The Wellness Scoop - Why the Gut is the Key to Health

Episode Date: January 31, 2022

We’re joined by Dr. Emeran Mayer; a professor, gastroenterologist, scientist, and author about the latest research on the gut microbiome, the connection between the gut microbiome and the immune system, and how we can improve the health of our gut to support our overall health. We discuss: What is a healthy gut microbiome Is it nature or nurture that determines the health of our gut? The link between the gut microbiome and the immune system Why diet has a major role in how our immune system functions How inappropriate activation of the immune system is implicated in chronic disease How diet can be used to modify the immune system back to its normal state The importance of fibre, and a largely whole foods, plant-based diet The role of chronic stress in gut health and immune function How processed foods impact the gut microbiome The 3 key things we can do to support our gut microbiome Emeran Mayer: ‘The Mind-Gut Connection’ ‘The Gut-Immune Connection’ See acast.com/privacy for privacy and opt-out information. Learn more about your ad choices. Visit podcastchoices.com/adchoices

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Visit BetterHelp.com today to get 10% off your first month. That's betterhelp, H-E-L-P.com. Hi, I'm Ella Mills, the founder of Deliciously Ella, and this is our podcast, Delicious Ways to Feel Better. Each episode explores various aspects of our mental and our physical health to help you make small, simple changes to your life to feel that little bit happier and healthier. And today we're looking at how to support the immune system and why our gut health is just so integral to feeling well. I think we're facing a similar challenge as it has been with

smoking cessation. The majority of people had this unhealthy habit. It was unthinkable that it would be possible to change these habits, but it was possible. So I would say the challenge is similar going to a gut microbiome healthy lifestyle is feasible, challenging, and will have at least as big an impact financially and health-wise as a smoking cessation had. And before we delve into the episode, I wanted to let you know a little bit about our sponsor. So for the next few months, our podcast sponsor is going to be Simprove, a supplements company that I've been using to support my gut health for about five years now. So I've been using it for years and years before I started working with them. I know gut health is such a prevalent topic at the moment and we're

going to have a mini episode specifically on eating for gut health at the end of January, as I know it's something so many of you are interested in too. The gut microbiome is made up of trillions of bacteria that support pretty much all aspects of our mental and physical health, from digestion to our immune system, energy production, and mental health. And keeping the right balance of good bacteria in our gut is just so important. Our diet and lifestyles have a huge impact on that, but adding in live bacteria can really help too. The bacteria in Simprove, which is a water-based supplement, can really survive the long journey from the mouth to the gut, where they can then multiply

and support our microbiome. I truly swear by it and I hope you love it too. For anyone wanting to try it, they've shared a 15% off code with us, so you just need to use Ella15, which is valid on Simprove.com for new customers based in the UK but they also have a subscribers package if you're an existing customer. Today's guest Dr. Emmeryn Mayer is a professor, gastroenterologist, scientist and author. In 2016 he published The Mind-Gut Connection which delved into the groundbreaking research that was starting to emerge about the close interaction between the brain and the gut microbiome. In his new book published last year, The Gut-Immune Connection, he takes this even further looking at how the gut microbiome has a major influence on all of our organs including our immune system and that changes

in the microbiome play a really fundamental role in the growing epidemic of chronic diseases, including diabetes, heart disease, and cancer. So welcome, Emarin. Thank you so much for joining us on the podcast today. Yeah, it's a real pleasure. Thanks for the invitation. I'm looking forward to this conversation. So I wondered if we could really just start at the beginning, I guess, with a bit of gut microbiome 101, because I'm sure it's something that anyone listening today has heard a lot about. We hear so much about the gut at the moment in the press and in the media but for any listener who wants a refresher could you give us a bit of an overview of what the gut microbiome actually is and why it's taken such center stage over the last few years? Yeah, so the word microbiome really refers both to the microorganisms, so viruses and bacteria that live in our gut, but also to their functions, meaning to their genetic pool. And so there's

about 40 trillion of these bacteria living inside the gut, invisible, living predominantly in an oxygen-free environment in our colon. And they interact closely with the viruses. We know less about the viruses, but there's a symbiotic relationship with the viruses inside of us. And there's also a symbiotic relationship of these 40 trillion microorganisms with our gut. There's many receptors and mechanisms, communication channels that have evolved in evolution, has benefits for both sides. So the microbes have a protected environment. They're always exposed to the food that we eat that they can use themselves. And we derive a lot of benefits from them because they produce a lot of things from vitamins to molecules that stimulate pretty much most cells in our body, our immune system, our brain.

So this design in evolution has turned out to be really successful because it's stayed for millions of years. Virtually every animal on this planet has its own microbiome. And I think a certain degree of confusion still remains there in kind of how we describe what a healthy gut is. Again, I'm sure that's something you see all the time it's in the media. But I think it can be a little bit confusing to decipher. How would you describe a healthy gut microbiome? How would you know if you had one? Yeah, so let me start with what is a healthy gut microbiome how would you know if you had one? Yeah so let me start with what is a healthy gut so there's many cells in our gut there's a nervous system in our gut there's an immune system in our gut there's hormonal systems if all these systems are in balance and there's very little engagement of the immune system and the gut is not leaky or permeable to substances that get into the

systemic circulation, then I would say that's probably the best definition of a healthy gut. A healthy microbiome, there you have to really go to these ecological terms. So the microbiome is an ecosystem. It's not that the individual microbes are the main influence that this exerts, but it's the interaction of these thousands of species of microbes that ultimately produces the outcome that interacts with us. So it's an ecosystem composed of many components. And the main characteristic of a healthy ecosystem is really diversity and richness. So diversity that you have a lot of different types of components or microbes, and that

each of those components has a sufficient number. And some of the things that are being measured in many tests is always the relative abundance of individual microbes and the overall diversity and richness. And that diversity has suffered over the years. So what we have today is very different from what we had hundreds of years ago and also what we had 75 years ago. So the diversity has decreased, the richness of some organisms has decreased. And some of this decrease has happened because some microbes vanished over time. They're no longer there.

Others are only present in very low abundances. So the richness has gone down. And most of these changes, we think, have happened in response to the modern Western lifestyle with a lot of components, you know, from diet to medications to how we come into this world with C-sections. So there's a lot of factors that people think have contributed to this change in diversity and richness that we see today. That was my next question. What is, is this diversity something that you could say was nature or nurture, or is it a combination of the two that influences what we as individuals have within our gut microbiome? It's definitely both. So for example, in mouse models, genetics plays the major role. You can have a hundred different strains that are genetically different and each of those strains, mouse strains, has a different microbiome. In humans, it's not so much determined

by the genetics, but it's equally important what factors have acted on the programming of this microbiome from early on in life, from the time an infant goes through the birth canal and then the environment, the sterility of the delivery room, the antibiotics that are given from early on either to the newborn or to the mother, the breast milk, composition of the breast milk of the mother, which have many molecules that are important to nurture the early microbiome. And then, you know, once it's programmed in the first couple of years of life, then there's also the other lifestyle factors as adults.

Diet, I would rank pretty high, but there's also influences from the brain. Stress, negative emotions play a big role. And there's even things like exercise levels. At different phases of life, there's different kinds of modulation. The programming happens early, first two years of life. The modulation of what we have inherited then and what has been programmed earlier can happen throughout the lifespan. Amazing. I've got so many questions based on that, but I'm going to try and go back to the beginning a little bit again, which is that I know your big focus is as well on the

link between the gut microbiome and the immune system as well, which I think is something that our listeners might not be as familiar with. Again, I think with a lot of the mainstream conversation at the moment about the gut microbiome, we hear quite a lot about the gut-brain access and the link between the brain and the gut, but I don't think we think so much about the immune system which is obviously I feel particularly this episode will be coming out in January and there's a lot of questions around COVID again I think quite a lot of people thinking quite a lot about their immune system so could we just start to understand how that colony within our gut those trillions of cells that we've built up over our lifetime,

how do they interact with the immune system? What's the relevance there? Yeah, and I was just going to make a brief comment about this, what you say about, you know, so the mind, when I wrote my first book, the role of the brain-gut communication, the brain-microbiome communication was really not something that the most that anybody really knew about much so the interest grew with time and right now actually it's kind of interesting the main interest of the media seem to be in the mind gut microbiome connection and so the connection with the immune system has not been on center stage but it's equally important. So we have 70% of our immune cells in our gut. They're just microns. These immune cells are microns away from these trillions of microbes

that live on the other side of the gut wall. And not only that, but immune cells, they have these little sensors that reach into the gut, into the inside, that are covered with a mucus layer. So they're not in direct contact with the microbes but they're very close so anything that happens to this mucus layer to this barrier between the microbes on the one side and the immune cells on the other side has a major influence on the activation of the immune system so the minute a microbe comes in contact, in physical contact, with any of these receptors on the immune cells, you get an activation of the immune cells and they produce cytokines, these inflammatory molecules, which then are amplified first in the gut and then they can spill over in the systemic circulation and reach every part of the body. So we are designed in a way that the microbes and the immune system

are the two components that are in closest proximity with the greatest consequence. If you imagine just a contact of the cell wall of a microbe with any of these sensors on these immune cells, triggers the alarm bells in the immune system. So in the past, we thought this has to be pathogens or infectious organisms that trigger that immune response. But now we know any contact with a microbial cell will do that. So you can imagine anything that influences this gut barrier, either the mucus layer or actually the permeability or leakiness of the gut wall, have a major influence on our immune system activation. And that doesn't stay in the gut, that immune system activation, but it spreads throughout the body, including the

brain. So based on that, people have coined these terms, the gut-lung axis, the gut-liver axis, and this basically just represents that there's a communication, the predominant one through immune cells, between what happens at the gut level. Now, the microbes are influenced, as we know, in the adults to a large degree by our diet. So this gives the diet a major role in how much our immune system gets activated. So to put it very simply, could you say if your gut isn't as strong as it could be, you've got an unhealthy balance of your microbiome, does that create a less healthy, less strong weakened immune system? Well, paradoxically, you know, it's not a weaker immune system because what the problem is, is this inappropriate engagement of the immune system.

It shouldn't be, you know, normally it should be activated by an infection, not by the fact that the barrier between the microbes and an immune system has been narrowed by a poor diet. So yeah, people always ask that. There's always this question about what can I do for immune support and strengthening my immune system. It's actually what we want to accomplish is that there's less chronic engagement of the immune system. We want an immune system that responds quickly to an invader, but we don't want it to be engaged all the time,

which is what we're seeing now. So, you know, as I wrote in my book, this chronic disease epidemic that ranges from chronic degenerative brain disorders like Alzheimer's and Parkinson's to obesity to fatty liver disease in colon cancer, all of these involve this inappropriate engagement of the immune system because the barrier between the microbes and the immune system has been compromised.

So, you know, there's a lot of writing and discussions on podcasts and the lay media that everything can be blamed on a leaky gut. I, as a scientist, I don't think that's giving the complexity justice, but it is certainly an important part of it. So what we would like to do, I think, to modify the immune system back to its normal state, not enhance it, but modify it back to its normal state. So it's not chronically engaged and causes secondary damage on all these other organs. And so to do that we need to have a strong barrier between the gut microbiome and where our immunity lies on the other side of it and you were saying that poor diet contributes to a weakening and a sense of permeability within that layer. What should we be doing to create

strength within that layer? Yeah so we talked doing to create strength within that layer? Yeah, so we talked about how dangerous it is when microbes come into close contact with these immune cells and sensors on immune cells. At the same time, so you get the engagement of the immune system, inflammation, generation of cytokines. At the same time, certain microbes produce chemicals from the digestion of complex carbohydrates, you know, many plant-based fiber molecules that have an anti-inflammatory effect that oppose this engagement or this chronic engagement. So these are the short-chain fatty acids. The most important one, a studied one, is called butyrate. And there's a whole group of these beneficial microbes that generate these molecules. And so we want to enhance the relative abundance of these microbes. And how do we do that? We do it by eating a highly diverse and largely plant-based diet.

Now, you could also contribute to this by, if you prefer to eat supplements with prebiotics, which is essentially fiber-type molecules. The benefit of doing this naturally is that you get a big variety. You get hundreds, maybe thousands of different fiber molecules, which increases the abundance and the diversity, as we talked about earlier so what we can do with diet is one is we can strengthen the production of the mucus layer by and there's other molecules that that are involved in this for example this is one called akkermansia and we can also increase the production of these anti-inflammatory molecules by feeding these complex carbohydrates that translate into short-chain fatty acids. So in some ways, that makes it quite simple to

understand why a largely, and I emphasize largely, not exclusively, plant-based diet has these health benefits, and also why we have seen this increase in a compromised gut microbiome and gut health. It's because our dietary habits have just changed in a direction that is very different from our ancestors. And I'm always surprised, you know, that there's still controversy. There's still people that propose, you know, like the keto diet is one example where you would take out most of these complex carbohydrates and just focus on protein and fat. That whole diet basically bypasses all the knowledge that we've gained to nurture and to improve the health of our gut and our gut microbiome. Yeah, it's absolutely fascinating because people have such a nervousness, I think,

still of carbohydrates, even very healthy carbohydrates. And it's immensely frustrating, as you said, because the evidence, it's so clear. And I'd actually love it if you could just give us a definition of inflammation. And again, what the crossover there is with our immune system and not over activating it, but trying to modulate it and keep it in a healthy, balanced way. Because I think it's one of those words you read about a lot, but don't necessarily always understand exactly what we mean by it and why it's not good for our body and perhaps what's also causing it. Well, I mean, the immune system is really a warning system, you know, that detects any potential threat. It has similarities with the nervous system. The nervous system is a warning

system that detects threats in the environment and we react to it reflexively, instinctively, but also with decisions we make. The immune system is kind of an older warning system that picks up different kinds of stresses and threats. It has two components, the innate immune system and the adaptive immune system. The innate immune system reacts. What I told you about these sensors from dendritic cells that pick up any microbe that comes close to it. As far as the innate immune system, the adaptive immune system then will produce specific antibodies against threatening components, either microbes or other components in the environment. Unfortunately, both of those systems are being activated now increasingly. So I'm always talking about the main stress for the immune system in the gut comes from diet. It's a dietary stressor. This diet threatens the homeostasis or the metabolism of the body.

And we have the constantly increasing chronic stress, particularly the last two years with the pandemic and the uncertainties. And, you know, both of these kind of stressors compound each other in a negative way. And I think a lot of these modern Western diseases that we see from metabolic syndrome, type 2 diabetes, hypertension, and I mentioned these other diseases earlier, are a consequence of these increasing immune and nervous system stressors. So stress in that context is just a perturbation, a threat to the homeostasis of the body. And because, you know, brain and gut are closely interacting, the brain has an influence on the microbes as well. That makes the problem even more serious now.

And as we go in the future, there are trends for a healthier diet, healthier gut microbiome. But obviously, we can't escape the chronic stresses. And so it's the hidden threat, I think, to our health. The prevalence of these diseases has been increasing continuously in the last 75 years. Stop sitting on your Aeroplan points and get big savings so you can be somewhere you actually want to be, like on a beach. Right now, you can save up to 25% in Aeroplan points when you book a trip to one of 180-plus Air Canada destinations worldwide. So stop sitting on your next trip and start saving on one.

Don't miss out. Your chance to save in points ends February 23rd. Book at AirCanada.com. Conditions apply. You're a podcast listener, and this is a podcast ad heard only in Canada. Reach great Canadian listeners like yourself with podcast advertising from Libsyn Ads. Choose from hundreds of top podcasts offering host endorsements or run a pre-produced ad like this one across thousands of shows to reach your target audience with Libsyn Ads. Email bob at libsyn.com to learn more. That's b-o-b at l-i-b-s-y-n.com absolutely and it's a fascinating but sometimes difficult conversation i'm sure you'd be the first to say that sometimes to have these conversations and i think i would just like to clarify that because i think it's

one of those things that sometimes what we put on our plate you know what any of our listeners make for lunch today or dinner today or what they eat next week, it's very difficult to understand, I think, sometimes the tangible effects of that on, as you said, some of these chronic diseases that we're all so familiar with, whether that is the various different metabolic issues, whether that's high blood pressure, whether that is the growing instances of cancer. Cores then are all related to what we put on our plate. But as you said, there is this growing epidemic that's impossible to hide from. Could you just explain a little bit more about the link between what we put into our bodies, the psychological stress that we

are under, our gut health, our immune system, and this rise in diseases and that they really are linked? There's many pieces of evidence that link it. And many of these studies are not, they don't necessarily prove causality, they're associations, so they compare populations, large populations, often hundreds of thousands of people that eat a healthy diet and those that don't eat a healthy diet. And then they compare their life expectancy, how long they live, how healthy they

are in older age and that evidence is very strong you know there's lots of evidence for that if you on a healthy diet you can add at least you know five to ten years at the end of your life during which you are healthy then there's other studies now that show that these same kind of diets are associated with a healthier microbiome. So on the one side, health indicators, on the other side, microbial indicators that show that this, and there's a few studies now that have studied this. If you do an intervention, you put people, for example, that are in the state of mild cognitive decline, elderly, and you put them on a healthy diet. And when I say healthy, it's always

what we talked about earlier, the largely plant-based diet rich in complex carbohydrates. One could also add rich in naturally fermented foods. So there's a few studies now that have shown if people start on that diet, they will reverse the negative trends in terms of systemic inflammation, some of these like metabolic derangements. So a lot of evidence from association, epidemiological studies, cross-sectional studies, a growing number of studies now that show actually there's a causality between the healthy diet and what aspects of the healthy diet. I think we should really make this very clear that there shouldn't be a debate what a healthy diet is. I mean, I mentioned in my last book, if you are mainly concerned about the health of your microbes, in some ways, that's all you need to worry about.

Because if you eat a diet that's optimal for the diversity and the richness of the microbes, you will also have the best diet for your own body that's so interesting i think it's so easy to forget these extraordinary things that are happening in our body every millisecond and what they're really doing for us and and when you were talking about how we've had this decline in our microbiome over the last hundreds of years but especially over the last 75 years is with this change in the way that we're living with the rise in both dietary stress but also psychological stress are we seeing that rate of decline start to speed up? I've not seen data that it would speed up because it's been a continuous progressive so when I say 75 years that's after world war ii with the with the introduction of highly processed

foods the introduction of industrial agriculture which had a major impact on on on our food that we eat the food processing so these are all things that have gradually increased over time and there's been this gradual change in the microbiome and the gut health in a gradual increase in all these diseases that we mentioned that dramatically increase psychological stress that we've seen during the pandemic there are studies now coming out that the impact of that stress on for example mental well-being of particular children has been severe and it will probably continue to be severe. So we don't know yet if that is, there's many studies going on about the microbiome as well now

from the time of the pandemic. But I would say that chronic stress that has been increasing over the last couple of years for several reasons. One is increase in world population, greater competition for the number of jobs, job insecurity. So there's a lot of these psychological factors that we sort of don't talk about too much. But with the pandemic now being restricted to the home, I think the uncertainty is a big thing of that lack of social contact, social interactions. I think this will take time to see that. The studies will have to be done to really determine how that accelerated the prevalence of these diseases. I would predict

there will be a bump. If you look in 10 years from now, you see that there was a bump in the prevalence of many of these diseases and with an associated change in the microbiome as well. And do you think we can turn that around? Or do you think that bump that we might see may continue? Do you think that there's change in our dietary patterns in the chronic stress obviously has been exacerbated by the pandemic, but I think people are feeling in their day-to-day lives so much at the moment. Do you think we can, can we change it? Yeah, so I would say in theory, that is possible. In practice, I think we see a lot of positive developments, which is happening in the US, mainly in the coastal cities, certainly in Los Angeles, many startups popping up and even some big food companies jumping on this bandwagon now of healthy, sustainable diets, which are good for you and for the planet.

It's kind of remarkable in the last couple of years of how that trend has. I think consumers demand this in these places, in the coastal areas. There's also been a remarkable increase in popularity of devices and techniques, digital techniques to improve mental health. So from apps that teach mindfulness-based stress reduction, digital cognitive behavioral therapy. So there's many modalities that are popping up all of a sudden that are much easier to use than in the past. These kind of interventions where you have to join a group and, you know, drive to a meeting. It's kind of remarkable, you know, how this counter movement is actually developing. To what degree this will change dietary habits sufficiently in the majority of people,

populations in Western countries, that's hard to predict. I mean, things have happened with smoking that nobody thought that the smoking habits would dramatically change. This could be a similar phenomenon that all of a sudden, you know, there will be a tipping point that when enough people, enough consumers demand these healthy foods and put pressure on agriculture and food processing companies, that this will change. I mean, I like to be optimistic. There's also one thing that, you know, a pretty dramatic thing.

So this decrease in diversity, and there's also animal studies that show this, is kind of transmitted from generation to generation. So if your mother was on a very unhealthy diet and you switch to a very healthy diet, there's no guarantee that you can completely reverse the damage to the microbial health that has occurred during your mother's generation or your grandmother's generation. So in animals, this is being transmitted, this decreased diversity over generations, even though you may now all of a sudden provide a healthy diet to the offspring. If that's really the case in humans, similar to animals, then there may be some radical interventions necessary, for example, to provide interventions early on in life when the programming

of the microbiome happens. So you could do something that's the equivalent of a fecal microbial transplant. You wouldn't need to transplant feces, but you could have the main organisms that we think are necessary to build a healthy microbiome in a cocktail, and you would give this to the newborn, and that would help the newborn to build this new diverse. So scientists have talked about this possibility. And I think if things are continuing the trend that we have seen last 75 years, this may be something that will be evaluated. You know, it's obviously challenging to do these kind of studies in newborns with all the risks, unknown risks, what happens. And so, Emren, you mentioned there's smoking.

And I think it's a very interesting one because not that long ago, a few decades ago, you could smoke inside, you could smoke on an aeroplane. And we all thought that was normal. And now we think that's extraordinary. And actually, I saw that New Zealand are going to ban smoking for anyone under 15 in 2023. They won't even be allowed to buy a cigarette legally in their lifetime so I mean what's happened over 30 years or so is extraordinary and do you think the issue that we're talking about today with this degradation of the gut microbiome via our lifestyle factors and of perhaps inherited lifestyle factors and the correlations we're now seeing with this rise in chronic diseases and neurodegenerative diseases. Do you think that the issue we're talking about today is as serious as smoking? Because I don't think that perhaps

most people think that it is. I think that might be quite shocking and surprising to some people. Yeah, I think this has not made it in the general awareness, you know, that link between these invisible diseases. The only thing that we see is obesity, but all the stuff that goes on under that cover of obesity, that's really what's the dangerous part. And I think the impact of the unhealthy, I can't give you the exact dollar numbers now, but what changed with the decrease in smoking, the prevalence of lung cancer obviously has gone down dramatically, and the costs associated with lung cancer has gone down dramatically and the cost associated with lung cancer has gone down dramatically so I think something it will require a major educational campaign. But do you

think it's as big a problem do you think that what we're doing to our gut health now is a bigger problem socio-economic for our collective well-being do you think it's as big a problem as we saw with smoking? I think it is I mean the, the only thing that's different, you know, we didn't have a curative therapy for lung cancer. So once you had the diagnosis of lung cancer, you know, most people would die. Now with this epidemic of all these other diseases, we have lots of medications. We have medications for high blood pressure, for high lipids, for diabetes, which keep people from dying. But it doesn't change the presence of the disease process. I mean, I've seen numbers that in the UK, there was a survey that if you use the criteria that medicine currently uses,

that would indicate the use of statins as a medication, I think close to 100% of people over 60 in the UK would have to be on statins when you think about this. So it's almost become like the norm, you know, that people have this metabolic disease, and they need to be on these medications. So there's much less of an urgency from as it was with lung cancer, because people were just dying from lung cancer and chemotherapy was not really or radiation was not really that effective but now for these new diseases this epidemic we have medications to keep people from dying to keep mortality down whereas morbidity has been continuing to increase so i would say it's as severe a problem economically

and for general health of the population as the smoking is, maybe even bigger. But the solutions that we've had to deal with them, the medical system, there's more ways to keep emphasizing that, to keep people alive with those diseases. It's such an interesting topic. And I've just got one last question before we go on to, I guess, the more positive and leave people with what they can do to support it, which is,

there was one study I saw that had come out quite recently. I know it's quite a newer area of research, which is understanding, I know you said the rise in processed food, but what it is in processed food that's so disruptive to the gut health with emulsifiers and preservatives and stabilizers and additives which and now I think it's both in the US and UK the stats are quite similar it's over 56 percent of of calories consumed or bought are ultra processed and therefore contain these sorts of foods what is it about those in the food that we're eating because again I think it's very hard to to visualize that when you buy something in the supermarket that it're eating? Because again, I think it's very hard to visualize that when you buy something in the supermarket, that it could be having that effect on your gut. Yeah. So, I mean, obviously there's so many chemicals that, you know, it's not one mechanism

that mediates these effects on the gut, but certainly this gut barrier, the compromised gut barrier is definitely one target that has been identified in animal studies that is compromised with many of these substances being added to ultra-processed foods. Ultra-processing also implies, for example, taking out the fiber molecules from food. So you get all these refined products, the white rice and the kind of potatoes that are best for french fries that are almost devoid of fiber so many of this is a simple thing so you take out all the fiber from all the the main staples and you add to sugar i mean sugar is obviously a key component of these processed foods because normally they wouldn't contain that then you have all these emulsifiers. Many of them have very distinct effects on the

microbes and then indirectly on this gut barrier that we talked about plays such a big role in preventing the immune system activation from the microbes. So some pretty clear-cut studies in animals have demonstrated some of these effects. For example, you know, artificial sweeteners. There's this myth that they would actually be good for a diet. Coke would be good if you could drink as much as you want if you're diabetic or if you have metabolic syndrome. That has turned out to be completely wrong because these artificial sweeteners were shown to have a negative effect both on the microbes but also on the metabolic system. So there's probably very few people that have lost weight on a diet with artificial sweeteners because there's other mechanisms that compromise the metabolic system.

So I would say there's a list of chemicals and there's a list of mechanisms that kind of converge. And there was a book by Michael Pollan a few years ago, you should eat things that look like food and nothing else. So that's a simple advice, not that easy to do anymore if you go to a supermarket, because all the snacks and bars and cereals are ultra-processed foods and even drinks. I mean, just about everything you find in the regular supermarket

falls under this category of being ultra-processed. It's extraordinarily hard to do. I agree with that. It kind of surprises me every time when you turn over the back of a packet, read the ingredients and see what extraordinary compounds they manage to get into something that you don't expect in the slightest. So to finish, I wondered if you could share the take-homes for our listeners on the three things that they could do to really try and restore their gut microbiome to optimize their health. Yeah, so I would say I would start with diet,

as we've talked about throughout this hour. And it's what you eat, when you eat it, and also be aware of where this food comes from. I think these are, for me, the three criteria. What you eat, we talked about, largely plant-based, high in fiber molecules, and high in polyphenol molecules, both of which have clearly been demonstrated to have health-promoting effects. The second one is when you eat it. So there's ways we've developed habits that we eat almost like around the clock during the day and then in front of the TV, snacking. And so there's only a few hours of the 24 hours where we don't

put food into our intestine. So increasing the time that we don't put food into the gut is beneficial for the microbes because first of all, the gut produces a way of cleansing itself if there's no food inside so the microbes that don't belong into the small intestine are moved down and the third thing is where does the food come from does it come from industrial agriculture with chemical fertilizers and pesticides and all these things so criteria. Then how you eat it makes a big difference. So the mindfulness about eating, being aware that stress and negative emotions through the brain-gut axis affect the gut and the microbes.

So if you eat the same meal in a state of anger or anxiety, could be food-related anxiety, it will not be the same, would not have the same health benefit as if you eat it when you're relaxed with friends. Much evidence that the close social interactions in Mediterranean countries around food intake have a contributing effect to the health benefits of the Mediterranean diet. So that's about food. The second one I would say, I mentioned this a little bit, is the mind factors. We know that negative emotions and chronic stress have very clear cut of negative effect on the gut, on the leakiness of the gut, directly on the gut microbes. It

changes the behavior of microbes, these neurotransmitters that come in contact with them. So being aware that when you sit down to eat, that there is this connection, the mind-god connection, that you need to take into account. So not just what you bought in the market, but also when you eat it, that is in the context of a conducive environment. And I would put the social interactions pretty high up on the list here. And then the third thing is regular moderate physical exercise, which again has been shown in several studies to have a benefit on gut health, on microbial health. And those three things really interact. It's not that one of them explains 100% of what happens in your gut. If you look at a healthy lifestyle, it should always have these three elements in it. So lifestyle modification, I would say, is the big challenge.

You could start with, depending if it's a young person or elderly, with one of those that's most feasible. But ultimately, you want to get to that. And we know from studies that if they looked at the factors that can add 10 disease-free lives at the end of your life, and you look at this at age 50, it includes these regular exercise, healthy mind and diet as key components. That is such brilliant advice.

And as a last question, our podcast is called Delicious Ways to Feel Better. And I wondered if you could share the one thing that you do every day to optimize your health and to feel good in yourself. Yeah, I have to say working in this area and, you know, giving a lot of podcasts and being in a lot of discussions, clearly those factors that I just mentioned to you that i think are essential i and we as a family have incorporated into our lifestyle the pandemic was helpful for that because we live we live in an area where you can just step out the door and go on a brisk hike every day walk out at home with weights and things weight weight-bearing exercises, and putting a lot of focus on diet.

So one thing that we have started, not everybody can do this, there's a farm just outside of Los Angeles called the So A Heart Farm from these people that made the movie Kiss the Ground. This may be more familiar. And you can order this box of sustainably, organically grown vegetables and fruits that comes to your front door. And that I think is a simple thing that where you can capture many of the things

we talked about. Where does this food come from? It's all plant-based. And having visited this farm, it's credible. It's not something that somebody tells you it's organic and you know there's many products that are sold being organic that are not really meet the strict criteria so yeah i would say the exercise the diet and the dietary factors and the mindfulness i mean that may be the hardest when you're stressed to actually manage to find the time and the energy to do your meditative practices every day

I personally find that it's one of the harder parts of that but living these three lifestyle factors I would say overall it's not rocket science it's more discipline and awareness of why you need to do that I really like that that, that it's not rocket science. It's absolutely true. You hear the same things again and again, and whether you're talking about gut health or brain health or the next thing, it's the same, isn't it? It's about that looking after your body day in, day out. It's not rocket science, it's discipline. I think that is such a brilliant place to end. Well, Emren, thank you so much for your time today. We so appreciate it. Thank you everybody so much for listening, and we will see today. We so appreciate it. Thank you, everybody, so much for listening.

And we will see you back here again next week. Thank you. You're a podcast listener, and this is a podcast ad heard only in Canada. Reach great Canadian listeners like yourself with podcast advertising from Libsyn ads. Choose from hundreds of top podcasts offering host endorsements or run a pre-produced ad like this one across thousands of shows to reach your target audience with Libsyn ads. Email bob at libsyn.com to learn more. That's b-o-b at l-i-b-s-y-n dot com.