ZOE Science & Nutrition - Best of gut health - anniversary edition

Episode Date: March 7, 2023

Gut health is a topic we talk about a lot at ZOE. The gut doesn’t just fight disease, it boosts our mood, processes energy and so much more. Today’s bonus episode journeys through everything we’ve learnt about gut health so far. And what a myth-busting journey it is! In this episode, Jonathan delves into the microbiome, highlighting the most useful tips from conversations with ZOE’s U.S. Medical Director and resident gut health expert, Will Bulsiewicz, and Tim Spector, one of top 100 most cited scientists and author Food for Life.  Download our FREE guide — Top 10 Tips to Live Healthier: https://zoe.com/freeguide Timecodes: 00:00 - Intro 01:27 - Is bacteria bad for us? 04:10 - How is the microbiome affected by what we eat? 10:00 - What happens to the gut when fasting? 11:53 - Why bacteria eats the inside of our bodies 13:59 - What causes heartburn? 17:00 - What’s going on with gas and bloating? 19:09 - Tell-tale signs of constipation 22:42 - How to treat constipation 25:52 - Other signs of an unhealthy gut 27:20 - Why do doctors ask about your trips to the bathroom? 29:37 - Tips for tackling an unhealthy gut 31:40 - Outro Episode transcripts are available here. Will’s book is available to buy here. Tim’s book is available to buy here. Full length episodes mentioned: Signs of an unhealthy gut Gut bacteria and fasting: meet the night crew - The Big IF Dailies Gas and bloating: the causes and how to stop it Your gut is full of bugs: why this is great news The ultimate guide to constipation Heartburn: Why it happens and what you can do Referenced in today’s episode:  A redefinition of constipation from King’s College London The State Of The Nation’s Gut, a report from the U.K.-based Love Your Gut initiative Epidemiology of constipation in Europe and Oceania: A systematic review published in BMC Gastroenterology  Recent advances in understanding and managing chronic constipation published in F1000Research The Bristol Stool Scale ZOE’s Blue Poop Challenge Blue poo: Impact of gut transit time on the gut microbiome using a novel marker published in Gut  Follow ZOE on Instagram: https://www.instagram.com/zoe/ Want to create your own podcast? Contact Fascinate Productions to bring it to life. 

Welcome to ZOE Science and Nutrition, where world-leading scientists explain how their research can improve your health. Our guts help fight disease, process energy and boost our mood. They're more important than we ever imagined. But why? And what is going on down there to make this the case? Today, we journey into everything we learned about gut health on the podcast so far and what a myth-busting journey it has been. Our journey involves blue poo. It will show you how your marriage might affect your gut health, why heartburn medications might not be a good option and provide a comforting reminder that you have the power to make change.

Nothing is set in stone when it comes to your gut health. Let's dive in and take a look back at some of our most eye-opening episodes exploring all things gut health. And we're going to start with your bugs. That's right, your gut is packed full of them and that's a good thing. The trillions of bacteria that live inside our guts make up what's called a microbiome. It's something we've learned about only recently. Like for instance, did you know that in just a few weeks you could alter your microbiome through what you eat? In this episode, I'm joined by regular contributor and Zoe's US Medical Director, Will Bulsiewicz, board certified gastroenterologist

and New York Times bestselling author of the microbiome book, Fiber Fueled. Will, thank you for joining me again today. Why don't we start as we often do with a quick fire round of questions from our listeners around this topic of the microbiome. Are bacteria bad for us? No, it's actually time for us to re-evaluate because most bacteria are good. Does everyone have a gut microbiome? Every single person. Yes. Every single person throughout human history has had a gut microbiome. Awesome. So if you're listening, you have one too. Does your gut microbiome affect your health? Absolutely. Yes. In an extremely powerful way, which we're going to talk about today. Can gut bacteria change your mood? Yes, there are studies that indicate that our gut bacteria actually are intertwined with our mood. Can you change your

gut microbiome with food? Yes, 100%. In fact, changes will take place very quickly. It's only been in the last 20 years that scientists started to observe and understand the gut microbiome. Now we're at a really exciting point. We're beginning to see how we might even be able to manipulate the microbiome for applications in medicine. One fascinating area of research is the interaction between gut microbiomes and our weight. What's the evidence for the way that it can impact our metabolism and our weight? Because I think a lot of the initial studies around the microbiome actually restarted in this area, didn't they? Yeah, they did. So some of the completely

eye-opening studies from around 2006 were that they showed that you could actually transfer a body habitus, meaning like a body shape, through the microbiome in mice. Let me share a fascinating twin study where they took two identical human twins and one was obese and one was skinny. Okay. So they have the same genetic code, yet they are not the same in terms of their body habitus one is obese one is skinny and they actually took a microbiome specimen from these humans and transferred it into mice and then fed these mice the exact same food so one mouse receives the microbiome from an obese human and the other mouse receives a microbiome from a skinny human. These mice receive the same food and they consume the same number of calories.

And yet the mouse that receives the obese microbiome becomes obese, and the mouse that receives the skinny microbiome becomes skinny, even though they're eating the same number of calories. It challenges in many ways, the calories in calories out paradigm that many people have been suggesting is everything that matters in terms of our weight balance. We are more complicated

than that. And part of what's necessary when we evaluate our metabolism is to actually look at the gut microbiome. We know the microbiome is affected by what we eat. In fact, if you change what you eat, you could see changes in some cases within the space of a few days. Well, you know, if somebody's listening to this, they're really convinced that their gut microbiome matters to them. And they're saying, you know, can you give me like three tips around food? Because you talked about some other things. So sort of three tips around something that we can do around food that might be able to be positive for my gut health?

Absolutely. So if I'm afforded three opportunities, three tips, the first thing that I would do is to say that we need to increase the consumption of plant food in our diet. Now, this is not necessarily applicable to every single person. You might be 90% plant-based, and that is a very healthy diet and I celebrate you. But in the US, and this is not radically different than the UK, the average person is only 10% plant-based. And that means we have a lot of room to increase our plant food consumption because these are the foods that our microbes love to eat. The second rule from a dietary

perspective, and this applies to everyone, no matter how healthy your diet is, is that we need more variety in our diet. The food system actually doesn't want this to happen. 75% of the calories that come from plants come from only three plants, wheat, soy, and corn. So if it's going to happen, if we're going to eat more variety of plants, it has to come from within. We have to be the ones to initiate this despite the system. And so I encourage everyone to focus, make this a focus with your food, with every meal, eat a wider variety of plants. And the third thing is that we're in an exciting time because

science is validating things that we've believed to be true, yet didn't yet have the research studies to back it up until recently. And just in the last year, new science from Christopher Gardner, who's one of my partners on the Zoe Scientific Advisory Board, he's at Stanford University. And in collaboration with Justin and Erica Sonnenberg, also at Stanford University, they looked at an intervention where people consumed more fermented food. And in just 10 weeks of increasing their fermented food consumption, they were able to increase the diversity within their gut microbiome and reduce measures of inflammation. That's powerful.

That's amazing, isn't it? But the thing is, factors other than food also affect the microbiome. These can include how well you're sleeping, what exercise you're getting, the time you spend outdoors, or even whether you choose to have pets at home. And there's another factor that I, for one, was really not expecting. Jonathan, this is new research that actually I find to be very exciting, where they have shown that we share microbes with our spouse. And actually, we share more microbes with our spouse than we do with our siblings, even though we are in the same family and we share genetics.

In this study, Jonathan, what was fascinating is that they discovered that partners who feel very emotionally connected to one another share more microbes together than partners who, for example, feel distant and separated. And we are social creatures. Oh, that's amazing. So there might be some new relationship tests. I love the idea of this, where we can both get our microbiome sequenced and you can figure out how well the relationship is going with an external scientific test. It's going to completely blow the minds of the marriage relationship business. Now that would be interesting and perhaps quite controversial, but that would be an

interesting thing for us to do. And there's one more crucial relationship you can't neglect when it comes to your microbiome. The other thing too that's important, like very important, is the relationship that we have with ourself. We have to love ourselves. And if there are things that are unsettled, that are bothering us, there's actually physiologic ways. This is not woo-woo. This is actually science. There are physiologic ways in which during times of stress, our pituitary glands will release a hormone called CRH, corticotropin-releasing hormone. And that will set off a cascade of stress response, that if you follow it down to the gut microbiome, you will discover that

the gut microbiome becomes disturbed. We use the word dysbiosis. And this is why in times of stress, many of us will manifest digestive symptoms like diarrhea or abdominal cramping or bloating. The gut is connected to our mood. So the gut is connected to our mood. I don't know about you, but I find that quite exciting or maybe scary depending upon what you're eating. Either way, we're learning so much more about how our mind and our body are linked. Another area we're learning lots about is intermittent fasting, particularly a type of intermittent fasting called time-restricted eating. This is an eating pattern where you would generally extend the time that you're fasting while you're asleep.

So instead of your normal sleep where maybe you would go to bed at 11, you might eat at 10, start eating again at 7 in the morning and maybe only fast for 10 hours, you'd actually extend that to, for example, 14 hours. And then you'd eat all your meals and snacks during the set time window of 10 hours. But how does fasting affect our gut health and our gut bacteria? When we were looking for someone to speak about what's happening in our gut when we fast, we didn't have to look very far. In fact, one of the leaders in this field is someone I speak to most days, and someone you likely know too. I'm Tim Spector. I've been studying the microbiome for 12 years now. I do research in this area. I have a medical background. And more importantly in Tim's estimations, when it comes to fasting...

I've also tried it myself, so I've got some practical experience. If you don't know Tim already, he's one of the world's most cited scientists. When it comes to what's going on inside our gut when we fast, Tim says a lot of this comes down to two different teams of bacteria that operate inside us. We've known for a while that when you fast, a different set of bacteria appear in your gut because bacteria replicate every hour or so. And when there's no food for them, suddenly the group that depend on food die away or go into a bit of a sleep and others that live off the debris and the rubbish that's left behind come out of the woodwork and multiply.

Each time you eat, the brain sends signals to the gut, mobilising an army of specialist microbes. Some get to work on fibre, some on fats. But others aren't interested in the food we eat. They have a taste for something a little more human. One such microbe is named Acomancia munisfilia. Catchy name, I know. Well, these little critters love to chow

down on our mucus. So when the food-loving microbes disappear, Accomansia comes out in force. And it then feeds off the surface of the gut, which is free of food and free of these other food-eating microbes. So it eats the sugars that are on the mucus layer of the gut and it basically trims them down so that you get a nice smooth surface. This then allows the gut layer to keep regenerating new cells. Having bacteria eating away at our bodies from the inside, it doesn't sound good. But Tim says it's not really that different to having a manicure. You know, we cut bits of our body off all the time, like our hair and our nails, and we're constantly shedding our skin. So our bodies are constantly repairing in ways we can't see. This is a natural phenomenon. It's an essential

part of our repair processes and keeping our immune system strong. That means that all the time, dead tissues are being removed, and this allows all fresh tissues to work perfectly. We'll take Tim's word for it. So we need to give the nighttime microbes a chance to play away from the greedy calorie-hungry day crew. In a nutshell, you have one set of bugs who love to chow down on our food. They're pretty wild and they don't half make a mess. Then at nighttime, another bug crew comes out in order to take out all that rubbish.

But they can only work if you give them the time and space to do so. In other words, there can't be any food around, which means you're fasting. In fact, some people who have shifted to intermittent fasting say they have more energy, better mood and even experience weight loss. Though this doesn't work for everybody and I have to admit that I am miserable when I'm intermittent fasting, I have less energy and worse mood, so as always these things can be personalized. So we know the gut microbiome is hugely important and that positive changes to diet and lifestyle

will help your microbiome thrive. But what if you are having gut issues like constipation or heartburn? They're incredibly common. We're going to look at some of the most common of such pesky digestive issues. Firstly, the dreaded heartburn, also known as acid reflux. So let's start with the basics. I did some research, and although it's called heartburn, it's not actually your heart that's burning, but it's this sort of burning sensation in the chest caused by acid from your stomach. How does this happen, Will? Heartburn can occur when acid from your stomach travels in the wrong direction back up into the esophagus. You have to understand, Jonathan, the lining of your esophagus is very different from the lining of your stomach.

It simply isn't designed to handle acid. So what happens is the acid causes injury in this area, and it can be either microscopic or in some cases even manifest as a full-blown ulcer. So heartburn is what you feel when the acid is irritating the nerves. Then I guess that's where, you know, for the audience who's familiar with many of these symptoms, they're like, okay, so what do I do? And I think they go to the doctor and they take these medications that are used to treat heartburn. Can you tell me a little bit more about them? Sure. So the most commonly used medicines are called proton pump inhibitors. They have drug names like omeprazole, lansoprazole, or pantoprazole.

So these medicines, they work by blocking the stomach acid from being secreted, which makes people feel better because what refluxes into their esophagus is now less acidic. So far, so good. But what's concerning is when people depend on these medicines to suppress the symptoms. And so why is that a problem, Will? I mean, there's lots of medications that people use for decades for their blood pressure or whatever, and why are you concerned? And I'm guessing this is linked to your explanation that the medication actually reduces people's stomach acid for the long term? Jonathan, we evolved to have stomach acid for a reason. And so reduction

of stomach acid can alter the balance of bacteria. It can increase our risk for infections. There have been a number of infections that have been associated with taking these medicines chronically. One specifically that people may have heard of is called Clostridioides difficile, or more commonly referred to as C. diff. And I'm guessing that in addition to this, if we are reducing our stomach acids, then it's somehow going to alter the way that our bodies are going to process the food that we eat? Yeah, stomach acid is in fact a part of our digestive process. And so it can change how we digest our food.

And this could affect access to our nutrients. So those who regularly consume heartburn medications could potentially become deficient in vitamin B12, calcium, iron, just to name a few. Of course, this isn't to say you should never take heartburn medicine. But Will is saying it's worth looking at the other ways to tackle heartburn, although you may not like his advice very much. Sorry to the listeners at home, just the messenger. The reality is that lifestyle choices and foods that we often find to be fun can actually provoke acid reflux. So just to name a few spicy or acidic foods like citrus and cooked tomatoes can irritate the esophagus and

aggravate the symptoms. You'll want to be conscious of fat intake from fried foods, meat, full fat dairy. And the reason why is that the fat slows down the stomach emptying, which can worsen reflux. And some sweet treats like chocolate or peppermint, they actually relax the lower esophageal sphincter. So these things also could potentially make things worse. Apparently, ideally, you also want to go to sleep with an empty stomach, which means three or even four hours between dinner and bedtime. The next common issue, gas and bloating. Studies estimate that one in six of us experience these discomforts. Many of us think gas and bloating is the result of having a lunch that's a little indulgent

or eating certain foods that cause excess gas. But there's actually a lot more to it. What's happening with your body is a bit more complicated. That's the thing that people need to understand. If we want to get better at managing the bloating issue, we have to actually understand the nuance. That's what's going to allow us to get there. So you're saying there's quite a lot of different things that might be going on that explain why I might be suffering from it. Exactly. In fact, I would say there's four main causes of bloating that are worth discussing. The first is swallowed air,

second constipation, third is a struggling microbiome, gut microbiome specifically, and then the last is our food choices. In my experience as a gastroenterologist, the number one cause of gas and bloating that I've seen is actually constipation. And in people who are constipated, the most common symptom that they experience is gas and bloating. So these two are very sort of tied together, Will. Yeah, they're very much intertwined. And we actually have research, Jonathan, showing that people who are constipated, they produce more bowel gas.

So in these cases, if you can remedy the constipation, you can hopefully offset some of the unpleasant side effects of bloating? Yeah, that's actually what I typically will strive to do as a gastroenterologist is from my perspective, I want to get them into a rhythm and get their bowels more regular. And if you can accomplish that, what I typically have seen is that the gas and bloating goes away. And when it comes to nutrition, Will has another tip that's a little hard to swallow. And from your experience, Will, what would you think are the two biggest areas of concern if somebody is experiencing chronic gas and bloating and listening to this? I have advice that I routinely would give to

people who come in with gas and bloating, like literally on the first visit, and that would be to eliminate non-fermented dairy and artificial sweeteners. Okay, now let's get into one gut issue that people often think they understand, but may not. Constipation. You may be very surprised to learn you can have a bowel movement every day and still be constipated. The formal definition, just to be clear for constipation, is having fewer than three bowel movements per week. Now, let me just say, as a gastroenterologist, I actually find this definition to be too narrow and simple. It doesn't cover all the forms of constipation that I've seen

in the clinic. Constipation is incredibly common, and there's been some recent data that suggests that a quarter of people worldwide have at one point reported constipation symptoms. The survey conducted by King's College actually indicated that a third of the patients, they weren't even able to recognize the signs of their own constipation when they were describing their symptoms. They didn't even make the connection between their symptoms and constipation. You know, I find that really interesting because when I think of constipation, I think it's really simple. I have a very simple image in my day, but now I'm on the third day

of my holiday and nothing's happened or like I'm going and I can't sort of fully empty myself. And I would say, honestly, that you just summarized many of the forms of constipation that can exist that don't necessarily meet into this definition of less than three bowel movements per week. Those are absolutely signs to look for, Jonathan. And it could also even include, believe it or not, the idea of not feeling the desire to go or not even feeling the instinct like, hey, I have this urge. I feel like I have to go. Will tells us that gas and bloating is a telltale sign of constipation. Almost 100% of people who are constipated will experience gas and bloating, but other symptoms include a distended belly, nausea, loss of appetite, fullness after meals. People often

will have a crampy abdominal pain and that discomfort can actually come in waves. And it can be extremely intense. Like some of these people think it's so intense that they have some sort of surgical issue when in fact it's just constipation. And the other thing too is fatigue. So this can be another common symptom of constipation. And so if we're looking at all those problems, how do you actually diagnose constipation? It sounds like it's such a sort of broad mix of things. It is a broad mix of symptoms, but the first step is that you have to prove that the person is actually retaining stool and backing up. And the perhaps easiest way to do this is with an imaging test. So this could be an x-ray or a CAT scan, or there's a test called a SITS marker study.

But the important point is that even though you can demonstrate that a person has constipation with these tests, you can't prove what the cause of the constipation is based upon that test alone. And so there are many potential causes for constipation beyond just slow movement of the intestines. And over the last two decades or so, we've developed new testing that's pretty impressive and allows us to really get to the heart of understanding these problems. There are a few ways to treat constipation when you first notice the signs, and it doesn't necessarily mean taking pills. From my perspective, it's sort of common for people to head straight to the pharmacy to pick up whatever sort of medication is available to treat their constipation. And sadly, in many cases

in our healthcare systems, the doctors will recommend these things. But I personally think that we need to start with diet and lifestyle first. This should be our first step. And there are simple steps such as increasing our intake of whole plant foods, where by doing that, by increasing our whole plant food intake, we are actually increasing our fiber intake. And when we reduce our ultra processed food intake in combination with this, we ultimately are guiding ourselves towards a number one, more microbiome friendly diet. Number two, a dietary pattern that can improve

the health of our bowel movements, including potentially resolving mild constipation. So I kind of feel like, whoa, whoa, whoa, let's not jump to the medications first. We may get there. And one of the things that I've been really struck at looking at all the members who go through the ZOE program and they report back on sort of changes in their health is there's a lot of people who've been reporting significant reduction in constipation. And I'm struck by that because it wasn't something that any of the scientists were talking about as they were working to optimize this guidance. So it's a sort of really, for me, really unexpected byproduct, all of these people are following these programs,

personalized to them, focused really on their long-term health, and then they're coming back quite early on in this program saying, well, like, wow, like my constipation has got much better. I guess, are you surprised by that? And can you help to explain why that's happening? So I was gonna say, I'm actually not

that surprised to be totally honest with you. And what's interesting about it is that the Zoe program was developed using the microbiome and looking at things like blood sugar, blood fat. We're attempting to improve the health of the microbiome. Now, these microbes, they are connected to our bowel movements, to our digestive health, our digestive function, and to all these other facets of human health. And so when we develop a program intended to sort of improve the gut health towards blood sugar, blood fat, we're simultaneously improving the health of these microbes in general. And this leads to these benefits that we see that like, we can say it was unintended. This is an unintended benefit that a person has better bowel movements and improves their digestive health and reduces

their constipation. But this is exactly the way that this is supposed to work, which is that when we enhance the quality of our diet and we enhance the health of our gut, we will see better bowel movements. We will improve constipation. We will have less symptoms. That's a beautiful thing. There, we see the power of the microbiome once again. So obviously gas, bloating, heartburn, constipation are all clear signs that something's wrong. A healthy gut should be free from these digestive problems and have a good balance of microbes. So what do we know about the other signs of an unhealthy gut? To be clear, everyone has occasional digestive symptoms. I mean, particularly if you have one too many pints and you load up on

the spicy, greasy food. But really what I'm talking about are chronic symptoms that are occurring weekly or even more than that. There are many ways that they could manifest. As a clinician, my first question to the patient is very simple. How do you feel? That's actually the same question my therapist asked me. So I like that. It's sort of getting straight to the point. So if you're looking for symptoms in this case, and I think you said, look, these are symptoms where you're having this at least once a week. That's where you're starting to say this is not just because you ate something that you're not used to, but this is sort of really starting to be something you might talk to a doctor about.

So what are the sorts of symptoms that I or any of the listeners might say, hey, that's a manifestation of an unhealthy gut? Sure. I mean, of course, it could be digestive symptoms. So some of the classic digestive symptoms would be gas, bloating, constipation. But, you know, it's important to understand that it also goes beyond the gut. So it could be issues with sleep, skin changes such as rashes, sugar cravings, or even unexplained mood disorders. I always think about the whole person. You have to think about everything, not just the gut and the gut symptoms. Then after your doctor has asked you how you're feeling, it's time to talk about a topic that a

lot of people want to avoid. So you've asked this first question. What's the next thing that you're going to ask our sort of hypothetical gut patient who's coming to see you? The second thing, it may be a bit taboo for a lot of people, but as a gastroenterologist, I found this to be incredibly important and that's bowel movements. So Will, we've talked about this before. You know, normal people, when you first meet them, you don't ask them how often they go to the toilet. In fact, it's something that lots of people don't even want to talk about with their family or their partner. So why do you have to ask them this?

Cardiologists look at blood pressure and heart rate. As a gastroenterologist, I look at bowel movements. This is my vital sign. And I see it as a window into digestive health. When things aren't working the way they're supposed to within our gut, it's typically going to manifest in the toilet bowl. And so what kind of things do you talk about with patients, Will? So the first thing that I look at is rhythm. Very similar to the heart. If you knock it off rhythm, then things just get disrupted and they don't work the way they're supposed to. So we're supposed to have a cadence. And that means that we should be pooping on a regular basis.

And as well as rhythm, you should, well, feel good afterwards. Like you're sort of strutting out of the bathroom with a smile on your face. Not like you've just done, you know, five rounds in the boxing ring. Certainly not five rounds. Maybe we're not supposed to say this, but you're allowed to feel good. You're allowed to feel well after a good, healthy evacuation. You know, as a medical doctor, that's where I want you to be. And the bathroom experience really should be something that's positive and relaxed. So for a healthy gut, you want to feel good overall and your bowel

movement should be regular and easy. Then there's something known as gut transit time. And here's the point in our journey where we finally get to blue poop. Yup, you heard it right. Gut transit time is how long it takes for food to travel from your mouth to the other end. Will, can you tell us a bit more about that? So we actually did some exciting research into this, Jonathan, and by simply eating food that contains this blue dye coloring and then tracking how long it takes from when you first eat that food to when it ultimately comes out the other end with a blue bowel movement, the blue poo, as we like to say. What's really interesting about this is like it's curious, it's cheeky, but also it's science based. The blue poo we have discovered is actually correlated with characteristics within your microbiome. We found that transit time can actually be a better

measure, believe it or not, of your gut health than looking at things like your stool consistency or the frequency or even the Bristol stool scale. So if you're listening to this thinking, hang on a minute, I do have some of the signs of an unhealthy gut, don't panic. There are things you can do. Eat a varied diet that's high in fiber by including plenty of whole grains, vegetables, and fruit. But also eat more slowly, drink more water, and make sure you're getting good quality sleep. Cutting back on all highly processed foods can be another step that people can take. And if I do all of those things, do you think I would expect to see a change in my gut health if I was exhibiting some of the things that you've been talking about earlier? Absolutely. I mean, remember that, you know, it kind of comes back

to this basic first question, which is how do you feel? You should feel better. When your gut is becoming more healthy, you should feel better. You should see an improvement of food intolerances. You should have better bowel movements. And over the long run, you may be able to improve your health status in terms of reversing or improving or reducing your risk of these chronic medical conditions that we've been talking about. And one of the things I always love, whether it's you talking about this or Tim or anyone else, is there's a huge amount of positivity because this is an area where you're always saying, you know what, there's a power for us to make changes that can really improve our health. And I think most of the time, we feel we're sort of stuck in a one-way deterioration. So like, it's all like, oh, you know, my body was great when I was 21. And now

it's just getting worse and worse. Or, you know, there's nothing you can do. All you do is just sort of holding back the tide. And so I think what's really great listening to this is you're saying to lots of people, actually, you can really improve your gut health so that it's a lot better in a year's time than it has been, you know, maybe for decades, maybe since forever. I'm twice the age of a 21-year-old at this point in my life. And I think I have twice as much health as I did when I was 21 years old. And that's because of changes that I've made to my diet and lifestyle through the years that have allowed me to get to a better place. And I think it's really a message of empowerment here, which is that you are not a genetically pre-programmed list of medical conditions and health-related

problems. That you actually have the power through your choices to make small changes that can actually yield massive results in terms of your health. That to me is the important message and it's really exciting. That's one thing we're really committed to at Zoe, showing you that when it comes to your gut health, you have the power. I don't know about you, but I'm really excited to see what we're going to learn in the next 20 years. If you enjoyed today's episode and want to find out more about gut health, why not listen to the episodes featured in today's show in full? You'll find links to each of them in the show notes. If based on today's conversation, you'd like to learn how to feel more energetic, improve your gut health and reduce your risk of

long-term disease, then you may want to try Zoe's Personalized Nutrition Program. Your Zoe membership comes with our app that gives personalized guidance throughout the day on exactly what's best for you to eat. Supported by nutrition coaches, so you can learn how to change your diet and your health habits to be best for your biology. To learn more about Zoe, you can head to joinzoe.com slash podcast and get 10% off your purchase. If you enjoyed today's episode, please be sure to subscribe and leave us a review. Or if you know someone you think would enjoy the show, share it with them. As always, I'm your host, Jonathan Wolfe.

Zoe's Science and Nutrition is produced by Fascinate Productions with support from Sharon Fedder, Yellow Hewings Martin, and Alex Jones here at Zoe. See you next time. you