Kind: captions
Language: en
Tim Spector welcome to the show it's
great to be here I'm excited to have you
so I think if people want to lose weight
the odds are that they are barking up
the wrong tree so I want to ask you a
few questions to help people understand
what matters and what doesn't so if
somebody's trying to lose weight do they
need to be counting calories
no it's one of the worst things they can
do okay I think that's going to surprise
people what about exercise
very unlikely to help most people lose
weight maybe help you keep it off but as
a starting point it's a bad way to do
again very shocking and in terms of
are there things that have been billed
as healthy that people would be
surprised to find out are actually
moving them backwards
yeah the number of foods that people
regard as healthy
um things like juices orange juice
things like oatmeal porridge
things like
brown whole meal breads
Lots potentially
other fruits in large amounts
and a whole range of foods that are told
are low calorie low fat
low-fat Dairy low-fat yogurts the
yogurts that children get given
are all super unhealthy
and most people will be surprised by
that yeah I think people will be very
shocked to hear that especially the
calories part so why how is it possible
given what we know about thermodynamics
which say that if you're taking that
energy in it can't be created or
destroyed so something has to happen to
it so how is it possible that if I'm
trying to lose weight that calories
isn't the place that I start and if
exercise is burning calories how is it
that I'm not going to be able to
leverage that to get lean what is it
that people are getting wrong
they're treating the body as a simple
furnace
like a tube where you just burn stuff in
it and it comes out and you measure
everything whereas it's a much more
complex machine that is adapting to
what's going in an evolution has given
us this really fine control mechanism
over our bodies that we haven't really
reckoned with so that the
even if the inputs stay the same or
change are our outputs are the amount of
food we're burning is all is altering
and it's been very hard to measure but
we do know that
our bodies are always trying to get us
to stop
losing energy losing weight and they're
trying to maintain us in our in our
current state and that's that's been the
big mistake we've made so we've assumed
that just by some simple averages or
calculations we can guess how many
calories the average person Burns a day
and then simply work out okay we just
have 500 calories less than that and
you'll lose weight and
a those calculations are wild guesses
because most people are not average
and also there's a fallacy that your
body doesn't change so once you reduce
your calories your body is fighting to
get those calories back so it slows down
your metabolism
and it ramps up all the signals to your
brain making you hungrier and making you
much more likely to overeat at your next
meals and so this happens without you
knowing about it
and that's why people struggle if
they're only
reducing calories
to make any inroads long term in the
health everyone will lose some weight
the first few weeks without whatever
diet you tried but long term
the vast majority of people returned to
where they were because the hunger
levels just build up to a level you
cannot
sustainably ignore and your metabolism
means that you need less and less food
so if you're going to continue losing
weight you've got to keep eating less
and less because your body's fighting it
and the same thing happens more or less
with exercise
we know that it gets harder and harder
to lose weight and that
people who you know the trajectory is a
weight loss are really quite rapid
initially and then you maintain exactly
the same intake in very strict
conditions and it and it just tails off
so your body's just fighting the whole
the whole thing all the cellular
processes are everything's geared to
minimizing any energy expenditure and
it's all done without you knowing about
it and that's pretty Universal there
might be some
some range but as a as a response to
that calorie restriction that's what
happens so it's it's why you can't just
carry on losing weight your your body is
bringing you back up to the level it
wants to be and that's evolutionary wise
we we are our survival was dependent on
us going through
a few days without eating and then
getting our strength back and and
retaining that so through most of our
history
so it's what's controlling that
uh it's our evolutionary genes driving
it and
hunger is the primary
um mechanism we've got as well so
there's
so that you've got two things you've got
the metabolism and you've got the hunger
signals to the brain and
the metabolism is being slowed right
down and it's
definitely a brain
mechanism primarily but it's probably
being fed by signals from the gut
the microbiome signals as well
uh definitely a key role in that but we
know you know these appetite signals are
crucial and we can see this with the new
ozempic drugs
uh they're blocking those that hunger
Drive
and as soon as you block that then you
know you can lose weight but if you
don't block it it's sort of virtually
impossible for most people to just fight
that continually because it just gets
ramped up and ramped up and ramped up so
you're just thinking about food all the
time and
your body is designed to
um get back to where it was and so the
idea of relying just on calories as a
weight loss
tool has has been shown to be flawed in
numerous controlled trials
because eventually your body wins and
let me ask you because if you don't
change
other aspects of eating
and you're just obsessed with the
calories and that and that's if you can
count the calories anyway because most
of these trials
are not real life they're done in
highly controlled scenarios with nurses
ring you up and you know confirming what
you're eating and you know it's the best
possible scenario and even in those
scenarios 80 percent of people have
failed at two years
meaning they put the weight back on yes
can you lose fat without being in a
caloric deficit
yes
um
I mean you can obviously do that by
increasing your muscle to Fat ratios
but
used I mean ultimately uh calories are
still important
but I don't think we understand the the
subtle balance and the fact that food
also has other mechanisms
triggering hunger that aren't related
just to calories so the nature of the
food the quality of the food is
something that we're uncovering which we
never in the past talked about so we've
been so obsessed with the calorie
you know there's all kinds of problems
with the calorie it's not very accurate
to measure you know and it ignores the
structure of food so the way we've been
counting them is wrong
a great example is a study we did
in the in the Zoe product studies where
we gave
and in these days we gave everyone a
thousand odd people identical meals at
the same time muffins
and
everyone responded very differently to
those muffins but some people responded
with a sugar dip at three hours I don't
know if you had any sugar dips but
um when you were using cgms but one in
four males one in three females get a
marked sugared it below Baseline after
they've had a carb meal three hours
before I do not much to my dismay well
no it's good you don't want to dip
because those people they were blinded
they didn't know they were dipping but
they reported greater hunger uh lower
mood less energy and they over ate by
about 15 that day
so identical calories a different
response just because the nature of the
food and we were giving people the
equivalent of ultra processed food which
is what the average American diet is uh
in its highly refined form it had a very
different effect and you could give
identical calories
in a different format different
structure you would get a different
result and so
there's not another famous study from
the NIH where they gave people
um two weeks of Whole Foods and two
weeks of ultra processed foods and
identical calories and macronutrients
and the ultra processed food group over
at
so they were overeating by
equivalent 300 calories a day and so
if you only had calories as your
objective and you go back to this you
know there was the law of physics and
all this kind of stuff you missed the
point about food being so much more
complex and it's about the structure of
the food and we're not accurately
measuring the calories because you get
very different responses to the
theoretical identical calories I don't
think people know what you mean by
structure I have a guess but I'm not
sure that I'm right but before we get
into the structure of the food one I
want to plant a flag to say that the
people are having a different response
to the exact same food so even if the
structure of the food is the same
different people are going to have
different responses I've also heard you
say that the genes that we've identified
so far that have to do with
um weight loss or actually in the brain
which I thought was utterly fascinating
but I want to make this really human for
a second so there are people in my life
who I love very much and I know they are
good people they are smart people but
they absolutely cannot lose fat
do you have people like that in your
life and what do you think is the
problem because I have a hypothesis as
to why they can't lose fat and if they
would just do what I tell them they
would lose it but I'm curious do you
have people like that in your life
so you see who can't lose weight or why
use the word fat on purpose because of
course losing muscle is going to be a
very different experience than losing
fat
so
um but yeah for the average person they
just think of it as losing weight
but I am talking about adipose tissue
well there are definitely some people
who find it harder to lose weight than
others there's no doubt do you have
people in your life that struggle with
this
yes I've got um okay so now imagine
those people you don't have to out them
obviously but what's the problem is the
problem do they lack discipline
are they not smart enough to pull this
off like what is the the Trap that
they're caught in because they know you
so the odds of this being that they just
don't know what to eat is effectively
zero
but they're still not doing the things
they need to do to lose weight
so what's the Trap
for many people I think it's they have a
a drive that is
making them hungry and they're getting
increased hunger signals compared to
other people say like me
um so their brain is always telling them
to eat more
and although that's not often not
mentioned I think that's one of the big
drivers that uh they once they've got
into a state
they are regularly eating more and their
brain is saying eat carbs rather than
other things for for example
does it really just come down to you
there's something it's compelling them
to eat more but this is still a calorie
problem or is it compelling them to eat
carbohydrates and that's our problem
I think it's the latter so I think it's
they're they're pointed towards foods
that are likely be fattening for them
they could have arugula but it's not
going to fill them up therefore you know
their brain is saying you've got to have
something else have some bread with it
or whatever it is and they're not
satiated in the same way that other
people would be no don't get that
sensation of fullness those hormones are
not kicking in and
you know it's it's a bit of a vicious
circle because
these people are because they're getting
these sudden impulses to eat they're not
able to plan all they're eating as as
well as other people that have these
huge drives of their body to to do this
and we we see this all the time in
everyday life
um
if you've ever lost had a really poor
night's sleep
for some reason your brain tells you and
we've we've done this in the Zoe
predicts studies that it it tells you to
overeat and
we've seen it people eat carbs
much more uh after a poor night's sleep
than if I had a good night's sleep why
well our brain is is doing something
that we don't understand why but it's
because it's stressed and I think
it's just a hypothesis that the stress
you know related to not sleeping perhaps
your body say oh you need energy you
know it's like some evolutionary idea
you might need to run or you know get
quick energy
go for these kind of foods and it's also
comfort food if you had a really bad
night you know you lack a bit of comfort
you know you feel terrible and so it's a
way of pleasing your brain so so we're
hardwired on a lot of these things that
we don't realize are really are really
happening and no one's really studied
these things between you know exercise
and sleep and and food and on our mood
and all these because we've been so
obsessed with this
blind alley of of calories hmm
okay so when you were talking about
um they've got this drive they want to
eat carbohydrates you get Comfort out of
doing it my question would be from an
evolutionary standpoint nature only has
Pleasure and Pain as sticks to prod you
to do what it wants so it wants you to
eat these things
what is is the reason just quick energy
because you might be in danger or is
there something else going because I'm
trying to figure out why after a bad
night's sleep so one after a bad night's
sleep you're you are it's something like
you have the
um insulin sensitivity of a diabetic
so your body's basically saying I don't
want the fat in my cells I want to leave
it in my bloodstream and I want you to
go eat it's it is the exact metabolic
State you would be in if you were about
to hibernate so my question is do you
have a guess I'm sure there's not a
study on this yet but do you have a
guess like why if you get bad sleep or
you're stressed or whatever does your
body go oh I'm gonna treat this like
we're about to hibernate I'm gonna get
you to eat the most glucose spiking
things I can make you insulin
insensitive so it's not going to go into
the fat
why that seems so cruel but obviously
there was an evolutionary advantage to
this at some point
well your guess is as good as mine I
just think it's the body's just picking
up a stress it's saying this guy's you
know anxious stressed is not slept maybe
there's some threat maybe they're in a
war situation uh maybe they have to
leave the cave and and go walk for three
days you know
um without eating
um and you know we weren't programmed to
be living in the modern world we're
programmed you know thousands of years
thousands of years ago our genes haven't
really changed so it's fight and flight
idea I guess it's getting the wrong
signal and that's
but everyone's experienced it I think
you know in
and uh
similar with perhaps with hangovers and
things like this that you know this is
some Shock to the body
and it behaves out then out of character
and then this actually makes the whole
thing worse but it it wasn't designed
perhaps to do that
um but so so I but I think we're very
early stages of working out the links
between sleep and eating and mood
we just haven't studied it in detail and
that's why we're getting this amazing
data in real time
you know from wearables and other
gadgets that just allow us to collect
this incredible stuff so I think in the
future you know we're gonna
uh Zoe we're thinking about you know
linking the Sleep data to warnings about
your breakfast and saying you know give
you a little warning say hey your
brain's about to tell you
uh this you should be doing the opposite
quickly because you know if you'll get
inside you you know because what what
triggers that warning what do you know
what data are you collecting well it
would be say sleep duration or Sleep
Quality oh oh so you recognize you had a
bad night's sleep here's what your
body's gonna give you the impulse to do
very interesting is that part of the Zoe
predict
um well we collected the data as part of
the Zoe predict study but these these
are just future ideas to go into the Zoe
product
um it's not there yet but these are all
as we're collecting more and more data
and we've now got over 50 000 people's
information you know and
it's growing rapidly we're being able to
dissect these things and start to
personalize you know that information
even more not just based on your diet
and your age and hormone level menopause
Etc but you know on day-to-day
differences in exercise level or sleep
levels so that we can just start to give
people those
those heads up about hang on your
brain's trying to tell you to do one
thing but you know we know that's not
good
um and you know if you are just carb
loading after a bad night's sleep you'll
eat you you tend to all these people in
our study after bad night's sleep over
it
so you can see how people get into these
Vicious Cycles very easily and they're
overeating on carb heavy stuff so you're
getting as you said more more
more sugar spikes more insulin and and
maybe that also means you it might eat
late and therefore you don't sleep as
well the whole thing keeps going so it's
it's trying to little tricks to get
people out of these these bad habits
it's very interesting so I want to give
people a quick breakdown of what I see
as your sort of General thesis because
you've brought up Zoe a couple times
which is your company but the idea of
Zoe is that hey boys and girls the
reason that you're having such a hard
time is the one size fits-all notion of
eat less calories one ignores variance
in food but two maybe more importantly
it ignores variance in your individual
metabolic reality I'm calling it that
but I really mean your genes I mean your
microbiome probably most importantly
because you've done some fascinating
work on Twins and even twins have
different outcomes and different
responses to eating the same thing there
are clones you wouldn't expect that but
in fact you do because our microbiomes
end up becoming very Divergent
and if there's anybody listening to this
that's never heard of a microbiome
inside of your guts are just
a bazillion bugs microbes a whole bunch
of different things that help you
process food and depending on what you
eat and what bacteria you have and fungi
and viruses like all kinds of things
will determine metabolites which then
signal your body it's a whole Cascade of
things that happen that's highly
individualized okay so setting that
stage I want to go and finish the loop
on this idea of what response your body
is having to a stressor so
a year ago I was going through the most
stressful period of my life it was
insanity and I found myself walking
across a room opening a cupboard and
grabbing food before I realized that I
had gotten up and I was like whoa this
is a very powerful impulse and so I
started thinking of that as the the
metabolic anxiety response
so if anxiety from an evolutionary
perspective is valuable because it makes
you take a Potential Threat seriously
that oh I should plan in this way and
the anxiety makes you really do
something about it keeps you from being
lazy in the face of of a real
existential problem that's my gut
instinct about why you find yourself in
what I'll call foraging behavior that
you just sort of Click over almost like
a zombie and you're just gonna go do the
things that you would need to do to get
that food because the body's like yo we
might have a problem there's already
some sort of stressor in this case from
lack of sleep
um
that makes a lot of sense to me and gets
at some of the complexity that I think
that you're trying to lay out you can
reboot your life your health even your
career anything you want all you need is
discipline I can teach you the tactics
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today
now I want to bring that into this
discussion of okay we both know these
people amazing people smart
these are not problems of
necessarily even willpower and I look I
will say if they can stop themselves
from eating enough calories on a long
enough time period they are going to
lose weight but it is a very different
battle than just like do don't do it as
you said it ratchets up and ratchets up
and ratchets up and it can be very very
difficult
so
the the punch line I think to all this
is that this becomes so highly
individualized that if you don't take
control of your situation if you don't
start running NF1 experiments on
yourself and see what works for you what
doesn't work for you you're never going
to be able to get a hold of it and I may
over index here and I'll be curious to
get your feedback so to the people that
I love I'm talking to you now that are
struggling with your weight this is a
microbiome question and you now have to
start thinking about eating to alter
your microbiome because your microbiome
is going to signal to your brain to say
I got in here because you eat McDonald's
french fries and so you'll crave
McDonald's french fries and so until you
force yourself to eat for an extended
period of time the things you quote
unquote ought to eat the things that
will give you the body composition that
you want
um you'll never win the war
yeah you're never going to win the war
if you've got an unhealthy set of gut
microbes that are fighting against you I
think that's the that's the key here and
I think it's the other way of thinking
about nutrition is rather than you know
just worrying about the inputs it's just
saying well
uh
you you should be nourishing these guys
who are these magical pharmacies that
can help you pump out all the right
chemicals to send you the signals of
fullness to dampen down the inflammation
stop the stress messages going around
your body and you know allow you to deal
with all these situations and improve
your immune system and
your those brain commands and I think
that's a really important message and if
you are
you know you you've lost the battle for
a few years you're eating junk food you
you are going to have a gut that's
really low in diversity you've got
microbes you won't have many of the good
guys left that have been wiped out been
taken over by the the bad guys who are
these microbes that love inflammation
they Love Actually these stress
chemicals they love the fats and
saturated fats that are coming from your
um fast food
so sorry before you move on I need to
understand that better so when you say
that they love the stress chemicals
what does it mean can they metabolize
the chemicals like what how is it well
we don't know exactly but
when they've done all kinds of
experiments both in mice and and humans
where you say give people junk food from
you know you change dramatically their
diet from healthy to unhealthy
you get an increase in these microbes
which uh are always associated with
inflammation so when you look in the
blood levels you see these markers of
blood inflammation which is this like
low level stress in the body like little
mini fires going around throughout the
body and
they take over so it's like we think
it's as a subtle change in maybe the
acidity of the gut in tiny amounts and
he takes a tiny tweak for one one group
of microbes to out-compete the others so
these guys are the pro-inflammatory
microbes and the anti-inflammatory ones
who are normally they're dampening down
these fires are really they've got
nothing to eat okay so that hypothesis
makes a prediction let me see if this is
accurate so if I were to
um not change the diet at all but I were
to dial up or down the inflammatory
response of the body
if I dial it down would those microbes
start dying off without changing the
diet just changing through medication or
whatever the inflammation
probably I don't think we know
absolutely but we think it's working in
both directions so it's partly a
response to the inflammation and partly
a Cause
so it you know so when people when you
look at someone who's got a chronic
inflammatory condition whether it's
osteopolitis rheumatoid arthritis some
autoimmune condition and all their blood
markers of you know these stress are
High
um you see more and more of these these
microbes appearing
and if you transplant them from say one
Mouse to another you can make that
Mouse's gut more inflamed
so it's both a cause and a consequence
of of it so it's not as
clear-cut
but it's a bit of both but if you can
like you give people steroids you reduce
that inflammation they won't be doing as
well because they they're thriving in
that particular environment
you know it's a bit like when you're
doing fermented foods and you tweak the
environment you get a bit of acid you
know lactic acid produced yogurt
that's tiny change in PH means one group
out competes another
and I think we think this is what's
happening in the in the human gut that
there's some stress chemicals in there
we can't yet measure but are this these
microbes are super sensitive to that
means that one group suddenly out meets
another these guys take over these are
the guys that want more McDonald's and
are selling the wrong messages to the
immune system and and the gut and
altering your metabolism make it harder
to lose that weight make you hungrier
doing all these things so
going back to your initial idea yes in
order to
start to lose weight properly you've got
to deal with your gut microbiome you've
got to redress this good
good guy bad guy balance that we we see
you know in all 50 000 people we see
this quite clearly there are these Good
Guys the bad guys and it's absolutely
correlated with not only weight but also
Health all the health outcomes
so if you can get people
to eat more healthily
then once you've re-established the gut
microbiome then you can start to much
better control your weight
but you you can't just do it just like
that with with the crummy microbes how
changeable is our microbiome
Studies have shown that if you go
through a dramatic change say from Total
meaty to American starter vegan you can
see a change within a week
and
others other Studies have shown you can
change it quite several weeks if you
make a big enough change
things like fermented foods can have
quite a big impact within just a couple
of weeks on your on your diet
has a bigger impact the worse you are
so that the worse your starting point
the easier it is to change it's quite
hard to re improve someone who's really
good
to get them better is is quite tough but
if you've got a really
um
a sparse set of microbes they're quite
easy to change and we see that
with fecal transplants we put poo
transplants in people they work best and
people who've really got hardly any
decent microbes they've got terrible
infectious diseases works really well
doesn't work very well when it's at high
complex saturation but it overall it's
an optimistic message most people
can within a few days improve their gut
microbes just by feeding them the right
things and reduce them are the bad guys
very quickly Okay so
is from a fecal transplant
standpoint does that last because I had
heard that it you know maybe it works
for a couple weeks and then you start
reverting back to your Baseline and my
wife went through a very dramatic
microbiome issue and we have found it
brutally difficult to rehabilitate her
it took us years and it got so bad at
one point I was considering a fecal
microbial transplant just a little
worried that we don't yet know enough
about what you're transferring over so
we didn't
um but and I am perfectly willing to
accept that we just didn't do it well
but our experience was that it's even
though because she got tested and she
had like they were like whoa your
variety is is just atrocious it's so low
and we just found building back up has
been really really hard
yeah well it can be and I I've got
um
an example of my son
who
I uh got to volunteer to do the
McDonald's diet for 10 days
and because he was a student and he
liked McDonald's and he was happy for me
to pay for him
and he thought it was all quite fun as I
did and uh
he um he did this at all his meals at
McDonald's
for 10 days straight with any effort to
be healthy or literally just give me a
number one with a large Coke yes he
didn't supersize and so he just did the
regular and he found he couldn't eat
more than twice a day he initially the
idea was to go for all three meals but
he he started to feel a bit nauseated so
he uh but yeah it was and he had just
just the um
the Big Mac and the um
uh nuggets
with the odd McFlurry and uh Cokes and
he didn't feel well at all but he'd lost
40 percent of his gut microbes whoa in
that in that time amount like by volume
or by diversity by diversity okay so we
we this is a while ago we measured it
with a 16s test which is a fairly crude
measure and it was an end of one study
so you know there's some
uh
uh give and take on those results but
that was quite shocking
um that you know I'd done this to my son
and tried to feed him up
um and it's proven remarkably difficult
in him too so I'm right at the top five
percent of uh outs my diversity in
microbiome he's still in the bottom 10
percent
and uh it's been a struggle in it but I
think it was interesting that some
people
you know
may have susceptible microbes
particularly that you know going through
a time like a student when you eat
terribly you've got no budget you know
you just eat whatever you can
may go such a long time without fiber
and nutrients for the microbes that the
many of the good guys just just die off
and find it hard to get going again
so there are these these scenarios but
um coming back to the fecal transplant
question it is highly effective for some
infectious diseases so 90 are cured with
a single transfusion if you've got
something called recurrent clostridium
difficile and it's an official treatment
now uh across across the US for that is
that an orally or did they go in
rectally and deposit at very specific
places in the it doesn't seem to matter
there's three different ways of giving
it you can have it through an endoscope
through in a nasal
you pass down through your nose into
your into your stomach and then put down
just below the stomach uh you can have
on colonoscopy
uh or you have it by mouth with these
dried
um capsules
uh which are acid resistant coats they
go through the stomach which
affectionately known as capsules
so gnarly the idea but all three of them
are eating that's yeah absolutely
well if you're that ill and you're going
to the toilet 30 times a day Fair uh you
you believe me you'll do anything so and
it's a 90 success rate with a single go
but
when they've looked at other diseases
it's been much more difficult to get an
improvement and the initial idea that
you could cure things like obesity with
these as trimmed to be a false Dawn
really hasn't happened and so it's only
other
the only other one that works really
well is another inflammatory condition
of the bowel called ulcerative colitis
and there you do get absolute remission
so it's a cure in about one in five
people
and can be dramatic but other conditions
as you said it some people get remission
but others do need multiple top-ups and
things like so it's proven much more
difficult than I think we thought it was
going to be maybe 10 years ago when the
first results came out so it could be
because we're all so different
and we're not matching the donor and the
recipient
to colonize it's a bit like a you know
doing blood blood transfusions or marrow
transfusions if you've got different
immune cells you know they might be
fighting it off so that's one reason
they they probably don't work so I think
it's still an evolving science
and it could still be
potentially beneficial if you find what
the key say 10 microbes are then you
could create them in probiotic pills and
um and give them so people a lot of
companies still working on it and
it is proved to be very useful in cancer
treatment as well
so that's that's one area that's really
big and so you know that's big source of
optimism in in in the cancer successes
really underscore how important the
microbiome is for your immune system and
all the new successes in cancer are due
to us
invigorating the immune system
and people with poor gut microbiomes and
poor diets do very badly on these
immunotherapy drugs
and
there are
um whereas if you've got good microbes
good healthy diet good plant-based diet
you're twice as likely to survive do you
have a quick way to describe what a good
microbiome looks like
it's one that has a lot a wide range of
different species
so that's what we call diversity
and it's also one that has a high rate
ratio of uh good healthy bugs compared
to unhealthy bugs and we is that a fair
breakdown or is it
um context specific so this bug is good
if you have uh you know this much
diversity and you're eating apples but
that bug is bad if you have low
diversity and you're eating McDonald's
fries but it's the same bug but in a
different setup or no there are just
some if you get them these are
problematic well what you said is true
for some bugs
there are some bugs that if if you live
in Africa are very healthy and they're
very unhealthy if you uh live in America
because of the foods you're in taking or
something we don't know the environment
the air animals the soil
um or that you know it's just different
the environment they're living in so
they're they can't cope with that
environment and they it's abnormal so
we've known that but
with in the Zoe study we've now got
these 50 000 gut microbiomes it's the
biggest study in the world and we've
we've got their diet data and we've got
the health data and so we've now worked
out a whole series of microbes that are
associated with uh healthy foods and
healthy Health outcomes and a whole
series of microbes that are associated
with junk Foods you know bad unhealthy
foods and unhealthy outcomes and
we know that these are common in most
people so we're excluding the rare ones
that you know we've all got the unique
ones to us but these are the common ones
and so using that score that's by far
the best predictor of what we think is a
healthy gut microbiome and it's an
evolving science so we've got bats based
on 50 000 but when we get to 500 000 it
might change and it it's probably
different between just Americans and
Brits be a subtle difference in some of
these we are seeing quite big
differences in in a few species just
even you know in what you think would be
similar diets and different similar
countries all right so let's go back to
what you need to eat in order to alter
your microbiome and one thing I want to
say very quickly
reading your book you said that kids
their microbiome is actually more you
didn't say plastic but I'll say plastic
more changeable than adults
I'd be very curious as to why and then I
want to get into the like what are the
specific things that the I I totally
understand there's no one size fits all
but I'd love to get a general sense of
eat like this
okay so kids the reason that flexible is
we're not we're not born with a complete
gut microbiome so we're born pretty much
sterile
and we acquire
our set of microbes our Colony we sort
of put it together like a jigsaw puzzle
in different ways after the birth
process
so and this happens to all male all
mammals
and so
the fact that the birth process is so
messy
and you've got blood and vaginal fluid
and poo and everything and it and the
baby's face is actually smeared in it is
actually for a reason
it was messy for a reason and that's the
way the microbes get into the into the
infant uh gut and they start to colonize
it and that's a crucial part of our
Evolution because you need those bugs in
there in order to break down the uh
complex sugars in breast milk
so and break them down so you can get
the nutrients from them so we've all had
to do that as babies acquire these uh
micros from this rather messy process
that you think would have been better
done by Evolution and that's the first
thing that happens and then once you get
the breast milk then you start to get
other microbes coming in from the skin
of your mother and the environment and
you slowly build up this more complex
set of gut microbes that become your
adult one
and you acquire them but it's it's a bit
of a random process and there is a lot
depending on your environment
and if you're born by cesarean section
you might have a completely different
early set of microbes they end up being
quite similar but
the first year or two they'll be quite
different I've heard there's a link
between cesarean births and autism that
may be tied to microbiome
that something you've heard something
makes sense I think that I've heard it I
think the evidence is fairly weak the
evidence is stronger for increased rate
of allergies
and increased rate of childhood obesity
hmm in cesarean birth kids
and that's even when you adjust for
breastfeeding
so the worst case scenario for your gut
microbiome is to have a cesarean birth
and then you're bottle fed
you're not getting anything like the
natural microbes into your system you
don't have the complexity that play has
an effect on your your growing immune
system and
is literally one reason why we have this
epidemic of food allergy Etc because
very high rates of cesarean section now
and over sterilization of the whole
birth process
so that the baby is not
getting the same microbes they would be
that our ancestor baby's got
surrounded by animals in dirt and the
way that you know we probably performed
a microbiome much quicker
than sort of Western babies
so I think it's
Evolution would just become a bit too
smart but too clean but too sterile and
of course
other problems a lot of babies and given
antibiotics and the mother is given
antibiotics
mothers generally get antibiotics at the
time of cesarean section that those
antibiotics go into the baby another
reason that uh
you know they have a bad start to life
so
um those first few years are really
quite flexible and every time a baby
gets a virus or an infection it can
really
change totally the um
the microbiome
uh
composition
because you remember the first few years
the baby is protected from the ma by the
mother's immune system so it doesn't
need a fully functioning one so it's got
a time to get its own act together and
so by the age of four then it's more
stable and that's more or less what you
take into adult life
it doesn't tend to change dramatically
you sort of
you've got that form formative years but
clearly if those years are you're being
pumped with antibiotics you're having
all kinds of sterilization problems you
know you're kept in a a nice Urban
bubble
it's not going to be good for you
because you're not going to have the
same range of microbes that
um a healthy kid
might have in a developing country where
you know they're much more exposed to
things right so if I had a baby and at
like day one I was like
Tim I gotta bounce for just like a year
I'll be right back if you could what
would you do with my kid to make sure
that when I got back they had a nice
robust immune system well I guess
specifically through the microbiome
so you're going to donate your baby to
me and let you borrow it for a year just
because you know I I need it I needed to
be tipped out of shape when I get back
okay well I'd be putting all kinds of
things in their mouth so when kids
grabbing the dirt in the grocery store
or whatever and then put their little
fist in their mouth that's a good thing
let them do it yeah so
um
when um
um they've done some studies when kids
drop a
um what's it called pacifier pacifier
yes
because spit the dummy but they're The
Pacifier
um when they drop on the floor they did
some studies that parents who put the
put it straight back into the mouth of
the baby had better gut microbes than
those that instantly sterilized oh yeah
it triggers every like sterilizing
desire I have so basically I would I
would have a an approach by you know I'd
keep things clean yeah you wash it but
you don't sterilize it all why wash it
then
well because you don't want to be giving
them infections necessarily you don't
mind small amounts of bacteria so it's
just quantity it's just the quantity
yeah I don't want to deliberately give
food poisoning to your baby right you
might be thank you they didn't survive
so but what I'm trying to figure out my
reaction stuff but I wouldn't be putting
every single bottle every single
pacifier into a sterile container I
wouldn't be using liquids I wouldn't be
sterilizing but all the surface which is
the time when the the dummy falls on the
floor it didn't hit the bad food
poisoning bacteria that's why I'm just
like uh like even with myself
I'm just going to sanitize I don't know
and maybe I would pick up good bacteria
but maybe not
so I don't understand how a parent is
supposed to know that it's okay to pick
it up and put it back in their mouth but
at some point you need to wash it
because it could have picked up bad
bacteria
well I think you don't know for sure you
could have there's no such thing as 100
but you're just saying listen this is
how our ancestors you know how or
probably you know even people born
before me were brought up and we have a
more robust immune system than the
people who are brought up in this
sterile sort of Nanny state where you
know everything's swabbed and cleaned
and screwed up and died a lot more uh
yeah
yes but not uh but they had much more
robust
immune system so that it wasn't allergy
and the all these food allergies are
completely new
uh in the last 50 years when I went to
school no kid had a food allergy in my
school can I run a hypothesis by you
that you're probably going to hate but I
think might be true
I think you have to let things be a
little dangerous and I think that for
the greater good you have to let kids be
in a situation where some of them are
going to die but the ones that live
they're going to be better off and that
once you try to save every single one of
them you get the problems that we see
today that sounds terrible when I say it
out loud but I that seems true to me
in general I agree I think
um
doing things to have to save a one in
million chance of something happening
because we're gonna remember you know
anyone listening it is incredibly rare
if you dropped a pacifier on the floor
and you put it back in your kid's mouth
that they're gonna die of food poisoning
right
I I've never heard of a case so I don't
say it doesn't happen but it just
incredibly rare and the chances are that
by doing that you're going to actually
protect them against many disease when
they get older improve their immune
system build them up is far greater it's
like people they've done studies of
people who have dogs in the house
smelly dogs are coming in Licking the
babies and kids those kids are healthier
they have better gut microbes and the
family is generally healthier with you
know these other dirty microbes in the
house so it's it's in it's it's changing
that House's environment from the
sterile place to one that is more
natural to us where we wanted as many
bugs in us so that we can train our
immune systems properly to defend itself
and know when it's a real threat or a
fake threat so it's not going to get
upset about when we eat peanuts uh which
is a recent phenomenon peanut allergy
and it's gonna but it is going to react
against uh you know cholera or
salmonella you know properly so I think
it's this training of our gut microbes
that we we need to reinstill and eating
real food is a part of that as well so
yes there's the environment but also
the idea of weaning kids early onto real
foods
and uh playing with food and playing
with vegetables uh even if there's some
dirt on them
it should be part of every every kid's
repertoire is that true even if you
bought the food from the grocery store
because I'm always conflicted I want to
get the microbes and I'm worried about
pesticides well you for a young kid I
would if you've got the money I would
buy organic because you will get some
pesticides on it but you get a
10 to 20 so 80 80 less than you would in
a non-organic product so if you're
particularly keen on fresh vegetables
definitely worth doing that for your kid
um but it's you know it's
I think it's just
moving away from those sterile cans of
uh pre-treated Ultra processed foods
baby foods and exist to to actual real
foods and getting them to play with
their hands and things so that they are
they're just constantly
ingesting foods and um and playing with
the environment and and not worrying
about them getting dirty does this apply
for adults as well like should I be
touching more things dirty surfaces
licking my fingers and not I am captain
paranoia so I haven't been sick since
February of 2020 so I realized that when
covid kicked off I just elevated my
level of paranoia to uh 11 and I haven't
dialed it back down and I still I
haven't gotten covet haven't had a cold
nothing and I used to get at least one
cold every year for sure but now my
vigilance is just on another level I've
destroyed the speaker phones on two
iPhones because I sanitize them if I go
out and about as soon as I come home I
sanitize my phone Santa's has my hands
wash my hands like and it's been
effective in terms of me not getting
sick but am I now cruising for a
bruising as I get older and it's like my
my immune system has been been allowed
to get lazy or like how does this play
out in the long run
the honest answer is we don't know
um
I was like you I I used to get colds all
the time
covered marvelous no colds no sinusitis
nothing and you know
but two weeks ago I got a cold I said oh
no it's Dreadful
um
but uh I think I have to look at your
gut microbes to to tell if you had
really good looking healthy gut microbes
I say you don't have to worry too much
um but at the same time
you know there's a difference between it
going out and you know you
going on the subway in New York
or you're going for a walk in the park
in the woods
uh playing with dirt playing with
animals
so I think we have to be sensible about
what the threats are
you know you don't want a respiratory
virus so going you know getting close to
people
um breathing on you you don't know that
could be infected that's a reasonable
precaution
but uh worrying about our natural
environment that's not a natural thing
to do you should yeah you don't have to
be near people but you should be quite
happy with animals and uh space and dirt
and if you are too sterile I think you
will run into problems if you're not
exposed to that because you your immune
system does need a stimulus I know of
a lot of medical colleagues who from
India and
they say that they have to go back every
six months to eat Street Food
in order to stop being ill
because they once went a few years
without going and every time they went
back home they got ill use it or lose it
but exactly so they had to go and have
some you know slightly polluted uh bit
of fruit
and it kept them their defenses uh ready
you know so they they I remember going
of course they're horrified as they go
you know some grubby looking Fruit Stand
in India and uh picking some breadfruit
and eating it I said no I'm fine you
know I'll be okay now that's so
interesting but that makes sense I get
it okay so we're probably not going to
go straight to street vendor food in
India but what should we be eating to
get diversity so in the beginning we
talked about the structure of food so
this all started with calories the
calories not a calorie there's something
far more complicated going on here uh we
know that it's not as simple as you can
devastate your microbiome and then just
eat your way back but eating your way
back not over sterilizing those are
probably other than uh fecal microbial
transplant those are our options so how
do we eat well for our microbiome
okay well the rule one is eat a
diversity of whole plants
and if you could snap your fingers and
not for ethical reasons but if you could
snap your fingers
to for people to feel better or live
longer or all that would it would we all
be vegan
I think we'd all be vegetarian
I don't think the evidence is out
that Dairy makes such a big difference
and in the studies
uh the early citizen science studies we
did the American gut and the British gut
projects we found that the sweet spot
for gut health measured by diversity was
30 different plants a week and it didn't
matter whether you're a a meat eater a
pescetarian a vegan or a vegetarian as
long as you got those on your plate
your gut was happy
so I think that's a really important
point that we don't get too obsessed
with these sort of religious categories
of eating
and realize that what is the really good
thing about this
and focus on those good things and and
there are many different ways you can
achieve that I think that's really
important and
and it's not as hard as we think because
a plant is every different type of nut
every different type of seed herb it's a
difference between a purple sprouting
broccoli and a normal broccoli purple
carrot an orange carrot have different
chemicals so they're all
giving nutrients to different microbes
so they will you'll get a greater range
of microbes feeding off them that's
that's
the important thing and going back to
the question you asked me ages ago it
had an answer was about structure
these are all Whole Foods so they are
structured completely differently to
ultra processed food so that
you're getting all the the structures of
that plant you're getting the fiber
you're getting all the nutrients and all
the layers of the plant and
the calorie is is the energy is not
going in fast the body so
um it's going to release slowly most of
it will get to the lower intestine where
the microbes are it's not if it was
refined and in poor structure same
calories it would have a very different
effect because it'd be released straight
into the bloodstream so whole structure
is im