When you lose weight by cutting calories, your basal metabolic rate drops by about 25%, and for all practical purposes, it's permanent. Study after study has shown if you cut calories, you lose weight, you lose muscle, which in turn reduces "BMR," and you will regain the weight as fat.

And I estimate that 50% of the population of North America has this small intestinal bacterial overgrowth. We say "SIBO" could have been blundering dietary guidelines. It could be the misguided efforts of agribusiness. But they've all led us down this path of distortions of human physiology.

So a major driver of abdominal fat is insulin resistance. So we restore vitamin D and basic stuff, omega-3 fatty acids. Those four nutrients, when restored, synergize to minimize insulin resistance, getting rid of "SIBO," huge reduction in insulin resistance.

But there's also something called myokines. Less muscle you have, less myokines you have. The more myosteatosis you have, the lower myokines you have. And we know people with lower myokines have more insulin resistance, more likely to have osteoporosis, early death. But the microbial solution to myokines begins with eradication of "SIBO."

Doctor "Davis," somebody tuning in today, saying to themselves, I've tried all the diets. I've tried losing weight countless times. Nothing works for me. For somebody wanting to get to the root of their body composition here with us today, how is what we're going to talk about different? "Jesse," you said the magic words, and that is body composition. So this idea of losing weight is woefully outdated, and the science is clear. This is not my speculation. I didn't make this up last week. The science has become very clear, particularly in the last decade, that if you try to lose weight by cutting calories, that can take on a variety of forms. As you know, it could be a diet program, could be your doctor, move more, eat less, all the things we've all heard. It could be a bariatric procedure like lap band or gastric bypass. It could be a pharmaceutical, like a "GLP-1" agonist. "Jesse," these are all variations of the same theme, reducing calorie intake.

So, for instance, if you were to inject yourself with "Mounjaro" or "Wegovy," or you had a lap band, they reduce your intake of food by either reducing stomach volume or, in the case of "GLP-1" agonists, reducing your interest in food and slowing stomach emptying. But they're all the same. They reduce calories. And we know now, with very good evidence that when you reduce calories, regardless of the method, you're going to lose muscle. So about 25% of the weight you lose will be muscle. And we now know when you lose muscle, your basal metabolic rate, we say "BMR," that's the rate at which your body burns calories for the work of life. Moving, breathing, digestion, manufacturing replacement proteins, all the stuff our bodies do without effort, that requires calories. Well, when you lose weight by cutting calories, your basal metabolic rate drops by about 25%. And for all practical purposes, it's permanent. And that's why study after study after study has shown if you cut calories, regardless of the method, you lose weight, you lose muscle, which in turn reduces "BMR" and you will regain the weight as fat.

I was talking to one of the graduates of "The Biggest Loser" TV show. So he won the eighth season. He lost -- 239 pounds in seven months. Extraordinary. And by the way, goes against this notion that people are obese because they're lazy or slothful. Here's a guy who lost 239 pounds in seven months by exercising as much as six hours a day, taking in 800 calories per day, which is starvation, essentially, loses the weight. He wins, he gets the $250,000 prize. I talked to him about eight years after he finished the program, and he had left the program, "Jesse." Left the program, kept up a very rigorous two hour per day exercise routine six days a week, resistance training, aerobic exercise, and a low calorie lifestyle. He regained all the weight, and he told me he'd go back. Every year the producers of the TV show would have a reunion, and he saw all the other graduates all regaining the weight. And almost every last one said, I don't get it. I'm exercising, sometimes to extremes. I maintain a very low calorie lifestyle, yet I regained all the weight. And so the science has become clear this is due to the loss of muscle and the resultant permanent drop in basal metabolic rate.

Okay, for somebody tuning in right now, hearing that word permanent, because they're in that boat which a lot of people would be in because following conventional advice, you're gonna break your "BMR." How can somebody begin to work their way back even though it is quote unquote permanent? What's the best they can hope for and how do they work their way back to a healthy metabolism? Well, ideally you never do it in the first place, because once you reduce your "BMR," when I say permanent, the longest evidence there is six years. So maybe it reverses after 10 years. But for all practical purposes if you go from say 250 pounds down to 150 and then you regain it, whether it's 8 years, 10 years, it's for all practical purposes a permanent or at least a very long term effect. So firs order of business, don't lose weight by cutting calories using any of those methods.

If you have lost a huge amount of muscle. So let's say somebody paid $12,000, which would be common for a year's worth of a "GLP-1" agonist drug, they lose 40 pounds. And those drugs, no question, "Jesse," very effective for losing weight. So this person loses 40 pounds, which would be very typical of that weight. 30 pounds is fat, 10 pounds is muscle. Now think about 10 pounds of ground beef on your kitchen counter. It's a huge pile of muscle. So you lose that, you stop the drug because most people can't afford it forever, or you're starting to have side effects because these are very nasty peptides, drugs. And you regain 32 to 34 pounds of fat or more. You have more fat than when you started with, and you don't regain the muscle. There's almost no regain of muscle. And so because that lot of that fat's in the abdomen, you're more insulin resistant, you're more likely to become a type 2 diabetic, prediabetic, have hypertension, risk for coronary disease, cognitive decline, dementia, breast cancer, numerous other conditions is now greater. After you paid all that money, you're now sicker than you were at the start. And of course, you're just as fat as you were at the start or even fatter. So that's what people are dealing with.

So the key here is to never cut calories. You can do it for a few days at top, like some people do this time restricted eating, for instance, or brief intermittent fasts, that's okay. But the longer you go, probably beyond about 72 hours of fasting, you start to turn down your basal metabolic rate. But let's say somebody did that and they lost 10, 20, 30, 40 pounds of muscle. Not uncommon. You gotta rebuild it. But I'll tell you, "Jesse," it's hard work. It does have to involve resistance training, but it also means paying attention to all the things that amplify... muscle growth.

So one of the biggest things we do... is we manage the microbiome... So one of the major disruptors of muscle health, there's a parallel issue here, it's called myosteatosis. And all that means... is people who tend to have abdominal fat... in the abdomen that encircles the intestines, pancreas, liver, et cetera. Almost always also have fat infiltration of muscle, arms, thighs, buttocks, chest. If you had this so-called myosteatosis, it's a very, very bad marker for premature death... We know this with good evidence... So we need to get rid of it. And you get rid of it with exercise... It doesn't have to be strenuous. It could be just a walk, it could be just riding your bike, it could be swimming, it could be digging in your garden, it could be raking leaves. But it's physical activity that reduces myosteatosis.

But you can go farther. And one of the biggest things you can do is to work on your microbiome. Because if you're overweight to begin with, even after you lose the weight, you've had massive disruption of the gastrointestinal microbiome. But specifically an over-proliferation of fecal microbes. Of course your colon, when you go number two in the toilet, you're passing fecal material that came from --- the rectal colon. Well, in people who've gained a lot of weight, even after they lose weight, they've had over-proliferation of those fecal microbial species that has ascended into the 24 feet of small intestine. So 24 feet of "E. coli," "Salmonella," "Klebsiella." By the way, they may sound familiar because those are also the species of food poisoning. So... those species not good if they're in your French fries or hamburger from the fast food joint because the kid didn't wash his hands or he was using some utensil that had fecal contamination... Sadly not that uncommon. - So if you take that orally, you get very sick. Vomiting, diarrhea, fever, et cetera. Same thing happens though when those fecal microbes didn't come in by way of tainted food, but came by way of ascending from the colon. And I estimate that 50%... of the population of North America has this. Half the population has this... small... intestinal bacterial overgrowth. We say "SIBO," S-I-B-O... and "Jesse," if you said that to me... a few years, I would have said, I don't think that's right. That seems like an exaggeration. But several things happened... that have borne this out. One is the availability of this device called the "AIRE" device. A-I-R-E, that's the original. It measures hydrogen gas... This is a more recent one. And I have no relationship with the company. I know the inventor, Doctor "Angus Shortt" from Dublin, Ireland. He's an engineer. A "Ph.D." engineer. This is the more recent device. Measures hydrogen gas and methane... You blow into it and it registers a number 0 to 10 on your smartphone. Because microbes in the gastrointestinal tract produce these gases, but you cannot... So you can use these devices to map, to tell where microbes are living. There's a protocol you have to follow. You just can't test blindly, but it's very simple. It's in my "Super Gut" book, by the way. - How to use the device. But... there's a prep diet for about 12 to 24 hours. A diet free of any fiber, no alcohol, no plant matter except for green leafy vegetables. Nothing with fiber in it. - That fiber of the sort, digestible by microbes... Then you test baseline next morning, and then you consume some that microbes metabolize... We use inulin powder, for instance, a fiber, and test every 30, 45 minutes. And if there's a rise within the first 90 minutes -- fecal microbes, are living... in the upper gastrointestinal system, stomach, duodenum, jejunum, et cetera.

- But here's the thing. - Why would microbes in the small intestine have effects like obesity... or insulin resistance or dementia? Well, because the small intestine is... very, very permeable... Normally, because that's where we absorb nutrients, amino acids, vitamins, minerals. But when fecal microbes have come to colonize the small intestine, these microbes don't live very long. They live for a few hours... So when you have trillions of microbes, fecal microbes, living in the small intestine, living and dying in the space of a few hours, huge turnover. When they die, they leave their components, but specifically their cell wall components, something called... endotoxin. That endotoxin enters the bloodstream because of the permeability of the small intestine... That's called endotoxemia. Endotoxemia is a major driver... of weight gain, myosteatosis, muscle loss. So you can imagine if all you did... was do a gastric bypass or took a "GLP-1" agonist that reduces appetite, you've done nothing for this major... driver of weight gain, insulin resistance, myosteatosis. So that has to be addressed. And by the way, the way I address it, you could address it with antibiotics. But "Jesse," if antibiotics are a big part of the reason that got us here. If you take an antibiotic it's very common to gain about 8 to 10 pounds in the first few weeks after the antibiotic, reflecting the major role that bowel microbes play in regulating weight and fat and... other aspects of metabolism... So we know that the gastrointestinal microbes play a big role in your shape and body composition. So if you take an antibiotic, you could push it back for a little bit, but antibiotics got us here. So I have a very hard time believing that antibiotics are part of the solution. So I asked these questions, "Jesse." I said, well if you have this problem, small intestinal bacterial overgrowth with fecal microbes, what if you just took a probiotic? Will it go away? No. It might push back a little bit, might reduce some bloating, but it won't go. It won't kill off 24 feet of trillions of microbes. So I asked this question, what if we chose microbial species that colonize the small intestine, which is unusual. Most microbes don't do that. That is, most beneficial microbes don't do that. Pathogens do. Fecal microbes do. But what if we chose beneficial microbes that colonize the small intestine and... produce... what are called bacteriocins, natural antibiotics, peptide antibiotics... that kill... the species of "SIBO." So... I chose three... a strain of "Lactobacillus reuteri," a strain of "Lactobacillus gasseri," and the most recent recipe I modified a little bit since I wrote the "Super Gut" book, I replaced the "Bacillus coagulans" with "Bacillus subtilis." So these are three microbes that either colonize or germinate the spore former. The "subtilis" germinates in the ileum and then produces bacteriocins that kill fecal microbes. And so far, we've had very surprising amount of success with this. Crudely estimate, about 90% of people will normalize their hydrogen gas or get rid of whatever phenomena we could blame on endotoxemia. Now, I have clinical trials designed and ready to go. I'm just waiting for funding. We'll do that to formally show this. But, "Jesse," we're talking about something that looks and smells like yogurt that you make in your kitchen. We're not talking about removing your intestine or a nasty biologic drug that causes liver failure or opportunistic infections. We're talking about something that you have with blueberries and chia seeds, and also provides a long list of beneficial effects. So the threshold, the hurdle to doing this is extremely low. A little bit of hassle, a little bit of expense sourcing the microbes. But the issue is so small and so accessible that people are doing this and we're seeing unexpected success.

Okay, a couple changes you've made. You mentioned one, that one switch of a microbe from "Bacillus coagulans" to "Bacillus subtilis." Talk more about why you made that switch. Because we've been emailing back and forth, we're always keeping in touch. And even about six months, a year ago, "coagulans" was still part of your recipe. So this is relatively new. Talk about why. So "coagulans" is a very interesting microbe. This should not reflect badly on "coagulans." The reason for it was we did a bunch of assays. So one of the things we've done repeatedly is count the number of microbes. So part of a lot of this is getting sufficient counts. So for instance, the "Lactobacillus reuteri," if you ferment that by itself, when you co-ferment a number of microbes, they compete with each other, so you get lesser counts. But let's just for the sake of argument, say we've fermented "reuteri" by itself and we use 36 hours. We want to let the microbe double 12 times because it doubles every three hours. As you recall, microbes don't have sex, they just double themselves. So "reuteri" doubles every three hours or so at human body temperature. So we're going to let it double 12 times, 36 hours, when we count the number of microbes. There's a method called flow cytometry. It's a laser-assisted method because we're talking about trillions of microbes, it's a lot to count. We get about 300 billion per half cup or 120 milliliter serving. So that's part of the reason I believe we're having such great success is we're boosting counts of microbes far beyond what you get from a probiotic, because microbes are very costly if you're going to make a probiotic. - You'll see commercial probiotics typically have 1 billion, 2 billion, 10 billion, sometimes more. The reason they limit the number is it's very expensive to make these things. So we're going to use a low count, increase it by fermentation, in this case, by something that looks and smells like yogurt. It's not yogurt, by the way. --- And it's a very inexpensive way to boost counts hugely. So we did this with "Bacillus coagulans" and found it was very erratic and very unreliable in getting very high numbers in dairy. So in other words, if you were a manufacturer, you wouldn't do it in a dairy product. You would do it in some kind of, they say, broth with controlled "pH" and osmolality and mineral content. Well, we're not going to do that in our kitchens. So I replaced it with "Bacillus subtilis," which is very easy to ferment. And it happens to be a champion at making bacteriocins. It's not uncommon for many strains to make about seven different bacteriocins with a broad range of effect in killing those fecal microbes. So the "subtilis" is just a little more reliable. Got it. But results are similar. But the results are either the same or better. I think now we got to formally prove that. But it's --- very costly to do that because while we can't do it as yogurt, we have to do it in an encapsulated form. So we're going to have to put probably something like 100 billion per species per strain in the capsule. So it's going to be a very expensive trial. And we're not pharma, we don't rip people off for billions of dollars to fund stuff. So we have to rely on our own internal resources to do these clinical trials.

In the show notes, we'll link up a blog post of yours, how to make this. But in a really general sense, let's get people the lay of the land. And again, in email, I was asking you because I was going to take this on and I wanted the best yogurt maker. You told me about the "Luvele," which I love. Start there and talk about other yogurt makers, if there's any other ones that are good. And then let's go through the basic recipe. - "Jesse," they're very simple devices. It could be a yogurt maker like "Luvele." It could be a sous vide, a slow meat cooker, basin or stick. You can get two kinds. It could be an "Instant Pot." All you need is some device that can maintain a temperature. Most human-sourced microbes do best at about human body temperature. So 37 degrees celsius, 98 or so degrees fahrenheit. I say 100, 37, 38, just so it's easy to remember. Now that's not true for all microbes. There are microbes that like room temperature. So for instance, "Lactobacillus plantarum," very interesting microbe, does fine at room temperature. - I tell your listeners that because if you're going to ferment microbes, you have to be mindful of what. So if I said, "Jesse," we're going to go sit in Death Valley and it's going to be 140 degrees, well, you're not going to survive. So different creatures, different species thrive at different temperatures. Same with microbes. Most of the microbes we're talking about are human body temperature. These are human-sourced microbes.

I was at a beer brewing store and they were telling me about how they brew their beers and their wines. They use species like "Saccharomyces cerevisiae," a fungal species, sometimes "Lactobacillus brevis," if you want to get some of the malt flavour out. And they asked me, what are you fermenting? And I said, human microbes. They were horrified, "Jesse." They were like, what... no way! It struck me that's what we're doing. We're fermenting human microbes. Whether it came from breast milk or originally, not the one we use, but fecal matter from the colon, it comes from humans. And we're restoring microbes that we've lost because it just takes one round of antibiotics. "Jesse," let's say you took clarithromycin for whatever reason, or doxycycline, whatever common antibiotics, you have literally killed off hundreds of species... most of which will never return. So that's one course. And most people in North America have gotten 30 courses of antibiotics by age 40. ---- In the US alone, 650,000 prescriptions are written for antibiotics every day. Every day! So there's a time and place antibiotics are necessary. If you've got sepsis, if you've got urinary sepsis or "pneumococcal pneumonia," you need an antibiotic. But as you know, a lot of people are just given antibiotics because they have a dry cough from a viral respiratory infection, or your child has sniffles, they're given an antibiotic. And sometimes the parent is to blame. "Johnny" has a dry cough, he needs an antibiotic. So there's massive overuse of antibiotics. One of the unintended consequences of that is loss of literally hundreds of species in the gastrointestinal tract and by the way, in other microbiomes too. Skin, mouth, vagina, prostate, airway. So we have decimated our microbiome. So what we're doing here in a lot of ways is restoring microbes that were lost because of our wild overexposure to antibiotics.

Okay, we're going to come back to the yogurt. But while we're on this, talking about the negative impact of overuse of antibiotics. What are some of the other things in that realm we're doing or things in the environment that are decimating our microbiome, whether it be oral, skin, gut, and so on? There's probably a lot of things. Unfortunately, -- there's only evidence for a handful of things because when there's not a pot of gold in studying something, it's hard to get those studies done. So we have to rely on what we have, which is we know antibiotics, of course, we know that many food additives, but specifically preservatives. So preservatives are put in food to prevent, for instance, mold from growing in your baked products or your cheese or whatever. So preservatives are antimicrobial in your food and in you. So preservatives in food potassium sorbate, sodium benzoate, long, long list of these chemicals. - Emulsifying agents that keep food mixed like ice cream. Ice cream is the worst. It's got typically three or four or five emulsifying agents like gellan gum, xanthan gum, carrageenan, polysorbate 80, carboxymethylcellulose. A salad dressings, because -- people want it to stay mixed. Oil and vinegar. Probably a lot of other things, though the evidence is kind of skimpy. Chlorinated drinking water. -- Other drugs stomach acid blocking drugs, non-steroidal anti-inflammatory drugs like ibuprofen and naproxen, birth control pills. In other words, we all swim in a sea of factors that have disrupted the microbiome. But it's the antibiotics that are the worst. --- -- as well as all those other things. That's why when we study indigenous populations, hunter-gatherers in the Brazilian rainforest or the savanna of Africa or the mountains of New Guinea, they all have very different microbiomes. They have far more species than we do. They have different species and by the way, interestingly, they all have microbiomes that look almost identical to each other, even though they're separated by oceans and thousands of miles. And so presumptively, they have the microbiome of the Stone Age, of the Paleolithic, that is the period before we had antibiotics, chlorinated drinking water, food preservatives, other food additives. Glyphosate is ubiquitous now. It's in virtually all foods. It's in our water, it's in the air, other herbicides, other pesticides. In other words, we're surrounded by these things. It's probably like avoiding microplastics. You really can't do it completely. All you and I can do, and all your listeners can do, is try to minimize our exposure. But sadly, in the modern world, we can't avoid them altogether.

Earlier, I mentioned a couple different areas I've seen you change your ways when it comes to the "SIBO" yogurt, one being that microbe switch. Another thing I've heard you talking about lately is fermenting the different microbes separately. It seemed like initially it was a co-ferment. And now I'm seeing you pivot away a bit from that. So talk about when somebody would want to ferment them together versus separately. So if we ferment the "reuteri" by itself, we get something as I mentioned, 300 billion per 120 milliliter serving. When it's kind of like your backyard garden, "Jesse." So if all you and I did in our, let's say 10x10 plot, was grow tomatoes, you're going to have a lot of tomatoes at the end of the growing season. But what if you grew tomatoes and cucumbers and watermelon and squash and zucchini? How many tomatoes will you have? Far fewer. Same principle. So when you co-ferment microbes, they compete with each other and you're going to have fewer. We have not performed a count. -- You have to do "DNA" sequencing with flow cytometry to get the final composition of your yogurt. But I will say the original formula, "reuteri," "gasseri," "coagulans," did work. It worked great despite some of the difficulties with "coagulans." -- But we have not performed a relative count. And I'm seeing more and more people with really bad "SIBO." These are people who say things like, well, I took antibiotics for three years for Lyme disease, or I took doxycycline for two years for my acne or whatever they took antibiotics repeatedly or chronically. They have massive disruption. And I found that if you individually ferment these microbes, you get higher counts of each microbe and you get some increase in potency against these really bad cases of "SIBO." So it's still fine to co-ferment. But if you think you're a person who's got really bad "SIBO" because of your history of antibiotic exposure, or you've had something that signals a really bad case, histamine intolerance would be one example of a really bad case of "SIBO," intolerances to other food "FODMAPs," nightshades, fructose-containing foods, legumes. If you say, a lot of people say this, I have a list of eight foods I can eat. I can't eat anything else. That's really severe "SIBO." So if you're in that group, it might be better to individually ferment to get much higher counts because it's like -- an army. If you're going to go up against an army of 100,000 soldiers and you start the battle with a thousand of your own, you're going to lose. So you want to go to battle with sufficient numbers.

Okay, good to know. I've always co-fermented. I've always used the "coagulans" up until now. I just ordered the "Bacillus subtilis," I think it's the "HU58." So I'm going to swap that in next batch and swap out the "coagulans" and see how it turns out. But just trying to get a lay of the land here, different ideas for people in different ways you've seen people do this that have worked. Oh yeah. And the "coagulans" as I said, I wouldn't take this as a -- bad reflection on "coagulans." It's a very interesting microbe. I used it a lot with my daughter, for instance. She -- retired, but she was a professional tennis player and had a bunch of injuries, oddly. And she'd have to take time off. When she came back, she found that she lost her ranking. And when you lose your ranking, you have to start from scratch and you have to qualify to play at Wimbledon, US Open, all that stuff. So she'd have to go through qualifying rounds. Well, in the main draw, you play every other day, typically. In qualifying rounds, you play every day. So these ladies are playing often in 90-degree weather, two or three hour long matches. You're exhausted, you're beat to heck. At the end of your match, you gotta do it again tomorrow. You're sore and beaten, and then if you win it, gotta do it again. And only then do you get to the main draw. So there's a major disadvantage having to qualify. Well, one of the interesting effects of "coagulans," if we believe the evidence, is a dramatic reduction in muscle injury during strenuous exercise. So if somebody runs a marathon, for instance, and we measured what's called creatine kinase, it's a measure of muscle breakdown when they cross the finish line. There's about a 10 to 30 fold increase in muscle breakdown proteins measurable in the bloodstream. That's why some marathoners or triathletes will pee brown. That's muscle. They're peeing muscle to an extreme degree. It's called rhabdomyolysis, and that can actually be very dangerous for you. But if you get "coagulans," if we believe the evidence, it cuts your muscle breakdown by about 50%, meaning someone like my daughter, she'll still be sore and tired, but less so when she has to re-exert herself. So the "coagulans" is still very interesting, reduces pain from arthritis, has all kinds of beneficial effects, just happens to be not very happy in a dairy medium.

Given there's different ways of making this and now one of the microbes is switched, so people might be using a different microbe for that third one there. Do we have any idea macro composition of the final product when it comes to carbs, protein, and fat? We've not done an analysis, but we know that the process of fermentation, particularly our extended fermentation so unlike yogurt you buy in a store that's been fermented typically a few hours we're going to ferment for this extended period, and that maximally converts the lactose. That's the -- carbohydrate, the sugar of dairy. It actually converts the lactose to lactic acid. So a lot of your listeners who've made this will say it's very tart. And if we test the "pH," it's typically 3.5, which is tenfold more acidic than conventional yogurt. So it's very acidic from the accumulation of lactic acid. So there's virtually no lactose. We've not done a formal analysis, but we know from fermentation... and the evidence that there should be next to no lactose. For that reason, a lot of people who have lactose intolerance are fine with this extended fermentation yogurt. And people who have issues with casein, the risk may be reduced because that level of acidity, 3.5 "pH," also denatures or breaks down the casein protein, particularly the casein beta "A1" that's prevalent in North America. And so people are less likely to have immune-type responses to that casein. So we haven't eliminated all the issues with dairy, but I think we've minimized them.

And your recommendation when it comes to consuming this, at least for the protocol, is half a cup a day. Any reason we can't go well beyond that? I find for myself, I love the taste, and if I'm hungry, I want to have more than that. Any disadvantage to consuming more than the half cup? -- I just made that up, "Jesse," there's no science behind it. But my reasoning was this, we know that dairy has issues. Now, we've minimized some of the issues, but despite the prolonged fermentation, the acidity, all that stuff, there's still some hormones in there. There's still some other proteins that are not denatured that may have immune consequence. The risk is low. The whey protein is still there. That's the watery part. The whey protein has what's called an insulinotropic effect. That it provokes insulin. So as your listeners will recall, it's sugars and carbs that trigger insulin. Proteins typically don't. The exception is whey. Whey does provoke insulin. So some people will have their weight loss blocked or even gain a modest quantity of weight when they're exposed to the whey. So if someone's concerned about that, it's easy to pour off when it separates. - You can make a Greek-style yogurt where you take your yogurt, you put it in a strainer lined with cheesecloth or a coffee filter, and then put that in some larger vessel, cover it, let that go for anywhere from four to eight hours or so, and you'll see the whey drain out. You can either discard the whey or some people save it in an ice cube tray and use that as your starter for future batches. That's one way to minimize that whey effect. But there are issues with dairy, and so I was mindful of that. So I said, yeah, maybe don't overdo the dairy. But it's a very, very soft cutoff, "Jesse." You can easily go more than that.

You know what the most tasty yogurt is? It's "Lactobacillus crispatus." This vaginal microbe of all crazy things. Very interesting, "Jesse." So "Lactobacillus crispatus," the science in the last few years has been hugely clarified. If a woman lacks "crispatus," because like "reuteri" and other "Lactobacillus" species, it's very susceptible to common antibiotics. So if a woman took amoxicillin for an upper respiratory infection 10 years ago, she lost "reuteri" and her "crispatus" more than likely. Well, a woman who lacks "crispatus" is much more prone to miscarriage, so losing a baby, more likely to have premature labor, which can be catastrophic. If a woman delivers a child at 28 weeks, that child's going to have -- problems for a lifetime. Immune, neurological, psychological impairments. So lack of "crispatus," more likely to have premature -- delivery of a child. -- In the menopausal years, a woman who lacks "crispatus" is more likely to have vaginal dryness, pain, irritation, discharge, more likely to have pain with penetration, more likely to have repeated urinary tract infections, which is a big problem for ladies, and incontinence. Cough, sneeze, wet yourself. Very socially crippling. And by the way, the conventional healthcare solutions for these issues are terrible. They're terrible. - A woman has to often make decisions like, should I take estrogens and risk endometrial cancer and blood clots, thromboembolic disease? So I believe restoring "crispatus" is such an easy, simple way to reduce risk for all those things. It restores vaginal moisture, it reduces cervical inflammation, because it's cervical inflammation that caused the cervix to prematurely relax and deliver a child prematurely, for instance. So "crispatus," instrumental, critical for a woman's vaginal and urinary health. And we're seeing this. A lot of this data came from "Loyola," which is about 10 miles from my house where I'm sitting right now. They have very elegant work showing that "crispatus" reduces risk of urinary tract infections dramatically and even reduces incontinence. And what's even more amazing is the bladder that we thought was supposed to be sterile has a microbiome. And among the creatures that should be there is "crispatus." And even more remarkably, "Jesse," a woman can take "crispatus" orally, and it will colonize the vagina. How? There's no connection that we know about. -- And then it colonizes the bladder. So it's probably by contiguity, that is nearness, because that's an area that microbes are always. That's another thing, microbes don't stay in one place. They move around. - That's good and it's bad. So, for instance, one bad example is the oral microbe "Fusobacterium nucleatum," which over-proliferates if you have bleeding gums or gingivitis or periodontitis, very common. And that microbe will enter the bloodstream and then colonize your colon, where the evidence is good, is very solid. It's a major driver of colon cancer. So think about that, "Jesse." Colon cancer begins in the mouth. So the gastroenterologist is busy doing colonoscopies left and right, removing polyps, never thinking about neither the colonic microbiome nor the oral microbiome. You can see that to really understand a condition like colon cancer, you can't just look at the colon. You got to look at the entire body, including the mouth.

So you mentioned there the fact that "crispatus" taken orally makes its way to the vagina. Any other advantage... in putting the bacteria right into the vagina or right into the colon from the other side, or just going orally will be enough? - Tough questions, because no one's done these kinds of things. But I was talking to a research group who had a strain of "E. coli" that they thought prevented urinary tract infections, and they wanted to deliver this microbe by taking a big honking needle right through the abdominal wall into the bladder. And I said, why would you do that? It hurts like hell. You can miss. You can hit something, a vein or artery, and have the woman hemorrhage. You introduce injury and adhesions. A lot of reasons to not do it that way. And I said, it's your moral obligation to first prove this can't be done orally. They got mad at me. They said, no way. No way. I told them, we know -- that microbes, this is called translocation, can go from one location to another. How do you explain urinary tract infections with "E. coli," a fecal microbe? How did it get there? Fecal contamination. We know that microbes can migrate, whether you did it because you didn't wipe properly or because it just did it because of surface contiguity in the perineum. -- It can migrate into your bladder. So we know that microbes can translocate. This is well-established, but we can use it to our advantage with a microbe like "L. crispatus" because wouldn't you rather have your wife or your daughter or whatever take something orally rather than having. Because once you introduce a vaginal suppository. - So a lot of these ladies will have atrophy. It hurts. It's painful. You can typically cause bleeding. You also cause infection because when you insert things, you introduce microbes like "Staphylococcus aureus" and "Streptococcus" and fecal microbes. So the simple act of putting a suppository into a woman's vagina has risk associated. So we can do this by oral consumption. That is fantastic and spares a woman a lot of risk and discomfort.

Okay, that makes sense. And up until now, we were focusing on making this yogurt to enhance the counts when it comes to "L. crispatus," are we making a yogurt for that, or are capsules, probiotic capsules, enough? So you're getting to an area, "Jesse," where we don't have really solid answers yet, and that is the world of dose response. So I remind everybody, microbes are not drugs. They're not metabolized by your liver, they're not cleared by the kidneys. -- More or less colonize the gastrointestinal tract, and in the case of "L. crispatus," vagina and bladder. So they act differently, but we often don't know. The "SIBO" yogurt, we aim for super-duper high counts to overcome the trillions of microbes invading your small intestine. In a lot of these instances, we just don't know what the necessary count is. So a typical "L. crispatus" product will have about 5 to 10 billion. Is that enough? Don't know. So to illustrate, there's a study that came from Korea, where they compared a strain of "Lactobacillus gasseri." I believe it was the "BNR17" strain or the 2055, one of those two. ---- And they gave participants placebo, 0, 1 billion, or 10 billion, and their endpoint was waist circumference. So obviously, placebo, 1 billion, no effect. 10 billion, about 3-plus centimeters of waist circumference reduction. No change in diet, no change in exercise. Just get this microbe 10 billion and their waist shrunk by about 3 1/2 centimeters. And when they did a "CT" scan or "MRI" and mapped out the cross-sectional area of fat in the abdomen, about 21 square centimeters. So significant just from this microbe. Now, if 10 billion worked, what would 50 billion have done? What would 100 billion do? What would more than a trillion do? One of the things when you do dose response studies, it's very expensive. Pharma has the resources to do that, but a lot of us don't have those resources. So let's say your study cost you $150,000, which to pharma is a rounding error it's nothing. To us, it's a lot of money. But we added, let's say, three more dose possibilities 10 billion, 50 billion. Now your cost is more like 500,000. So it multiplies the cost of your studies hugely. So most of us don't have that. So to a large degree, "Jesse," we're in the dark. But that's why the yogurts are this cheap, easy, safe way to amplify counts dramatically. So in the original "L. reuteri" recipe, we start with 200 million, which sounds like a lot, but to a microbe, it's just nothing. It was a dose made for infants. We take 200 million, 36 hours, 12 doublings, we get 300 billion. So you get this huge increase in numbers. But I don't really know how many are really necessary. If you said, hey, I want more muscle from "L. reuteri" or I want smoother skin from "L. reuteri" or I want my testosterone to go up, or I want my wife to have better vaginal sensation and moisture, what's the dose required?" We don't know. But it's probably gauging by experience and thousands of people, it's probably in the 40, 50 to 100 billion range per day. Probably. As time goes on, we will get smarter as our evidence, other people's evidence accumulates, and we'll know better. And it may be different for different microbes and different indications, but it's in the tens of billions. And that's one of my criticisms of the commercial probiotic world, is a lot of the probiotics have what I would regard as trivial quantities of microbes, particularly these probiotics that have multiple species. So if somebody says, well, we have 50 species, well, yeah, but they're at such low numbers, does it really have any meaningful effect? So it's an area we have to work on.

Can we use the template we went over there for the "SIBO" yogurt for other human microbes like "L. crispatus?" I believe that's a human microbe. Other ones in that category. Can we use our "Luvele" and the system we've been talking about to enhance the counts? And then to explain what I'm getting into here a little further, talk about the difference between fermenting human microbes versus microbes that are on plants. In general, to make life simple, "Jesse," most, not all, but most "Lactobacillus" species "Lactobacillus reuteri," "Lactobacillus gasseri," "Lactobacillus crispatus," and others. Most do best at human body temperature. In other words, they're adapted to life in mammals your dog, deer, raccoons, and you. So they like human body temperature, which is the same in most mammals. There are some exceptions, but by the vast majority, like human. So that means "*Lactobacillus crispatus," same thing human body temperature, 36 hours. And by the way, it's the tastiest yogurt you ever had. I secretly call it vagina yogurt because it was sourced from the vagina. Some people objected. I'm sorry, but it's a vaginal microbe. And by the way, very preliminary evidence to suggest "Lactobacillus crispatus" may be very important for prostate health. -- Prostate, "Jesse," is something I haven't talked about much because there was so little we could do. There's stupid things out there like saw palmetto or finasteride. Yeah but -- I'm talking about doing natural things to set wrong things right. And it's become clear that men with prostate disease, one, almost all have "SIBO," which surprised me. A study showed that men with prostate disease, whether it's prostatitis, benign prostatic hypertrophy, "BPH," or prostate cancer, virtually all have "SIBO." Which is odd because if you had your prostate examined, the doc puts his finger in your rectum. It's right there. It's right there so I would have predicted it's the rectal microbiome that was the dominant factor. It is a factor. So it was a surprise that small intestinal... overgrowth was a major factor in prostate disease. So it must be by way of bloodstream endotoxemia. But even more remarkably, if you and I were to biopsy prostate glands that were diseased prostatitis, bacterial or non-bacterial, "BPH," prostate cancer, none of those men have "Lactobacillus crispatus." If we were to biopsy normal prostates, they all have "L. crispatus." Now, that doesn't prove that "L. crispatus" caused prostate disease, but it's starting to look that way. - --- So men with prostate disease, until we know better, means address your "SIBO," restore "L. crispatus," and address the rectal microbiome, meaning the colonic microbiome. And we do things like the fermented foods, "L. reuteri," "L. gasseri" all the things we do for "SIBO." --- Fibers, prebiotic fibers, in other words, recultivate a healthy microbiome. In other words, so even prostate colonic health, starts in the mouth. - Likewise, prostate health begins in other parts of the body. Interestingly, I call the prostate... I'm getting off topic, forgive me, but I call the prostate the Grand Central Station of the microbiome. Because if we were to biopsy a diseased prostate, prostatitis, "BPH," et cetera, you'll find oral microbes, "Fusobacterium," "Porphyromonas gingivalis." You'll find skin microbes like "Cutibacterium." You're going to find gastrointestinal microbes, of course. In other words, you find microbes from all over the body in this little prostate gland. Now, are they causal or are they just benign accompaniment? No one knows. Kind of very tough to prove. But it's looking like prostate disease doesn't start in the prostate. It starts in other places.

Interesting. Any area of the body sterile? You've talked about so many different areas now, including the prostate. Do we know of any area where microbes are not habiting? But so far, everything that's been studied has yielded microbes, like the brain. It was thought for years, forever, that the brain was sterile. It's not sterile. It's filled with very worrisome oral microbes, especially people who have dementia, Parkinson's disease, Lou Gehrig's disease, et cetera, diseased brains. But even the people without diseased brains have oral microbes like those two in the prostate. "Fusobacterium," "Porphyromonas." The diseased brains are filled with fungal species, "Candida" species and others. Now, what's not clear is whether they play a causal role in those diseases. - So we know, by the way, with good evidence (a lot of this work was done in Spain) that diseased brains in people with dementia are filled with fungal species. Does that mean we should eradicate fungi at their source, maybe oral, maybe gastrointestinal? Because there's a lot of fungal overgrowth in the gastrointestinal tract as well. No one has done that study, so we don't know. But it opens the question, does prevention of dementia, once again, start with eradication or reducing populations of microbes like fungal species in the mouth and the gastrointestinal tract? Don't know. But you can see that even something we thought was sterile, like the brain. So unfortunately, some things have not been studied, like the thyroid or the thymus gland or the vitreous in the eyes. These had not yet been studied. But so far, every organ that's been studied seems to have a microbiome and a unique signature of a microbiome.

Well, given what you just shared there and the expansiveness of this, what are the different inputs we have control over in the simplest way where we can try and regulate things like the prostate, like the brain? Obviously, we can't go in and find specific bacteria for each one and try

And put them locally and ingest them. What's the best we can do with what we know? So it's a work in progress, "Jesse," so I don't have a final answer for you.

But to make it more manageable for your listeners, as I mentioned earlier, compare your body to a backyard garden, because we're trying to cultivate microbes and acting like your body is a garden. So if you want to have a garden springtime, how do you do that? Well, you lay out your plot. You pick out the stones and the sticks and the weeds. You plant seeds for the vegetables you want. And then you water and fertilize the growing season and you have your bounty of whatever, turnips, tomatoes, et cetera.

Microbes are the same in your body. We're going to clean up the soil, meaning removing things that disrupt the microbiome, preservatives in food, emulsifying agents, minimize antibiotics, try to choose organic whenever possible to minimize your exposure to herbicides and pesticides, try to avoid getting things like stomach acid blocking drugs, anti-inflammatory drugs, and other pharmaceuticals. And there are ways, by the way, to minimize. Maybe you can't entirely eliminate in some instances, but in many cases you can minimize your exposure to such things.

So we're going to prepare the soil, then we're going to plant seeds. The seeds are like the yogurt you're talking about. We're going to restore "Lactobacillus reuteri." We're going to restore "Lactobacillus gasseri." We're going to get fermented foods.

Fermented foods are so interesting, "Jesse," because if you ferment, let's say sauerkraut or kimchi or pickles on your kitchen counter or whatever, onions, you can ferment just about anything and you let it go. So let's say you ferment some tomatoes with garlic and eggplant and red onions, very common, takes about three days. And it's going to ferment on your kitchen counter faster if you add a starter. And you consume that, where you're getting species like "Leuconostoc mesenteroides" or "Pediococcus" species.

Now, what's interesting about that is those microbes don't take up residence in your gastrointestinal tract. They might take for a brief time, but you ingest them and you put them out. So what good are they? Well, it looks as if these fermenting, these vegetable fermenting species, and these are the microbes that ferment at room temperature. In their passage from mouth to anus, then the toilet, somehow cultivate the proliferation of beneficial species that are adapted to the human body and take up residence.

So if you ingest fermented foods, you get a rise, for instance, in "Faecalibacterium," a very important beneficial microbe, in "Akkermansia," in "Ruminococcaceae," and all the other "Lactobacillus" species, "Bifidobacteria" species. So something very unique and wonderful about fermented foods, even though it's not the fermented microbes themselves that take up residence.

And then fibers, not fibers like in bran cereal, that's just inert cellulose. We're talking about fibers mostly in legumes and other plant matter that microbes can metabolize. So root vegetables, onions, garlic, shallots, asparagus, brussels sprouts, beets, radishes. You can buy them as powders. Also inulin, "FOS," "galactooligosaccharides," all these things that nourish. That's the water and fertilizer, by the way, for your garden.

And by the way, a very important fiber that almost everyone's forgotten about, hyaluronic acid, one of the few fibers that comes from animals. But it comes from organs like brain and skin and pancreas and heart. And people say, yuck, I'm not going to eat that because most people have been told, cut your saturated fat. And most people have stopped consuming organ meats. And they'll do things like buy boneless, skinless chicken breast with all the hyaluronic acid thrown away.

So because hyaluronic acid, one of the rare fibers sourced from animals, is a wonderful way to proliferate or to increase the reproduction of "Faecalibacterium," "Akkermansia," "Clostridium," all those really beneficial species. Now ladies all say this -- oh, don't tell me about hyaluronic acid. I know all about it. I pay $150 for an ounce of hyaluronic acid, and I put it right here. And it works to reduce my crow's feet. Well, yeah. So I asked them, what did it do, putting it here, to the wrinkles on your neck or on your abdomen? Of course, nothing, because it's a local topical effect.

The real magic of hyaluronic acid is consumed orally because then it goes to the dermal layer of skin, reduces wrinkles body wide. It goes to the synovial fluid of your joints and increases the lubricant in your joints, and it stimulates production of collagen in joint cartilage. And there's something called glycocalyx, that's a signal molecule that lines your arteries. And the glycocalyx is made of hyaluronic acid. The uterus, cervix, and vagina... is made largely of hyaluronic acid.

So here we are, "Jesse." We've been leading this hyaluronic acid-depleted lifestyle and suffering all the arthritis, acceleration of skin aging, hypertension, acceleration of atherosclerosis, vaginal dryness and atrophy, and so restoring. Now, most people, sadly, will say, I'm not going to eat brain. I'm not going to eat pancreas. And it's hard to get anyway. Most butchers throw it away or turn it off to the factory, make dog food, and so you can get it as a supplement. So 120 milligrams per day is a typical dose of powder. It's very easy to get. And think about a return to some organ meats, maybe a 50/50 mixture of ground liver with your ground beef or something like that. Some people eat tongue. That's another way to get hyaluronic acid.

And by the way, hyaluronic acid sources also come with collagen, which is yet another thing absent from the modern diet because we just don't eat collagen-rich foods. And collagen, another item on the list with major effects on your shape and body composition, because we know with good evidence collagen intake reduces abdominal fat and increases muscle. So this idea, just losing fat, outdated and dangerous. I should mention to you one of the reasons this comes to the fore now. All these people losing muscle on "GLP-1" agonists, and we know we now have the benefit... I'm so impressed that there are some groups that did this. The groups like the "NIH" that accumulated the "NHANES" database, the "EPIC-Norfolk" Western European database, the "ASPREE" database, these large collections of people who've lost weight and then followed for up to 10 or more years. Question asked, what happens to people who lose weight? The vast majority losing weight by cutting calories. Because if you ask any doctor, hey, what do you tell your obese patient? Well, I tell them reduce your calories, move more, eat less, reduce your portion size. And if that doesn't work, we use a "GLP-1." If that doesn't work, we put you on a gastric bypass, right? All they know is reduced calories.

And we know from these large databases, in aggregate over 60,000 people, that people who lose weight, particularly if you lose more than 10% of your body weight. So 180-pound woman losing 18 pounds, 240-pound guy losing 24 pounds you're going to die several years younger. And your last few years are much more likely to be characterized by falls, fractures, frailty, loss of independence, sarcopenia, myosteatosis, and premature death. So we've created this world, "Jesse," the conventional healthcare world, where we're giving people tools to die younger and be disabled earlier than they should have. So we've got to be smarter and talk about muscle, preservation of "BMR," and all those kinds of things.

So we have hyaluronic acid, comes from organs, fiber from animals. You mentioned collagen as well. Would that be another fiber from animals? It's a protein from animals. Yeah. There's no plant collagen. So hyaluronic acid and collagen are two things, a fiber and a protein, only sourced from animals. You can't get it from any plant source. You can manufacture it in a fiber fermentation vat, but for the most part, they're sourced from animals. So collagen comes from tendons, ligaments, tough cuts of meat, organ meats, et cetera. Most people, because we've been so turned off and become squeamish about consumption of organs, at least most of us, that most of us turn to supplements. And you get for instance, 20 grams of bovine-sourced collagen will do all these wonderful things reduce abdominal fat, increase muscle, increase the collagen in your joint cartilage, increase synovial fluid lubrication, and probably other benefits as well. But yeah, collagen.

So all we're doing, "Jesse," all we're talking about, you and I, are restoring things that people have lost. "Reuteri," we've lost it. "Gasseri," we've lost it. "Crispatus," many ladies have lost it. Collagen, hyaluronic acid, absent from the modern diet. All we're doing is restoring things that should have been part of the human life all along. But because for a variety of reasons—it could have been blundering dietary guidelines, it could have been exploitative practices of the food industry, it could be the misguided efforts of agribusiness—but they've all led us down this path of distortions of human physiology. And my colleagues come to your rescue with this awful, awful advice to cut calories, diet, pharmaceuticals, or procedures. And that's wrong.

Just look at what happens to these poor people who go through bariatric surgery is held up as the gold standard by my colleagues. They're even telling teenagers to have it, by the way. Well, what happens to people who go through a bariatric procedure? Lap-Band, gastric bypass, and some other variations. Well, we know you don't often hear this because the follow-up is very poor, because a lot of the studies are performed by docs who have a very deep interest in the profit made from those procedures. They often are sponsored by the device manufacturer or otherwise benefit financially from this process. But if you look at the evidence, it's clear that people who have bariatric surgery die of suicide. There's a huge increase in suicide after. It might not happen right away. It might take three years, five years, but there's a huge uptick in suicide. At least half develop "SIBO." And all of them lose huge amounts of muscle, meaning their future is much more likely to be characterized by falls, fractures, frailty, loss of independence, increased risk for dementia, sarcopenia, and dying several years earlier. This is the best that conventional healthcare has. So you can see this is not a matter of looking better. It is not a matter of having a firmer buttocks or thighs. This is really about life and death and having a long, productive life and very important issues. That's why I rant and rave about this, because I see the ridiculous success of the "GLP-1" agonist world. Billions of dollars now being dispensed, being prescribed for these awful, awful drugs that ruin your life, and yet they're being held up as miracles and breakthroughs. There's no shortcuts.

No, but there's smarter ways. Because you know what I hope is you and I get to, I'll get there sooner than you but get to 95. And by the way, I don't want your listeners to confuse this conversation with longevity. That's something different. That's something largely fraudulent or based on nonsense. So I hear people saying things like, well, I'm going to take these things to increase mitochondrial energetics. I'm going to take urolithin A or methylene blue or coenzyme "Q10" or ribose... or any of the factors that participate in the "Krebs" cycle for mitochondrial production of energy, and I'm going to live to 140 years old. Well, good luck with that. It'd be amazing if you extend your life by three weeks, by 50 years. Highly unlikely, at least with current science. So there's a lot of nonsense out there.

So I don't want people confused what I'm talking about, which is trying to extend your vigor and youthfulness by addressing factors like muscle, basal metabolic rate, intake of... nutrients and factors that support your muscle, reduce fat, et cetera. But this may result in longevity if you don't have type 2 diabetes or coronary disease or dementia, but it's not longevity per se. We're not going to have you live to 130 or 140 years old. That's a separate conversation.

Coming back to collagen, I'm a fan. I'll sometimes put it in my coffee. I was just wondering if you'd put it in that category of quote-unquote, animal fiber, like hyaluronic acid... It sounds like you don't really think of it like that. It does come from animals. The most common source is bovine... cow. You can also, if you look, you can get it from porcine pig sources. Marine source. Chicken's another source, even eggs. The white membrane on the inside, is also a source. Marine is becoming a little more popular, but one of the issues is dosing. So if it's a component of food, you typically don't think about dose. But dose does matter to some degree. So 20 grams for most sources. Except when it comes to marine, because marine source collagen is not just one thing. It's many different things... It might have come from some species in the South Pacific or in the North Atlantic. Very different kinds of fish. Some are bony, some are cartilaginous. So the collagen... type and content can vary a lot. But the critical factor appears to be the relative content of what are called di- and tripeptides.

So for years, everyone said, why is collagen any different? If I take whey protein or eat a piece of pork or beef, I don't get better skin and better joints. It's just a protein. Because your body breaks proteins down to single amino acids, it makes no difference how the protein comes. Well, collagen is unique in that there are specific two and three amino acid sequences, di- and tripeptides, like... "Gly-Pro-Hyp," glycine-proline-hydroxyproline, and the dipeptides that derive from that that are resistant to human digestion, they remain intact. And they go, for instance, to the dermal layer of skin or provokes increased collagen in the dermal layer and increases moisture retention. That's why ladies love collagen, because it smooths their wrinkles. It goes to your joints and stimulates production of joint cartilage. Joint cartilage is 70% collagen. So getting collagen is very important for preservation of joint... cartilage. And the marine source seems to be concentrated in those di- and tripeptides... But dosing is just not clear. There is evidence that doses of as little as 0.5 to... 2.5 grams. So 20 grams bovine, we're talking about 0.5 to 2.5 grams, some forms. The problem is commercially, if you go to a store and you buy marine source collagen, you don't know where it came from. They often won't tell you. When I deal with collagen, I know where it came from. I got it say from "Nitta Wellnex" from Japan or I got it from "Nutri" in South Korea, where they tell us where they sourced it from and the relative content of the active di- and tripeptides. Unfortunately, that information is not available at the commercial, at the retail level. So what I've been telling people is if you have a marine source, we don't really know without knowing the source. So try 10 grams, probably will be... sufficient. Or... dispense with the uncertainty, just use 20 grams of bovine. And that's the stuff that's most widely available.

Coming back to our "crispatus," I was going to ask you about "crispatus" for men. You mentioned the fact that it has an affinity for the prostate. That gets me thinking, zooming back as a whole, how different is this for men versus women? Are there any specific microbes women want to make sure they're getting or men that the other... doesn't have to worry about? Or is it all very similar? A work in progress, "Jesse."

So one thing is clear, that in most locations, so let's say, for instance you lost... 500 species because you took antibiotics in the past. Thankfully, you don't have to try to restore all 500 species. It'd be impossible. And you can't get them anyway. If... you want to get some species, you really can't buy it commercially. And you can't ferment it. So you can't replace all microbes, but thankfully restoring what I would call keystone species. So in the vagina, "Lactobacillus crispatus" would be a keystone or foundational species. In the gastrointestinal tract, "Lactobacillus reuteri," "Lactobacillus gasseri," foundational species. Now supplemented by thankfully fermented foods and all those... species that are in fermented food but don't take up residence, somehow cultivate keystone species.

So if you said, well, I understand that "Faecalibacterium prausnitzii," the most important... producer of butyric acid, or butyrate, in your gastrointestinal tract and thereby leading to reduction in blood glucose, blood pressure, triglycerides, fatty liver, deeper sleep, - extended "REM" periods of sleep, in other words, all these wonderful effects. But how do you get more "Faecalibacterium?" Because you can't buy it, you can't cultivate it... because it dies upon exposure to air. Well, you do it by getting fermented foods. And those fibers, so hyaluronic acid, for instance, inulin, "FOS," and other fibers are wonderful cultivators of that "Faecalibacterium." So you don't have to get all the microbes you want... restoring the keystone microbes.

But with the vagina, it's not clear how far you have to go. "Crispatus" is clear. You gotta have it. Maybe "Lactobacillus gasseri." And by the way, it's the vagina and skin, the two organs in the body, that must be acidic for health. Most other parts of the body are either neutral or basic, non-acidic. The blood is 7.4 "pH" slightly acidic. Neutral 7, of course the vagina really likes about 4.5, skin about 4.5, quite acidic. The "pH" scale, of course, is logarithmic. So a "pH" of 4 is tenfold more acidic than a "pH" of 5. So the vagina loves acidity... Well, one of the reasons why "crispatus" is so important, and maybe "gasseri," is they're producers of lactic acid, just like our yogurts, and bacteriocins, they kill. So if a woman has "E. coli" invading her vagina, which is very common, "E. coli" vaginitis having an acidic "pH" as promoted by... "crispatus," tends to suppress "E. coli" and other invading fecal microbes. But it's not clear, "Jesse," how far a woman has to go. Should she get "gasseri," another species, "Lactobacillus jensenii," "Lactobacillus iners," "Atopobium," "Gardnerella." We don't really know whether... a woman should, but probably not. It's my prediction. I don't know this for a fact. It's my prediction. If a woman restores "Lactobacillus crispatus," she's already... taken a huge step towards a healthier vaginal... and urinary microbiome...

"Lactobacillus gasseri," one of my favourite microbes, by the way. "Gasseri" real important for female health. It's been shown to reduce the phenomena of menstrual cycles. Menstrual cycles are misery for a lot of ladies... And "gasseri" reduce the intensity of cramps and bleeding. And for the menopausal years, it reduces what are called vasomotor symptoms like hot flashes... So "gasseri" is... very important for female reproductive health. How far does a woman have to go beyond that? Not clear.

One thing I think we need to get into in further detail, and we've touched on this organically throughout the conversation, is the... letters and numbers that are part of the strain. So it's not enough just to say "L. reuteri," "crispatus." If people want to do this right, we need to make sure we're getting the right strain. And obviously in a podcast it would be hard to go through all the different microbes, all the different strains. But just explain the importance of that so people can be aware when they're buying these.

Yeah, it's a real tangle, "Jesse," and it's almost impossible to manage unless you have somebody who understands the science. So, for instance, if you want to use "Lactobacillus reuteri" as part of the effort to reduce your "SIBO," so you want a strain that's been shown to colonize the small intestine and produce bacteriocins. So for instance, I will "DNA" sequence our microbes to show that it has the genes for both those characteristics. Problem. There are strains of "Lactobacillus reuteri." The most popular strain of "reuteri" is called... and I'm sorry about this, --- but I don't make this up, "NCIMB 30242." That strain does not produce bacteriocins, so it's useless for this purpose. So it's "reuteri," same species, but it does not. It's useless for helping you eradicate "SIBO." So... I can tell you, if I say get this strain. I've looked at it, I've looked at either other people's evidence or we ran our own evidence, "DNA" sequenced it to show it has the characteristics we want.

So for instance, the "Bacillus subtilis," I like, we "DNA" sequenced it and it produces seven bacteriocins... and a surfactant... like dishwashing liquid... Because... part of success in eradicating those invading fecal microbes is microbes are smart. We don't think of them as smart, but they're very adapted and -- they create a... so called biofilm... so that they can hide. That's why, for instance, if you had a fungal infection of your prosthetic joint, antifungal drugs are worthless. It won't get rid of it because those fungi are very good... at creating a biofilm to hide in... It makes them impervious to antifungal drugs. That's why they have to take the prosthesis out, which is terrible. But the "Bacillus subtilis" that I like. I know produces seven bacteriocins since I mapped its genes and a surfactant... and colonizes, in this case it's a spore. So it doesn't colonize, it germinates in the ileum. So you essentially have to trust the people who deal with microbes who study these things either know the evidence or have performed the evidence... And... unfortunately it's impossible for, let's say one of your listeners to say, well this is a strain of "subtilis." Is this helpful or not? You won't know unless you actually search the evidence...

Another layer of uncertainty is a company will get a strain and then change the designation to hide what it is or to fool your competition... So maybe you got the... 30242 strain of "reuteri," but you... relabeled, and this is true, you relabeled it "UALre-16." No joke. That's true. That's a real story. So you try to find. It took me a year to figure out what "UALre-16" was. I called the company, I searched the stuff, I couldn't find it. Oh that's what happened. I talked to the manufacturer, they finally set me straight. But I had to go all the way back to the manufacturer to find out what that microbe was. So bottom line, you really can't on your own, you can search literature if the strain designation was not changed by a commercial source or you rely on people who, I hope to say, like me, who actually... understand the science, know the science or perform the science, who... can say oh yeah, yeah, that "crispatus" produces lactic acid and produces two bacteriocins. -- And we "DNA" sequenced it and it has the --- characteristics we need.

We've gone over a short list here throughout our conversation, different microbes. Somebody new to this say they're going to make the "L. reuteri" yogurt. Can they go to your website and get the brands or strains for the ones we've been talking about? Obviously they're likely more popular, the ones we brought up today... Can they go there to find that information?

Yeah, I try to make it as crystal clear... So it's in the "Super Gut" book. It's also in this new "Super Body" book. Where to source the microbes, how to ferment them. So as you point out "Jesse," different microbes ferment under somewhat different conditions. Thankfully, most "Lactobacillus" species ferment human body temperature... and typically 24 to 36 hours... "Subtilis" is a "Bacillus" species... So that one you can ferment at 90 degrees Fahrenheit. So what's that, about 34 or so Celsius, something like that. And you can ferment for 24 hours or even a little less because it's a very rapid fire fermenter. So it depends.

"Bifidobacterium" species, "Bifido," we haven't even touched on that. "Bifidobacterium longum," "Bifidobacterium bifidum," very good species. "Bifidobacterium infantis," really cool species... with a whole bunch of really cool functions, including support of a female's reproductive health and... infant's health. So if a child lacks, for instance, "Bifidobacterium infantis," it's much more likely... to not develop neurologically normally. - To be at greater risk for type 1 diabetes, type 2 diabetes, later on, obesity as a teenager, as an adolescent more prone to autoimmune diseases. So one of the things we want to make sure in a newborn is that this child has "Bifidobacterium infantis," especially if it's going to breastfeed... because breast milk is rich in something called human... milk oligosaccharides. And if the child lacks "Bifidobacterium infantis" for a lot of the same reasons, exposure to antibiotics, mom or baby, it can't digest... those... human milk oligosaccharides. If the child has "infantis" and can thereby digest human milk oligosaccharides, it's much more likely to have improved neurological maturation, likely to have a higher "IQ." Less likely to have type 1 diabetes, autoimmune disease, etc. In other words, critical for the life of this child... to have that microbe.

What's shocking, "Jesse," to me, so I happen to be thinking a lot about these things because I have a daughter in law who just delivered her third child. And... this is a woman with great resources. -- She has access to all kinds of resources, docs, multiple specialists. No one tells her about all the things a woman can do to stack the odds in favor of successful... healthy pregnancy and delivery and early childhood. No one mentioned "Bifidobacterium infantis." No one mentioned "Lactobacillus crispatus." No one mentioned "Lactobacillus reuteri." No one mentioned, outside of microbes, the huge effects of omega-3 fatty acids on stacking the odds in favour of full term pregnancy... and neurological maturation of the child. -- Omega-3 fatty acids are critical for that period. No one mentioned it. So there's a whole bunch of things here not being passed down because the microbiome science is relatively new, meaning in the last 10 years, and it's going to take two generations, sadly, for most of my colleagues to say, let's say to your wife, hey, --- we should assess your vaginal microbiome to see if you have "infantis" that you can pass on to your child, see if you have "crispatus" to ensure you have a full-term pregnancy. Almost no one's doing this, so it's going to take some years. So in the meantime, we educate your listeners and they tell their docs, I'm taking "Lactobacillus crispatus" and making yogurt out of it, and it's delicious, and I'm giving my baby "Bifidobacteria infantis." By the way, you can make yogurt out of that also. So it means people having to take the reins themselves.

People say, this is too much. You get all these crazy species names, and now you have "Jesse" talk about strains. But you know what? It's worth it. We're not talking about little benefits, we're talking about huge, life-changing benefits. But some education, some work is involved. Some, you have to understand these things to some degree. It's not impossible, but it does take some work.

Early in the conversation, I mentioned the fact that for my yogurt, I'm in the process of switching from "coagulans" to "Bacillus subtilis" HU58." How is that strain, and what strain do you personally use? The "HU58" is a fine strain. I got it from my friend, Doctor "Kiran Krishnan." He's a microbiologist who started "Microbiome Labs." He's since sold it and left, but he remains a friend of mine. He lives -- 20 miles from my house, so we meet for lunch now and then. And he has studied that "subtilis," and he says this, so he's got good evidence. He did the science and showed this is a producer of bacteriocins, et cetera, all those things. Now, I say that because there's a strain of "subtilis" you can get by buying kombucha, and it's the "DE111" strain. It's a wonderful strain that produces no bacteriocins. So, if you choose a "subtilis" that you want to use for eradication of "SIBO," you don't want to choose the "DE111," you want to choose the "HU58." And I have a strain that I've studied that we know is this huge bacteriocin producer that I'll be talking about in the future also.

Can you tell us the strain or not yet? It's so early, "Jesse." We haven't even named it yet. Make it easy on us with that name. "Hahahaha." But we did exhaustive work to make sure, because I would, primarily -- want to do that clinical trial. And I want to say, okay, we chose a "reuteri," and a "gasseri," and a "subtilis," and we proved that they have the genes for colonization or germination in the small intestine and produce bacteriocins. We don't want to start with a microbe, let's say, "DE111," otherwise fine microbe, but it would be useless for this purpose. So I thoroughly studied those three species, had to discard a few. Some of the species just don't -- meet our requirements. And so I screen them. So if I say this is the strain to use, it's because I have evidence to show it has the characteristics that you need for a specific application.

So as of now, you recommend the "HU58" to somebody listening? Yeah. Sadly, "Microbiome Labs," they tell me they got acquired by "Novozymes." There's a lot of reorganization in the microbiome world, and I'm told they're going to phase it out. So I'm hoping to be able to provide a strain that will replace the "HU58," because a lot of the "subtilis" strains were not studied for this. In other words, you can imagine if you have several hundred different strains within a species, not every strain has been studied. So a lot of times we have to start from scratch and we have to submit it for "DNA" testing to see if it's got those genes. And so it's a work in progress.

Now, this is not that important when it comes to fermented foods. So if you want the microbes, say, like "Leuconostoc" or "Pediococcus" and all the wonderful effects from those from sauerkraut or kimchi, well, now we're talking about thousands of strains within a species. And so with fermented foods, don't even worry about it. You can't know if you bought commercial sauerkraut, for instance, that was fermented. They won't tell you what the strain of "Leuconostoc" is. - And the only way you'd know would be to submit it for testing, and no one's going to do that. So you just have to accept some uncertainties with your fermented foods. And so key to this with fermented foods is variety.

That's where I wanted to go when it comes to fermented foods, whether it be animal-based like salami, plant-based like kimchi, sauerkraut. And then when it comes to fibers, too, we'll expand out hyaluronic acid and different plant fibers, with all four of those different pillars. Talk about how somebody goes about getting diversity in without going too far, because it would really never end. There's so many varieties of all these things. How do we balance that diversity in a practical sense?

So, as you point out, variety in your fermented foods and thereby the microbes contained is part of it. Variety in your fibers is there's benefit to that because not all species can metabolize all fibers. So, you can see if -- you really can't micromanage this. You can't say, for instance, I'm only going to get inulin "FOS" so I can cultivate "Faecalibacterium" and "Akkermansia." It becomes impossible. So the key is variety in all those things. Variety in your fermented foods, variety in your fiber intake. And all that means is making sure you get some, maybe inulin "FOS" in your coffee. Have asparagus once in a while. Make sure onions and garlic are part of your cooking or sauteing all the time. - Make sure other root vegetables, legumes, black beans, white beans, lentils, chickpeas, hummus... make sure there's at least some of this in every meal. And by the way, I find that a very practical method. Make sure there's something fermented and a source of fiber in every meal. And that way you'll never forget. It's not hard. If you have an omelet, for instance, just make sure you get some onions, some garlic, maybe chop up some asparagus in your mix, but make sure there's some source of fiber, and then maybe have some kimchi or have some sauerkraut or some fermented pickles or some fermented tomatoes or red onions. --- With your omelet, of course, you don't want to cook your fermented foods because when you heat them, you kill them. So you make your omelet, then you have whatever your fermented food alongside, but not in the omelet.

Somebody who is in maintenance mode, they're taking in fermented foods, they're taking in fibers, they want to accentuate what they're doing with the diet by doing some ferments. They've already made your "SIBO" yogurt, cleared out "SIBO" again, maintenance mode. What does that look like? A handful of different ones. And I could probably guess "L. reuteri's" definitely a part of this, but there's also "Saccharomyces boulardii." There's so many that I know you're a fan of. What does that package of foundation of at-home ferments look like for maintenance?

Once again, variety. So I have right now probably seven different vegetable mixes fermenting. So you just have to kind of incorporate it into your habits. One thing I don't know is I choose the components of the "SIBO" yogurt, the "reuteri," "gasseri," "subtilis," for their capacity to colonize the small intestine to produce bacteriocins. How important is that once you get rid of your "SIBO?" Well, "SIBO" loves to come back for unclear reasons. So it's probably worth doing it at least intermittently, maybe three times a week, something like that. - I don't know if there's a point at which all the other things you're doing, fermented foods, maybe a commercial probiotic, can they take the place and keep your "reuteri," "gasseri," sort of going? Probably not, but I don't know for a fact. So there's a lot of things here we just don't know. But I think it is clear that fermented foods need to be a lifelong habit. And variety in fermented foods, the intake of fibers metabolizable by microbes, needs to be a lifelong habit. I don't know how important it is to continue the consumption of these keystone microbes. That I just don't know. I hope in the future I can say, "Jesse," listen, a lot of your listeners are saying, I'm sick and tired of making the "reuteri." What do I need to do to make it take up permanent residence? Right now, we don't know. I suspect maybe in a few years I'll say, all right, what you do is you restore "reuteri" with these, I don't know, seven other microbes, and it will take up permanent residence just like your mom gave it to you. So if mom gave you "reuteri," at birth, and barring your and her exposure to antibiotics, you'd have it for a lifetime, but almost nobody has it anymore. -- But why would it take up permanent residence if your mom gave it to you, but only temporary residence if you got it as a yogurt? No one knows. But it's probably what microbiologists call the consortium or the guild of microbes, that microbes live in a community. And we don't know what reuteri's community should look like.

So when it comes to the "reuteri" yogurt, your favourite is to do half-and-half. You can also use coconut milk. I emailed you about buffalo milk and you gave me a little direction there. I tried it. It seemed to work good. The consistency wasn't the same, but it still seemed to work out. What I'm getting at is different types of milk or dairy. And even within a certain type, like cow, using -- whipping cream versus half and half versus milk. So different mediums to make this yogurt. I'll have you riff on that.

They all work. The consistency will be different. I chose half and half because it gives you a nice, thick, rich end product, and we don't care about fat or calories. So just like we talked about in the start, never limit calories. And so if you have something with high calories, who cares? It doesn't matter. Cutting calories is dangerous. Taking in calories is not dangerous if your diet is otherwise filled with good foods. So half and half, higher in calorie, higher in fat, but who cares? It gives you a nice, beautiful end result. But you could use cream, you could use whole milk. It may help to preheat your whole milk, even if it's pasteurized, because it denatures the proteins, gives you a better mouthfeel. The half and half or cream already gives you great mouthfeel, so there's no point in preheating. - But likewise, those other milks you can preheat. But it may differ with each source to improve the texture.

But you can also ferment hummus... salsa, pico de gallo. - You can ferment all kinds of things. What I don't know is the relative counts, because we can't possibly, of course, perform flow cytometry on every different food. -- But you do get high counts. But here's something to remember also with fermented foods... So there's two ways to ferment your veggies. You can ferment with the microbes resident on the surface, naturally, or you can ferment with some starter source. The starter source could be a commercial packet you bought. It could be a commercial, let's say, sauerkraut you bought, or commercial fermented pickles. Take some of the brine, and that can be used as a starter and that will accelerate the fermentation process considerably. But those ferment at room temperature. So you can --- slice your pickles, for instance, got to make sure they're organic, make sure they're not coated with waxes. Because you want the microbes on the surface, and you don't want those waxes anyway. And then you ferment it on your kitchen counter. I emphasize this because people will say things like, I'm going to ferment my pickles with "reuteri." You really can't without heating it to human body temperature. And that changes the food. If you did berries, for instance, it would make them really mushy. So you can't always ferment our human microbes in food, but some you can. Hummus I've done successfully. Salsa I've done, pico de gallo I've done, and some other foods that you can. But you have to heat it if you're going to use a human-sourced microbe. So when it comes to vegetables, we need that microbiome that's naturally on them unless we're going to add a culture to it.

What about dairy and people using raw dairy? I assume there's a whole microbial community already within that. Have you seen anybody use that as a base to make the yogurt you recommend? Yeah, and it's a shame because you really have to heat it. Because even though there's great microbes in that raw dairy, there can be, even if there's a little teensy, weensy bit, very low counts of "Listeria monocytogenes," or "Staphylococcus aureus," and you ferment it, the number of "Listeria" and "Staphylococcus" will increase dramatically, and you can die of that yogurt, especially if children consume it. And so in other words, the process of fermentation amplifies microbial counts about a thousandfold. And so if you do that and there's some "Listeria" or "Staphylococcus aureus" in there, you're going to ferment the pathogens, and you can make it. - So for that reason, you really can't ferment raw. Consumption of raw milk is different than consumption of yogurts fermented from raw milk. Two very different things.

All right, as we wrap up here, I want to come back to body composition, how we started out. We've talked about how calorie counting, that's a mess. And we're going to lower our "BMR." We're going to cause muscle loss. We don't want to go that route. We talked about how eradicating "SIBO" is connected to body composition. Come back to that, and then we'll go from there and talk about your way of modifying body composition for somebody right now that has weight to lose.

So among the most important things is, as you point out, "Jesse," eradicating "SIBO." And I would urge people to do it with our "SIBO" yogurt that you make, not with an antibiotic, but with the "SIBO" yogurt. And it's fun to do. It's delicious. And it's inexpensive. - Restoring factors lost from the human experience. Collagen, hyaluronic acid, as well as things that influence. So a major driver of abdominal fat is insulin resistance, the inability of your body to respond to insulin. So we restore vitamin D and magnesium, basic stuff, omega-3 fatty acids, iodine. Those four nutrients lacking in modern life, when restored, synergize to minimize insulin resistance. Getting rid of "SIBO," a huge reduction in insulin resistance. Restoring microbes that normalize hormones "reuteri," "gasseri." - As it happens, the same ones in "SIBO" yogurt also normalize cortisol. So anybody who's stressed, for instance, wakes up at 3:00 in the morning wide awake and they can't fall back asleep, that's an inappropriate cortisol surge. It's hard to shift the timing of that cortisol to 6:00 a.m. where it's supposed to be, but you can at least subdue its rise. "Reuteri" does that. "Gasseri" does that. We want to boost oxytocin from the brain. "Reuteri" does that. And a healthier diet and restoration of the intestinal lining via endocannabinoids. That also increases oxytocin release because oxytocin, even though oxytocin is called the hormone of love and empathy, I call it the hormone of -- shape and body composition.

Now, resistance exercise in some form is very helpful, but I've become, to my great surprise, "Jesse," I've become a big fan of vibrating plates because the evidence is quite good. Now, when I first heard about people telling me about vibrating plates, I thought, what, no way. --- And that's going to change... It does, the evidence is quite good. -- So think of vibrate... It's called whole-body vibration. It's a mimic. It's an exercise mimetic. It mimics the effects of exercise. But to my great surprise. So there's a world of things called myokines. You've heard of cytokines like leptin and adiponectin. These are peptide mediators of metabolism, most of which come from fat. But there's also something called myokines. These are peptide mediators of metabolism that come from muscle. The less muscle you have, the less myokines you have, the more myosteatosis you have, fat infiltration of muscle, the lower myokines you have. And we know people with lower myokines die younger, develop loss of muscle, have more insulin resistance, lower testosterone, more likely to have osteoporosis, hip fractures, early death. So myokines confront... And so we haven't even talked about that. But the microbial solution to myokines begins with eradication of "SIBO," because we know that myokines and muscle metabolism contributes, not solves, but contributes to reduction of inflammatory mediators that antagonize your myokines. So eradicating "SIBO," big first step. Resistance exercise helps. Vibration plates that have been shown to reduce abdominal visceral fat, a source of adipokines that antagonize myokines, that also have been shown... Vibrating plates are not so good at increasing muscle mass, but they're spectacularly effective for increasing muscle strength. So a very common result with vibrating plates is about a 25% increase in your strength in the first few weeks using it 10 minutes a day. So we're talking about effects that may even surpass the benefits of exercise. So that, kind of in a nutshell, is what we're doing to take back control from this awful thing called weight loss and replace it with being aware of muscle, "BMR," myokines, and all the things that lead to a long, healthy life.

All right, Doctor "Davis," we're going to leave it there for today. I always enjoy our conversations. We're going to link up the new book, your website, social media, everything in the show notes. Thank you again. Thank you, "Jesse." Thank you for your thoroughness and your perseverance, which is fantastic. Now that you're done, you're going to want to stick around here and catch this other incredible episode. You don't want to miss it. I'll see you over there. We're all born with about 200 very important microbes, and they're starting to go endangered now. We're lucky to get a handful. We're missing a lot of them. And I think as soon as the public starts to learn about how important

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1/2 Cup per Day to Fix Insulin Resistance & Shrink Belly Fat | Dr. William Davis

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