What I have here is a variety of

different shapes and sizes of poop.

Yeah. What does this tell us about our

health? Well, if your poop looks like

this, to me that's grounds to talk to a

doctor. Dr. Will Bulsiewicz,

world-renowned gut health doctor.

Who has a wealth of information on

how we can improve our gut health

through food and lifestyle changes. We

are currently living through an epidemic

of gut health issues, and if we want to

be healthy humans, we absolutely need a

healthy gut microbiome in order to

accomplish that. So, let's break this

down. First of all, microbes are

invisible. On your thumb, there are as

many microbes as there are people in the

UK.

Really? And gut microbes play a critical

and essential role in controlling

whether or not you suffer from

depression, because 95% of the happy

hormone is produced by the gut. It

controls your cognition, your memory,

your energy levels. Your gut is the

place where you are making decisions,

and study after study after study shows

us that when people eat more

not only do they empower the gut

microbes, but also they lose weight,

they're less likely to die of heart

disease, less likely to be diagnosed

with multiple different types of cancer.

No way. Yes. What about alcohol?

The science is clear. When we drink to

the point of having a hangover, is that

dehydration? Absolutely not. The issue

is you have caused significant damage to

your microbiome. But the gut is

forgiving, and the choices that you make

today, within 24 hours, will have an

effect on your microbiome. I want people

to eat a diet where they can eat as much

as they want without restriction and

still achieve their weight goals. And

this is completely possible by consuming

a diet that's

Quick one. This is really, really

fascinating to me. On the back end of

our YouTube channel, it says that 69.9%

of you that watch this channel

frequently, over the lifetime of this

channel, haven't yet hit the subscribe

button. I just wanted to ask you a

favor. It helps this channel so much if

you choose to just subscribe. Helps us

scale the guests, helps us scale the

production, and it makes the show

bigger. So, if I could ask you for one

favor, if you've watched this show

before and you've enjoyed it and you

like this episode that you're currently

watching, could you please hit the

subscribe button? Thank you so much, and

I will repay that gesture by making sure

that everything we do here gets better

and better and better and better. That

is a promise I'm willing to make you. Do

we have a deal?

Dr. Will,

if someone's just clicked on this

conversation and they've they're

deciding whether to listen or not, what

would be the pitch to those people?

What's the benefit if they stick around?

Welcome to a what I sincerely believe

will be a life-transforming conversation

for you. Because the issue is that we

are currently living through an epidemic

of gut of gut health issues.

If we look across the board, this is

everywhere. And it's not just, you know,

digestion. This is so much more than

that. We need this now more than ever.

Because ultimately, if we want to be

healthy humans, which to me is one of

the highest goals that we should hold

for ourselves, if we want to be healthy

humans, we we absolutely need a healthy

gut microbiome in order to accomplish

that.

What's your sort of academic

professional background?

Oh gosh, where do we begin?

Um So,

uh I graduated from Vanderbilt

University

with a chemistry degree. That was my

college, and um I went to Georgetown,

which is one of the top medical schools

in the country. I

spent 3 years at Northwestern as a as

internal medicine resident. I won the

highest award that they give while

there. Then I was the chief medical

resident, and I spent 4 years training

as both a gastroenterologist in the

hospital and also working on clinical

research. So,

I didn't expect, when I finished all

this, that I would be continuing to

publish papers at any point in my life

in the future. But now, in my work with

Zoe as their US medical director, I've

been heavily involved in clinical

research again. You mentioned a big G

word there. Gastroenterologist.

Yeah. What is that?

Uh we are the specialists in terms of

basically like the intestines, the gut.

So, if I were to summarize it, I would

say guts and butts. Guts and butts.

Yeah.

The conversation around the gut

microbiome and the gut generally has

exploded, really since what, 2000 and

what, 2006, 2007 time?

Before then, I mean, to be fair with

you, I think

as far as I'm aware, and I'm not that

close to doctors or hospitals or

research, I've only started hearing

about the gut microbiome

in the prevalence that I have in the

last

2 years? Yeah. 3 years? What is the

central misconception that most people

have as it relates to their health? That

guy that looks into the mirror and goes,

"I don't like what I see here. I don't

feel good." That's cold, they're they're

bloated, they've got gut pains.

The current sort of line of thinking

will say it is X,

but there's something that you believe

it is.

What is that?

Well, I think that all these things

ultimately connect back to our gut

microbiome, and I think that's the piece

of the puzzle that's been missing this

entire time. You know, there's it was

sort of this black box. If you eat well,

you will improve your health. If you do

this, you will improve your health. Um

what we were missing was the

understanding that all of those choices

ultimately impact these gut microbes,

and by impacting these gut microbes, you

can actually transform the physiology

within your body.

Gut microbes. Yeah. What is that?

Gut microbes is my nerdy way of talking

about these microorganisms that like

you can't see them right now, but

they're there. They're, you know, if you

hold up your thumb, literally on your

thumb, there are as many microbes as

there are people in the UK.

Really?

And they cover our entire body from the

top of our head to the tip of our toes.

Every single external part of our body

is covered with these microbes, but the

main spot is actually deep inside of us,

which is our colon, the large intestine.

In that spot, you can find 38 trillion.

Now, these, when I say microbes, it's

referring to the fact that they're

microscopic and they're alive.

It's mostly bacteria.

Um in addition to bacteria, could also

be fungi,

could be parasites, could be viruses.

But we have 38 trillion of these, mostly

bacteria, focused and concentrated

within our colon. So, when we talk about

the gut microbiome, we're really

referring to them. How did they get

there? So, you started in your mother's

womb. Mhm. And evidence these days would

suggest that you're already starting to

come into contact with these microbes,

Mhm. but um but for the most part, you

haven't really met them yet.

Until the water breaks.

And in that moment, for the first time,

you are exposed to the world.

And the world is covered in microbes.

Everything that's alive, everything,

has a microbiome.

Could be a plant, could be an animal,

could be an insect, could be us. So,

when mom's water breaks, these microbes

then enter into the uterus, and you meet

them for the first time. But you are

particularly exposed to them as you pass

through the birth canal.

And this is basically like nature's way

of being like, "Hello, welcome to the

world, and meet your partners.

They'll be with you for the rest of your

life.

And they're here to help you.

And they will make you healthier, and

this is the result of coevolution that

goes back over a billion years. We have

been evolving, and which is crazy,

because humans

have only existed for three three or

four million years.

But these microbes were the first life

on the planet,

and all life evolved with these

microbes. And things like, for example,

our immune system is the product of

evolution that started a billion years

before humans even existed. We always

think of ourselves as one organism, but

you're making the case that I'm maybe 36

trillion, or whatever you said,

organisms in one.

And we would call you a superorganism.

And that sounds like a Marvel character,

which is cool, and we'll take that. But

that's actually completely true, because

the issue is that if we withdrew these

microbes from you,

if you were, like, hypothetically, you

know, we could talk about the bubble boy

from

the 1970s, where they actually did this.

They tried to have a child live in a

sterile world,

because he had a specific immune

deficiency. So, their thought was if we

keep him separate from all the bacteria,

then he'll never have a problem. But the

issue is that there are consequences.

There are consequences to living without

microbes, because we need them.

So, and through this process of

coevolution,

literally from the very first human,

we grew to trust them.

And we trusted them with things that are

critically important to us and our

success as humans.

And we allowed them to integrate into

our physiology in a way where, once

again, if we don't have them, we're in

trouble.

And that includes things like digestion,

breaking down our food, which to me is

like that's the essence of life. Like,

you can't get energy into your body

without this.

And they help us to accomplish that, but

they also train our immune system.

You know, we talked a moment ago about

what happens when you're born, and

that's the very beginning of training

your immune system. And during those

first 3 years of life, it has a massive

impact on whether or not you develop

allergic issues, autoimmune issues, down

the road.

They affect our metabolism.

Our research at at Zoe has

overwhelmingly shown that they play a

critical and essential role in

controlling, for example, your blood

sugar,

your blood fat response after a meal.

They affect your mood.

Um literally, your energy levels.

Uh whether or not you suffer from

depression, your cognition, your memory,

your ability to focus.

All affected by these microbes.

They affect our hormones. So, in women,

conditions like endometriosis,

polycystic ovary syndrome, associated

with damage to the gut microbiome. In

men,

erectile dysfunction,

which, I mean, to be honest, is not

talked about enough.

Um

perhaps because we've stigmatized this,

but the the guys that have this issue,

this is like the most important issue to

them.

And so, when you think about all these

things, whether it be

digestion, our immune system, our

metabolism, our hormones, our mood, our

brain health,

like to me, this is um

uh an overview of everything that

matters for human health from my

perspective as a medical doctor.

And is my gut microbiome different to

yours?

Uh or do we all have different sort of

jungles inside of us?

We are all different. And this is one of

the things that makes us actually

profoundly different. So, to be honest,

it's it's this is mind-blowing. If we

looked at your genetic code Mhm. and my

genetic code,

even though clearly we are different

people,

we our genetic code would be 99.99%

the same.

It's a small part of our genetics that

is different between us as humans.

But our microbiome, these 38 trillion

microbes that are living inside of us,

they can be completely different. So, as

a as a classic example, let's pretend

that you have an identical twin brother.

Identical twin brother. Mhm. All right,

so you share the exact same genetic

code, you share the same mother. For the

vast majority of cases, you would have

shared the same childhood and largely

the same upbringing and food and things

like this.

And our research shows that only about

25% of your microbes would be shared,

even though you come from the exact same

place. You would be 75% or more

different. So, you and I,

it's hard to say exactly. Like if our

diet was, you know, quite similar, then

we would have a more similar microbiome,

but it still would be more different

than the same.

And how much then So, I've got a twin,

we've got completely different micro gut

microbiomes, these sort of um

microbes that live inside our bodies.

How much of our microbiome

can be associated back to disease and

things like that in your view? What

percentage of disease do you think links

back to the gut microbiome?

Well, it's hard to say globally, right?

It's hard to give an exact number. Um

you would have to I think go condition

by condition to say.

But what I would say is this, my you

know, the reason that I became very

interested in this as a

gastroenterologist

is that I was convinced,

and I continue to believe this to be

true,

that every person that walked through

the door to see me

had a gut microbiome problem.

Right? People with irritable bowel

syndrome, Crohn's disease, ulcerative

colitis, celiac disease, acid reflux, go

down the line.

Every single one of these, when we study

them, we discover that they have got

issues.

But the other thing, if you expand that,

one of the things that I would always

do,

you know, I'm about to go see a patient.

I'm going to walk into the room, and you

take the chart off the door, right? You

hear if you're the patient, you hear

that. You're in the room, and you hear

the chart come off the door.

And the doctor flips it open, and what

do I do?

I take a look at their medical history.

And when you when you look, what you see

is a laundry list of conditions that

have been associated with damage to the

gut microbiome. So, they're here to see

me for their digestive problem, like

irritable bowel syndrome.

But when I take a look, I see that they

have hyperlipidemia, high blood

pressure, type 2 diabetes, history of

major depression. Uh they may have uh

autoimmune condition.

Right? So, and then it starts to

implicate these different systems that

like we have not classically associated

immune like autoimmune issues or

metabolic issues or cognitive issues or

mood issues. We haven't classically

associated those things with the gut

microbiome, yet they are.

And so, to me, do I need like for that

particular patient, do I need a poop

test to tell me that they have a damaged

gut? Absolutely not. It's already clear.

And what's the relationship between our

gut microbiome and our immune system? I

was reading in your the introduction to

your book that 70% of the immune system

is is the gut. Yeah.

The um

the walls of your intestine

are actually the home of your immune

system.

We classically would think of the bone

marrow as being the place where the

immune system exists. That's not true.

That's where the immune the immune cells

are born there.

But then they basically emigrate out,

and then they take up residence and live

within the walls of your intestine. And

by the way, this makes complete sense

from an evolutionary perspective because

our gut is actually the most of

vulnerable part of our body.

This is where we come into contact with

the outside world. Your skin, you may

think of that. No, your skin is a wall.

Your gut is the place where actually you

are making decisions. Do I absorb and

allow this into the body,

or do I reject and keep it outside?

And in order to help facilitate that,

yes, we need our immune system there.

But the other thing that we need is we

need a barrier.

We need something to basically um

uh section off the inside of the

intestines and keep things separate.

So, what we have is called the

epithelial layer. And this is quite

humble.

Like given how important this is in our

body,

it is just a single layer of cells

that are being held together by this

kind of cement called tight junctions.

They stick together. On one side is 70%

of your immune system. On the other side

are 38 trillion microbes.

And when this barrier breaks down,

this is how things that are inside your

intestines can get access to your body,

um get into your bloodstream,

potentially cause a whole body

infection.

And then the immune system is forced to

react.

And when this is like we have an

infection,

it's it's really important. We we This

is why we have an immune system to

protect us in that setting.

But what's happening in the 21st

century, what started in the 20th

century,

is chronic inflammation.

And chronic inflammation is the result

of a broken barrier.

When that gut barrier breaks down, now

we are giving access to our body to

things that aren't supposed to get

access. And the result is that the

immune system stays perpetually active

because it is constantly trying to clear

stuff out because the barrier is broken.

And for those who are wondering, so, Dr.

B, then how do we how do we fix the

barrier? Not to put the question into

your mouth, Stephen, but

Please do. Please do.

The answer is the microbes.

The answer is the microbes because they

are the stewards of the gut barrier.

They help to repair it. Every three or

four days,

you actually completely transform and

recreate your gut barrier. So, it's not

the one that you were born with, it's

the one that you developed in the last

three or four days.

And you will turn that over. And when it

turns over, we need these gut microbes

to help us to form a strong gut barrier.

So, because it's constantly turning

over, this is where the microbes come

in, and they're and they're critically

important.

Again, the microbes, when you when you

reference microbes, you're talking about

the bacteria, the yeast, the parasites,

the viruses that exist in our in our

guts. And how long do they live for? You

said they turn over in 3 days. Does that

mean that they live for 3 days

typically? So, the

uh the gut barrier

turns over every 3 days. Yeah. Yeah, so

and those are human cells. So, those are

not the microbes.

Okay. Okay, so those are your human

cells keeping the microbes separate from

your immune system and your body. Mhm.

Um these microbes, they are um

turning over like literally every 20

minutes. They die every 20 minutes?

So, well, not necessarily dying.

Replicating. Replicating. Okay. Right?

And so, if we think about this, if we

had if you had one microbe

in your intestines right now,

and we feed it something, whatever it

may be, good thing, bad thing, whatever.

24 hours from now, that microbe will

have spawned at least a thousand new

microbes.

So, if you think about the power that

exists there to amplify choices,

starting with one and ending 24 hours

later with a thousand, it's crazy.

There's this really interesting sort of

reframing in the introduction of your

book, which

is really simple, but it does cause you

to I think it's a really powerful frame

to think through about what we and how

we eat, which is where you say that um

each of us consumes an average of 1.3 kg

of food per day. Keeping the math

simple, that's 475 kilos of food per

year, meaning we'll consume about 36,300

kilos of food during our lifetime.

And in contrast to the couple of

milligrams of medicine that we take,

it really makes you realize that food is

in fact the medicine that we're feeding

our body at all times. We think we sort

of compartmentalize food over here as

this energy source that quenches hunger,

and then we have medicine over here to

fix stuff. Yeah. But in fact,

you're doing 36,000 kilos of food in

your lifetime. So, the the thing that's

having the biggest way on your medical,

your sort of uh physiological health and

your your your gut health is of course

the food.

The food is the medicine. Well, I think

that there's two important takeaways

from that cuz there was a study actually

that changed my life in 2014 that came

out. Um this was published in the

journal Nature, which is literally the

top journal on the planet. And um uh the

author was Warren David from Duke

University. And you have to understand,

if we go back, this is almost 10 years

ago. In this moment, we didn't know if

food changed microbes in humans. We

didn't know this.

This is new information.

We knew it in mice, but it's not the

same. Mice are not humans.

Um so, what they did to try to prove

this is they put people on uh

diametrically opposed diets.

So, a completely 100% plant-based diet

versus a completely 100% animal-based

diet. It was only a 5-day study,

which is interesting because within 5

days, you can actually see massive

results. And the key one of the key

takeaways from this study

is that the choices that you make today,

within 24 hours,

will have an effect on your microbiome.

In that study, when they changed a

person's diet, 24 hours later, you could

already see things underway shifting.

So, now, the other thing to keep in mind

here is that I think is really important

is the gut is forgiving.

I mean, to a degree, you can only beat

it up so much.

But the gut is forgiving. So, this

doesn't mean that there are foods that

are on the table and off the table.

Everything is on the table.

But what we want is we want to create a

weight or a disproportionate consumption

of those high-quality foods because when

we do, we are lifting these microbes up.

Explain that process of food and the

impact it has on the microbes. So, is it

like watering certain microbes? Is that

a way to think about it in simple terms?

These microbes are as alive as you and I

are, Steven, and we need to eat.

Um if I don't eat, I get quite hungry.

And they do, too.

And but it turns out that the reason

that they took up residence, cuz they

could have been anywhere. They could

have stayed inside soil or lived on a

plant or something like that. They chose

to live inside of you. And the reason

why they are inside your colon is

because they get access to nutrition.

You do that for them. You go out, you

find food, and you deliver that to them.

Whatever goes into your mouth, whatever

it may be,

it will come into contact with these

microbes.

And they will consume it. And and this

becomes their energy source because they

are alive, they need energy.

So, but the choices that you make

impact which microbes get to eat.

So, not every single microbe likes kale.

Not every single microbe likes sugar.

But there are some that like sugar and

some that like kale.

And when you make these choices,

whatever it may be,

those choices ultimately are going to

feed specific families of microbes, lift

them up, and allow them to thrive.

So, when we talk about, you know,

improving dietary quality, and you hear

me talk about this in Fiber Fueled,

which is a message that I started

sharing publicly back in 2018.

Um and the book came out in 2020. Or if

you listen to Tim Spector,

who published the paper that I'm about

to talk about.

Um the science is clear.

The way to lift the microbes up is by

eating a variety of plants.

Now, in Tim Spector's paper that

originally came out, it's called the

American Gut Project. But by the way,

the British Gut Project was a massive

and critically important part of the

study.

In that study,

um you have to understand the magic

number that they came to was 30.

A lot of that had to do with just the

technique that they were using to

measure.

It doesn't mean that 29 is bad and 30 is

fantastic.

It's all on a spectrum. 30? 30 different

plants per week. Mhm. Yeah. 30 different

plants per week. So, the key is we want

varieties of plants, and every single

plant choice ultimately is fuel for a

healthy gut microbiome. So, that's

fruits, vegetables, whole grains, seeds,

nuts, and legumes. It's not just

veggies, it's not just kale. And to me,

like one of the things that I've always

tried to do, whether it be as a medical

doctor or as an author, I want to meet

people where they are.

So, like if it were if I were consulting

with you, I want to know where you stand

right now.

And then we're going to set realistic

goals. Because so, for a person who's

eating 10 different plants per week,

which by the way is more than I was

eating 10 years ago,

to go to 30 instantly, that would be

quite hard. And when it's hard, it's

more likely to become unsustainable.

I would go from 10 to 15. And when you

hit 15, I would be celebrating. How many

plants does the average person eat in

the Western world, America, the UK,

Europe?

Do you know?

Uh I believe in the American Gut

Project, the number was around 10 to 15

for the average person. It was a

minority of people that were hitting 30

per week in that study.

It's interesting. When I I did my Zoe

test, I got my results back, and it did

say that I had quite a narrow gut

microbiome in comparison to my partner.

And I was thinking about this. I was

like, you know, whenever we go

somewhere, whenever we go to a

restaurant, she orders

new things Yeah. all the time. And if

you look at our fridge, it's like tahini

and this and all this like all these

plants, especially the top part of our

fridge, it's all like fermented stuff.

She eats like she's a like a rabbit or

something. She just eats anything. And

she eats diverse food, and she orders

new things, and then there's me. Yeah.

I like what I like.

And if I go to a restaurant, anyone

that's been to a restaurant with me like

three times could order for me because

they know

um until I got my Zoe results back, and

it was it was pretty alarming cuz she

had her

microbes were like a like the Amazon

rainforest. Nice. And mine were like,

you know, a park at the end of the

street. Ugh. You know? I think that it's

important to start with food that you

like. Yeah. We're all like that, what

you described. But the issue is finding

that motivation to push yourself. To me,

this is the this is the piece of the

puzzle. Like again, this was a black

box. We didn't know anything about the

gut microbiome. We just had like

nutritional ideas being tossed at us.

Now, this is filling in the gaps where

it's like, hold up. No. Nutrition

affects the microbes, the microbes

affect us as humans. Now, we can connect

those dots. And to me, I find this very

empowering and motivating to know that

that exists and to know that those

choices, every single meal, is an

opportunity to

follow this concept and add more

diversity to your plate. But the other

thing is you mentioned that your partner

is eating fermented food.

That's a lost art.

People have not been consuming fermented

food in the Western world.

And the research is quite clear and

standing out at this point that actually

there um was a fascinating study out of

Stanford University,

randomized controlled trial. The

intervention was to add fermented food

to the diet in people that had not been

consuming fermented food. And what they

found 8 weeks later is that they had

increased the diversity within their gut

microbiome. What does that mean?

If your microbiome is the park at the

end of the street,

adding fermented food, we can we can

make it into a jungle. Give me some

examples of fermented foods. And what is

the fermented part? Like what does that

mean?

Well, uh first of all, we we mentioned

that all

all life on this planet has a

microbiome.

So, there was an interesting study where

they analyzed the microbiome of apples

and discovered that when you eat an

apple, like you just grab an apple off

the uh out of the fruit bowl,

um that apple has about 100 million

microbes that are a part of it.

So, they're already there. And those

microbes have been a part of that

apple's life, helping it to grow from a

flower to a fruit.

Okay. So,

um now,

these microbes, they are also involved

in the life cycle of that apple. So,

when the apple goes to spoil,

the microbes are the ones doing that. In

fact, I would argue that when food

spoils, I actually find that reassuring.

If food doesn't spoil, we should be

concerned.

The microbes are helping to facilitate

that spoilage that takes place, and

that's because the Earth is taking it

back. It's this it's the cycle of life.

It's going to turn into dirt.

Right? Now, fermentation is where we

actually grab that process,

and we control it. Almost like a

magician, we're shaping it.

And what we're having is we're

empowering certain microbes

to protect that food so it does not

spoil. And they transform it.

So, if you were to take cabbage,

you know, you don't need to do anything

special to this cabbage. You literally

just buy cabbage, perhaps at your

farmer's market.

Chop it up, put it into a mason jar,

pack it in there,

and add a sea salt brine solution, a

salt water solution.

And you basically put this into, you

know, a nice cool space.

Give it a week,

you will have sauerkraut.

Sauerkraut is not salty cabbage.

It's tart. It's bitter.

Uh it's acidic.

Um it's delicious. When you make it

yourself, it is completely different

than the sauerkraut that I grew up on

that came from a can,

which was soft and disgusting.

So, this is what fermentation is. It's

transformation.

The microbes, specifically bacteria and

yeasts,

are transforming the food for us.

And when they do this, they also are

eating.

So, because they eat, they grow

stronger, and they multiply.

So, you are creating a food that is high

in microbes, which we could call

probiotics.

It has been transformed to unlock the

nutrition,

which we could call prebiotics.

Prebiotics are the parts of our food

that actually feed the microbes inside

of us. It's their food, prebiotics.

And they are releasing new chemicals

that can have beneficial effects on your

body, which we call postbiotics.

You find all of this in that one jar of

sauerkraut.

So, that to me is a superfood.

And it could be sauerkraut, it could be

kimchi.

Uh pickles, like pickles are not meant

to be a vinegar thing.

By the way, vinegar is the product of

fermentation.

But pickles were never meant to be, hey,

add cucumbers and some vinegar and call

it a day.

Cucumber

True pickles are meant to be that you

take the cucumbers, you don't skin them,

you allow the microbes that are on the

surface to do their job, and you put

them into a salt water solution with

some, you know, some dill, some garlic,

black peppercorns, and a couple days

later, you will have a pickle.

I want to make sure I'm super clear on

those three

biotics that you mentioned. So,

prebiotics are the food for microbes.

Probiotics are

the microbes themselves.

And then postbiotics are the compounds

that the microbes make.

Is that roughly accurate? That's roughly

accurate. And there's a minor caveat,

which is that for these things,

prebiotic and probiotic,

they have to have beneficial effects on

humans in order to count. Okay. So, we

can't call it a a

because it has just an effect on

microbes.

Sugar has an effect on microbes. It's

not a prebiotic. Ah, okay. Okay, so and

the same is true for probiotics. Now,

the original conception of probiotics

that most of us have it comes from a

capsule.

Right? And the reason why we can call it

that is because we have demonstrated

through clinical studies that the

specific types of bacteria or or yeasts

in some cases that you find in that

capsule have been proven to be

beneficial to humans.

So, the prebiotic is a food. The

probiotic is actually alive. Yep. And

then the postbiotic is not alive. That's

a compound that's produced by the things

that are alive.

That's right. And the key with all of

this

is the postbiotic.

So, one of the And And these can be

things that are completely beneficial

and good to us as humans. An example of

this are the short-chain fatty acids.

Short-chain fatty acids are the product

of consuming fiber or resistant

starches.

And they come into contact with your

microbes. Again, you would not be able

to get these if you were sterile.

Can't I just drink them in a can?

Postbiotics. Is there not a can of

postbiotics that I can just drink?

Well, so they're coming out now with

supplements that um are these

postbiotics in some cases. Mhm. Okay.

And uh the issue that I've taken with

them and I've actually discussed with

some people within the supplement

industry

let's not assume that that's going to do

the exact same thing that eating a

high-fiber diet is going to do.

It's not the same. So, let's then talk

about what happens with those

I'm assuming that the postbiotics um

compounds are the things that have the

help all the health benefits. So, the

reason why the gut microbiome is so

healthy, the reason why these microbes

are so beneficial is because they

produce postbiotics. And these

postbiotics help our body in various

ways. Yes. So, we uh

mentioned earlier we were discussing how

we have this gut barrier that's key to

protecting our immune system.

And I mentioned that the the microbes

are the stewards

of that of that barrier.

It's the postbiotics.

It's the short-chain fatty acids.

Butyrate, acetate, propionate

that are produced by these bacteria that

builds the wall.

When you want to build your wall and

protect your body and reduce

inflammation

you need more of this.

Now, it's not That's not the only thing

that they do. Those postbiotic

short-chain fatty acids also directly

affect your immune system.

Directly affect your metabolism.

Cross the Get into your bloodstream.

Pass throughout your entire body. Cross

the blood-brain barrier.

They have the ability to actually get

access to your brain

and can affect your brain. And we could

talk about different ways that that they

can do that.

But the point is that this is what um

really matters because the microbes

produce these short-chain fatty acids

and these short-chain fatty acids have

healing effects throughout the entire

body. And when we when we see human

studies looking at fiber consumption

and showing us how beneficial fiber is

to us as humans

the reason I want everyone to understand

the reason why fiber is beneficial to us

as humans is because

fiber comes into contact with microbes

and those microbes release short-chain

fatty acids. That's what's happening.

Metabolism.

Metabolism is the I've been learning a

little bit about metabolism recently.

When people think of metabolism, they

think of the speed in which I process my

food. So, people in society say I've got

a high metabolism, which means they're

probably going to be quite skinny. A low

metabolism means, you know, I'm probably

going to take longer to process my food.

What is the role between the

relationship between my gut and my

metabolism? And have I defined I've

probably defined metabolism wrong there,

but

what is the relationship?

Well, metabolism is basically dealing

with the currency of energy. Right? So,

And it's the engine that drives us as

humans.

And so, how do these microbes affect our

metabolism? Well, we have uh

researchers at Zoe looking at this

directly

called the Predict One study.

And in that we were looking at like what

is the thing that tells me predicts

what your blood sugar response is going

to be to this food

or your blood fat response after a meal.

And when you start to line these things

up, they're individually different.

They're not the same.

But if you look at both of them the gut

microbiome plays an essential and

critical role in each.

So, in other words, if we know what your

gut microbes are

then that empowers us to be able to

understand

why you have high blood sugar, why you

have low blood sugar.

Now, if we want to get super nerdy and

detailed into the weeds a little bit of

how this is actually happening, it does

come back in many ways to these

short-chain fatty acids. They're not the

only thing. We're, you know, in some

ways we're reducing it a little bit too

much. So, I just want to be clear to

everyone. There's other things going on,

too. But these short-chain fatty acids,

they have the ability to basically

activate certain receptors in cells that

will basically like allow us to have

more sensitivity to insulin, to reduce

fat storage, to enhance fat burning. So,

at the end of the day when we think

about these sort of measures of

metabolism cuz there's certain things.

Blood sugar response.

Blood fat. Cholesterol levels.

Um

uh visceral obe- visceral adiposity

meaning meaning like fat that exists

around our stomach.

When you look at all these things, the

gut microbes play an essential role in

regulating every single one of them. And

the short-chain fatty acids tend to be

the key. I I read in your book that 60%

of poop is bacteria. Yeah.

Which it just blew my mind. Yeah, and I

think that this is an important

conversation to have because we have

stigmatized poop. We're not allowed to

look in the bowl.

We should be looking in the bowl.

And the reason why is because if I were

a cardiologist

I would come over and I would check your

pulse.

I would listen to your heart. And those

vital signs would allow me to have an

idea of how you're doing in terms of

like just on a basic level, your

cardiovascular health.

All right? I'm a gastroenterologist. If

I want to know the basics of what's

going on with you in your body, I want I

need to know how you're pooping.

And what your poop looks like because

60% of it is

microbial in origin.

Because it is not just the excrement of

your food. What your poop looks like

allows me to have insights into your gut

health.

And we've actually proven this. We've

actually proven this at Zoe because what

we found we did a study called um

blue poo.

And we fed people blue muffins. It had a

blue food dye.

And basically it's quite simple. You eat

the muffins

and then you wait to see when they show

up in the toilet bowl.

And based upon that time, which is

basically your gut transit time, how

long it takes for the blue dye

to pass through your intestines

we could tell you um

what's going on with your gut

microbiome.

We could talk about cardiovascular risk.

We could talk about visceral fat.

All quite simply tied to your gut

transit time based upon eating a blue

muffin.

So, these things Many of these um things

that you and I are discussing today,

whether it be the gut connecting to our

metabolism, our immune system, or

whatever it may be

we can connect them back to these simple

measures like what does your poop look

like?

Or

um

or how long does it take for you to have

a bowel movement?

The gut transit time. That's super

fascinating. I do want to talk about

poop as well, but um the gut transit

time.

Yeah. That's the time it takes for a

muffin to go from my lips to the toilet

bowl. Yes. And is a high gut transit

time better than a low one? And what is

determining whether I have a high gut a

good gut transit time or a not so good

one? Yeah. So, gut transit time is a um

uh

a personal measure of the health of this

entire digestive system.

The reason why you do the blue dye, by

the way, instead of like eating beets or

something like that is that the blue dye

we have like clinically validated this.

So, this this paper was published in the

journal Gut, which is the top European

gastroenterology journal.

And there's a couple of specific time

points that we can use to sort of cut

off these measures.

Um the first is 14 hours. If you are

less than 14 hours, that is very fast.

The other is 58 hours. If you are more

than 58 hours, that's very slow.

All right? So, you eat these muffins and

then you basically just record when did

they show up?

And the average person is somewhere on

the range of 24 hours

or 48 hours. Typically 1 or 2 days after

eating the muffins, that's when you you

start to see this. And those are both

considered to be normal.

Now, if we were to break these things in

out into less than 14 hours, more than

58 hours, or you know, these two sort of

peaks at 24 and 48 what you start to see

is that this is four groups and these

four groups every single one of them is

a little bit different in terms of their

gut microbiome.

A little bit different in terms of their

gut diversity.

And we can make associations between

these things and what people are eating.

So, the high-fiber consumers are all

showing up in the middle which means

normal.

And the low-fiber consumers are the

people that are showing up on the

outside.

And it brings us to one of the

properties of fiber that's kind of

fascinating which is that whether you

have diarrhea or constipation there's

only one thing that can correct both of

those.

Diarrhea and constipation are both fixed

with dietary fiber. It helps to

normalize our stool, bring it back to

the middle. So, in a perfect world,

where do we you to be? We want to

generally be pooping about once a day.

So, you want your gut transit time to be

about 24 hours or less.

Um that being said, like is a person

unhealthy if it takes 2 days for this to

show up in their poop? No, I wouldn't

characterize them as being unhealthy.

But I I do think that this is one of the

things that we can look at that's

simple, it's it's nearly free, and um

available all of us to try at home.

So, yeah, so you you you would have said

that if someone's going to the toilet,

you know, three or four times a day or

more, then there's probably a fiber

problem. There's may well be a fiber

problem. And if they're

you know, they're sort of chronically

constipated,

it's also probably a fiber problem at

the heart of it.

Generally speaking, yes. Now, I will say

that fiber is not as simple as I wish

that it was, and and the reason why I

bring that up is that for a person who's

low on their fiber consumption,

um and they may suffer with these

issues,

increasing fiber is hard for them.

And many people don't feel well if they

go too hard too fast when they do this.

It folds them over. They feel unwell. I

was in the exact same spot 10 years ago.

If I tried to eat like, you know, chili

with a bunch of beans, I was not happy.

So, I preferred to stay away from that.

So, the point that I'm trying to make

about this, the reason why people

struggle with fiber, is because we are

100% reliant

on our gut microbes to digest our fiber

for us.

We don't have the enzymes to break them

down to break down fiber.

The gut microbes are doing it. So, if

you have a damaged microbiome,

and you never eat fiber,

you're you can't expect your microbes to

be good at digesting fiber. Our

microbes, they learn and they get good

at the stuff that we allow them to

practice.

So, when we start to add more fiber, the

way that I had recommend to people do

this

is to start low and go slow. That just

means adding a little bit at a time,

slowly over over the course of at least

weeks, if not months.

Um and this is what allows your your gut

microbes basically to keep up and adjust

to what you're doing. What about fecal

treatment? You said that that if our gut

microbiome is damaged, um it's not going

to be great at processing the fiber. So,

can't I just get someone's poop who has,

you know, that 60% of their poop is the

the microbes,

and eat it?

Or do some kind of fecal treatment where

I put it in my body?

So, this is this is actually being done.

Um now, we've been doing fecal

transplants where we would take from a

donor

and put it into a person for an

infection called C. diff.

And we've been doing this for more than

10 years.

And it is fascinating.

The studies with fecal transplants in

humans

have not been

um

as successful

as they were for the C. diff.

So, we would love to say that we could

treat ulcerative colitis,

which is inflammatory bowel disease,

with a fecal transplant.

Um

generally,

it seems that we cannot, at least where

we stand today.

But there is something that interesting

that we found in one of the studies on

this topic, which is that there was one

study where, again, these studies are

small. Like, we need bigger studies to

really fully understand this.

There was one study where

they did have a couple of people on with

ulcerative colitis who went into

remission, meaning that their disease

was no longer active

after a fecal transplant.

And they asked the question, what was

unique?

And they found they all had the same

donor.

So,

what we think is that there's probably

specific donors

for specific diseases

that could actually potentially fix

those issues because at their root, they

are gut issues.

I think that the future of fecal

transplant is very promising.

But the complexity of figuring out who

are these donors, like could I be a good

donor for some specific disease that I

don't even have myself, and don't know

anything about?

Possibly. And this is what we have to

figure out.

And how do these poop transplants

happen?

Is it orally or is it

some other way? Are they injecting this

poop? Are they putting it up their butt?

What are they doing with it?

There's a couple ways. So, the classic

is a colonoscopy.

So, the way that I always I would always

administer it is that the patient comes

in for a colonoscopy. They're completely

asleep. They're not aware of anything

that's happening. And during the

procedure, I basically release this

stuff. It's a liquid. It's not as gross

as it sounds.

So, that's a tube up the butt. The

colonoscopy? Yeah. That's a tube up the

butt. Okay. Yeah, that's a tube up the

butt. Now, the new technology that's

been emerging in the last few years is

that they can actually dry out the

stool, so they lyophilize it, and put it

into capsules.

You have to take a ton of capsules in

order to do this. But this is an

alternative choice. It's like you could

start taking this. What I think would be

interesting

Well, hopefully not.

Do you know what I mean? I've had a

couple of mega omega-3 capsules break,

and it's a nightmare. So, Oh, dear.

Yeah. This is not where we want to be.

Um

what what we're transitioning towards,

like the past was this big event. You

had to come in, get a big procedure,

colonoscopy. Well, to do that repeatedly

is simply not sustainable. That's not

realistic.

Now, what we're entering into is the

possibility that you could do this every

day.

You could just take your poop capsule

every single day. God, I'd love to be

the CEO of that company.

That would be so fun.

I mean, I think that I think that this

is going to happen. We just need Yeah,

but I think we need the the technology

is there.

The technology is there. So, what do we

need? We need to identify who are the

proper donors for this.

And we need to run the clinical trials

to prove that it will work. But to me,

this is a super probiotic. Cuz it's not

just, you know, most probiotics are just

one single strain. Um and they can be

beneficial. I'm not disparaging

probiotics in any way. They can

definitely be beneficial. But what we're

talking about is a new future where

you're actually

reconstituting a healthy microbiome. And

Steven, on this topic, real quick,

it is fascinating because some of the

people who are in this space,

they're worried about the way the world

is going in terms of microbes.

Right? So, there's been this concept

that perhaps you've heard about where

which is that um

there's like been this great uh

extinction event that's taken place.

Right? Where many species of animals are

dying. And

um and they're gone.

Microbial scientists are worried cuz the

same thing is happening on a microbial

level.

So, if you were to compare our

microbiome as Westerners

to a person who lives in a more uh

primitive environment in Africa,

we have half the microbes that they do.

And so, what these scientists are doing

is they're saying,

"What if those microbes that you find in

those people,

what if we need them? What if we evolved

and they're required for us?" So,

they're creating a bank where they're

collecting these poop samples from like

pr- uh primitive tribal people,

and saving them

in the event that it turns out that the

only way back

is to actually take the poop from these

people and create super probiotics that

would help to reconstitute our

microbiome.

I'm so compelled by this whole idea that

there's going to be this range of

supplements in the future that are just

like poop capsules.

I don't think it'll be supplements,

though. I think it'll be completely

regulated. Well, what I mean by that is

there's a difference in regulation

between supplements

and um pharmaceuticals. And I don't

think they'll have any choice but to

regulate this on the same level that you

would a drug. Cuz in my head I have this

idea of, you know, if this really takes

off,

people with great poop are going to be,

you know, expensive. Dude, I think my

stock is rising. Yeah, how much is your

poop?

All right. If you want my poop, you will

have to pay for it.

But it's going to be expensive. If you

only go to the cuz you're healthy, you

go to the toilet once a day, it's going

to be like gold.

Um and that's the fascinating thing.

Poop is on the biggest comeback in the

history of comebacks right now. Maybe

maybe that's where we live in a post AI

world. Maybe that's the currency we

trade in. You know what I'm saying? Cuz

we're going to have lit- little else to

do. So,

I you know, gosh, that is a dark uh

disturbing vision for the future, but I

could see where I could see where that's

possible. I mean, I I do think like it's

fascinating to consider that what what

we once disparaged as completely

worthless has turned into the powerful

treatment that doctors are administering

in the hospital to treat the uncurable

infection, and now is the future of

science. Mm.

It's going to be so interesting.

Could like, you know,

change the class system in the country.

Like, you know, like upper class could

just be people with the best poop, and

then lower class is if you've got like a

really narrow gut microbiome, and your

poop is useless, you can't sell it to

anybody. Well, it's kind of fascinating

that you say that because the issue is

that if you look at the microbiomes of

countries that are less developed than

the US and the UK,

um you know, they they they have less

money,

which the result of this is that they

eat a more basic diet,

which often is based upon whole grains

and legumes.

Right? Like, that's the essential, like

beans and rice

is like the essential diet. Yet, these

things are actually so good for our gut

microbes. Like, to me, legumes are the

least talked about food that we should

be talking about because they're high in

fiber, they're high in resistant

starches and polyphenols, all of which

are prebiotics. And this is why when

people eat more beans, they live longer

with less disease. So, it's kind of

interesting cuz like proper food, cheap

food,

is the food actually that is the best

for us because it feeds these microbes.

Lazy Westerners are going to get on a

boat like they did once upon a time, the

colonials, to go get the incredible, you

know, they the the gold and the diamonds

and whatever else they

it's claimed that they stole from

Africa, and they're going to get back on

that boat and go over there and start

stealing poop. I think that that I could

definitely see that happening. There has

actually been fights over when they they

discover

um

uh prehistoric poop, like fossilized

poop. There's fights over who gets to

control that, because if you think about

it, it's like Jurassic Park, right? In

the beginning of Jurassic Park, there's

that amber with the mosquito, and the

needle goes in, you extract the DNA.

What if we could extract the DNA from

prehistoric poop

and study that and potentially use that?

Mhm.

The poop studies that have been done,

really compelled by them, cuz I hear

that there's been a lot of sort of poop

transplant studies done in in mice as

well.

Yeah. And what what what are we seeing

from those studies? Well, okay, so we've

talked about these different um

conditions that are connected back to

our gut microbes. Mhm. And part of the

way that we prove this, of course, we

want human research,

but part of building

uh our argument and and filling in the

pieces of the puzzle is like mouse

research.

And these mice, it's we have complete

control, and they're much more simple to

manipulate. And so we have the ability

to do a fecal transplant, even

potentially from a human,

to a mouse, and then see what happens.

And so let me take you through a couple

of examples of what we have seen in

clinical studies, and I'm more than more

than happy to point people towards the

studies that I'm referring to.

Um classic study. They took identical

human twins. So again, we were talking

about this in the beginning of the of

the episode.

Identical human twins, same genetic

code,

and in this case, one was obese and one

is thin.

And they have a different microbiome.

And when you transfer human poop

into mice,

you also transfer the body type,

even when you feed the mice the exact

same food, the exact same number of

calories.

So we hear about this calories in,

calories out concept, which by the way,

we could talk about if you want to, but

it's not perfectly true, and this is

showing you the complexity that exists.

Your microbiome impacts how you work

with those calories. The mouse that uh

receives the obese microbiome, it's like

swimming against the current. The

microbiome is making it basically so

that that mouse absorbs all of those

calories.

And then the thin mouse mouse, um it's

like swimming with the current at your

back. It's a lot easier. You consume the

same number of calories, you don't gain

any weight.

That's just metabolism. By the way, we

have studies also diabetes can be

transferred. We have studies in humans

where you can actually do a fecal

transplant from a person who does not

have diabetes

to a person who does have diabetes,

and their blood sugar measures will

improve

in humans.

We have uh immune studies. You can take

a person who has ulcerative colitis,

which we're talking about a moment ago,

and transfer their poop into a mouse,

and that mouse will have ulcerative

colitis.

We have um

mood studies

uh where you could take a human

who has anxiety

or depression

um or PTSD

and

transfer their poop into a mouse,

and the mouse receives the mood

phenotype.

So basically like again, this uh needs

to be studied more in humans. We are

more complicated. You can't just cure

diseases like this by transferring poop

among humans, yet.

But when it comes to mice, where they

are less complicated, it's very clear

that the microbiome plays a central role

in these conditions, because you can

transfer the condition using human poop.

And take me on a journey of what that

poop's doing. So I I get the skinny poop

from a skinny twin,

and I put it into a mouse, the mouse

gets skinny. Or I get the obese twin, I

take the obese twin's poop, and I put it

into a mouse, the mouse gets obese.

What's going on in that mice's body to

make it obese? I'm I'm assuming it's

basically picking up some of the

microbes, which are impacting the gut

microbiome, which is creating a

postbiotic compound, Yep. which is im-

influencing its metabolism,

or something something like that. You

could eat the So if you have a

microbiome designed to produce

short-chain fatty acids, you and I could

eat the exact same meal, but the person

who has the microbiome designed to

create short-chain fatty acids will get

more short-chain fatty acids.

And the and the product of this is that

those short-chain fatty acids now will

have effects throughout the entire body,

including affecting our metabolism,

affecting our blood sugar, affecting our

insulin sensitivity, affecting our blood

lipids after a meal, affecting fat

storage, whether or not you turn on fat

storage or whether you turn off fat

storage and turn on fat burning.

It really does shine a light on this

calories in, calories out thing,

because yeah, I mean, there's so many

people who've talked about this a few

times that just think

you just have to eat below the required

amount of calories for your body and

you'll lose weight. But in that example,

it proves that there's this other

process going on that's going to

determine

I guess is it how many of those calories

go through, or is it just how your body

processes that energy?

Part of it is part of it is

thermogenesis, meaning fat burning.

Yeah.

Part of it is also what you poop out.

Okay. They've actually found that people

who have a healthier microbiome, they

poop out more calories. Uh okay.

Interesting.

What do you think of the calories in,

calories out thing? If someone comes to

you and they say

uh I want to lose weight, doc.

And they say I've I've heard this

calories in, calories out thing is the

answer, so I'm just eating less. I mean,

I eat lots of pizza, but I'm just having

less calories.

I don't I don't like that, obviously. So

to me, dietary quality is the key. Um

there's too many examples where dietary

quality So first of all, our weight is

our our health is not entirely

determined by our weight.

Is it a major factor? Yes, it is. But

there's so much more. So dietary

quality, study after study after study,

shows us that dietary quality is crucial

to the health of our microbiome,

and also to our global health, our

longevity, and our risk for disease.

So to pretend that that doesn't matter

would be completely false and

inaccurate.

Um the idea that calories is the only

thing that matters, what I do want to

say is this.

There is some truth

to the concept that calories matter.

There's absolutely some truth to this.

If you reduce your caloric intake, you

will lose weight. The problem is that

your body will compensate by slowing

down your metabolism, and so then it

puts you in a in a predicament where you

can't continue to do this. It's not

sustainable, because that weight loss

eventually will stop,

and then you will

uh your appetite signals will grow so

much that you will start to overeat. And

then when you overeat, not only do you

gain the weight back, you rebound.

Yo-yo. You yo-yo, and you go above where

you were before. Wow. And the problem

with this is that when people lose

weight, they don't just burn fat.

They lose muscle mass. Like all weight

loss is associated with a loss of muscle

mass.

When you gain the weight back, the

muscle doesn't come back. You're just

getting fat.

So So the issue is you end up less

healthy than when you started.

To me, what I want is I want people to

eat a diet where they can eat as much as

they want without restriction until they

are full,

and still achieve their weight goals.

And this is completely possible

by consuming a diet that's high in

prebiotics,

because we hear so much about uh Ozempic

or Wegovy,

um which is semaglutide semaglutide.

We hear so much about this, and it's a

GLP-1 agonist. GLP-1 is a gut hormone

that exists within our body,

and uh it makes us feel full.

We can stimulate

GLP-1 through our dietary choices.

If you eat the right food, which is

basically a high prebiotic diet,

you will activate the GLP-1, and you

will naturally feel full.

And the result of this is that in the

process of actually activating your

normal satiety signals, you will consume

less calories. Satiety signals are

basically hunger signals. Hunger

signals. So basically like

Yeah, so the issue that we all have is

that we eat an ultra-processed diet.

An ultra ultra-processed diet

number one, makes us ravenous, right?

Like we can't stop, we want it so bad.

Number two, it doesn't activate those

fullness signals.

And so the result is when we eat an

ultra-processed diet, we overeat.

And then you feel like trash. You feel

like trash for a couple of hours, and

that is is the result of you overeating.

You've thrown yourself metabolically out

of balance.

Right?

Don't we all love the meal

that tastes great, but you eat until

you're full, and you stop, and actually

feel energized,

and don't need to take a nap or drink an

energy drink to compensate for what you

just did?

And that happens when we do this the the

old-fashioned way. By old-fashioned, I

mean like prior to modern history, when

ultra-processed foods came into uh

existence. If we go back to the old way

of eating, you would simply eat until

you activate these hormones, things like

GLP-1, which, you know, is concentrated

in this drug, or peptide YY.

These are gut hormones that basically

tell our body when to stop eating.

Everyone's going crazy about Ozempic. I

keep hearing about this drug. I think

Elon Musk recently said he had had it,

and I know a few other people that have

um started taking his impact there.

I would say

you know, then none of them are

overweight necessarily. Yeah. Um but

they're doing it because it's now been

framed as kind of super drug

which can help you drop weight super

quickly by making you feel satiated.

Yeah.

What do you think of his impact?

Well, let me come back to this. So,

first of all, let me say that for people

who need it, it's I'm glad it's there.

Um I don't think that the entire world

needs Ozempic in order to be healthy. Is

there any side effects or 100%.

100%. First of all, digestive symptoms.

Um massive

uh massively common digestive symptoms.

But there's also long-term risks and

many of which we don't simply know much

about because people haven't been using

the drug long enough for us to really

fully understand what happens if you use

because once you start using it, you're

not going to stop.

If you stop, you gain all the weight

back.

So, once you start using it, you're

basically committing to however old you

are, you're going to be doing this for

years and years if you know, decades.

Um we don't know what happens after a

couple of years. Isn't it kind of

skipping a step in the process of

developing the gut microbiome taking

Ozempic?

Yeah, I think that's the point is that

if we so, you know, if we look at our

countries, the US and the UK,

um there's a major fiber deficiency.

And I don't think, you know, I realize

I'm out there pounding the drum on this,

but I don't think this is talked about

enough. Perhaps because people don't

think that fiber is sexy.

But I think fiber is sexy because it's

so crucial and important to our to our

health and this is an example where this

is 100% true. So,

uh 95% of Americans are deficient in

fiber. The average woman is getting 15 g

of fiber per day.

She's supposed to be getting at least 25

in the US.

The average man is getting 18 g of fiber

per day. He's supposed to be getting 38.

That's a massive massive deficiency.

And the issue is that the fiber is what

actually empowers the gut microbes. By

the way, through short-chain fatty

acids.

The fiber is what empowers the gut

microbes through short-chain fatty acids

to release these gut hormones so like

GLP-1 and peptide YY. So, my thing is

this.

Cuz again, like our health is not

determined exclusively by our weight

balance. There are other things other

than that.

Why don't we cons try consuming these

foods?

The average American is 10% of their

calories from plants, fiber-containing

food.

What if we can make that 30% or 50%?

I think that we would see a massive

difference. There was a study that was

done. It's one of my favorite studies of

all time by uh

uh

professor in New Zealand. His name is

Andrew Reynolds.

And he compiled all of the available

data on fiber. What happens when people

consume more fiber?

Here's what happens.

They lose weight.

Uh they are less likely to have a heart

attack.

They're less likely to die of heart

disease.

They're less likely to have a stroke.

They're less likely to be diagnosed with

diabetes.

They're less likely to be diagnosed with

multiple different types of cancer.

They're less likely to die of cancer.

Um their blood pressure goes down.

Their blood sugar control improves.

Their cholesterol goes down.

Okay.

Like that's

sitting there for us.

Available. All we have to do is make the

dietary changes. And again, what happens

in that process is you consume more

fiber. It comes into contact with your

gut microbes. They release short-chain

fatty acids and they have healing

effects throughout your entire body.

So, to me, I agree with you. I think

that we're missing this

um this middle piece and when we're

reaching for something that's an

expensive drug, it's very expensive.

We're reaching for something that's an

expensive drug and it has a very real

risk of side effects and it also has

risk in the sense that we just don't

know what happens after you take it for

a couple of years.

Um I I don't understand why we would do

that when think of the benefits that I

just listed by simply increasing your

fiber intake.

I have so many conversations with my

friends about

various drugs that they're taking,

performance drugs, modafinil, Ozempic,

etc.

And when I speak to them, they they're

very passionate that there's no side

effects on all all of these sort of

things that I consider

cheating. Yeah. And I and I have to

caveat this because there are some

people who are in a situation with

diabetes or other cardiovascular issues

um

who can have their lives saved with some

of these drugs. Yeah.

But for the most part, the people that I

know that are consuming these drugs

aren't doing it for that reason. They're

doing it for vanity reasons or for

performance reasons where it's like

taking a shortcut and every shortcut I

believe in life comes with a cost. Yeah.

You're talking like a doctor. You're

talking like a doctor because basically

what you're talking about is risk versus

risk versus benefit. And the way that I

think and every other doctor thinks

about their patient is does the benefit

outweigh the risk? But there is always

risk in association with these drugs.

And what makes me different from most

other doctors

where I turned the corner in my career

is when I started the ask ask the

question, why are we waiting until we

get to the point that we need to write a

prescription for a drug? Why are we

waiting until that point?

Why are we not intervening in a much

earlier point where we could transform a

person's life and get them to a place

where they never actually get this

disease or if they get this disease,

it's so much easier for us to control

that. And this is so to me, what I come

back to is basically what you're getting

at is why would we why would we take a

drug

if we could change our diet and our

lifestyle