Prebiotics & Immunity, Mood, & Metabolism | Dr. Jason Hawrelak

Hello and welcome back to the Goodness Lover Show. Today we're joined by Dr. Jason Horolak, PhD and ND to talk about prebiotics and how they can influence immunity, your mood, your metabolism and so much more. This call was so insightful and I'm excited to share it with you. Let's dive in.

Doctor Jason Horolak, you are a guru, a well known person in the space that a lot of people refer to and you've got over 20 years of experience with the microbiome. So we've been actually waiting to have you on the show for a very long time. So it's very exciting for us. Welcome to the show.

Thank you. It's great, great to be here. I always love chatting about gut health with people who are passionate about health and gut health specifically.

Awesome, very humble. Well, we wanted to talk to you today about prebiotics and this is, I guess in the consumer world a little bit of a new thing. But to you guys that have been Studying this for 20 years, it's not so new. So for those that have just maybe heard of the term for the first time, can you just explain to us what, what is a prebiotic and how is it maybe different to a probiotic?

Yeah, because I think you're right that whilst there may have been tools that I've been reading about and using for, for 20 years in practice, but I still recall, I can go back to when I did my naturopathic training which finished in 1999. We did almost nothing on prebiotics as part of that. Yeah, we covered probiotics in a decent amount of detail as much as they were doing in those courses back then. But it's really when I started delving into for my, for my honours degree and then PhD, I was going, what are these things? Prebiotics? What's lactulose? Never heard of lactulose. They've never heard of, you know, fructoligosaccharides or galactooligosaccharides, which are three of the main sort of prebiotics that we use in clinical practice. So even for me at that point it was a major learning curve. You're like, I don't know what these things are you delve into. Oh, a prebiotic is a selectively fermented substance that encourages the growth of beneficial bacteria and a selected range of beneficial bacteria that has health enhancing effects on the host who consumes them. I think that's probably the clearest definition. So there's a few aspects of that. So Essentially they're not digested or absorbed. We eat them, they don't get broken down, they reach the colon. They're then fermented, but only selectively. So only a few species of bacteria have got the right machinery to break those down and they can ferment them and then their population goes up because they're getting a selective food source. And then we get flow on benefits from that because they're beneficial species essentially and we get more of their benefit byproducts as well. And because they can also through that fermentation process create these things called short chain fatty acids, we increase the amount of that and that lowers the ph in the colon, which is actually a good thing because most pathogenic bacteria are sensitive ph and like growing in a more neutral environment. So if we make it more acidic, we're actually discouraging the growth of pathogenic bacteria or even what we might call pathobiots, which are species that are problematic when in high amount, but they're okay when they're and the right amount and further encouraging the growth of beneficial bacteria, most of which like growing in a more civic environment. So we get that sort of general flow on effect from prebiotics. But I think the term is often misused as just being anything that's a fiber is a prebiotic. And that's not correct. I think fibers wide diversity of dietary fiber in your diet to be consumed in your diet is fantastic and helps create a wide diverse feed, a wide diversity of microbes in your ecosystem. But it's the selectivity of prebiotics that makes them different. So when we eat a prebiotic, like lactulose for example, we feed a limited number of species like Faecalobacterium, like Bifidobacteria Lactobacilli in higher amounts and Akkermansia for example. Those four are the ones that tend to go up pretty exclusively actually in the vast, vast majority of patients. And we also have a decrease in levels of species that are more problematic, more pro inflammatory, like Proteobacteria and bacteria steroids for example, with their consumption. Now differentiating that from probiotics, which is going back to your original question was probiotics are live bacteria that when consumed have health benefits on the host. So what prebiotics are doing is they're really encouraging your own indigenous population and your ecosystem to be healthier versus a probiotic is a supplementary live bacteria that is a temporary resident of your gut, but then has health consequences when it's consumed and for potentially duration afterwards. But Prebiotics are really encouraging your own individual unique microbes of your ecosystem, because I think sometimes we forget that your ecosystem is unique. Just like your fingerprints are unique, your ecosystem is. So your strains of bifidobacteria are different from other people's strains of bifidobacteria. And taking one in a supplement doesn't really can't necessarily replace your indigenous populations. And what I like about prebiotics is they are encouraging your own bifidobacteria strains to become more dominant in that ecosystem, your own Faecalobacterium strain to become more dominant.

Well, if you weren't convinced that Jason's the guru, I think in that first opening, your belief is there. The belief is there right now. So someone's like, okay, cool, I want to increase these and I want to support this population within my gut. What do I eat then? Like, how do I. Is there anything that I can do to actually impact, you know, by increasing prebiotic foods or whatever, certain activities? What, what? Tell us more about that.

Yeah, so prebiotics you can either do essentially as a supplement or as foods. And we're lucky that a lot of food stuffs that we have access to contain decent amounts of prebiotic compounds. And I look at what are technically referred to as inulin type fructans, which are also more commonly known as fructooligosaccharides or fos. And I might just use FOS because it's much easier to say from this point on, moving into the future. Now, phos comes in very high levels in onions and garlic and Jerusalem artichokes, which commonly called artichokes because of their content of phos. Yeah, because it's indigestible, it reaches the colon, feeds benefit bacteria, but they do increase gas. And that's probably the one, the main side effect that's consistent across prebiotics in general. The odd exceptions, some are a little bit more prone to causing gas than others, but in general, they all enhance gas production. Yeah, yeah. So we can eat more. Make sure we're having onions and garlic juice, artichokes, globe artichokes and. And certain food stuff that used to be part of our diet as, you know, people from a European background, but less so now. And that would be things like burdock root or dandelion root, you know, that used to be like, oh, it's springtime, we'll go harvest our dandelions. Or at autumn, moving into winter, we'll harvest our burdock roots, which are quite high In England, in fact. And same with dandelion roots and dandelion leaves. But because they taste bitter, you know, Western taste buds are like, oh, don't want to go through anything bitter, sadly, chicory root, you know, and even that chicory beverage that we have is actually quite high in Indian type for tens. And there are some more sort of lesser consumed foods like jicama roots and yacons, Peruvian ground apples that are also really high in England type fruit ants. And yacons grow really well. They even grow here in Tassie, but they grow even better as you move your way further north from Tasmania. And they grow these lovely big tubers that you just peel and you can just slice and they've got the amazing crispiness. But they're really, I think it's like 10 or 15% inland. So it's very easy to get a therapeutic dose. And jicama root is you often find in more Asian grocers because they're again, you can, you can grow them in warmer parts of Australia, but they're not commonly grown. But this lovely big tuber of a leguminous plant, which is somewhat unique but again really nice to sliced up raw because they've got that sweetness. Because inulin type fruit 10, they're quite sweet. Yeah. Now with things like dandelion, there's all these other bitter factors that kind of override that sweetness to make them slightly less pleasant for Western taste buds. But you know, it was something that we generally consumed a fair bit of. And the other probably category of foodstuffs that contain a good amount of prebiotic compounds are legumes. So legumes contain in general good amounts of galactooligosaccharides, slightly different than the fructooligosaccharides, which are made up of sort of branching fructose molecules and attached in a way that our digestive system can't get at them. And with galactoligosaccharides, it's galactose sugars that are kind of joined in a way that we can't break apart and again it reaches the colon feeds bifidobacteria and fellow bacteria, more specifically when it comes to galactosaccharides. But it's really late games. There's small amounts in, in, in beets, beetroot and small amounts in like sunflower seeds and pepitas and some broccoli cauliflower type family foods as well. But legumes are really the powerhouse, you know, and by eating, you know, a couple of legumes Per day you can actually get a therapy dose of those galactic saccharides in and, and I mean I've got a particular love of legumes because you're getting that lovely source of protein, you oligosaccharides, you're getting resistant starches, you're getting polyphenols if you're using black legumes or red, red skin legumes for example, and other soluble fibers. So really as a single food that can, can nurture the ecosystem in many different ways, it's hard to beat legumes.

Well, that is fantastic news because I do love my legumes all, all of them. I don't discriminate. So I think it would be awesome to talk a little bit more about, I guess, the benefits of feeding our bacteria via prebiotics. So you mentioned before the call that there's a strong connection to immunity which everyone obviously is more interested in at the moment. Could you tell us a little bit about how that works?

Yeah, and I think some of the research was done probably initially on probiotics and immunity initially and showing that, that, and there is good, good research that's flowed on from that in the last 15, 20 years showing that ingestion of probiotics, there's some strains that are more, probably more effective than others, but in general can, can up your non specific immune response, you know, protect you against getting respiratory tract infections and reduce their duration. I think there's like a Cochrane review and I think it was 2015 that found that I think there was a 47% reduction in respiratory tract infections for people taking probiotics daily and a 1.89 day reduction in symptoms. So that's nearly two days less when you're taking a probiotic. So that's pretty substantial. And the good thing about that kind of immunity is that that your body's, it's not like it only protects you against one or two different types of invading organisms. It ramps up that non specific immunity that's just ready to protect you against any kind of virus or any kind of bacteria that you're actually exposed to. So I think there's that research that came out first and it's certainly continue to build upon that. Which is why there's a number of studies looking at the potential of probiotics for Covid prevention and treatment, for example, most of which as far as I'm aware haven't actually come through with clinical trial results yet. But they're in the, in the offing. But then there was research on, on prebiotics and the first study I found was, was using looking at fructooligosaccharides and it was as a supplement and it was given to toddlers. And toddler age group is a fantastic group to study because they get sick a lot in toddler age kids particularly going to daycare. You know, and this is what the study population did. Like they get sick like 10 to 12 times a year versus an adult, it might be two to four, you know, so it's pretty, it's much easier to see sick that often. So even a 50% reduction is really noticeable. But going from 2 to 1 less noticeable in adults. So they often choose that population because it's much easier to see changes in. And there was about a 50% reduction in respiratory tract infections, giving 1 teaspoon of fals per day. And this stuff, it tastes like white sugar. It's like amazing. It tastes like cotton candy. Actually. It's really easy to give kids. You don't get compliance issues with 99.9% of kids or the occasional kids too sweet for their taste buds. But most we quite happy to take it. And I've had parents who, they're just blown away because, because their kid was going to daycare, getting sick every week, then their parent can't go to work because their kids are sick. And it has a huge impact on their life. And every time that it does get better, they get sick again. It's driving them mad. And they see them and they're like, okay, well let's just take this one thing. Not changing anything else in your diet, not doing anything else in your routine, just giving 1 teaspoon a day of foss and they come back months later going, it's miracle. I can't believe this white sugar had such an impact. That is not getting sick anymore. And when that study first came out, which I think was in the mid 2000s, it became like the mainstay of my immune practice, particularly for kids, but even for other age groups as well because it just worked so well and it still is. And I think there's another study looking at that kind of age group as well, showing again similar results of decreased fevers, decreased antibiotic usage, decreased I think like 90% reduction in lost daycare days. So they didn't miss many days of daycare versus kids in the placebo. So like a massive reduction and all the flow in effects to that is the parents can work, they can make money. All those other things that go with when your kid's sick, you know, never Mind just the fact that they're sick and it's mostly inconvenience when it comes to respiratory tract infection typically. Yeah, so. So you can see all those other flow on effects that come from that, you know. And so for me it's been a mainstay of my practice really since that time and it has maintained that way. And there are certainly with adults I'll use, you know, I'll use herbs like echinacea or andrographis and you know, tulsi, basil and guduchi for example to enhance immune response. But I still go back to using prebiotics as a core part of that. And with kids it's mostly, mostly just that because it's such an inexpensive effective option. You can give one tub of Foss you might buy for $12 and it does you for three months, you know. So it's very inexpensive, compliance wise, easy and effective.

Incredible. Man, I wish we had that. When we were in, in Bali we lived with two kids that were at daycare and just like I, we don't have children. So this was their first experience of the kids getting sick and they'd come home, one would have it, then one by one all the adults would like fall and then the kid would get better, back to daycare, get sick again and we'd all again. I've never been as sick in my entire life as that year we lived with those children.

I could imagine. Yes.

Yeah.

So is it just the fructooligosaccharides that have been linked to immune function or is it, are that more probiotics?

I would say that, yeah, I would say the fastest, probably the best research in the area. But there is some research on galactic oligosaccharides as a supplement as well. And I think the study I can think of was looking at older adults. I think there were 55 or above and they were looking at infection rates. They're looking at impacts on immunity and they found that by giving them a supplementation, I think it was five and a half grams of gas per day, there is an improvement in nonspecific immunity and a decrease in inflammatory markers body wide, which is also a benefit because I think when we're looking at again relevant for now, it seems to be like that hyper immune response that's involved with severe Covid versus mild Covid that has these very high inflammatory markers like things like interleukin 6 or tumor necrosis factor alpha. And the research on GOs in this age group was like they decrease those two parameters specifically, but enhancing non specific immunity, which should flow on to improved infection resilience as well. But I don't think the research has necessarily gone through to that that stage. So I still prefer using inland floss mostly, although I will still use gauss or a combination thereof. And then the other pre product that I really like is, is lactulose, which we can't get as a food source, unlike the other two you can take as supplements or as food. Lactulose is a semi synthetic version of lactose where they've essentially boiled lactose and it changes the configuration of the bond. So it's non digestible to everybody. Whereas lactose is arguably non digestible to 80% of the adult world's population, but is to some northern Europeans who have essentially a genetic defect that allows them to break down that lactose, whereas lactose is essentially indigestible to everybody. So reaches a colon again very selectively fermented. There's not so much immune data that I've seen around lactulose, so it's probably not the one I would use most in that area. I mean it should be helpful given it has a similar effect on the microbiota as inhuman phos. But without the clinical trials I will stick to using the ones that have got the higher quality data and keep using lactulus for the changes in the ecosystem that it induces because it's quite potent. Capacity to increase levels of beneficial bacteria and to decrease levels of pathogens in the gut. I'd argue even more so than GoS or Foss, but it doesn't have the data on immunity as of yet.

Very interesting, thank you.

I guess I'm just trying to get my head around this because it just seems so like full, like so bizarre to me that something that like a probiotic can have such a huge impact on the immune system. Is the mechanism behind this well understood? Is it something that's really emerged in recent years or it's something that we still don't fully understand?

I'd say that we, you might argue we don't fully understand. You know, there are postly mechanisms there and part of that is obviously to do with that shift. Probably the core aspect is that shift imbalance is that when we increase bifidobacteria, increase faecalobacterium, we tend and decrease levels of pathogens and pathobiomes. We alter how the microbiota interacts with the immune system. 85% or so of your immune cells are in your gut. So the capacity of microbes to interact with your gut, your broader immune system is actually quite substantial. And if we change the composition of that ecosystem that we're actually changing how that interaction plays out and we're taking away a core pro inflammatory driver, those Proteobacteria for example, which are a classic group of pro inflammatory bacteria in the gut, when their population goes down, that essentially takes away a lot of inflammatory stimulus that your body would otherwise have to deal with.

Interesting. So fascinating. And so outside of foods, is there any specific, has any studies been done on lifestyle factors, exercise or meditation? I don't know. Is there any sort of intriguing things that have seen that while we're on.

The topic of, while we're on the topic of immunity.

Of immunity and also just yeah, the positive impact on our microbes, you know, because people, I think people will be thinking I'll just need to take a supplement but they're not thinking about the, you know, that holistic picture of themselves. So I'd be interested to see what you've, you've discovered in that area.

Yeah, and I think you're right that and I'd rather people just take a prebiotic way than not. But I think it's better if you can do, you know, change your diet, you know. And I think again, if we're looking at a healthier microbiota composition, we're looking at diversity of microbes and how do we get the best, most diverse ecosystem we eat, Diversity of whole plant foods, diversity fibers, diversity of those color compounds and plants called polyphenols. That's really the best way of increasing the, the level of beneficial bacteria as well as the diversity of that ecosystem. You know, so I think that prominently plant based Mediterranean style diet is really key here for, for promoting the healthiest microbiotic composition possible and for balancing out that pro and pro inflammatory, anti inflammatory components the ecosystem. Because I think that's a good way of looking at the gut and certainly that's the way I do when I do a microbiota analysis. We're looking, okay, what species are pro inflammatory, which ones are anti inflammatory, which ones kind of go in the middle but can be, can be pro inflammatory if there's too much or can be anti, if they're in the right amount. So you're looking at that and how do we adjust that? And you know, yes, prebiotics are a component of that and in some patients who are more resistant to dietary change or have other disease processes going on that make dietary changes really tricky because of symptom flares or something that we might, you know, work with prebiotics, you know, more gently to start with, et cetera. But the whole aim there is and I think an ideal situation. Yes, we want to work on that diversity of the diet, more whole foods, avoiding processed foods altogether. You know, lots of nuts, seeds, fruit, veg, legumes, you know, whole grains I think are key. Even though they're often demonized in some parts of the blogosphere at the moment, like fruits and legumes and whole grains for example, I think are often demonized in certain circles. But from microbiota perspective, legumes and whole grains are actually really good for microbiot composition fruit fantastic for, for, for gut health as well, you know. And yes, while isolated fructose is problematic from a blood sugar perspective and microbiota perspective, fruit containing an equal amount of fructose is not and actually encourages the growth of beneficial bacteria. So sometimes we get really reductions. Oh, fructose bad, therefore fruit is bad. Like no, no, it's not like that. Yeah, so I think it's really trying to get around some of that mythology that's out there around those foods and encourage our patients to eat those things again. And yes, sometimes people have issues with gluten. Fair enough. And there's a certain proportion that definitely do. So you may be gluten free, whole grains are the go, or a decent proportion of people, for example. Yeah, and I think there is research looking at that Mediterranean style diets being protective against depression and range of cancers and cardiovascular disease and even I think, you know, a range of autoimmune diseases as well. So I think that is kind of like a core strategy that's protective from a whole range of different things to do. And yes, I think there's good data around in modern exercise helping improve immunity, you know, and this is an area that I've spent too much time going, going into just trying to keep up with microbiota, prebiotic, probiotic research is enough to fill my every single minute of every single day. But there is good research on like, you know, exercising moderately reduces your risk of developing Covid and severe Covid for example, eating Mediterranean diet protects yourself from developing Covid based on the data that we have, you know, and people aren't talking about those, those other factors sadly as much as what they should be at the moment. Other things you can do to keep yourself healthy and your immune system working well and other things like vitamin D status and zinc status are other things which a little bit outside the question, but I think that need to be considered. We're looking at optimal, optimal immunity, you know, because many of us are stuck inside all the time. Some like me live very far from the equator. So we can't make vitamin D for six months of the year and if we're lucky enough to escape like I did up to North Queensland and soak it up for a month and I could store up enough to get me through the winter, hopefully spring like now I can get out there and get some sun again and make some vitamin D. Yeah.

Awesome.

Great tips.

Thank you. So I can just, I can just imagine like someone's getting excited about prebiotics but they're, they're like fructo what they're trying to write it all down. But is there any tips I guess as to how someone would actually purchase some of this if they've never even heard these words like where do I find this? Like how do I purchase. I guess if they're going down the supplement route to start off with.

Yeah, it's a good point and I think because they're not widely discussed and there's not even that many products around them comparatively like you look at the ranch of probiotics that are out there, huge and ever growing prebiotics, they're growing slowly but the amount of space they take up on a typical pharmacy or health food shop would be pretty minor. Pharmacies don't have them at all I would say and the occasional and healthy trials might have inulin foss like a good naturopathic dispensary will have a whole range of from lactulose to fructooligosaccharides to galact oligosaccharides to partially hydrolyzed guar gum are probably the key pre products that I would use in practice and have a good research base around them. Like our natural dispenser here in Hobart has a wide range of two different types of galactoligosaccharides and a couple different types of lactulose and different size containers etc. You know we're pretty fine tuned in that way. And there's even different types of phosph from short chain to long long chain to short chain to in between combinations that are more nuanced usage that again we've got the whole range but that would be more rare. So you might have to ask your health food shop to you know, especially order it in or you look online for, you know I know there's suppliers like more life up in southeast Queensland that will sell kilogram bags of fragosaccharides for example, as ways of getting it, you know, so that's certainly a possibility as well. And I mean, the only caveat there, as I mentioned before, is just the gas factor. So just beware. And my general rule with prebiotics is start low and go slow. Yeah, yeah. So, so maybe the therapy dose is one teaspoon. Well, start off with half a teaspoon a day for the first week and then if it seems good, then go to the full teaspoon a day for that, that point onwards. And you do, there is a dose response. You get better shifts in ecosystem composition with higher doses in general with prebiotics, but you don't generally want to start with higher doses because you're going to get a lot more gasolated symptoms. But you start low, your body tends to adapt, you know, so yes, your flattest level will go up for the first week and then it tends to peak and go back down. Then you can go up to a higher dose, it'll peak a bit and then it'll go back down with that. So I think that just keep in mind, go, start low, go slow. So some people start with a quarter teaspoon and it's like, yeah, it's fine. Whereas others can easily start with a teaspoon without any issue at all. Maybe a slight increase in flattest. But if you do have issues with bloating or distension or pain or cramping with them, then it really means there's something wrong with your gut and you should get that sorted is what I would suggest. It doesn't mean there's something wrong with those things. It means that there's something imbalanced in your gut that's not allowing your body to deal with the gas that's being produced properly. And that can be things like sibo, small intestinal bacterial overgrowth. It can be constipation, slow transit time, and it can be visceral hypersensitivity, where your guts, the nerves in your gut are hypersensitive. So even a small amount of gas causes pain and if you increase that gas production, they're like, oh, I feel horrible pain from that. And yeah, you can blame that or you can blame legumes from a dietary perspective, but why are you getting symptoms from that when you should just be farting more? Really? That's what's supposed to happen when we have these sort of gas forming oligosaccharides is just let out more flatness, particularly when we're first getting used to it. So I Think it really means you should see a practitioner and delve into why you're getting those symptoms because it does flag that there's something wrong with your gut. It's not behaving the way that it's supposed to. Now I should flag too. There's an increase in flattest, but it's usually less smelly. So yeah, that's a good takeaway, that's a good thing.

I can just imagine all the conversations, people going to health food shops going, I need to get some, I'll come back. Right. I'll get the notes from the goodness level podcast.

They're just pulling up the podcast again, trying to write it down. I need to get this. Can you listen?

Awesome. Thank you. So before the show you also mentioned some really exciting research around movies mood and I'm very interested in that. So I would love to pick your brain on why prebiotics are important for mood.

Yeah, I think it is a very exciting area, you know, and I think it, it again goes back to when we're starting to look at the gut microbiota having far reaching tendrils outside the gut into other areas like the nervous system and how your brain functions. Yeah, and you would have said that 15 years ago, people would have gone, nah, you're crazy. There's not that connection there. But then you get research like I think there's a 2016 paper where they took fecal matter from depressed people, gave it to rats and those rats become depressed. And it's just like pretty mind blowing that we can actually shift that. And there's even isolated case reports of fecal microbial transplants to treat something like C. Diff. They got a fecal transplant from someone who was obese and then that person becomes obese despite no change in diet, no change in lifestyle, no change in exercise. You know, that, that backs up that kind of animal research. So you know, there's, there's data around the importance of changing the microbiota and the repercussions of that. But yeah, looking at that, at the gut stuff or the brain's brain guts connection is probably more recent around that. And that kind of model showing that, okay, we changed the microbe, we changed the brain, has really led to an expansion of research around probiotics for mood and prebiotics for mood as well. And looking at the microbiotic composition of, of depressed anxious people versus healthy controls. And there's certainly still early days in the data collection here because as I mentioned before, everyone's ecosystem is so unique that when you have A study with just 30 people in it, it's really hard to see patterns because everyone's ecosystem is so different to begin with. It's only when you start including hundreds or even thousands of patients that you start really seeing patterns with specific disease states more clearly. It's like we're early days, we're seeing things build up. But some research has certainly shown higher levels of proteobacteria, which is that pro inflammatory group of bacteria that I mentioned before in people who are depressed and anxious. And that's important because proteobacteria just, they grow something called endotoxin. Just like we grow hair, we grow nails, they grow endotoxin. And they're not doing it to make us unwell specifically, but it does, they release that because they're constantly breeding up and dying. And when they die, they kind of release that endotoxin. And about 80% of their cell wall is endotoxin and that gets absorbed and that actually changes the inflammatory media in the entire body. Your whole inflammatory level goes up a notch with more, more endotoxin in your system, the more your inflation goes up. Endotoxine, endotoxin damage your blood brain barrier and they even change the neurotransmitters your brain produces because it causes neuroinflammation. Yeah, like it's pretty amazing stuff. Like there's some fantastic research where they took happy, healthy people, gave them a dose of endotoxin, and for four or five hours afterwards they are anxious and depressed. This acute response, people who were happy and healthy before that, and yet we've got people due to dietary choices and potentially lifestyle factors as well, have this chronic absorption of endotoxins happening 24 hours a day and then higher amounts after certain meals, for example, and that floods their system or after even alcohol use too. You get a flood of endotoxins hitting your, your, your whole body and your, your brain after that. And that changes, you know, your mood and it causes that inflamed low level systemic inflammation. Your body is constantly at this kind of low level inflation which we now see as a core component of obesity and type 2 diabetes and metabolic syndrome. You know, the same things we see as risk factors for Covid too, for that matter. It's this sort of low grade chronic inflammation is kind of there body wide. But yes, the endotoxemia is what it's referred to. And the low grade endotoxemia is called metabolic endotoxemia is immensely common in people eating western diet, which again is correlated with high rates of depression Anxiety compared to a whole food Mediterranean style diet that protects you against developing depression anxiety. So there's a lot of data around that. Plus there's research on prebiotics for decreasing immune response and not immune response, sorry, stress response, so that it will decrease that morning cortisol for example, when we take black oligosaccharides daily. Glycoligosaccharides have also been shown to decrease anxiety as well when taking larger amounts around the 5 to 6 grams per day Mark decreases anxiety scores in patients too. So there's hard clinical trial data, there's good data around changing the ecosystem to reduce levels of pro inflammatory species, increased levels of gut healing body wide anti inflammatory species too because I think we have to remember that, and I linked this before around the composition of the ecosystem really determines whether you're getting an inflammatory driver from your gut ecosystem or anti inflammatory drivers. And we take prebiotics where we shift that balance. We're getting more of the anti inflammatory drivers from species like Bifidobacteria, species like the Callobacterium. And that pans out in essentially a less potent stress response to an external stressor. And it pans out in terms of potentially changing our neurotransmitters as well because we're taking away those, those stress or those systemic inflammation inflammatory compounds like the endotoxins, which we know actually can change the way that tryptophan gets shunted in your brain so it doesn't go into becoming serotonin, it gets shunted down to another pathway called kynurean pathway which doesn't make the happy compound serotonin.

Wow.

Yeah, wow. Fascinating, fascinating stuff. I feel like you've dropped so many bombs in that that I just want to keep like where can we go? There's so many interesting things, man.

So much like pumpkin seeds. I'm eating every day and I think I'm getting with tryptophan and then.

But if you're inflamed, it's not going to become serotonin.

Yeah.

But yes, very interesting stuff. Thank you for sharing. I guess I would like to know, as you are the expert, the key expert in all this stuff, what does your prebiotic routine look like personally?

Yeah, for me a lot of I try to do as much as I can through diet. So I, I eat Mediterranean style, probably plant based. Lots of legumes, lots of whole grains, lots of fruits, you know, and, and some are even more fruit. I quite like the summer bounty that that comes with that. But in terms of prebiotic so you know, I'm trying to get a lot of, of of microbiome nurturing stuff through my diet when I can. Lots of onions and garlic on a daily basis and when I can get things like yacon or jicama roots, then I will get those or grow those. Sadly I lost my yakon tubers to my garden so I'm a bit sad about that. But soon though they'll be. I've got some growing to harvest in the future so it's okay. You get there and then it would be. I would take a teaspoon of inulin phos or probably two teaspoons a day and then partially hydrolyzed guar gum is probably the other prebiotic that with part of my regular routine because of its capacity to nurture beatrite producing species. But I'm trying to do a lot of that through diet anyway. So that's legumes and that's resistant starches. So I might make a mixture of red rice, brown rice and black rice for dinner for example. I'll let it cool then have that as a rice salad that day or the next day. We know in that cooling process we actually increase the amount of resistant starch and resistant starch is resistant to our digestive processes and feeds those beta ray producing species in our gut quite selectively. You cooked and cooled pasta does the same. So you know, have some beautiful gluten free pasta again eat that the next day when it's cold roasted root vegetables. Again I'll eat a lot of stuff the next day cold. So I do eat something eaten through too. But I like, like trying to optimize the microbiome modifying potential of my diet when I can. But the phdg is a bit of a, you know, just extra coverage to make sure those B rate producers are being well nurtured. But inulin phos I think is really one of the or lactulose has been in and out of my regime over times but at the moment I'm into inulin phos just for that, that daily dose because of the immune aspect to it, you know. So I've got kids who do bring home illnesses than what I'd like, you know and that tends to shorten their duration of it getting it too and minimizes the infection rates they get. But then it helps protect me too because I don't like getting sick because it means I can't do the things I need to do, which is frustrating. Yeah, yeah.

Oh, I really like that I, I like that your dietary optimizations because it's just like, okay, we know that, you know, like whole, whole, like brown rice would be good for your microbiome. How about instead of just having one type, have three different, like black, red, brown. And then on top of that, how about we have it cold? So it's just like these optimizations without making it too difficult. So that's great.

It's not that much work to have three types of rice rather than one. Same amount of work required to make it. And letting it cool is pretty easy. You just have to be more prepped for it, then let it cool down and then, you know, adjust your taste buds a bit too. Choice. Sort of a cool rice dish rather than a hot rice dish. Yeah.

Yeah. Great.

Interesting.

I remember talking to csiro, one of the people on that panel that did all that microbiome research, and they were just talking about this, this whole how food today is just so, well, you know, cooked and prepared, but it's really just lacking that ability to reach our colon like our friends in that colon. So it's just so fascinating. Hey, is there any other aspects of you wouldn't want to be eating things like constantly raw or like stale bread all the time bread? Like, that's basically. That was commonplace not that long ago, but now we just don't eat like that anymore and it's having a huge impact. So is there any other aspects, a little secret cold versions of food that you, you use?

Yeah, I think I've covered probably the most of them. The other one I'd tag on that would be oats, though, in that if you do so doats versus cooked oats, like if you just soak your oats overnight and eat them the next morning, it's much higher in resistant starch. But when you cook the porridge, the oats, they kind of split open that cellulose protective pocket and you don't get nearly as much resistant starch from it. And even from a blood sugar regulation perspective, like, soaked out is so much better for regulating blood sugar. And that if I, if I have porridge, for example, like two hours later, I'm shaky from. Which is weird because I don't get any other food, just porridge. But soaked oats, I totally do not. And I could go for like five or six hours on. On the same amount of oats that were soaked instead of cooked. And that just is demonstrating the difference between having more of that starch is resistant versus the starch is easily accessible to us. The human cells of ours just grabs it and soaks it up really Quickly, and the blood sugar kind of drops down more quickly. So I think that's the other thing that's simple for people to do. And they can even warm it up. If they're really not keen to having cool oats, they can warm it up to around body temperature, and that will split open those oats in the same way as a high cooking process will.

Right.

That is so fascinating.

Sorry, I was kind of laughing at Matt's face because he is like, like, really into what you're saying now.

He's like, I mean, all that blood sugar because.

And we have, like, oats most days, so we're like, if there's room to optimize them, then we'll do that. That's great.

Yeah.

Yeah. That's like, whoa.

Whoa.

You should try and see what impact it has. Like, for me, it was a pretty. Like, I could distinctly notice a difference between cooked oats and soaked oats. And I won't go near cooked oats now because the after effects on my blood sugar are so, so poor. And listen, I don't get that from. If I have a bit of organic sourdough bread or something like that whole grain stuff, my blood sugar is totally fine. But something about that cooked oats, that really is not good for me. And I've had another patients in some of the boats, but soaked oats, totally fine.

Interesting.

So connecting it with mood, though. I mean, like, now that we're on this blood sugar regulation thing, that's a huge impact on mental health that people probably don't realize. Can you explain more about that in terms of the microbiome, like, what's happening, like, you know, in our guts when we have something that can spike up blood sugar like that?

Well, I would say there's probably a lack of data around what's happening with the microbiota. I'd say in that. In that situation, and even looking at the impact of things like sugar that's been widely demonized as being bad for the gut, there hasn't been nearly as many studies on that as you'd expect based on the amount of people discussing it. I'm not suggesting we eat altar sugar, by the way. I'm just saying from a research perspective, there's more dam. More research on high protein diets causing harm to the microbiota or ketogenic diets causing harm to the microbiota than there is on high sugar diets. And up until recently, there wasn't much stuff out there. Now that's beginning to grow and. And the microbiota research has always argued the issue with the high, the processed sugary stuff is that nothing reaches the colon. So everything's absorbed in the small intestine, leaving nothing. So you don't feed any of the good guys. You just. And the bugs are like, oh, what do I eat? I'll eat a bit of. You eat away your protective gut lining instead because they're not being fed, you know, and they might get bits of protein that have escaped digestion and they might get, you know, bits of bile to consume. The composition is poor as a result of what's not being fed rather than what is being fed. But there is some more research that's coming out on starting to put on, on higher fructose on its own, you know, and higher sucrose type diets when impact that might have. But it's still minimal compared to where you'd imagine it'd be when you read people's in the blogosphere around it.

Yeah.

And I mean I'll just flow on because it just seems like the right time. But there's some pretty cool research that's looked at legumes and blood sugar regulation and they've done these studies where they compared eating a big steak for breakfast and eating a bowl of legumes for breakfast and said okay, what's the short term blood sugar response versus what's the long term blood sugar response? All of it was better with legumes. It was better in the short term even though it had carbs in it versus not. But for the next 24 hours their blood sugar was much better controlled than the people that had, you know, just a chunk of meat for, for breakfast. And, and that will blow some people's minds because I totally fix it on carbs and protein being the only thing that matters. But there's fiber and resistant starches. They matter. Yeah. And when we're eating something like legumes, they're high in those things and they're feeding butyrate producing species of bacteria in your gut. And butyrate has this amazing effect on blood sugar regulation that it actually enhances insulin sensitivity sensitivity and you might and it really does impact how your blood sugar system, your metal system works. Butyrate, it's a fantastic substance. And that's where I think the, the missing piece in the puzzle. When we're just looking at macronutrients only and not consider just like protein or carb content versus you've got to look at the microbiota interaction with this too. Just like I've seen. I remember Having a patient who was seeing an integrative general practitioner and they were prescribed a ketotype diet was just, there's tons of duck lard and meat for. I can't remember what the reason was, but this Guy developed type 2 diabetes as a consequence and his, never mind his blood, you know, fats of cholesterol and triglycerides went through the roof. But his blood sugar went totally off board. And people like, whoa, he's not eating carbs. No, but he's eating things that are actually. He's taking. You're taking. By eating that diet, you're taking away food for your butyrate producing species in your gut and they go down. You're taking away be food for bifidobacteria and fecalobacterium. So all those sort of benefit of bacteria go down, but you're also increasing levels of species that actually end up thriving on that kind of diet. The ones that putrefy protein, the ones that eat bile, and those ones cause worsening gut leakiness, but they also release more endotoxin into the gut which we know actually is a core driver of blood sugar dysregulation. Is endotoxins core driver of making your insulin not so, not very effective and decreasing that disinflammatory tone body wide which again flows on to making your, your blood sugar more dysregulated. You know, never mind the fact that that kind of high saturated fat diet actually saturated fat binds these endotoxins and increases their absorption into your, your bloodstream. It's crazy. You know, so you're getting that, you know, negative alterations to the gut ecosystem. Plus you're increasing the absorption of the endotoxins which are there in greater amount because of what you're feeding your gut. And you're taking away the populations of bacteria that, whose job is to heal your gut when it's damaged. Yeah, and it's a very bad combination in this case resulted in, you know, type deal and type 2 diabetes and you know, major blood lipid abnormalities which did improve when he went on to, you know, include plants into the diet. Once again.

Just a little casual detour down there and our minds are blown. Once again, super, super cool stuff.

So good.

I know time is, you know, where we could talk for hours with you.

But I'm just wondering, just mining your.

Mind, is there one, one other area that you would like to take us down just briefly before we finish up?

You know, I, I think the, the impact of, of microbiome modification and asd so kids on the spectrum, autistic spectrum disorder kids, I think just because you can see such dramatic changes with it and you can't guarantee it and you can't necessarily see it in 100 of patients, but you, you can just see some dramatic impacts on cognition connection, your speech, where you had paid, you know, sometimes you can work, do a microbiota assessment, see what the ecosystem looks like, okay, Take these prebiotics, make these sort of dietary changes and like a week later the kids tells her mom they love them for the first time ever and starts verbally talking for the first time and has eye contact. It's just like, it's mind blowing because you never would have guessed that such a substantial shift could occur from altering the microbiota. Even me, who's got like 20 years of loving the gut microbiota has been incorporated our research. I was not expecting to see such dramatic shifts in that, in that sort of time frame. It's not always that quickly or that dramatic, but it can be. And I think it's just making people keen to let people know that microbiota modification should be a consideration with kids on the spectrum because there is the capacity for things to shift dramatically or even more minorly in terms of just more slower steps moving forward versus some kids with giant leaps. And there's some fascinating research looking at Fecal microbial transplants, FMTs in this population too, with long standing gains. Again, on a personal level, when you're working with patients, it's something some kids have made giant leaps in cognition and can read and communicate in ways that they couldn't even just a week before their fecal transplant. Which is a much more, I would say, interventionist and a bigger gun that I'd prefer working on microbiota optimization through diet and prebiotics and things first before discussing FMT type options. But it just adds to that body evidence showing how important the microbiota is and how it can actually really alter how the brain functions and your level of inflammation body wide. And I think those are key. You look at the chronic diseases we see in Westerners, they're all associated with this systemic low grade chronic inflammation. From, you know, you'd argue cancers to cardiovascular diseases, to, you know, depression, anxiety, multiple sclerosis, Parkinson's, you know, all these things all linked with this and you think, okay, well the microbiome has got such a capacity to alter this and to be used as a essentially treatment for systemic low grade inflammation by nurturing the right group of bacteria and kind of suppressing the growth of those that are contributing to that inflammation.

Wow. So much we could talk about there, but I think that's, I think that's a, I think it can help a lot of people and I know many of us would be listening to this going, oh, I hope someone could listen to this because obviously, yeah, autism is such a challenging thing for many people to deal with currently and it's huge. Like, it's, it's staggering the statistics that are coming out at the moment. So thank you so much for sharing that. So, wow, it's been such an incredible interview.

I loved it.

It's been well worth the wait to get you on Jason, to the show and yeah, we really appreciate you do. And thank you so much as well for being part of our upcoming Gut Immune System, Gut Immune Solution series. Like, you've made incredible contribution there as well. So watch this space if you're wondering what that is. And so if people want to learn.

More about you, more education, where should they go?

They want more mind blowing information, more.

Dr. Horalac in their life.

Cool.

Yeah.

I've got a website called Probiotic Advisor and we have a range of courses on there that are designed to essentially enhance people's knowledge of gut health and to treat gut conditions and gut microbiota. For me, that's my passionate education around gut health and gut microbiota. So I put a lot of courses up to help people make informed decisions, both practitioners and the general public, to navigate that area. Because I think, sadly there's a lot of great information out there online, but there's some rubbish information out there too, and it can be really challenging to navigate safely. Actually, in terms of there's lots of patients that end up being harmed by following bad advice around how to fix up your gut microbiota or these really restricted diets that actually end up causing them harm. The symptoms get worse over time, which is sad. So I've got a passion to try to prevent that from occurring as early as possible by putting information resources out there, including doing podcasts like this, because this gets a chance to reach people and actually change lives, which I think is absolutely fantastic. So thank you for doing such things too.

Well, definitely check out that resource. And it's not often, you know, we interview a lot of people obviously, but you've got this naturopathic, you know, naturopathic doctor combined with the science PhD, PhD in this, in this topic. So that combination you can really tell and how you've obviously expressed yourself so clearly and eloquently and with good you know, really good research behind you. So that is such a unique combination. And yeah, we really appreciate that. Yeah.

And I do want to encourage everyone to. That's listening to check out probiotic advisor.com There's a. Of course, as Dr. Horlath mentioned, there's a bunch of courses on there. I have a few of them and they're just really dense, well researched presentations and you can tell that every, every line, every sentence, every slide in the slideshow is just so well researched, you know that years and years, decades of experience have gone into it and years of reading journals have gone into every sentence. So you know that it's good quality stuff and it's good, well worth your time. Plus there's a database of probiotics, so you can go in and check out what's this strain of probiotic and what is the science, what evidence is there for its usage, so you can find out which is best for each scenario. And I guess if the marketing of something you've read is like actually accurate or not. So fantastic resources. So check it out probiotic advisor.com and no, I was not paid to make.

This is not a sponsored post.

This is not a sponsored post.

Sponsored by Jason Horror.

It sounded like it did.

I'm like, wow, I'm being really like, gushy, but it's good.

I. Are you reading like his transcript before the call? Thank you.

Good stuff.

Good stuff.

Yeah. Awesome. Well, thank you so much. We can't obviously wait to hopefully having you on again at some point in the future. And thank you so much for the work you do.

You're very welcome. I'm glad to be here to share.

Did you enjoy that one?

I did.

Did you tell I was a bit fangirling at the end there?

Yeah. It was cool though. It was like you were really off a script for his.

Well, generally. Anyway, I don't need to say it again, but I do think it's a great resource. Check it out.

He came highly recommended when we first filmed the Gut Solution and we're really lucky to have him for that. And yeah, it's just super cool to just dive into someone's mind that's done this for 20 years.

Yeah.

And not only are they doing it in a clinical setting, they're also doing it in a research setting. So it's such a unique combination and he brings so much to the table. So definitely check out his site and if you enjoyed the podcast, leave us a comment below. That would be great. And as well, if you want to help support free content like this. Give us a like and a subscribe. And if you're an auditory person, only if you're not on YouTube, listening, watching right now, then please leave us a review that really helps grow us. If you're on itunes or wherever your podcast provider is, leave us a review that would be amazing. Anyway, we will see you very soon.

Thanks for joining us.