Transcription
It was long thought that aging was linked to genes. If you apply the longevity strategy that I develop in this book, 99% of people will reach the goal. Yes. Knowing that it can be applied at any time, is it still more or less reversible? We know from studies that one can extend one's life expectancy by many years, 5 to 10 additional years. If the right strategy is applied starting at age 45, one must not consider the human being as an assembly of independent organs. All bacteria circulate from organ to organ with a central computer, a conductor who is the intestinal microbiota. In reality, it is humanity's first social network, but it is unique to each of us. Metamorphosis, the podcast that awakens consciousness. What if aging well was not a matter of luck but of daily choice? According to my guest today, a gastroenterologist and microbiota expert, 90% of our longevity does not depend on our genes. In "Live to 100, thanks to your microbiota," published by Harper Collins, he reveals the secrets of centenarians and the vital importance of taking care of our intestines. I am delighted to welcome Dr. William Berbi to Metamorphosis for the first time. Hello. Hello. Thank you for having me. You are most welcome, with pleasure. It's true we'd never met. No, there's a first time for everything, exactly, and I said it off-air, so I'll repeat it, it's a true bible of the microbiota, I find. You say at the end of your book that it's more than 25 years of scientific study and research, as well as experimentation, because in this book you also give your own secret tips. That's what you practice daily in consultations and what you obviously give in consultations. You have focused on science, in any case, you are at the forefront of what can be said about the microbiota and aging. Let's first try, in a first part, to understand aging a little better. You write that aging well is not a matter of luck, it's a strategy. Hmm hmm. So that's really interesting. If only 10% of our health is beyond our control and 90% depends on our lifestyle, what does that change? It's a revolution, in fact, to know that. Now we're getting into epigenetics, but this figure is enormous. I'm going to take a very short break in this absolutely fascinating episode about the microbiota to introduce our partner of the day. Friends, you might be listening to Metamorphosis while enjoying a nice hot infusion. Like me, when you take this little moment for yourself, you might think about what's really in this cup. Our partner Poua's infusions are made from organically grown plants, carefully selected with particular attention to sustainable wild plant harvesting and fair trade. It's this coherence and this invitation to simply slow down that I love about this gentle little ritual. A cup in hand and an infusion with an intense flavor, made with respect for nature and those who cultivate it. You can find Poua infusions, I'll spell it for you: P-U-2-K-A, in organic stores, pharmacies, supermarkets, and online. H h, so that's really interesting. If only 10% of our health is beyond our control and 90% depends on our lifestyle, what does that change? It's a revolution, in fact, to know that. Now we're getting into epigenetics, but this figure is enormous. Exactly. Exactly. And it's a scientific figure, it's not, it's not, it's not far-fetched. It's the scientific data from all the global research on aging. Yes. And indeed, it's, it's stratospheric information because we long thought that aging was linked to genes. We talked not so long ago about centenarian genes, and therefore, that implied that we inherited longevity from our parents. Well, that has been disproven by facts, because in families, we didn't see a chronology, if you will, from father to son of centenarians; there was one, and then there were no more, you see. So that was the first thing, and we realized that genes themselves didn't represent much in terms of a person's health destiny and longevity, and that it only represented 10%, since we've discovered over the last twenty years or so, with various studies on the epigenome, that the ends of chromosomes, which we do inherit at birth, 46 XX or 46 XY, well, the ends, what we call the epigenome, are modifiable, and it's this modulation of the epigenome that will allow cells to multiply for a long time and for us to live a long, healthy life. So, contrary to a common misconception that is still very widespread today, it's not at all about saying "I was lucky or not. I inherited good genes or not." It's that from birth, everything we do will lead us to have a long, peaceful, and healthy life, or not. Now, there will always be the counterexample of people who tell us, "That's not fair. Some people smoked, look at those rockers who did drugs, smoked, drank like madmen, and are still rocking at 90 years old." Sometimes it seems unfair. Yes, of course, but there are exceptions to everything. So, if you apply the longevity strategy that I develop in this book, 99% of people will reach the goal. Knowing that it can be applied at any time. Is it always more or less reversible? If we listen to you now, we're 50 years old, halfway through our lives. Exactly. Exactly. So that's very interesting to say too. That is to say, indeed, at birth, we start with a certain inheritance that we will modify during our lives. But in reality, we can do ourselves good much later. Obviously, you shouldn't wait until you're 75, but if at 45, someone has a poor diet, because diet plays a crucial role for the intestinal microbiota since it's the prebiotics, those famous substances like inulin that nourish the microbiota and allow for a balanced intestinal microbiota and therefore longevity. Well, if you do this late, for example, at 45 or 50, we know from studies that you can extend your life expectancy by many years, 5 to 10 additional years, if you apply the right strategy starting at 45. So it's not irreversible, it's partially reversible, and it's never too late to start. So that's the good news. Exactly. At any point in life, in fact, one can decide to start and apply the advice I develop, and thus extend one's life expectancy proportionally to the age one is at that moment. Now, obviously, in this interview, we will talk at length about the microbiota, which is your main subject. We're still a bit interested in aging. You distinguish between chronological aging and biological aging, reminding us that looking young is not necessarily a sign of having organs as young as or vice versa, it's not because you look old that you don't have healthy internal organs. And there's an interesting paradox to reveal here, perhaps. Exactly. Today, there's a race for physical appearance, to look young. Well, there are many techniques, which I won't go into here, to achieve that, but just because you have young-looking skin doesn't mean your intestinal microbiota is young. You can do a lot of treatments and so on, and then in fact, you have a lifestyle that isn't necessarily good, for example, smoking or diet, and you can have an intestinal microbiota that isn't that of a young intestinal microbiota, because the key, as you've understood, is, and we find this in centenarians, and we'll come back to it, I imagine, well, it's that a young microbiota allows you to live long. So indeed, you can have a young or beautiful external appearance, and that doesn't necessarily mean you have a perfect or adapted lifestyle for the intestinal microbiota. So that's interesting, in any case. And moreover, on this subject, when you talk about biological age, you talk about markers that are quite simple, and it would be interesting to describe them to us. And you also say that we have a functional reserve, like a kind of stock in our organs. Well, I'm not a doctor, so I don't explain it well, but you will explain it to us. Which allows us, perhaps, to draw from it sometimes, or even to optimize it. That's it. That's it. So, precisely, if you like, I'm making a parenthesis here on my holistic approach. That is to say, one must not consider the human being as an assembly of independent organs. The heart, the lungs, the liver, it makes no sense. These are the fundamentals of internal medicine, which I also practice, by the way. And these are the fundamentals of the microbiota medicine that I created, because in fact, all bacteria circulate from organ to organ with a central computer, a conductor, which is the intestinal microbiota. So, in fact, everything is interconnected, and in reality, it's humanity's first social network, but it's unique to each of us. So, in fact, one must not reason at the level of organs. First point. Now, we sometimes hear, and there have been well-known world leaders who have said, "I'm going to have my organs replaced, I don't know if you've heard that," and "I'm going to live to 120." The issue is not there at all, because, as you said, organs have a functional capacity beyond what we need. The lungs, the heart, they have an intrinsic capacity to function for a very long time. Yes. And ultimately, it's not the fact that the lungs age in themselves. Obviously, if you smoke a lot, you'll damage them. But it's that there will be cellular aging. It happens at the cellular level. And this cellular aging will depend on several things, including the epigenome and the ends of chromosomes, which are called telomeres, which shorten. A cell, if you like, divides, and that's how we get new cells all the time, but at some point, the end of the chromosomes, these telomeres, become too short, because with each cell division, the telomere shortens, and at some point, it's too short, and cell division, therefore regeneration, cannot occur, and at that point, these are cells that will die, and that's what accelerates aging. And in the longevity methods that I develop in this book, we know what to do to maintain these telomeres for as long as possible. And moreover, telomeres can be measured today, if you like. There is a blood test that allows you to measure them and thus know the length of your telomeres. So, this blood test, do we simply go to our doctor and ask for a prescription? Is it that simple? Yes, it's that simple. If the doctor, in theory, in theory, provided the doctor, but I know because I'll be asked the question immediately after. Yes, our listeners will say, "Can I ask for it like that?" So you're right to anticipate. Yes, of course, except that it's not reimbursed, obviously, since it's a test related to longevity, and longevity is a medicine. Yes. And it's something very innovative. We're at the beginning of this revolution too. The microbiota revolution and the longevity revolution. So, very honestly, doctors don't necessarily know about it. But, on the other hand, anyone can go to the laboratory and ask for their telomeres to be measured, except they won't necessarily know how to interpret it. Except they won't necessarily know how to interpret it. So, indeed, they need to go to a doctor who is a doctor, an expert who specializes in the microbiota or in aging. Yes. So, if we don't know where our telomeres are, you say there are still simple ways, which is to make sure they are longer. And here, we have incredible ways to act on them, especially through physical activity. So, I'll add, excuse me. Yes, go ahead. I'll add that it's not just telomeres, meaning that there are other tests without Ah yes, because we'll come back to the others, but since you were going full steam ahead on telomeres, I thought let's dig into telomeres for now. Exactly. So, physical activity is absolutely crucial, and indeed, we have today, because there was a study on walking and telomeres, that's why I, yes. Of course, of course. Absolutely. So, I've also included a detailed protocol of what has been evaluated by research as the most effective for telomere length, to keep telomeres as long as possible. That is to say, you can perhaps say it because you're creating a lot of suspense, otherwise I won't say it, for the activity. Yes. Well, it's alternating fast and slow walking, in fact, that's interesting. It's a chronology, and there are times to respect, and so on. So, that has been studied. It's research that measured telomeres before and after. There were different studies, so this technique, there were other physical activities, possibly intense, or running, and so on. And so, that's what emerged from this study on telomere length. And so, yes, physical activity is absolutely essential in reality, and we are facing a paradox. That is to say, today we know that physical activity will extend. So, regular. So, what does regular mean? That's what I tell my patients in consultation. Everything is adaptable, in fact. You don't have to say, "I don't like running, so I won't do it," or "I don't like playing tennis, so I won't do it." In fact, everyone will adapt according to their abilities. Those who like swimming can swim. Those who like running can run, play tennis, golf, or simply, simply brisk walking or cycling. But brisk walking, nothing simpler. 30 minutes of brisk walking per day. So, I put on my sneakers, my tracksuit, and I go for a brisk walk. The criterion is very simple to know if it's effective: you should be a little out of breath and sweating. If you're not a little out of breath, it means you're not going fast enough. And so, you do this for half an hour a day. So, it's very easy to implement. And if you can't because it's raining, you can use an exercise bike on those days. So, in fact, it's within everyone's reach, it's super simple, and we know from studies that physical activity plays an absolutely crucial role in longevity and in the health of the intestinal microbiota, since certain specific substances will be produced. So, since we were talking about markers earlier, there are some that are simple. You've talked about telomeres, you also talk about inflammation, for example, and we'll talk about that again later, or the quality of the microbiota. So, perhaps to tell us again, what can be easily measured in the microbiota, in terms of markers, what can be easily measured? Well, there are hundreds of markers, and there are companies in the United States today, not yet available in France, that can measure your blood markers every week or once a month and give you your biological age, as opposed to your chronological age. So, I'll quickly explain the difference if you like. Well, chronological age is what's on our ID card or on our birthday candles. And then biological age is the real age of our body. And that can be measured through various blood markers. I mentioned telomeres, but there are hundreds of other markers that are compiled. There are different tests with algorithms, if you like, and a combination of different markers that will reveal your biological age. So, today, anyone can have a blood draw, which is what I do in consultation when a patient comes to see me for aging, to measure telomeres and measure biological age through these different markers. And so, it's interesting because we can have levers afterwards depending on whether I'm behind or ahead of my aging. You see, if someone is younger, in other words, if someone has tests that show they are younger than their chronological age, well, everything is fine. If, on the other hand, they are at their age or older, then we can act through certain dietary supplements. So that's something else. But physical activity extends healthy life expectancy. And so, if you do 30 minutes of brisk walking per day, depending on the time of life when you start, you extend your life expectancy by 5, 10, 15 years. And for example, you can have very good parameters, very good markers, and others that are very bad, or in general, it's usually a combination that gives a trend. For example, can I have long telomeres because I do a lot of physical activity, but have a messed-up microbiota and therefore not have good immunity? I imagine so. Or is it more nuanced? The question is interesting because the intestinal microbiota, today, we cannot study it reliably. We cannot have it studied reliably. Telomeres, yes. Blood markers, yes. But the study of fecal microbiota as it is sold today by labs and startups has no scientific interest. Yes. Yes. You say that, don't you? Yes. And it's very important because there are many people, patients, who come with tests that are expensive and that are completely useless. So, why are they useless? And it's very important to explain this if we have 2 minutes. It's that to know what an abnormal microbiota in dysbiosis is, that's the term dysbiosis, an unbalanced microbiota, we first need to know what a normal French intestinal microbiota is, because the microbiota of Peru, France, Great Britain, the United States is not the same. Or Switzerland, or Switzerland, no, I'm joking, or Switzerland. So, if you want, we first need to have the data, and that's the work of French Gut, which we are currently doing, and of which I am an ambassador, and we are collecting stool samples from 100,000 French people to study their stool and thus truly know the composition of a normal French intestinal microbiota. From this data, we will be able to determine what is abnormal. It's like blood sugar. Before knowing that the definition of diabetes was 1.26 grams per liter, we studied hundreds of thousands of diabetic people to see at what threshold they were considered diabetic. So, it's exactly the same here. Except that for the microbiota, let's assume we are in a situation, if you take the microbiota of the population of a country, for example, the United States, where we know there is a lot of junk food, I'll take Texas. Come on, I have nothing against my Texan friends, but for example, it's true that we know that in New York or perhaps in California, people have a lifestyle that is perhaps a bit healthier. These are assumptions, I ask you to bear with the example, but and that consequently France is in the same state, let's assume, and that the normality of the microbiota is bad. Let's assume, because we've reached such a point, we'll take that as the threshold of normality. Of course. Yes, of course. Since we are in, so we will have a threshold of normality, so to speak, that is unhealthy. So, we'll know that when we get the results, but that will be the basis, if you like. We'll know what a normal French microbiota is, basically, if you like. What is the typical understanding, if you prefer? And so, it's from there, so it's complicated, I won't go into technical details. If we take, if we take a people with a hyper-healthy microbiota, its normality, it will be, you see, the base will be that. We need to know that there are, we have thousands of species, and each of us has hundreds of species, so we have a unique intestinal microbiota. So, that's what makes it complex to identify what a normal French intestinal microbiota is. But from there, the goal, if you like, in your question "I want to know if I have a microbiota that is rather good or rather bad and know the imbalances," we will be able to know it once we have a standard. That's what it means. So, in short, it means don't do your fecal microbiota study for now, because it will have no significance in evaluating your aging. So, how can we evaluate this famous intestinal dysbiosis, since you say there's no real protocol? Well, I imagine that with anamnesis, with a good healthcare professional, we still have a lot of leads. What are the markers at this level? Well, you need to understand. Now, there are two questions, if you allow me. You were talking earlier about the Western microbiota, which is indeed not excellent. The United States is worse. France is average. Here's a simple figure to illustrate that: for the intestinal microbiota to function well, it needs 30 grams of net fiber per day. Yes. Yes. You insist a lot on fiber in your book. Yes. And that contains prebiotics. So, that means a lot of vegetables, fruits, legumes, complex cereals, seeds, and so on. And today, we know, the figure is astronomical and stratospheric. One in ten French people consumes at least 30 grams of fiber. So, necessarily, since 90% don't, the typical French microbiota, in absolute terms, is much less good than that of the Tanzanian tribes we studied. We have studied various tribes in the Amazon or in Tanzania who still live an ancestral lifestyle from 40,000 years ago, and they have an incredibly diverse and incredibly stable intestinal microbiota compared to what we have in Western countries. So, obviously, ours, the average microbiota, let's say, is not the same as the microbiota of tribes who eat vegetables and have not consumed ultra-processed foods and have not been polluted, and so on. Can we, another question, but I mustn't get lost in the flow, is that we can actually have a healthy diet but still have a bad microbiota, or is that impossible for you? And in that case, if we have a healthy diet but perhaps a bad microbiota, I'm not talking about the genetic factor which could certainly intervene, can there sometimes be something detrimental that ultimately messes up everything else? Excellent question. I'll go back to the thread you were talking about, since you asked me how we can ultimately identify that we have a balanced microbiota. Well, first of all, you need to know that when you have a resilient intestinal microbiota, theoretically, apart from a particular external factor, you will be in good health. So, you won't have any illness, logically. There are exceptions to everything, of course. So, in consultation, the patients who come to see me have a specific problem. It could be stress, it could be irritable bowel syndrome, it could be a weight gain problem, etc., or recurrent gynecological infections. So, as soon as a pathology develops, it means there is an underlying dysbiosis. That's the first point. So, how to measure it? Since the study of fecal microbiota is not useful today, I will measure a certain number of parameters in the blood that are useful for the proper functioning of the intestinal microbiota. For example, vitamin D, which is extremely important and is totally underutilized in the French and global population, totally under-prescribed by doctors, both in terms of dosage and in terms of supplementation. It can also be omega-3s, it can also be vitamin B12. Yes. So, there are all these parameters, we know that bacteria will use them to function well, and therefore it is crucial, and that's what I do in my microbiota and longevity medicine consultations, to dose them and correct all these deficiencies. That is essential. You insist, I've mentioned it, you know, recently with Dr. Your colleague, Dr. Guillaume Fond, who is a researcher and psychiatrist, who has also been very interested in dietary supplements. Ultimately, we're almost saying that the entire population would benefit from taking them almost all year round, vitamin D. Well, yes, now, I'm going to disagree a little with my colleague in the sense that, well, I'm not saying he's the only one who says it that way, but generally we see that there is a deficit. I'll put it that way. Yes, that's correct. Now, obviously, I'm going to place myself from the perspective of the general population and what I do in my practice, because in my practice, I know that no one has the same deficiencies. And so, we find ourselves facing another paradox, that today many people take a lot of dietary supplements. It's a market, as you know, that is colossal, and in fact, very often for nothing. Why for nothing? Because in fact, the intake is not adapted. For example, vitamin D, everyone, or almost everyone, takes vitamin D, but in fact, if you haven't measured your vitamin D level beforehand and you haven't brought your level up with an adapted protocol, you will remain deficient even if you take it, and therefore chronic intake will be useless. Same for omega-3s, since you have 3 omega-3s, you have plant-based and you have two fish-based, EPA and DHA. So, in fact, in most cases, patients take fish omega-3s, which, by the way, are not the right ones, because you should take algae, which are much less polluted. I say that too. Very good. So, you see, great minds think alike. Yes. That's it. And so, on the other hand, a vegetarian, they eat a lot of vegetables, so they won't lack it. But there are people who eat a lot of fish and take fish omega-3s. So, regularly, because I measure this, regularly, I see people who have fish omega-3 levels above normal, so they are taking it for nothing, in fact, since they are already overdosed, and they are lacking plant-based omega-3s. So, in fact, if you want, my approach is very personalized, that is to say, I consider that you cannot give the same thing to everyone, which is logical, since it would be like saying that everyone, all humans are identical. Yes. All humans have the same levels of everything, and all humans have the same microbiota. That is obviously false. And so, if you want to take the same dietary supplement for everyone, well, if you think about it, it doesn't really make sense, and therefore, you have to measure the different parameters as much as possible when you can. Yes. So, since not everyone can see Dr. Bibbi, because you already have a huge demand and you're taking, that's why I wrote this book. Yes. So, we go to our doctor and ask for dosages. Yes, we ask for dosages. Now, you should know that these dosages, which are very important for the health of the microbiota and for longevity, are very poorly known by doctors. You should know that nutrition in general is poorly known by doctors. There is little training in medical school, which remains very academic today, organ by organ, segment by segment, and therefore, ultimately, nutrition is not taken at its true value, even though it is absolutely crucial, since it is the food we give to our intestinal bacteria that will keep the intestinal microbiota young. And so, there is a huge, let's say it as it is, there is a huge deficiency in knowledge at this level. So, I hope, because I have the opportunity to organize, at the end of the year, by the way, I'll take this opportunity, the first world congress of microbiota medicine in October in Paris, and so there will be a day for doctors. So, I hope many will come and be able to benefit from these developments and revolutions to train themselves better. A little better. Yes, exactly. Exactly. Is it accessible to the general public or only to health professionals? Yes. There will be a day for the general public and a day for health professionals. So, yes, there will be a day for the general public on all the discoveries I'm working on. Now, another biological marker of aging is chronic inflammation. Perhaps we'll talk about it again later, especially when we talk about the brain. To finish, perhaps, on intestinal dysbiosis, even though we could do a whole podcast on the subject. 5 to 10 million, you say, people in France have it, that's huge, for irritable bowel syndrome. Yes, for irritable bowel syndrome. Exactly, it's huge. Now, are these diagnosed or would they be diagnosed? No, well, we haven't diagnosed them all, obviously, since most of them are unfortunately lost. Now, this is a huge, huge deficiency in French public health, since unfortunately, what happens is that, once again, I agree with the overly academic aspect of teaching. The patient complains, has pain, has diarrhea, consults the doctor once, twice, eventually undergoes examinations like colonoscopy, gastroscopy. Fortunately for them, they have neither Crohn's disease nor cancer, and then they are told, "Well, you have nothing." That's the reality on the ground, if you like. And then the patient is left alone and does their own research, and falls upon extremely random therapies, to be moderate in my wording. And at that point, the patient is lost, spends a lot of money for nothing for years and decades. Yes. Because they see that something is wrong. Yes. They are looking for a solution, and in fact, they don't find it. Exactly. And all the patients I see, if you like, tell me the same story. And so, what I tell my patients, I can tell you now, because it's what I tell my patients. I tell them, realize that you are getting better now. We have managed to do things and improve things for you. But there are 5 to 10 million people in France who suffer from this syndrome, as you just said, and most of them will unfortunately live their entire lives with their pain, their transit problems, and so on, without ever finding a solution. When in reality, the solution exists. How do you help them, precisely? Well, I will dose all the parameters. So, obviously, it will involve the intestinal microbiota, since it regulates all of this, and there is intestinal dysbiosis, particularly colonic dysbiosis, in irritable bowel syndrome, which is actually a driving mechanism, since the fundamental mechanism is the disturbed gut-brain axis, meaning the dysbiotic microbiota sends negative information to the brain. The brain itself, generally, these are patients who are a bit more stressed than average, but that doesn't summarize the syndrome at all, obviously, or sensitive, more sensitive, more reactive, and so on, generally, but in any case, even if they weren't, having chronic pain will generate bad signals for the brain, so they will become stressed by the pain. We know that chronic pain, if you like, will generate an increase in cortisol, which is the stress hormone, to put it simply, and that high cortisol levels in the long run will worsen dysbiosis and affect the intestine.
Here is the translation of the provided French text into English:
them. So in fact, you have this disturbed gut-brain axis. So we need to, so what I'm going to do is measure, as I was telling you, all the parameters useful for the proper functioning of the intestinal microbiota, but before that, I'm going to listen to the patients to properly understand their needs because here too, there is sometimes a problem with listening, and then we will treat the symptoms, because the symptoms, for their part, send a negative message to the microbiota, and it is by normalizing the gut-brain axis that we manage to heal patients, and I do mean heal. And so you, uh, you then heal the symptoms of the signals, as you explained. Yes. Yes. Of course. The pathology plus the pathology. So, based on what, generally? So, what will I do in practice? I will treat both poles. So I will treat the symptoms, as I indicated. I will specify these diarrhea, constipation, bloating, and so on. And I will balance the intestinal microbiota with two levers. The first is that I will identify, because often there can be intolerances or hypersensitivities to different foods in irritable bowel syndrome, which are associated with this syndrome. Now, I'll clarify a point: absolutely do not do the Ig or IgG food intolerance tests. Yes, you say it. Yes. So I have, then say it, because I read it, but not everyone knows what IGG food intolerance tests are, which are useless, which are pure scams, as I've already said on social media, on LinkedIn, and on my Instagram account. And so, in fact, when you have positive results, it just means that you have eaten these foods in your life, and not at all that you are intolerant, for a very simple explanation: when we come into the world, we will gradually eat foods that will be identified as foreign, and so, like with any stranger in the human body, we will develop antibodies against wheat, eggs, and so on. And so it means absolutely nothing, and to put it plainly, it is the biggest scam currently in terms of medical tests sold, obviously not reimbursed. So, what can we do then to know the products to which we might be sensitive? So I will do three phases. I created a sequential diet because the low-FODMAP diet, you know, is a diet that is generalized, which is a bad diet. The low-FODMAP diet is a bad diet. Just like the ketogenic diet, you say. Well, for other reasons. For fiber reasons, but we'll come back to that. For other reasons. So, in fact, the low-FODMAP diet is a bad diet. Now, this is much less known. Why is it a bad diet? Firstly, because it is extremely complicated to implement. Secondly, because the reintroductions that are proposed are simply impossible when you have a normal social life. The third reason is that ultimately, people manage to stop eating so many foods that they end up having a very low intake of fiber and therefore prebiotics. And we know from studies, since we have studied it, that after 4 weeks of a low-FODMAP diet, patients have more significant intestinal dysbiosis than at the start. And so the paradox is total, because as you understood, we give people, patients who have intestinal dysbiosis, a diet that will itself worsen the dysbiosis. So, there are studies that have shown this, because I imagine that one would find detractors. Now, I'm not scientific enough on FODMAPs, you know. Of course, of course. To say that, but of course, you know, I'll tell you something, I don't have a personal opinion. What I say is always and in 100% of cases based on international publications. There is never a personal opinion. I keep my personal opinion to myself. So it's the life, it's the life of science, in a global sense. So, obviously, we have studied it, and it is a proven fact. So, from there, the diet, I found it interesting in the idea of saying that there are foods that need to be highlighted. So, I created another much simpler diet, which is the sequential diet. I created three phases: without fructose and polyols, without gluten, and then I remove legumes and certain vegetables. And in 3 x 7 days, so 21 days, I identify the food groups that are likely to bother the patient. Once I have identified that, I will be able to modulate the prebiotic intake, because as I said earlier, we need 30 grams of net fiber. So, but there is, for example, someone who will not tolerate legumes. So, we will stop legumes and switch to more whole grains, of good quality, organic preferably, more vegetables, and so on. And so, thus, we can modulate the diet to reach these famous 30 grams. By the way, 30 grams, tell us in passing, what does that represent in terms of fiber? It represents 150 grams of raw vegetables or salad, 200 grams of cooked vegetables, fruits, it represents 100 to 150 grams of whole grains and legumes. And it represents a handful of almonds or walnuts, for example, a small handful, and seeds like flax seeds, chia seeds, a teaspoon per day at a minimum. And if you do this every day, so you see that it's not nothing, you know, to do it, well, if you do this every day, you have your 30 grams net, and therefore, in fact, an intestinal microbiota, from a dietary perspective, that will be healthy. We don't forget to soak the seeds or nuts if necessary. There, understood the legumes. There, we can, we can indeed soak, especially almonds, in relation to phytic acid, because it will reduce and prevent absorption from being diminished, particularly iron, for example. Exactly. Exactly. So that's good to know because many women, in particular, who are listening to us, are deficient. That's true. They can have a healthy diet because they eat nuts, seeds. But ultimately, I don't know to what extent absorption is slowed down. Well, it's slowed down by about 30%. That's not insignificant. Well, that's not insignificant, but if you don't do it, it's not either. It's better to do it, and if you can't, it's better to eat almonds and not do it than not eat them and the seeds. So, a clarification: you can eat all the seeds you want. In my home, I have jars of all existing seeds. And there, perfect. And the, just the flax, the flax seeds, just grind them a little so they are better absorbed. That's the flax seeds. And I'm thinking of sesame seeds too, which are very small. Sesame seeds too. Well, in terms of omega-3, it's less necessary than for flax seeds. We lose less absorption, if you will, but we can do it too. You have hemp seeds, you have poppy seeds, and so on. Well, when we have seeds at home, we often have myths too, dietary myths. I don't know if that's the case for you, but I do. Yes. Well, it's true, and that's a completely different subject, which has nothing to do with it. It's true, you're right. That's why you have to buy them in sealed packages. Yes. Well, a clarification, a small clarification, exactly, a small parenthesis. So this famous microbiota, you say it's really the second, it's not the second, forgive me, I haven't answered the whole question. Prebiotics, so diet, and probiotics, obviously. So probiotics. Here too, there's a huge gap, if I may say so, because today, here too, the global knowledge by doctors is not sufficient. And in reality, when I started communicating to the general public not so long ago, 3 or 4 years ago, probiotics were a totally opaque universe. Today, when I do interviews, I notice that journalists have integrated, and patients of course, but journalists, that probiotics were very useful for health. That's something that has evolved. So that's a positive point. On the other hand, what is very poorly understood is the characteristic of the strains, because, and you will perhaps come back to it. Yes. Yes, absolutely. No, no, but it's still the big problem. I've talked about it in many shows because there's probiotic, it's automatic, probiotic, it's not automatic. The problem is that, as you were going to say, people don't necessarily know their flora. That's it. And so, what type of, it's the strains, the validated strains especially, but also depending, I imagine, on a pathology or even a given microbiota, what type of probiotic is right for me, since we are unique? So, that, that will depend on the pathology you have. So, a patient who consults for a problem, we know that in irritable bowel syndrome, in gynecological infections, or in weight gain, the dysbiosis, which is common to all of these, is not the same. So, in research work, we will know what type of dysbiosis there is, pathology by pathology. That's the first point. So, dysbiosis identified in research work, in accredited expert laboratories, of course. From there, in research work, strains, strains will be studied in populations with irritable bowel syndrome, infections, stress, and so on, stressed or depressed patients, and we will identify if a strain has worked or not. When it has worked, it is published. And so, it is on this basis that I will create my protocols, if you will, of microbiotic medicine. So, I will wait for human studies, not mouse studies. And when there is a study, or several studies in humans with sufficient populations, then I will be able to, and if the strain exists, because sometimes it doesn't exist commercially, then I will be able to use it with my patients. And there, indeed, there are extremely surprising results. Today, are we talking about meta-analyses on the subject, or is it still studies on small quantities? Well, there are large studies, hundreds, we're talking about, not thousands, because the problem, if you will, is that probiotics do not have marketing authorization, unlike a medication. A medication that comes out, phase 1, 2, 3, so there are studied populations, and so on, and it requires marketing authorization. That doesn't exist for probiotics for several reasons: one, because they are considered food supplements; two, because the molecules are different from one country to another. And so, if you will, the difficulty is indeed identifying the right strains and following this as closely as possible and being able to benefit each month, I would say, where new studies are released on strains or combinations of strains totally unknown before. Recently, for example, there was a study on the association of vitamin D and 14 strains of probiotics to treat migraines. So that's very recent. So it's constantly evolving, and so there will be more and more studies like this. But on the other hand, studies with hundreds of thousands of people are extremely difficult to implement. And so, I have my clinical expertise, if you will, meaning I will be able to evaluate and observe, since we are talking about probiotics, about good bacteria, so bifidobacteria and lactobacilli, so zero risk, and so I will be able to evaluate myself, on the ground, in practice, in my clinical practice, which strains I have observed to be the most effective. So I will adjust things a bit based on that. Well, they say probiotic, so zero, you say zero risk, but if in fact my flora doesn't need it, even if I took the right dosage and there was the right quantity, and I did my research well, and it's of good quality, if it doesn't suit my flora, even if I introduce pro bacteria, can they be harmful? Well, harmful, never. Ineffective, it's possible. Yes. And so, there's a rule of changing the strain. That is to say, let's take the example of irritable bowel syndrome, since you were talking about it earlier, we consider that probiotics, I consider that probiotics have not been effective when I have tested three different strains. So, well, I always give a higher intake of bacteria at the beginning, because I regularly find in the patient's history, who has irritable bowel syndrome, either a very frequent digestive infection, when you have traveler's diarrhea or food poisoning, it will generate dysbiosis, and a few months later, there are parasites, for example, or not necessarily, regardless of bacteria, parasites, viruses, the fact, if you will, of having an aggression, in this case infectious, of the microbiota, will unbalance it. Yes. Yes. Regardless of its origin. Okay. There. So if before, you arrived, so to speak, at the event with a microbiota that was already a bit unbalanced, because you took a lot of antibiotics, for example, or you have an inappropriate diet, well, then you can tip over into intestinal dysbiosis, which will become clinical and will manifest as symptoms. And then the symptomatology appears. So, always test three different validated strains, of course. Well, look, for example, irritable bowel syndrome. Today, there are hundreds and hundreds of probiotics sold. Today, you have six validated strains. Well, so that means that there are hundreds of products sold for this that have never shown their effectiveness in studies. Yes. Because there are quite a few people who say, "Oh, I'll do a little probiotic cure without having any idea of what ultimately suits them or not, or the quality of the strains." Exactly. Well, in a roundabout way, your question is perhaps, unless I have misunderstood your thought, is it possible to take probiotics when one has no pathology? Yes. Well, there are two situations, if you allow me. The first is when you take antibiotics. So there is a huge, a huge deficiency here too. That is to say, we know, it has been studied in France in research, in studies with epidemiological publications, that 90 to 95% of antibiotic prescriptions are not associated with a probiotic prescription. So, which is crazy, since we know that antibiotics, we know that antibiotics will treat the infection but will also cause dysbiosis. At best, you are given Ultralevure. But Ultralevure is a probiotic. Yes. Yes, there are two. It's not complicated that I detail in the book, which is Ultralevure, which is a probiotic yeast. And so the objective is to take the probiotic throughout the duration of the antibiotic, at least 2 hours apart, because otherwise it will be destroyed, and thus to cushion, if you will, the dysbiosis that has been generated by taking antibiotics. Okay. So, interesting about probiotics. I also wanted to come back to this figure. You say that 80% of our cells, well, the immune system originates 80% in our intestines. That's why you talk about the first brain and not the famous second brain. I imagine everyone talks to you about it constantly, right? But it's still important to come back to it and to reiterate why, in fact. Well, in fact, the first line of defense of the human body is located in the intestinal microbiota, so in the intestine. If we conduct a survey, and ask what are the important immune cells in the body? Everyone will say the blood. That's false. 80% of immune cells are in the intestine. That is to say, the intestine will serve as a barrier, we'll say white blood cells, more or less. Yes. Yes. Yes. That is indeed the most frequent answer. The moral of the story is, you have 80% of immune cells in the intestine. The intestine will have a mechanical barrier role, but it will have an immunity role, so immune regulation, and therefore it will stop many aggressions from substances that would want to pass into our blood to go to different organs, and it will destroy them upstream to prevent this phenomenon. And it will also regulate everything related to autoimmunity. And indeed, we know very well from research that when you have intestinal dysbiosis, you no longer have immune regulation. This means that a food will become, even if you tolerated it very well before, poorly tolerated because it is identified as an aggressor by the fact that your intestinal immunity is no longer satisfactory. I imagine that many people listening to us would be interested in having your feedback in testimonials, whether on our YouTube channel Métamorphose or on our social media. Phases in our lives where suddenly we feel bloated, we don't digest the same way anymore, and we say, "I don't understand this thing, I used to digest it well." It can be that kind of symptom. Absolutely. That's the explanation. Yes. The explanation is in the intestinal microbiota. Now, I'll give you a concrete example that everyone will understand. Lactose intolerance, which we talk about a lot, and about which a lot of false information circulates. We'll come back to yogurts. Perfect. Like Maria, the famous Maria, 98 years old, or I don't know what age, 117 years old and 168 days. 117 years? 117 years. Oh yes, and we studied her microbiota, but we'll come back to that. Yes, we'll come back to that. Oh yes, 117 years. It's true that up to 122 years, that's the oldest. That's it. Yes. Yes. We'll come back to that. By the way, I make my own fermented yogurts at home. I fermented them for 24 hours. You'll tell me if that's good. Yes. Well, I'll tell you. Uh, so where were we? Tell me. Stay with us. No, no, we were saying, we were talking about immunity, and you were saying, you were saying there's something unclear about lactose. Well, lactose intolerance, you should know that it depends, about 20-30% of the population is lactose intolerant, so that's a lot of people. Secondly, we all have a lactase level. Lactase is the enzyme that breaks down lactose, which decreases over the course of life. That is to say, we are born with a level, and it gradually decreases at a more or less rapid pace. When you have an aggression, for example, a digestive infection, gastroenteritis, even a common one, you will have dysbiosis. This dysbiosis will therefore unbalance your intestinal microbiota, and at that point, it will accelerate the decrease in your lactase level, and you will, in a way, become lactose intolerant, even if you weren't before. Now, this can last more or less long. It can recover after about 1 year on average, but it can last. So, in fact, from the moment you have a balanced intestinal microbiota, you will have efficient intestinal immunity. You will therefore have efficient blood immunity, since the intestine will send information to the immune blood cells and will say, "Okay, we're good or we're not good." And from there, autoimmune diseases can develop, among others. And if you have unbalanced immunity at the intestinal level, indeed, you will become intolerant to foods that you previously tolerated very well. And at the same time, one can say, I don't know, I haven't studied many mammals, but regarding breastfeeding, we are the only mammal that continues to consume milk from other species after maturity, when it has become an adult. Absolutely. Yes, one doesn't imagine an adult piglet suckling from a goat, absolutely, or milk from another species. What I mean by that is that milk is indeed a real question. Do we need it in the long term? I specify that you absolutely, you say it, you have no conflict of interest. None. You state at the beginning of the book, no conflict of interest whatsoever with the food industry or third parties. Uh, well, it won't have escaped you that humans, even if they are mammals, are a bit different from other mammals, from certain great apes, sometimes not far away. There is a notable difference, which is that in humans, we can study the influence of a food on cancer incidence and know if the food is beneficial or not, which is not done in animals. Okay? So that's the key, in reality. That is to say, we have the data. It doesn't come out of thin air, if you will, and besides, as I have, there must be data on animals, because I imagine that there are people who have studied mammals that must have been raised with milk because they were rescued or whatever, of course, but if you will, it's not studies on the same scale as what we have, let's say, in humans, which involve millions of people. So the data are simple, they are published. They are international recommendations, French recommendations are simple. It's two dairy products per day, whether it's yogurt, 30 grams of cheese, or a small glass of milk. And two dairy products per day, so according to the recommendations, reduces the risk of colon cancer, the risk of breast cancer, and the risk of cardiovascular disease. And that's where we find our ancestor. There, we find Maria. So indeed, so for me, dairy products are a subject I talk about a lot because there has been a lot of misinformation on the subject to push people to consume plant-based drinks which have no health benefit and cost twice as much, whereas we know the positive effects of dairy products. And so Maria, indeed, 117 years and 168 days old, whom I adore, and I posted about her because we studied her microbiota. And indeed, she ate, when I read her biography, because all centenarians or super-centenarians that I have studied, I have studied their biographies in a way, I have done research, if you will, on them, in depth, to know their life trajectory, and Maria indeed consumed yogurt every day. Yes, you have also closely studied these famous blue zones, haven't you, these famous secrets of centenarians. I've talked about it in many shows, but I'd like us to revisit it. You're giving me an opening, since we're talking about centenarians. You also show that the microbiota of centenarians was surprisingly young. Some centenarians have the microbiota of 20-year-olds, you say outright. And so, obviously, we know a lot about populations, particularly in Okinawa, which have been studied, their diet, the regularity of their habits, their lifestyle, and so on. There is something that we perhaps know a little less, particularly among the Okinawans, I don't know how to pronounce it, which is the importance of their social connection. Absolutely. And here we come back a bit to the stress you mentioned earlier. Absolutely. Well, I'll make a parenthesis about what you indicated. So indeed, researchers have looked into the question of why there are centenarians in significant numbers statistically in certain zones. This has been studied by several different researchers. Ultimately, there is a synthesis, and four blue zones emerge today in an undeniable way. Okinawa in Japan, Nicoya in Costa Rica, Sardinia with six villages, and Icaria in Greece. There are the four blue zones where there are extremely high rates of centenarians and super-centenarians. So obviously, if you want, well, obviously, perhaps it's not that obvious, but even less so today, I think. Yes. No, and what I mean is that obviously, when studying the intestinal microbiota, we asked ourselves, do they have a particular intestinal microbiota? And we have Edgar Morin, Edgar Morin, 104 years old, I believe, who has a brain in remarkable working order. And so, he's a good example, just like other centenarians, I regularly post on social media about centenarians who achieve athletic feats, who compete at 105 years old, and so on. And so it's extremely enriching and inspiring to see them, because, well, it's true that in the collective imagination, many people imagine that they are old at 70 or 75 years old. Well, in fact, it's, or that these people have exceptional genetics, and that it can't happen to them. Yes, and that it can't happen to them. And in fact, that's false, because indeed, we hold our destiny in the palm of our gut and through our microbiota. And so, I find it very inspiring to say that and to show that it's far from being something exceptional, since in France we have 42,000 centenarians. So that's quite something. Yes, I was surprised to read these figures in your book. There. Uh, me first, when I saw this figure, which I imagined to be lower, and practically 700,000 in the world. And so, we were talking about Maria, weren't we? We were saying, what do these centenarians teach us? There. Sorry. So, we studied their microbiota. Well, we studied Maria in particular. Well, we studied her intestinal microbiota. We studied all her blood cells. We measured a certain number of markers in the blood, so of aging. And there was a major study in China as well on a Chinese population of 300 people, centenarians or super-centenarians. And in fact, the 300 centenarians or super-centenarians, but initially there were thousands of people, they took age groups: 70, 80, 90, 100, 110 years or more. And in fact, normally, what one needs to understand is that someone with a standard microbiota, who has not followed the strategy to live to 100, will have their microbiota become less varied as they age, which is on average around 65-70 years old. Because the characteristic of a resilient microbiota, that is to say, efficient, if you prefer, is variety, and that is to say, the variety of species. Yes. Its diversity, you mean. Its diversity. Exactly. And so, if you will, we studied, and in these studies, it emerges that centenarians and super-centenarians, instead of having a microbiota that becomes less and less varied, maintain a surprisingly young intestinal microbiota. And in these populations, so there were 300 centenarians, super-centenarians, or Maria, we found the same thing, that is to say, a 20-year-old intestinal microbiota. So, it's absolutely fascinating. Well, what makes this microbiota healthy? A number of factors. Can we describe the most important ones? Well, you were just talking about it, stress, and in conjunction with that, kindness. So, that's social connection. Exactly. So, if you will, it's also a chapter, each one, it's a chapter in my book. Stress is very important. We know that chronic stress will indeed have an impact on aging, that chronic stress will notably increase cortisol levels, which, as I said earlier, will make the intestine porous and generate dysbiosis. Secondly, chronic stress will generate, let's say, there are many mechanisms, but we'll focus on two main ones. I'm also coming back to what you were telling me earlier about low-grade inflammation. Indeed, chronic stress will generate low-grade inflammation. So, what is low-grade inflammation? Inflammation, we know what it is. We sprain an ankle, the ankle swells, we get a cut, the skin turns red, and so on. That's classic acute inflammation. Low-grade inflammation is very insidious, it's silent. It's silent. We don't see it, and we can't know that it's developing. And chronic stress will accelerate this low-grade inflammation, and low-grade inflammation will generate cellular aging, which in turn will reduce life expectancy. That's why you put your feet in the earth from time to time in the morning. Exactly. Exactly. You've read me well, I see. Indeed, I have a morning ritual, and I will make contact with the soil, with, I will put myself into action, I will make contact with water, for a thermal and tactile sensor, and so on, to reactivate my body in a certain way, and I will indeed walk in the earth whenever I can to recover bacteria from the soil microbiota, because there is a well-known soil microbiome that plays a role in nutrition, as it diffuses into vegetables, and so on. And so, indeed, stress, fighting stress, is extremely important for fighting aging. Now, there are, there are, there are many ways to act, of course. There is physical activity, which is crucial. There are obviously simple techniques like relaxation through abdominal breathing, which I invite everyone to do morning and evening, or heart coherence. And then there are indeed social connections. Social connections are extremely interesting. Indeed, when the book comes out, on March 11th, I have set up, I will set up a challenge, a 100-year challenge, micro, the 100-year microbiotic challenge, hashtag, which will have you do one centenarian action every day. Well, if we're still around at 100, we'll do another interview. Ah, gladly, we're saying it now. But you know, I'll tell you something, and that will be our 100-year challenge. Absolutely. Absolutely. And I'll tell you something, which is that by working, well, I've been working on the micro for 16 years now, since 2010, I created microbiotic medicine and its practical application in 2016, so for 10 years, but and I've been studying longevity for several years. And the more I've studied the subject, the more I've said to myself, "Wow, but in fact, it's perfectly achievable." Yes, it's perfectly achievable. And you've applied it to yourself. Of course. Well, for me, it's been a long time since 2010. Before that, it's not that old, if you will, in the span of a life. Ah, well, it's not that old, but I'm not saying you're old. I'm saying that when, no, no, no, but when you, you said it earlier, medical studies are sometimes the poor relation, and I imagine that as a doctor, you discovered things and said, "Wow." Well, I can give you a revelation, if you like, and a confidence, which is that there are thousands of people listening to you. Or, if you will, so I had a classic hospital-university background in gastroenterology. I quickly found that gastroenterology was too narrow a field, even though it's a broad specialty. And so I did internal medicine in parallel at Saint-Antoine Hospital, and in 2010, there were studies that revolutionized my vision of human health, in fact, which are the studies of metagenomics. So, in a nutshell, it means we break down bacteria, we recover the DNA, and we analyze the DNA. And that's how we discovered the composition of the intestinal microbiota, and we didn't know it before 2010. So, it's very recent, in reality. Which also explains the lack of knowledge, university knowledge. Yes, exactly. And if you will, on that day, you know the Eureka moment, I found it, and on that day, it was my Eureka moment, and I said to myself, "Here, something is happening that will, you stumbled upon it, for you too, that's it, it's something, you know, spiritual, intuitive, where you say, oh my, oh my, it's no longer you who possess it, it's the thing that possesses you. You can't do otherwise than follow this thing." Yes. Yes, it's astonishing, isn't it? Okay. Well, I, that's it, I'm done. I understood everything. Well, I understood a lot of things. I understood, in particular, why I was failing in treating patients with certain pathologies like irritable bowel syndrome, and it was a huge frustration for a doctor, of course, that I had, you know, before 2010, and patients would come to see me, and I would treat them classically, with antispasmodics, laxatives, and so on, and they would come back saying, "I, how..."