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As humans, we've discovered
so many new things on this planet.
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We've even flown to the moon.
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But hardly anyone has really adventured
into their own gut.
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We feel a lot of shame about our gut.
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But it influences
so much about our health.
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About how we feel,
if we are overweight or not,
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{\an8}what kind of diseases we can get,
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{\an8}how our immune system is being trained,
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{\an8}and, really with that,
the course of our lives.
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The nation got a report card
on obesity today, and the country flunked.
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Rates of colorectal cancer...
Heart disease...
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- [reporter 3] Irritable bowel syndrome...
- [reporter 4] Increase in autism...
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...depression, anxiety
are skyrocketing.
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What is healthy?
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Why is eating painful?
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What changes
do I need to do to get healthy?
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Why's it so hard for me to lose weight?
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How do I still not know
what's right for my body?
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How do I fix my gut?
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Do I have to spend
$100 a month on supplements?
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{\an8}Mmm!
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There's a lot of noise
thrown at us.
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Is it diet?
Is it carbohydrates? Is it no diet?
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- And if you just look at...
...the gut...
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...all this gets much easier to understand.
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We really just think about our gut
as a place where our poop comes from.
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{\an8}But it turns out to be
the center of a biomedical revolution.
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Diseases like anxiety,
and depression, cancer,
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autism, Parkinson's
are all related to the gut.
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Huh?
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This is new science, tip of the iceberg.
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{\an8}There's another 97% left to discover.
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♪ I've got a gut feeling ♪
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We're getting to the point where
we can make a more precise definition
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about what you should eat.
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♪ I've got a gut feeling, feeling ♪
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The gut is flexible. It really changes
when we change the way we eat.
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And once we've realized that,
everything changes.
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Until I was 16 or 17,
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I was just as confused by my gut
as everyone else.
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I couldn't deal with lactose.
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I had a skin disease.
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I was suddenly chubby as a child,
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although there was
no apparent reason for it.
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And so I read a lot about the gut,
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and I realized that
when you really look at the organ,
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you find so many of those answers.
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One morning, my roommate
came into the kitchen and asked me,
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"Giulia, you love the gut.
You talk about it all the time."
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"How does pooping work?"
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And I had no idea.
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So, I went up to my room,
and I looked in, like, three books,
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and when I found out, I was like, "What?"
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"Even this part is really cool about it."
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There's nothing to shy away from, really.
All of it is cool.
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We feel guilty and shame a lot
when it comes to our gut.
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And it's completely crazy
when you think about it,
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'cause this is the organ
that keeps you alive.
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And as soon as you just know a few facts,
you feel a lot of respect for it.
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Science can help us navigate
the questions about our health.
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I remember when I did this the first time
with Professor Krammer, and he just said,
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"See? Everybody looks the same inside."
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We start with the esophagus.
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It'll transport food to the stomach,
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{\an8}which passes it on to the small intestine.
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{\an8}What's left goes to the large intestine,
the colon.
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{\an8}And whatever we really don't need
goes out of the butthole.
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And then we're done.
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{\an8}Gut science has been the hottest area
in all of biomedicine
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{\an8}for the last decade or more.
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{\an8}It is the missing part of the puzzle.
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{\an8}Our gut affects our whole body.
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{\an8}It can even affect
certain conditions in the brain.
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Wow!
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We've known for hundreds of years
that this is so important.
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All we have to do is look to our language.
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When we're disappointed, we're gutted.
When we're brave, we make gutsy moves.
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When we have... we're nervous,
we have butterflies in our tummy.
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The gut really is the second brain.
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Wow!
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And from an evolutionary perspective,
our brains have never existed
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without signals coming from the gut.
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I'm being swallowed by my gut.
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I mean, you know,
it's the gut fights back.
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This whole field
is disrupting modern medicine.
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This is an exhibit
that's based on a book
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that my sister and I did about the gut.
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And the purpose of it
is to just turn the inside out.
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This is probably better.
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This is much more accurate,
actually, when you look at it like this.
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The intestinal tract,
it's not a straight thing.
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It's a bit, you know,
crooked here, crooked there.
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The stomach, for example,
it goes like this.
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So on top of it, there's an air bubble.
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So when you really have a lot of air
in your stomach,
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and you want to get it out,
lay on your left side
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because then the air bubble
actually can go out quite nicely.
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Whee!
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And then if I were a food particle,
and I would arrive at the small intestine,
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then all these folds and villi
would stick out,
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and I would be like, "Ah!"
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And I could be, like, digested
and be taken up into the blood.
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What's interesting is that
we can't digest on our own.
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We need microbes
in order to do that properly.
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The tiniest virus
works with the small bacteria,
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works with a much larger yeast,
works with a super big human,
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and this is what we call the microbiome.
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Most people think
that bacteria are bad,
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but, actually, 99% of them
don't do anything to us,
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and some can even help us.
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Some bacteria have more important roles
than we could have imagined.
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If we let them live on us,
they'll actually lend us their skills.
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They help with digesting our food.
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Yummy!
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{\an8}They help to quiet inflammation
and make the immune system less likely
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{\an8}to cause autoimmune disease.
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Approximately 70%
of our immune system lives in our gut.
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Bacteria train that immune system
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to respond to bad organisms
that might have a consequence on health.
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Ouch!
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{\an8}They help produce chemicals
which we can't.
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Microbes can shape our hormones,
and they can make us feel hungry or full.
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{\an8}They can be communicating with the brain.
They're communicating with other organs.
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They shape our brain
early in life and as we get older.
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If you looked at the genes
in and on our bodies,
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we would be more than 99% microbial.
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We oftentimes believe that
our human genes determine our health,
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but now we know that the microbiome
is very central to being obese,
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being depressed, having allergies,
or how stressed or relaxed you'll feel.
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We don't know how big is the part
that it plays in these entities.
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For some people,
it might be really relevant,
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and for others, it might be smaller.
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Take one.
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Thank you.
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We may not want to admit it,
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but we all have problems with our gut
from time to time.
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People differ
in their relationship to food,
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in their diseases,
in their response to medication,
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in their overall life history.
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If I eat pretty much anything
that's not vegetables,
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I start getting stomach pains,
which makes my job incredibly difficult.
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You realize
how much you took for granted.
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{\an8}Like something as simple
as being able to poop.
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I've had to learn
to become grateful for the tiniest things.
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I've tried
to control my weight all kind of ways,
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{\an8}but I would lose a lot,
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{\an8}and I would gain
a whole lot more.
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I hear people say they're hungry,
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and they look very happy
after they've eaten.
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I'm jealous of those people
because I no longer feel hunger.
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We're trying
to understand what's going on
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with all this variance
that makes people different.
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We think the microbiome is key to that.
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In order for us
to understand our differences,
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we have to first look at
where our microbes come from.
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You're born
largely without microbes.
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{\an8}Microbes colonize you
once you enter the world.
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When we're born, this is really
the moment where it tips off everything.
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When a baby is born vaginally,
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they're being exposed
to the bacteria in the mom's vagina.
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And then, when you come out,
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the face is going down
in the direction to the butt.
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You also get some gut bacteria
because you're so close by the butt
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that you already get
your first microbial colonists.
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And they start making this
a habitable place to live
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for other microbes.
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We shape our microbiome
by all the little choices and adventures
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we have in our life.
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Whoever we kiss, what we put
in our mouth, where we travel.
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The food you eat,
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the relationships you have
with your siblings,
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whether you have pets, exercise, stress,
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{\an8}your experiences when you were a child,
whether you had adversity or not.
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Because of this,
everybody has a unique microbiome.
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So it's sort of this collection
of microbial memories.
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Knowing that the microbiome could be
the key to health is really exciting,
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because you can't change your genes,
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{\an8}but all of us have the ability
to change our own microbes
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{\an8}through simple changes
to our diet and our lifestyle.
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Perfectly greasy. Oh my God.
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{\an8}The industrialized microbiome
is probably pretty unhealthy
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{\an8}and may be pushing us towards a lot
of our most common and serious diseases.
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{\an8}That could result
in a lot of these chronic diseases
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{\an8}that are very, very prevalent,
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like obesity, diabetes,
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hypertension, food allergies.
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{\an8}So, I think the way we think
about disease needs to change.
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Big changes to our environment,
Western diet,
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the way babies are born, C-sections,
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baby formula,
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sanitation, antibiotics
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all lead to decreased
microbiome diversity.
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Exactly what we see
in the industrialized microbiome.
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I was a C-section baby,
who was breastfed for...
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I'm not entirely sure for how long.
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I'm always running
for my children or my job,
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so I'm always super stressed out.
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Five-time Nathan's Famous champion,
Takeru Kobayashi!
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I don't think
there's anything healthy
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about what I do.
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I wonder what damage I've done to my body.
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It does make me kind of wonder
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how that affects your health
and what that does to your microbiome.
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We've lost hundreds of species
in our gut.
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They've gone extinct.
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And what we're realizing now
is that the most important factors
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of determining the health
of this microbial community is your diet.
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There are some major deficiencies
in the typical American diet,
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even the typical American diet
that's healthy.
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Currently in the States,
nearly 60% of all the calories eaten
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are ultra-processed food.
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The food is ultra-refined.
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It's been stripped of all its nutrients
of the original natural ingredients,
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and then they add back in
all types of chemicals
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and large amounts of sugars.
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But people are confused about what to eat
because it's made to look healthy
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by adding labels on the packet
that say this is low-cal
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and therefore healthy,
or this has extra vitamins.
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When you look at
some of these labels in detail,
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really hard to work out
what's actually inside them.
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That's actually not too bad,
that one.
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It's not?
I looked at it. It has tons of sugar.
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Does it? I couldn't see.
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It's 30% sugar. Yep.
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Just looking at this, it's fiber-packed,
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it's got fruit and nuts, it's got
dark chocolate, it's got sea salt.
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This to me, first look,
it looks pretty good.
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It's only when you
look into the ingredients,
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you see, "Oh! That is far too sugary."
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00:15:04,945 --> 00:15:07,364
You... You see? I was fooled.
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00:15:09,074 --> 00:15:12,077
It's hard to navigate
what you should be eating
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00:15:12,578 --> 00:15:14,455
because you go to the supermarket,
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00:15:14,455 --> 00:15:20,961
and the lists of powders and tonics
and things that you need just grows.
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00:15:20,961 --> 00:15:22,922
Can chlorophyll
prevent cancer?
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Medicinal mushrooms...
238
00:15:24,548 --> 00:15:27,384
- [reporter 3] Red wine's healthy...
Probiotics for your vagina.
239
00:15:27,384 --> 00:15:29,261
Spirulina. Chocolate.
240
00:15:29,261 --> 00:15:30,846
Collagen. Blueberry extract. Coffee!
241
00:15:31,513 --> 00:15:37,227
So, yeah. I find the food world
and wellness culture incredibly confusing.
242
00:15:41,440 --> 00:15:44,860
Today we're gonna make teriyaki chicken.
243
00:15:44,860 --> 00:15:48,530
We have... We have garlic, ginger, sugar,
244
00:15:48,530 --> 00:15:52,576
{\an8}soy sauce, sesame oil, and onions.
245
00:15:53,702 --> 00:15:56,497
{\an8}-First, you...
- You have great confidence, I have to say.
246
00:15:56,497 --> 00:15:59,583
{\an8}- I was a confident cook when I was four.
247
00:15:59,583 --> 00:16:05,422
Some soy sauce, a lot of ginger because
we can't get enough of that ginger.
248
00:16:05,422 --> 00:16:06,674
All of the garlic,
249
00:16:06,674 --> 00:16:10,427
because we never can get enough
of garlic either.
250
00:16:10,427 --> 00:16:12,846
Cooking and food is truly in my blood,
251
00:16:12,846 --> 00:16:15,391
and it's something
I've been doing since I was really little.
252
00:16:16,725 --> 00:16:19,395
And now it's my passion
and my art and my career.
253
00:16:23,065 --> 00:16:26,944
I received my first Michelin star
when I was 23.
254
00:16:27,987 --> 00:16:32,950
I won Eater's Hottest Chef.
So ridiculous that that was even a thing.
255
00:16:33,659 --> 00:16:36,370
But you do feel the need
to cultivate this image
256
00:16:36,370 --> 00:16:40,124
of the goth, cute pastry chef
with tattoos.
257
00:16:40,124 --> 00:16:43,377
There was just a massive amount
of pressure on me,
258
00:16:43,377 --> 00:16:48,090
and so then I kind of
just let it get out of control.
259
00:16:51,552 --> 00:16:56,390
I was really anorexic
for a long time.
260
00:16:57,933 --> 00:17:02,771
But now, my eating disorder
has kind of shifted to orthorexia,
261
00:17:02,771 --> 00:17:08,360
where I'm very obsessed with wellness
and maximizing your nutrition.
262
00:17:09,403 --> 00:17:13,115
So this is, yeah, like,
guarana, suma, reishi, lion's mane,
263
00:17:13,115 --> 00:17:16,535
Cordyceps, the spirulina,
Chlorella, moringa.
264
00:17:18,287 --> 00:17:19,788
Basically, I eat a lot of vegetables
265
00:17:19,788 --> 00:17:22,458
and then supplement it
with potions and powders
266
00:17:22,458 --> 00:17:25,169
and things that the Internet tells me
that I probably need.
267
00:17:28,839 --> 00:17:31,216
I have taken so many things out of my diet
268
00:17:31,216 --> 00:17:34,636
and tried to reintroduce,
you know, "fun foods."
269
00:17:36,221 --> 00:17:39,516
But when I eat sugar,
pork, butter, things like that,
270
00:17:39,516 --> 00:17:42,394
then I feel bloated,
and I feel like I have to throw up
271
00:17:42,394 --> 00:17:44,521
for three, four days afterwards.
272
00:17:46,690 --> 00:17:50,402
Which is really hard because I am trying
to fix my relationship with food.
273
00:17:51,445 --> 00:17:55,074
And then when it feels like
your body is betraying you,
274
00:17:55,991 --> 00:17:57,785
it's, um...
275
00:17:57,785 --> 00:18:01,163
It's hard to... to get past that.
276
00:18:06,335 --> 00:18:09,797
I think ultimately
I would really love to know
277
00:18:10,380 --> 00:18:13,008
what I should be eating,
or what I shouldn't be eating,
278
00:18:13,717 --> 00:18:16,887
and what healthy is for me, specifically.
279
00:18:23,310 --> 00:18:27,064
When my patients ask me,
"What makes a microbiome healthy?"
280
00:18:27,064 --> 00:18:28,982
I like to compare it to a forest.
281
00:18:31,443 --> 00:18:35,489
You can't put a few healthy plants in it
and expect everything to change.
282
00:18:36,573 --> 00:18:38,617
A forest needs a healthy balance
283
00:18:38,617 --> 00:18:43,956
where the plants and the life can be okay
with the circumstances,
284
00:18:43,956 --> 00:18:47,000
with the light, with the water,
with the nutrients from the soil
285
00:18:47,000 --> 00:18:48,919
and function together.
286
00:18:51,797 --> 00:18:55,217
Our gut bacteria,
they want just a few grams of fiber
287
00:18:55,217 --> 00:18:58,095
from vegetables and fruits every day,
288
00:18:58,095 --> 00:19:02,432
and it's weird
that it's so hard for us to manage this.
289
00:19:03,392 --> 00:19:06,145
Current recommendations
in the United States suggest
290
00:19:06,145 --> 00:19:10,524
{\an8}that we should be eating
28 to 40 grams of dietary fiber per day.
291
00:19:10,524 --> 00:19:14,653
{\an8}And we're only eating
15 grams in the average American diet.
292
00:19:14,653 --> 00:19:17,489
{\an8}The field of microbiome science
is realizing
293
00:19:17,489 --> 00:19:22,202
{\an8}that we probably should be eating
in excess of 50 grams per day.
294
00:19:56,278 --> 00:19:58,906
How much fiber
is in one hot dog?
295
00:20:00,699 --> 00:20:02,409
What? Zero grams!
296
00:20:05,829 --> 00:20:08,332
Whether you have meat
on your plate or not...
297
00:20:08,332 --> 00:20:11,210
You can be vegan, non-vegan.
Doesn't matter.
298
00:20:11,210 --> 00:20:15,964
The key is getting the diversity
of plants in all their forms,
299
00:20:15,964 --> 00:20:19,635
as many as you can
on your plate to feed your microbes.
300
00:20:21,428 --> 00:20:23,555
Why should I eat my veggies? You know?
301
00:20:23,555 --> 00:20:26,934
I'm a big fan of understanding this.
Of course, there are many nutrients in it,
302
00:20:26,934 --> 00:20:29,728
and not so many bad things
that are in processed foods.
303
00:20:32,564 --> 00:20:35,234
But also if the front part
of your body was see-through,
304
00:20:35,234 --> 00:20:39,529
you could actually see digestion,
and you would be able to very easily see
305
00:20:39,529 --> 00:20:42,199
the difference
between processed foods and vegetables.
306
00:20:43,450 --> 00:20:45,160
With processed foods, you could see
307
00:20:45,160 --> 00:20:47,829
that within the first centimeters
of the small intestine,
308
00:20:47,829 --> 00:20:50,123
it's basically all taken up in the blood.
309
00:20:51,541 --> 00:20:54,127
There's a surge of sugar
in the bloodstream,
310
00:20:54,127 --> 00:20:56,380
and we have to pack it
in the cells really fast.
311
00:20:56,380 --> 00:20:59,716
It's, like, almost a stressful event,
actually, for the body,
312
00:20:59,716 --> 00:21:02,844
because, "Where should I put
all this sugar?" You know?
313
00:21:02,844 --> 00:21:04,596
It has to really push it everywhere.
314
00:21:05,764 --> 00:21:08,183
But with the fiber
that we have in vegetables,
315
00:21:08,183 --> 00:21:09,935
it's just more stable.
316
00:21:10,894 --> 00:21:13,981
It would be taken up a little bit,
go further,
317
00:21:13,981 --> 00:21:15,857
be taken up a little bit, go further.
318
00:21:15,857 --> 00:21:17,776
It would even land in the colon
319
00:21:17,776 --> 00:21:21,280
and would be a good source of food
for the microbes there.
320
00:21:21,280 --> 00:21:22,197
Delicious!
321
00:21:22,197 --> 00:21:24,825
So it's
a completely different mode of digesting.
322
00:21:24,825 --> 00:21:27,828
You know,
like a long walk instead of sprinting.
323
00:21:32,291 --> 00:21:36,962
If a gut microbiome is very diverse,
has many different kinds of bacteria,
324
00:21:36,962 --> 00:21:39,339
it'll just have
this bouquet of possibilities
325
00:21:39,339 --> 00:21:41,883
to react to what life throws at us.
326
00:22:00,027 --> 00:22:03,280
Kobayashi continues
to just pound 'em down.
327
00:22:05,365 --> 00:22:09,411
Putting on a clinic.
Look at him go. He's moving his arms and...
328
00:22:09,995 --> 00:22:14,708
So what happens if we don't eat
enough fiber to feed these microbes?
329
00:22:14,708 --> 00:22:17,169
Takeru Kobayashi!
330
00:22:17,169 --> 00:22:20,297
If you're not feeding
your gut microbes dietary fiber,
331
00:22:20,297 --> 00:22:22,716
your gut microbes will start eating you.
332
00:22:24,926 --> 00:22:28,221
All these microbes are great.
They help your body a lot.
333
00:22:29,556 --> 00:22:30,974
But they're also microbes.
334
00:22:30,974 --> 00:22:34,895
So there has to be a friendly border
of respect, and this is produced by mucus.
335
00:22:35,979 --> 00:22:39,274
Mucus is a good way of doing that
because it's also a bit permeable,
336
00:22:39,274 --> 00:22:41,902
{\an8}so nutrients and everything
can come through,
337
00:22:41,902 --> 00:22:45,072
{\an8}but the microbes
are being held a little bit distant.
338
00:22:46,156 --> 00:22:48,950
Well, it turns out
if you stop eating dietary fiber...
339
00:22:48,950 --> 00:22:49,951
No! No! No!
340
00:22:49,951 --> 00:22:52,954
...the gut microbes
still need to eat something,
341
00:22:52,954 --> 00:22:57,084
so they will start eating
that mucus lining as a backup food source.
342
00:22:58,335 --> 00:23:01,546
And gradually, over time,
they'll deplete that mucus lining.
343
00:23:02,381 --> 00:23:05,717
Your bacteria are going
to places in the body
344
00:23:05,717 --> 00:23:07,260
where they're not supposed to go.
345
00:23:08,428 --> 00:23:11,765
And when immune cells
that reside there see that,
346
00:23:11,765 --> 00:23:14,017
- they go into a defense mode.
347
00:23:15,102 --> 00:23:17,854
And this can cause
a battle of inflammation,
348
00:23:17,854 --> 00:23:21,983
and it can change
the microbial composition of your gut.
349
00:23:22,692 --> 00:23:26,071
And that is one of the things
that can lead to many diseases
350
00:23:26,071 --> 00:23:28,031
like inflammatory bowel disease,
351
00:23:28,031 --> 00:23:30,826
or some types of irritable bowel syndrome.
352
00:23:36,039 --> 00:23:39,584
When we started
to explore chronic inflammatory diseases,
353
00:23:39,584 --> 00:23:42,003
scientists had this thought of,
354
00:23:42,003 --> 00:23:45,173
can we find the microbe
or the microbial community
355
00:23:45,173 --> 00:23:49,177
that makes this disease
or creates that feeling that's bad?
356
00:23:49,845 --> 00:23:53,598
But now when we think about
how this ecosystem interacts,
357
00:23:53,598 --> 00:23:57,436
we have this newer approach
where we also ask ourselves
358
00:23:57,436 --> 00:24:01,356
if we are missing certain bacteria
that are usually there to protect us.
359
00:24:14,411 --> 00:24:16,371
My name is Daniell Koepke,
360
00:24:16,371 --> 00:24:20,750
{\an8}and I am a clinical psychology
doctoral student.
361
00:24:21,751 --> 00:24:25,046
It's really hard for me to remember
what it was like to eat food
362
00:24:25,046 --> 00:24:31,011
before it became associated
with anxiety and pain and discomfort.
363
00:24:32,137 --> 00:24:36,475
When I was in undergrad,
I had a pretty bad diet.
364
00:24:37,017 --> 00:24:40,228
And that diet, the high-sugar foods
365
00:24:40,228 --> 00:24:43,690
and the absence
of more fruits and vegetables,
366
00:24:43,690 --> 00:24:45,650
led to IBS-like symptoms.
367
00:24:46,234 --> 00:24:48,737
So I was experiencing indigestion,
368
00:24:48,737 --> 00:24:51,114
stabbing pains from trapped gas,
369
00:24:51,114 --> 00:24:54,242
constipation, not being able
to go to the bathroom at all.
370
00:24:55,952 --> 00:25:00,624
When you have multiple gut symptoms
that can't be easily put into a box,
371
00:25:00,624 --> 00:25:03,251
a lot of doctors don't know what to do.
372
00:25:04,377 --> 00:25:07,130
Antibiotics are given out
like candy.
373
00:25:07,130 --> 00:25:09,466
"You don't feel good
or think you might have this thing?"
374
00:25:09,466 --> 00:25:10,800
"Here. Take some antibiotics."
375
00:25:12,344 --> 00:25:17,057
In the last five years, I've been on
six rounds of antibiotics in a year.
376
00:25:18,934 --> 00:25:21,937
I lost a lot of weight
when I started getting sick
377
00:25:21,937 --> 00:25:24,481
and had to cut all of these things
out of my diet.
378
00:25:26,274 --> 00:25:28,193
I don't know
how many things I can eat now,
379
00:25:28,193 --> 00:25:32,239
but it's probably
anywhere between 10 and 15.
380
00:25:33,365 --> 00:25:39,496
It feels really limiting,
and I often feel really deprived.
381
00:25:41,623 --> 00:25:47,963
So I have to take these supplements
to maintain my baseline functioning.
382
00:25:49,422 --> 00:25:51,967
These are even more supplements
that...
383
00:25:51,967 --> 00:25:55,929
...I've taken in the past
that no longer work. Um...
384
00:25:56,471 --> 00:25:58,515
I know that pills aren't the answer,
385
00:25:58,515 --> 00:26:04,813
{\an8}but I feel stuck because I don't know
how to grow these new bacteria that I need
386
00:26:04,813 --> 00:26:07,315
{\an8}when I can't eat a lot of these foods, uh,
387
00:26:07,315 --> 00:26:10,860
{\an8}that are required
to, like, have a healthy gut microbiome.
388
00:26:13,238 --> 00:26:18,285
If we cut foods out of our diet,
we'll change our microbes drastically,
389
00:26:19,119 --> 00:26:21,746
because who can live there
if you don't feed them?
390
00:26:24,291 --> 00:26:27,002
And if we want
to reintroduce fiber,
391
00:26:27,002 --> 00:26:29,087
we'll have a far more difficult time.
392
00:26:30,171 --> 00:26:34,301
So people who suddenly
eat healthy again will be bloated,
393
00:26:34,301 --> 00:26:36,344
will have some stomach pain.
394
00:26:37,137 --> 00:26:40,473
So it's a process of changing their diet,
but not too drastically,
395
00:26:40,473 --> 00:26:44,519
in a way that all the microbes
in the gut can adjust.
396
00:26:46,730 --> 00:26:49,608
Since I've had
such a restrictive diet,
397
00:26:50,567 --> 00:26:56,656
I wonder was I also starving
the microbes in my body at the same time?
398
00:26:58,491 --> 00:27:01,328
And has that changed
how my body can process foods,
399
00:27:01,328 --> 00:27:03,872
and does that mean, like, my future,
400
00:27:03,872 --> 00:27:06,499
I'm always going to have issues
with eating something,
401
00:27:07,751 --> 00:27:10,211
or is it partially a mental block?
402
00:27:10,211 --> 00:27:13,923
I'm not really sure...
...what's going on.
403
00:27:15,342 --> 00:27:18,386
It's something that I would love
to actually learn more about.
404
00:27:27,062 --> 00:27:29,064
Oh. Cool.
405
00:27:46,665 --> 00:27:47,957
It's like Christmas.
406
00:27:48,583 --> 00:27:50,251
I wonder what this is.
407
00:27:50,960 --> 00:27:52,212
Oh no.
408
00:27:56,341 --> 00:27:59,552
It's weird. All of a sudden,
I don't care about being healthy anymore.
409
00:28:01,137 --> 00:28:03,973
"Collect one scoop of solid stool..."
410
00:28:05,058 --> 00:28:07,102
"...or four scoops of liquid..." Ooh!
411
00:28:07,102 --> 00:28:08,520
"...into tube."
412
00:28:09,229 --> 00:28:10,480
"Mix well."
413
00:28:10,480 --> 00:28:13,066
It's like the world's grossest recipe.
414
00:28:13,692 --> 00:28:17,320
Ooh! This is like a spoon.
415
00:28:17,987 --> 00:28:19,572
I guess you do this.
416
00:28:21,074 --> 00:28:22,992
I've always found the idea
417
00:28:22,992 --> 00:28:24,994
of gut testing really fascinating.
418
00:28:25,578 --> 00:28:28,081
It would be awesome if I could understand
419
00:28:28,081 --> 00:28:29,916
what's happening in my own body.
420
00:28:31,251 --> 00:28:34,129
I've tried
so many different things to lose weight.
421
00:28:34,838 --> 00:28:37,090
Hopefully, this might be the thing for me.
422
00:28:37,757 --> 00:28:41,052
I want the test
to tell me why I don't have an appetite.
423
00:28:41,052 --> 00:28:44,764
And about the relationship
between my organs and eating.
424
00:28:45,557 --> 00:28:48,810
I've never had
my gut microbiome tested.
425
00:28:48,810 --> 00:28:52,939
I don't think, at this point of time,
it makes a lot of sense.
426
00:28:53,815 --> 00:28:55,817
All the things you can do
to have a healthy gut,
427
00:28:55,817 --> 00:28:58,903
eating differently,
treating your gut nicer,
428
00:28:58,903 --> 00:29:02,574
you can do them
without having an analysis first.
429
00:29:03,992 --> 00:29:06,578
But if you just want to do
a fun experiment, go ahead.
430
00:29:06,578 --> 00:29:09,164
And for research, it's a great tool.
431
00:29:15,712 --> 00:29:18,173
At the beginning
of microbiome science,
432
00:29:18,173 --> 00:29:20,341
we were really our own guinea pigs.
433
00:29:21,259 --> 00:29:24,512
So myself and my colleagues
were collecting our own poop
434
00:29:24,512 --> 00:29:26,264
and sticking it in freezers.
435
00:29:28,057 --> 00:29:31,728
{\an8}So you take a little piece of used
toilet paper, you color the piece you swab
436
00:29:31,728 --> 00:29:33,980
{\an8}with a little bit of poop,
make it a bit brown,
437
00:29:33,980 --> 00:29:35,732
then we extract the DNA from that.
438
00:29:35,732 --> 00:29:39,694
But now we've expanded
to thousands of thousands of samples
439
00:29:39,694 --> 00:29:41,780
from thousands of people
around the United States
440
00:29:41,780 --> 00:29:43,364
and, indeed, around the world now.
441
00:29:47,577 --> 00:29:50,914
If you gave me your microbiome sample,
I wouldn't be able to tell you
442
00:29:50,914 --> 00:29:54,292
a hell of a lot
about how sick or healthy you are.
443
00:29:54,959 --> 00:29:59,464
I can only do that by comparing you
to a really large group of people
444
00:29:59,464 --> 00:30:00,757
and seeing how you fit.
445
00:30:02,342 --> 00:30:05,470
Does your microbiome
look like people who have asthma?
446
00:30:05,470 --> 00:30:06,554
Do you have asthma?
447
00:30:06,554 --> 00:30:08,973
Does your microbiome
look like people who are obese?
448
00:30:08,973 --> 00:30:10,475
Are you obese?
449
00:30:10,475 --> 00:30:12,685
If that's true,
then I can find a signature,
450
00:30:12,685 --> 00:30:14,479
which can help me unpin that.
451
00:30:15,814 --> 00:30:20,193
Each teaspoon of stool contains
terabytes and terabytes of information
452
00:30:20,193 --> 00:30:22,779
encoded in the DNA of the microbes.
453
00:30:22,779 --> 00:30:27,450
{\an8}So each dot on the screen represents
all the complexity of the microbiome
454
00:30:27,450 --> 00:30:30,662
{\an8}of one person distilled
just down to one point.
455
00:30:31,955 --> 00:30:34,374
So what this display shows you
456
00:30:34,374 --> 00:30:37,210
is what kinds of microbes
are shared between samples.
457
00:30:37,210 --> 00:30:39,295
So two samples that are close together
458
00:30:39,295 --> 00:30:42,590
are ones that have
very similar microbial communities,
459
00:30:42,590 --> 00:30:44,259
whereas samples that are far apart
460
00:30:44,259 --> 00:30:46,636
have entirely distinct communities
from one another.
461
00:30:50,181 --> 00:30:52,642
When we started
studying the gut microbiome,
462
00:30:52,642 --> 00:30:54,352
the field assumed
463
00:30:54,352 --> 00:30:57,856
that if we looked at the gut microbiome
of healthy Americans,
464
00:30:57,856 --> 00:31:01,860
we would get a good picture
of what a healthy microbiome is.
465
00:31:04,946 --> 00:31:08,157
This visualization shows
the differences between microbes
466
00:31:08,157 --> 00:31:11,077
{\an8}of the industrialized world
down at the bottom,
467
00:31:11,077 --> 00:31:14,664
{\an8}versus the less industrial world
up on the top there.
468
00:31:15,623 --> 00:31:19,669
{\an8}What you can see so clearly is how,
in the non-industrialized microbiome,
469
00:31:19,669 --> 00:31:21,421
{\an8}you have more diversity.
470
00:31:22,881 --> 00:31:26,050
So if we only focus
on the Western world,
471
00:31:26,050 --> 00:31:28,136
{\an8}then we are not getting a full picture
472
00:31:28,136 --> 00:31:32,223
{\an8}of what a healthy gut microbiome
composition looks like,
473
00:31:32,223 --> 00:31:33,850
{\an8}or looked like in the past.
474
00:31:46,362 --> 00:31:49,073
It's difficult to walk here.
475
00:31:52,577 --> 00:31:55,288
We're going
to traditional communities
476
00:31:55,288 --> 00:31:59,208
and asking people
to donate their... their... their poop.
477
00:31:59,208 --> 00:32:01,169
- Namaste.
- Namaste.
478
00:32:03,755 --> 00:32:05,757
When we go to communities
479
00:32:05,757 --> 00:32:07,383
and say "Can we collect your poop?"
480
00:32:07,383 --> 00:32:11,012
Most of the time people are like,
"Oh no, no, no. Poop? No. Poop, no."
481
00:32:12,055 --> 00:32:17,602
But when I explain to them what I'm doing,
they're like, "Sure. Why not?"
482
00:32:23,149 --> 00:32:27,403
It turns out that
the gut microbiome of rural populations
483
00:32:27,403 --> 00:32:29,280
have hundreds of more species
484
00:32:29,280 --> 00:32:32,825
that we just don't see
in the industrialized gut microbiome.
485
00:32:34,911 --> 00:32:40,375
By studying populations that are
still practicing traditional lives,
486
00:32:40,375 --> 00:32:42,460
we will begin to understand
487
00:32:42,460 --> 00:32:46,714
what microbes have been lost
from industrial populations,
488
00:32:47,423 --> 00:32:50,134
and how this is influencing
our overall health.
489
00:32:58,518 --> 00:33:00,144
{\an8}We ready?
490
00:33:00,144 --> 00:33:01,980
{\an8}Hi, Maya. Nice to meet you.
491
00:33:01,980 --> 00:33:05,316
{\an8}So would you like
to discuss your results now?
492
00:33:05,316 --> 00:33:06,651
Sure. Yeah.
493
00:33:06,651 --> 00:33:10,863
{\an8}What we found in our studies
is that overall, you're pretty healthy.
494
00:33:10,863 --> 00:33:12,740
It's definitely above average.
495
00:33:12,740 --> 00:33:15,660
{\an8}All those vegetables you're eating
every week have not gone to waste.
496
00:33:15,660 --> 00:33:16,577
Cool.
497
00:33:16,577 --> 00:33:20,790
{\an8}You know, I've also struggled with having
a disordered relationship with eating.
498
00:33:20,790 --> 00:33:23,710
I've always been very,
kind of, restrictive in my diet.
499
00:33:23,710 --> 00:33:26,087
{\an8}So, Maya, yeah,
many people think like you,
500
00:33:26,087 --> 00:33:30,425
{\an8}that just having
a really healthy kale salad every day
501
00:33:30,425 --> 00:33:32,552
{\an8}is going to keep them healthy.
502
00:33:32,552 --> 00:33:35,179
That's not as healthy as we thought.
503
00:33:35,179 --> 00:33:40,018
The more diversity you consume,
the more rich your microbiome will be,
504
00:33:40,018 --> 00:33:43,062
the more species of bacteria
that will be present inside your gut.
505
00:33:43,062 --> 00:33:48,276
And that does allow you to deal with
allergies and intolerances better.
506
00:33:48,276 --> 00:33:50,945
{\an8}- Yeah.
- It's not about restricting things.
507
00:33:50,945 --> 00:33:56,743
{\an8}It's about enlarging your world of foods
that are possible for you to eat.
508
00:33:56,743 --> 00:34:01,539
Well, I think part of the problem is that
I have some kind of, like, mental blocks
509
00:34:01,539 --> 00:34:03,374
for some foods, like pork,
510
00:34:03,374 --> 00:34:07,003
and occasionally my stomach
just reacts really poorly to it.
511
00:34:07,003 --> 00:34:09,130
{\an8}Is that something that I can overcome,
512
00:34:09,130 --> 00:34:12,925
{\an8}or is it just I'm never gonna eat bacon
ever again in my entire life?
513
00:34:12,925 --> 00:34:14,469
{\an8}Oh! Don't say that. Sounds horrible.
514
00:34:16,262 --> 00:34:18,556
- Yeah. It's a struggle, right?
- Yeah.
515
00:34:18,556 --> 00:34:21,684
We do think to alleviate it,
516
00:34:21,684 --> 00:34:24,937
introducing these things
in very small doses, microdosing,
517
00:34:24,937 --> 00:34:29,150
{\an8}and then building it up over time
into large doses can play a role.
518
00:34:29,150 --> 00:34:32,779
Try small amounts,
you know, bring them into your diet.
519
00:34:32,779 --> 00:34:35,364
And if you do that gradually over months,
520
00:34:35,364 --> 00:34:40,703
you might start to regain the ability
to eat a much wider range of foods.
521
00:34:40,703 --> 00:34:44,540
I do really love the idea
of microdosing chips, though.
522
00:34:44,540 --> 00:34:46,000
{\an8}Oh man. So do I now.
523
00:34:46,000 --> 00:34:48,586
Yeah. Yay, that's so exciting.
524
00:34:48,586 --> 00:34:51,547
I'm getting emotional
thinking about it. I'm sorry.
525
00:34:52,673 --> 00:34:57,011
But yeah, it's...
it's been a really long, hard road.
526
00:35:03,017 --> 00:35:06,646
I'm really excited by the idea
of microdosing potato chips.
527
00:35:08,523 --> 00:35:11,984
You know, just changing my diet
a little bit at a time.
528
00:35:13,111 --> 00:35:13,945
And it's been fun.
529
00:35:13,945 --> 00:35:17,240
I mean, I eat, like,
three potato chips a day sometimes,
530
00:35:17,240 --> 00:35:19,158
and I don't feel bad.
531
00:35:20,243 --> 00:35:23,412
It does make me wonder
if I'm eating the right things,
532
00:35:23,412 --> 00:35:28,084
or is it, something's changing chemically
in my brain?
533
00:35:45,476 --> 00:35:48,813
According to the world
and all these graphs and charts,
534
00:35:48,813 --> 00:35:53,568
because of my height and my weight,
I'm considered morbidly obese.
535
00:35:55,194 --> 00:35:56,737
I tried to control my weight before.
536
00:35:56,737 --> 00:35:59,240
I went and got
this expensive gym membership.
537
00:36:00,491 --> 00:36:01,826
I've tried diets.
538
00:36:01,826 --> 00:36:05,580
I've tried the weight loss medicine,
and it didn't work for me.
539
00:36:06,497 --> 00:36:12,086
I would lose a lot of weight at first,
and then it just comes right back.
540
00:36:14,005 --> 00:36:15,840
Diabetes runs in my family.
541
00:36:15,840 --> 00:36:17,967
So even though I'm healthy now,
542
00:36:17,967 --> 00:36:22,430
I wanna lose weight before any of that,
you know, onsets in my life.
543
00:36:22,430 --> 00:36:24,640
I wanna be here
as long as I can for my kids.
544
00:36:26,893 --> 00:36:30,229
Society, you know,
makes women feel less than
545
00:36:30,229 --> 00:36:31,522
because they're larger,
546
00:36:32,315 --> 00:36:38,863
and I'm not looking to be skinny
or 120 pounds, just more healthy.
547
00:36:39,906 --> 00:36:42,992
I'm just gonna be this plus-size diva
till the end.
548
00:36:42,992 --> 00:36:46,245
♪ I'm feeling myself ♪
549
00:36:46,245 --> 00:36:51,626
♪ Living it up, straight to the top
I'm flexin', I'm flexin'... ♪
550
00:36:56,339 --> 00:36:58,633
You can be positive
in the body that you're in,
551
00:36:58,633 --> 00:37:02,470
but also be conscious of your health
because you ultimately need that.
552
00:37:04,222 --> 00:37:05,640
♪ I'm flexin', flexin'... ♪
553
00:37:05,640 --> 00:37:08,434
So my question about eating is,
554
00:37:08,434 --> 00:37:10,686
what in the world are y'all eating
that I'm not eating
555
00:37:10,686 --> 00:37:13,481
that cause y'all to lose weight
and not me?
556
00:37:20,613 --> 00:37:25,326
As a physician,
when we try to explain to our patients
557
00:37:25,326 --> 00:37:28,788
why they're having
such a hard time losing weight,
558
00:37:28,788 --> 00:37:32,833
{\an8}we have a tendency of blaming
the individuals, blaming the patients.
559
00:37:35,169 --> 00:37:38,673
The population
has been doing what we were recommending
560
00:37:38,673 --> 00:37:40,091
for many decades,
561
00:37:40,091 --> 00:37:45,471
yet the obesity epidemic
has not slowed down or reversed.
562
00:37:48,891 --> 00:37:50,851
The word "diet" is really confusing.
563
00:37:50,851 --> 00:37:52,436
Low-fat versus low-carb.
564
00:37:53,187 --> 00:37:56,691
{\an8}Most people understand it
to be really a sprint that I'm gonna do
565
00:37:56,691 --> 00:37:59,318
{\an8}for some period of time to lose weight,
566
00:37:59,318 --> 00:38:02,154
and then I can go back
to my previous patterns
567
00:38:02,154 --> 00:38:04,407
of eating whatever I want to eat.
568
00:38:05,491 --> 00:38:09,578
But a diet, it's really about
changing your lifestyle for life.
569
00:38:12,873 --> 00:38:17,336
Another reason why diets don't work is
that they really focus on the wrong thing.
570
00:38:17,336 --> 00:38:21,632
And in that sense,
they actually could be misdirecting us.
571
00:38:23,843 --> 00:38:26,762
When we put these calorie labels on boxes,
572
00:38:26,762 --> 00:38:28,806
we think, "Okay,
this is the amount of energy
573
00:38:28,806 --> 00:38:31,851
that we will all extract
if we ate that same food."
574
00:38:31,851 --> 00:38:33,644
But of course, that is not true.
575
00:38:38,107 --> 00:38:40,693
If you would give
an identical apple
576
00:38:40,693 --> 00:38:42,611
to three different people,
577
00:38:42,611 --> 00:38:47,575
each of these individuals would show
a different response to the same apple.
578
00:38:52,913 --> 00:38:54,790
You know I can't eat this, right?
579
00:38:55,624 --> 00:38:58,544
They will each process it
in a different way.
580
00:38:58,544 --> 00:39:02,214
They will each extract
different nutrients from it.
581
00:39:04,175 --> 00:39:06,802
They will each extract
different amounts of energies.
582
00:39:07,636 --> 00:39:10,639
You go your whole life thinking,
"Okay, it's calories."
583
00:39:10,639 --> 00:39:12,600
"Me and you can eat the same thing,
584
00:39:12,600 --> 00:39:15,144
and we should both have
the same results, ultimately,"
585
00:39:15,144 --> 00:39:17,396
and that's just not what it is.
586
00:39:18,773 --> 00:39:21,609
So, rather than measuring the apple,
587
00:39:21,609 --> 00:39:24,528
one needs to start measuring
the people who eat the apple.
588
00:39:25,821 --> 00:39:27,865
Now we focus
on blood glucose levels
589
00:39:27,865 --> 00:39:29,867
in the two hours after you eat a meal
590
00:39:29,867 --> 00:39:33,704
because we understand
that your blood sugar levels after a meal
591
00:39:33,704 --> 00:39:37,458
are directly connected
to weight loss and weight gain,
592
00:39:38,292 --> 00:39:41,253
and also to the development
of multiple diseases.
593
00:39:43,714 --> 00:39:44,924
Good, good, good.
594
00:39:44,924 --> 00:39:47,134
Some cream cheese.
595
00:39:49,345 --> 00:39:51,555
I ought to check
my sugar levels this morning.
596
00:39:51,555 --> 00:39:52,973
Especially after that.
597
00:39:52,973 --> 00:39:54,433
Let's see if I beat you.
598
00:39:55,393 --> 00:39:57,186
Oh my God, you're going up really fast.
599
00:39:57,186 --> 00:39:59,522
{\an8}- Definitely beat you this time.
Yeah.
600
00:39:59,522 --> 00:40:01,232
Bagels have that effect on me.
601
00:40:01,232 --> 00:40:02,733
That's okay for me.
602
00:40:07,822 --> 00:40:10,991
One of the seminal works
in the field of microbiome
603
00:40:10,991 --> 00:40:15,079
was a study led by Jeff Gordon
in which he took identical twins,
604
00:40:15,079 --> 00:40:18,374
but one twin was obese,
and the other was lean,
605
00:40:18,374 --> 00:40:23,379
and he transplanted
the gut bacteria from the obese twin
606
00:40:23,379 --> 00:40:25,714
and the lean twin into mice.
607
00:40:26,507 --> 00:40:30,886
The mice that received the bacteria
from the obese twin
608
00:40:30,886 --> 00:40:35,224
gained more weight on the same food
as compared to mice
609
00:40:35,224 --> 00:40:38,394
who received the bacteria
of the lean twin.
610
00:40:41,272 --> 00:40:43,149
And that's helping us to understand
611
00:40:43,149 --> 00:40:47,153
why some people experience more difficulty
losing weight.
612
00:40:48,362 --> 00:40:50,698
For some people,
you lose weight, put on weight,
613
00:40:50,698 --> 00:40:53,617
lose weight, put on more weight,
lose weight, put on even more weight,
614
00:40:53,617 --> 00:40:54,618
and it keeps going up.
615
00:40:55,870 --> 00:40:57,913
We think the microbiome is key to that.
616
00:40:59,915 --> 00:41:03,836
You may have to go on a diet
for 9 to 12 months
617
00:41:03,836 --> 00:41:06,297
to reshape the ecosystem,
618
00:41:06,297 --> 00:41:09,633
to prevent the weight
from coming back with a vengeance
619
00:41:09,633 --> 00:41:11,552
when you start eating a hamburger again.
620
00:41:18,392 --> 00:41:22,605
Using the microbiome data
that we collected from individuals,
621
00:41:23,481 --> 00:41:28,402
we can start to predict
which foods are the best for each person.
622
00:41:29,028 --> 00:41:31,739
At least as far as blood sugar levels go.
623
00:41:32,990 --> 00:41:34,658
Oysters, that's good.
624
00:41:35,326 --> 00:41:37,912
Can't have eggplant sandwiches,
that's bad.
625
00:41:38,746 --> 00:41:43,501
For somebody like me
where obsession is an issue...
626
00:41:43,501 --> 00:41:47,796
...having scores
is not necessarily helpful for me.
627
00:41:47,796 --> 00:41:50,341
We should put hot dogs in there.
628
00:41:50,341 --> 00:41:53,844
The hot dog and bun
on its own is rated yellow.
629
00:41:53,844 --> 00:41:56,639
- But that's not too bad, right?
- It's not too bad, but also not good.
630
00:41:56,639 --> 00:41:59,183
But it's better
when it's with cheese and avocado.
631
00:41:59,183 --> 00:42:00,809
Oh, I like avocado.
632
00:42:00,809 --> 00:42:01,894
It's amazing.
633
00:42:01,894 --> 00:42:04,355
The more toppings
you add to it, the better.
634
00:42:06,273 --> 00:42:08,776
Oh my God. Pork tenderloin.
635
00:42:08,776 --> 00:42:11,695
So you mean to tell me pork is good?
636
00:42:11,695 --> 00:42:13,572
Nobody better not tell me nothing else.
637
00:42:19,703 --> 00:42:20,996
Hi, Kimmie!
638
00:42:20,996 --> 00:42:22,581
Hi, Annie!
639
00:42:22,581 --> 00:42:23,999
- Hi, Kimmie.
Hi, Eran.
640
00:42:24,792 --> 00:42:26,919
{\an8}You know, you had asked before, like,
641
00:42:26,919 --> 00:42:30,005
{\an8}why is it that
when you try to lose weight, you can't.
642
00:42:30,631 --> 00:42:33,425
So when we looked at your microbiome,
643
00:42:33,425 --> 00:42:37,346
we saw that you had
a less diverse microbiome.
644
00:42:37,346 --> 00:42:40,891
In particular, we noticed
a specific type of bacteria,
645
00:42:40,891 --> 00:42:43,102
it's known as Prevotella, you had zero.
646
00:42:43,102 --> 00:42:44,061
Oh my goodness.
647
00:42:44,061 --> 00:42:47,982
So people who have
that pattern of no Prevotella
648
00:42:47,982 --> 00:42:50,234
have a hard time losing weight.
649
00:42:50,234 --> 00:42:52,194
Then the other thing we found
650
00:42:52,194 --> 00:42:56,282
{\an8}was that there were
three other specific bacteria in your gut
651
00:42:56,282 --> 00:42:58,158
{\an8}that were in low amounts.
652
00:42:58,158 --> 00:43:02,621
{\an8}They're associated with the production
of a specific type of gut hormone
653
00:43:02,621 --> 00:43:04,039
{\an8}that makes you feel full.
654
00:43:04,039 --> 00:43:06,375
{\an8}It could be why you're always hungry.
655
00:43:06,375 --> 00:43:11,880
But it's never as simple as one bacteria,
because no bacteria acts alone.
656
00:43:11,880 --> 00:43:16,051
So you really need to understand
how they act within an ecosystem,
657
00:43:16,051 --> 00:43:19,013
which is why we analyze
the microbiome as a whole.
658
00:43:19,013 --> 00:43:20,681
Does that make sense?
659
00:43:20,681 --> 00:43:24,393
Absolutely. I mean,
I'm kind of amazed, actually.
660
00:43:24,393 --> 00:43:29,565
I mean, just to be able to find out
all those different things about myself,
661
00:43:30,232 --> 00:43:31,775
simply from testing poop.
662
00:43:33,027 --> 00:43:36,947
{\an8}But I don't know.
I guess it just seems so difficult.
663
00:43:36,947 --> 00:43:40,451
{\an8}Why does it seem like... like I'm stuck?
664
00:43:41,076 --> 00:43:43,996
- Am I stuck?
- Yeah. No, you're not... you're not stuck.
665
00:43:43,996 --> 00:43:48,584
So, the good thing is you got here,
but you can also get out.
666
00:43:49,293 --> 00:43:53,088
You really want to do,
I would say, a lifestyle change
667
00:43:53,088 --> 00:43:55,549
where you really change your food,
668
00:43:55,549 --> 00:43:58,344
such that it better matches
your good bacteria.
669
00:43:58,344 --> 00:43:59,303
Oh yeah.
670
00:43:59,303 --> 00:44:02,348
And we might be able to find
something that is enjoyable,
671
00:44:02,348 --> 00:44:05,601
something that could be sustained
for a long period of time,
672
00:44:05,601 --> 00:44:07,311
and would also be good for you.
673
00:44:07,311 --> 00:44:11,857
{\an8}You know, we talked about ABCs,
"always be counting,"
674
00:44:11,857 --> 00:44:12,775
{\an8}not calories,
675
00:44:12,775 --> 00:44:17,488
{\an8}but always be counting
the number of fruits and vegetables
676
00:44:17,488 --> 00:44:20,240
{\an8}that you have per week.
677
00:44:20,240 --> 00:44:23,410
Between 20 and 30
is usually considered good.
678
00:44:23,410 --> 00:44:24,328
Okay.
679
00:44:25,621 --> 00:44:27,748
It definitely clears things up
a little more.
680
00:44:27,748 --> 00:44:32,044
Different bacteria,
you know, different lifestyles,
681
00:44:32,044 --> 00:44:36,465
just different things happening
for different people at different times
682
00:44:36,465 --> 00:44:39,760
just creates different outcomes.
683
00:44:43,806 --> 00:44:45,182
My life is pretty hectic.
684
00:44:46,058 --> 00:44:48,477
I'm responsible for a lot of people.
685
00:44:49,061 --> 00:44:51,980
I have a sick mom
that I'm constantly taking care of.
686
00:44:53,232 --> 00:44:56,485
I'm a single mom
to three beautiful children.
687
00:44:57,486 --> 00:45:02,574
My baby boy, he's autistic,
so I'm always teaching him.
688
00:45:05,536 --> 00:45:09,373
Eating in a household
with different age groups
689
00:45:10,165 --> 00:45:11,625
that all want different things,
690
00:45:11,625 --> 00:45:15,003
you gotta cook for you,
and then you gotta cook for them, and...
691
00:45:16,255 --> 00:45:18,882
It can be difficult,
and it can be expensive.
692
00:45:20,968 --> 00:45:26,473
So getting my kids on board
with one meal that everybody likes,
693
00:45:26,473 --> 00:45:27,683
that's my project.
694
00:45:37,401 --> 00:45:39,570
I'm sure
that I've eaten 10,000 hot dogs
695
00:45:39,570 --> 00:45:41,363
{\an8}since the beginning of my career.
696
00:46:00,090 --> 00:46:05,304
I am Japanese,
but I've eaten like an American.
697
00:46:05,304 --> 00:46:11,310
I think that's what's damaged my body.
698
00:46:17,232 --> 00:46:18,734
Wow, this aroma.
699
00:46:19,443 --> 00:46:22,446
This is real Japanese food, huh?
700
00:46:22,446 --> 00:46:24,656
So beautiful.
701
00:46:24,656 --> 00:46:26,033
So beautiful.
702
00:46:27,326 --> 00:46:29,536
{\an8}- Mmm!
703
00:46:30,120 --> 00:46:33,248
Is competitive eating
damaging your stomach?
704
00:46:33,248 --> 00:46:35,417
When we go out together,
705
00:46:35,417 --> 00:46:38,462
I mean, the rest of us
eat more than you do.
706
00:46:38,462 --> 00:46:39,671
Yeah, it's true.
707
00:46:39,671 --> 00:46:42,090
Kobi thinks he might be broken.
708
00:46:42,090 --> 00:46:44,510
He doesn't feel hungry or full.
709
00:46:44,510 --> 00:46:47,596
- He doesn't feel those things at all.
Oh really?
710
00:46:47,596 --> 00:46:51,266
There are times when he realizes that
he hasn't eaten anything in three days.
711
00:46:51,266 --> 00:46:53,644
It's that bad, really?
712
00:46:53,644 --> 00:46:57,815
I feel like the more you eat,
especially junk food,
713
00:46:57,815 --> 00:47:00,442
the more you damage your body.
714
00:47:00,442 --> 00:47:01,485
Hmm.
715
00:47:03,570 --> 00:47:09,326
Ever since I started this career,
I've wondered
716
00:47:09,326 --> 00:47:12,955
what damage I've done to my body.
717
00:47:16,834 --> 00:47:22,881
I want to know how it is damaging
my brain and nervous system.
718
00:47:29,179 --> 00:47:31,890
Earlier, I think
I had this image of myself,
719
00:47:31,890 --> 00:47:34,309
like, I'm this head and brain, and rest,
720
00:47:34,309 --> 00:47:36,103
and this is how I go about life.
721
00:47:36,103 --> 00:47:39,731
My feelings and everything,
my thoughts, are just produced up here.
722
00:47:39,731 --> 00:47:41,441
And this is a bit silly,
723
00:47:41,441 --> 00:47:45,487
and it reminds me even about the way
my little nephew draws people.
724
00:47:45,487 --> 00:47:47,948
It's just this head
with two little feet on it.
725
00:47:47,948 --> 00:47:51,493
And we now know that the gut
is an important adviser to the brain.
726
00:47:51,493 --> 00:47:54,121
It'll collect this information,
send it up to the brain,
727
00:47:54,121 --> 00:47:56,665
and it'll become a part of how we feel.
728
00:47:59,001 --> 00:48:01,712
{\an8}So we all know our first brain up here,
729
00:48:01,712 --> 00:48:05,841
{\an8}but we have a second brain
in here within our tummies.
730
00:48:05,841 --> 00:48:09,052
And there are more nerves
in this second brain
731
00:48:09,052 --> 00:48:10,679
than there is in our spinal cord.
732
00:48:12,389 --> 00:48:17,477
The gut-brain axis is
the two-way street of communication
733
00:48:17,477 --> 00:48:21,565
between what's going on in our bellies
and what's going on in our brains.
734
00:48:22,357 --> 00:48:25,569
Think of the brain
and the gut as BFFs.
735
00:48:26,069 --> 00:48:30,490
So if either one is not working,
the other eventually is gonna follow suit.
736
00:48:31,074 --> 00:48:34,578
It may be what allows us
to enjoy the food we eat,
737
00:48:34,578 --> 00:48:37,539
to tell us what to eat, when to eat,
738
00:48:37,539 --> 00:48:40,959
and it's not only
that the microbes could affect your brain,
739
00:48:40,959 --> 00:48:45,797
but it's the food you take that can affect
the microbes that can affect your brain.
740
00:48:59,853 --> 00:49:04,066
So, today we're
at the English Market here in Ireland,
741
00:49:04,066 --> 00:49:06,568
and this is where I go shopping
on a Saturday.
742
00:49:07,986 --> 00:49:09,488
You come to the market with a list.
743
00:49:09,488 --> 00:49:11,949
But I end up
throwing it out every time.
744
00:49:12,616 --> 00:49:15,327
The smell, the colors,
everything here, you're drawn to,
745
00:49:15,327 --> 00:49:18,830
but your gut is also drawing you
to things maybe it shouldn't.
746
00:49:20,874 --> 00:49:25,170
Our food choices, you know, we think
about it all being driven by our brain,
747
00:49:25,170 --> 00:49:28,507
but what if it's actually
the signals from our gut
748
00:49:28,507 --> 00:49:31,176
that are really pulling the strings?
749
00:49:32,469 --> 00:49:35,180
Now, this is what my microbes really love,
750
00:49:35,180 --> 00:49:37,683
and I have to have this internal struggle
751
00:49:37,683 --> 00:49:41,269
because it's just a recipe
for me to gain weight.
752
00:49:44,189 --> 00:49:47,401
How hungry you feel,
how much you want to eat something,
753
00:49:47,401 --> 00:49:51,989
could come from a tiny bacterial
population in your gut being like,
754
00:49:51,989 --> 00:49:55,325
"I really would like to eat those fries,"
or something, you know?
755
00:49:56,493 --> 00:49:58,912
{\an8}You eat a lot of sugar,
you get sugar-loving bugs.
756
00:49:58,912 --> 00:50:01,123
{\an8}You eat a lot of fat,
you get fat-loving bugs.
757
00:50:01,915 --> 00:50:05,627
So when I go to China,
and I'm not consuming so much sugary food
758
00:50:05,627 --> 00:50:07,921
because there's very little sugar
in the Chinese diet,
759
00:50:07,921 --> 00:50:11,174
I completely lose my desire
to eat chocolate, for example.
760
00:50:11,174 --> 00:50:14,636
Normally, in North America,
I'm craving chocolate every single day.
761
00:50:15,637 --> 00:50:17,097
Morning.
Morning.
762
00:50:17,097 --> 00:50:18,765
- How are you?
Good, and you?
763
00:50:18,765 --> 00:50:20,058
Good, good.
764
00:50:20,058 --> 00:50:21,226
Morning.
765
00:50:21,226 --> 00:50:22,853
Ah!
766
00:50:23,562 --> 00:50:26,189
Today, my microbes win,
767
00:50:26,189 --> 00:50:29,276
so it's gonna be the chocolate
that we're gonna go with.
768
00:50:31,611 --> 00:50:33,155
I get cravings a lot.
769
00:50:33,155 --> 00:50:36,533
Sometimes, literally,
the only thing that sounds good
770
00:50:36,533 --> 00:50:39,327
is, like, a super rare steak.
771
00:50:40,245 --> 00:50:43,874
I kind of try to just push it
into the back of my mind and ignore it,
772
00:50:43,874 --> 00:50:46,418
but I'm trying to listen to my body more.
773
00:50:46,418 --> 00:50:49,588
My body craves ice cream
or sweets or hamburgers.
774
00:50:50,630 --> 00:50:53,133
I really wish I could eat this.
775
00:50:53,884 --> 00:50:57,596
I love seafood.
I try to eat as much seafood as possible.
776
00:50:57,596 --> 00:51:00,265
I used to crave
777
00:51:01,308 --> 00:51:04,978
cakes and curry when I was little.
778
00:51:04,978 --> 00:51:09,649
I don't feel that joy
about eating anymore.
779
00:51:13,070 --> 00:51:15,197
Digestion was very much likely
780
00:51:15,197 --> 00:51:18,909
the first form of thinking
that animals developed.
781
00:51:18,909 --> 00:51:22,537
It was there so that the nerves
could tell the quality of the food,
782
00:51:22,537 --> 00:51:26,500
how the surrounding tissue was doing,
the immune cells that were passing by.
783
00:51:26,500 --> 00:51:28,919
And only after that worked really well,
784
00:51:28,919 --> 00:51:31,880
it was like a nice add-on
to also have this brain up there
785
00:51:31,880 --> 00:51:33,340
that can coordinate senses.
786
00:51:39,221 --> 00:51:41,932
Hi, Kimmie, we're ready for you
if you wanna come on back.
787
00:51:44,643 --> 00:51:47,854
I'm going to get my MRI done today.
788
00:51:49,856 --> 00:51:52,359
I'm a little worried.
789
00:51:54,528 --> 00:51:59,950
But I'm looking forward to understanding
what's going on in my body.
790
00:52:03,870 --> 00:52:05,747
I'm still a little confused.
791
00:52:05,747 --> 00:52:08,542
I'm just trying
to figure out how my body works,
792
00:52:08,542 --> 00:52:10,669
so moving forward, I can be a better me.
793
00:52:15,090 --> 00:52:17,008
All right, Kimmie.
How you doing in there?
794
00:52:17,008 --> 00:52:18,218
Good.
795
00:52:18,218 --> 00:52:20,929
We're gonna go ahead
and put up a slideshow for you
796
00:52:20,929 --> 00:52:22,848
of a bunch of pictures.
797
00:52:22,848 --> 00:52:27,352
And we're just gonna ask you to watch it
like you would watch TV or a movie, okay?
798
00:52:27,352 --> 00:52:28,520
Okay.
799
00:52:30,105 --> 00:52:33,733
What we're looking at
is activity in the brain.
800
00:52:34,693 --> 00:52:39,906
Seeing how Kimmie and Kobi respond
to a stimulus. In this case, food cues.
801
00:52:41,491 --> 00:52:44,077
We have high-calorie sweet foods,
802
00:52:44,077 --> 00:52:46,454
or high-fat, high-calorie savory foods.
803
00:52:47,372 --> 00:52:51,835
And what we see with Kimmie's brain
is that when Kimmie sees food,
804
00:52:51,835 --> 00:52:55,589
the emotional part
of her brain gets activated,
805
00:52:55,589 --> 00:52:57,465
but more importantly,
806
00:52:57,465 --> 00:53:02,304
the ability to control
these emotional responses are diminished.
807
00:53:03,972 --> 00:53:07,809
With Kobi's situation,
it's definitely more complex.
808
00:53:08,560 --> 00:53:11,021
Hunger is a complicated process.
809
00:53:11,021 --> 00:53:13,315
There are multiple systems involved.
810
00:53:13,315 --> 00:53:17,235
The brain, the gut microbiome,
inflammation,
811
00:53:17,235 --> 00:53:21,990
but also your mood,
your memories, your environment.
812
00:53:23,200 --> 00:53:25,911
There are so many things
that are related to hunger,
813
00:53:25,911 --> 00:53:27,954
and we need to think about the whole body.
814
00:53:29,581 --> 00:53:31,625
Doctors are divided up
into specialties
815
00:53:31,625 --> 00:53:34,169
where they just focus on this one organ,
816
00:53:34,169 --> 00:53:37,130
and they ignore
the entire rest of the body, essentially.
817
00:53:37,714 --> 00:53:41,551
It's minimizing our understanding
of how everything is connected.
818
00:53:41,551 --> 00:53:44,346
The beautiful thing about
the microbiome is it's everywhere,
819
00:53:44,346 --> 00:53:46,514
and its effects are felt everywhere.
820
00:53:48,975 --> 00:53:50,894
We have to think more holistically.
821
00:53:50,894 --> 00:53:55,065
And so, one of the things
that I'm really interested in
822
00:53:55,065 --> 00:54:00,362
is when we have co-occurrences
of gut problems with brain problems,
823
00:54:00,362 --> 00:54:02,239
and it's very common.
824
00:54:02,239 --> 00:54:05,951
It's very common
in autism, in Parkinson's disease,
825
00:54:05,951 --> 00:54:09,329
but also in stress-related
psychiatric illnesses
826
00:54:09,329 --> 00:54:11,289
like anxiety and depression.
827
00:54:11,289 --> 00:54:15,710
And so, which came first
is always the question.
828
00:54:19,589 --> 00:54:21,508
In the last five or so years,
829
00:54:21,508 --> 00:54:24,302
we found that people
with certain depression-like symptoms
830
00:54:24,302 --> 00:54:25,887
are missing bacteria in their gut
831
00:54:25,887 --> 00:54:28,890
that produce chemicals
which shape brain chemistry.
832
00:54:28,890 --> 00:54:30,850
That changes how you feel.
833
00:54:30,850 --> 00:54:35,563
And it can lead, we believe,
to the onset of depression-like symptoms.
834
00:54:37,816 --> 00:54:41,903
When you give a normal mouse
microbes from a healthy person
835
00:54:41,903 --> 00:54:44,823
and give them the opportunity to explore,
836
00:54:46,241 --> 00:54:51,037
they'll want to see bright areas
and be generally inquisitive.
837
00:54:51,037 --> 00:54:54,916
Whereas if you give them
the microbes from a depressed individual,
838
00:54:55,542 --> 00:54:57,669
they'll huddle into dark areas,
839
00:54:57,669 --> 00:55:02,257
and they will develop
stress, anxiety, and depression.
840
00:55:06,094 --> 00:55:09,389
There was changes
in the chemicals involved in serotonin,
841
00:55:09,389 --> 00:55:10,515
the mood molecule,
842
00:55:10,515 --> 00:55:13,059
- in their gut and in their brain.
843
00:55:14,019 --> 00:55:16,396
When we added bacteria
into our animals
844
00:55:16,396 --> 00:55:19,441
that's often missing
in people who are depressed,
845
00:55:19,441 --> 00:55:22,861
it actually dampens down
that depression response.
846
00:55:22,861 --> 00:55:27,157
So they may still have depression,
but they don't feel it as severely.
847
00:55:30,994 --> 00:55:34,914
Yeah, it makes sense.
848
00:55:34,914 --> 00:55:38,626
When I'm training for a competition,
849
00:55:38,626 --> 00:55:41,963
I feel aggressive,
850
00:55:42,547 --> 00:55:47,135
and I don't feel like
talking to other people.
851
00:55:49,471 --> 00:55:55,518
It's scary to think that the brain and gut
are so closely related.
852
00:55:56,728 --> 00:56:00,106
It makes me want to be more careful
with what I eat.
853
00:56:07,072 --> 00:56:08,156
That's really cool.
854
00:56:09,657 --> 00:56:11,659
Ah, man. You're doing really well.
855
00:56:12,952 --> 00:56:17,499
As a father with a son with autism
and another son with ADHD
856
00:56:17,499 --> 00:56:20,043
and having depression in my family,
857
00:56:20,043 --> 00:56:23,380
I've been very interested in seeing
if there's maybe a link
858
00:56:23,380 --> 00:56:25,673
to disruptions in the microbiome.
859
00:56:25,673 --> 00:56:27,926
And that's shaped my research career.
860
00:56:27,926 --> 00:56:32,013
And I've gone after looking at
which bacteria might be playing a role.
861
00:56:35,642 --> 00:56:38,019
We found that in many cases of autism,
862
00:56:38,019 --> 00:56:42,399
there are children who have diarrhea
or severe constipation.
863
00:56:42,982 --> 00:56:46,027
In other diseases in the brain,
like Parkinson's,
864
00:56:46,027 --> 00:56:48,822
we often see an onset of constipation,
865
00:56:48,822 --> 00:56:53,326
sometimes even decades before
the actual brain disease manifests.
866
00:56:56,663 --> 00:56:58,081
To understand this connection,
867
00:56:58,081 --> 00:57:01,876
we take bacteria from humans
with a certain disease like Parkinson's,
868
00:57:02,669 --> 00:57:04,003
and put them in mice.
869
00:57:08,341 --> 00:57:12,137
When we add missing bacteria
into the mice, their symptoms improve.
870
00:57:14,973 --> 00:57:16,891
It's a natural thing.
871
00:57:16,891 --> 00:57:21,354
Just naturally rebalancing that ecosystem
and that chemistry inside the body.
872
00:57:26,151 --> 00:57:29,571
And so, we're really starting to see
that the relationship,
873
00:57:29,571 --> 00:57:33,783
our study of the body as a whole unit,
is essential
874
00:57:33,783 --> 00:57:37,370
if we're really gonna get a handle
on some of these chronic conditions.
875
00:57:41,249 --> 00:57:43,084
{\an8}Well, very nice to meet you, Kobi.
876
00:57:43,084 --> 00:57:44,210
Hi, doctor.
877
00:57:44,210 --> 00:57:46,588
- Hi, Kobi. Hi, Maggie.
Nice to meet you.
878
00:57:47,172 --> 00:57:49,007
So I have some results.
879
00:57:49,007 --> 00:57:50,341
{\an8}We were excited to see that,
880
00:57:50,341 --> 00:57:54,554
{\an8}that your bacteria
actually looks pretty good.
881
00:57:54,554 --> 00:57:58,224
Wow.
That really surprises me.
882
00:57:58,224 --> 00:58:01,394
So even though
the competitive eating,
883
00:58:01,394 --> 00:58:03,563
{\an8}you know, may have had an effect,
884
00:58:03,563 --> 00:58:08,193
{\an8}the fact that you eat
a normal healthy diet, Japanese diet,
885
00:58:08,193 --> 00:58:10,528
it influenced your microbiome.
886
00:58:10,528 --> 00:58:13,531
Because the bacteria in your microbiome
887
00:58:13,531 --> 00:58:17,660
responds, like, within 24 hours of eating.
888
00:58:17,660 --> 00:58:18,578
Wow.
889
00:58:18,578 --> 00:58:21,289
But when it comes to the loss of appetite,
890
00:58:21,289 --> 00:58:24,167
it could be a combination of many things,
891
00:58:24,167 --> 00:58:25,877
{\an8}like the actual stomach stretching,
892
00:58:25,877 --> 00:58:29,255
your hormones,
some sort of slight inflammation,
893
00:58:29,255 --> 00:58:31,174
or also the speed of digestion.
894
00:58:31,174 --> 00:58:33,676
- Just to name a few things.
- Okay.
895
00:58:33,676 --> 00:58:36,888
But the other part is the head.
896
00:58:36,888 --> 00:58:39,933
And usually, I am not a fan
897
00:58:39,933 --> 00:58:42,852
of doctors telling people
it's in your head,
898
00:58:42,852 --> 00:58:47,524
but when I looked at your brain scan,
everything was firing.
899
00:58:47,524 --> 00:58:49,984
Basically, every area in the brain
900
00:58:49,984 --> 00:58:52,570
{\an8}that can have something to do
with eating, with food,
901
00:58:52,570 --> 00:58:55,823
{\an8}with feeling nauseous or full,
like, everything is on.
902
00:58:55,823 --> 00:58:57,575
It's almost like it's confused.
903
00:58:57,575 --> 00:59:00,328
Okay,
I don't like the sound of that.
904
00:59:00,328 --> 00:59:02,914
The only way
this made sense for me was
905
00:59:02,914 --> 00:59:06,084
{\an8}if everything has to work together
to suppress
906
00:59:06,084 --> 00:59:07,627
so that you don't feel full,
907
00:59:07,627 --> 00:59:10,964
so that you don't get disgusted
by more and more food.
908
00:59:10,964 --> 00:59:14,467
You can see how far your body goes
for what you want,
909
00:59:14,467 --> 00:59:16,261
even if it has to harm itself.
910
00:59:17,804 --> 00:59:20,098
He said, "I know."
He said, "I'm already scared."
911
00:59:20,098 --> 00:59:22,350
He's like,
"I don't know if my brain is okay."
912
00:59:22,350 --> 00:59:27,814
Yeah, but it's not that something
is turned off, or gone, or broken.
913
00:59:28,398 --> 00:59:31,067
It's all there. It's all turned on.
914
00:59:31,067 --> 00:59:33,903
It's just wired differently maybe now.
915
00:59:33,903 --> 00:59:37,282
{\an8}Your brain is still trained
to think that you're competing
916
00:59:37,282 --> 00:59:39,158
{\an8}or eating those highly processed foods.
917
00:59:39,158 --> 00:59:42,370
Here I think
the situation is very complex.
918
00:59:42,370 --> 00:59:45,999
Something that would be interesting to try
919
00:59:45,999 --> 00:59:49,836
- would be to learn to listen to the body.
- Yeah.
920
00:59:49,836 --> 00:59:54,882
{\an8}If it's just a smell,
or just sensing very basic things,
921
00:59:54,882 --> 00:59:57,802
and just learning to feel it, sometimes.
922
00:59:58,845 --> 01:00:00,972
It's a long journey.
A long one indeed.
923
01:00:00,972 --> 01:00:04,267
He said, "This is gonna be
a long journey though, right?"
924
01:00:05,310 --> 01:00:09,647
I overeat because
I am a competitive eater.
925
01:00:10,481 --> 01:00:14,152
But ordinary people overeat too sometimes.
926
01:00:16,821 --> 01:00:23,494
When you eat too much,
you don't savor the taste
927
01:00:23,494 --> 01:00:27,165
or fully enjoy the smell of the food.
928
01:00:28,499 --> 01:00:34,797
You ignore your body's signals,
like fullness.
929
01:00:37,133 --> 01:00:38,885
It starts early.
930
01:00:39,385 --> 01:00:41,679
Many kids are raised telling them,
931
01:00:41,679 --> 01:00:45,391
"Clean your plate. Eat the whole plate
'cause that's what good kids do."
932
01:00:47,518 --> 01:00:50,229
So we learn to ignore our appetite,
933
01:00:50,229 --> 01:00:53,066
but get accustomed
to just times where we eat.
934
01:00:53,733 --> 01:00:55,360
We're on the phone the whole time,
935
01:00:55,360 --> 01:00:57,820
or on the computer
with the brain and screen.
936
01:00:59,030 --> 01:01:03,242
Reconnecting, it's really more about
just listening to your body.
937
01:01:05,703 --> 01:01:11,209
I hope to live a long and healthy life.
938
01:01:11,751 --> 01:01:13,044
Good morning.
939
01:01:14,212 --> 01:01:18,925
I've decided to retire
from competitive eating.
940
01:01:21,135 --> 01:01:25,098
It's all I have done
for the last 20 years.
941
01:01:26,057 --> 01:01:28,935
I am worried about
what my next step will bring,
942
01:01:28,935 --> 01:01:31,229
but I'm also excited about my future.
943
01:01:31,229 --> 01:01:33,314
I have mixed feelings.
944
01:01:36,234 --> 01:01:38,027
But first,
945
01:01:38,027 --> 01:01:44,826
I want to fix my brain and my gut.
946
01:01:47,537 --> 01:01:50,415
We're actively working
to enhance the number
947
01:01:50,415 --> 01:01:53,543
of different microbiome therapies
that are out there.
948
01:01:57,130 --> 01:02:01,384
If your microbiome's damaged,
can we actually use poop to fix it?
949
01:02:03,594 --> 01:02:07,974
This is very, very valuable,
more valuable than gold.
950
01:02:08,975 --> 01:02:13,813
{\an8}What would you say if a doctor told you
someone else's feces could save your life?
951
01:02:13,813 --> 01:02:17,567
A Fecal Microbial Transplant,
simply called FMT,
952
01:02:17,567 --> 01:02:22,280
puts feces from someone else
into the body of an infected patient.
953
01:02:22,280 --> 01:02:26,409
He offers a treatment through
colonoscopy, an enema, or pills.
954
01:02:26,409 --> 01:02:30,455
Fecal microbiome transplant
is the first FDA-approved therapy
955
01:02:30,455 --> 01:02:33,958
which involves the microbiome
that's available to clinicians today.
956
01:02:33,958 --> 01:02:38,129
However, it's only allowed to be used
for one particular type of disease.
957
01:02:38,129 --> 01:02:43,176
C. diff. When bacteria inflames
the colon and causes extreme diarrhea.
958
01:02:43,176 --> 01:02:46,304
We take the bacterial community
from a healthy person,
959
01:02:46,304 --> 01:02:49,056
just spray it
up inside the colon, literally,
960
01:02:49,056 --> 01:02:53,978
in order to re-poop-ulate,
repopulate your gut bacteria inside there.
961
01:02:53,978 --> 01:02:57,315
It's a procedure
that has a 90% cure rate.
962
01:02:57,315 --> 01:02:59,525
Scientists are now trying
to figure out
963
01:02:59,525 --> 01:03:03,696
if it can treat hundreds
of other conditions, mental and physical.
964
01:03:04,989 --> 01:03:09,202
With fecal microbiome transplants,
there is really compelling evidence,
965
01:03:09,202 --> 01:03:11,287
but the science is still developing.
966
01:03:11,287 --> 01:03:12,789
We're still working on
967
01:03:12,789 --> 01:03:15,416
if it actually has benefit
in wider populations,
968
01:03:15,416 --> 01:03:17,293
if the benefit is long-lasting.
969
01:03:24,217 --> 01:03:27,887
Here it is,
next to the food we're gonna eat later.
970
01:03:29,847 --> 01:03:32,892
Is it in the healthy range?
This is a good one.
971
01:03:35,436 --> 01:03:36,854
I think for most people,
972
01:03:36,854 --> 01:03:40,566
it would be scary
to do a fecal transplant,
973
01:03:40,566 --> 01:03:42,527
especially when it's DIY.
974
01:03:43,194 --> 01:03:46,656
I also think that most healthy people
don't know what it's like
975
01:03:46,656 --> 01:03:50,076
to get to a place
where your quality of life is so low.
976
01:03:50,701 --> 01:03:53,162
I felt like I had no other options.
977
01:03:58,334 --> 01:03:59,544
Is this love?
978
01:04:00,127 --> 01:04:01,587
Yes, true love.
979
01:04:07,468 --> 01:04:13,266
The first time I did a fecal transplant,
I used my brother as a donor.
980
01:04:15,017 --> 01:04:20,773
I slowly started gaining weight,
despite not changing my diet at all.
981
01:04:22,275 --> 01:04:24,193
And I was able to go to the bathroom
982
01:04:24,193 --> 01:04:27,822
for the first time in, like, three years
on my own.
983
01:04:29,866 --> 01:04:31,993
But I started getting worse acne,
984
01:04:32,618 --> 01:04:35,955
and my brother has a history
of hormonal acne.
985
01:04:37,373 --> 01:04:41,878
And then I decided to use
my boyfriend as a donor.
986
01:04:41,878 --> 01:04:44,380
He has no physical health conditions,
987
01:04:44,380 --> 01:04:46,924
but he does have
some mental health issues.
988
01:04:48,384 --> 01:04:50,887
I took my boyfriend's pills
for several months.
989
01:04:50,887 --> 01:04:52,513
Stopped getting the acne.
990
01:04:53,347 --> 01:04:55,141
But over time, I noticed
991
01:04:55,141 --> 01:04:57,935
that my depression
was worse than it's ever been in my life.
992
01:04:59,353 --> 01:05:02,231
I got whatever bacteria he normally has,
993
01:05:02,231 --> 01:05:05,568
and it exacerbated
the depression that I already had.
994
01:05:08,070 --> 01:05:10,573
I went back to using
my brother as a donor.
995
01:05:10,573 --> 01:05:14,035
Within a week,
that depression completely went away.
996
01:05:16,162 --> 01:05:17,622
Going right in there...
997
01:05:18,873 --> 01:05:20,166
with the ice cream.
998
01:05:23,419 --> 01:05:25,588
There are risks with FMT.
999
01:05:27,173 --> 01:05:30,635
When you get an FMT,
you get the good bacteria,
1000
01:05:30,635 --> 01:05:33,971
but the bad bacteria
could also come along for the ride.
1001
01:05:33,971 --> 01:05:35,348
{\an8}
1002
01:05:35,348 --> 01:05:38,517
I would love it
if this was the perfect solution.
1003
01:05:40,519 --> 01:05:44,315
But all the gastroenterologists
I know are extremely cautious.
1004
01:05:44,315 --> 01:05:48,569
We could transplant the susceptibility
to all sorts of diseases.
1005
01:05:49,946 --> 01:05:53,658
So I ask people,
don't try and experiment on yourself
1006
01:05:53,658 --> 01:05:56,535
with some of these
more aggressive therapeutics.
1007
01:05:58,955 --> 01:06:03,876
If a fecal transplant would give you back
1008
01:06:03,876 --> 01:06:07,922
your feelings of hunger and fullness,
would you do it?
1009
01:06:07,922 --> 01:06:13,052
Yes, if it could help me with my problems,
1010
01:06:13,052 --> 01:06:15,262
I would definitely try it.
1011
01:06:15,262 --> 01:06:18,057
I'll be the guinea pig.
1012
01:06:18,557 --> 01:06:21,352
Someone else's feces could save your life.
1013
01:06:21,352 --> 01:06:22,812
Fecal microbial...
1014
01:06:22,812 --> 01:06:25,106
I thought it was weird as hell,
1015
01:06:25,648 --> 01:06:29,026
but all this talk about poop
just kind of helped me understand
1016
01:06:29,026 --> 01:06:30,987
that pooping is normal.
1017
01:06:30,987 --> 01:06:33,864
It's everyday life.
It's something everybody goes through.
1018
01:06:33,864 --> 01:06:35,116
So why not talk about it?
1019
01:06:35,116 --> 01:06:39,620
I'll bring it up, and it's just
a random poop conversation.
1020
01:06:40,746 --> 01:06:43,582
And when I hang up the phone,
I'm like, "Was that weird?"
1021
01:06:43,582 --> 01:06:47,169
Before it was,
but now it's like, "No, it's normal."
1022
01:06:50,965 --> 01:06:53,884
Fecal microbiome transplants
are quite a blunt tool.
1023
01:06:54,510 --> 01:06:56,721
We prefer to use a targeted approach,
1024
01:06:56,721 --> 01:07:02,143
like a precision probiotic
to improve health in a very specific way.
1025
01:07:03,894 --> 01:07:07,815
Most probiotics you can buy in the store
aren't really gastrointestinal bugs.
1026
01:07:07,815 --> 01:07:10,568
They're not designed
to live inside our guts.
1027
01:07:10,568 --> 01:07:14,989
They're normally bugs that you would find
associated with fermented milk or cheeses,
1028
01:07:14,989 --> 01:07:16,991
Lactobacillus organisms.
1029
01:07:16,991 --> 01:07:19,952
So they're not really designed
to take up residence.
1030
01:07:19,952 --> 01:07:23,622
It'd be like taking a houseplant,
and throwing it into the Amazon jungle,
1031
01:07:23,622 --> 01:07:26,125
and hoping beyond hope
that it would suddenly grow.
1032
01:07:27,585 --> 01:07:31,005
Modern medicine is very much
about treating the symptoms of a disease
1033
01:07:31,005 --> 01:07:33,799
rather than the underlying problems
that lead to it.
1034
01:07:34,759 --> 01:07:37,678
Moving forward,
we want to have a smarter approach
1035
01:07:37,678 --> 01:07:42,600
{\an8}to target the microbes in our gut
to actually have positive effects
1036
01:07:42,600 --> 01:07:45,770
and prevent many of the problems
from even starting.
1037
01:07:47,897 --> 01:07:50,858
And so, the microbiome
is a game changer for medicine
1038
01:07:50,858 --> 01:07:53,778
because everyone
can be their own pharmacist
1039
01:07:53,778 --> 01:07:56,280
just by picking the right foods to eat.
1040
01:08:00,034 --> 01:08:02,828
Inspired by our findings,
one of my colleagues decided
1041
01:08:02,828 --> 01:08:06,415
{\an8}to start drinking smoothies
with 60 different kinds of plants a day.
1042
01:08:06,415 --> 01:08:10,628
And so what you can see is he's over here
in this red region with his regular diet.
1043
01:08:10,628 --> 01:08:12,797
But now,
he's moved over to this orange region
1044
01:08:12,797 --> 01:08:14,048
after eating the smoothies.
1045
01:08:14,048 --> 01:08:15,758
Took a few weeks, but he's really changed
1046
01:08:15,758 --> 01:08:18,260
to this completely different region
of the plot.
1047
01:08:18,260 --> 01:08:21,180
And by the time this ends,
which is a few months later,
1048
01:08:21,180 --> 01:08:24,600
he's now got a much more diverse
microbiome configuration
1049
01:08:24,600 --> 01:08:26,185
than he had at the beginning.
1050
01:08:26,185 --> 01:08:28,187
But you haven't started
drinking these?
1051
01:08:28,187 --> 01:08:30,356
No, I tasted them.
1052
01:08:30,356 --> 01:08:31,816
I think this is one of those things
1053
01:08:31,816 --> 01:08:34,985
where you really need a collaboration
between scientists and, say, chefs
1054
01:08:34,985 --> 01:08:37,488
to not just get all the things
you want in there,
1055
01:08:37,488 --> 01:08:39,198
but to make it taste good as well.
1056
01:08:42,868 --> 01:08:45,663
Well, I have no idea
what that means, but that's cool.
1057
01:08:45,663 --> 01:08:49,208
Um, all right, let's get started.
1058
01:08:57,007 --> 01:08:59,552
Red and green lettuce, check.
1059
01:08:59,552 --> 01:09:02,721
Spinach, check. Purple kale, check.
1060
01:09:02,721 --> 01:09:04,890
Carrot-top greens, check.
1061
01:09:04,890 --> 01:09:11,188
Tomatoes, carrots,
zucchini, some avocados.
1062
01:09:11,188 --> 01:09:16,110
Radishes and dates
is a combination I have yet to try,
1063
01:09:16,110 --> 01:09:19,238
but maybe that'll be
my new macaron flavor, who knows?
1064
01:09:21,323 --> 01:09:24,034
How much smoothie does he eat?
1065
01:09:24,034 --> 01:09:28,956
The produce out here is about
what I eat in produce for, like, a week.
1066
01:09:28,956 --> 01:09:31,250
So one cup of water.
1067
01:09:33,377 --> 01:09:36,881
It does feel a bit like doing
a science fair experiment.
1068
01:09:36,881 --> 01:09:38,966
I'm going to throw in
a whole knob of ginger.
1069
01:09:38,966 --> 01:09:41,510
'Cause you can't get enough
of that ginger.
1070
01:09:43,012 --> 01:09:46,765
I mean, my initial reaction is,
who has time to do this?
1071
01:09:49,143 --> 01:09:51,437
We'll do a whole fig. I like figs.
1072
01:09:51,437 --> 01:09:55,941
I feel like the pink color is probably
extra good for you or something.
1073
01:09:55,941 --> 01:09:57,234
Antioxidants.
1074
01:09:58,027 --> 01:10:00,487
Oh, the potato. I'm also...
1075
01:10:01,572 --> 01:10:03,532
It's going to be so, like... Ugh!
1076
01:10:04,074 --> 01:10:05,284
First time for everything.
1077
01:10:06,952 --> 01:10:07,995
And a teaspoon.
1078
01:10:07,995 --> 01:10:09,830
I think that's it.
1079
01:10:11,332 --> 01:10:12,291
Okay.
1080
01:10:12,958 --> 01:10:16,545
I think this is going to be
an incredibly interesting color.
1081
01:10:25,930 --> 01:10:28,182
Doesn't look bad.
I mean, it doesn't look great.
1082
01:10:28,182 --> 01:10:30,893
But I've drank grosser smoothies.
1083
01:10:32,228 --> 01:10:33,479
Smells real green.
1084
01:10:34,813 --> 01:10:36,899
Oh, it's so thick.
1085
01:10:40,611 --> 01:10:42,029
It's got texture to it.
1086
01:10:48,744 --> 01:10:50,079
It's actually not bad.
1087
01:10:51,914 --> 01:10:54,500
It's fine. It tastes healthy.
1088
01:10:56,043 --> 01:10:57,670
How would you make this better?
1089
01:10:57,670 --> 01:11:01,006
Just, I mean, removing things
like the brussels sprouts
1090
01:11:01,006 --> 01:11:03,717
that will kind of, I think, overpower it.
1091
01:11:03,717 --> 01:11:06,971
Or if you're gonna do that,
just turn it into gazpacho.
1092
01:11:06,971 --> 01:11:10,140
I think a lot of the green smoothies
I eat would be so much better
1093
01:11:10,140 --> 01:11:12,393
if they embraced what it is
and added some salt
1094
01:11:12,393 --> 01:11:15,688
and, like, a little bit of vinegar,
and you're just drinking gazpacho.
1095
01:11:15,688 --> 01:11:19,984
It sounds great, but they just need
to season their smoothies, I guess.
1096
01:11:21,777 --> 01:11:23,946
Mm-mmm.
1097
01:11:27,283 --> 01:11:30,661
It is kind of spectacular
what food can do to you,
1098
01:11:31,287 --> 01:11:34,123
and how what you eat
really does change your body.
1099
01:11:35,082 --> 01:11:39,461
What you eat today will impact
your microbiome tomorrow, within 24 hours.
1100
01:11:40,045 --> 01:11:43,382
{\an8}My rule is ABC, always be counting.
1101
01:11:43,382 --> 01:11:46,677
{\an8}Always be counting the number
of fruits and vegetables you're eating.
1102
01:11:47,803 --> 01:11:51,849
If you eat about 20 to 30
different fruits and vegetables each week,
1103
01:11:51,849 --> 01:11:53,392
I think you're good.
1104
01:11:57,021 --> 01:11:59,940
If you want
some simple rules to follow,
1105
01:11:59,940 --> 01:12:02,943
think about what
the generations before us ate.
1106
01:12:03,569 --> 01:12:07,990
I mean, vegetables, fruits, nuts, beans,
1107
01:12:07,990 --> 01:12:12,077
even fermented foods that are teeming
with different types of microbes.
1108
01:12:12,703 --> 01:12:15,831
Fermented foods
were really the original probiotics.
1109
01:12:17,875 --> 01:12:21,879
You can just take vegetables, add salt,
and let them sit at room temperature,
1110
01:12:21,879 --> 01:12:25,132
and you're gonna have this delicious
fermented food in a couple days.
1111
01:12:29,386 --> 01:12:31,013
- Doing great.
You doing great?
1112
01:12:31,013 --> 01:12:32,765
- Uh-huh.
That's good, baby.
1113
01:12:32,765 --> 01:12:36,226
Is this what corn looks like
when it's just not corn?
1114
01:12:36,226 --> 01:12:39,855
You mean when it's fresh
and not out of the bag? Yes.
1115
01:12:39,855 --> 01:12:41,774
There's corn in here.
1116
01:12:41,774 --> 01:12:42,858
Yeah.
1117
01:12:44,151 --> 01:12:46,779
I was definitely confused in the past.
1118
01:12:47,654 --> 01:12:50,491
Learning the science
helped me to know that,
1119
01:12:50,491 --> 01:12:53,577
"Okay, you can't just say I'm on a diet."
1120
01:12:53,577 --> 01:12:56,372
You literally have to change
your lifestyle
1121
01:12:57,539 --> 01:13:00,501
and doing little things every day.
1122
01:13:00,501 --> 01:13:02,753
Potatoes cut and rinsed.
- Cut and rinsed.
1123
01:13:02,753 --> 01:13:04,755
My kids are super competitive.
1124
01:13:05,714 --> 01:13:09,051
I get them to help me.
I've made it like a cooking competition.
1125
01:13:10,219 --> 01:13:12,388
I get them to go
to the grocery store with me.
1126
01:13:12,388 --> 01:13:13,889
Then we get to cook.
1127
01:13:15,391 --> 01:13:18,143
So we've been spending
a lot more time together while doing it.
1128
01:13:18,143 --> 01:13:19,311
What are you doing?
1129
01:13:19,311 --> 01:13:21,855
I'm helping you.
I wanna be a chef, forever.
1130
01:13:21,855 --> 01:13:22,856
You wanna be a chef?
1131
01:13:22,856 --> 01:13:26,026
Yeah, I wanna cook every single day.
I want to be a chef.
1132
01:13:28,487 --> 01:13:33,075
I've experienced
how people talk about their body,
1133
01:13:33,075 --> 01:13:35,702
and what way of relationship
they have with it.
1134
01:13:36,328 --> 01:13:38,622
Two eggs and two egg yolks.
1135
01:13:38,622 --> 01:13:41,708
There's not one super health food
that you can eat,
1136
01:13:41,708 --> 01:13:45,462
or this one advice that you can follow
so everything gets better.
1137
01:13:45,462 --> 01:13:49,133
It's really more about
building up a relationship to the gut.
1138
01:13:49,883 --> 01:13:52,553
Y'all are doing
such a great job. High five.
1139
01:13:52,553 --> 01:13:56,265
Reconnecting can be done by science,
and can be done by knowledge,
1140
01:13:56,265 --> 01:13:59,560
but only also if you,
you know, get a feeling,
1141
01:13:59,560 --> 01:14:00,894
get a smart feeling for it.
1142
01:14:02,187 --> 01:14:05,149
Carbonara is kind of like
the complete realization
1143
01:14:05,149 --> 01:14:07,401
of the foods that I am most scared of.
1144
01:14:09,403 --> 01:14:11,780
Since I've gotten into
the topic of the gut,
1145
01:14:11,780 --> 01:14:14,741
I have become much more relaxed, actually.
1146
01:14:15,534 --> 01:14:19,621
I feel like I know how resilient
and strong and stable this organ can be
1147
01:14:19,621 --> 01:14:21,582
if I treat it right most of the time.
1148
01:14:22,666 --> 01:14:25,419
It's really more about
just listening to your body
1149
01:14:25,419 --> 01:14:27,504
to create a smarter body feeling.
1150
01:14:27,504 --> 01:14:30,257
Throughout my career,
1151
01:14:30,257 --> 01:14:34,928
what's influenced me
more than competitive eating
1152
01:14:34,928 --> 01:14:36,805
is the hot dog.
1153
01:14:36,805 --> 01:14:42,060
Okay, we're adding avocado,
shiso, shiitake, and garlic.
1154
01:14:42,060 --> 01:14:44,396
Yeah! It's so good.
1155
01:14:44,396 --> 01:14:49,610
I want
to create a healthier hot dog
1156
01:14:49,610 --> 01:14:52,279
by combining it
with healthy Japanese ingredients.
1157
01:14:53,071 --> 01:14:54,698
Mmm! This is good.
1158
01:14:54,698 --> 01:14:56,033
Very delicious!
1159
01:14:56,033 --> 01:14:59,036
This is something new. Unstoppable.
1160
01:15:00,662 --> 01:15:03,582
You can eat something
and then see, how do I feel,
1161
01:15:03,582 --> 01:15:06,001
one and a half, two,
or two and a half hours later
1162
01:15:06,001 --> 01:15:07,920
when it's being taken up in my blood.
1163
01:15:09,463 --> 01:15:13,258
A piece of cake or fries, chips,
tastes great in the first second.
1164
01:15:13,258 --> 01:15:15,010
You'll be like, "Ah! More of these,"
1165
01:15:15,010 --> 01:15:19,181
but later on, you'll feel really tired,
or foggy, or whatever.
1166
01:15:20,682 --> 01:15:25,229
And a meal of, like, rice and vegetables
might not be as addictive,
1167
01:15:25,229 --> 01:15:27,231
but it'll make you feel more stable.
1168
01:15:27,231 --> 01:15:29,650
Or it might not with you. You can check.
1169
01:15:31,360 --> 01:15:33,820
It feels very validating
1170
01:15:33,820 --> 01:15:36,823
that I can allow myself
to enjoy food more.
1171
01:15:39,743 --> 01:15:43,997
The idea that I could have
a bowl with my husband
1172
01:15:43,997 --> 01:15:50,587
and not punish myself
by not eating the day after,
1173
01:15:51,547 --> 01:15:53,423
it would be nice.
1174
01:15:55,300 --> 01:15:57,427
Mom, good job on the corn.
1175
01:15:58,095 --> 01:16:01,390
We're gonna do a cheers
towards Mom's good cooking.
1176
01:16:01,390 --> 01:16:02,808
All right.
- Yes!
1177
01:16:03,850 --> 01:16:05,185
♪ I'm feeling myself ♪
1178
01:16:05,185 --> 01:16:06,603
♪ Never give up ♪
1179
01:16:07,229 --> 01:16:08,272
♪ Straight to the top... ♪
1180
01:16:13,819 --> 01:16:15,696
The only thing that matters
1181
01:16:15,696 --> 01:16:18,657
is how you feel,
what you think, what you do.
1182
01:16:18,657 --> 01:16:20,242
Nobody else matters.
1183
01:16:20,867 --> 01:16:24,496
And maybe my body being different
is the best thing for me.
1184
01:16:25,163 --> 01:16:26,248
♪ I'm flexin', I'm flexin' ♪
1185
01:16:27,416 --> 01:16:31,378
Your body is really the expert,
and you should listen to it.
1186
01:16:32,337 --> 01:16:35,841
Knowing more about the gut
made me feel more proud of it.
1187
01:16:35,841 --> 01:16:37,676
I guess I could even say
1188
01:16:37,676 --> 01:16:40,387
I have a feeling of loyalty
towards my gut,
1189
01:16:40,387 --> 01:16:43,974
and even my butthole.
1190
01:16:53,483 --> 01:16:56,028
Not everybody should talk
about their poop all the time,
1191
01:16:56,028 --> 01:16:57,904
especially if they don't feel like it.
1192
01:16:59,364 --> 01:17:01,450
But I think you should know
something about it.
1193
01:17:02,868 --> 01:17:06,955
There are, for example,
seven different consistencies of poop,
1194
01:17:06,955 --> 01:17:10,334
neatly described
in the Bristol Stool Scale.
1195
01:17:11,084 --> 01:17:13,837
Seven and six are a rather liquidy stool.
1196
01:17:13,837 --> 01:17:17,966
This can happen if digestion was disturbed
by something like an infection.
1197
01:17:18,967 --> 01:17:22,971
Four and three is what
you want to find in the toilet,
1198
01:17:22,971 --> 01:17:28,018
and is described as a sausage or snake,
smooth and soft.
1199
01:17:30,854 --> 01:17:33,774
And then we get
to the droppings of a goat,
1200
01:17:34,566 --> 01:17:36,735
and these are the areas of constipation.
1201
01:17:37,944 --> 01:17:42,824
So the consistency or shape
can be a very helpful solid information.
1202
01:17:42,824 --> 01:17:45,118
Like a little text message from your gut.
1203
01:17:45,118 --> 01:17:47,996
So you might as well sometimes
just turn around, check it out,
1204
01:17:47,996 --> 01:17:50,582
and then, you know, take the hint.