Transcription
Get ready for a microbiome master class today because we are talking about optimizing your gut health right here on the Exam Room.
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Welcome to the Exam Room Live, brought to you by the Physicians Committee. Hello, I'm the weight loss champion, Chuck Carroll. Thank you so very much for watching and downloading in more than 10050 countries around the world and making the Exam Room one of the most consumed nutrition podcasts anywhere on the planet. Today, indeed, the microbiome is the topic du jour. Today, we're talking about how to optimize the microbiome. How do you do it? Does it all come down to food, or do diet and exercise and stress play a role too? All of that on tap, plus foods that heal, foods that harm, restoring the microbiome after antibiotics, and questions from Exam Roomies. And with the answers that we seek is a man whose favorite show is indeed Howdy Doody. And follow his advice, and you'll be saying, "I'm a new me," because he will transform your bowels from being like the rock to turn you into a stone-cold bathroom stunner. His T-shirt, if he had one, would read, "Fiber 314, because I just dropped a deuce." He is a number two time New York Times bestselling author, a friend of yours, a friend of mine, the Pharaoh of Fiber, the Master of the Microbiome, the one, the only, Dr. Will Boltz. Welcome back to the show, sir.
Hello, Chuck. I need to catch my breath after that one. I think that like, in the beginning, I wasn't, I was like, "Oh, I don't know, Chuck. Howdy Doody? I'm not really sure." But then when you got to the stone-cold stunner, you got me. You win. I was particularly proud of the "Fiber 314, I just dropped a deuce" thing. I think that's, that's so good. That's so good. And if you know, you know. Anyway, let's talk about mastering the microbiome, my wrestling friend. Number one, how important, overall, for those who haven't been watching our episodes recently, how important is it to have a healthy, well-balanced microbiome in terms of overall health?
I mean, I think it's critically important, right? And it's not this thing that exists in isolation, separate from the rest of your body. But I think that the, the key story here, what we have been learning over the course of the last 10 years or so, maybe a little bit longer, is that these microbes that are, um, not even human, are absolutely essential to our health. And they sit there, right there, in the gut, which is the interface between our body and the outside world. And the food that we invite into our body is manipulated and transformed by these microbes to release bioactive chemicals that will then spread out throughout the body and have either healing or inflammatory effects. And so, ultimately, what we want is, we want to build a gut microbiome that powers our health. And when it comes to powering our health, Chuck, it's not just digestion. I mean, as a gastroenterologist, I'm convinced that people that have digestive health problems, there is a gut microbiome issue to be dealt with. But it's not just digestive health, it's also our immune system, our metabolism, our hormones, our mood, and even the way that our brain functions. So, we're talking about many different facets of human health that you may not think are connected back to the gut, and yet, here we are, and the science is telling us the gut is connected to every single one of these things that I just mentioned.
All right, now, we know that the average person probably isn't leading the healthiest lifestyle, eating the standard diet, lots of fat, lots of calories, uh, lots of ultra-processed food. So, my question then would be, how long does it take to optimize that microbiome, bring everything back into balance? Can you give us the worst and the best-case scenarios?
Yeah, I can. But I think I want to start by saying this, that optimization of the gut microbiome is a lifelong endeavor. And it's more than just what you eat. And our job is to normalize patterns within our life that will foster better health. And a big part of how they foster better health is by changing our microbiome, which, by the way, I'm not going to unpack the entirety of that right now because that's what we're going to discuss during the course of our conversation today, is different ways in which we can manipulate the microbiome to be more healthy. But my point is, what you eat, and how you move, and your sleep, those are related to your physical health. But also, let's not forget that there are elements of our emotional health, and there's elements of our spiritual health. And all of these different things ultimately feed into our gut microbiome, which becomes this command center for human health.
All right, now, now that I got that out of the way, to answer your question, Chuck, it depends. Like, to me, what I want is a gut microbiome that is not functioning properly to be transformed into a gut microbiome that is functioning properly. That doesn't necessarily mean optimized, that just means no longer dysfunctional. But as a gastroenterologist, I would love to take my patients who have Irritable Bowel Syndrome and make them symptom-free. I would love to take my patients who have Ulcerative Colitis or Crohn's disease and put them into remission and make it so that they don't have inflammation in their gut anymore. And how long that takes is dependent on the individual person. I'm of the belief, Chuck, that, so first of all, the choices that we make today will be reflected in our microbiome by tomorrow. One week of dietary change will start to really change the microbiome. Four weeks, to me, is the sweet spot because I'm of the belief that during the course of four weeks, we can really make a, a big impact on our gut. But that is not to say that a person who has complex inflammatory bowel disease should do a four-week program and expect their disease to be in remission. That's not the way that it works. For those people, because of the depths of their dysbiosis, meaning a damaged gut, because of the depths of their dysbiosis, it will take longer, certainly longer than four weeks. And for them, it can be on the order of months, potentially even over a year. The point from my perspective is, let's start to make the choices and make the changes that are transformative. Here we are in January, it's the perfect time for us to be doing this. Small choices really add up when you do them consistently, and they will transform your gut over the course of time. And I, you know, I'll just say this, Chuck, that like, for me, when I made my dietary change years ago, which I wrote about in my books, and people, everyone's heard me talk about this, when I made those changes, it wasn't a month later that I was a totally different person. We're talking about years, years of transformation, right? To get me to the place that I am today, where I feel really good, and I'm in my mid-40s, for sure. Man.
Now, let's talk about the person who is fired up, they're ready to put in that work. What does the process of starting then to optimize the microbiome look like? What are those first steps somebody should be taking?
Well, you have options. There are options on the table. And what I would propose, if we're, you know, if we're looking at this as like, "Hey, it's January, people are motivated, what are we going to do?" Okay, let's focus on making the choice that you are excited about and are willing to sustain, willing to do. Because if we can lock that in and make it consistent, it will transform your health. So, if we're talking about food, choose the food that's plant-based. We'll talk more about that. But let's talk, let's just say, choose the food that is plant-based that makes your mouth water. Start there. One meal. Enjoy it. If you don't enjoy it, find a different one. But try it. And then, if you love it, bring it back next week and continue to build from there, right? But also, there's ways to transform our health without even wielding a fork. It could be as simple as taking a 30-minute walk in the morning. It could be as simple as maintaining a consistent bedtime, right? These things really can be transformative for us.
Can you give us a 90-second nerd out and tell us how the microbiome is influenced by that walk in 90 seconds or less? Because I'm sure there's a lot of mechanics that go in there, and we can talk deep science here, but let's try to be succinct.
Sure. All right, so 90 seconds on how an outdoor walk. So, a few things. Number one, exercise, um, forces an adaptation on our gut microbes. So, they are a product of their environment, and we create that environment. We have the ability, through all of our choices that we make during the course of a day, to create the environment. So, if you are a sedentary person, you will have a gut microbiome that is adapted to be sedentary. And if you get up and move, your body is going to basically send clues to the gut microbiome of what it needs in order to perform better, and your gut microbes will provide. So, quick example, Chuck, they did this study among people who were marathon runners and they asked the question, "What's unique about their gut microbiome?" And they found this one specific bacteria called *Veillonella*. And it was fascinating is that *Veillonella*, which was really powerfully represented in marathon runners, distance runners, is a microbe that helps us to process and break down lactic acid, which is what causes muscle fatigue. The microbes were contributing to your ability to be an endurance runner. But there's other microbes that benefit us if we're powerlifters, if we're doing strength-based exercises. All right, so that's exercise. And then, real quick, in terms of the getting outside, outdoor sunlight exposure to sunlight has a number of different health benefits for us, including creating vitamin D. But part of it is also, when we do this in the morning, it reflects off the back of our retina and it sets our circadian rhythm. And it teaches our body, this is when our day starts. You will be more energized, your mind will be sharper and more powerful as a result of taking a walk in the morning. But then, 14 hours later, you will be ready to go to bed because you have taught your body, here's when the day starts, and 14 hours later, that's when the day ends.
That's wild to me that the body is as smart as it is that it can, in the case of the marathon runners, tap into that specific, specific bacteria that breaks down lactic acid. Like, doesn't it still blow your mind just how incredibly powerful and smart this machine, machine that we call our body, actually is? And I was not a science guy growing up, but what you just said, like, blows my mind, man.
Well, there's, there's adaptations that occur throughout our entire body. And I, I think that like, science, the science of the '90s and early 2000s was to say things like, "Hey, look, when you're a distance runner, your heart gets more efficient. You squeeze more blood with every pump. It doesn't have to beat as fast." Right? Like that's the adaptation that people saw in someone who's an endurance runner. But now, what we're starting to see is, like, for the first time, because of new testing, we're opening up our minds to what's happening with these gut microbes, and we're discovering there's adaptation there too.
All right, let's go ahead and open up the doctor's mailbag. I want to grab a question from Angela. Uh, talked a little bit about the other factors beyond diet, and we will be tapping more into diet here in just a moment. But Angela's got a good question. We haven't yet talked about stress, and she's wondering what role that can play in how the microbiome develops in our gut.
Yeah, so I mentioned a moment ago, physical health, emotional health, spiritual health, all of these things play a role in how we feel and manifest ultimately in our gut. Think about the idea of having to go up, if you're someone who's not comfortable with public speaking, how you feel in that moment before you have to go and hit the stage and deliver a message to a group of people. Stressed. And then you manifest it here, right? And there's a reason why this is happening. Activation of the stress response, um, through the sympathetic nervous system, releases a hormone from our brain called CRH, corticotropin-releasing hormone. And this CRH is basically designed for our body to be like, turned into flight, fight, or flight mode, turned into stress mode. If we're under attack, we're ready to defend, we're ready to go, we're hyper-alert. And there's a compromise. There's always a compromise. And the compromise is your gut. And so, the result is damage to the gut. And damage to the gut translates into activation of the immune system, which creates inflammation. And this is the way in which stress affects our gut. Stress affects our immune system. And many of you can think of, like, examples from your own life where you're stressed, and then you get a cold, right? Things like this. Perfect example. I, I don't know a single person who that hasn't happened to.
Let's take a question from Jennifer. For as we dip into the food here, so give us, uh, the good and the bad here. Let's start with the good. What foods have the greatest impact on gut microbiome?
Well, the, the beautiful thing is, I wrote a book, and you can see it right behind me here, um, called *Fiber Fueled*. And the reason why I called it that is because I wanted to celebrate fiber, which is a part of plant-based foods. Plant-based foods have fiber, and polyphenols, and phytochemicals, and resistant starches. And these are things that you will only find in plant-based foods. So, if you want them, that's what you need to eat. And the beauty of it is that these things that I've just described are things that shape the microbiome. And a big part of the reason why they so powerfully shape the microbiome is because we don't have the enzymes to digest them. So, ultimately, these, uh, these plant-based nutrients come into contact with our gut microbes, and that results in transformation.
So, let's talk about the bad then. Automatically speaking, if fiber is exclusively found in plant foods, does that mean that virtually everything else then becomes the dietary enemy, so to speak?
On some level, I mean, I don't, I, I think that the idea of like, being very black and white about nutrition isn't really the right way to handle it, right? So, like, I don't think that it's like, all plant-based foods are automatically super healthy, and all animal-based foods are automatically completely unhealthy. There's a spectrum. There's a spectrum that exists. Um, now, that being said, like, if we talk about something that, like, you see in your supermarket, and the box says "plant-based," and it's an ultra-processed food, keep in mind, ultra-processed foods could be vegan, could have the label "plant-based," and definitely not be healthy because they can contain additives that are completely unnatural. They're chemicals manufactured at a chemical plant, didn't exist for your great-grandparents a hundred years ago, and here they are, and they're a profound part of our dietary, of our food system, right? So, we have to be conscious of that. The ultra-processed foods. And then, um, when it comes to animal products, again, I believe that there is a spectrum. So, it's not fair to just categorically pretend that they're all the same and they're all categorically bad. But in general, you give me the choice, any, any animal-based food and compare it to a person eating more beans, I would take more beans.
You would? The king of fiber would take more beans? I'm shocked and amazed, my friend. Shocked and amazed.
All right, uh, Mary's looking for some specifics. She says, "All right, boys, you're doing good, but which fruits are best for promoting a healthy and diverse gut microbiome?" Here, so let's talk fruit specifically.
Yeah, so, you know, there's certain specific nutrients that we can find in plant-based foods. I mentioned these earlier, and they do include fiber, and they also include polyphenols. Polyphenols are what give plants really bright colors. And so, when I think about like, which fruits I would naturally gravitate towards, first of all, above all of them, but second of all, I'm looking for the ones that have that color that's so rich that it's going to stain your cutting board. So, immediately, what comes to mind is a pomegranate, right? A pomegranate, because it's so densely packed with polyphenols, and those polyphenols are going to make their way down to your gut microbes, transform your gut microbes, allow your gut microbes to do their job better, repair and restore the gut barrier, reduce inflammation. That's what we're going to see. So, I love pomegranates. I love other bright, colorful foods. I love berries. Raspberries are a personal favorite. They're very high in fiber and simultaneously, um, high in polyphenols. Chuck, what do you like?
I would have thought, for sure, you'd say there would have been the kiwi, given, you know, the *Fiber Fueled* book and the kiwi logo and the affinity with which you've talked about the kiwi, uh, but man, I'm, I'm huge on berries. Frozen blueberries are a staple for me with breakfast. If I'm having hot oatmeal, frozen blueberries are going on top of that. If I'm having a bowl of cereal, frozen blueberries are going on top of that. You know, if I'm making ice cream, sometimes I'll add frozen blueberries on top of that, not even mix them in. I absolutely love the blueberry. Love mangoes, probably get that from our buddy Cyrus Khambatta. I love bananas. Like, I don't know, honestly, that there's a fruit out there that I don't enjoy. I guess I kind of fall into the same bucket as you in that regard, man. They're, they're all kind of sweet and delicious in their own unique way.
There's so many, and I, I, uh, I completely agree with your choices. And, you know, what, you're right, like kiwi, I should have mentioned kiwi. And, and, and being on the spot, I didn't. But kiwis contain fiber. There's a unique type of fiber that actually really sort of expands, um, it, it sort of absorbs a lot of water, and so it's very good for addressing constipation. This is why kiwi fruit is so good for constipation. And kiwis also contain polyphenols and unique enzymes. You can almost taste those enzymes because there's a spice to them that help you to process and digest your protein. Blueberries, I'm a huge fan of the color blue, that deep blue that will stain anything, right? Um, those are, that's from anthocyanins. And anthocyanins are a type of polyphenol that is known to have benefits in terms of our cognitive health, in terms of our brain health. So, you, you're rattling off a whole bunch of stuff that I love, Chuck. But you, you know what? There is one that comes to mind. I love the flavor, but if somebody could tell me how to eat blackberries without getting the seeds stuck in your teeth, I would be all ears to that. Those things, I love them to death, but the seeds, they just drive me up the wall.
Kimberly, as long as we're talking about fruit and natural sugar, Kimberly is wondering, how does refined sugar consumption affect the balance of gut bacteria compared to the natural sugar that is found in the fruit that we're talking about?
Oh, excellent question, Kimberly. Thank you. Um, so, I, like, to me, I would completely separate these things. Because when we talk about sugar that naturally exists in food, it, it's not like just floating sugar out there that's going to spike you, like spike your blood sugar like this. It exists within what we call the food matrix. So, the food matrix is the actual structure of the food. The structure of the food is complex. This is why you're forced to chew before you can swallow, right? And you may be disrupting that food matrix a little bit, but it still continues to exist even after you swallow it. And there's fiber in there and other elements that are allowing to maintain balance with the natural sweetness and sugars that exist within our fruit, which is very different than if you take something and you sprinkle some sugar on top of it. That's wholly unnatural. That is not the way that it exists in nature. Like, nature didn't prepare granulated sugar for us. We have to at least take a plant and do something to extract the sugar from it. So, in a way, we are creating something that's rather unnatural when we do this, Chuck. And it's gonna, it's gonna spike our blood sugar and create issues for us. And so, I, you know, one of my big things when it comes to gut health, since we're on the topic of like, gut health, one of my big things, particularly for people that are trying to reduce inflammation or trying to lose weight, is don't worry about naturally occurring sugars in whole foods, but do worry about added sugar. Like, look at products and make sure that there's no added sugar whenever possible.
Let me ask you this, as long as we're talking about sugar and, uh, let's pivot over to blood sugar levels. Have there been any studies on the microbiome composition of somebody living with diabetes versus somebody who has not? What's the difference between the two?
Oh, tons of studies. I mean, a person who has diabetes, particularly type two diabetes, but also type one, because type one is an autoimmune disease, right? So, type, type one, uh, diabetes does result from inappropriate activation of the immune system against yourself. But in both cases, what we see, not exactly the same, but what we see is basically loss of diversity within the gut and dysbiosis. There's damage to the gut microbiome that exists in both places. Now, type two diabetes is a little bit different because, by definition, it is the result of insulin resistance. And insulin resistance actually has very strong motivations in the gut. I mean, if you, if you were to take a look at a person's blood sugar response to food, it's, first of all, highly individualized. We could give the exact same food to a hundred different people, we would see very different results in terms of how that happens. And the interesting thing is, like, many of us would say, "Oh, well, that's genetic, runs in my family, that's the way it is." But actually, if you look at the data, that's not really the truth. That actually our blood sugar response after a meal, and particularly our insulin response, how much insulin we release to control our blood sugar, is actually the result of our gut microbiome in a quite powerful way. So, there are these interconnections that exist where when we manifest disease, there is, um, damage to the gut microbiome. But part of the reason why there's damage to the microbiome is not just from the disease, it is a two-way street. But it also, it's also that the, the damaged gut microbiome is what's actually propelling the disease.
All right, uh, let's talk about a specific fruit here before we pivot over to vegetables. Barbara is wondering whether bananas can be effective as a prebiotic for gut health. I have not heard this before.
They can. But they, but you have to, um, think about the life cycle of a banana, right? It goes from green to yellow to brown. As this happens, it gets softer and it gets sweeter, right? So, what we're seeing is what initially is a resistant starch in the green banana that's being broken down with, uh, plant enzymes to create sugar that exists within the banana. So, if you were to skew towards those green bananas, which, by the way, are hard, they're very firm, they're not very sweet, but if you were to skew towards those green bananas, they would contain resistant starch that is actually going to feed and fuel your gut microbiome in the exact same way that fiber does. So, now, does that mean that I'm telling people to like, crack a green banana? No. But what I am telling people is, my preference would be that there's still some green on the banana when you eat it, as opposed to it being brown. Like, I would rather do it early than than late. And what I'm also telling people is that you have the opportunity to throw that into your blender as a part of your smoothie. If you're going to put a banana into the blender for your smoothie, let it be closer to green than it is to brown.
Yep, see, that's a good pro tip. I don't like eating a green banana, just not quite as sweet, even leaves a little bit of a film in my mouth. I feel like, I don't know, maybe I'm overanalyzing the banana. But the bottom line is, I think putting it in the smoothie is a great, great, great idea.
Speaking of things that are green, as we pivot over to vegetables, Linda's question, how do leafy greens like spinach and kale impact gut bacteria?
Well, the beauty of these leafy greens is that when I, when I think of greens, I think of free nutrition because, like, basically what I'm saying is there's almost no calories. You could eat an entire pound of greens, which would make you go crazy because you'd be chewing all day, and, um, and that has 100 calories. So, but yet, these are the most nutrient-dense foods that exist. They're so densely packed with vitamins, minerals, different plant-based nutrients. Um, kale specifically is, uh, is part of a family of plant-based foods that actually have cancer-fighting properties. And arugula would be in that same family, along with broccoli, broccoli sprouts, um, Brussels sprouts, things like like this, the cruciferous vegetables. So, whereas spinach, like spinach is very easy for people to eat. This is why we love it. Um, and it is a good source of iron. So, like, from my perspective, these are beneficial foods. They do contain fiber, they contain other plant-based nutrients, and therefore they're good for a good microbiome.
All right, Don is wondering, kind of the same question about garlic. Is there something special about garlic that makes it really healthy in terms of building back better microbiome?
Yeah, um, so there's a few things. So, these, this category, garlic, onions, shallots, they contain, um, a significant amount of fiber. They also have things called fructans, and fructans are prebiotic and good for a microbiome. So, what I've just described is two different types of prebiotic. They're kind of close to each other, they're like cousins, but, um, they're feeding and fueling your microbiome. And then, in addition to this, you have sulfur-based compounds, sulfur-based chemicals that naturally exist within the, uh, allium vegetable family that includes all of these, that are, um, actually antiviral and have, um, effects in terms of healing, or rather, shaping our gut microbiome. So, we have the prebiotics that are benefiting the good bacteria, and simultaneously, we have these sulfur-based compounds that are helping to suppress the pathogenic microbes. And this is, you know, this is a big part of the reason why, uh, they're so good for our metabolism, they're so good for us in terms of our cardiac health, and they also protect us from cancer.
We were talking about beans a little bit ago, and William chimed in. Ah, that name sounds familiar. Uh, what role do legumes play in feeding beneficial gut bacteria? What is the specific mechanism in beans that make the gut sing, my friend?
Well, the mechanism, the mechanism is very straightforward, which is that these are the most fiber-rich, resistant starch-rich foods that exist. And they have polyphenols as well. So, there's three major classes of prebiotics, and you find all three of them reflected in legumes, and densely packed. And this is the reason why, like, bear in mind, when a person eats beans and then they get gassy and bloated, right? That gas is the result of microbial fermentation because you have loaded up with prebiotics in a way that your gut microbiome is not typically used to trying to process and unpack. So, it's a bit overwhelmed. But if you were to eat those beans on a regular basis, you would actually find that you don't really get gassy and bloated at all. So, a quick example, Chuck, something that I've been kind of enjoying recently is, I will take a can of soup, like a minestrone, for example, and I'll take this can of soup and I'll add an entire can of chickpeas. And that's my lunch. And I feel awesome. I feel satiated, right? I feel satiated and I feel strong and white and sharp, and I don't need a nap in the afternoon. And, um, I actually feel like on those days, my body is thriving. So, this is something I've been doing quite a bit lately.
That's pretty good, especially during the cold winter months. That's a nice hearty soup right there. That's well played, sir.
Yeah, that's well, well played. Uh, all right, let's take a question from James, who I think a lot of people wonder about. I know that we get this question with virtually every episode that we do. He's wondering whether it's even possible to restore the microbiome after taking long-term antibiotics. So, you're not just on it for a short 5 to 7 day or even a 10-day course, but somebody who is on them consistently, what can they do?
Well, I mean, there's, in fairness, like, I would, I would love, I would love to say that every, every single person gets all the microbes back. That's not true. Um, the way that we think about this currently is that antibiotics effectively create a scar. So, in the same way, like, when I was a kid, I fell off my bike, I got a scar. I got a big scar on my leg. It's kind of cool. I'll show it to you sometime, Chuck. Um, and seriously, it was, I, I did the coolest, like, I was like blasting down this hill, and there's a ramp at the bottom of the hill, and I got major hang time. But the problem is that I lost control, went flying over the handlebars, and my bike landed on top of me. And landing, man, the landings will get you every time, won't they? It was not fun. It was not fun. So, anyway, but now I got a scar story, right? Now I got a scar story. And but in the same way that a scar forms and it's there and it's lifelong, a scar forms in the gut microbiome when we take antibiotics. And the longer that we take antibiotics, the more that that scar is going to be a big scar, and it's going to be deep. So, and there is some evidence to suggest that we can potentially take antibiotics to the point of losing species permanently. So, we have to, we have to call it what it is. That being said, there are opportunities to bounce back our gut. There are opportunities to add new microbes, to add diversity. An example of this is fermented food, right? So, if you commit to the process, you are not lost or hopeless in any way, right? You're not where you want to be, but we can work on this. And with consistency, we can get you to a place where you are where you want to be. The beauty of the microbiome is that it's, I have never heard of a gut microbiome that it wasn't possible for us to heal it. It's always possible.
I love that, man. That's, that's a bomb-diggity quote right there. That's the one I'm walking away with today. Uh, let's grab two more and then I want to ask you about an interesting study that just dropped. But, uh, first, from Deborah, how does age affect the gut microbiome, and what can be done to help maintain a good, healthy gut balance over time?
So, our gut microbiome could be used potentially as a marker of age. It does evolve as we age, and and generally, what we see is as people age, they lose gut diversity. They lose diversity within their gut. Now, why would that be? Well, part of this is that we get into specific patterns. We like these specific meals, these specific foods, and we never disrupt that, right? Our, I wrote about this in in both of my books, that our food system is designed to feed us like the basic same ingredients time after time after time. And our food system is not going to give you diversity within your diet. You have to be the one to make the choice to do that. So, as we age, if we get into sort of, if we become creatures of habit and we eat the same things all the time, it will affect our gut diversity. Um, the other thing is, like, obviously, there's other things that can happen, particularly as we age into our, into our senior years, where, like, poor dentition may affect our ability to chew our food. And obviously, eating a salad requires our ability to chew unless you blend it up into a smoothie. So, that those types of things can affect us. Or if we're living in a, um, uh, facility for, you know, retired, retired seniors or something of this variety, like, they may have a kitchen, and the kitchen serving you whatever they're serving you. And, yeah, they have a salad bar with iceberg lettuce and like a tomato, and that's your salad, right? That's not diversity. So, the, the key from my perspective, though, is that the gut microbiome throughout our entire life, no matter what age you are, whether you're 5 years old, whether you're 100 years old, is adapting to the choices that you make, including sleep, including moving your body, including your diet. And this is, to me, the reason why if you look at the Blue Zones and what Dan Buettner presents there, I can show you the science, right? I can show you the science that shows you that every single concept that you will hear Dan Buettner talk about in the Blue Zones, this is what they do. I'll show you the science that says, and that's how it affects your gut, and it's, and it's to your benefit. That could be a really fun show. Thanks for the idea. Let's see if we can't make that happen.
Uh, last question before we close up the mailbag comes to us from John, who is wondering about different types of fat. You know, there's a bunch out there, but he's wondering specifically about omega-3s and trans fats, and how they might affect gut health.
Yeah, I feel like the old way, I, I hope that we're moving forward from this. I feel like the old way was just to categorically vilify fat. Um, and it's funny because, like, plant-based people, we don't like it when people categorically vilify carbs, right? So, we shouldn't categorically vilify any macronutrient. We need all of them, and we just want to optimize the quality of our macronutrients. So, there's good carbs and bad carbs, we should eat the good ones. There's good fat, there's bad fat, we should eat the good fat. And so, if I were to, like, lay out a spectrum for you, Chuck, the way that I would lay it out is like this: I would put trans fats as the absolute worst. Trans fats are the most inflammatory fats that exist, worse than saturated fats. And then I would do saturated fats after that. And then after that, I would do, um, excessive amounts of omega-6 polyunsaturated fats. Now, not to, like, get into the big debate that exists, we don't want to spend too much time on this, but when people replace saturated fat with omega-6 polyunsaturated fats, they have less inflammation. This is why the American Health Association, American Heart Association, is on board with omega-6s. I'm not arguing for more omega-6s, we get plenty. I'm arguing for less. I'm just saying it's better than saturated fat. And then after that, I would do, now we're getting into what I really want you to try to get more of, which are the monounsaturated fats, which is what you find, for example, in olives and olive oil and avocados. And above all else, at the absolute pinnacle, are omega-3 fats. All, all omega-3 fats come from plants. All of them. So, if you're eating something because you want to get more omega-3s, just know the omega-3s didn't come from that thing, that thing was storing the omega-3s. All omega-3s come from plants.
There it is. So, is it, I mean, this is a simplistic way of looking at it, but could we look at it and say, well, the trans fats, they go in there and they just destroy the healthy microbiome, but the, the healthier fats that you were talking about, the omega-3s, they go in there and they restore that?
Yeah, I mean, there's actually, there's actually a highly compelling argument that omega-3 fats are prebiotic. Not in the ex, yeah, no, truly. Like, not in the exact same way that, um, that fiber is prebiotic, like, you don't create short-chain fatty acids from omega-3 fats. But what you do, very similar actually to what polyphenols do, is omega-3 fats will cause a shift within the microbiome towards a healthier profile. And that healthier profile will be designed to process, digest plant-based foods. And so, and that's a beautiful thing because basically, you're priming the pump so that when you do go to eat that, you know, that legume or that salad or that high-fiber thing, you actually are improving the efficiency of your gut microbiome of digesting it, and you're improving the efficiency of producing short-chain fatty acids, which are the anti-inflammatory compounds that we want.
Very interesting. Very interesting. All right, let's go ahead and close up that doctor's mailbag. If we didn't get to your question today, have no fear. We will do our best to get you an answer on an upcoming episode. And if you're watching on demand at a later date, no problem. Leave your question here. I promise you, we do go back and pick out the really good ones and, and do our best to get you the answer. Uh, now, Dr. B, a brand new study, hot off the press, as we do this show, looked at the gut microbiome composition of people eating a vegan diet, a vegetarian diet, and an omnivorous diet. What did those findings show?
Yeah, so I guess, just a matter of background on this, Chuck, real quick. This is actually a study done by my colleagues at Zoe. And it kind of started with me basically saying to them, "I think that there's something going on with the vegan microbiome, and we need to take a look at this closer." So, anyway, the, um, in this study, basically, what they showed is that our, our gut microbiome, first of all, is, um, clearly tied to our dietary pattern in a way where you could actually, these three groups, omnivore, vegetarian, and vegan, if you didn't tell me which one you were eating, but you showed me your gut microbiome, I could reliably predict based upon just your gut microbes which pattern of diet you have. So, in other words, your diet is reflected in your gut microbiome, and your gut microbiome tells me what you're eating.
All right, so, um, and and there were specific, as a result of this, like, that means that there's differences, like, there has to be differences that are distinct in order for us to be able to do something like that where we reliably predict what you're eating routinely. And basically, what they found is that there's things specific to plant-based foods that ultimately, the more that you're eating those plant-based foods, it will reinforce itself and be reflected in your gut microbiome. And what you will, will create, is an anti-inflammatory gut microbiome that's designed to basically, you know, uh, produce short-chain fatty acids that have healing effects throughout our entire body, right? So, the vegans, by nature, were consuming the most, the most plant-based foods, and as a result of this, they got the benefit of that, this anti-inflammatory gut microbiome. Vegetarians were along the spectrum. There were certain microbes that are specific to dairy products. An example of this is one called *Streptococcus thermophilus*. If you, if you've ever made yogurt at home, you've heard of *Streptococcus thermophilus* because that is the essential microbe for creating yogurt. And this was the one of the key microbes that was distinguishing people who ate, um, dairy foods, compared to people who were vegan. So, you could make that distinction. Now, the, the key with dairy is that when you consume dairy, you're not consuming plants, right? So, basically, you're taking up space within your diet that could, in theory, otherwise be more plants. So, vegetarians, on average, in this study, were consuming less plants than the people who were vegan. And this is part of the reason why you saw distinctions between the vegan microbiome and the, and the vegetarian microbiome. And people who were omnivores were eating even less plants, and they were consuming meat. And what they found is that meat, actually, in the same way that plants are tied to certain specific microbes, meat is tied to certain specific microbes. Part of this is the protein, the protein gets fermented by our microbiome. Part of this is the fat, the fat has an effect on our microbiome, specifically saturated fat. And also fat leads to the release of bile from our gallbladder that has an effect on our microbiome. So, there's a number of different ways that the consumption of meat impacts our microbiome. Red meat versus white meat had the same general effect. The difference is that that effect was more powerful in people that were eating a lot of red meat. So, red meat seems to impact the microbiome even more so than white meat does. Um, now, the microbes that people would get were things like *Alistipes*, *Proteus*, *Bacteroides*, or, um, *Bifidobacterium*. Okay. Two things that are interesting about this. Number one, these are the exact same microbes that were implicated 10 years ago in the study where they had people do an all-meat diet for five days. This is the exact, read the paper, Sonnenburg, David, Nature, 2014, is the exact same microbes. All right, so it's validation. Number two, these microbes continue to this day to be associated with concern for colorectal cancer and inflammatory diseases. All right, so you could have an anti-inflammatory microbiome, or you could have this microbiome that is skewing you towards something that you don't want. Um, now, the last point before, uh, we move on, Chuck, and I'm happy to answer any questions you have about the study if you like, but there was one thing, which is that the name that you gave, right? Like, basically, people were asked, "What, what's your dietary pattern?" And you answered one of these three. All right? But the name that you gave wasn't as predictive of the health of your microbiome as the food that you actually ate. So, in other words, if, in theory, a person who is eating an omnivorous diet was consuming more plant-based foods than the vegan who is eating a lot of ultra-processed foods, if that were the case, the person in the omnivorous diet would have, we would expect them to have a healthier microbiome than the vegan who's eating ultra-processed foods. So, what it boils down to is actually the measure is plant-based foods. The more plant-based foods that you eat, the healthier gut microbiome becomes as a result of that. And anything that gets rid of the ultra-processed, anything that gets rid of the plant-based foods, whether that be animal-based foods, or whether that be ultra-processed foods, that's going to skew you away from that, uh, beneficial microbiome.
Right, let's see if we can tie all of this together there and then look at this in terms of health, big picture. Let's say somebody has that healthy microbiome, the one that's got a lot of plant foods in there, a lot of diversity. What is their general health going to look like versus somebody who's not eating a whole lot of diversity or plant foods?
I mean, you mentioned the risk of colorectal cancer, but I would, I would assume that there's a whole lot more that we could go into here.
Yeah, I mean, there's, there's so many different factors here. But I do think that it's very interesting, Chuck, that like, this study basically aligns, you know, back in, I, I, to the spe, in 2014, this study by Lawrence David from Duke University, he put people on five days of a plant-based diet and five days of an animal-based diet, and like, literally, the exact same microbes were showing up on the two sides. So, these are, these are distinctly different foods that have different physiologic effects on our body, right? And ultimately, it's our choice, like, what do we want our diet to be made up of? And we're in this place where, you know, in the United States, we consume plenty of meat. Like, the average person is consuming more than their body weight in meat on a yearly basis. Um, and yet, like, the most popular diets right now are are ones that encourage us to eat even more meat. We're not deficient, we're not missing that, right? On the flip side, 95% of Americans are deficient in fiber. Fiber is a marker for plant-based food intake. 95% of Americans are deficient in this. This is what we're missing out on. And what the study is showing us is, if we would address that issue, regardless of what the label of your dietary pattern is, yeah, if you would address that issue, there's an opportunity for gut healing.
Do you think that we'll see a shift in terms of the popularity in meat, given the fact that the
Early dietary guideline recommendations that just came out seem to like, and not just seem to, they do say we need more plant protein and less meat in the diet. I think that's a complex question, Chuck, because I think that no, truly, because the issue is that like the world has changed substantially from where it was when you and I were kids, and the access to information is completely and totally different. And people have different ways in which they collect and receive information, including the internet, right? And social media, and they have certain sources that they prefer. And there's, um, increasing skepticism of certain institutions that were traditionally trusted. And like, that's an entire conversation of its own that has nothing to do with nutrition, but it is affecting the way in which people receive information, the fact that people feel that way. And so I, all I can say is this, that this is, this is the way that I feel because I, I like think about these things, Chu, right? I mean, I think about the fact that, you know, hey, there's a lot of people that aren't eating the way that I recommend, right? And, um, at the end of the day, like for me, this is not a popularity contest. This is, I am a medical, medical doctor, and my career has moved in a direction where my job is to try to help people to improve their health through a number of different avenues, and I'm going to speak with honesty, and that's just the way that it has to be. And if that's not popular, so be it. And maybe in five years, it will be popular, who cares? Because at the end of the day, if I'm not providing information that actually helps people to accomplish the goal that I want them to accomplish, then I wouldn't be able to look at myself in the mirror at night, you know?
So you've done a fantastic job of providing people a ton of information, uh, not just here on the show, but certainly on your website. I know that you've got the big microbiome Mastery course that's up right now at the plant-fed gut.com. I would imagine like today, maybe we just scratch the surface, but in your Mastery course, like talking about the ultra deep dive.
Well, you know, microbiome Mastery is to me, like, I, I love microbiome Mastery because this is a seriously, it's, it's a January thing, okay? This is a January thing where basically we convene a large group of us. I set a price point that is intentionally very, very, very low, trying to make it as accessible as possible so that people can come in. There's a big group of us and we're going to have some fun for three weeks. We're going to learn and we're going to create healthy habits. Like that's to me what January is about. It's not about doing something for 21 days and then going back to the way you used to be. It's about knowing the compass, knowing what direction you can go to transform your life. That's what microbiome Mastery is about. I used to have a, a challenge in the new year called, um, microbiome 21, and I did it, I think for two, two or three years, and, um, and it was great, and people had an awesome time. H, but I felt like, you know, with anything, you reach a point where you're like, dude, I want to do this over. Like, I wanna, I want a clean slate because I think we could make this so much better. And that's what microbiome Mastery is. So I changed the name. I have a brand new platform. We have a, a really cool community framework. We have more videos. We have more recipes. We have tons of new content. So the bottom line is that this is a great experience. Anyone who wants to join, you're still able to join if you want to just come to my website, the plant-fed gut.com, and, um, and you'll be able to get access to it. And again, we're going until, uh, the 24th or 25th of, of this month.
Thank you. And look, there's a link to the plant-fed gut.com in the show description, so go ahead and link off to that from right there. And listen, man, I cannot wait for March 7th in Miami. Number one, because as we're doing the show, I got a foot of snow outside my window and icicles hanging down from the shingles. Uh, but number two, this will be the first time you and I have ever done one of these fun shows together on stage in front of a live audience. And brother, nothing has me more pumped up than the idea of doing that with you.
Oh, dude, it's going to be so much fun. And I can't wait to get that crowd pumped in here, hear the crowd pop when we get up there, maybe get some dance moves going. We'll see what happens. And here's the deal, all right? I've been telling you that tickets are going on sale very soon. Here's the score. I now have a date for you. If you have already secured your tickets to Dr. Neil Barnard's Bon Voyage Bash, which is later that night, you will be receiving an email with the first crack at tickets to the podcast as well. So make sure that you have secured your tickets because these two events, they are intertwined, my friend. So the bash is later that night, the podcast kicks everything off, but you got to get your bash tickets first. Very limited seats. We are talking about very, very, very few seats. It's an intimate arena where you and I are going to be doing this, Dr. B. So very few seats. If you already have your tickets for the Bon Voyage Bash, you will be getting an email with the opportunity to purchase tickets. Everybody else, if you just want to come to the podcast, that's cool too. Those tickets, what's left, will be going on sale next week. All right? So say the week of January 13th, that is when those tickets will be going on sale, but I'm telling you, they are not going to last long. Just a few seats are going to be available, Dr. B. So we're going to sell this place out. We're going to have some fun. You can hit those dance moves because I was born with a lot of talents, but rhythm was not one of them, man. So you dance the night away and I'll be there just cheering you on. I'll, I'll just get up behind you and I'll, it'll be like in, uh, Happy Gilmore. It's on the hips, it's on the hips, it's on the hips. Oh, I'm pumped for that sequel too, but we, we can talk about that on the next show, man.
Thank you so much for your time today. Again, uh, the plant-fed gut.com is where you go to sign up for microbiome Mastery. You are the man. And I got to get my hands on one of those Fiber 314 t-shirts, man. Those are going to be best sellers. Epic best. Happy New Year, everyone. What's rock and roll in 2025? I'm pumped. Let's go. Let's do it. That's Dr. B, the Gut Health MD. I also want to say thank you to the crew behind the scenes for making the magic happen and for you exam roomies for hanging out and having some fun with us as we master our microbiome. We head into this new year. And for everybody here at the Physicians Committee, I am the weight loss champion, Chuck Carroll. We will talk to you again very soon. But until then, keep it plant-based.