you intrigued, and I know it will, Will just released a comprehensive seven-week online course about gut health

and reversing dysbiosis that goes quite a bit beyond what he was able to offer in the book. So I'll link that up in the show notes, or you can just hit him up on his website at theplantfedgut.com. So here we go, Dr. B and me. You look great.

The only thing that would be better is if we were in the same room, but that's not possible. I was holding out hope that we would make this happen in person, but I couldn't wait any longer. So nice to see you through the computer screen. It's great to see you too. I wish we were happen in person, but I couldn't wait any longer. So nice to see you through the computer screen. It's great to see you too. I wish we were together in person. I look forward to someday, you know, hanging out. We'll do it. We'll do it.

As soon, you know, as soon as this lifts, we'll get you out into the studio and we'll go for round two. Because there's no way that we can explore everything that I want to talk to you about today. We're only gonna scratch the surface, but this is long overdue. So super psyched.

I'm excited to see where you're gonna take this. I have great confidence in you as an interviewer. Well, the first thing I wanna say is that I spent the month of December in Australia and I spent quite a bit of time with our mutual friend, Simon Hill. And every time I got together with him, he's like, you gotta meet Dr. B. You gotta, he's the best. And I know that you've been on his podcast, I think five times at this point. Yeah. So I went

back and listened to all of those episodes and there's a lot of, there's so much good information there. So like I said, we're only going gonna scratch the surface today. And if people are left wanting more, which I know they will be, they can go and check out Simon's excellent podcast, Plant Proof, which is really, that was kind of a launch point for you initially, correct? Yeah, I had 10,000 followers going into that podcast and doubled that in a month.

And it went viral. I mean, that's still the most downloaded episode that he's ever had. I mean, it's over 250,000 downloads for him. Yeah, that's great. So many things to talk about. I think an interesting launching off point for this would be to kind of contextualize your work with what's going on currently in this pandemic era that we're all navigating through. And what I've been thinking about lately, and I'm interested in your thoughts on, is how we square this need to socially distance and sanitize our environments and kind of cloister ourselves

from other human beings and restrict our exposure to a variety of environments with this paramount need to increase our biodiversity, not just with the foods that we're eating, but with the environments that we visit and the people that we interact with. Like these two things are at odds, this importance of biodiversity, maximizing that with this need to kind of over-cleanse everything at the moment. Yeah, I feel like gut health has never been

as important as it is right now. There is a direct connection between your gut microbiome and the strength of your immune system. And for that reason, it becomes imperative that we take care and nurture a healthy gut microbiome. And the thing that sort of stands out to me, Rich, is yes, like excessive cleanliness, sterilizing our environment, not being allowed to socialize and connect with other humans. Like all those things are there. But to me, the most powerful influence is the stress. The stress is something that is affecting all of us. The stress is something that is affecting all of us. We are living through a moment of collective stress. We're all forced to take this on. There's no avoiding have different ways that we cope and deal with that stress.

And for many, it's to turn to unhealthy habits. And that includes unhealthy food and, in many cases, alcohol. And we're compounding that stress and we're actually compounding the harm that it does to our gut microbiome. You know, many people, when we think about gut health, we talk about food and my book discusses food in great detail. The part of the book that I really wanted to elaborate on, and there just weren't enough pages for me to go there, is the effect of trauma. The most challenging patients that I see as a gastroenterologist are the people who have been victims of physical, emotional, sexual, psychological trauma. And it changes them

and they don't realize the way that it affects their gut. And typically when they get to me, I'm the fifth or sixth doctor gastroenterologist that they've been to. They're looking for solutions related to their gut microbiome or to their digestive issues. And what I discover after getting to know them and building that trust and that relationship is that the solution, the path is actually not through food. More so, it's actually about healing that trauma that is eating at them on a subconscious level. And all of us are dealing with trauma right now. And I feel like collectively, this is affecting our gut microbiome and it's at the worst possible time. There's a direct line between gut health and our immune system. 70% of our immune system

lives in our gut. And when we have that emotional trauma that's affecting our gut, and then we also compound that by consuming alcohol or by eating junk food, we're putting ourselves into a vulnerable place where if we do get the virus, we don't have our defense system built up to protect us. And that's the scary thing because increasingly we're seeing studies, Rich, that are making connections between the gut microbiome and severe manifestations of COVID-19. I mean, the doctors are all asking the questions, who are these people that get COVID-19? And one of the first things that we discovered is it's the people that have diabetes and high blood pressure and coronary artery disease and are overweight. And then when you think about all of those things that I just mentioned, diabetes, heart disease, high blood pressure, being overweight, they're all connected back to the microbiome. Yeah. This idea that 70% of your immune system resides in the gut

is profound. And I want to dive into that a little bit more deeply, but let's talk for a couple minutes about the importance of buttressing and maximizing, optimizing our immune systems right now. I mean, there's a lot of talk about social distancing and wearing masks and all the precautions that we're all embracing and undertaking to protect ourselves. But I think, in my opinion, not enough communication and conversation around how to buttress our immune system so that if and when we come in contact with the virus, we're in the best possible sort of situation in order to combat it and overcome it. Yeah, I totally agree. I feel like we have fixated on ways to reduce transmission of the virus, which is a good thing. You know, you can affect how contagious this virus is

and change the R0 with these sort of social, physical distancing measures or wearing face shields, things of that variety. But that doesn't help the person who contracts the virus. And a huge percentage of us ultimately will. And so I agree with you. I think that we need to speak more broadly about this. And to me, the key in this conversation is this connection between the gut microbiome and the immune system. You can't separate them. that if you were to zoom in on a microscopic level, what you would see is this single layer of cells that we call the epithelial layer that's so thin that the naked eye can't pick it up. And this single layer of cells separates on one side, 38 trillion microbes, your gut microbiome, and on the other side, 70% of the immune system. And they're communicating with each other. They're in constant conversation.

And so as a result, when things affect the gut microbiome, they affect the immune system and vice versa. When I was researching my book, I wanted to compile a list of the immune-mediated disease states that are associated with alteration or damage to the gut microbiome. So basically we're talking about oergic issues. We're talking about autoimmune issues. We're talking about inflammatory bowel disease. And as I started to look for studies making this connection, I didn't find a study where the answer was no in terms of the connection between the immune system and the gut. It either had not been studied or the answer was no in terms of the connection between the immune system and the gut. It either had not been studied or the answer was yes every single time. That when you have these immune-mediated disease states, allergic autoimmune-type diseases, when they look at

the gut microbiome, they always find that there's damage to the gut microbiome in the setting of these conditions. And so I feel like this is really quite critically important. And I'm happy, by the way, to elaborate more on some of the science that makes these connections and shows us how important it is to optimize the immune system as opposed to just have a bigger, stronger immune system. So when you say that 70% of our immune system

resides in the gut, what exactly does that mean? I'm trying to imagine a locus of this or what it looks like. Like, what do you mean specifically when you say that? Well, what we're referring to are the GALT, the GALTs, which are the gut associated lymphoid tissues. And this comprises 70% of our immune system. And the thing that's interesting is this, our intestines, our colon,

which we refer to as our bowels, I mean, it's literally the deepest part of the human body, is actually the place where we interact with the outside world the most. Our skin is effectively a barrier. It's a wall to keep things out. Our gut is where we are actually interacting with the things that we choose to put in our mouth and swallow down, you know, basically indicating that we trusted enough to include it. And our gut is where, you know, our body is basically interacting with it. It's our place of most vulnerability. And as a result, it's really no surprise that this is where the immune system, you know, sets up shop and performs the task of helping us to identify like

what is good, what is bad, what can we leave alone, what should we be attacking, you know, bad? What can we leave alone? What should we be attacking? You know, things of that variety. And so, you know, the immune system isn't just carelessly floating around the body. You know, it's intentional. It has a purpose. Right. This is the first line of defense, the place where the outside world interacts with your body. It's outward facing, which is sort of people don't really understand that or realize that, but it is actually outside of ourselves. And this is the place where the body decides what comes in and what doesn't. Yeah, this is the gatekeeper. And the immune system is a critical part of that process in terms of protecting us from potential threats. And at the same time, you know, basically

standing down and allowing the stuff that's good for us to flow right through and come on in. So essentially to ignore gut health or to not have a optimally functioning microbiome is to put yourself at peril in terms of your immune response to COVID or anything. I feel like this connection is critically important in the 21st century period. I mean, look at the explosion of immune-mediated disease states. You know, look at celiac disease up 500% in the last 50 years. Look at inflammatory bowel disease, that's absolutely exploding. And there's conditions, Rich, that when I was a kid literally didn't exist that I'm diagnosed in sometimes twice in the same day that are immune mediated, things like ESNFL, esophagitis. And so independent of COVID,

I feel like recognizing this connection is really critically important because the problem is once you trip that wire, once you cross that line, you may find yourself with one of these conditions that I don't believe that there's necessarily a cure. I think that you can put yourself into remission. But once you have one of these conditions, I think that you have it, and it's there. Well, let's take a step back and define our terms a little bit. I mean, the microbiome is not a new subject matter for this podcast, but I think it would be helpful to kind of talk a little bit about what we're talking about

and also to get a little bit of your background and what got you interested in this field. So the microbiome, just to define some of these terms, the microbiome is an expression that we use to refer to the collective DNA that is provided by these microbes that are a part of us. We're these big, strong humans and we think of ourselves as these autonomous creatures

that are the masters of our domain when in fact we are covered from the top of our head to the tip of our toes with these invisible microbes. I hold up my thumb. I mean, to the listeners at home, you can literally look at your thumb right now, and there are as many microbes there as there are people in the UK. So it's absurd how many of them there are. And I think you said in the book, 39 trillion microorganisms. Yeah. 39 trillion throughout the entire body. About 38 trillion of which are actually in your gut. That's where they're focused. And this number is so hard to understand or fathom. But to put into

perspective, you take our galaxy, the Milky Way, and take literally every single star that exists in our galaxy, and you would need 100 Milky Ways, 100 of our galaxy to equal the number of microbes that are a part of you right now. Not just you, Rich Roll, but the listeners at home. Yeah. You can't even wrap your head around that. So it's impossible. It's completely absurd. And they're not just there. They're not innocent bystanders. They're not along for the ride. They're not, for the most part, blood-sucking leeches that just take from us. We have had a relationship with these microbes going back all the way to the beginning. There never was a sterile human. The very first human going back millions of years,

they had a microbiome and we rose and fell together. Co-evolution. If we survived, they survived. And so we actually, through the years, grew to trust them with certain things within our body. And as a result, we basically asked them like, hey, we need you to take care of digestion for us. We're incapable of keeping up with the different varieties of plants that exist across our entire planet. We need someone who can adapt more quickly than a human can. So that's what they do. And we have them connected to our immune system, to our metabolism. I'm sure we'll be expanding on some of these ideas, to our hormones, to our mood, our brain, the way it functions, and even to our genetic expression. So they're really

critically important to human health. Some of the terms, the original question was, let's define the vocabulary. So the microbiome is the collective pool. Really, we're referring to the genetic profile. And the microbiota is the term that we use for the actual microbes. And I probably, during this podcast, am going to make the mistake of using these terms interchangeably, and I apologize for that. How dare you? Yeah, it's quite common. So the microbiota are the microbes. And so those are sort of the key terms. And what are we talking about here? We're talking about mostly bacteria. Mostly good guys, to be honest with you.

Some bad guys, E. coli, salmonella, shigella, we've all heard of the scary ones, but actually most of them are good and they're to help us. We also have yeast or fungi. And they're in competition with the bacteria. They're quite similar in terms of what they like to eat, their energy source. The archaea are my personal favorite. Archaea are these single cellular organisms. They're not bacteria, they're not fungi. And they have been on the planet for 4 billion years, which is fascinating to consider because we've only had oxygen for 2.5 billion years.

And they need to fire their publicist and hire a new one because it wasn't until your work that I even had heard that term before. We've all heard of viruses and fungi and bacteria, single-celled organisms, et cetera, but I had never heard this word before. So elaborate a little bit more on what this is and why is this your favorite? Well, it's my favorite because they're so hardy and resilient. I mean, they existed for 1.5

billion years on like a fire scorched earth that didn't have oxygen. And you'll find them at the bottom of the ocean inside of a rift vent, like miles deep And you'll find them at the bottom of the ocean inside of a rift vent, like miles deep. You'll find them inside of a volcano and then you'll find them inside your colon. I mean, I personally think between those three choices, I guess I would choose the colon if I had to of those three residences. But they are a part of the balance as much as the bacteria and the fungi are. And they actually are very deeply involved in the production of methane gas. We call them methanogens. So now some people who suffer from gas and bloating will hear this and think, oh gosh,

that means I need to get rid of them. But actually, they're a part of the healthy balance in terms of processing our food and don't necessarily just unilaterally produce gas. They also protect us from heart disease. There are studies that suggest that if we destroy them, that their destruction would actually put us at even greater risk for coronary artery disease, the number one killer. So they are a critical piece of the harmony and balance that exists within this ecosystem that is the gut microbiota. And just to sort of round things out, Rich, there's also viruses. Viruses are not alive, but they're actually a part of the harmony and balance. Right now, the word virus is sort of almost triggering in a way, but they're actually a part of the harmony and balance. You know, right now the word virus

is sort of almost triggering in a way, but there are viruses that don't mean us harm and they help us to sort of keep things balanced within the microbiome. And that's a healthy part of that. And then finally, some of us may have parasites or protozoa, which exist. And they, in some cases, can be part of the healthy balance too. So the point is that there is this complex diversity of potentially a thousand or more species. They live in harmony and balance. Some of them are good guys. Some of them are bad guys.

What we want is we want the good guys to outweigh the bad guys. And when they're there, they all exist with a purpose in the same way that you would find in any other ecosystem throughout the world. Go to the Amazon rainforest. There's things in the Amazon rainforest that I don't particularly like, but if we destroy them to the point that they're extinct, we would leave a hole in the ecosystem. Yeah, what's interesting is how everything in the macro is mirrored in the micro. We can look at the microbiome and the principles that apply in terms of trying to create a robust ecosystem apply equally to the Amazonian rainforest. to the Amazonian rainforest. And it's interesting to understand that there's a kind of a beautiful orchestrated harmony in all of that,

that helps you to really get that, you know, we're not separated from nature. We're very much, you know, a part of it and can't be extricated from it in any way. And I think, you know, what's interesting about the work that you do, I mean, just contextualizing it, there's been an explosion of interest in the microbiome

and the number of studies that are coming out right now. I mean, I think you quoted like, you know, there's like thousands of them that are coming out all the time, but this is a relatively new field and you're dealing with so many variables and trying to wrap your head around the mechanisms that are at play here and how they apply to health and disease. So, you know, what got you interested in this and, you know, what does it look like for you in terms

of staying on top of what is current versus, you know, because it seems like our knowledge base is progressing so rapidly here. Yeah, this is incredibly difficult to study the specifics of the microbiome because it could change in 24 hours. And the tests that we have currently are not perfect. But to answer your question, for me, I didn't go into medicine thinking that I would be a poop doctor. I actually thought I was going to be a pediatrician, to be honest with you. I love kids. To me, the idea of helping teenage kids to orient their life properly was really exciting. So I actually thought I was going to be an adolescent psychiatrist. And I got into medical school. I went to Georgetown and I was in my third year, which is when you rotate through the hospital. And I did my

pediatrics rotation and it just, unfortunately, you know, I mean, I love pediatricians and God bless them, but it just wasn't for me. You know, the parents, frankly, were driving me insane because they either were down your throat or they just didn't care about their kid, which was incredibly sad. And I just couldn't deal with like the, the polar nature of that. So what I loved about gastroenterology is that I am an internist first, and I get to use my mind to break down and dissect complex problems. And I also get to use my hands on a routine basis. About 50% of my time is done doing endoscopy. And so that's what attracted me. And the gut microbiome really wasn't on the radar in 2006 when I graduated medical school. I went to Northwestern and things were going really well for me professionally.

I won the highest award in my residency program. I was the chief medical resident. program. I was the chief medical resident and yet I was miserable. I was 30 years old. I was 50 pounds overweight relative to what I weighed in high school, which was hard to swallow because I think of myself as an athlete. I was a great athlete in high school. I had high blood pressure. I had a ton of anxiety. I was basically fueled by either six six coffees a day or, or Red Bull. I felt like I was 60 and I had low self-esteem, which is really weird to say because to outsiders, they would see what was happening in my life professionally. They would think, gosh, like everything was going well for you. And I needed something to change.

I was desperate to find a solution. and I needed something to change. I was desperate to find a solution. And the problem is that my medical training, as wonderful as it was, as skilled as I became at acute care of the complex ill person who would roll into the ICU or the hospital, I didn't really have a solution for my problem. Overweight, having low energy, low self-esteem. And I tried to outwork it. So, you know, typical guy. I was like a good type A. Yeah. You know, I was like the typical guy. I was like, I can eat whatever I want if I just work hard enough. Right. And so I was hitting the gym six days a week. Um, I mean, not exaggerating 30 to 45 minutes every time of heavyweights and then jump on the treadmill for five to 10 K or jump in the

pool for a hundred laps. And I could run a good five to 10 K and I was getting stronger, but I couldn't lose the gut. And so anyway, I ended up meeting my, the person who's now my wife and we would go on a date and she would, you know, like I would be sitting there ordering ribeyes and pork chops and stuff. And we'd go on a date and she would ask the waiter to do something that wasn't even on the menu. Just like, make me a plant plate. Have the chef put a bunch of plants on a plate for me. And I was just like, what the heck is going on over there? I'd never been around someone like this before. But what I saw was that she could eat as much as she wanted without restriction.

She was cleaning her plate. She was loving her food. She was loving her food. She was satisfied, very happy with the food. And she had no weight issue at all, complete control. She looked amazing. And so for me, it just opened up my mind. Maybe there's something to that. Maybe this diet that I was raised on and was okay when I was a teenager, maybe this is the problem. So did that inspire you to start looking into diet and nutrition a little bit more deeply?

I mean, where did you turn? I initially, I feel like for me, I remember like literally the day that this happened where I usually would go to, I mean, I would literally a couple of times a week go to Hardee's. I was in North Carolina now and I would go to Hardee's. Trust me, I figured out whatever fast food joints were nearby, wherever I lived. That's the one thing I was adaptable. I know it well. And Hardee's had this deal. It was five bucks. And it's like, I mean, it's disgusting to imagine that you can get like 2,500 calories for $5. Like double cheeseburger, chili cheese dog,

an apple pie, and a soda and fries for five bucks so um one day i was like you know what i'm just gonna go home and make a smoothie and see what happens and i did that just bananas greens berries um i made it like it was like 35 ounces and i felt amazing i mean it like energized me. I felt so light. I didn't have the hangover where I have to lay on the couch for a couple hours. I went to the gym an hour later, smashed an awesome workout. And that really motivated me.

And so I started down this path of starting to make healthy substitutions. You know, nutrition is really just about leveling up. It's just about healthy substitutions. And so I went down this path and literally the fat started to melt off my body. And these issues, the anxiety started to lift. I started to feel so much better. My workouts were getting better. My recovery was better.

I wasn't as sore. And so for me, I'm a man of science. I have such great respect for the scientific process. And it wasn't enough to have this experience. I needed to see that there were actually studies to back it up. So that sent me in this direction where I started to look into it and I opened up PubMed. I thought there'd be like five or 10 studies. And I could not believe that there were literally thousands that I'd never heard about. It just wasn't part of your medical school curriculum at all. We're so busy learning about thousands of medications and their side effects. It wasn't part of your medical school curriculum at all.

We're so busy learning about thousands of medications and their side effects. We're so busy learning about these rare disorders that we'll never diagnose in our entire career that we lose sight of the practical information that the routine person needs coming through the door. that the routine person needs coming through the door. And so yeah, nutritional education is completely devoid in our traditional medical education. And I just didn't have it. So when I opened up and saw these studies, I was shocked. And very quickly, I found the connection between nutrition and the gut microbiome, which was starting to really take off. And it was really affecting my field as a gastroenterologist. And that finding, I just started devouring these studies and bringing them into the clinic because I'm taking care of these people

with irritable bowel, Crohn's disease, ulcerative colitis. And they're real people and they want to know. Like, doc, I can't eat without pain. What am I supposed to eat? I mean, it's a basic question. And most GI doctors don't have great answers to that basic question. And I needed to find something. So I spent basically nights and weekends studying and learning, educating myself, and implementing this in my practice. And was shocked by the results. I mean, amazing transformations in my patients. And it got to the point, Rich, where after years of seeing these people who...

Like for me, what I discovered is that this is the root of the issue. And if we don't address the root of the issue, what are we doing? Just covering it up. So taking on the root cause of these digestive issues, damage to the gut microbiome, allowed me to really alter the health of my patients and get them to a much better place. And so it got to the point where I was like in 2016, I just felt compelled to share the story. And I started my Instagram account with zero expectations at all. You know, I mean, I have to tell you, like when my wife and I were dating, it means my wife and I've been talking about how surreal it is for me to be on your show. You're the dude. Come on. I'm serious, man. Back in 2014, you know, when my wife and I were dating, we used to do early when we were dating, we would call it the best weekends ever. And we would be like

blasting all over the Southeast, having fun, you know, going to Asheville or, you know, going to the beach in Charleston or whatever. And we would be in the car together on the best weekends ever. And we'd be listening to Rich Roll podcasts. And so it's really cool now, here we are six years later. And I started this Instagram in 2016 with zero expectations. If I had 500 followers, I would have been thrilled. Yeah, but now you're a New York Times bestselling author. Even that is really weird. The book, it debuted at like number six, right? I think.

The book debuted at number six. Launching a book in the pandemic too, not an easy thing. So I think it just, listen, the book is amazing. We're going to get into the book in a little bit, but the book basically provides you with everything you need to know to begin this journey for yourself. And it's written in a way that is digestible for anybody. You don't have to be a scientist to understand, like you communicate in a very practical way, but I think it's also an important book for practitioners as well. And I'm sure you had that in mind when you were writing it. And I think it really is important because as we speak about preventative medicine, it's all about getting to the root cause of what is creating all of

these chronic illnesses. I mean, when we talk about chronic lifestyle disease, people are thinking about heart disease, cancer, diabetes, et cetera. But just to the side of that, we also have all of these autoimmune disorders and all of these food allergies. And basically all of this can be tracked back to the health of our microbiome. And right now that microbiome is under attack constantly from environmental toxins, from processed foods, from antibiotics, all of these things that we inundate ourselves with

that erode our ability to maintain health and effectively combat disease. And so to just sort of diagnose and prescribe with the latest medication is to remain blind to this whole world that you're opening us up to about how to prevent us from getting into this situation to begin with. And it begins, you know, when you're a baby and, you know, having a vaginal birth and making sure that you're, you know, you're adequately breastfed and all of these things that contribute to creating this robust ecosystem that will ultimately thrive and maintain your health. Right. I agree with you 100%. And, you know, it's fascinating to think about that connection and how it starts, you know, between us and these

microbes early in life. Because when a child is born, this is the closest they, I mean, they're not sterile, but this is the closest they will ever get to being sterile. And they are wide open recruiting new members to their microbiome. Come on in. I want you to be a part of it. And,'s things that happen during this period of time from that point up to age two to three, where a child has a fully formed adult size gut microbiome. Like my son is three and his microbiome is as big as dad's. And this is a really critical period of time because this is also when the immune system is developing and learning what is good and what is bad. And when we disrupt the gut microbiome and its normal development,

we also potentially disrupt our immune system. And we see this, it's as you were alluding to, Rich, when you pass through the birth canal, that is mom basically donating her gut microbiome to this newborn child. Now, it's quite fascinating to think about that at 36 weeks of pregnancy, late in pregnancy, see mom's vagina has a microbiome. And it's very different than the gut microbiome. But at 36 weeks of pregnancy, the vaginal microbiome starts to change to more closely resemble mom's gut microbiome so that the child passes through the birth canal and receives that

initial gift. And then that child is born and the perfect food is potentially administered. And by the way, let me say this, that I know we have a lot of parents who may hear this and get concerned that their child was born by C-section. Both of my kids were born by C-section. You can have a 100% perfectly healthy child that was born by C-section or that was bottle fed. So don't be upset when you hear this. But breast milk milk, to me, is literally the perfect food. It has everything that we need to nourish a newborn child. And what's fascinating to me is that the human breast milk contains these things called human milk oligosaccharides, HMOs. And these HMOs literally have zero nutritional value to the child, none. They do

nothing for the child. Because what HMOs are, human milk oligosaccharides, is they are food for the developing gut microbiome. They are prebiotics and they actually help the right bacteria, specifically bifidobacteria, to grow. And this also helps with development of the new immune system. So when you disrupt this normal process, birth by vaginal delivery, breastfed, frankly, as long as possible, when you disrupt this through cesarean section or through bottle feeding or through antibiotics early in life, you affect the developing microbiome. You also potentially affect the developing immune system. likely, not that they're all going to, but more likely to develop immune-mediated diseases like type 1 diabetes or like celiac disease, or even metabolic diseases like childhood obesity.

This is the reason why this occurs, is that this disruption of this normal development process can have downstream effects that can carry forward through childhood and even potentially into adulthood. In terms of the protocols that we should all be undertaking to buttress our microbiome, you're not necessarily advising a specific type of diet other than to say plant diversity is king. Like this is the vector of all vectors for you, right? So it's not about, oh, it's vegan or, I mean, it's a predominantly plant-based or plant-based diet, but the diversity of plants is really what's important in terms of making sure that you're doing everything you can

in the interest of your microbiome. Well, I think the critical piece to me, so the book is called Fiber Fueled and that's because I feel like fiber has been this ignored superfood. Well, it also needs a new publicist. It desperately needs a new publicist. You are that publicist.

You are, yes, you're hired. I'm the guy. So yeah, no, I'm here to fight on behalf of fiber and get it back on the map and part of the conversation because we've been ignoring it. And part of it is that we've been thinking about it as this orange drink that grandma stirs up so that she can poop. When in fact, it's incredible, the connection between fiber and our gut microbiome. the connection between fiber and our gut microbiome. Fiber doesn't just go in the mouth and shoot out the other end. Soluble fiber is a specific sort of general category which feeds the microbiome. This is their preferred food. And when we give this to them,

they consume it. They grow stronger. Our microbes actually multiply, grow stronger. And then they turn around and they reward us. And the way that they reward us is by releasing short-chain fatty acids. And these short-chain fatty acids have healing effects throughout the entire body. So we've been emphasizing a little bit the immune system. Short-chain fatty acids optimize our immune system. There are studies that we could talk about if you want to connecting short-chain fatty acids in terms of protection from respiratory viruses. They can have their effect in the lungs on the immune system. Short-chain fatty acids reverse leaky gut, which is dysbiosis. That is

the root cause of these digestive issues that I take care of on a daily basis. They directly prevent colon cancer. They lower our cholesterol. They prevent and reverse insulin resistance, which is type 2 diabetes. They travel throughout the entire body having their healing effects. We think that they can actually reverse coronary artery disease. We think that they can actually repair the blood-brain barrier for people that have brain fog. They actually travel into the brain through the blood-brain barrier and they have their effect. They affect our mood, our memory. Believe it or not, we have studies that suggest that they prevent Alzheimer's disease. These are incredibly powerful. And the way that you get them

is through the consumption of fiber in your diet. And here's the problem. 97% of Americans are not getting an adequate amount of fiber in their diet. And that's creating issues for us. Everybody's worried about their protein intake, but they don't give a second thought to their fiber intake. 97% of people are fiber deficient. I mean, that's a shocking statistic. You know, and that's, well, and that's

with both standards. I mean, the expectation or the standard that we're holding is 25 grams for women and 38 grams for men. And the average American is somewhere in the 15 to 18 gram range. the average American is somewhere in the 15 to 18 gram range. And you see the problem exists, Rich, when we try to do academic studies looking at fiber. And the way that we'll set the study up is we'll say, okay, let's take the high fiber consumers in the United States and compare them to the low fiber consumers. And next time you guys, if you ever read any of these studies, I mean, I'm a nerd, so I read these studies. If you ever read one of these studies, take a look at the high fiber consumers. Even the high fiber consumers are deficient in fiber. Wow.

Unlike the Hunza, which you talk about, right? Unlike the Hunza. Yeah, the Hunza, which is this tribe that lives in Tanzania, which is, they're fascinating because they are modern hunters and gatherers. They don't farm. They don't have organized agriculture. They live off the land. They eat whatever is available. Yes, they eat some meat. But they eat mostly plants. And these hudza are consuming 100 grams of fiber per day. And critical piece, like Rich, let me ask you a question. I'm just curious.

So I know you eat a very healthy diet. If you had to estimate in a given week, how many plants do you think you have in your diet? Give me a general idea. Yeah, I mean, it's probably, I mean, it's gonna be higher than most, but it can't be more than, I mean, 30, 40. Okay, and I would challenge the people listening at home right now,

like if you have to hit the pause button, take a minute and think about how many plants you actually have in your diet, okay? So most Americans are definitely less than 30. The majority are around 15 to 20. And the Hadza are consuming 600 varieties of plants in a given year. Right. Like 600. 600 because they live off the land. There are literally 300,000 edible plants on the planet. The problem is that we've narrowed it down to the point where 75% of our diet is from three of them. And we're ignoring this diversity. We've put pressure, unfortunately, on our farmers where the farmer has no choice but

to opt for high yield breeds of crops. And so we are narrowing down the biodiversity within our diet through our food systems. And so with the HUDSA, do they, I mean, I presume that they have lower incidences of all of these chronic ailments as a result of this biodiverse, plant forward diet. They have their challenges. They don't live in the United States

with the healthcare system. They don't have access to a guy like me, right? But when we actually look at their microbiome, what we look at is the diversity of species. Okay. So biodiversity is a really important word these days. And the biodiversity within your gut microbiome is a measure of health. The more species that you have, the more that your gut microbiome is resistant to sort of disturbances. It has all the different players that are available. They're not all the same. They have different roles. So when you have that diversity, you have all the pieces that you need, no matter what you throw at your gut, it's ready to step up and do the job. And so we want that biodiversity. And when we studied the HUDSA and we compare their

biodiversity within their gut microbiome to that of a person that's say in the UK, we see that they have 30% more diversity than a person in the UK. And I hate to break it to all the Americans who are listening right now, but we're even worse. They have 40% more biodiversity than we do. And the connection that's really important for people to understand, and frankly, if there's only one thing that you take away from this podcast listening to us have this conversation today, this is what I want you guys to hear. Okay. The way that it works is this.

Fiber is not just fiber. There are millions, if not billions of types of fiber in nature. It's so incredibly complicated from a chemistry perspective that we're not even capable of creating an estimate to how many types of fiber there are. But every single plant has its own unique types of fiber, multiple different types within that plant. Every single plant is going to have prebiotic fiber that feeds the microbiome. This is their preferred food, these prebiotic fibers. And the key is that they are picky eaters. They don't, they're like us. You know, you have different food preferences than I do, even though I'm sure that many people would label us as having the same diet.

You eat differently than I do. We have our own preferences and they do too. They have specific food preferences in terms of the different types of fiber. To put it in perspective, take a black bean. You give these microbes a black bean, and there are certain specific species that are going to multiply and thrive, and they're going to be stronger and be more prepared to help you because you just fed them. They are energized. But the opposite is true. You take that black bean away. You say, I'm going black bean free. Those same microbes that were thriving because you were feeding them are starving. And they're not getting what they need.

And so, Rich, looking at the HUDSA and comparing it to Americans and seeing 40% more biodiversity within their microbiome, that's interesting. That's okay. That's cool. But to me, I wouldn't write a book based upon an idea. And that is not enough for me to say with confidence that the most important thing for our gut microbiome is the diversity of plant species. I need something more.

And where you find it is the American Gut Project. The American Gut Project is the largest study to date to take our diet and lifestyle and connect it to the biodiversity within our gut microbiome. It is actually an international study, even though it's called the American Gut Project. They have people who are participating from over 40 countries from around the world. And there is no study more positioned to answer this question. What is the number one predictor of a healthy gut microbiome? And when they analyzed this, it was clear cut. The number one predictor of a healthy

gut microbiome is the diversity of plants within your diet. And so when we set off this question, you said, well, you're not necessarily ascribing to a specific diet. Well, here's why. you said, well, you're not necessarily ascribing to a specific diet. Well, here's why. So I'm vegan, you're vegan. Okay. But in this study, diversity of plants was more powerful than being vegan. Because if you are vegan and you eat the same 10 or 15 foods every single day, you are not feeding your microbiome. And there are alternative diets that you could do where if you really focus on diversity of plants within your diet, you're going to feed your microbiome and do a better job. So to me, it's not about the label that we apply. It's about understanding the concept, which is that it's critically important to the health of our gut microbiome that we apply. It's about understanding the concept, which is that it's critically important

to the health of our gut microbiome that we incorporate as many different varieties as possible. And in the American Gut Project, the line that they drew in the sand was 30 different plants per week. That doesn't mean, by the way, that there's a magic difference between 30 and 29, or that 35 isn't better than 30. The point is we want as much diversity as possible. And that's the critical piece. Yeah. That's super interesting and also so different from the way that we're kind of wired. Like as humans, we want to know, all right, tell me what food is the best and I'll eat that. Or, you know, just give me the list of the five things that I need and I'll focus on that.

Whereas you're saying, look, you gotta broaden the aperture here and you gotta be trying lots of different things and, you know, explore. And it's not about like you need to eat these three things. It's about basically eating as many different things as possible and getting out of your comfort zone a little bit. And I think what you're saying essentially

is that the more that you're in the practice of doing that, it's almost like an insurance policy that you're taking out for your gut health. You're seeding your gut with the biota that will then ultimately be able to grow and thrive the more that you're feeding it those types of plants. Yeah, no, I totally agree. And just to kind of pick up where you left off, every single plant has its own unique types of fiber. That's what I've been talking about for the last few minutes.

But there's so much more. Every single plant has vitamins, minerals, phytochemicals. I don't know how much your listeners have heard, I'm sure they have, about phytochemicals. These are the unique chemicals that you will find in plant foods, exclusive to plant foods. That's what phyto means. There's at least 8,000 of them. to plant foods. That's what phyto means. There's at least 8,000 of them. Very few of them have we actually studied. An example of one is resveratrol. So you hear about resveratrol. Resveratrol is capable of actually changing the microbiome by itself. David Sinclair in Lifespan talks about resveratrol and its benefits for healthy aging.

And this is just one example of one phytochemical that you'll find in these plants. And the other thing, by the way, that's kind of interesting, most people don't realize this. The plants have a microbiome of their own. Every single plant... Yeah, you don't really think about that. No, you don't really think about that, but they're not sterile. Every single life on this planet either has a microbiome or is a part of the microbiome. And depending on how you choose to zoom out, you could almost make the argument that us humans are part of a larger microbiome in a way, right? Which is planetary health and the way that it all functions. But these plants have their own microbiome. If you take an apple, for example, because we have a study that shows this, the apple has a microbiome that is there from literally the seed

through the flower and all the way through to the fruit. And that microbiome is dynamically evolving and changing and helping this to actually this transformational process to occur. And the apple has literally over a thousand species of microbes, more than us humans do. And potentially a hundred million microbes. When you eat an apple, you're getting the fiber, you're getting the phytochemicals, of which there are many, you're getting the vitamins and the minerals, and you're even getting the microbiome that the apple contains. And so each plant has a story like that. Each plant has something positive that it wants to bring to your health. Every single one wants to bring something to your health. And if we overemphasize the superfoods, we can, you know,

I could eat kale all day and I'll have vitamin K dripping out of my eyeballs. Okay. Way more than my body needs, but I'll make myself deficient in other things because I'll be overemphasizing certain things and I'll be missing out on the other opportunities. I personally would rather take 10 mediocre plants and put that in my diet than one superfood. I mean, I honestly think that the diversity, because you play off of the strengths of all of them. And when you have that, you get all of the amino acids, you get all the different types of fiber to feed your microbiome, you get all the different phytochemicals. You just can't get it done with one plant.

There's no perfect plan. Right. Diversification. It's always important. Just like we need to do with our finances, right? It's like your retirement fund. Yeah, yeah, exactly. Shifting gears a little bit here, let's talk about the relationship between the microbiome and inflammation, which is sort of at the root of so many of these illnesses that we're seeing. Absolutely.

So many people don't realize the connection between inflammation and dysbiosis, which is the word that we use to describe damage to the gut microbiome. So let me zoom out for a moment and do some new definitions. So eubiosis, E-U, refers to balance and harmony within the microbiome. This is what we see in the HUDSA. This is a broad, diverse microbiome, all the different species. Yes, there are good guys and there are bad guys, but guess what?

The good guys outweigh the bad guys so much that the bad guys can't do anything. They're incapable of really hurting you. That is eubiosis. When we deviate from that place and we lose that harmony and balance, we are moving into something where there's a loss of species, potentially gaps or holes in the microbiome that we don't have the species to fill for us because we're missing them. And the bad guys become more prominent to the point that they could potentially cause harm. When this happens, we call this dysbiosis. When this happens, we call this dysbiosis. Okay. Dysbiosis. And dysbiosis is more than just a change to the microbes. It starts to affect that epithelial layer that we were talking about before

when we were describing the immune system and the microbes, that single layer of cells. And these cells are held together by things that are like spot welds. We call them tight junctions. And if you break down those tight junctions, they pop open. And now you've got a hole that allows things to leak into the body that are not supposed to be there. The scientists will call it increased intestinal permeability. Other people will call it leaky gut. I get it.

We're talking about the same thing. We're talking about dysbiosis. And when this occurs, what's leaking from the gut into the body is a specific thing called bacterial endotoxin. Bacterial endotoxin, also called lipopolysaccharide, also called lipopolysaccharide, actually activates the immune system. And this is inflammation. In one word, bacterial endotoxin is inflammation. That is the word. And it can be on a number of different levels. You could have smoldering, low-grade inflammation. And that's the type of inflammation that leads us to developing cancer or heart disease or Alzheimer's. That, again, is driven by bacterial endotoxin. And we can also have a surge or a spike of bacterial endotoxin all at once. And that is sepsis. Sepsis is where you have over-activation of the immune system,

where the immune system actually becomes your enemy in the setting of an overwhelming infection. And this is particularly relevant when we discuss COVID-19, because we all know that the people who are the sickest with COVID-19, what ultimately is threatening their life is respiratory failure. They developed something called acute respiratory distress syndrome, ARDS. And ARDS is not the virus. ARDS is the response of the immune system to the virus. system to the virus. A overactive immune system overreacts to the virus, basically goes nuclear, basically starts unloading all its guns at once. The point that it basically breaks down the lining of the lungs and both lungs fill up with fluid. And that is not, you are incapable of sustaining life unless you're on a respirator in that setting. And so, so sepsis, you know, where a person is critically ill with an

overwhelming infection may get ARDS, they drop their blood pressure, their heart rate goes up. They're not even conscious, you know, they're, they're, um, totally confused, the pale, they're totally confused, the pale. This is actually driven by excessive amounts of bacterial endotoxin, excessive inflammation. So, and it could be that full spectrum. Wow, I mean, that's amazing to hear that. And so in order to avoid that, what are the things that we can do that you haven't already mentioned

to make sure that we have that gut lining intact and we're not, you know, basically creating that kind of inflammation? So, you know, to me, there's, my book focuses a lot on diet because diet is ultimately the most powerful driver of the balance within our gut microbes.

And we've talked already about diversity of plants. So we don't need to go there again. But just keep in mind how important this is where 97% of us are not even getting the minimum daily amount of fiber, nor eating a diversity of plants. So that's a great opportunity. But you don't want to sabotage your own health. And so we need to also take a look at what are the things that are holding us back or causing harm to the microbiome. And this is where I start thinking about, if we're going to talk on the dietary side of things, look at the average American's diet. 10% plants, 60% processed food, 30% animal

products, meat, dairy, and eggs. To go a little bit deeper on those things, processed food. Okay. So basically when we refine grains, we strip the fiber. Not a good idea. We're throwing out the healthiest part. We're keeping the least healthy part. When we build these processed foods that are capable of sitting on the store shelf in a box for literally a year and not changing, they are completely lifeless. They have no microbiome. We have pumped them up with chemicals. The Food and Drug Administration has approved 10,000 additives that are in our food

supply right now. I'm not trying to be a fear monger. I sincerely don't have any intention of being that. But I think that the issue is this, when you allow in a very short period of time, 10,000 new things into the food supply that weren't a part of our great grandparents' life. And the level of expectation for study is it does not require human testing. That's at least 80% of them. And the 20% that do have human testing, it's, oh, you're still alive after a week. Cool. Yeah. Yeah. Right. Right. So, but, but, but Rich, what happens when you eat that food for 30 years or 50 years? Right. And these foods, you know, people need to understand that there is a cycle to our food. There is a life cycle to our food where nature naturally will take it back. I mean, look at a

piece of meat or look at a vegetable and at some point it's going to decompose. And that process of decomposition is done by microbes. You had your chance. Now it's past the point of being human food and the earth is taking it back. This is going to become soil for us in the future, right? Particularly the organic matter that you get from the plants. This is compost. We will create humic substances. And so how do we disrupt that process, that natural process?

Get rid of the bacteria. Get rid of the microbes. Prevent them from being a part of it. How is it possible to have cold cuts that sit in the refrigerator for a year unchanged and you take a couple slices off every once in a while? You are keeping away the bacteria that would rot the meat. And that's how it stays that way. And so what do you think happens when you drop those food additives and those chemicals

that are designed to retard microbes? What do you think happens when you drop it into 38 trillion living inside your colon? It's impossible to believe that that's good for us. And then moving on to, so beyond processed foods, moving on to animal products. In the United States, we eat 220 pounds of meat per person per year. It's the English speaking countries that are eating the most meat. I mean, China's up and coming, Brazil's up and coming, but we are setting the highest mark in the United States and Australia in the UK. And there are people who are telling us that we should double and triple down on this idea. And it's unnatural.

The Hadza are not eating 220 pounds of meat. They're eating 100 grams of fiber per day because they're not that efficient as hunters. Right, so let's get into that a little bit. We have the paleo diet, the keto diet. Now we're seeing the carnivore diet, the low-carb enthusiasts. All of this are very animal product heavy, animal product forward. And you'll hear from proponents of these dietary protocols that they are reducing their inflammation,

that they are overcoming their food allergies. It's a very restrictive protocol. But, you know, on the kind of front lines of the nutrition wars on Twitter and et cetera, there does seem to be, you know, a war for the hearts and minds of people as to which way is eating best. And it would appear that these diets are in many ways winning that war because people like to hear that they can eat these foods that they like. So what does the science say about these protocols? And what does the impact of these types of diets

have on our gut microbiome? And I think that's where I would start, to be honest with you, is to look at the impact that these diets have on our gut microbiome, because that's what I'm here to talk about. And that's my area of expertise. But I also want to share some of the layers of evidence that exist going beyond the gut. Because to me, you can't prove anything with just one study. As a scientist, what I want to know is I want to know the full complete information. And then I want to see what the general, like, where are things pointing for us? And I want to see all the layers. If all the layers are

pointing in one direction, then we have, we have scientific power. And so when it comes to the gut microbiome, one of my favorite studies right there with the American Gut Project is a study from 2014 that frankly for me was a game changer in my quest to change my diet. Up to this point, I was just kind of leveling up, making some small changes. But when I saw the study, it really made me say, I just don't think there's any role for animal products at all when it comes to the gut microbiome. So let me tell you about the study. It's the authors were Lawrence David, who's at Duke and Peter Turnbaugh, who's at University of California, San Francisco. It was published in Nature, the top medical journal in the world. And effectively what they did is they took a group of people and, you know,

let me say this, like they're not a part, this was not done as part of the diet wars. All right. These are extremely high level microbiome researchers who were trying to prove in humans what we have seen in animals for years, but had never to this point proven that this was possible in a human being. Okay. So now we accept some of these things as true, but this was 2014. They took a group of people, they put them on five days of a completely plant-based diet. And then those same people would cycle over to five days of a completely animal-based diet. And then those same people would cycle over to five days of a completely animal-based diet or vice versa. Some people started on the animal-based diet first, but they wanted to see what's the effect on the microbiome. So they measured the microbiome every

single day. And what they saw in both cases was that in less than 24 hours, you can actually change your gut microbiome. Your dietary changes that you've made, like what you had for lunch today is already changing your gut microbiome. The reason why is because it is evolving so quickly in a way that's hard for us to fathom. Every 20 minutes, there is a new generation of microbes. In one day, in one day, you have at least 50 new generations of microbes that have evolved. That's like in one day, they're doing human evolution that would take us all the way back to the pyramids.

Yeah. Wow. And so they're, they're changing dynamically very quickly. And, um, so what they saw was when people were on five days of a completely plant-based diet, your gut adapts to what you are eating. And when you're on a plant-based diet, you generate microbes that are really good at breaking down fiber. And as a result, you have what are categorically described as anti-inflammatory microbes that are capable of producing these short-chain fatty acids that I was heralding earlier in our conversation.

Okay. So basically you eat the fiber, you get more microbes and they want to reward you with short chain fatty acids. So you get more of those. The alternative with the animal-based diet to me, when I saw this in 2014, I found it disturbing what I was reading. In literally five days, you are seeing number one, the disappearance and reduction of those microbes that are anti-inflammatory. You are seeing, no surprise, the loss of short-chain fatty acids. If you don't eat fiber, which animal products have zero fiber, if you don't consume fiber, you don't get the benefit of these short-chain fatty acids. Instead, we saw different types of bacteria emerge. Bacteria that we would describe

in science as being biophilic. What this means is they like bile, bile from your liver. Bile from your liver comes in response to fat. It's meant to help you to digest and absorb fat in your diet. it's meant to help you to digest and absorb fat in your diet. But bile actually changes the microbiome. When we consume a high animal fat diet, this bile starts to change the microbiome. And what we see are the emergence of these bacteria that thrive in that environment, less of the anti-inflammatory. And these ones we describe as inflammatory. So for example,

one specific bacteria that we saw emerging during this five-day period is something called bilophila wadsworthia. And bilophila wadsworthia is known to produce hydrogen sulfide, which has been strongly connected, this particular bacteria, to the development of inflammatory bowel disease, Crohn's and ulcerative colitis. We also saw more microbes that are really good at taking the bile and transforming it into what we call secondary bile cells. So like, look, we all produce bile. It's a part of who we are. bile salts. So like, look, we all produce bile. It's a part of who we are. But what we don't want is having microbes that are going to take that bile and actually use it against us

and turn it into these secondary bile salts, which are carcinogens. They have been strongly connected to the development of colon cancer, the number two cause of cancer death in the United States. And it's no surprise of colon cancer, the number two cause of cancer death in the United States. And it's no surprise that colon cancer, just kind of looking at some of the broader evidence, colon cancer is connected to red meat consumption and to processed meat consumption. So we see these changes, but perhaps the most alarming change was in just five days, they actually saw antibiotic resistance within the gut microbes on this animal-based diet. And you say, gosh,

what's the deal there? Is that because the animal products are antibiotic-laden themselves? Exactly. 80% of the antibiotics in the United States are not administered to humans. Tons and tons and tons of antibiotics are being administered to the livestock as a part of animal agriculture. And what this is showing is that it's becoming a breeding ground for antibiotic resistance. You know, if this COVID-19 thing is scary to you, let me tell you what's way scarier than COVID-19, a world where antibiotics don't work. Because that would be taking us back to 1900 before we had penicillin. And in 1900, the top five causes of death, heart disease wasn't in

the top five. The top five causes of death were infections. And this is why people were living only on average to be about 50 years old. Yeah, that's a scary thing. But I think we're inevitably headed in that direction if we don't course correct with the extent to which people are eating animals that are so antibiotic laden. It seems like a natural byproduct that we would develop resistance to that. We're creating a system where it is the definition of short-term gain and a long-term loss because the animals receive the antibiotic not because they're sick. They receive it because the studies show that they will gain 15% more weight, which by the way, scientifically speaking,

that's because you're destroying their microbiome. When you destroy a person's microbiome, they gain weight. So, but you know, the point from my perspective is even if you go, okay, well, we're going to, we'll go antibiotic free then we'll, we'll stop this practice of giving 80% of our, you know, 80% of our antibiotics to the cattle and we'll go antibiotic free. It does not change, Rich, even if you go grass-fed, free range, it does not change the biology of the high saturated fat content that you get from the animal products that causes a disturbance and alteration of the gut microbiome, which causes dysbiosis.

Where does TMAO come into play with that? TMAO, which by the way, was not studied in the 2014 study that I mentioned because it wasn't really on our radar at that time. TMAO, just to define for your listeners in case they haven't heard about this, TMAO is produced by microbes in our gut. Our microbes will produce TMA when they come into contact with carnitine, carnitine that you find in red meat or also in energy drinks. in red meat or also in energy drinks, or choline, which you will find in high-fat dairy, eggs, and meat, and also some plants. And so when these microbes in our gut come into contact with those things, carnitine and choline, they can potentially produce TMA, which gets transformed into TMAO by the liver. And TMAO is, I mean, honestly, very disturbing.

It has been connected to the development of coronary artery disease, our number one killer, to stroke, a top 10 killer, to chronic kidney disease, a top 10 killer. Okay. And so TMAO, what's fascinating about it is that you can actually train your microbiome and make it incapable of producing it. But the way that you do that is the elimination of animal products. They had a study where they looked at a vegan and this vegan in the name of animal products. They had a study where they looked at a vegan and this vegan in the name of science agreed to eat steak. And when they fed a steak to this vegan, there was no TMAO. They were incapable of producing it. When they fed that same steak to someone who is an omnivore, they spiked their TMAO levels 600%.

Now, here's the issue. Your gut, in all cases, whether it's for better or for worse, your gut is adaptable and it will change. And so if you take a group of vegans and you start giving them carnitine and choline, whether it be in supplement form or they start consuming animal products, they'll start producing in about four weeks, they'll start producing TMAO. So the gut will adapt and start to produce it. And this is, when we think about the long-term risks of an animal product meat-heavy diet, the TMAO is a biomarker illustrating for us the connection between these foods and some of our top killers, heart disease, stroke, chronic kidney disease.

And it's no coincidence that you will find these same foods in population-based studies to also be connected to these same outcomes. And this to me, Rich, is why... So let me say this. When I hear people give anecdotes that they healed their autoimmune disease on one of these diets. I don't doubt you. I don't doubt you. I don't think you're making this up. I want to see more studies, but here's what I think about that. There are 10,000 food additives in our processed foods. Those processed foods for most Americans are more than 50% of their caloric intake. When you eliminate those processed foods for most Americans are more than 50% of their caloric intake.

When you eliminate those processed foods, you potentially may heal your immune system. That by itself is a step in the right direction. But the problem is that are you going to pay the price when you consume one of these diets over 10, 20, 30, 40 years? I'm concerned that with the loss of diversity within the diet, you are causing harm to your microbiome. And that may come very early in the process. But in the long run, I don't view these diets as promoting longevity or promoting health span. You're not going to live longer because you eat a 100% meat diet. That's the issue.

I'm worried about the risks of heart disease, stroke, chronic kidney disease as you age, and it may shorten your life expectancy, which by the way, is what we see in population-based studies when they study a low-carb diet. It's a shortened life expectancy. There's a version of that argument that gets thrown at plant-based people that goes along the lines of the reason you feel better on a plant-based diet or a vegan diet is by dint of removing the processed foods and you will see a spike and benefits in the short run, but it's ultimately nutrient deficient and to perpetuate this way of eating over time, you will see diminishing results and potentially harm yourself in the process. Right.

How do you respond? You know, I'm sure you've seen that argument. Well, of course, but it's an argument that's being made when people are shooting from the hip and not actually looking scientifically at what they're saying. Because when they have studied all of these different diets and all the different varieties that exist out there, a vegan plant-based diet, I mean, I want to separate out that you could be vegan and eat a junk food vegan diet, and that's not a very healthy diet. But a 100% whole food plant-based diet, when they did an analysis of this, that was the most nutritionally complete diet.

And the deficiency that exists is really B12, which is so easy to supplement. And you would argue that omnivores should be supplementing because when they've studied omnivores, about 40% of them are either deficient or borderline deficient in B12. So they should be taking the supplement too. And it's so easy to supplement B12. Let's talk a little bit about the gut-brain access, because this is fascinating stuff. And I think it relates back to one thing we touched on at the beginning of this conversation, which is the anxiety and the stress that's accompanying a lot of people right now. And what goes hand in hand with that is depression, our emotional state. And you've done some fascinating work and you talk about it in your book, this relationship between the gut microbiome and our emotional

well-being. You can't separate the two. You can't separate the two. Your brain's best friend is your gut. And it's really fascinating to think about because we, you know, in the hierarchy of organs, we kind of think of the brain as being at the top. And I mean, it is, it's critical. It's a critical part of being a human. But brain health goes through gut health. You know, if you have an unhealthy gut, it is going to affect your brain. And if you have a healthy gut, you have a brain that is being optimized. So here's how this works.

This is a two-way street in terms of communication. They are talking to each other right now. I mean, they are literally, your brain and your gut are like two teenage girls on the phone for six hours straight. Like, how do you talk to one person for six hours on the phone? I have a 16-year-old daughter, so I know well how that works. You can relate. Yeah, exactly.

So anyway, they're talking to each other. They're talking to each other literally right now. Your brain has the ability to talk to your gut through your vagus nerve, which is the information superhighway between the two, through hormones that are released from the pituitary gland, and even through your sympathetic and parasympathetic nervous system. So your brain has the ability to affect your gut. This is part of the reason why we sort of led off the conversation talking a little bit about stress. why we sort of led off the conversation talking a little bit about stress. And when the brain releases CRF, CRF has the ability to alter the balance of the gut microbes and induce dysbiosis. Stress by itself can induce dysbiosis. Now, on the flip side, the gut has a number of ways that

it will communicate to the brain what's happening downstairs and alter brain function. It can talk again through the vagus nerve. The gut also produces neurotransmitters. Literally, the gut produces over 30 neurotransmitters, which is fascinating because when I was in medical school, I didn't even realize there were 30 neurotransmitters. I thought there were like 12, 90% of serotonin. So serotonin is the happy hormone. Serotonin affects our mood, our focus, our energy levels, our memory. If I want to alter a person's serotonin balance, I can give them things

like Zoloft, which is sertraline. And that is a serotonin reuptake inhibitor. It will boost serotonin. All right. And that's how I treat depression or anxiety. But 90% of serotonin is produced in the gut. 90%. Yeah, that's nice. I give Zoloft, it's only affecting 10% of the serotonin in the brain and the rest of it is affecting your gut. And there are precursors to serotonin and precursors to dopamine and other neurotransmitters produced in the gut that are capable of crossing the blood-brain barrier and altering our mood. This is the reason why we have studies that show that you can alter anxiety and depression with diet alone, and that a plant-based diet is beneficial in many cases.

And so it's fascinating to consider these connections. But one of the other things that people need to hear about is that short-chain fatty acids like butyrate, acetate, and propionate, which come from the consumption of fiber, also have the ability to cross the blood-brain barrier and be effectively ways that the gut is able to communicate to the brain and alter brain function. So there's all these different ways that they're in constant communication and affecting each other. And it's dynamically occurring literally right now as we're sitting and talking to each other. actually, like we all think like, oh, I'm craving this, so my body must need it or something like that. But it's quite literally your gut flora saying, these are the kind of foods we need to stay alive because this is what's going on down here right now and we need to keep this going.

So you need to eat these foods. And I think that's absolutely fascinating. And it goes to that point of us being much more sort of microorganism than human. We're a super organism. We're a super organism. We are a human body that is like we are carrying life within us. And they're a part of the story. And yes, they are completely capable of altering the cravings that we have. And it's important because it also means that if you change the microbiome,

you will change your cravings. You will change your taste buds. So to me, the idea, you know, part of what... People don't believe that. People have a hard time believing that, but that's 100% true. It's 100% true. So for me, when I was thinking about changing my diet, what stood in the way is my favorite foods

I was gonna have to give up. I wasn't eating these foods just aimlessly. I mean, I was eating what I enjoyed. And so that's what scared me. And what was fascinating was that as I made the change, the taste buds, although they lag a little bit behind because you need to change your microbiome, they came along for the ride. And I knew that something had changed for me because it's kind of like this. You go on vacation, right? You're away from your home for like seven days or 14 days. And you come back and there's that one meal that you can't wait to have.

You're like, I'm going to that place as soon as I land. And for me, back in the day, it was always Jersey Mike's. Go and get a sub, you know? And I realized that things had changed when I started coming back from trips and being like, I cannot wait to go to my salad joint and also get a kombucha. I can't wait. Right. It's so weird. Like what the hell happened to me, man? What the hell? How dare you? One of the things that I hear a lot, and I'm sure you do as well, One of the things that I hear a lot, and I'm sure you do as well, are people that are saying, I get it, like I wanna go plant-based,

I've tried it, it didn't work for me, I got super gassy, I had all these digestion issues, it just, it doesn't work for me, I understand it works for you, good luck, but I'm going back to my keto or paleo or whatever it is. So can you speak to the issue of gassiness that people experience, the relationship to the microbiome and this idea that eating a plant diverse diet

might work for some people, but not others? Sure. Trying to do a little myth busting here. Yeah, totally. Well, I think this is actually one of the, I mean, it's potentially the most important chapter in my book, which is chapter five, how to find your plant passion with a sensitive gut. Because the people that come into my practice on a daily basis that I take care of for a living,

these are people who are suffering with food sensitivities. When you have a damaged gut, you often will have food sensitivities. It's not a damaged gut, you often will have food sensitivities. It's not a coincidence. When you're sensitive to the food that you eat, it's not just a coincidence. It's indicative of dysbiosis. It's indicative of damage to the gut microbiome. And the specific categories of foods that people struggle with are fiber and FODMAPs. FODMAPs are the fermentable parts of our food that can be transformed into gas. Now, if you literally just heard that and stopped right there, you would go, whoa, those things sound horrible.

Why would we ever want that? FODMAPs are incredibly healthy, actually. They're prebiotic. They feed and nourish the healthy bacteria inside of us. And when you think about fiber and FODMAPs, what are the foods that are the most rich in fiber and FODMAPs? It's the exact foods that are creating sensitivities for people. Beans are huge on fiber, contain galactans, which are FODMAPs, and contain resistant starches, which are also prebiotic, but can be disruptive for some people. Whole grains, again, extremely rich on fiber, also contain fructans. Fructans are a FODMAP that can be disruptive. So what we've been hearing for the last 20 years is that, oh, if you're sensitive to that,

you are incapable of eating that food. And also, by the way, that is inflammation. That's what we've been told. That is inflammation right there. First of all, it's not inflammation. There's no evidence to suggest that. What it is, is it's sloppy digestion. It's sloppy digestion because you have a damaged gut microbiome. I want people to understand the way that this works on a cellular level. If we were to zoom in on what is happening when your microbes are digesting your food, here's what you'd find. There is this fiber, which is biochemically complex. And these microbes, aesting your food, here's what you'd find. There is this fiber, which is biochemically complex. And these microbes, a team of them, multiple different types,

go to work on this fiber and they break it down and deconstruct it. And to do that, they use enzymes called glycoside hydrolyses. Now, glycoside hydrolyses we big strong humans we don't have them we only have 17 of them if we didn't have a microbiome we would be completely incapable of processing fiber completely incapable but we do have a microbiome we've always had a microbiome, when they study this, may have 60,000 varieties of these enzymes. 60,000. A single cellular organism that you and I can't even see with the naked eye may have hundreds of these enzymes. So when the fiber goes down the track, it's untouched by the small intestine because we

lack these enzymes. And then it gets to the colon where all the microbes live. And they go to work using their tools, which are these enzymes to break down and deconstruct the fiber and ultimately to release the short chain fatty acids. If you're missing the microbes that you need to process and digest that food, you're going to struggle. And that's what we see in the person who has dysbiosis, where there's a loss of diversity. There's less species. When you lose those species, they may not be represented in a way necessary at that moment. Process and digest your food.

But here's the key. The gut is trainable. The gut adapts. That's the key. The gut adapts. And whatever choice you make, the gut will change. We talked about the study from five days of plant-based versus five days of animal-based. In less than 24 hours, the gut had changed. So I want people to think about the gut like it's a muscle. A muscle can be strengthened. You do that through exercise. It doesn't just randomly happen. It happens because you specifically go to work with that muscle and you work it to a certain point and then you stop and then it becomes stronger. And next week you come back and you can do even more but when you're training a muscle if you go to

the gym and you haven't been working out and you and you grab 300 pounds you're gonna hurt yourself mm-hmm the person who has not been consuming beans and like you know says what the hell and grabs the four bean chili hey like Yolo we're going for it. Right. They're going to hurt because they haven't been consuming beans and their gut is not adapted to eating that way. For the person who consumes these foods and struggles with food sensitivity, if you reduce the amount of those individual foods, if you moderated them and got it to a level that your gut was actually capable of doing,

that's where you want to be because that's when you're exercising your gut. And it will become adapted and better the more that you feed your gut with these foods. And over time, you will get those enzymes because your gut will adapt to what you're doing and become capable of everything that you want. But the key, Rich, is this. If you take those foods away, if you say, I'm going to categorically restrict these foods. So hypothetically, beans and grains. Beans and grains are gone. Boom. Okay. All of those microbes that were thriving on beans, they are growing weaker by the day. All of those microbes that were thriving on whole grains, they're growing weaker by the day.

You are not strengthening your gut by removing foods. You're making it weaker. And I see these people in my clinic every day that they eliminate food. And if they're lucky, they get a couple of weeks where they feel better. And then it's back to the same problem. And it's a vicious cycle where they actually get worse and worse with time. So with that person that comes into your clinic to extend the gym analogy,

you give them a light workout by incorporating small amounts of these important foods and then increasing the dosage of them over time. So you're seeding the microbiome with the plants that are the prebiotics that are going to lead to the gut flora that's going to ultimately improve the health and the quality of the microbiome and make it capable of digesting these foods at a certain point? 100%, but I would just tweak the way that I frame it, Rich, to say this. A person who has a normal healthy gut, okay, they can go to the gym and exercise. The person that I see who has dysbiosis and they're suffering

with these digestive issues, this is not going to the gym. This is going to rehab. This is me with an injured shoulder and I'm not going to the gym to see if I can lift 20 pounds overhead. I'm going to the physical therapist to see if I can literally lift my arm. And I have to go through a process. When you're rehabbing an injury, you have to go through the process and you recognize that it's going to hurt. It's not necessarily going to be fun, but you are restoring function to your body because your body is healthier when you restore that function. Right. So if somebody's experiencing that gas, like just keep going, basically, you're going to get to a point where your body's going to acclimate to this. Keep going. But what you want to do is you want to make adjustments. You want

to tweak how you're doing it. You may need to moderate. If you identify what food is causing trouble, and many people are good at this, They'll say, oh, it's garlic. Garlic and onions. Or, oh, it's whole grains. Or, oh, it's beans. If you identify the food, you can moderate the fiber and FODMAP content and reduce it down slightly. So that you're not putting such a burden on your gut all at once. And just take your time.

Go low and go slow. It's like the Beastie Boys song. Slow and low, that is the tempo. Yeah, yeah. Does that also apply to food allergies? I would think that that might be a different situation. So food allergies is activation of the immune system. And so it's a different concept,

but actually there is an approach, which I wouldn't want people to read a book and do by themselves at home, but there is an approach with food allergies where conceptually you can do the same thing, but even on a smaller level where you reintroduce these foods gradually over time and you can actually accommodate the immune system so that it stops activating. Let's bust a few more myths. Okay. Talk to me about lectins. A lot of people out there terrified few more myths. Okay. Talk to me about, talk to me about lectins. A lot of people out there terrified of lectins. Okay.

Well, first of all, I would encourage you if you're terrified of lectins to go to PubMed and search the word lectin. And what you're going to find is that probably more than 50% of the studies are celebrating and heralding the benefits of lectins for the prevention of cancer. Lectins are often anti-cancer molecules. I don't know, Rich, how you write a book if you're being balanced. I don't know how you write a book and forget to mention this important fact that lectins can actually protect us from cancer, which is the number two cause of death in America, you know, borderline infringing on number one. But when it comes to

lectins, I want people to understand that, you know, where people worry the most are, it seems to be in, in legumes and beans. Okay. If you don't cook your beans, like you eat a dry bean, it's got a lot of lectins and you could actually hurt yourself. There was a incident that occurred in Japan. It's one of the few publications that showed in humans that lectins truly can have adverse effects. There was an incident in Japan where they told people to grind up dry beans and then eat that powder. And a whole bunch of people got sick because of the lectin content. Right. It was like health day or something like that? Yeah. And there was another incident on health day in a hospital of all places back in the 80s where they served a bean dish that was not properly cooked and people got sick.

But that sickness was like they had a bug for 24 hours, then they were back to normal. There's no study saying that people are dying of lectin consumption. There's no human studies. I want people to understand the hierarchy of evidence. Anytime that we do a test tube study or an animal model study, we should always look to verify those results in real humans. I find it interesting when you put in a test tube some weird concentration of lectins and then mix it with human cells and you go, oh my gosh, look what happens in this test tube some weird concentration of lectins, and then mix it with human cells. And you go, oh my gosh, look what happens in this test tube. All right, I find that interesting. But what happens when a real person eats beans? Show me what happens when a real person eats

beans. You know what happens? They live longer with less heart disease and with less cancer. The longest lived populations on the planet in the five blue zones are the heaviest consumers of lectin-rich foods, legumes, and whole grains. The lectins are not something that we should live in fear of. I'll be honest. I feel like we deserve better than to be propping up or creating these dietary monsters to basically be demonizing our food to the point that we are actually giving people eating disorders. I've actually seen this in my clinic. People with full-blown eating disorders because they get so scared of certain food and they end up on a super restrictive diet. And then they end up with a disordered eating pattern. We deserve better

than this. I think that the solution is to stop running away from these food monsters that are artificially created. And instead, we need to start running towards the food that actually nourishes and heals our body and promotes a longer life with vitality. Yeah, there is quite a bit of fear mongering out there. And what's interesting about the work that you do is that it's not about reducing certain things. You're talking about what you're building. It's very additive. Like this whole diversification of your diet is about building new things into your diet as opposed to focusing on what we're removing. I feel like it's easily applicable, but conceptually extremely sound. Like from my

perspective, 50 years from now, this is still going to be the best way to eat, to consume a broad variety of plants, to be as predominantly plant-based as possible. I wrote the book, Rich, to meet people where they are. So when you say, well, you're not rigidly adherent to any particular diet, I want people to be 90 to 100% plant-based. That's what we find in the blue zones. That's what I think from a nutritional perspective is the highest quality diet. And I do think that when people get to be 90% plant-based, they're going to feel so good, they're going to want to keep going.

But I also think that there's an argument that goes beyond nutrition and talks about the health of our planet and talks about the compassion for these animals. And I think that those should be a part of the conversation. Even if they are not directly human nutrition, I think that COVID-19 has taught us that when we abuse this planet, when we abuse these animals, I kind of feel like it's going to fight back. It's beautifully put. And that just speaks to the inner relationship of everything. You can't talk

about the microbiome without referencing the macro biome. The health of our gut is related to the health of the planet and vice versa. The soil health connects to human health. vice versa? The soil health connects to human health. The health of our soil, which is the source of our nutrients, is critically important to human populations moving forward. I have children and I am scared of what this planet looks like 100 years from now when you consider what it looks like today compared to 1920. And the reality is that we need to just look at population. Right now, we have 7 billion people. In 2050, we will have 10 billion people. Consider that in 1900, there were only 2 billion people. Consider that in 1800, there was only 1 billion people. We're going to have 10 times the population in 250 years. And that's putting a strain on the

environment, on our planet, a strain on these animals. Biodiversity is the word. It's critical to our gut health. It's critical to planetary health, and it needs to be upheld. It's critical to our gut health. It's critical to planetary health and it needs to be upheld. I would say that that's a great place to end it, but I'm not gonna let you, I know you gotta go in a few minutes here, but I'm not gonna let you go

until we talk about fecal transplants, which is like my favorite subject. Oh man, how much time we got? I know, we can keep it brief because you have to actually go like perform a procedure, right, in a few minutes here. I am still a practicing doctor, yes. I had our mutual friend, Robin Shetkan on the podcast a while back,

but she regaled me with fantasies of the future in which there will be salons that people will go into and get their very bespoke fecal transplants to buttress our microbiome. And I think the science here is truly phenomenal. You talk a lot about it in the book and we'll close with the book, but the idea that the adaptability of the microbiome is so dynamic that you could insert the biota, the fecal biota of another human being into a different human being and see tremendous changes in that person's health and well-being as a result. It's true. It really is related to restoring harmony and balance, moving away from dysbiosis and back to eubiosis, and having the genetic profile that we need, which is potentially missing. And that's because 99.5% of our genetics come from our microbiome.

We are, in terms of our genetic code, only 0.5 percent human. Rich, you and I are 99.9 percent the same in terms of our human genetics. That close. And I'm not saying that our microbiome makes you look the way that you do. That's your human genetics. But our microbiome may be radically different, and it's certainly not the same. Each one of us has a completely unique gut microbiome. Fecal transplant really came to become a necessity because of an epidemic infection called Clostridium difficile. We now call it Clostridioides difficile, C. diff.

This became an epidemic infection when I was in medical school in the early 2000s. You would see this occasionally. Typically, it was elderly women who were on clindamycin, a specific antibiotic, and they were in the hospital. And they would get this infection. You would treat it with antibiotics and it would go away. In less than 10 years, it got to the point where 30,000 people were dying per year. That's a ridiculous amount of people. And we had antibiotic resistance around 2010 to the point that we would have people perpetually on antibiotics. They were just constantly on them. We didn't have a solution. And in our most desperate of times, most dire of need,

And in our most desperate of times, most dire of need, we turned to the gnarliest of places, poop. And this actually became the healing grace of, you know, this is 21st century healthcare on the highest level is to use poop as medicine. And what we saw is this rip-roaring, nasty infection that, Rich, I have had people, I have seen people die from this infection. I've also had people have their colon removed as a result of this infection. This nasty infection, if you take a healthy person's microbiome

and you basically administer it, you know, I mean, painlessly during a colonoscopy, like they don't even realize you're doing it. You give them a new microbiome within two days, the infection is gone almost a hundred percent of the time. I mean, on an amazing level. And really all you're doing rich is it goes back to an earlier point. And really all you're doing, Rich, is it goes back to an earlier point. The good guys suppress the bad guys. So when you restore a healthy balance and you get more good guys in the game, they will suppress this rip-roaring nasty infection. The C. difficile, as nasty as it sounds, just get more good guys in there and they can suppress

it. The future of fecal transplant is exciting. We have studies ongoing to look at fecal transplant for everything from acute issues all the way up to chronic issues, including autoimmune issues. If you want me to venture a prediction for you, Rich, here's what I think is going to happen. I think that we're going to discover that fecal transplant is really good for dealing with acute issues. So when I say acute, like this infection, C. diff, that's an acute issue. That's not something that's going to chronically affect

you. And so if you can disrupt the disturbance in the microbiome by restoring a healthy balance, you could resolve the acute issue. That's why it's so, so effective in that particular setting. so effective in that particular setting. The challenge is the person who has a chronic issue, can you fix their chronic issue by changing their microbiome? Could you take a person with MS, change their microbiome with a fecal transplant and move on and get rid of the disease. And I don't mean to throw a wet towel on the idea, but I don't think that this by itself is going to be adequate. Here's why. We have a study, Rich, that I mentioned in chapter one of the book, looking at young men who had insulin resistance and they gave them a fecal transplant. And what they saw, which was amazing,

because they changed nothing else in these young men, they ate the same food. When they gave them the fecal transplant, their peripheral insulin sensitivity improved. So basically you fixed the insulin resistance issue. But the problem is that over the course of about four weeks, this benefit, it dwindled. Yeah. It's like watering a plant one time. Yeah. And so the issue is if you don't change their diet, you give them these brand new microbes, you know, and you restore balance and a healthy microbiome, but then they continue to live the same way. They continue to basically have a lifestyle that disrupts the microbiome.

They're going to go back to what they were before. And so it takes about four weeks for that to happen. So now if you could do a fecal transplant, new idea, if you could do a fecal transplant and pair that with dietary intervention, where you change their diet, you change their lifestyle, you give

them the tools to uphold this new healthy gut microbiome. Now that is an idea that may have some legs, but it still requires the dietary intervention, which gets back to what my book is all about, fiber-fueled, which is that you can change your gut microbiome. You can transform it with diet and lifestyle. And so I think that this is exciting, but you could start doing that today without getting the poop transplant. Right. And the way that you start doing it today

is with the F goals, right? So just rifle through these and I'm gonna let you go, I promise. All right. So the F goals, it's like this. Earlier in the episode, you said, look, we've been taught that we need these superfoods. And I stepped in and I said,

oh, no, no, no, no. We need 10 different plants instead of that one superfood. Okay. Here's the way I want you guys to think about this. Plant-based diversity is the king. That is the core philosophy. But you're not going to eat every single plant the same amount every single day. So at the end of the day, what I want is if the plants are our friends, which they are, they're trying to help us be healthy.

If the plants are our friends, I want you to have as many friends as possible, but why not make the superfoods your best friends? In real life, if I could have Rich Roll and Simon Hill as my best friends, I would do that. That's exactly what I would do. That's what you need to do with your diet. Make the superfoods your best friends. F-Goals is my acronym to help you keep track of the main things that you should have in your diet, if not every day, at least a couple of times a week. F, fruit and fermented. G, greens and whole grains. O, omega-3 super seeds. So flax, chia, hemp, put all three of them in your smoothie. Boom, done. A, aromatics. Really, I'm talking about the flavor foods, garlic, onions, shallots. L, legumes. Like I said, whole grains and legumes, I actually view those as foundational foods for

the microbiome. And then finally, S, I couldn't control myself on S. I had so many I wanted to add. So here's what I did. I got three, but I'm going to save the best for last. Shrooms. Okay. Technically not plants, but we're making them honorary plants for this conversation. They do benefit the microbiome. Seaweed. Really it's sea veg. It's an untapped into resource. You want to add diversity to diet. I'm not talking about making whole meals out of seaweed. I'm talking about a little snack. And it's got unique types of fiber and unique nutrients, which by the way, when people criticize the vegan diet, you can find many of the nutrients that people bring up in sea vegetables. And then finally, my favorite out of all of them, this is my favorite, is sulforaphane.

It's the nerd in me to mention a phytochemical. I can't help it. You had to do it. Yeah. It's the nerd in me. We could do two hours on that alone. And if you want to, I'll come in and we'll talk about it. But basically, sulforaphane is a phytochemical that you will find in cruciferous veg like broccoli, cauliflower, brussel sprouts, etc. And it is the most powerful cancer crusher that I've come across. It basically impairs cancer through seven different mechanisms. There are literally over

a hundred studies of sulforaphane. And so what's cool about sulforaphane is yes, you will find it in these cruciferous vegetables, but there's one place where you will find it above the rest, which are broccoli sprouts. Broccoli sprouts contain up to a hundred times more sulforaphane than you will find in adult mature broccoli. So today for lunch, I had a miso soup bowl and I threw a whole bunch of broccoli sprouts in there and they're delicious. And they have this sulforaphane, which is nourishing my body and helping to protect me from the number two cause of death, which is cancer. So if you tuned out for this entire podcast

and you just need one takeaway from this whole thing, it's broccoli sprouts. They're magic. Thank you so much. I know you gotta go. I'm gonna let you go. Really appreciate the work that you're magic. Thank you so much. I know you gotta go. I'm gonna let you go. Really appreciate the work that you're doing. You're breaking new ground here and you're helping a lot of people

with a lot of difficult problems that they're having. I have tons of friends that have gut health issues, everything from leaky gut to ulcerative colitis. And I could ask you a million more questions. I got a ton of notes here. We didn't get to, we got to maybe 5% of all the things that I wanted to talk to you about. So please come and visit me when the pandemic lifts enough so that we can responsibly be in the same room together. In the meantime, everybody pick up FibroFuel. Thank you for

sending me a copy. You wrote a nice like thing here. Appreciate that. Yeah, man. Support your local booksellers if you can online and, or you can get it on Amazon. I'll put a link up in the show notes to the book. Congrats on making the New York Times bestseller list. It's well-earned and well-deserved. And I think that this is all very much just the beginning for you. So I'm excited to see where you take all of this advocacy. In the meantime, you can learn more about Dr. B at TheGutHealthMD on Instagram. That's the main place, right? Anywhere else you want people to go?

The main place is Instagram. Well, I have a bunch of great resources at my website, which is theplantfedgut.com. I have a bunch of great resources at my website, which is theplantfedgut.com. And, you know, for example, I feel like we're living in this confusing time in terms of knowing, you know, you hear me say that lectins are totally fine. And then you hear a different doctor say lectins are destroying our health, right? So, and people are kind of sick of this. And so I wanted to provide a solution. So, and people are kind of sick of this.

And so I wanted to provide a solution. So I created a research guide and it's meant to give people the basic tools that they need to understand the fundamentals of clinical research and how to find truth within the noise. Because the truth is out there. The truth exists. With all my training, 16 years of training,

you know, master's of clinical investigation, I know how to sift through this stuff and find the truth. But I want you guys to have basic tools to know what to do. So I created this research guide, which also includes all the references from my book, completely free for download on my website. I also have a COVID-19 guide. I have an active email list that people seem to enjoy. And then the last thing I just want to mention real quick, I hope you don't mind, is that I'm super excited about this book. I'm super excited about the response. You know, to me, if you say to me, Will, you got a choice. You can be a New York Times bestseller and help no one, or you can help a shit ton of people and not be a New York times bestseller. I'll hand you the

New York times right now. All right. I'll give it to you right now. And so I'm really excited about the messages that I'm getting from people who are feeling the benefits from this book. I want you guys to reach out to me. I also want you to know that I'm creating additional resources. I have a course that I'm launching this summer. I beta tested it twice with amazing results, with amazing results in groups of people. And it's a seven-week course basically to take an even deeper dive into the ideas that you find in my book so that we can really unpack this stuff. And effectively what it is, Rich, is I wish, like when people read this book, I hope they

feel that they're hanging out with me and we're just having a great conversation. And in building the course, what I'm constructing is the seven-week conversation that I wish I could have with every single one of my patients. I want to teach you everything that you need to know to transform your health. And that's what it's about. That's great, man. We should also point out that the book has a, in addition to being this incredible primer,

you have a 28-day program here too that you can take people through the second half of the book, essentially. 28-day plan. It's got basically 80 recipes. It's got, I mean, and one of the things I'm most proud of with this, by the way, with the

plan is it is designed to meet you where you are. Okay. So the reason why I didn't write this book to be, Hey, you need to be vegan. And if you're not, it's a bad choice. The reason I didn't write that way is because I want to meet you where you are. I want to get a trajectory in your diet and your lifestyle that is going to transform your health. I want to point you in the right direction. And then let's get the ball rolling and let's do it together. And so every single person who's doing this 28 day plan is going to have their own experience. No two people will do it the same. And I celebrate that. And I want people to use the plan as a tool to get the compass pointing in the right direction,

but also to be comfortable making the adaptations necessary to make it your own. And I really think it's going to get people to a better place when they do it. Great, man. All right, well, to be continued. Be continued, my friends. Yeah, thank you so much, man.

Really appreciate it. Good luck with everything, man, and look forward to finally meeting you in person at some point. 110%, look forward to it you so much, man. Really appreciate it. Good luck with everything, man. And look forward to finally meeting you in person at some point. 110%. Look forward to it. All right. Cool. Peace. Good stuff, right? I mean, talking about the microbiome is almost like science fiction, like science fiction becoming science in real time. It's amazing stuff. Hope you guys enjoyed that. Dr. B is a total gem. If his words and his wisdom hit home,

I highly recommend picking up his New York Times bestselling book, Fiber Fueled, and check out his brand new seven-week comprehensive online course linked up in the bio. I'm not an affiliate. I have no financial entanglement here, just sharing good stuff. And also let Will know how this one landed for you

by tracking him down on Instagram or Twitter at theguthealthmd. If you'd like to support the work we do here on the show, subscribe, rate, and comment on it on Apple Podcasts, on Spotify, and on YouTube. Share the show or your favorite episodes with friends or on social media. And you can support us on Patreon

at richroll.com forward slash donate. I wanna thank my team for working hard to put on today's show. Jason Camiello for audio engineering, production, show notes, and interstitial music. Blake Curtis for videoing and editing the visual version of today's show. Jessica Miranda for graphics,

Georgia Whaley for copywriting, DK for advertiser relationships and theme music by Tyler Pyatt, Trapper Pyatt, and Hari Mathis. Appreciate you guys. I love you. I don't take your attention for granted. I will see you back here next week with another amazing show. Until then, be well, treat yourselves right, stay safe, but increase the biodiversity of your microbiome. More fiber, more fiber. Peace. Plants.

Namaste. Thank you.