B (6:08)

Amazing. That sounds perfect.

A (6:10)

Awesome, man. I wanna start with what is essentially your primary thesis, at least insofar as the new book is concerned, which is that the gut immune system connection is the root determinant of inflammation and chronic disease. So elaborate on that. What does that mean?

B (6:27)

Well, let's work backwards, and let's start with the chronic disease epidemic that we're facing today in the 21st century, which is that, as we currently understand it, three out of five people will die from chronic inflammatory health conditions. This will be their cause of death. Right? We may not look at the death certificate and call it inflammation. We might call it heart disease. We might call it cancer or a stroke or diabetes. But there is inflammation that is underpinning every single one of those health conditions, contributing to that manifestation. The World Health Organization calls this the topic of our time. I believe that this is the topic of our time. And that's why I wanted to write a book about it. And just to contextualize. Fiberfueled to me was like, hey, I'm a gastroenterologist. The gut microbiome is exploding. I want to tell you this story. Here's the basics of it. But as I've matured as an author, as a doctor, I want to turn my attention to where I see opportunities to really help people heal. Inflammation is the opportunity that I think that we have. And the connection between the gut and inflammation is, to me, totally undisputable. So the way that I approached this, Rich, was that the first question, and I should mention I spent three years studying this topic because I wanted to make sure that I understood it properly. This is a complex topic, and I wanted to write a book that would, like, take that complexity and simplify it into actionable tools. And as I approached this, I started with the first question. How many health conditions can I identify where? If I go on a podcast with Rich Roll, I can pull out the studies, hundreds of studies, and show any scientist who's in the audience the proof that inflammation is connected to that disease. And I found over 130 different health conditions. So then I followed that up with a secondary question, which is, of these health conditions, how many of them are connected to dysbiosis? What's going on with the gut microbiome? Let's lift up the hood and take a look at the engine and understand what's the deal? And I found that they were all associated with dysbiosis. In fact, I am happy to challenge your audience to find me A study where the microbiome looks healthy and someone is suffering with one of these chronic inflammatory health conditions. So I think that, you know, what I discovered is there's this powerful connection between the two. So I double clicked on that. And as I dove deeper and deeper, I started to understand that if you manipulate the microbiome, such as with antibiotics, such as with a fecal transplant, in the opposite direction, right. If you break down the microbiome and you make it less healthy, or if you make it more healthy, the immune system follows the pattern. Inflammation rises and falls in parallel with the gut microbes. So from my perspective, the opportunity that we have is actually really exciting because, yes, we have a problem, but I also am presenting a solution which exists within the gut. It's rapidly adaptable. The choices that you make today, by tomorrow will start to have an effect and reshape your microbiome. It is highly forgiving. But we do have to change, because the reality is that our lifestyle, our diet, our culture, the way in which we live in the 21st century is disconnected from the way that our biology works. And that's negatively affecting our gut, which is resulting in inflammation.

A (10:08)

So the distillation of this idea is essentially that dysbiosis, or a dysregulated gut microbiome, leads to chronic inflammation which precipitates chronic ailments. A healthy gut, by contrast, will ameliorate the inflammation, will reduce that inflammation, will allow the immune system to function more optimally, and thereby putting you in a position to sidestep so many of these ailments that are unnecessarily debilitating people. Is that a fair statement?

B (10:47)

It's a fair statement. And just. Just to, you know, tap into some of the nuance that's in there, though, I'm not making the claim that the only thing that matters is the gut microbiome. Right? These are complex topics, complex health issues. Clearly, there's a genetic component that contributes to the manifestation of disease. My argument is that the gut microbiome is absolutely a part of the story, and it is the part of the story that you have the most control over. And so we should be taking advantage of that, because I'm not saying that we can cure all disease by getting a healthy gut, but what we can do is we can reduce the manifestation of disease. We can take the disease that's already there and ideally put it into remission so that it's no longer causing the issues and symptoms that we're struggling with.

A (11:35)

You shared with me that 70% of the immune system is located in the gut. But to me, the immune system is like this invisible thing like that. It doesn't exactly have a specific locus like the pancreas. So what is it and how does it function to keep us healthy?

B (11:52)

Yeah, so the immune system is endlessly complex. And there's people who are, for example, immunologists, they study this for a living and they can't figure this out. So there's so much complexity to this. But to simplify it, we think of it as two main arms of the immune system. There's the innate immune system, and there's the adaptive immune system. So now, historically, the innate immune system was the first that we evolved to have. And basically these are cells that are designed to like, react and respond in an automatic fashion based upon what they know. Based upon what they know is a threat, right? So anytime there's a threat, activation of the immune cells, and they're gonna respond to that threat. And those are like the basic cells. So we hear about these, we hear about like neutrophils and macrophages and things like this, right? And that's what I'm talking about right? Now. You can think of them almost like little robots that are defending you, right?

A (12:54)

So if you get a cut, for example, and you get some bacteria in there, the body will automatically respond and send those macrophages or whatever to the locus of the injury to resolve it.

B (13:06)

This is actually the perfect way to sort of set up the conversation, because just the fact that you got a cut, regardless of whether there's bacteria in there, just the fact that you got the cut, that actually requires your immune system to repair that wound. And that's a perfect example where our immune system is friendly and helping us. So the immune system should not be turned into the enemy, right? When we have an infection, it defends us in terms of that infection. So there's a lot that's good that the immune system does, but what's bad is when we sort of live a lifestyle that puts our immune system into a forever war. And that's chronic, low grade inflammation. And going back to this sort of two arms of the immune system. We talked about the innate immune system. Like, those are like, you know, the simple soldiers, right? They just. All they know is like, tell me where to be, tell me who the bad guy is, I'm gonna fight him, right? But then there's the adaptive immune system. And that's actually the far more complicated, more sophisticated part, which is that there are like these bacteria, they evolve so fast we can't keep up. Our immune system struggles with that. And so the innate immune system, it can respond quickly. But evolved bacteria, they sneak through. So we need the capacity of something that will adapt with us. And that's where we're talking about these T cells. So T cells that produce antibodies, B cells that produce antibodies, that. They're classically called lymphocytes. They're defending us, and they're adapting to the threat. So when a child is born, their innate immune system fully powered up, not really changing during the course of their lifetime, but obviously can be targeted and precise, but also weak and inept. But their adaptive immune system, from the time of birth, has a memory. And as time goes on, that memory grows and we develop antibodies to threats, and we ultimately become better at queering infections. So this is the way that basically nature has provided for us to defend ourselves. And the issue, rich, again, is that when the immune system is working the way that it's supposed to, we're very grateful to have that immune system. This is the reason that we're able to live as long as we are. And without that, we'd be in very big trouble. But the way that the immune system is connected back to the gut is that we're not sufficiently protecting these immune cells and we're exposing them to perpetual threats because to protect them, that requires an intact gut barrier. So you mentioned 70% of our immune cells are in our gut. That's absolutely true. They mostly reside in this tissue that's called the gut associated lymphoid tissue. G A, L, T. All right, but really, it's easy to think about. They're just on the other side of this single layer of cells that we call the epithelial layer. And they're there to stop things if they come across that barrier before they get to the bloodstream. That's what the immune system is meant to do. So that single layer of cells is held together by proteins called tight junctions. And every three to five days, we install a brand new gut barrier. So this is actually the area of the most rapid turnover of cells in our entire body, which, by the way, is an opportunity, because I'm telling you that in the next three to five days, you could install a healthier gut barrier. And when the gut barrier is intact, the immune system is protected. It's not facing the typical threats, and it's able to stay organized, targeted, and it's ready to take out any real threat that happens to show up. When that gut barrier is weak, then we get what's called increased intestinal permeability, which you could call leaky gut if you want to. Things start to get across. And as they come across, those immune cells that have been trained to know their enemy, they see it, they react, they get activated. That is chronic low grade inflammation. So we need an intact gut barrier and the stewards of the gut barrier are our microbes.

A (17:27)

And what is it specifically about chronic low grade inflammation that is contributing to chronic disease? Like, what's that nexus all about?

B (17:36)

Okay, so you have, let's sort of discuss the manifestations of acute inflammation versus the manifestations of chronic low grade inflammation. So acute inflammation, you get a fever, you hurt your joint, it gets red, it gets warm, it becomes tender. Right. You know, it's inflamed. It's so obvious. Chronic low grade inflammation, it's far more subtle. So starting at the top and going and moving our way down, could be a headache, could be your mood that changes, could be your ability to focus, could be brain fog, could be congestion in your nose. In women, hormonal issues, and that can affect fertility or perimenopause or menopause. In men, erectile dysfunction could be the manifestation of skin issues, rashes, outbreaks in the gut. Bloating is a classic symptom of inflammation, but there's also so much more. And then if we sort of zoom out, like, the number one symptom of inflammation that always shows up is fatigue. When people are inflamed, they feel tired. Next time you're sick, I promise you, you may not have a fever, but you're tired.

A (18:57)

Right.

B (18:57)

Because your immune system has been activated. So the problem with chronic low grade inflammation is that I just rattled off a laundry list of symptoms that affect your mood, your cognition, your hormones. We could get into your metabolism, we could talk about your gut and your digestive system. Those are different systems. You go to different doctors for these different symptoms. Yet there's one story that's tying it all back together, and that story is inflammation.

A (19:27)

But when you do go to the doctor, they're either going to attribute that symptom to a specific condition without tying it back to the gut microbiome. And then you will get a prescription that will treat the symptom of that underlying condition. But there's not going to be any talk about the dysregulation of the gut or what the permeability of the gut lining is or is not.

B (19:53)

Yeah, and you know, there are some reasons for this. Part of it is testing. So we don't have a good reliable test. In humans to prove what the state of your gut barrier is. And by the time you would get those results, it would have changed anyway. And with regard to your microbiome, you know, the way that we do testing today is a poop test. But there's a little bit of an issue there because, once again, it's constantly evolving and changing. But also when you take a stool specimen that is clearly more reflective of what's happening in your rectum than it is what's happening, for example, over in your right colon, right lower area. Yet these parts your colon's microbiome. So just to sort of establish some things for listeners who haven't heard us discuss this before, which you can absolutely go back to our prior episodes, and they're wonderful. You love those. But inside of your large Intestine, there are 38 trillion microbes, mostly bacteria, some yeasts, possibly parasites, these things called archaea, and they live there. This is your microbiome, and they're deeply intertwined with your physiology. But the issue is, it's not just one microbiome. That would be like pretending that California, everyone who lives in California, lives in the exact same type of location. That's not true. So the microbiome in one part of the colon is different than the microbiome in a different part of the colon. And when we get a poop test, we're not really capturing that geography.

A (21:32)

And there is no way of doing some kind of test where you are getting a sample from that part of the colon that would reflect accurately what's going on that would look lead to a better diagnosis.

B (21:44)

Well, so you'd have to get a local sample. And it becomes confounded by the fact that if you were to do a colonoscopy, you just flushed out the microbiome. Right. And that's the inherent issue with, you know, for example, colonoscopy. Like, I'm a huge believer that colonoscopies save lives, because I've seen it with my own eyes. But there is a price that we pay for that, because you flush out the microbiome in the process of doing that. So you wouldn't be getting an accurate sample if you were to give someone a bowel cleanse. If, in theory, you had something that you swallowed and it just naturally, organically floated its way through your intestines, and you were somehow getting micro doses of the fluid as it's floating through, then you would get a decent measure of what the microbiome is in different locations. But the other thing to keep in mind, Rich not to make it too complicated here is that there's what we would describe as the luminal microbiome, which is basically like the poop that's floating through. And then there's also the mucus layer. And the mucus layer is basically like a gelatinous coating on top of that epithelial layer. The epithelial layer is the gut barrier again. So there's this sort of gelatinous coating that's there, and there's microbes that live inside that. So unless you actually take a biopsy of the mucus layer, you would be missing that.

A (23:14)

And those microbes in that mucosal layer are helping to mediate what gets through and what doesn't.

B (23:20)

110%. Because the gut barrier, the most important part of repairing and restoring the gut barrier is the work that the microbes do. And that's because the microbes are what give us access to short chain fatty acids, acetate, propionate and butyrate. So when fiber in our diet comes into contact with these microbes, particularly in the right colon, as I was mentioning before, it stops being fiber. And those microbes use their sophisticated enzymes, working in teams, to unlock these new nutrients. Short chain fatty acids and butyrate becomes the source of energy for your colon cells and also powers the production of the proteins that hold the cells together.

A (24:11)

There's a lot to be said about short chain fatty acids. I want to set that aside for right now. I'm still back on this idea of trying to self diagnose ourselves. Like, okay, yeah, I'm tired, I have occasional brain fog. You know, I don't always sleep so great. I have anxiety, I have stress. I mean, this is the state of life in the modern world. Like, who isn't at least periodically suffering from some version of this or from a variety of the symptoms that you mentioned? And so this can't always be about the microbiome. Or is it your contention that the microbiome is probably where we should look first if these are things we're suffering from?

B (24:55)

Well, I'm not arguing that the microbiome is the only cause of fatigue that exists. There's many different health conditions that do. But not everyone in America feels fatigued. It's just a lot of people do. Not everyone in America is struggling with their mood, but a lot of people do. And when we sort of step back and look at the data, the problem is quite obvious, actually. So starting with the small statistics, 10% of America has an autoimmune disease. Well, that's A lot of people, that's tens of millions of people with autoimmune diseases. Those are chronic inflammatory. One in three people have allergic diseases in America. So that's again, over 100 million people. Chronic inflammatory health conditions like heart disease, diabetes, cancer go through. There's an entire list of these metabolic health conditions. It's at least 60% of America that's been diagnosed with one of these. But then when you think about obesity being overweight, that's associated with inflammation as well. And the data say 75% of America is overweight. But actually, if you double click on that specific topic, in terms of metabolic health, there's Data that say 88 to 93% of America is not metabolically healthy. That's also associated with inflammation. So I'm not trying to make it sound like 100% of us have an inflammation problem. I pray that the people who are listening to us, that they feel well. I want people to feel well. I also believe, though, that this idea of what we're discussing today is completely applicable to 100% of people, because you should not ignore the greatest opportunity for health in your lifetime or for longevity in your lifetime when you have an opportunity to intervene today. And it's, you know, you said in the modern world, but that's the problem, right?

A (26:53)

The modern world is an antagonist to health. And our microbiome is the outer world. It's technically on the outside of our body, and it is a reflection of not just our food environment, but our broader environment.

B (27:07)

Yeah. So your microbiome, from my perspective, tells a story, right? There's a story because the way that everything that you do, even the things that you have no control over, ultimately leaves an impression, leaves an imprint in the microbiome that will be reflected there. So it really is a story about who you are, where you come from, and the way in which you live your life. And that story will continue to evolve during the entire course of your lifetime. They're your partners in life. And so, not to be cheesy, but we can turn it into a good story, right, where they're working for us to our benefit, and we're thriving. We're feeling the best that we can.

A (27:54)

Foreign. This episode is brought to you by Prolon Fasting. It's all the rage these days, especially for its clinically substantiated health and longevity benefits. But dang, there are just so many kinds of fasting. There's time restricted eating, there's intermittent fasting, partial fast, religious fasts, one meal a day, even water fasting it is confusing. It's also legit to be a bit scared about not eating for days. And this is just one reason why Prolon is so fantastic, because they cut through the confusion and they make it easy. The best part is that Prolon is a program that permits you to actually eat and at the same time take advantage of the benefits of fasting courtesy of their five day Fasting Mimicking diet which is a plant based nutrition program that delivers the meals to your home along with a specific structured plan to help reset your system, support digestion and gut health and bring your energy back online. I've used this approach myself and it's one I genuinely trust. So just in time for the New year, Prolon is offering my listeners 15% off their five day nutrition plan program for your post holiday glow up. So go to prolonlife.com richroll that's P R O L N life.com richroll for 15% off prolonlife.com richroll. I would say that I'm somebody who is interested in longevity and health span less so however, in the audacious claims that that many products make. Because I'm really not a fad guy, I do need to see the science which is how One Skin caught my eye. The skin company that makes topical products based upon 10 years of evidence based research that targets aging at the cellular level. The active ingredient in one skin products is a peptide. It's called OS1, which according to five clinical studies is proven to target the cells that cause the visible signs of aging, helping you unlock your healthiest skin now and as you age. I've been using their OS1 face for about a year at this point and I will say that my luscious, gorgeous 59 year old skin does feel healthier. I think it is more resilient. And One Skin is certified for sensitive skin, no irritating ingredients and they have the National Eczema association seal over 10,000 five star reviews from people seeing real results. Right now you can get up to 30% off your first three subscription orders with code RICHROLL at OneSkin Co Richroll. So if you've been listening to me for any amount of time whatsoever, you already know that AG1NextGen is the daily health drink that has been clinically shown to fill common nutrient gaps. But what you might not know is that the person who's running the Ag show is a woman called Kat Cole. Now, despite the fact that I've been a loyal customer and fan of this product for about a decade at this point I actually had yet to meet CEO Kat. That is until recently when I got to spend a few hours with her at this event that I attended recently called Eudaimonia. And what I can tell you from spending time with her is that Cat is a real one. Not only do we really connect, not just about the company, but really as humans. I left our time together just super impressed by how much she really cares about the purity of the formulation, about transparency, and also about innovating new ways to best nourish people. So if AG1 is a product that you happen to be tiptoeing around, I would like to confidently say that this is your moment to finally jump in. Just one scoop contains 75 plus vitamins, minerals, prebiotics, probiotics and superfoods. So it's about as easy and convenient as nutrition can possibly get. Making for a new habit that will actually stick through my link@drinkag1.com richroll Get a free AG1 flavor sampler and try all the flavors plus free vitamin D3 plus K2 and an AG1 welcome kit with your first AG1 subscription order. Before we get into interventions and solutions, let's talk a little bit about what is driving this. What is it about our food environment and our general environment that is contributing to poor gut health and in turn chronic low grade inflammation?

B (32:51)

Okay, so out of curiosity, your grandparents, like generally speaking, what year were they born?

A (32:58)

Oh Lord, probably my grandparents just like ask me. Probably in the 19 late 1910s.

B (33:06)

Okay, yeah, so my grandparents were born right around World War I. 1918. Right? Think about the way in which the world has changed in such a short period of time. Electricity was brand new for them. There was no television, not many people had cars. You had to ride your bike to school, right? You knew your farmer, you knew if you ate meat, you knew your butcher, you knew all these different people, right? And you know, now think about where we are today and the way in which there are things that dominate our environment, our world, even our choices. Choices that honestly they're difficult because we there are things that we are addicted to, right? And they've been designed that way that we struggling with. So our food right now for adults, 60% of our calories come from ultra processed foods. When my grandparents were kids, those didn't exist for our children. 70% of their calories come from ultra processed foods. One of the most disturbing statistics that I can cite is that for every 10% of your diet that comes from ultra processed foods, your risk of death goes up by 14%. So basically if you take 14. And you multiply it by seven. In our kids, you end up with what they're being exposed to during their childhood and they don't like have total control over this. They're not mature enough to understand their choices. Right. That's our diet. And then we must acknowledge all these other elements that have changed where, you know, okay, so how much time do you spend outdoors? Like, if you look at what percentage of people walked to school today compared to the way it used to be. So the average adult right now spends 93% of their time indoors, very little time outside. But that is going to ultimately mean that our surroundings are man made, sterile, artificially lit, as opposed to in nature, surrounded by microbes and being paced by the sun. Right. So and then in addition to this, like our devices, there's an entire conversation here. And social media is not the only thing. But, you know, I'm actually the last generation that remembers what life was like before Nintendo and in my childhood. So I was born in 1980. I'm 45. I remember playing outside, building forts, riding bikes. It was so fun. And then we got a Nintendo and there was only one thing on my mind. How can I get time with that? And if we go back nostalgically, I love it, the old Nintendo. But if you compare that to what our kids get on a tablet or a device today, let alone the video games, it's like completely different. So the average adult in America right now spends six or seven hours per day on their phone. And yet we all feel too busy. We don't think that we have time. And there is an epidemic of loneliness. Before the pandemic started, 50% of Americans reported that they were feeling lonely. And actually, if you look at the data around loneliness, we don't talk about this often enough. I know that you've had people on your show that have talked about this, but like nationally, there hasn't been an adequate conversation about what that means and what that impact is. The impact of loneliness, because we are such social creatures, is on par with smoking cigarettes in terms of how it impacts our health.

A (37:22)

Yeah. I mean, this is a conversation I had with the Surgeon general, the former Surgeon General on the show. I mean, it is Vivek. Yeah, Vivek. You know, it's certainly a thing. And he did what he could to initiate this conversation.

B (37:33)

He made that his focus.

A (37:34)

Yeah, yeah. But you know, this conversation needs to mature and continue for sure. I like how you are adopting a very holistic and mind body kind of approach to this and not just being the hardcore hard scientist and drilling down into biological mechanisms here, because there is a broader conversation around how we live our lives in the modern world and how that's contributing to the poor health of so many people right now. We can't solve this problem unless we address all of those things. But taking them individually, like, let's start with ultra processed foods. Like, what is it about ultra processed foods that's leading to gut dysbiosis? Like, is it a specific ingredient? Is it a lack of nutrients? Like, what is the mechanism in these prepackaged, you know, products that are high in sugar, salt and fat that are producing the result that you're seeing?

B (38:38)

Right. So first of all, how unnatural are they? I mean, it's really wild. What we have the capacity to normalize where something could sit on the shelf and be unchanged for two years and you purchase it. And that doesn't set off alarm signals for us because we've normalized it so much before we even get into the chemicals and some of the data that we see there. Let's just start with these three basic nutrients that are basically smushed together as food scientists create ultra processed foods. And those are, as you mentioned, sugar, fat and salt. And each one of these on an individual basis, you can drill down and see what the impact is on the microbiome. So take sugar, for example. The average person in America consumes over 150 pounds of sugar on a yearly basis. And when I say sugar, I'm not talking about eating berries. I'm not talking about whole food in any way. I'm talking about the only way that you get access to this is that someone has managed to extract a refined sugar carbohydrate and then reinsert it as they're building these ultra processed foods. And so. And sugar, we know with total clarity is a gut barrier disruptor. And there's a couple of different ways that this seems to work. Part of it is the impact that it has on the microbes themselves, guiding those microbes towards dysbiosis. But there's also your actual blood sugar response. So when your blood sugar is. It's not to say that when your blood sugar goes up after a healthy meal, that that's problematic. That is not what I'm saying. But for the listeners, imagine for a moment that you have that sugary dessert or that breakfast that's like, you know, a croissant, something like this. You feel great in the moment, and then don't you feel kind of terrible within the next couple of hours?

A (40:56)

Sure. Don't you feel terrible hundred percent of the time.

B (40:58)

Yeah. And that's not exclusively what your blood sugar is doing. That is the impact of what your blood sugar is doing on other systems. Because when your blood sugar spikes so hard from those refined carbohydrates, you ultimately are disrupting the gut barrier. Salt. We have a trend in this country of like an obsession with electrolyte drinks. Yet the recommended amount of salt on a daily basis is 2,300 milligrams per day. The amount that we're actually consuming on average, by the way, driven by ultra processed foods. So 70% of our salt comes from ultra processed foods. The amount that we're actually consuming is 3,600 milligrams per day. So we already are 50% above where we should be from a salt perspective. And then if you take an electrolyte drink that provides you with a gram of salt, I'm sorry, a gram of sodium, you actually get yourself up to where you are, double the amount of sodium that you should be consuming on a daily basis. What's the impact of sodium? There is an interesting study where they took a look first at the animal model and the microbiome, and what they found is you were depleting the Lactobacillus, which are beneficial bacteria. Many of our probiotics are Lactobacillus, depleting them by 90%, 90%, 90%. And then the emergence of an immune cell called TH17. And this TH17 immune cell has been associated with autoimmune disease. And they tested this out in humans in a pilot study, small group. And they had them crank up their salt intake and they watched as those same species that were shown in the mouse model, they became non existent. So there's a compelling argument there. And then the last is fat. Now, as you know from checking out my book, I don't think fat should be categorically vilified. In fact, I don't think any macronutrient should be categorically vilified. I object to people saying carbs are.

A (43:09)

Bad.

B (43:11)

But there is bad fat just like there's bad carbs. And to me, the problem that we have is actually with our saturated fat intake. It's not to say that I would advocate for zero saturated fat in our diet. I'm asking for balance. And we don't have that right now. The average person in the United States, if you were to take saturated fat, just the fat, and turn it into a block, that block on a yearly basis would weigh 23 pounds. Right? That's a pretty substantial amount of fat. That's the type that I'm arguing. We don't want more of that, we want less. Now, I get that the Internet has a debate on this topic, but the scientific community does not. So the Internet is a place where we can be whiplashed from you should be vegan to you should be carnivore within three years. Science today hasn't radically changed relative to where we were the last time you and I recorded, other than we've added more. So it's important for people to understand that these, to me, these three nutrients, these are an issue. And if you combine them, you end up with a pattern which we call the Western diet. And the Western diet, I performed an analysis to understand, okay, so how many studies has the Western diet been associated with in terms of disease, right? Like how many diseases can I find where they believe that this is at least contributing to it? I found 55. So out of my list of 130, at least 55 of them, the data are there, the other, the rest of them, I don't think we've done the study yet. So this is concerning quick little comment. And this is I think quite relevant to like you have Kevin Hull on your podcast. So there's this concept of hyperpalatability. And hyperpalatability basically means that it's designed for you to overeat, that your satiety hormones like GLP1, which is what's been transformed into a medication with Ozempic and Wegovy, that you lack the ability to activate those hormones and so then you just keep starving for more. And basically what they've shown is that the concept of hyperpalability, it's actually been established as a definition now where it requires two out of three. So if you combine sugar with salt, sugar with fat, fat with salt, if you combine these things, you get two out of three, you're going to make a hyper palatable food.

A (45:57)

And the problem with hyperpalatability is that you basically can't stop eating it and you outpace the signal that tells you you're full and you should stop eating. It's not even necessarily the food itself. It's the way in which you're interfacing with the food, which is meaning you're eating too much of it.

B (46:20)

Well, because a whole food is not the same as taking that exact same whole food and grinding it into a powder and then turning it into a meatball.

A (46:28)

Right?

B (46:28)

Like those aren't the same thing. The structure of the food actually matters a lot.

A (46:33)

The Matrix.

B (46:34)

So the food matrix. That's right. And in Kevin Hall's study that he did, he convincingly showed that you could give people effectively the same diet, but one is ultra processed and one is whole food. And the people on the ultra processed diet are going to consume 500 calories more per day, and that's a pound a week.

A (46:51)

Yeah. And the minimally process processed diet, they stop eating when they're full. They don't overeat well, because it requires.

B (46:57)

You to actually chew.

A (47:01)

All right, so we have the western diet, we have the food environment that's contributing to dysbiosis and in turn chronic inflammation. And rich, you want to lose something more. Yeah.

B (47:11)

We have to also mention the chemicals.

A (47:14)

Right.

B (47:14)

Because all we've talked about is sugar, fat and salt. That's not the only story here. We have 10,000 additives in our food system and almost all of them were approved through a loophole called generally recognized as safe. And they're entered the grass loophole. The grass loophole, which is part of.

A (47:32)

That's part of Kevin Hall's work as well, is addressing that.

B (47:35)

Yeah. And this is like a lot in the world that we're dealing with today are the ramifications of choices that were made immediately post World War II, like within 15 years of World War II. And so basically they came back from World War II and, and they said, okay, we need some sort of way to regulate food. We know that vinegar is safe, we know that salt is safe. Right. We don't need to test those things in a human clinical trial. So let's just say they're generally recognized as safe. But that loophole's been exploited to the tune of 10,000 different additives now. And the problem is that we don't have testing on those 10,000 additives of humans actually consuming the food and seeing what happens to the, to their health. 80% have no feeding study of any variety. And what we also don't have for sure is long term data. So what happens if you're raised on this food as a kid and you eat it throughout the entire course of your lifetime? We don't know. But there's a study that literally came out in the last few days where they took a look at the impact of over a thousand chemicals that are found in, like, consumer goods. And part of these are food based and part of these are like, for example, like we have a cup and you're gonna drink from that cup and see what happens. Right. So they tested over a thousand chemicals, they found that 168 of them had a significant impact on the gut microbiome. And the impact was disturbing in terms of the effect that it was ultimately having. Gut microbiome testing is not a part of what our regulatory bodies do in any way. These 10,000 additives, if there's a gut microbiome study that's been done, it wasn't done because they were required to do it. And most of the time, the food industry, they would not want to know.

A (49:25)

It's even worse with the broader consumer product market, like with cosmetics and things like that. I've had Greg Renfrew on here, and it's absolutely unregulated in that regard. And any chemicals added to these products are considered safe until proven otherwise. But nobody proves them otherwise because there's no money to test these things on humans in any meaningful way.

B (49:50)

There's no money. The industry is not going to pony up unless you require them to. The government's not funding it.

A (49:55)

So we're just running this massive generation after generation experiment on the human animal.

B (50:02)

Well, we are, but without actually monitoring what happens.

A (50:06)

It's not even an experiment because nobody's paying attention to what's happening.

B (50:10)

We're just letting whatever happens happens. And the compromise is your health and the health of your children.

A (50:18)

Is there any effort whatsoever to change this? Is there people like yourself testifying on the Hill or trying to, or calling for some kind of rational regulation?

B (50:30)

Well, you've had people on your show who are more qualified than me to comment on that specifically. Let me just say that I've kind of stopped paying attention for the most part to what our regulators are doing, because regardless of what their promises are, I'm not seeing much. And so it's highly disappointing because there was a big talk about change and what we were gonna do. And certain people who are involved have a platform of things they've talked about for a long time that I agree with. And yet it seems that whatever it is that's in there, that's stopping them, blocking them from actually getting things done, whatever that may be, and I don't know what that is.

A (51:16)

I know what that is.

B (51:17)

That's.

A (51:17)

I mean, do you want me to say it out loud? Maybe it extends.

B (51:21)

It could be one word, right? It could be one word.

A (51:24)

These are the parameters of this podcast. But essentially there's what gets said and then there's the agenda of the powers that be, which is essentially deregulation. Like, let's clear the path for corporations to do whatever they want so we can talk about food additives and food colorings, you know, blah, blah, blah. But what's actually happening is basically currying favor with big corporations so that they continue to fund political campaigns. Well.

B (51:52)

And I think it's a universal problem.

A (51:56)

Yeah.

B (51:56)

It's not one whatsoever.

A (51:58)

I'm not saying it's specific to this administration.

B (52:02)

No. But I was hoping for. I was hopeful.

A (52:05)

I get it.

B (52:06)

I was hopeful that there was going to be something there because there was a big talk and it was different than what we've heard in the past.

A (52:10)

There was a lot of energy around that. Yeah. But not so much action, so.

B (52:14)

Well, anyway, here's the thing. From my perspective, the way that I feel about this is that if you're waiting for your government to fix your problems, we have a problem. Right. Like, ultimately, we need to take agency over our own lives. And I'm here to basically, like, find the information that you need, turn it into a story that you enjoy reading, and then give you the actionable tools, put them on the table, let you decide what are the things that you ultimately want to do in your life that can make a difference. But we have to reshape our own environment, and it starts in your own home. That's the way I feel about it. Who cares what's going on out there?

A (52:56)

I agree. I would say. And then we can move on. And it's not necessarily even pushing back, because I think you would agree with this. And this is. Is essentially what Kevin hall says as well. It's like, we need to make these better choices, and we do have agency, and here's how to make those better choices and how to think about that. But fundamentally, we're in an environment that is, you know, pushing out. That is an antagonist. Right. And unless we have systemic change to shift our food environment and our broader environment, we're kind of stuck, always swimming upstream against these forces that are working against our health.

B (53:33)

I agree with the sentiment, but if it ever does happen, it certainly isn't happening today.

A (53:43)

No, it's not. So let's focus on what we can do.

B (53:46)

That's what I'm saying, is I got you. You can start today and you can make choices. And the problem is, this is what I see, is that if you allow I'm not perfect, do I yield for processed food? Of course I do. Right. Do I make mistakes or always perfectly follow my own advice? Of course I do not. But the point is that you have the ability to shape your own environment and make it a healthful one that will lift you up and make you better as opposed to something that's holding you back. But if you accept cultural norms, you're in trouble.

A (54:22)

Yeah. Then you're waving the flag of surrender and just, you know, giving up the fight. There are so many things that we can do.

B (54:30)

You're aimlessly drifting in a current that's taking you to a place that you don't want to go.

A (54:36)

So let's start with these interventions and these things that we can do. I mean, top line, like, how do you see the most, like, in terms of, like, a hierarchy of importance? Like, what is the first thing you want people to understand who are trying to understand what you're saying and take better control of their gut health?

B (54:55)

There's many directions that we could go with that question. So I wrote a author's note in the front of the book, and what I said to the reader is that one of the things I struggle with as an author is that I have to write just one book and I can't personalize it to you. But that being said, you're going to have a personal experience when you read the book, and there should be something in there that's your aha moment. So the way that you experience it may be the way that someone else may be different from the way that someone else experiences it. So I want you to find that thing that is your most important thing. So for the person who's been subjected to trauma, that's the most important thing for them. But that's not everyone. So with the question that you're asking me, where would I begin?

A (55:50)

For whom? And yeah, I understand the personalization of it.

B (55:53)

From a public health perspective, though, if we just look at the statistics, we have a tremendous opportunity in terms of our diet. And the things that I focus on within the book have been proven to improve your gut microbiome health, to improve your gut barrier and make it strong, and to reduce inflammation. And each of the things I'm not going to choose, things that you're already getting enough of, that makes no sense. Unfortunately, that's what most of the focus ends up being in nutritional conversations today. Where our focus should be is on the things that we're not getting enough of, because that's where the opportunity is. If you're insufficient and we bring you to a place of not only sufficient, but how about optimization? If we can take you to that place, we can radically transform your health through what you eat.

A (56:49)

So where do we begin with this? If we're thinking about not necessarily what to stop doing, but what to build in, and I'M talking about nutrition and diet here. Are you talking about fiber as being the number one thing that we could all do, you know, do better, getting more of or what are you saying specifically?

B (57:09)

So let me just to contextualize, as I contemplated, hey, what am I going to say to these people about an anti inflammatory diet? I thought to myself, you know, it doesn't really matter what we ate as cave people because the caveman didn't have a car or a smartphone or air conditioning or a supermarket filled with all kinds of food. We have to look at the modern world and ask the question, who's actually thriving? Like, who's actually doing well in the 21st century with our modern constructs? And so I went on a global mission, which by the way, a shout out to Dan Buettner because it starts to sound like a blue zones thing and. But tip of the cap, because like, that's where you find a lot of this information actually is you go and you look out across the globe and you say, who's out there thriving right now? And what I came to, what I identified were multiple dietary patterns. I identified a Mediterranean diet, a traditional Japanese diet, a flexitarian diet, a vegetarian diet, a vegan diet, a pescetarian diet. All of them have merits in terms of preventing disease, reducing disease and being anti inflammatory. All of them have merits and studies to back them up. So it's not one size fits all. And it's actually not the label that matters. It's the specific nutrients. And what you discover are four specific categories of nutrients that we're mostly missing. And if we could address them, those are our greatest opportunities. So of course fiber has to be in there. Because fiber, as my entire platform has been laying out since 2016, 95% of America is deficient in fiber. Our children, 97% of our children are deficient in fiber. And fiber is without a doubt the longevity nutrient. Right? We need protein for muscle, you need fiber for longevity. Because fiber is so powerfully connected to these microbes and all of the downstream effects that impact our immune system inflammation, but also our metabolism, our hormones, our motor, our brain health. So fiber to me is the first opportunity. And that's because we can get short chain fatty acids.

A (59:46)

And the reason people aren't getting enough fiber in their diet is because the western diet is fiber deficient. Is it the ultra processed foods or what are the pieces that are missing that we can build into our diet? Even if you're, you know, you've been on a western diet for as long as you can think like, what's the process of starting to bring more fiber in? What are the foods that you would recommend?

B (60:10)

It's so simple, we just have to actually do it. So first, to address your question, ultra processed foods have been devoid of fiber, right. And when they do include fiber, it tends to be a what I would describe as a perversion of the entire concept. Because you're gonna like create your sugar, fat and salt laden food and then you decide, well, you know what, I could get a label that says fiber, great source of fiber. If I sprinkle 5 grams of inulin in there and that's a monofiber, it's like one specific type that's been extracted artificially. So cheap, so easy. And it's wild how popular some of these products that are like literally just throwing inulin into soda, right? Or whatever it may be Health Washington.

A (61:01)

And people just believe that they're meeting their fiber needs, right?

B (61:04)

Hey, I know I need fiber. Dr. B says I need fiber. And therefore I'm gonna drink this soda that says that it's going to fix my microbiome.

A (61:10)

Fiber fortified.

B (61:11)

Yeah. And I'm absolutely against it. So what we need is so simple. It's food. It's whole food, right? It's food that's grown in soil, fruits, vegetables, whole grains, seeds, nuts, legumes, mushrooms. That's it. All of them contain fiber. Fiber is exclusive to plant based food.

A (61:33)

And fiber is essentially a prebiotic, meaning that this is what the microbiome needs and wants to feed on to propagate in a healthy way.

B (61:44)

There's different types of fiber. We don't have an estimate of how many types there are. There could be billions of them. It's so complex. If you were to look at a fiber structure, it makes my eyes water. It's like, what the heck is going on here? And I was a chemistry major in college. But they have different characteristics. Not all of them are prebiotic. Some types are just roughage. They just move their way through your intestines and they come out the other end and you have a great bowel movement and there's definitely value there. But it's not impacting your microbiome. But prebiotic fiber is fuel for your microbes. And the reason why is because you don't have the enzymes to break it down. So it goes from your throat, through your stomach, through your small intestine, which is 15ft long, and it enters into your colon and that becomes the food for these microbes. And so the ones that eat, which are the Good ones, they become stronger and then they become more capable of producing short chain fatty acids, because that's what comes of that relationship. The microbes come into contact with fiber. This is the intersection of your environment and you and this ecosystem inside of you. And it's producing the short chain fatty acids that your immune cells, that your gut barrier are starving for. Now, there's one other real quick thing I want to mention that's cool, is resistant starch. So resistant starch is not exactly the same as fiber, but it behaves a lot like the prebiotic fiber. So we don't have the ability to break down the resistant starch either. That's why it's called resistant. It lasts all the way to the colon and comes into contact with your microbes. But here's what's cool, Rich. The research is showing us that fiber, generally speaking. And by the way, if you're listening at home, I'm patting the right lower part of my abdomen. People on YouTube will see this fiber generally feeds the right colon. That's the first part of your colon after it leaves the small intestine. But you have microbes throughout your entire colon. They need to be fed too. Resistant starch feeds your left colon. So it's quite fascinating to think these complementary pieces that we don't even think about. If you just eat a variety of plant based food, it naturally addresses everything that I'm saying. You don't need to make it more complicated than that. But what I'm telling you is the science is showing us some really cool stuff about how fiber feeds one part, resistant starch feeds another.

A (64:24)

Wow, that's wild. But the rule of thumb, and we talked about this last time, is ancient for a diversity of plant foods on your plate with the goal of trying to get at least 30 different types of plants over the course of a week. And that holds true.

B (64:43)

It holds true. But let's also understand where that number 30 came from. It's not a magical number, it's not.

A (64:50)

A cliff, but it's an easy to remember thing.

B (64:52)

It definitely is. But it's the core concept, which is that I don't want you to get to 30 and stop. Right. I don't want you to shortchange yourself by taking the bread that's got 21 grains and counting that as 21 and then getting nine more. Right. What I want you to do is to have a life where when you walk into the supermarket, you're thinking about this idea. Dr. B says, Diversity of plants, when you're in the kitchen and you're preparing dinner, you're thinking about this idea. Let me open up the fridge. What can I get? Let me look in the pantry. What can I get? By the way, plants are not just fresh produce, right? There's tons of nonperishable stuff that we can do. And then when you sit down to eat and you're building your plate, where are the opportunities? And if you gamify it and you do this at every meal, you will naturally add variety to your plate, and your microbiome will respond to that variety, and you will become healthier as a person. And you don't need to count grams of fiber if you just count plants.

A (65:53)

The ardent carnivore tribe will tell you that everything about fiber is overstated. You don't really need fiber in your diet. If you just eat a carnivore diet, you're gonna be fine. What is your response to that, for the record?

B (66:09)

So let me start with this coming from a position of compassion. As a medical doctor, I want people to be healthy. That's all I can. And so if a person does a diet that I don't agree with and they get healthy, cool. I'm happy for them. I also wouldn't argue that that's the right choice for them for the long haul, because something that helps you for a year is not the same as something that will help you for a lifetime. But the issue with this, there's this little kernel of truth to it, Rich. And the problem is that the Internet doesn't allow nuance like you and I can have in a conversation. If you go zero carb, which is what a 100% carnivore diet is, then your body will flip into ketosis. And when you are in ketosis, because you won't, like, you really will not come out of that. When you are in ketosis, you are producing two major ketone bodies. Beta hydroxybutyrate and acetoacetate. So here's the interesting thing. I think this is like a lesson for all of us. We all need to hear this. Beta hydroxybutyrate is conceptually similar structure to butyrate. Acetoacetate is similar structure to acetate. If you looked at the receptors that receive acetate or receive butyrate, acetate and butyrate fit perfectly lock and key. If you look at those same receptors, they will accept acetoacetate and beta hydroxybutyrate, but it's not a perfect fit. So you do get some level of activity from those things, but it is diminished. It is fractional. So if you take the person who was on a western diet, who doesn't have butyrate anyway, doesn't have fiber in their diet, and you were to in theory put them into ketosis, which clearly a 100% animal based diet would do that, then they would be getting something that they're missing. Right? And so I understand where that's coming from because there are these people who report that they got better. And this is how I understand that this may actually be helping them in the short term. But there's other issues. That's not the only thing that matters in your body. And so the problem is now Your LDL cholesterol is 500. You and I discussed last time. I'm not gonna repeat the same argument for why the idea that LDL cholesterol should be just dismissed when it comes to heart disease. We're gonna have long term studies at some point. This dietary concept is too young for us to have the long term studies. So the people who are doing it, they are in fact testing a new idea. And what we've also seen, Rich, is that a lot of the people who follow this pattern, they end up having to walk in. And I fully acknowledge there are some people on the vegan side who've had to walk it back. But the reason that people are walking it back is because it's not just that it's not a sustainable pattern. It's not just that it's hard to follow that pattern. It's that actually they're having serious health issues. Part of it is depletion of glycogen, part of it is affecting their hormone levels. Right? And you hear these stories and if you look out, I'm not going to name any names, and I actually don't mean any disrespect whatsoever. But if you look out at the people who have followed that pattern, they don't last long in that pattern.

A (69:40)

One of the more popular podcast episodes of the last five years was the one I did on the benefits of Sprouting with my very energetic longtime buddy Doug Evans, who at the time this was back in June of 2020, had just released a bestselling book on the subject called a Sprout Book, and has kind of gone on from there to become this sort of chief evangelist of the entire planet on all matter. Sprouting. He really hit a nerve in that conversation because ever since then, ever since it aired, I've just been inundated with people sharing photos of their sprouting setups, Kitchens turned into Beautiful sprouting farms and all these stories of health transformations, Doug's message set in motion. Since then, interest in sprouting has only grown. And this is in part due to growing awareness around the evidence based science that Dr. Rhonda Patrick shared on my show a while back about the nutritious superpowers of broccoli sprouts, which are loaded with sulforaphane and antioxidants and other types of sprouts that support our bodily systems and mitochondria in ways that are truly substantial. And the crazy thing is how easy and inexpensive it is to grow these tiny seeds like baby broccoli, alfalfa and lentils into these tiny plant bunches bursting with concentrated nutrition at home in just a few days time. But apparently not easy enough, Doug realized, because not nearly enough people seem to be doing it. Doug saw the problem and set about fixing it by founding the sprouting company and creating an even easier all in one solution. What he did is create the world's first high capacity all in one sprouter, making the entire process more convenient. Also beautiful and super safe and very much affordable. Now you can pack your plate with living foods high in B vitamins, iron and sulforaphane, one of the most studied plant compounds for cellular health and detox, all for under a dollar a serving, pesticide free and guaranteed to grow. The thing that Doug taught me is that sprouts are not a garnish. They can be a much larger part of a meal or if you're like Doug, the entire meal. I put them on salads, of course, but I also blend them into my smoothies and sometimes I just eat them by the handful. Doug has really created something special that can make a gigantic difference in your personal health that will actually save you money over time. And the time is right now to check it out because he and the team team at the sprouting company have put together something special for this community. 10% off to get you started and a free copy of the sprout book for the first 1000 orders. Just go to thesproutingcompany.com richroll and use the code. Richroll I have been doing a lot of traveling lately and it occurred to me that while we think travel is about the city we're visiting, we actually don't realize how much of the experience is colored by the choice we make about where we're staying. For example, I was recently in Palm Beach, Florida to speak at this event called Eudaimonia and they put me up in this perfectly fine hotel that served as the event hq. But then I had lunch with my guy, Michael Chernow, who told me he booked a stay with Airbnb right down the road that had a sauna and a cold plunge and a kitchen. And I was like, what am I doing? I could have done that, and I could have filled it with all of my friends and had a blast. Instead, I did what I think most of us do when we travel, especially when we travel for work, which is shuttle between airport and hotel and conference venue or meeting place. Just kind of passing through a place we traveled very far to visit without ever really connecting authentically with it. And not for nothing, when you're away, your home is just sitting there empty when you could host it on Airbnb to give someone else that authentic experience instead of just another hotel room. And get this, the extra income you earn can help fund your next great adventure. Your home might be worth more than you think. Find out how much@airbnb.com host you mentioned short chain fatty acids earlier and the relationship between those and fiber. In the book, you say, I want to find it. I wrote it down. You call short chain fatty acids, especially butyrate, the most anti inflammatory thing I've ever come across in my medical career.

B (74:09)

100%. So explain that without a shadow of a doubt. Okay, let's go back to our core thesis, which is that your gut microbes impact your gut barrier. Your gut barrier protects your immune system. Three layers of defense microbes first, barrier second, immune cells third. They rise and they fall together. If we want to fix that relationship, we have to disrupt what's broken and get it healthy and back on track. Butyrate, all three short chain fatty acids feed the beneficial bacteria that live inside of you and they suppress the inflammatory ones. So your microbiome is about balance. And what I'm saying is that short chain fatty acids start right there in your microbiome, adding more good guys and reducing the bad guys. You have tilted the scale. Balance hard with short chain fatty acids. We look at the gut barrier.

A (75:15)

The.

B (75:15)

Most important nutrient for powering the lining of our intestines, which gets repaired and restored and remade every three to five days. The most important nutrient is butyrate. It actually is the fuel for those cells. That's where those cells get energy from. And the proteins that hold those cells together. Tight junctions are produced in response to to butyrate. So now we've fixed the first part and the second part and we're going to move to the third part, which is the immune cells, which is that butyrate has a global anti inflammatory effect. We could get super nerdy. I don't want to get super nerdy with your audience on like all the details of the immune system. But what I do want to say is the one part, one particular part that can't be missed, which is the T helper cells. So there are these special cells called T helper cells, and basically they're the peacemakers. They're the peacemakers. They're the ones that help the immune system to know what is good and what is bad. That has direct effects on our risk of autoimmune disease, our risk of allergic disease, and our risk of inflammation in general. The more T helper cells that we get, the more that our immune system is going to be in balance, which is where we want it to be. So the entire point from my perspective is we can fix the gut, we can fix the gut barrier and we can fix the immune system. And it's all in one stroke.

A (76:46)

And the most effective way to increase your consumption of short chain fatty acids is what?

B (76:55)

Food. So I mean, if you're getting at a butyrate supplement, is that what you're getting?

A (77:02)

Butter? No, I'm trying to get people's heads around like, okay, when they're thinking about what they're gonna eat, what are the foods that are going to be contributing the short chain fatty acids so that they're gonna reap this benefit.

B (77:16)

Yeah. So any fiber rich or resistant, starch rich food is going to be ultimately fuel and the precursor to short chain fatty acids.

A (77:29)

So that's what we ultimately, it's all about fiber. The short chain fatty acids are the byproduct of the fiber that are giving you this additional benefit.

B (77:38)

Yeah. I mean, we could drift the conversation into polyphenols if you like.

A (77:41)

Right. Well, you have these four workhorses. Right. So fiber is what we're talking about here. But then there's polyphenols, which is the second one.

B (77:50)

Yeah, yep. So, and by the way, thank you for mentioning that because I didn't even mention it myself, which is. Yeah. I'm calling these four major nutrients the four workhorses of plant power, nutrition. And to me, a workhorse is what helps you get things done. That's the engine that drives change. So fiber is number one. Polyphenols are number two. And you know, you hear this idea, eat the rainbow. People say this, right? You walk into the supermarket. Every supermarket in America has the colorful, fresh produce out front. Why? Because it touches Our senses, we are naturally attracted to that. Right. And you see all these different colors.

A (78:23)

And then we walk right past it and try to find the chips.

B (78:26)

That's right. And we're willing to pay more though if it was a beautiful experience when we first walked in. Right. So yes. And all these different colors, whatever color you may choose, there's a story behind it because every single plant, every plant based food has its own sort of fingerprint or unique way in which it's impacting your microbiome. And yes, part of it is the fiber, but let's not diminish that. There's other things that are packaged in there that are good for our microbes. And polyphenols bring the color. And we hear about these things. Quercetin in onions, resveratrol in red wine or grapes, curcumin in turmeric, they're all polyphenols. And these polyphenol molecules, like I said, fiber from biochemical perspective is big and complex. Actually, so are these polyphenols. They're big and complex. What that means is that we don't digest them, so they drift all the way down to our colon and they come into contact with our microbes and then our microbes activate them. So 90 to 95% of the polyphenols in your diet are going to come into contact with your gut microbiome, get activated. And when that happens, your microbiome is not the same. And what we see, Rich, is that your microbiome now becomes more capable of producing short chain fatty acids. So because there are polyphenols in there, you could keep the same amount of fiber and you will get more from it.

A (80:11)

That's interesting. So in the hierarchy of foods that are high in polyphenols, like what is, you know, what is at the top of that list? Like if you had to give people food recommendations like you gotta up your polyphenols, here's a few foods that I want you to make sure that you're building in.

B (80:29)

So of course, the messaging, I have to start by saying diversity, variety, Right, because when you get variety, you're going to get all these different colors anyway. And so, and that will.

A (80:40)

So it really is eat the rainbow.

B (80:42)

It really is eat the rainbow. Right? And that, and that concept with clarity is more powerful than me saying, hey, here's the three that I love. Right. But like we could start with berries and the polyphenol content is phenomenal. And this is part of what we get when we're eating raspberries. Blackberries, blueberries, and if you haven't heard of lingonberries, lingonberries are exceptionally high in polyphenols. They're actually the highest polyphenol berry that exists.

A (81:10)

I've never heard of that berry.

B (81:11)

Okay, so there's a cool story for them. They live in harsh conditions, so you won't find them down here. We would have to go way up north into Canada, and in these places where it's freezing cold coming out of the winter, into the spring emerges these high polyphenol berries. And what's fascinating is that polyphenols, which are great for our microbiome, are actually defense chemicals for these plants. And within the context of harsh conditions, they produce more. So if you had the choice between eating something that grew outdoors, exposed to the climate, versus the greenhouse, you choose what was outside.

A (82:06)

The stressful environment has an impact on the nutritional aspects of the food.

B (82:13)

So it's like plant hormesis. Right. But it's kind of interesting because a lot of those same concepts that make stronger plants, you could apply the same concept to us as humans.

A (82:22)

Right? I mean, this whole thing. I think we talked about this last time. What applies in the micro applies in the macro. Like, you're talking about, oh, you got the more diversity of plant foods that you're eating, the better. Well, the same applies to our soil. Like, the more diversity of plants that you plant in the soil, the more enriched the soil becomes. Like, you know, these are scalable ideas that, you know, make sense 100% in our environment, whether we're talking about the environment, the broader environment, or the environment inside of our bodies.

B (82:53)

And there's something that I talk about in the book that I know. You know, you read the book, but for the listeners at home, I talk about how the environment basically shapes our ecosystem. Right. And that ecosystem makes you so. And it gets back to. One of my core arguments is we need to shape that ecosystem. We need to use our superpower as humans to be shaping our ecosystem.

A (83:17)

I want to get into all of that, but I want to make sure that we cover the four workhorses first.

B (83:21)

Okay, so we got two.

A (83:23)

We have two. The third, healthy fats.

B (83:25)

So the third is healthy fats. So I don't think fats should be healthy, vilified. And then there's gonna be a caveat because, like, for example, Rip Esselstyn is a friend of mine, and I love the guy, and I think that there's a conversation to be had there. But there are healthy fats, monounsaturated fatty acids, omega 3 fats, which are actually things that our body needs. They're essential. And if you don't get enough of them, you suffer the consequences of that. In the same way that what if you didn't get enough of your essential proteins, your essential amino acids, right? Well, people are getting enough of their essential amino acids. What they're not getting is enough of these healthy fats that our body really is starving for. And it's an interesting thing because if you look at the impact of these fats on our microbiome, it's actually amazing how they, they actually help to create and foster an anti inflammatory microbiome. So this to me is a big part of the story of why the Mediterranean diet performs so well in study after study. Because the extra virgin olive oil in there is going to be a part of your broader pattern. It shouldn't be 20% of your calories, right? It shouldn't be. But whatever percentage it is, that's better than you consuming high saturated fat, right? And the omega 3 fats. I think that there's a message that needs to be discussed here and I actually think it's a message that needs to be discussed in the plant based community, to be honest with you, which is that most of us aren't getting enough. And you can eat all the chia seeds, flaxseeds, hemp seeds in the entire world. And there's a conversion issue because there's three major omega 3s, so ALA becomes EPA and EPA becomes DHA. And DHA is the most important one because it makes up 60% of the fat within our brain. And our brain is mostly fat, so it's also anti inflammatory, great for our gut, great for our immune system. But the problem is that that conversion is really inefficient, especially in men and postmenopausal women. Estrogen seems to play a role, so you could load up on chia seeds, flaxseeds and hemp seeds and you could absolutely be deficient in dha. So it's important that we get tested. There's an omega 3 index test that you can do. The goal is 8 to 12%. And if you're below that, if you are vegan and you have an ethical reason to not consume the food that contains the long chain omega 3 fats, I completely understand. And this is why we have algae based supplements.

A (86:23)

Is there a conversion issue with that? Because I have heard and first of all, I agree with you. I think that the plant based community, the vegan community, needs to be more Rigorously honest about this. I know that there is that conversion issue and I believe in responsible supplementation when it comes to something like omega 3. And if you're gonna take a fish oil omega 3, you're gonna have those long chain amino acids. Correct. And that conversion issue is not a problem. But if you are taking a vegan algae based Omega 3, there is the idea that that is still substandard comparatively. Like how do you see that? Is it just as effective?

B (87:08)

I actually think it's superior. Other than it costs more. Yeah. So because the issue is that the fish based omega 3, the fish oil is of course being harvested from the fish and who knows what that fish is storing in their fat.

A (87:25)

Yeah. I mean you do run into mercury issues and things like that.

B (87:29)

You run into heavy metal issues and then there's a major microplastic issue and you wouldn't know because they're not visible to the naked eye.

A (87:35)

But setting aside contaminants and things like that, just on the pure nutritional profile and the absorption and conversion issue, you're saying it's just as good.

B (87:47)

If not just as good, just as good. There are some challenges that exist. So like as you know, I'm the founder of 38 Terra, which is a supplement company. So I'm working in this space and I'm happy to talk about some of the things that I've seen and dealt with in the supplement space. There's a reason why I'm working in that space. So the challenge that does exist is that the EPA and DHA ratios in a fish oil are not the same as what is easily achieved with an algae based. So algae based you can quite easily get DHA as it's really hard to get the epa. And the problem is that epa, there's not retrograde conversion. So you would need to make sure that you have a supplement that includes both EPA and dha. But if you do that, and that's what would naturally exist within the fish oil. Right. So you don't even have to think about it. Whereas with the algae based, you need to make sure that it contains both EPA and DHA when you purchase your product.

A (88:44)

Understood?

B (88:45)

Yeah.

A (88:45)

Okay. Healthy fats, omega 3s. Get yourself checked. Supplement if you need to.

B (88:54)

Yeah.

A (88:55)

Extra virgin olive oil. What else do you want to say about healthy fats before we.

B (88:59)

The last thing, the last thing that I want to say is that so to me, the data on extra virgin olive oil. Because you know, this is a conversation within the plant based.

A (89:09)

Oh sure, I know. But like, yeah, it's a raging dual.

B (89:12)

I honestly think it's so harmful to the mission because if the family is divided, you can't get in.

A (89:19)

What's a mission without infighting, though? I mean, this is like, you know, this is just the kind of thing that happens. I think I get it and I understand both sides of this argument. And I, you know, like you, I know people on, you know, I've known these people for a long time on both sides. I think for the most part, you know, if I was to charitably, you know, if I was to channel my inner Rip Esselstyn right now, he would say something along the lines that when it comes to, you know, we're talking about like this, the rampant problem of chronic lifestyle ailments, right? Like most people are dying from heart disease or they're suffering from type 2 diabetes, obesity, high blood pressure, all the like. And we're overeating and, and we're overeating foods that aren't good for you. So, like, the easiest way to reduce your caloric intake is to remove all of the oil from your diet. And that's gonna get you more than halfway there.

B (90:17)

And he. From my perspective, that is 100% accurate because the issue is that there is nothing more calorically dense on the entire planet than oil.

A (90:29)

And every time we go to a restaurant, like, we're eating so much of these oils without even knowing it, I think. And he's, you know, he would, you know, he's drawing attention to the fact that, like, hey, if you pay attention to this, you'll realize, like, everything you're eating has this stuff in it and it's not making you healthy necessarily, as long as you're meeting some kind of basic needs. And it's so calorically dense and nutritionally deficient. And maybe that's where the tension is because you're saying actually there are nutritional benefits in this oil, specifically extra virgin olive oil, that we don't want to overlook.

B (91:05)

Yeah. And it's not a big tension. I think that the point from my perspective is, look, if you're overweight and you're trying to lose weight, you should cut out oil, period. Right. All of them.

A (91:12)

I agree with that.

B (91:13)

Right.

A (91:13)

Yeah.

B (91:13)

Yeah. But for everyone else, right. 98% of the world's is not plant based. And the likelihood of them going to whole food plant based, no oil is almost zero percent. We have to build a bridge to bring people in. And the data to me are totally clear both in the microbiome, where, for example, extra virgin Olive oil over the course of just a couple weeks, increased gut diversity, increased the beneficial bacteria, reduced inflammation. Right. Or you can look at the. I don't know if we really want to get into this, but the predimed trial, which was a study of 7,500 people and to me, like the great nutrition study of the last 25 years, like, if I have to argue. And in that study, actually the best group was the group that was guzzling 4 tablespoons of extra virgin olive oil per day. So anyway, the point from my perspective is let's allow people, if you are no oil and you are thriving, you should keep doing that. And if you are consuming oil and you are thriving, you should continue to do that. And if you're not thriving and you haven't tried a plant predominant diet the way that I'm characterizing, you should come on board and try this. And both of these options are on the table for you.

A (92:38)

Here's the low hanging fruit question, perhaps the low hanging fiberless fruit question for you that I would be remiss in not asking. There's also a big discourse online around seed oils. I'm sure you're aware, and part of that argument is seed oils are inflammatory and you should not be eating any seed oils under any circumstances. What say you, good doctor?

B (93:04)

What I say is that we've distilled this into two camps that yell at each other. There's the people who defend seed oils and the people who attack seed oils. And to me, nutrition is much more nuanced than that where it's about what are you replacing with what. So if you take butter, which is high in saturated fat, or you take cream high in saturated fat, and you replace it with seed oils of many different varieties, like sunflower oil, whatever it may be, the data are totally clear that you took a step in a better direction from an inflammation perspective. Okay. Now does that make me an advocate for seed oils? Absolutely not. In fact, in my book I was very clear I'm not on board with seed oils because why would you not do extra virgin olive oil with which is clearly better than the seed oils? And do I think that there's validity to some of these arguments about like the deodorization and the way in which these seed oils are processed and some of the things that are going on there? I think that it's reasonable to say that I don't like extreme processing of our food and I have concerns about that.

A (94:16)

Sure. And the way that we consume seed oils isn't by just drinking seed Oils, they're packaged in, in the context of an ultra processed food.

B (94:25)

But the problem that we have, Rich, is this entire idea that, okay, so seed oils are inflammatory, but we're gonna replace them with beef tallow. Actually, actually the data would say that's a horrible idea, that you've actually replaced the less inflammatory thing with the more inflammatory thing. So it really doesn't make any sense. Many of these arguments that people are.

A (94:44)

Making, there is a bit of appeal to nature fallacy and, and in that, like, oh, because beef tallow is natural and seed oil is something that is produced in a factory or what one might consider a lab bad, right?

B (95:03)

I think there's that. And I think that in order to actually get there, like, if you want to really believe this argument, then you have to totally dismiss the idea of saturated fat being problematic. And you have to totally dismiss the idea that LDL cholesterol is associated with the number one cause of death in America, which is heart disease and stroke. You have to dismiss those things. And you know, the problem is that like, look, there's people on the Internet that are doing that, but that is not what's happening within the scientific world.

A (95:32)

Enough said. Let's move on to fermented foods, the fourth workhorse.

B (95:36)

Okay, the fourth workhorse are fermented foods. Once again, we are not sufficiently consuming fermented foods. These are tradition based foods. If you went back 200 years ago, wherever your family came from, because United States is a cultural melting pot. Wherever your family came from, they were consuming fermented foods. Right? And now we're not. Because we don't need to. Because we invented these new preservation techniques that allow us to have food on the shelf for two years without changing at all. Or allow the bread to sit there for two weeks and it's still soft and fluffy and not moldy at all. But we now need to bring them back because they are transformed. And yes, they include a living ecosystem of bacteria and yeasts. And yes, the data show that those microbes in that fermented food can integrate into your microbiome and they can become part of yours. That is an opportunity, but it's actually much more than just this. You could kill those microbes. They may still have a benefit. We call those zombie probiotics. Right? Where the dead microbe, it's like the cell that's still intact. Even though the microbe is not alive, the cell still provides an anti inflammatory effect. And the transformation of our food, which includes carbohydrates, you create new forms of fiber that we call exopolysaccharides, transformation of our protein. You create these unique peptides, like for blood pressure. There's medications called ACE inhibitors. This gets produced actually in fermented foods. It's already in there. And our fats, they get transformed. So there's a fat called cla. And CLA is found in fermented food and is anti inflammatory. So the point from my perspective is we need these. And Christopher Gardner, who you've had here on the show, conducted a study at Stanford that showed that when you increase your fermented food intake over the course of eight weeks, by week eight, the population of people in his study were able to increase the diversity within their microbiome and reduce measures of inflammation. So not only is that an opportunity, eight weeks to change your gut, but that also is proof of the principle that I've been arguing here today.

A (98:12)

We're talking about foods like kimchi, sauerkraut. What would you add to that list?

B (98:18)

Miso tempeh. I include sourdough bread. For people who consume dairy, then I would include food fermented dairy. If you're going to consume dairy, make it fermented dairy. So kefir yogurt. We have to be fair with the data in the study that I just mentioned. Yogurt was actually the number one food that increased the diversity of the microbiome. But you can absolutely purchase or make, I actually prefer make your own fermented dairy. That's plant based. It absolutely can be done. It's not that hard to do. But I also think that we can stick to these classics.

A (98:52)

Yeah. All right, so those are the four workhorses. These are the four major sort of dietary interventions that everybody should be thinking about. And just to kind of recap that before we move on, Diversity of plant foods. Eat the rainbow omega 3s, healthy fats, foods high in fiber, fermented foods. I mean, those are the thumbnails here, right? Yeah.

B (99:18)

So the four workhorses are fiber, polyphenols, healthy fats and fermented food. And if you eat a diversity of plants, you will naturally achieve all four of these. And my argument is that one by one, as we've said, these are missing in the western diet. And if we restore and replace them, you will positively impact your microbiome. So it doesn't matter what you call your diet, it doesn't matter what that pattern is. If you build a pattern where the predominance of your food is driven by these four things, you will have an anti inflammatory diet. And it will be powerful and change your life.

A (99:55)

And just as we have agency over our food environment and by exercising that we can improve our health, we need to exercise agency over our lived environment. And here's where the, the book and your focus and your work starts to broaden to kind of canvas what our lives are like outside of just what we're putting in our mouth and the impact that that is having on the microbiome. And you contextualize it as mind body and I want to get into that, but let's start with just what's around us. We're living in a toxic environment. And I've participated in conversations where, you know, where I have somebody sitting across from me and it's like literally like everything in our world is like making us sick, right? There's a paralysis I think that comes with that. Like, you know, what am I supposed to do? Like everything's made out of plastic. You know, there's pollution in the air and like glyphosate is just floating around and ending up in our, you know, like there isn't, you know, it's like, well, you know, I just have to live my life. So how are you approaching this? And what are the guidelines that you want to offer people so that they can clean up what they can without becoming neurotic anxiety riddled messes?

B (101:08)

To be totally honest with you, I mean I do have a chapter in the book, chapter three where I sort of shine a light on these things because it has to be said, I mean you can't totally ignore the problem, right? But the focus of the book is not about what we exclude. The focus of the book is on what do we add? What are the things that we can bring bring into our lives. We just talked about food. There's other things. Your gut health is not just what you eat. We have tremendous opportunity with the choices, the way in which we structure our life. So and I would actually move the conversation into the acknowledgement of the power of consistency through our circadian rhythm. Because if you literally rich changed nothing except you woke up at the same time, you ate your meals at the same time, you went to bed at the same time, and you had a pattern for your day. If you changed nothing, but you maintained a pattern to your day, you would feel the difference, you would be much healthier. That actually is anti inflammatory. So to move into a circadian conversation, I want people to understand the opportunity that we have here, which is that we evolved with the sun every single day since the beginning of time. The sun Went up and it went down. And as a result of that, that's a daily clock. And that clock, your body is doing different things at different times. You're not just the same physiology. All day long, half of our genes are flipping on and off at specific times during the day. More than half of our microbes are rising and falling during the course of a 24 hour cycle to meet the moment so that they can do the thing that you need them to do. During the day, your microbes are focused on protein metabolism. Why? Because that's actually what we need because we're physically active. But at night, your microbiome is focused on recovery and restoring itself and restoring your cells in your body. So the timing matters a lot. In fact, in the chapter I call it, timing is everything, because it does become powerful. And what's missing is, if you think about this, my grandfather that walked to school every morning, he may have been sleeping inside of an edifice, like inside of a building, right? And that's a privilege that didn't exist until like relatively recently on some level. But he was getting outside, he was getting outside, he was walking, he was getting that sunlight. In the morning, that sun comes up and the light passes through your lens and it touches the retina in the back and both eyes and it enters into your optic nerve, which is like an X crosses over to the other side of your brain. But actually the very first spot within those nerves where you could collect information about what the eye is seeing, right at that crossroads, that's where we have a part of our brain called the suprachiasmatic nucleus, the scn. And that is the orchestrator of our circadian rhythm because it is taking that light information which is there, the essential information that the body needs to know. Where are we? Is it day? Is it night? Is it midday? Well, if you get access to sunlight, you would know. And by the way, I should mention the sun's rays are not the same in the morning as they are midday. And the physiology and effects on your body are not the same. So there's tremendous information. And the sun is providing this nutrient to us, but you only get it if you step outside. So if you walk from your car, from your home to your car and you're wearing glasses, you're not getting anything. If you look out your window, you're not getting hardly anything, right? All you're getting are the artificial lights that we have created in the last 100 years. But if you were to step outside, then you would. What happens, Rich, is the morning Hormone that sets our rhythm for the whole day, sets the tone for our body is cortisol. So cortisol, which we could talk about the nuance of cortisol, because this is the stress hormone. But cortisol spikes when we first wake up. So it goes from super low to boom, and it rises. And if you step outside and you get exposure to morning sunlight, you can bump that spike by 50%. And if you complement that with a little bit of exercise. And when I say a little bit of exercise, I'm not talking CrossFit. I'm talking about my grandfather riding a bike to school. I'm talking about us taking a walk. You can add another 25 to 50%, depending on the intensity of the exercise. And the message for your listeners is that if you do this, I'm challenging you, I'm challenging all of you who are listening right now to give this a try for one week. And I understand this show's gonna come out in January, so you either step outside, depending on where you live, or you can get a light box. And if it provides 10,000 lux, that's what you need for wintertime. But I'm challenging you to get light exposure within the first hour for one week. And I postulate that on literally day one, you will have more energy during the day, you will have better focus, you will get more done, you'll be more efficient, and that night you will sleep like a baby. And that I expect to start on day one, and then you will get even more as the time passes.

A (107:49)

Yeah, that's amazing and very well said. I mean, obviously this is something Huberman talks about all the time and, you know, continues to kind of underscore and re emphasize as a key, you know, aspect of what should be part of everybody's morning routine. But I think what's different? Yeah, let me just finish this thought. I think the added layer that you're adding to this conversation has to do with appreciating the circadian rhythm of the microbiome. Like, he'll talk about, you know, how the importance of cortisol and setting your circadian rhythm, but actually understanding that your microbiome has its own circadian rhythm. And by doing this, you are contributing to the health of that gut flora, I think was the piece that I didn't understand until I read it in the book.

B (108:41)

Yeah. And that cortisol, which is appropriately timed because it's synchronized to our circadian rhythm, that's actually cortisol is anti inflammatory when it's within that context. So think about this. So here's an interesting thing. Our immune system is nocturnal. And this was something I discovered while studying for this book, that our immune system is actually most active at night. Why would that be? Well, a few things. Number one, if it was too active during the day, you wouldn't be able to get anything done because the fatigue that you would experience. But also that's the perfect time for you to repair and restore things. And that's what the immune system's job is. But many of us get congested at night, right? So your nose gets full because your immune system is more active. That congestion is inflammation. And then you wake up in the morning and you start going about your business. And during the course of that first hour, you discover that the congestion clears on its own. You didn't have to take anything for that. That's cortisol, that's your morning hormone that actually is reducing inflammation in your body. But that same hormone, in context, in sync with your circadian rhythm, is also what propels these microbes. Your gut barrier reduces inflammation and allows you to actually have greater energy and get more done during the day.

A (110:09)

You said timing is everything. And then this idea that your microbiome is nocturnal, I mean, this was my aha moment. Because if there's one thing that I continually struggle with, it's the timing of my meals. Like I just eat dinner too late. And there are times when I wake up in the middle of the night and I go into the kitchen and, and I eat in the middle of the night and then I look at my whoop data and I see the stress levels and I see the impact on my hrv. But I just get this hunger impulse in the middle of the night and I go on some kind of autopilot. Like, this is like my big thing that I have to overcome this year. Cause I know, and now I know even more how damaging this habit is that I have. Like, I've got to find a way to complete all of my food intake during daylight hours, which is difficult in the wintertime when the sun goes down so early. And to get on top of this bad habit that I have of eating food in the middle of the night. It's terrible.

B (111:14)

And this is where I think this.

A (111:15)

Is my big confession.

B (111:16)

No, I appreciate that. This is where it feels like there's an opportunity to discuss time restricted eating. Because, you know, I'm not the first person obviously to talk about time restricted eating, which is a form of fasting. Like, basically, you know, what we're saying here is during this 24 hour cycle, we're going to set parameters on what are the hours we're allowed to eat and what are the hours that we will not eat. And there's actually good studies that suggest that if you can do 12 hours without eating, it's wonderful for the microbiome. And at Zoe, we did a study of 40,000 people in Europe who were all doing time restricted eating and they did 14 hours of fasting and 10 hours of eating and they had improvements in their energy, improvements in their sleep, improvements in their mood, and they had less bloating. But I think that the unheralded part of this conversation is not just, hey, how long did you fast? I think the unheralded part is that time restricted eating from forces you to create attention to your meal times and that creates consistency. And that consistency that you install as a result of having those parameters helps you to basically allow the microbes to know, hey, this is when Rich is going to eat.

A (112:37)

So if and when I don't eat dinner until 9 o'clock and as soon as I finish eating it, I go right to bed, what is happening metabolically and to my microbiome as a result of that?

B (112:50)

Okay, well, there's been a lot of focus on what the impact is on your blood sugar, which of course we already discussed can affect your microbiome. But actually there's a different part that I see as more important, which is your blood fat levels. So what we know is that after every meal, not only do you raise your blood sugar, you raise your blood triglyceride levels. Triglycerides are a form of fat and there's this period of time where those triglycerides are going up and that's on the order of about six hours and then they will start to slowly drift down. Well, actually there was research that was done by Zoe scientists and by the way, I should mention that Zoe is a nutrition company and I've been working with them for several years as their U.S. medical director. But there was a study that was done by Zoe scientist. I wasn't a part of the study where they actually looked at post prandial meaning after a meal inflammation. And they thought that they would find that blood sugar was really tied to inflammation after a meal. Actually, it was not. The part that was the key was the triglyceride levels. The triglycerides were associated with inflammation. And so what I'm saying is that the triglycerides go up for six hours before they start to come down. So what you've effectively done is that you go to bed and at a time when your microbes are supposed to be basically taking care of your body and recovering, they're not only digesting food, but they're dealing with the inflammatory function fallout, which is going to continue until 3 in the morning, peak at 3 in the morning, and then it's working its way back down. And then you wake up in the morning and you eat. And I mean, you should eat in the morning. That's actually the best time to eat. But the problem is, without giving them that break, you've actually stayed in a perpetual inflammatory state.

A (114:47)

So essentially the microbiomes wake up in the nighttime ready to do their good work. And instead of, instead they're like, oh, damn, we can't do that because we gotta go deal with all this food that suddenly arrives.

B (115:00)

We gotta deal with this dude.

A (115:04)

Okay, so circadian rhythm, morning sunlight, time restricted eating. I mean, basically you're saying a 10 hour window and try to complete your food intake before the sun goes down. Is that like a general rule of thumb?

B (115:18)

General rule. The main point, the main time point that I'm most worried about is unfortunately the moment that you just mentioned for yourself, which is, I don't want you eating late at night. I also don't want you drinking.

A (115:29)

Yeah. My next question was around alcohol.

B (115:32)

So first of all, alcohol drives up blood triglyceride levels more so than anything else out there. And there was a study that changed my mind on alcohol. And of course I know that you don't drink rich, which I love, but for me, I sort of saw like one drink, possibly two, as being quite benign. Of course, there's these studies that say, oh, well, moderate alcohol consumption is good for you. And then I came across this one study that changed everything for me where they took a group of people and they gave them an amount of alcohol proportional to their body so that they would get up to what is, you know, what, fail a breathalyzer test. And during this period of time, they checked their blood alcohol level every 30 minutes. But the other thing that they checked was blood levels of what's called lipopolysaccharide. And lipopolysaccharide is something found on inflammatory bacteria. It's like almost like their coat of armor on inflammatory bacteria. They're supposed to be in your intestine, but if your gut barrier is weak, it will show up in your blood. It's not supposed to be there. And this lipopolysaccharide, well, if we go back to the beginning And I was talking about the innate immune system that's been pre trained. Okay. We as humans have been on Earth for like, depending on the estimate, roughly 3 million years. But actually there's data to suggest that immune cells have been at war against lipopolysaccharide for a billion years. And in fact that it was somewhere in the range of 1 to 1.5 billion years ago that those inflammatory bacteria evolved to have this armor. So the armor became the signature of an invading threat for the immune system. So the immune system learned, the innate immune system learned from birth that if it sees lipopolysaccharide, it must be activated and destroy it. And so in this alcohol study, every 30 minutes they're checking the blood alcohol level, which of course is climbing, climbing, climbing. Well, guess what else is climbing, climbing, climbing the blood lipopolysaccharide level in parallel. And it was quite interesting because when the alcohol level peaked, so did the lipopolysaccharide level. But something weird happened and I can't explain why it is. If there's a scientist in the audience who understands alcohol metabolism and can explain this to me, I would love to have you reach out. The alcohol level peaked, it started coming down and then it went back up. And what did the lipopolysaccharide do? It peaked, it started coming down and then went back up. It just stayed in parallel the whole time. LPS lipopolysaccharide did not go to zero until alcohol went to zero. So there's a part of me that says I don't think there's any safe amount of alcohol. Now that's not exactly what that study was looking at, just to be clear. But I'm not convinced that you can consume two glasses of wine and not have this happen. And the tiebreaker, like the low hanging fruit that I could defend every single day of the week with total clarity, is that all it takes is one drink to ruin your sleep.

A (119:20)

But essentially, in the story that you just told, when you intake alcohol, you are de facto going to increase the level of LPS in your bloodstream, and this is by necessity, is going to produce an inflammatory response.

B (119:34)

Yeah, the argument is that alcohol appears to be disrupting our gut barrier, and when it disrupts our gut barrier, then you are creating an inflammatory response. And by the way, when you create an inflammatory response that's not just occurring with within the immune system, that starts to actually make the gut barrier weaker and it also starts to affect the microbes. So basically.

A (119:54)

So there's a Cascading effect.

B (119:55)

There's this cascading effect and it's like they're rising and they're falling together. So if you're gonna do something that causes the fall, they're all falling.

A (120:03)

I wanna turn our attention now to the emotional and spiritual piece. And I was chatting with you before the podcast and I was sort of commending you for having the courage to kind of go there. This is less well chartered terrain, especially for somebody with a traditional Western medical education. But I think it's really worthy of discussion and exploration because we can't truly be well unless we're holistically well. We have to be well emotionally and spiritually. And so I thought it was pretty cool and amazing that you tackled this subject matter to basically talk about. Like, listen, if you're not just anxious and stressed, but you have suffered some kind of childhood trauma, or you have something else complicated going on with you emotionally, or you are succumbing to loneliness, or you're enduring an existential crisis of the spiritual variety, there are going to be downstream negative health consequences as a result of that. And it's not unrelated to what's going on in your microbiome.

B (121:13)

Yeah, well, so first of all, as a scientist, we have to be willing to say that there's so much that we can't explain and there are some things that exist. This is part of what chapter eight digs into. And I should mention I view chapter eight of this book as my masterpiece.

A (121:35)

It's certainly my favorite part of the book.

B (121:38)

I've written three books. This was for me, a moment. It was cathartic. There were some things that I needed to get off my chest. And you find them in this book. And actually, if you get the audiobook, you also hear it in my voice because I read it. Healing comes in many forms. And yes, it can be changing your diet. I think sometimes we overemphasize that, myself included. Yes, it can come from changing, restoring your alignment with daily rhythms and creating a pattern that your body can understand what's coming. But we also must acknowledge that there is a crisis of loneliness out there. That 50% of America, before the pandemic, we already discussed this, complained of loneliness. That's like smoking a pack of cigarettes every day. And that also I see that there is a place inside of us that's yearning for human connection. And there's a place inside of us that's yearning to understand who we are and what our role in this planet is. And I think that there's absolutely evolutionary Concepts, if you want to talk about it, we could that explain the social nature of who we are as humans. The truth is that if you want to torture a person, you isolate them. Like to me, to ostracize is actually emotionally abusive. And on the spiritual side, I'm happy to double click and go as deep as you want. I see this as extremely important and needs to be discussed. And if I'm a doctor and I'm here to help people heal and I see something that is an opportunity to help the people who are listening to your show or who are going to read my book, there can't be boundaries to that where I'm scared. I have to be willing to say what I believe. And this is not to invoke a specific pattern of beliefs. I'm not telling you what to believe. I'm telling you that I know that you've been asking the same questions that I've been asking. Who am I? Where did I come from? Why am I here? What does it all mean? What happens after I go? What will be my legacy after I'm gone? These are questions that I've had and I think that you who are listening to me right now have as well. And there's an opportunity for us to fill this hole that we have in our heart with what's really missing and we're starving for.

A (124:36)

I think that's really beautifully stated and I think it's a much needed conversation in the context of health, particularly when the discourse around health is so reductive. Whether it's this supplement or this food or this dietary protocol or this metabolic pathway, ultimately, no matter how much you master any of those or even all of them, they are not going to resolve whatever kind of internal dilemma you're having or spiritual hole in your heart. Your attempt to control your environment, and perhaps even if it's focused on longevity. How long. How long can I live? We all have. We're all motivated on some level by existential urgencies and impulsed by our fears. And so we can only get solace or we can only find solace if we embrace the fact that we're but humble spiritual beings having a human experience and accept the fact that there are questions that we're not going to be able to answer for ourselves in this lifetime. And by embracing that and trying to find a way to make our lives about something more than ourselves and appreciating the mystery of all of that, not only is there peace and connection that comes as a consequence of, of that, there is an inner peace I think that creates an internal equanimity and, you know, perhaps even a more balanced microbiome as a result.

B (126:28)

Well, there is a physiologic explanation for how our body responds to these things. So it's not a total black box, right? It's not. We can explain what happens with loneliness. We can explain how your brain changes in response to trauma. We can explain a lot. And I'm happy to dig into the topics of sympathetic versus parasympathetic nervous system.

A (126:57)

Sure, go ahead.

B (126:59)

That we have these two major and diametrically opposed aspects to our autonomic nervous system. So autonomic, meaning that basically you go through your day and your physiology is functioning a certain way, but your brain has the ability to basically step on the gas if there's a threat. Or your brain also has the ability to pump the brake if you are in a place where things are slow and safe and pumping that gas. We evolved to do that for a reason. Right. If there was a threat, you need the ability to get focused, to have blood circulating to your muscle tissues, the ability to run and jump and climb a tree. Right. And that's your sympathetic nervous system. But the problem is that there is a price to pay when you're gonna activate because you're gonna sacrifice your gut and your gut microbes.

A (128:10)

We're constantly activated, though.

B (128:12)

Exactly. That's the point. So we're in what we call sympathetic overdrive, or you could call it sympathetic imbalance, because these things are supposed to be in balance, right? So you go through your day and you're disconnected, and you turn on Twitter and you're getting triggered in that space. Right. And yet you continue to do that every single day and subject yourself to that. And things that you have no control over are really affecting you in a negative way, and they're activating your sympathetic nervous system. And then I'm gonna tell you what's happening inside your body, which is that your brain releases corticotropin, releasing hormone crh. CRH is what basically helps to get all these things downstream, opened up and moving. So you get your heart pumping, you get your blood pressure up, you get focused. But then, I'm sure, you know, you've noticed, many people who are listening have noticed that in these times of stress, you actually manifested in your gut. Some people get headaches, but most of us, we manifested in our gut. So, like, you're going to go and you're going to give a talk, right? You have to go on stage, and you and I, we've done This a million times now, but back in the day, that made me really nervous.

A (129:29)

I still get nervous. But you feel it in your gut.

B (129:32)

You feel it in your gut.

A (129:33)

Call it butterflies or whatever, but, like, it is very localized.

B (129:36)

Yeah, absolutely. And that is the manifestation of your sympathetic nervous system, basically sacrificing your gut. And sometimes it gets worse. You could get waves of cramps, you could get diarrhea, or some people clam up and they get constipated. Right. So. And we live in this world of sympathetic overdrive. And what we need is to balance that recalibrate, which is to enter into a parasympathetic state. And a parasympathetic state, unfortunately, our culture is not making this easy because. Go, go, go. But what we really need is to slow down and do things that are allowing us to feel safe. And that's how you get yourself into that place. So when you're, you know, doing things that you can make it sound trivial, but I'm saying, Rich, these are things that are proven scientifically to activate your parasympathetic nervous system, which, if you have a wearable device, you will see it because your HRV goes up. Holding hands. Right. Spending time with someone you love, having a good conversation, spiritual practice, like prayer, reading the Bible, listening to music, dancing. These are, like, essential, celebrated elements of the human experience that actually we're not really doing much of anymore. And so I think that this helps to explain a lot of the core concepts that I walk through in this chapter of talking about the impact of our emotional connections or spiritual connections. But just to double click on the. These other topics real quick, trauma is not the same. It's different. Because what's happening with trauma? And let me first say, like, not everything that's bad in your life is trauma. We overuse the term. That's not appropriate. Trauma is when something occurs that overwhelms your ability to cope. And as a result of that, it leaves a permanent imprint. And, you know, you may not be thinking about it, it may not be in your conscious mind, but it is there as a part of who you are, and you don't get to escape that so easily. And the whole concept of, like, the most perfectly titled book, the Body Keeps the Score, it's, like, always a New York Times bestseller. That's a perfect title. It's so true, because it impacts your amygdala. Your amygdala is the fear center of your brain. And people that have been exposed to trauma, the data show actually their amygdala is Hyperreactive, meaning that it's always turned on. So they're living at a baseline of the foot on the gas. That's just their baseline. And there was a study, Rich, where they took kids. So I used to believe that if you can't remember it, then it can't affect you. It's not true. I was wrong. They did a study with kids and they took kids who were adopted before the age of two. Okay, they clearly don't remember this. Adopted into good homes, right? Like this. It was not an issue of like, they were abused or something like this later on versus healthy controls, similar age. And what they found is that the kids who were adopted, they had lower gut diversity. They were more likely to suffer with gut symptoms. And actually, the way in which their brain interpreted information was different when they did a functional MRI scan. And that was the only thing that was different between those groups. So trauma, like, to me, for your listeners, some of them, not everyone, but some of them, this is the most important part of our conversation because short.

A (133:30)

Of resolving that that amygdala will remain turned on and you will be in this hyper vigilant, sympathetic state. And that sets off a domino effect with all of these downstream consequences, not the least of which is chronic inflammation and the dysregulation of your gut. And what happens when that is going on.

B (133:56)

And then we have all these studies that show that these people are at increased risk for disease. They're more likely to be obese, they're more likely to have autoimmune disease. Right. And you're like, well, where does that come from? Well, I just explained it, and I've had many patients during the course of my career where, because of the experience that I describe in chapter eight, which you know from reading it, that I talked about how I begrudgingly got sucked into a clinic at the University of North Carolina that I didn't want to work in. But actually it helped me to see and understand because that doctor, his name is Dr. Douglas Drosman, he was both a doctor of, of gastroenterology and also psychiatry. And he was the one who was sort of like bringing these fields together. So I got to see what healing looks like for the person who's failed everything. And I've carried this forward in my career where they could eat everything, eat everything, right? They could follow exercise and sleep and meditate and do all these things. They're not better. And then five or six visits in, you finally have enough trust between you that you can have a real conversation about the Stuff that they don't want to talk about because they've pushed it to the side and are trying to ignore it. And when. The minute that you realize that, you know, it was never about fiber, it was about the healing within their soul that is necessary. And if you take that person and you get them what they need. That's not what I do. My job is to shine a light and bring attention to this connection. But if you get them the help that they need, the healing is off the charts, because most of the time, they're doing everything else right. So it's just like a rocket ship that's been chained down and you're breaking that chain.

A (135:55)

That is a powerful aha moment for anybody, I would imagine, who's watching or listening, who has that thing that they know they should deal with, and it's just inconvenient and, like, life's okay. Like, I don't really need to go there. Right. But understanding, you know, what that's doing, you know, not just in the brain, but in all of these other kind of downstream ways. But, you know, physiologically, that provides a strong motivation to final, you know, contend with that thing that's just so easy to compartmentalize.

B (136:32)

100%.

A (136:32)

Do you have any sense of whether this applies equally for, you know, you were. You're kind of. Your stories really have to do with, like, more like, early childhood situations. But, you know, for the veteran who's returned from a conflict zone and has PTSD, 100%, same thing.

B (136:49)

100%. Absolutely. Without a doubt. And I do, you know, specify in the book. Trauma comes in many forms. It's not just what happened to us as a child. And even some things that maybe you don't consider to be trauma, if they impact you in that way, where they overwhelm your coping abilities. It's just that we have less ability to cope as a child, so it's more likely to occur. If they impact you in that way, then it sticks.

A (137:12)

That's really powerful.

B (137:13)

It's a wound that needs to be healed.

A (137:14)

Like, if there is a lightning bolt moment or aspect of your book, I mean, I think this could be it for a lot of people.

B (137:23)

I hope so. And, you know, and one of the things that I did. I don't know how much you want to talk about this is I talked about my own story, which has been kind of secret, to be honest with you, up to this point, where I go out into the world and all these things start happening, and next thing you know, I'm a New York Times best selling author. And there's this common impression, and it's my own fault for this that I make it sound like, yeah, hey, yeah, I changed my diet and everything started to click for me. Actually, there was a lot more going on there.

A (137:56)

Do you want to talk a little bit more about that?

B (137:58)

Yeah, sure. Our family, when I was a kid, we went through a very hard time and it was confusing to me into adulthood. So first of all, let me just say my father is deceased. I dedicated my book Fiberfield to him. My mom I love dearly, and I've dedicated this book to her. And she's a wonderful mom. And she fought for us, me and my two brothers, and put herself through night school so that she could provide a life for us. Because we, you know, the short of it is that my parents, who were adults, something happened. I don't really know, but they split. And that process was brutal. And I was seven and I was the oldest child. My other brothers, they're two years and four years younger than me. And so the court system saw me as basically like, hey, he's gonna help us figure out what's going on. So. But the court system doesn't really account for, like, they're just trying to, like, come to conclusions on how do you divide up stuff they don't really account for, like, what's the impact on a child of like, having to sit at 7 years old. And like, I knew that the things that I said were going to go into the court, and that became a very complicated thing for me because I was deciding outcomes in my parents. And when you're. I come from a generation where a lot of us come from households where our parents were divorced. And of course, I pray that it was amicable for your. For like the listeners who have divorced parents. And in this case, it just was not.

A (140:12)

And.

B (140:15)

In that context, you as a child feel like you have to choose the winner. And I think, like, on some level, psychologically, the one you don't choose, they have to be bad. And so I started to build in my mind that my dad was the bad guy. And this continued to build momentum. And, you know, just let me. Before I go on with this, I just want to, like, be clear on something that actually he was not that my dad loved us deeply and he worked his tail off to take care of us. And this is the dad who, three boys, by himself, took us camping all the time in the summer and every vacation that we had with him, spring break, whatever it may be, he never said, I have something Else I want to do, it was always, we're loading up the car and we're driving somewhere from upstate New York, going to go into Canada, we're going to go up and down the Eastern seaboard, explore places. He's doing this by himself. So anyway, as I, like, matured into being a teenager, no teenagers, I'm dreading it. Rich teenagers, they sort of separate from their parents. And this was like an amplified effect because of the circumstances with my dad. So I like pushed him away hard. And this snowballed to a point where when I, after I graduated college, stupid reasons, so silly and stupid, but I made a decision that I'm not talking to that guy anymore. And we didn't talk for over 10 years. And my. My life was changed. I was blessed by an angel. And that's my wife, because she came into my life and she never asked me to do anything, but she helped me a lot and she helped me with my diet. And I wrote about those things in Fiber Fueled that my wife helped me to change my diet. What I didn't write to everyone about, but now I'm telling you right now, is that she said, you gotta call your dad. And so I picked up the phone one day before my wife and I got married and I gave him a call. He couldn't believe. He couldn't believe that I called him. And we, we reconnected and there was this period of time from, you know, basically he came to my wedding. It was the first time I saw him in 10 years. And there was this period of time that we got back in. We got back together and we got right back to loving the things that we shared that we loved so much together. Syracuse sports, Syracuse football, Syracuse basketball, Outdoors, hiking and camping in the Adirondack Mountains, upstate New York. And. And I don't know if you. I don't know if you've ever experienced this. I'm sure I don't know. I'm just going to speak to what I've seen, which is that I feel like sometimes when people are getting close to an unexpected death, they kind of know and they start behaving differently. I had an aunt that we lost unexpectedly to cerebral aneurysm. And her last four or five months were like almost like a world tour of her going and finding everything that.

A (144:32)

She wanted to do, even though she didn't. She was unaware of her.

B (144:36)

Totally unaware. She walked out of the hospital one day and she collapsed. Right. So with my dad, you know, the story is that he passed in January of 2020. I'll get into that a little bit more. But that was completely unexpected. We didn't know. No one knew. He wasn't sick. He didn't have any issues. So he was 70, so.

A (145:02)

But anyway, you were on good terms with him when he passed away.

B (145:05)

I was in great terms with him because my wife helped me to repair. And I'm so blessed. And for that I had this time with my dad. So. But in September of 2019. So he passed in January 2020. There was something that compelled me to go and see him. I have not been good about this. I get busy, caught up with my kids, but I felt like I gotta go see my dad. So I flew up to Syracuse, New York, and we had this weekend that was like. If you were to. If you knew that this was the last time that you were going to see a person, this is what we would have done. We went to the Carrier Dome and saw Syracuse football. They played the number one team in the country, and they almost beat him. Then we hopped in the car and we drove up into the mountains, went to all of our favorite stomping ground places in the Adirondack Mountains. It's like, super close, so it's like 45 minutes away. Get up into the mountains, go to our favorite places. This is my childhood. And then on the way down, before he took me to the airport, he took me through Rome, New York, which is about an hour outside of Syracuse. This is the place where my Polish great grandparents immigrated to the United States and settled. And he took me to the road and he showed me the houses for the first time of where our family came from. And that was the last time that I saw him. And so in January, I was at work one day and I get a phone call and it's the police in Syracuse. And they basically tell me that my dad didn't show up to work. They're at his house, they're breaking in, and they found him. He had passed away. And so. So I dedicated Fiber Fueleds. You can read it in my dedication to him. I dedicated Fiber Fueleds to him. I wrote that very emotionally, right after his funeral. Um, and I'm. All I can say is that I'm very grateful for the fact that we were able to reconnect and have that time together. But there are some things I never got to say to him. I never got to tell him that I got it wrong, that it was my fault. I never got to tell him that he was a great dad. He told me that my grandparents would have Been so proud of me for the work that I was doing. So there's a part of me that wishes that I could. And I felt compelled, Rich, to write this chapter. Not just about these relationships that I'm discussing right now and how important those human connections are to us. And how if you're someone who's listening right now and you have that relationship in your life. Cause many of us do, where you need to reconnect. I'm asking you to think about it. And I'm telling you that our family is so important to us. But also. My faith has provided me with a framework that allows me to know, not pretend to know. My faith has provided me with a framework that allows me to know that the things that I need to say to my dad, I'll be able to do that one day. And that means a lot and has helped me so much. And with what I see, I believe that there is a hole in our heart that needs to be filled by God. And I don't say that as, like, you need to be this religion. I say there is something bigger than just us. There's more to this world than just us. And your purpose is beautiful. You are here. No matter who you are, no matter how ugly it looks, you are here. And you are wonderfully made. And we all need that connection to our purpose and to higher power in order to. In order to feel good about who we are and where we're going and all these things.

A (150:00)

I appreciate you sharing that story with me.

B (150:05)

Just you, Rich.

A (150:06)

Yeah, just me. But it's a very relatable story. I think we all have our version of that story to one degree or another. And I would say to you, and I would imagine I'm not the first person to say to you, that even though you might harbor some feelings of regret for not having said those things to your father when you had the opportunity to, you know, as a parent that he already knows, like, he, like, on some level you didn't. Like, it doesn't matter. Because all he cared about was the fact that you were back together and you were just a kid, you know, and had it been a rift, you being the dad, and a rift with one of your children, like, would you need your child to say those things to you? Probably not. You would just be happy that they were back and you would understand and love them unconditionally.

B (151:05)

I close the chapter out by discussing the birth of my first daughter, who's 11 now, and how life changing that was for me, it was life changing. That was the Greatest moment of my life, without a doubt. And in that moment you feel pure love and you would do anything for that child. And you know, and at the same time we can have all the science in the world. And you know, I love science. My book, I literally have almost 1500 references in this book. We can have all the science in.

A (151:50)

The world.

B (151:54)

But something put a breath of life into that child that has a soul. Where did that come from? Science will never be able to explain that. And I think we must acknowledge that.

A (152:09)

There's so many things that I could say and we could pull on some more threads and go in different directions, but I kind of feel like we need to end it here because that was beautifully articulated and I don't want.

B (152:21)

To.

A (152:23)

Defuse it by saying much more other than to say that I appreciate you opening up to. I didn't know that we were going to go there. And I think that that is such an important piece in all of this and a palpable reminder about what like health, health is really about. You know, fundamentally we can talk about all the stuff that we talked about earlier, but these are the things that are most important.

B (152:48)

Health comes in many forms, many places and it's not just this like engineered concept.

A (152:56)

But if you want to re engineer your diet, you can. And you can find it in your plant powered program. Whether you're a beginner or in advance looking to master your plate. You can find it in the book as well as many other answers. But today I think we're going to leave it with the God shot spiritual arrow to the heart at the end. What do you think?

B (153:20)

I think that sounds good.

A (153:22)

I appreciate you will and you're of great service to the world and I think this book is going to help a lot of people. And I'm fascinated by the microbiome because I feel like we're just at the beginning of starting to understand what is essentially a universe of mysteries. And you're one of the people at the tip of the spear who's helping to translate what's being discovered so that we can take action steps and improve our own lives.

B (153:47)

Well, I appreciate you having me on the show and I think I say thank you to the listeners at home who have hung with us throughout the show and I'm excited to hear what people think about the new book.

A (153:59)

All right, man, well come back and share more.

B (154:02)

Thank you.

A (154:02)

All right, Peace plants, That's it for today. Thank you for listening. I truly hope you enjoyed the conversation. To learn more about today's guest, including links and resources related to everything discussed today, visit the episode page@richroll.com where you can find the entire podcast archive, my books, Finding Ultra Voicing, Change and the Plant Power Way. If you'd like to support the podcast, the easiest and most impactful thing you can do is to subscribe to the show on Apple Podcasts, on Spotify and on YouTube YouTube and leave a review and or comment and sharing the show or your favorite episode with friends or on social media is of course awesome and very helpful. This show just wouldn't be possible without the help of our amazing sponsors who keep this podcast running wild and free. To check out all their amazing offers, head to richroll.com sponsors and finally, for podcast updates, special offers on books and other subjects, please subscribe to our newsletter which you can find on the footer of any page@richroll.com Today's show was produced and engineered by Jason Cameolo. The video edition of the podcast was created by Blake Curtis and Morgan McRae with assistance from our Creative Director Dan Drake, content management by Shayna Savoy, copywriting by Ben Prior, and of course our theme music was Great, created all the way back in 2012 by Tyler Pyatt, Trapper Pyatt and Harry Mathis. Appreciate the love, love the support. See you back here soon. Peace Plants Namaste. Sa.