Gut Expert: Eating THIS Everyday Protects The Gut from Diseases | Dr Karan

Summary

The Neuro Experience – Gut Expert: Eating THIS Everyday Protects The Gut from Diseases | Dr. Karan

Main Theme

This episode features Dr. Karan, former NHS surgeon and founder of Loam Science, discussing the critical role of gut health—specifically fiber intake—in preventing colorectal cancer and improving overall wellness. Host Louisa Nicola and Dr. Karan explore the intersections of gut health with cancer, chronic disease, neurology, mental health, and practical habits for everyday gut optimization.

---

Key Discussion Points & Insights

The Rise of Colorectal Cancer in Under-50s

• Colorectal cancer is now the leading cause of death in people under 50 in the U.S. Early detection dramatically increases survival rates (90% if caught early; only 20% if caught late).
  • “When colorectal cancer is caught early, nine out of 10 people survive. When it's caught late, only two out of 10 survive, which is nuts.” – Dr. Karan [00:07]
• Younger populations are less likely to get screened and have lower fiber intake, contributing to the rise.

Why Fiber Is Essential

• Fiber is the "rent for your colon": It protects against DNA mutations, reduces cancer risk, and nurtures the microbiome.
  • "The rent for your colon is fiber. It reduces DNA mutations and reduces the risk of cancer." – Dr. Karan [00:42]
• Hunter-gatherer tribes (e.g., Hadza in Tanzania) consume up to 100g/day and exhibit minimal chronic disease and unique microbiome diversity.
  • “They have the lowest incidence of chronic disease in the world and have bacterial strains in their microbiome which don't exist in western populations.” – Dr. Karan [10:57]

Fiber and the Microbiome (Crash Course) [07:01]

• Think of the gut as a garden: Prebiotics (fiber) nourish the soil, allowing existing “seed” microbes to thrive.
• Prebiotics = food for probiotics; probiotics = live beneficial bacteria; postbiotics = the beneficial compounds (like short-chain fatty acids) produced by bacterial digestion of fiber.
  • Short-chain fatty acids (SCFAs) are anti-inflammatory, maintain gut lining, and block toxins.

Diets and Gut Health

• Carnivore Diet: Short-term benefits, but lack of fiber can shift gut bacteria to “putrefactive” types that feed on the gut lining, increase inflammation, and produce toxic byproducts.
  • “After a couple of months, my bowels just stopped, like someone just turned the tap off … they start digesting that, it turns into a pro-inflammatory atmosphere.” – Dr. Karan [12:39]
• Fiber-Rich Foods: Beans and legumes are highlighted as top choices (high fiber and protein).
  • “Absolute S tier food that everyone should have in their rotation … daily is beans, beans, and legumes.” – Dr. Karan [41:25]
• Gradual fiber increase: Needed to avoid initial bloating/gas as microbiome adapts (“fiber fart curve”) [43:11].

Beyond Fiber: Other Lifestyle Factors Impacting Gut Health

• Medication: NSAIDs, PPIs, antibiotics, SSRIs can disrupt microbiome (“gut dysbiosis”), increase gut permeability or “leaky gut”.
  • “NSAIDs are some of the most effective painkillers you can get. We unfortunately don’t have good alternatives for it that has an impact on the gut microbiome long term.” – Dr. Karan [19:11 - 20:23]
• Sleep: Poor sleep deregulates gut clocks, messes with bowel patterns.
  • “If you have a bad night's sleep…the abnormalities … can lead you to maybe miss your poop window in the morning.” – Dr. Karan [36:39]
• Stress: Via vagus nerve, stress triggers inflammation, alters gut motility and microbiome composition; linked to both acute diarrhea and chronic constipation.
• Physical Activity: Promotes microbiome diversity and regular bowel movements.

Gut Health & Longevity, Brain, and Hormones

• Gut-brain axis: Poor gut health linked with depressive symptoms. Certain beneficial bacterial strains (Coprococcus, Faecalobacterium prausnitzii) are lower in people with depression.
  • “Are we missing a paradigm of mental health treatment by not focusing on microbiome-mediated therapies for the brain?” – Dr. Karan [17:30]
• Gut-hormone interplay: Fiber helps regulate estrogen (impacts menopause, endometriosis, and fertility).
  • “Estrab alone…this subset of bacteria…have these enzymes called beta glucuronidase, which can unlink this conjugated estrogen.” – Dr. Karan [31:48]
• Link to chronic disease: Fiber intake lowers risk across many diseases—cancers (colorectal, breast, endometrial, pancreatic, liver), heart disease, type 2 diabetes, and fatty liver.

Testing the Microbiome – Limits and Utility

• Microbiome tests (now metagenomics) can track your own baseline, but lack standardization.
  • “You, you and I can do stool tests from four different companies and get four different results.” – Dr. Karan [22:24]
• Focus on symptom tracking and gradual diet/lifestyle improvement over chasing test perfection.

---

Notable Quotes & Memorable Moments

• “The rent for your colon is fiber.” – Dr. Karan [00:42]
• “When it's caught early, nine out of ten survive. When it's caught late, only two out of ten survive, which is nuts.” – Dr. Karan [00:07]
• “Hippocrates said it best. All diseases start in the gut. … We’re beginning to see how closely the gut is linked to so many organ systems via the microbiome.” – Dr. Karan [16:36]
• “Fiber is not sexy. It's boring, it's basic, it's right under our nose … but it is the cheapest, easiest needle mover for longevity.” – Dr. Karan [54:54]
• “I invented the ‘fiber fart curve’ ... Bloating and gas means your microbiome’s adapting!” – Dr. Karan [43:11]
• “If you increase your fiber intake by 10 grams per day, you lower your colorectal cancer risk by 10%.” – Dr. Karan [53:32]

---

Timestamps for Key Segments

• Colorectal cancer crisis & screening: [00:00]–[03:21]
• The microbiome crash course (gut as garden): [07:01]–[09:18]
• The Hadza tribe: fiber, diversity, and extinction of species: [10:12]–[11:42]
• Personal diet stories; carnivore, ‘fiber fart curve’, adapting gut: [12:35]–[14:45], [43:11]–[44:45]
• Medications & gut disruption: [19:11]–[21:15]
• Gut-brain axis, depression, and diversity: [16:36]–[17:30]
• Testing the microbiome, limitations: [22:04]–[25:06]
• Impact of stress, sleep, and exercise: [34:05]–[41:14]
• Best foods for gut health & beans as a superfood: [41:25]–[42:39]
• Preparation of beans & GI symptoms: [44:45]–[45:53]
• Eating the rainbow, fiber diversity: [45:53]–[46:57]
• GLP-1 drugs and gut health: [47:11]–[48:13]
• Probiotics vs. prebiotics: [48:13]–[49:07]
• Formulating effective fiber supplements (LOAM): [49:11]–[53:15]
• Three non-negotiable gut health habits: [53:32]–[54:54]

---

Practical Takeaways

Dr. Karan’s Three Non-negotiable Gut Habits [53:32]

1. Increase fiber by at least 10 grams/day (about 1 avocado or supplement, e.g. LOAM)
2. Prioritize good sleep
3. Manage stress and stay physically active

---

Final Thoughts

Fiber is THE underrated super-nutrient for gut and global health. Its benefits extend far past digestion—lowering cancer risk, benefiting the heart, hormones, immune system, and even the brain. A diverse, fiber-rich diet (think “beans and beyond”) together with good sleep, stress management, and movement lays the foundation for long-term vitality.

---

Host: Louisa Nicola
Guest: Dr. Karan
For more: Follow Louisa (@louisanicola_) or Dr. Karan on Instagram and look for research updates on Loam Science.

Transcript

[Louise Nicola]

As of this year, the number one cause of deaths for people under the age of 50 in the US is colorectal cancer. Is this scary to you?

[Dr. Karan]

Massively. Because when colorectal cancer is caught early, nine out of 10 people survive. When it's caught late, only two out of 10 survive, which is nuts. The problem is inflammation can cause mutations in the belt and cancer progress and eventually invade the mucosa and breach the lining of the colon. We're beginning to see how close closely. The gut is linked to so many different types of cancer.

[Louise Nicola]

There must be a reason why you're so passionate about this, because, you know,

[Dr. Karan]

I had my own health issues with fatty liver disease. So that started my journey of figuring out the microbiome in fiber. One of the dark matters of our universe.

[Louise Nicola]

Let's talk about why fiber is so important.

[Dr. Karan]

The rent for your colon is fiber. It reduces DNA mutations and reduces the risk of cancer.

[Louise Nicola]

Ultimately, what are three simple, non negotiable habits to dramatically improve gut health and lower their cancer risk?

[Dr. Karan]

10 grams of fiber. Sleep.

[Louise Nicola]

And I'm drinking low foam right now. Tell me what I'm drinking.

[Dr. Karan]

Six different prebiotic fibers which feed the entire colon and microbiome. It's almost three kiwis worth of fiber.

[Louise Nicola]

Three kiwis worth. Okay. I'm Louise Nicola and this is the neuro experience. Dr. Curran, welcome to the Neuro Experience podcast.

[Dr. Karan]

I'm excited to be here. Second appearance.

[Louise Nicola]

I know, I know. This time in person. You were on the front lines of the nhs. You were a general surgeon, so you've seen a lot. I want to start with a statistic that genuinely shocked me. As of this year, the number one cause of deaths for people under the age of 50 in the US is colorectal cancer. Now, you were a general surgeon at the nhs. Is this scary to you?

[Dr. Karan]

Massively. Because we're seeing the incidence of practically every other cancer go down except colorectal cancer, especially in the under 50s, as you said. And when colorectal cancer is caught early, 9 out of 10 people survive. Survive. It's like a 90% or over survival rate. But when it's caught late, only 2 out of 10 survive. So it is easily treatable in many cases, but we need to catch it early, we need to screen more, we need to look at our poop more, we need to eat more fiber. And unfortunately, we're lacking in a lot of those domains.

[Louise Nicola]

Okay, so break it down for me. Why is it under the age of 50, like, why are we getting this scary, alarming statistic of all of these people. And is it because the general screening age of a colonoscopy is like, not until our 40s.

[Dr. Karan]

Yeah. It varies country by country. Whether you're in the uk, Australia, the us the age at which you start getting a screening changes. And there's emerging research which suggests that we could continue to bring that screening age earlier, because the earlier you screen something, the bigger, better the chances are at stopping it progressing to a terrible stage. And there's a number of reasons why it's increasing in younger people. The younger people are more likely to be the ones that are fiber deficient and eating less fiber. They're also the ones that are not doing the screening because they're not hitting that threshold age in which they need a colonoscopy, or they're doing a stool sample test where they're scooping the poop and sending it in to look for blood. They're not doing all those things. And they're likely to think that it's a disease of old age, and they're less conscious of that. And so we're probably seeing it because of those reasons.

[Louise Nicola]

So colorectal cancer is something that can be detected almost like 95% with a colonoscopy. Right. And it starts off with polyps, is that correct?

[Dr. Karan]

Yeah, in many cases, it can start off as a polyp. You can have benign polyps which don't progress. You can had, you know, polyps which do progress and eventually invade the mucosa and breach the lining of the colon. Yeah, it starts with polyps. It can be polyps. It can be just metaplasia, which is a change in the cells or the number of cells. Dysplasia, where there's dysplastic cells, the actual mutation in the cells. And polyps are just one type. It can be so many different types. And actually, you've got multiple layers of the colon. You've got the mucosa, which is the inner lining. You've got the muscularis layer, which is the muscle layer. You've got the actual lumen. You can have the cancer at so many different stages of that. And you can even get extrinsic cancers which press on the colon and cause obstructive symptoms. You can get metastatic colorectal cancers, which come from another primary cancer source, like from the liver or from the bone, and then spread to the colon. So it's really wide. And even, you know, if 100 people in a room had colon cancer, they can each have different genetic variations of that colon cancer.

[Louise Nicola]

Cancer would you say I was. I'm bringing this up because I just. I spoke to a neurologist about Parkinson's disease and he believes that Parkinson's disease is a man made disease. Would you believe? Well, is this the same for certain types of cancer?

[Dr. Karan]

I mean, when you say man made, do you mean that it is a result of modern life and the vices of modern life?

[Louise Nicola]

Yes.

[Dr. Karan]

In which case, yeah, we can blame the environment as a influencing factor for a lot of things. For example, the. There's a growing appreciation for the gut lung axis. There's microbes in the lungs, there's microbes in the gut and they interact with each other. So the interface of the lungs with the environment and pollution and microplastics can, via the gut lung axis, potentially influence our microbiome. So yes, external influences can worsen or improve our health. And in many cases you could say yes. And you know, to your point, Parkinson's. Just to quickly touch on that. There's even some data suggesting that there could be certain bacterial species which contribute to and worsen Parkinson's and that could be a component in Parkinson's disease.

[Louise Nicola]

It's paraquat, I think, that chemical. And try something. Yeah, that's interesting. I know that you've switched your careers. Not switched, but you've taken a bit of a left turn. What do you do now?

[Dr. Karan]

What do I do now? I support my wife during her pregnancy. We're in the last few weeks before the baby pops. And I started Loam Science, a microbiome company, because, you know, I had my own health issues with high LDL cholesterol, fatty liver disease. I know we've spoken about cholesterol before via text and for me it was a result of very high protein intake with saturated fats, you know, sort of in 2018. And that led to fatty fat deposition in the liver. And it was a result of the high trans fats and saturated fats and low fiber intake. So that started my journey of figuring out the microbiome in fiber and led to me creating a fiber supplement that I couldn't find out there. And yeah, educating online. I love it, same as you do.

[Louise Nicola]

Yeah. Okay, I need you to break down this for me, all right? This is going to be a crash course on the microbiome for God knows what reason, why it's so hard for me to understand. Bring me neurology. I get it right. Bring me the gut and the gastrointestinal system and for some reason you lose me. But I do know that there's a direct relationship between the gut and the brain. So I need to know it. Let's talk about the gut and then let's talk about why fiber is so important.

[Dr. Karan]

Yeah. So I like to think of your gut as a garden. Right. And if you want to maintain that garden and look, make it look pretty, there's multiple routes you can go down. You can just keep buying more plants, I. E. Probiotics, and just throwing them in there. But a more sustainable and better option is to nourish the soil of that garden, the lining of the colon, and the already the seeds of life which are already in your garden, your natural microbes, and you nourish them with fiber. You nourish the soil and you kind of fertilize the soil. And that is the role of prebiotic fiber. And that allows the seeds, which are already present in your garden, to flourish. So you know, you're feeding the microbes which already exist, instead of adding stuff there. So you have prebiotics, which are the food for the probiotics. And when you feed the probiotics, they produce postbiotics, which are beneficial compounds like short chain fatty acids, butyric acid or butyrate propionate acetate. So that is the spectrum of pre, pro and post. And the rent for your colon is fiber. That is how you feed and nourish your colon. Because what happens is if we then put names to them, fiber is metabolized and broken down by the bacteria and they produce short chain fatty acids, which causes an anti inflammatory effect on the colon. It reduces the gaps between the junction cells, so there's less intestinal hyperpermeability and less toxins can leak into the bloodstream from the colon. And it nourishes the entire colon and other cells and reduces DNA mutations and fragmentation and reduces the risk of cancer ultimately.

[Louise Nicola]

Really?

[Dr. Karan]

Yeah.

[Louise Nicola]

How so?

[Dr. Karan]

It's directly as a result of the anti inflammatory effect, because inflammation can cause mutations in the colonic cells. That is one thing. And also fiber, when fiber is fermented and broken down by a lot of these bacteria, a lot of these anti inflammatory compounds reduce the propagation and growth of pathogenic bacteria like E. Coli strains, which might be there. And E. Coli strains are the type that can be oncogenic.

[Louise Nicola]

Yes.

[Dr. Karan]

And actually cause those little, you know, oncogenes to activate in the colon cells. So it's twofold, it nourishes them and stops the bad stuff happening as well. So it's both a shield and a sword.

[Louise Nicola]

So, okay, so you've got this massive garden which is your Gut microbiome. And we need to be feeding it with fiber rich foods to basically protect the pro, the probiotics, I guess, because the prebiotic. Would you consider that vegetables?

[Dr. Karan]

Yeah. So I think about it as the, you know, there's several food groups, the five food groups. You've got your nuts and then your seeds and then you got your fruits and you got your, you know, just vegetables and your berries, you know, beans, legumes, berries, nuts, seeds, fruit and veg. So you know, you got all of those different buckets. And a lot of people think that fiber is just vegetables or just fruits, but it's going beyond that as well. Like even for example, dark chocolate, that's a fiber rich source of food. Or, you know, avocado. People don't often associate avocado with fiber, but one avocado is 10 grams of fiber, which is a third of your recommended daily intake.

[Louise Nicola]

Yeah.

[Dr. Karan]

Which is nuts.

[Louise Nicola]

Wow. So 30 grams of fiber a day is the minimum.

[Dr. Karan]

This is what we're getting wrong. The government recommendations, most government guidelines suggest a recommendation of 30 grams of fiber a day. Right. But that is such a reductionist view and that's outdated information. We have data from a lot of these large scale epidemiological studies and trials and meta analyses. If you look at the dose response curves in those studies, there is continued benefit for health beyond 30 grams of fiber a day. And we know that if we look at certain populations around the world, like the Hadza tribe in Tanzania, they're eating upwards of 100 grams of fiber a day and they have the lowest incidence of chronic disease in the world and have bacterial strains in their microbiome which don't exist in western populations.

[Louise Nicola]

Bacterial strains in their microbiome, what does that mean?

[Dr. Karan]

So they've done microbiome analysis of the Hadza tribe and these people are considered the closest we have to hunter gatherer tribes. How we used to live hundreds of years ago. Right. And they're eating over 100 grams a day. And they also did the microbiome analysis of other African populations like in Malawi, Italians, USA and the uk. And the amount of bacterial abundance and different bacterial species is completely dominated in, in the Hadza tribe, They've got over 26 unique bacterial species which you don't find in other populations. So we seeing an extinction of bacteria in the rest of the world, but these guys are somehow maintaining it because of their fiber intake.

[Louise Nicola]

And those species, those 20 to 30 that they have, what is that doing

[Dr. Karan]

all sorts of things. I mean, different bacteria produce different compounds and have slightly different roles. Almost like different vitamins have overlapping functions but do different things. Vitamin A is slightly different to vitamin C, D, E, whatever. Bacteria are the same. They sometimes occupy different anatomical sites in the colon. They do different things, they can fight against different pathogens, they can produce different metabolites and compounds. So that's why we say diversity is good, because you've got different people, different workers in your body doing different things.

[Louise Nicola]

How many do we want of those?

[Dr. Karan]

Well, we've got thousands of different bacterial species living in our guts. You know, it's hard to quantify how many more or how much more diversity we had hundreds of years ago. But we can safely say that there is a gradual loss of biodiversity, not only in the real world, but microscopically as well.

[Louise Nicola]

So then you must hate the carnivore folks then.

[Dr. Karan]

The truth is Louisa, that we don't have enough long term data on health outcomes. The carnivore diet I have been a carnivore in 2016 for 10 weeks. I was a carnivore. My personal trainer was my friend at the time, still was my friend. He got me on the carnivore diet because I said I wanted to lose some weight and I did. I lost about 10 kilos in you know, less than two months. And I felt good, you know, it didn't have that fogginess in my brain. I had more energy. But after the couple of weeks, after the couple of months, my bowels just stopped, like someone just turned the tap off and I felt awful and I've just felt not myself. And you know our bacteria, they are natively, they're called saccharolitic species. They like to ferment fiber and when you deprive them of fiber, they switch modes like gremlins, they turn into proteolytic or putrefactive species. They start wanting to digest protein. And guess what's protein rich in your body, your tissues? Yes, the gut lining is protein. So they start digesting that, it turns into a pro inflammatory atmosphere and environment. You get the leaky gut symptoms where you get the gaps going. Protein fermentation produces ammonia, indoles, P cresol, all of those things are toxic byproducts and pro inflammatory guys.

[Louise Nicola]

I am a big believer in testing instead of guessing, especially when it comes to your health. And for years we've been told to wait until something goes wrong before looking at our blood work. I mean that's what the medical system is right now. Know you break an arm and you're in the hospital and that's great, but it never taught us how to get on track as a preventative method. And this is why I use function health. Because when you use function, it gives you access to over a hundred different biomarkers all in one place. They've got this amazing platform that you can look at everything. It tracks all of your biomarkers over time so you can start seeing your patterns. And for me, the power is in the insight. So instead of wondering why your energy is off or your mood or your focus, or you're wondering if you're in perimenopause, you can actually see what's happening inside your body and make decisions for real data. Now, if you want to get some clarity and if you want to get your blood work done with function health, you can. You'll get a discount if you sign [e-mail] louisianicola or go to functionhealth.com, use code NEURO100 at signup to get started. I need to talk to you about mito pure because if you listened to the episode last week, you will know that one of the most fascinating things about aging research right now is the role that mitochondria play in how we age. So these tiny little structures inside our cells are responsible for producing energy, and when they start to decline, everything from physical stamina to cognitive performance and diseases. I have been taking mitopure from timeline. It's built around a compound called urolithin A. Now, urolithin A, this is the only place you can get urolithin a helps your body recycle and renew damaged mitochondria so your cells can produce energy more efficiently. Now, I'm currently taking four of the timeline nutrition capsules. You can just go to timeline.com neuro you can search it all. But what I like to think about is this is not a stimulant or a quick fix. It's supporting energy at the cellular level, which is exactly what longevity science is. Now, these are phenomenal. If you want 20% off, go to timeline.com neuro you know, whenever I talk to a gastroenterologist, right, I speak to them, and they believe that the root cause of a lot of the diseases comes first and foremost. A they say it mitochondria, I think almost every physician know argues that. But then it's also gut microbiome dysfunction. Do you believe that?

[Dr. Karan]

I mean, Hippocrates said it best. All diseases start in the gut. And that sounded like a very fanciful way of, you know, saying, yeah, the Gut does everything. Well, they didn't know much back then. But we're beginning to see how closely the gut is linked to so many organ systems via the microbiome. You know, we've seen that in a lot of chronic inflammatory skin conditions. Acne, rosacea, psoriasis, eczema. When you improve the gut state, you can reduce exacerbations of those skin conditions and maybe even control them to some degree right by the gut skin axis. Because when you produce short chain fatty acids, which are antioxidant and anti inflammatory by nature, those are all carried around in the bloodstream. And you've got vessels in the skin, blood vessels in the skin as well, capillaries, and they travel there and can produce and manifest their effects in the skin and reduce that inflammation and redness in the skin. The gut brain axis, you know, we're

[Louise Nicola]

talking about suppressive symptoms.

[Dr. Karan]

Yeah, absolutely. Are we missing a paradigm of mental health treatment by not focusing on microbiome mediated therapies for the brain? You know, and we know actually there was a, there was a large Flemish study done where they looked at the microbiome of people with depression. In a population, people with depression had lower levels of Coprococcus and Faecalobacterium prausnitzi, which are two very beneficial anaerobic bacterial strains which are good to have. So actually in that depressed population they had lower diversity of bacteria in general and lower of those good species. I mean it's again, it's a population study, association correlation or causation. But at a certain point a big enough correlation becomes close to causation.

[Louise Nicola]

Yeah, population medicine and would. Okay, so let's break down then. What are we doing in our everyday life just today in 2026 that is eroding the good species of our gut other than not eating enough fiber? And by the way, I don't track my fiber. I actually don't track anything right now, which is when I say I'm going to be really transparent. I took my OURA ring off.

[Dr. Karan]

I did that as well.

[Louise Nicola]

I took it off and I've got a dent on my middle finger. Actually, I haven't been wearing the OURA ring. I don't track anything. And it's just a new thing I'm doing, right. I'm actually less stressed.

[Dr. Karan]

Okay?

[Louise Nicola]

So I don't wake up every day and I don't see my heart rate variability. It's a new thing I'm doing. So I don't even track my food. But I would say that I'm not Getting anywhere near that amount of fiber per day. So we'll talk about that. But other than food, outside of nutrition, what else is breaking down the lining of the gut that's making it more permeable, where pathogens can get in and cause it's causing leaky gut. Is that what it's called?

[Dr. Karan]

Yeah. So leaky gut is this, you know, phrase diagnosis, catch, all term popularized, you know, a lot online. There's no official leaky gut diagnosis, but you can get these leaky gut type symptoms which is like, you know, constipation, diarrhea, bloating, abdominal cramps, all those things are just kind of a vague constellation of symptoms. And you can categorize them into leaky gut symptoms. And there's a lot of other conditions which may have overlap with them, like small intestinal bacterial overgrowth, irritable bowel syndrome, including inflammatory bowel disease, you know, but ultimately, beyond the fiber deficiency state, there are other things that we could attribute to poor gut health. And it's something which helps to give us life but can sometimes limit it as well. You know, medicines which we need, non steroidal anti inflammatory drugs, you know, ibuprofen, neurofen, naproxen, all of those. People take it pretty often. You know, if you're an athlete and you've got inflammation, you've got pain, you might take an anti inflammatory. Right. A lot of people with rheumatoid arthritis or autoimmune conditions, they've got joint pains. NSAIDs are some of the most effective painkillers you can get. We unfortunately we don't have good alternatives for it that has an impact on the gut microbiome long term.

[Louise Nicola]

Why?

[Dr. Karan]

Because it's an anti inflammatory compound which also it can raise the risk of GI bleeding as well because it inhibits platelet function. That's one of its roles that it does. It causes dysbiosis in the gut. There have been studies which have been looking at certain types of medicines which cause gut dysbiosis. NSAIDs are one of them. We also know that proton pump inhibitors, omeprazole and zoprazole, they also cause gut dysbiosis because they reduce stomach acid production. Stomach acids are both good and bad. Too much stomach acid or a reflux can cause symptoms, but too little, you can get an overgrowth of some of the bugs that the acid was killing and they can then translocate deeper into the gut. Antibiotics, you know, life saving, but also damaging when it's used unnecessarily. So medications is like A sometimes self inflicted thing that we do to the gut.

[Louise Nicola]

I heard SSRIs as well, which are, you know, I don't know what the. So many people are prescribed SSRIS now, especially women in midlife. And I, I believe that that's one of the medications that's eroding the gut lining too.

[Dr. Karan]

This is one of the things that we need to fix because again, SSRIs, they only are effective for around 30 of people with depressive symptoms. So again, like, we need to expand the treatment options we have for mental health and we need to look into, you know, I'm so deep into like a lsd, psilocybin, rabbit hole for treatment and how that could be effective, but also like gut mediated, like what are we doing there? You know, are we prescribing gut stuff for people with mental health symptoms as an adjunct? Not as a primary treatment, but as an adjunct.

[Louise Nicola]

So you're saying if we can optimize the gut. I'm guessing you can test for gut health. Is there a way to test for it?

[Dr. Karan]

You've got microbiome tests and that's evolved. We used to have something called a 16s test, which just showed you the different types of species. Now we've got metagenomic screening, which is even deeper. We can look at the genomic gene makeup, the DNA makeup, and the function of different bacteria as well. So that's more advanced.

[Louise Nicola]

How is that taken?

[Dr. Karan]

Like, is that a stool test? Yeah, you can do it at home. But the problem is that there's so much variation in how they construct these tests, how they analyze it. You, you and I can do stool tests from four different companies and get four different results. It's only good if you're comparing yourself to a baseline. So if you did a test right now, stool test, and then you started an intervention, whether it's a probiotic or a prebiotic, and then tested yourself again in eight weeks, that would be useful data for you because you're just tracking, of course, doing any equals one study.

[Louise Nicola]

That means that like, I think when it comes to tracking your own health and tracking your own microbiome, it's. I mean, why would you compare it to anybody else, first and foremost? But I don't think the problem is, you know, testing your stool. I think the problem lies in nobody really knows what to do. Just like a blood test, right? People go and get, you know, all these different types of blood tests done. Do they really know what to do? Like what intervention to do to bring that biomarker down or Up.

[Dr. Karan]

It's the analysis layer that's always missing. You can do all of these tests, but there's always the so what? You need to answer the objection of the so what layer. Okay, I've got all this data with the microbiome. What do I do with this? What's the analysis of this? What the implications. And I think you have to start at first principles. What are the symptoms that you can target? Okay, bloating, that's the number one symptom that troubles me. What can I do to fix that? What are the causes of that? Can I increase my fiber intake? Can I cut out these specific things? Can I increase my polyphenol intake? So there's so many different layers you can go in and you can track symptoms first and foremost, because the symptoms is what's going to drive your quality of life and that perception of how you feel. Not the microbiome test, because same with blood test. Blood tests can say, hey, everything's normal, but you can still have symptoms. Endometriosis, for example, normal blood test, but you can have horrible pain and symptoms. Same with the gut. You can have bloating and constipation, but your blood test can be normal. So they are a snapshot. Microbiome tests can also show you as normal. And the truth is, we don't know what a good gut microbiome actually looks like.

[Louise Nicola]

So then how do you know what you're measuring up against?

[Dr. Karan]

A lot of the times you don't. We know based on mechanistic data that all of these different bugs are good. And if you can raise the abundance of these bugs, that's likely to be good as well. But when we just look at all of the microbiome data, it's difficult to tell that that person has a good microbiome. We can just take inferences from there. Oh, they've got more of this species. Like, they've got too much of one species, which is generally not good. You know, like, you need some diversity. So you can get some data from microbiome tests, but you can't diagnose based off it. And you certainly cannot make judgments or treatment plans based just purely on that.

[Louise Nicola]

It's February now. It's still the start of a new year. And what always makes me super excited is making my home feel calmer and more supportive. So I've been using Wayfair to refresh a few spaces. My most sacred space in my New York City apartment is my space where I read. And being able to use Wayfair for everything. Even from, you know, smaller details that make room feel finished for a couch, for bookcases, and for lighting. It's so easy. What I love is how easy it is to find exactly what fits your style and budget in one place. I don't know where I would be in New York if it wasn't for Wayfair. Now, I know you feel the same, therefore I want you to head to Wayfair.com to check it out. Every style, every home matters. Wayfair Team One thing people underestimate is how much the liver affects the brain, especially after stress, poor sleep, or even alcohol, which none of you should be drinking, by the way. When alcohol leaves your system, your brain actually goes into a rebound state, which is why you feel anxious, foggy, or you need a huge burger the next day. And at the same time, your liver is working to clear those toxic byproducts out. And by the way, if you're in your mid-40s and you're having just one glass of wine, this really does affect you. So I want to introduce you to this supplement called Cheese Health. It's a formula designed to support these toxic byproducts and getting rid of them after a big day. They're like hangover pills. I don't know if you guys have heard of them, but they help metabolize alcohol more efficiently while also supporting liver function and reducing that next day cognitive dip. It's also built around compounds like DHM and cysteine, which work overnight. So the idea is you wake up feeling more like yourself. So for a limited time, you can get 20% off your order by using code [e-mail] if you are going to have a big night out, you need to have these supplements. Chishealth.com code neuro there must be a reason why you're doing what you're doing and why you're so passionate about this.

[Dr. Karan]

Certainly my own health story. I figured in medical school you hear a lot of talk online that medical students and doctors don't get training in nutrition or.

[Louise Nicola]

Yeah, that's all we hear.

[Dr. Karan]

Yeah, you hear that all the time. And it's true, right? But one of the things that med school and being a doctor taught me was how to critically appraise research. And I got really good at that. So I could read something, not just the abstract, but actually go through it, look at the statistics, look at the charts and graphs and figure out the data for myself. If it's real, is it bullshit? And that's the same rigor I Applied when I was self learning the microbiome, fiber science, you know, fermentation in the colon and all that sort of thing, because I was interested in it from a personal point of view. But also these were the patients I was seeing. And not once in my life as a doctor and surgeon was I talking deeply to a patient about the microbiome. Because I didn't have time and I didn't really know it.

[Louise Nicola]

Yeah.

[Dr. Karan]

So I had to learn it because it is the next big frontier. Just like the brain. We're still figuring it out, right? You know, we're still figuring out the microbiome. It's a black box. It's the dark matter. It's one of the dark matters of our universe.

[Louise Nicola]

So you're saying that if we can fix this in the best way that we know today possible, then it can probably, I wouldn't say go so far as to say, eradicate disease, but we could definitely see like a downstream effect on all these different types of cancers, neurological diseases.

[Dr. Karan]

I do not doubt that one bit at all. Because we like to think about the microbiome in terms of bacteria, but there's also viruses, there's also fungi, there's also archaea, you know, single celled carrots and so on and so forth. So it's not just the bacteria we're trying to figure out and what they do in terms of decreasing and increasing our disease risk and cancer risk, but also the viruses. You know, there's like EBV epsilon, Barr virus. This is recently linked to multiple sclerosis.

[Louise Nicola]

Yes.

[Dr. Karan]

So there's so.

[Louise Nicola]

And cancer.

[Dr. Karan]

Yeah, multiple cancers, you know, HPV and so on. So we live with all of these creatures and they do good and bad for us. And some are just ambivalent. So unlocking that can unlock personalized treatments. A friend of mine is a surgeon as well. He was looking at how to optimize the microbiome to make it more receptive, to make cancer therapy and chemotherapy more effective. So can you nourish the microbiome in a way to make treatments more effective? So, for example, if we go back to mental health, for example, why do two thirds of people not respond to antidepressants? Right. Is it something to do with how they metabolize it? Is it something to do with the microbiome and the neurotransmitters and the crossover between that? Could you nurture and prepare the microbiome to such a degree that maybe they become less resistant to certain treatments? Possibilities are endless.

[Louise Nicola]

Is there a link between the. Between the Microbiome and cardiovascular health.

[Dr. Karan]

Absolutely. I mean, the biggest link is cholesterol. You know, the sort of gut heart axis, if you will. Your cholesterol, when it's excreted by the body, it's usually trapped in bile, bile acids that's produced by the liver. The more soluble fiber you consume that traps the bile acids and the cholesterol and things like estrogen and microplastics and excretes it. And the more cholesterol you excrete. By eating fiber, your bile has to pull more cholesterol out of the blood circulation. So you're reducing your cholesterol, namely ldl, LDL cholesterol, which is the sort of bad cholesterol. So that is one route via which it does that. But also the short chain fatty acid generated by the colon also has a role to play in lipid metabolism via the gut liver axis as well.

[Louise Nicola]

Oh, wow.

[Dr. Karan]

Yeah, it's all connected. Gut liver, gut hormones, and even in estrogen as well. We know that women going towards that perimenopause menopause stage, where the estrogen, you know, dives off a cliff. It's also associated with increased risk of insulin resistance, cardiovascular disease, higher LDL cholesterol. And that's because of the fluctuations in hormones. And we know that for fiber. And the colon has a role to play in regulating and supporting estrogen excretion by the enterohepatic circulation because you don't want too much estrogen floating in the body, because then you get symptoms like dysmenorrhea, menorrhagia, cramps, you don't want too little. So the estrab alone, this subset of bacteria which regulate, they have these enzymes called beta glucuronidase, which can unlink this conjugated estrogen. So so many roles in the microbiome.

[Louise Nicola]

I wonder if there's a link to. Because you mentioned endometriosis. So I'm wondering if there's a direct link between gut health and fertility.

[Dr. Karan]

I certainly believe there is, because, you know, fertility is very closely tied to estrogen. We have estrogen receptors in the colon. We have bacteria which have enzymes which are involved directly in estrogen regulation. And, you know, estrogen and fertility is more than just hormones. Right. It's also about the level of adiposity, sometimes levels of, you know, circulating, you know, glucose as well. Your HBO NC is general glucose control. There's so many factors going into fertility as well. There's even a psychological component as well.

[Louise Nicola]

Yeah.

[Dr. Karan]

So, and, you know, generally the oxidative Damage to eggs, for example. You know, how can you offset that? You were talking, you know, earlier about sort of egg protection and certain supplements. So there's just so many things that can influence the fertility. And this is quite fascinating. I'm not like, you know, told many people yet, but we're actually about to start a trial in endometriosis with LOAM because we want to pioneer microbiome research. And not enough people have looked at the microbiome in endometriosis.

[Louise Nicola]

What are you trying to do?

[Dr. Karan]

We are looking. Well, number one, there's not a lot of microbiome data in endometriosis. And I believe that the microbiome plays a huge role in endometriosis in like the symptomatology and disease progress because we're still trying to figure out what's causing it. It's probably genetic comp. It's a genetic.

[Louise Nicola]

Because you can start a, A girl can start having endometriosis at a young age.

[Dr. Karan]

Absolutely.

[Louise Nicola]

When she first starts menstruating.

[Dr. Karan]

Yeah. 11, 12. Genetic component, inflammatory component, autoimmune component, likely a microbiome component. So all these things have a role to play. I want to look at the microbiome and endometriosis and see what interventions can be had. Because right now the interventions are pretty extreme. It's like, you know, you're on powerful drugs or you have surgery. All of those things can be life altering. There aren't a lot of nutritional and dietary interventions. So I'm seeing, can low FODMAP gentle fibers have a role to play as an adjunct to alleviate some GI symptoms in endometriosis? Can we manipulate the microbiome? So, you know, something, I want to pioneer because I'm passionate about the microbiome. I love that endo as well.

[Louise Nicola]

Okay, so let's, before we get into what we should be doing to optimize, let's get into the biggest one, which is stress, which is probably having an effect on dysfunction. What, what exactly is stress doing? Is it a cortisol? Is it a function of cortisol?

[Dr. Karan]

I think it is mediated by the vagus nerve. I mean, the cortisol and adrenaline, I think no doubt have a role to play in how they modulate colonic contractions and gut motility. Because when you're stressed, you can actually get diarrhea and constipation. Right. Depending on the duration of stress. Acute stress can cause diarrhea. Chronic stress can cause constipation. And we see that in patients with depression. Hey, often are constipated the vagus nerve is this kind of superhighway that connects the brain and the guts, the enteric nervous system, with the central nervous system. The, you know, the two brains are communicating. And when you're stressed, there are chemicals and neurotransmitters from the brain which are sort of tickling the vagus nerve and sending signals down to the gut. And the gut is maybe put into a pro inflammatory state that worsens the gut environment. And you can get dysbiosis or abnormalities in the actual gut bacteria populations. They start panicking and churning out inflammatory compounds. A vicious cycle that feeds up to the brain causes a worsening of the mental state, goes back to the gut, and you see, there's a vision. Exactly. They're speaking both ways. And you know, it can get a bit hostile sometimes because stress is not just a psychological state, but a physiological one as well.

[Louise Nicola]

Okay, so that's, that's stress. That's one component. What else is another component that we're doing every day to mess up our gut?

[Dr. Karan]

I think sleep, you know, I have this sort of inverted pyramid hierarchy of what is good for the guts. And you know, at the base of that inverted pyramid at that very top is fiber, then it's water and hydration because they're coupled with each other. Then it is movement. And a key one people forget is sleep. Because you have the circadian clock in the brain, the suprachiasmatic nucleus, but you have clocks and clock genesis in every cell in your body, including your digestive, digestive system as well. So your colon, every cell in your colon has these clocks and they all pay heed to the master clock in the brain. So you often find that when you travel hours and hours on a long haul flight, you feel jet lagged in your brain, but your gut is also jet lagged, which is why your bowels can be irregular when you travel, right, because the clocks are synchronizing or not synchronizing properly. So if you have a bad night's sleep, maybe you go to bed late, you get a later rise of melatonin, you get an earlier rise of maybe cortisol and adrenaline because you're stressed. All the abnormalities in the normal cadence of release of hormones have an impact on digestive enzyme release, acid release, gut motility contractions, which can lead you to maybe miss your poop window in the morning. And that is another thing. So the timing is key. Our body is a slave to timing, and the gut is no dissimilar.

[Louise Nicola]

I just read a fascinating study and it showed that people who do not hydrate properly actually age their skin. And that was so scary to me because who wants to look like they have aging skin? So instead of just drinking liters and liters of water and electrolytes, I. I have decided to use Jones Road Beauty products because they not only have simple formulations that support the skin barrier rather than overwhelming it with unnecessary ingredients, but they also prioritize hydration. How many times do you just use products and products and products and your skin still doesn't feel hydrated and doesn't look hydrated? This is probably why. So I have been using Jones Road Beauty moisturizer and face wash. And let me tell you, their ingredients are so clean, most of the ingredients that we use in our skincare products contain heavy metals and other contaminants. So you need to make sure you are using very good skin care. Listen, this is a reminder that good skincare doesn't need to be complicated. It just needs to support your skin doing what it naturally does best. So if you want to try Jones Road Beauty, go to JonesRoadBeauty.com and use code Neuro and they'll give you a free little gift at the end. Okay, I want to give something to the menu listening here or honestly to anyone who has a man in their life. Let me tell you something. We spend so much time thinking about what we put in our bodies, but most men and women never think twice about what they're putting on their skin every single day. And a lot of those everyday products, I'm talking shampoos, body washes, contain ingredients linked to hormone disruption. This is why you or your man need to make the switch to Based Body Works. I actually introduced Based Body Works to somebody close to me, and the difference was immediate. First of all, let's talk about their shampoo. The shampoo from Based Body Works uses peppermint and argan oil. So the scalp feels clean without being stripped. And over time, the hair just looks healthier. No sulfates, no unnecessary chemicals, just ingredients that actually make sense. And you know what, guys? I know all of these products are usually made for women, but this one is made for men. So if the men in your life have been using the same products forever without thinking about what's in them and you're noticing those hormone changes in them, the easiest way to upgrade it is to change to Based Body Works. And if you want to, you can go to basedbodyworks.com, use code NEURO for 20% off. And guess what? They'll get a Free toiletry bag when they buy a set. Come on. We all know that the men want that. Because confidence shouldn't come at a cost of your health. Yeah, no wonder I'm going through so many right now because I'm traveling so much. I've never had any sleep problems or sleep disturbances. Now I do.

[Dr. Karan]

Wow.

[Louise Nicola]

Yes. And it's just because my body's like, are we, are we in Nashville? Are we in Texas? Are we in la? Are we in New York? Are we in Australia? And it's like, oh, my God, it's driving me absolutely insane. Okay, so are they the only, only two that are. That are causing our dysfunction of our gut?

[Dr. Karan]

Of our gut? What do we say? We said sleep, sleep, stress, stress. The drugs as well, you know, the medications.

[Louise Nicola]

What about lack of physical activity?

[Dr. Karan]

Oh, absolutely. So that was, that was number three in the hierarchy.

[Louise Nicola]

Yeah.

[Dr. Karan]

Again, studies showing that exercise contributes to a favorable microbial composition inside.

[Louise Nicola]

Is that just due to the. The amount of blood that's getting pumped throughout the body?

[Dr. Karan]

Blood flow generally, like you moving, feeling good, the colonic contractions, which keeps mucus moving, stool moving. There's not much stagnation, less bloating. All of that is beneficial because also there's a bit of a healthy user bias as well, because the more you exercise and if you are exercising, you're likely to have other areas of your life dialed in. Fiber, protein, sleep, you know, so it all goes hand in hand because exercise has so many positive downstream consequences that will probably make it so that you have a good gut.

[Louise Nicola]

So let's talk about optimization. Okay, we'll talk about, you've. You've created a supplement to help combat this. But let's first start with food. Right, so what are the most fiber rich foods?

[Dr. Karan]

Number one, absolute S tier food that everyone should have in their rotation. And you know, I'm going to say daily is beans, beans and legumes. I recently switched my breakfast of, you know, chia seed pudding, which is pretty healthy. I switched it to beans.

[Louise Nicola]

What type of beans?

[Dr. Karan]

Anything garbanzo or chickpeas, kidney beans, pinto beans, white beans. Literally just black eyed beans. Black eyed beans. A quarter cup of beans, which is like quite a small portion, is 9 grams of fiber. I have half a cup of beans, which is 18 grams of fiber, and I just fry that with a bit of garlic. Tomato passata and I just have that, maybe a bit of red onions. And I'm not even lying. In the last two weeks, my wife has been making me beans every day for breakfast.

[Louise Nicola]

That's A new thing I'm going to get on. So beans have got the highest.

[Dr. Karan]

Yeah, yeah.

[Louise Nicola]

Green beans as well.

[Dr. Karan]

Yeah. And if you want, the reason I like beans as well is because it's high in protein. Also it's beans, it's fiber and protein. Edamame, you know, if you wanted like a different one. Green peas are pretty good. High in fiber and protein as well. And berries, very low calorie, very high in fiber. And they've also got polyphenols because they're that sort of dark red color. Yeah, polyphenols are excellent.

[Louise Nicola]

Funny you said that. So I have a friend who's allergic. Well, gets extreme like GI distress from beans, including chickpeas. But she's always, constantly got a problem with her stomach. She's always feeling bloated. She's done every test. Well, she believes she's done, you know, she did a CT of the abdomen because she thought, oh my God, there's something wrong with me. Her, she's always got some form of stomach. Every day it's like something different to do with her stomach. And then I was like, oh, she's also, she can't have any beans. Yeah, I wonder if there's something in there or what she's doing or what she's not doing or what she's not testing for.

[Dr. Karan]

There's something I, a phrase I invented recently called the fiber fart curve. Right. And it is, it is, there's some physiology and some, you know, something here. It's not just a joke. It's like a bell curve. Right. And if you're fiber deficient or if you're a fiber maxer, you might not fart too much. Right. For different reasons. Because farting and gas and bloating is not always bad. It's a sign of a thriving microbiome or you're exposing your microbiome to some fiber rich compounds. If you're fiber deficient, you just don't have much fiber in the system. Maybe your microbes aren't fermenting much and there's not much gas so you don't feel anything. You start to increase your fiber intake from a low starting point. Now your bacteria are beginning to be overwhelmed, like, hey, what's this fiber load? And they start having to work harder. And the intense fermentation causes bloating and gas. Right. You push past that initial, you know, adjustment period and adaptation. Your microbiome begins to adapt. By increasing the fiber load steadily and slowly and persistently, you are exerting an evolutionary pressure on those Microbes and microbes evolve and upregulate their gene expression orders of magnitude faster than human evolution or other life. Right. Because they multiply so rapidly. So when you start exposing them to more fiber, they start increasing the amount of fiber digesting enzymes they have, so they become more efficient at digesting fiber. So eventually you get past the peak and then down to the other end of the bell curve where now you're getting towards fibre maxing territory. And actually you've got very efficient fermentation and less gas now with the same fiber input.

[Louise Nicola]

Here's my question, and this is me that's actually so interesting, right. Is there a difference between, you know, if you look at Great Northern beans or if you look at black eyed beans, you can get them and you have to boil them for, you know, X amount of hours. Is there a difference between getting them canned or boiling them?

[Dr. Karan]

They will produce somewhat of similar results because, you know. Yes, there will be people who are sensitive to beans because beans are, you know, high in fodmaps. So there's like fructan components in the beans which can trigger people with sensitive guts. I'm thinking things like ibs. Right. It can trigger some symptoms, gas and bloating and cramps. So if you pressure cook beans, if you buy canned beans and then rinse them, get the water out, all of that can reduce the fodmap content.

[Louise Nicola]

Okay.

[Dr. Karan]

So it can make it easier for those with sensitive guts. And you know, sometimes in certain types of beans you get this bean juice, Aquafaba.

[Louise Nicola]

Yes.

[Dr. Karan]

That is also rich in fiber and fodmap. So you can actually get rid of that. If you have no problem with beans, I would recommend and encourage you to consume more of bean juice. But you know, that can also go. So there are certain ways you can cook and prepare beans, like, you know, soaking them for longer to reduce that triggering potential.

[Louise Nicola]

Okay. So let's keep moving down because what I heard is that eating the rainbow is phenomenal. So I always think when I hear about that, I think about purple cabbage.

[Dr. Karan]

So cabbage itself.

[Louise Nicola]

Yeah.

[Dr. Karan]

You know, and we're talking just about fiber right now. It's not a particularly high fiber vegetable. It's good for health because of micronutrients and the signins. All great. Fiber specifically, it's not great. Like cucumbers are not high in fiber, but they're still a good food to eat for nourishment. Right. So it depends what you're trying to achieve. Eating the rainbow is good because you're getting a range of different compounds. And you're getting probably a range of different fiber types as well, because fiber is the wrong way to call it. It should be fibers. We don't say vitamin. We say vitamins because there's different types. Same with fiber. It's fibers, plural. Because there are different type of fibers. Pectin, galactooligosaccharides, inulin, fructooligosaccharides, beta glucan, rhamnogalactoran. There's so many different types of fibers, and they all have different roles in the body. They feed different bacteria which produce different health outcomes. That's why you need the rainbow.

[Louise Nicola]

And so I think the. The biggest issue that. What are you finding is the biggest issue with people, that maintaining this is just the amount of food that we're eating. Is it the fact that I haven't even, like, asked you about what role GLP1s play on all of this GLP1s?

[Dr. Karan]

And I'm saying this as someone who has seen multiple, like, you know, literally hundreds of patients on GLP ones, but also been involved with years ago in bariatric surgery, weight loss surgery. So GLP1s are eliminating the need for weight loss surgery, which, you know, has a lot of high risk of complications, you know. But GLP1s do alter the composition of the microbiome, you know, in multiple ways. GLP1s work on the brain. They reduce the food noise and the appetite. So you eat less. That's the point. Then you lose weight. But when you're eating less and you. When you've got a deficit of calories, one of the first things that gets cut out is fiber. So you're on a GLP1, you're eating less. You're also eating less fiber. Plus the fact that your gut motility slows down as well because of the GLP1s. Slow gut plus less fiber is a storm for changing your gut microbiome. And so you need ways to offset that. So in specific GLP1 case, as in many cases, fiber supplements are very handy, as are protein supplements and nutrients and multivitamins in general in that GLP1 population.

[Louise Nicola]

Okay, so what's the problem with probiotics and prebiotics? What's the like. I know that there. I spoke to somebody and they said that, you know, I don't know the difference between probiotics and prebiotics. I know you mentioned it earlier, but should we all be taking one?

[Dr. Karan]

No, I don't take a probiotic and I won't take a probiotic unless the Science evolves a bit more, because where we're at right now with probiotics is that they often don't colonize the gut. They don't stick around long enough to colonize. And if they do, it's like throwing a few goldfish in the ocean and expecting the ocean to change its ecosystem. It doesn't. It's such a small thing, you know, and so we're not quite at the stage where you and I can take a probiotic for optimization for specific conditions. Yes. You know, if you've got traveler's diarrhea, Saccharomyces boulardi is a well studied strain of probiotic, which can be helpful. So in specific conditions, some probiotics work.

[Louise Nicola]

I'm drinking loam right now. Tell me what I'm drinking.

[Dr. Karan]

You are drinking a blend of six different prebiotic fibers which have different fermentation speeds. A mix of fast, medium and slow fermenting fibers which feed the entire colon and microbiome. And it dissolves invisibly with no taste, feeling or texture. 10 grams of fiber and 12 grams of prebiotics.

[Louise Nicola]

You're joking. Yeah, that. That drink has 10 grams of fiber in it. And I can drink this throughout the

[Dr. Karan]

day and drink it throughout the day. It's more. It's almost three kiwis worth of fiber.

[Louise Nicola]

Three kiwis worth. Okay, go a bit deeper on that.

[Dr. Karan]

So, you know, when I'm choosing a fiber supplement, I like to look at some red flags. And this is why I formulated this, because I had problems. And that's why I started my journey on fiber supplements. I cycled through over 60, and the problem was these are the red flags to look for. Most fiber supplements have a low dose, between 4 and 7 grams of fiber. I wanted something higher, So I chose 10 grams, you know, because that's at least gives you that baseline 10 grams of fiber. You know, if you have that three times a day, that's 30 grams. So that 10 is a nice round number. The second thing is a lot of fiber supplements use cheap ingredients like inulin. Inulin is one of the cheapest ingredients you can find. And because, you know, people are looking at margins, not the science.

[Louise Nicola]

What's inulin?

[Dr. Karan]

Inulin is a type of fast fermenting prebiotic fiber. You find it in, like, chicory, you know, in these, like, prebiotic sodas that you get. They put inulin in that, and that can cause gas and bloating in high doses. So this has got low fodmap, low, gentle, slow fermenting fibers. A Lot of fiber supplements use things like maltodextrin, which in spike the the blood glucose and not be good for the gut. So you don't need any fillers or binders, you just need pure fiber. And finally, a lot of prebiotic fibers are not formulated with a mix of different things. I formulated loam with a diversity of different types. It's got six different types of fiber to mirror the diversity you should be trying for in your real life. Like when you eat a salad, you've got some corn, some red onions, some lettuce, some broccoli, some carrots, some peas, you might have different things, right? Like six or seven different vegetables there. That's the kind of diversity I wanted to mirror with the supplement. Where you've got different fibers, not just one. Don't want a monofibre, you want a poly fiber matrix which is feeding different microbes. So this was like a, you know, I don't know, a ambitious love project for me to find something that worked for me and I did it and I thought actually, maybe other people can benefit.

[Louise Nicola]

And now you're actually doing scientific research, research on this.

[Dr. Karan]

We did our preclinical studies and our clinical studies and we're just rounding off the data for that. It produced double the effects of inulin in terms of producing short chain fatty acids. It had less gas and bloating production than inulin in ulcerative colitis models and in healthy normal guts. And the funny thing is a lot of fibers work for a narrow range of people. We showed in our studies that, that it worked across different gut types or enterotypes, so it had consistent value and benefit across different gut types.

[Louise Nicola]

Both. What was the cohort, what was the population?

[Dr. Karan]

In both normal populations and normal population all have different gut types and microbiome makeups. And in the ulcerative colitis population as well, with different gut types. So whether it was you, I or a stranger taking loam, it's likely to have consistent reliable effects, which is what we want.

[Louise Nicola]

And what are they feeling.

[Dr. Karan]

So we saw that there was short chain fatty acid production and benefits within 48 hours. So two days of taking loam, you'll feel benefits. And people have reported benefits with reduced bloating, regularity, more energy. So like things which you can tangibly

[Louise Nicola]

feel, you can take this any time of the day, at night, in the

[Dr. Karan]

morning, any time of day, with anything. I gave it to our mutual friend Darshan Shah, and he was pouring it on his pasta like a Parmesan. You can mix it with food. I Pour it in my coffee. We've made sure it's heat stable so it can be baked with. You can put it to soups and sauces.

[Louise Nicola]

Now it sounds almost as good as creatine.

[Dr. Karan]

Yeah. In your morning coffee. Creatine and Loan.

[Louise Nicola]

You can.

[Dr. Karan]

Yeah.

[Louise Nicola]

You can mix them, right?

[Dr. Karan]

Yeah.

[Louise Nicola]

Okay, I love that. We'll link that below. I want to get practical and go beyond, just eat more fiber. Right. What are three simple non negotiable habits someone can start today to dramatically improve their gut health and lower their cancer risk.

[Dr. Karan]

Yeah. So I think the simplest thing to understand is like, you know, I know you said going beyond fiber, but it has to be said this one statistic, if you increase your fiber intake by 10 grams a day, you lower your colorectal cancer risk by 10%. Okay. So that's why that number 10 is so crucial. 10 grams of fiber, that's one avocado.

[Louise Nicola]

What about loam?

[Dr. Karan]

That's 10 grams of fiber.

[Louise Nicola]

And that's lowering my risk of.

[Dr. Karan]

Any fiber you consume will help to confer health benefits and reduce your risk of chronic disease.

[Louise Nicola]

In terms of just. Is it just colorectal cancer or can we just say, what about pancreatic? What about all the other types?

[Dr. Karan]

Increasing your fiber intake lowers your risk of multiple cancers. Breast, endometrial cancer, esophageal, pancreatic, liver, guts, colorectal cancer. So many different types of cancer. Definitely in the GI tract, but even beyond like prostate cancer as well. Type 2 diabetes, heart disease, fatty liver disease reduction. One in five people in the world have fatty liver disease, you know, and it's mostly asymptomatic.

[Louise Nicola]

Is it nafld?

[Dr. Karan]

Nafld, yeah. You know, so non alcoholic fatty liver disease or you know, hepatitis, It's a real thing, you know, which people. It's a, it's a result of metabolic dysfunction in the world.

[Louise Nicola]

I used to think that, you know, you know, 20 years ago the holy grail was a multivitamin. Right. Now almost no one's like thinking about that. We're all thinking about fiber.

[Dr. Karan]

Yeah. Fiber. Yeah. It's funny because we've, in the longevity space, we always chase after like flashy things. Peptides and molecules and infrared and you know, hyperbaric oxygen. Great. You know, all those may have benefits for specific use cases, but fiber is not sexy. It's boring. It's basic. It's right under our nose. And we don't want to. It's not ever had any good branding or pr, so we've always discarded it. But actually it is the cheapest, easiest needle mover for longevity.

[Louise Nicola]

I love that. I'm, I'm going to start. I can't stop thinking about the beans. So the beans are going to be my new thing. I want to veer away and just ask you, what are your thoughts, thoughts on, you know, we, we, we've been speaking about longevity. What are your thoughts on peptides?

[Dr. Karan]

Peptides are such a broad range of molecules. Right. Broad range of things. You know, GLP1 is a peptide. SM, it's a peptide. Yeah, all of these things. So yes, I think they can have such wide sweeping effects on health. Like if we just look at semaglutide. The number of research papers coming out showing effects beyond weight loss and weight loss independent effects on heart disease risk, on cancer, dementia, brain health, fatty liver. There's a new study looking at semaglutide and well, tirzepatide, which is one of the newer compounds in pcos. So you know, in inflammatory conditions, it's amazing what the potential for these things can do. However, they're also powerful hormone modulators and body systems modulators. So we need to be careful. You know, if someone wants to just off license, do something, you know, that's you. N equals 1. Do what you want. But for me, I'm always cautious. I want to wait for a research and some trials before I do something and you know, like everyone's talking about retatotride.

[Louise Nicola]

Yes. Apparently it's going to be like the holy grail of the GOP ones.

[Dr. Karan]

It may well be. And we still haven't closed out the final phase three trials for that. So let's wait.

[Louise Nicola]

Compounding it.

[Dr. Karan]

The compounding is dangerous because I don't know if you saw, there was a new report, report released by Novo Nordisk where they analyzed the purity of compounded peptides and they found both significant underdosing and significant overdosing, which is dangerous at both extremes.

[Louise Nicola]

Oh, 100.

[Dr. Karan]

So, you know, like compounding may be cheap and may allow some people to afford it, but it's not always safe.

[Louise Nicola]

My problem here with, with peptides, it's not the fact that, you know, amyloid beta is an antimicrobial peptide. Right. Peptides are just, you know, small chains of amino acids, as you said. But the problem that we have with these so called, you know, BPC157TB500, the most popular ones, the wolverine stack, is the fact that A, we don't have any human randomized control trials to show its safety and efficacy and B, they produce vascularization which is how they are helping in the first place. And that's great. Right, but are they vascularizing, you know, normal tissue or a cancer cell? And we just don't know. And that's what I'm trying to put out there. And I, you know, I put this statement out there in a solo episode and I got like completely beaten and I was like, hey, I'm all for anything that's going to make me look younger and live better and live longer. And I would be on this, I'd probably put my parents on it if I saw that they were safe. And I probably. Look, I know that they're putting a lot of money into it. I know that maybe in the next five years there'll probably be a safety study, maybe 10 years. But until then, you know, we've got millions of people that have gone through trials of insulin and GLP1s.

[Dr. Karan]

Correct. We've had decades of GLP1 research. So it's not a new thing. And we're continuing to have the sort of long term follow ups with them. Same with this. I mean, all of these things, whether it's like a herbal supplement or an actual pharmaceutical drug, look at the research first. You know, don't mess around with these things. Things.

[Louise Nicola]

Yeah. What else is happening in this world that you think that people should know about and that, you know, we're dancing around on social media praising it when there's really no scientific evidence to prove it.

[Dr. Karan]

Any supplement. Right. You should cast a lot of suspicion towards supplement because you know, you and I take supplements and we know a lot of people who do and we're in this world where a lot of people take, you know, 10 times more than either of us do combined. But those ingredient manufacturers and brands that produce things, you know, a lot of them are based on marketing hype. So look for some quality stamps. Have they done third party testing? Have they done some quality assurance? Have they done any research? Have they done, you know, due diligence in their supply chain? Because in the FDA in the usa, there's no FDA mandate for manufacturing standards, third party contamination testing or raw ingredient sourcing. Right. So in every industry there are benchmarks that you can hit. Has that company even bothered to set those benchmarks? Even if they're not mandated, have they gone above and beyond and set that? So I think the consumer is becoming more health literate and reading things and the labels a lot more and health washing and that science buzz, people saying it's evidence based is going away and you've got to Prove it.

[Louise Nicola]

Yeah. This actually makes me so excited that loam is actually produced and founded by a surgeon.

[Dr. Karan]

We've done the research, we've done the third party testing as well, thank God. And we found that we have less. For example, you know, lead is a concern for a lot of people. And in California, I don't know if you know, Prop 65.

[Louise Nicola]

What's that?

[Dr. Karan]

Prop 65. So there's like different heavy metal testing standards around the world. The most stringent in the world, even higher than FDA, is specific to California. It's called Prop 65 Proposition 65.

[Louise Nicola]

Wow.

[Dr. Karan]

If you go to, if you go to the supermarket, there are actually some items in California supermarkets, like actual things that you'd normally eat and wouldn't even think of in other cities or countries that have got a Prop 65 warning like this may contain lead or things like that, normal foods. So it's held to an unreasonable standard that actually in other cities, like in New York, you wouldn't even have that concern. Right. And there are these standards set by the FDA that you need to have, you know, no more than 10 micrograms of lead per serving or whatever. So it's like orders of magnitude under the human safety threshold. Prop 65 is even lower than that. It's like 50 times or whatever lower than that. We tested for lead, cadmium, mercury and arsenic according to Prop 65 standards. So for example, we have less lead in a dose of loam than you'd find in a tomato.

[Louise Nicola]

That's amazing. Congratulations. Not all foods go through props to 65 though.

[Dr. Karan]

In the. Well, for example, the standard is specific to California, so you won't even have that.

[Louise Nicola]

Does that mean that it's healthier in California than in New York?

[Dr. Karan]

No, no, because they don't do it according to that now people are so sensitized, desensitized to the Prop 65 in California, so they're not going to be like, oh, this carrot has got more than the Prop 65 warning. They just ignore it. But even though I think is a ludicrously, you know, stringent standard, we just use that as like our North Star to be like, let's just make sure we got.

[Louise Nicola]

Oh, that's amazing.

[Dr. Karan]

You know, because pregnant women, my wife takes this every day she's pregnant.

[Louise Nicola]

Oh, yes, right. Lactating pregnant women.

[Dr. Karan]

Exactly. Breastfeeding, all that. So I want to make sure, like we're building it for the most vulnerable.

[Louise Nicola]

Dr. Karan, you're amazing. I love following you on Instagram. You produce really funny content. But really worthwhile content. Thank you for what you're doing and thank you for being part of the newer experience.

[Dr. Karan]

Thanks for having me. This episode is brought to you by Athletic Brewing Co. No matter how you do game day, on the couch, in the crowd, or manning the snack table, Athletic Brewing fits right in with a full lineup of non alcoholic beer styles. You can enjoy bold flavors all game long. No hangovers, no buzz, no subbing out for water in the second half. Stock the fridge for tip off with a variety of non alcoholic craft styles. Available at your local grocery store or online at athleticbrewing.com near Beer Fit for all times.

[Louise Nicola]

Quick break this surprised me. The most useful advice I get now doesn't come from experts. It comes from regular people on TikTok. What works, what doesn't. No filters. Download TikTok and see for yourself.