Transform Your Health Through Boosting Your Second Brain with Dr Jason Hawrelak

Fecal transplant studies are cool because they can show these really quick changes. But we don't need fecal transplants to change the microbiome. You know, getting in nature, eating the right food for medicines. I use lots of prebiotics to help speed that process along too. There's so much we can do that we don't need to be of a fecal transplant.

Hey everyone, before we get into this week's podcast, we got a pretty cool announcement to make. You are now able to connect with us. We have a pretty cool little widget that's on the website. Just go to PaulTaylor Biz podcast and near the top of the page you'll see a little icon that says send a message to the Paul Taylor podcast. So what we can do with that, you just click on that and then you send us an audio message and we will get the audio message. Now the first thing I want to do with using it is actually do an ask me anything episode. So all you got to do, if you got a question that you want me to cover is just go to PaulTaylor Biz podcast, hit on, start the recording and then send us a message about what you would like me to talk about in the ask me anything and leave your name. We will call it out on the show. I'll get that all put together. And the other thing you could do is just leave us a message about what you like about the podcast, what you don't like about the podcast, I talk too much, all of that sort of stuff and just give us some feedback and we will use that to continuously improve. So looking forward to hearing from you. Now on with the podcast. Jason Horvillak. Hopefully I didn't murder your surname there.

Welcome to the podcast. Hey, thank you. No, no, it was good.

So we both presented. You wouldn't have seen me present because you were in Italy and you did a virtual but present at the acronym conference. And I've, I've seen you bunching around a whole heap of different conferences. You're. You trained clinicians mostly around the whole gut microbiome. But just give our listeners a sense of your background and how you really got into the microbiome and what you do right now.

Yeah, okay. No, thank you. I studied naturopathic medicine, naturopathy in Australia. Started in 96, finished in 99. And one of the last terms of my four year undergrad course, there was a lecture given by my, one of my professors on dysbiosis and how dysbiosis was causing chronic Disease this was back in 1999. Just to give some context around this because this has been discussed in naturopathic circles for a long time time. Even though we didn't necessarily have the same science as we do now and the same understanding, but there's a certainly understanding of altered microbiome causing disease that's been been part of naturopathic philosophy from God. There's some writers talking about in the early 1900s, again giving some context on that. So it's long been part of naturopathic thinking, just that now with a boom in science, we can just see all these different interactions and, and see what microbes are doing what that we could not see in the past. Anyway, this lecture was totally inspiring to me. So I went up to him right afterwards, said hey, you know, I just waited to finish and I was like, can I do my honors degree in this, in this area of dysbiosis? And then we got together and we did and we tried to pick a disease that was at that point in time shown to have a dysbiotic element and that was irritable bowel syndrome. You know, if you look at the diseases that Even in the 90s we knew altered microbiome composition were causative or definitely, you know, played a key role in IBS was like the poster child at that point. There's also, you know, inflammatory bowel disease and a couple others.

But C. Difficile.

That's right, yeah, that was another option. But we chose IBS because it really was not being handled very well by convention medicine. And I'd argue still isn't. And we're like, okay, well let's focus on that. So I did my honors degree looking at how probiotics and prebiotics and herbs would modify the microbiome in patients with IBS. And then we followed up with my PhD after that point. So, you know, I've been spending, this is now nearly 25 years since I started my, my sort of honors thesis literature review was back in probably December of 2009, sorry, 1999, delving into the microbiome and how we could, we could alter the composition of the microbiome with dietary changes through prebiotics, herbal medicines, and then also probiotics. And since then I did my PhD in that area. I've been teaching. Now I focus on teaching other clinicians to become, what we call, you know, microbiome clinicians or micro literate clinicians because it's still an area that is barely touched on in training of conventional health professionals. But Even in, I'd say naturopaths like it makes up a much more bigger percentage. But it's still, by the time when people graduate, they're still lacking a lot of details of how to actually implement this in practice, how to interpret stool tests, et cetera, how to make changes based on a microbiome analysis, for example, or even people from a dietetic background, nutrition background, et cetera. Same missing that kind of data. So I'm really trying to upskill conditions to move into that space and move into I suppose the new understanding of the human body where the microbes are key elements. We can't just ignore like we used to in the 1990s and before that. You know, you look back at that time and even then called it the microflora back then, but the Microflora researchers were like saying this is important, these microbes are important. We can't just keep ignoring their existence or keep taking a course, antibiotics and not thinking it has some long term consequence. But it's just been amazing to see again over the last 25 years how that has blown up so, so dramatically, you know, and that, that there's many people out there who are now aware of the microbiome and its importance, who, you know, this was not a talking point besides in small circles, you know, 20 some years ago. So during that time I still saw patients and I still see patients now because for me, and I've, I've talked to universities, I was at University of Tasmania for a decade in their evidence based medicine course. Now I teach at University of Western States, Naturopathic gastroenterology kind of units in their master's degree there. And I have research and I've had recently PhD students working under me too. So it's been that to me, that lovely combination of academia, education and patients and I think they feed into each other really well because when I'm reading up to prepare for a new lecture, I'm keeping up to date with all the new research that's been done. Then I can trial that out on my patients to go, does this actually work in real life or what dose, what modifications we have to do then I can teach that to clinicians so they can obscure them and get better results with their patients too. So I think it's been a great circle in that way.

It's interesting, isn't it? Because when you look at what the evidence says is that new research often takes about a decade or more to get into frontline medicine. Why is there such, have you any idea about why There is such a.

Delay in that preconceived biases, the lack of curiosity amongst many, I mean I would say clinicians like I find this is a sad state and not necessarily in my field but in other, other fields where clinicians might be, we might be co managing a patient with you know, a ulcerative colitis or something let's say or Crohn's disease that have been like not totally non responsive to conventional medicines. They work with me, we work on diet and work on microbiome modification and we get Crohn's disease in remission. And the physician to me would be like what the hell have you done? We've tried all these drugs for years, nothing's worked. You've done something but that's not been the typical response. It's like ah, okay great, move on. And they've got no interest in knowing why what they've done differently that that's created this positive change. And I've seen that quite commonly in the clinical field in terms of taking on the lack of desire to take on new information or keep learning. And you know we have having four standards for this and in the health professionals to, to help ensure that happens to a certain degree. But you can kind of pick and choose that as well. You know, if you have no nutrition interest or no nutrition microbiome you're not going to go to any CPE events that, that train you up in those areas. You'll just stick in your kind of lane. But even in academia I think it's it, it can be give the example of, you know, I worked at University of Tasmania for 10 years and you know, my PhD was in you know, area probiotics and microbiome alteration. And you know, there was so little of that in the sort of pharmacy course there. Like I had my own sort of, you know, evidence based compute medicine program which was a postgrad course that we had a different kind of student base. But for me it was like I just felt like a very underutilized resource that I should be here expounding the wonders of microbiome science to the generation, every generation of pharmacy students and how we should be using probiotics in practice and the evidence based of probiotics, et cetera. But you know, we only had a couple hours at, for your student to actually get any of that information in, you know and I think that that's not uncommon.

That becomes the major issue, isn't it? And I mean there's a certain amount I find as a bystander who goes to lots of different conferences. I talk at conferences. There is a bit of a looking down the nose from traditional medicine at naturopathic Medicine.

Yeah.

And thinking it's woo woo stuff and. But there is, as you taught an evidence based complem medicine course at a university. Right. And for me it's like if you've got anything that is originating in the gut and we'll explore the huge amount of diseases and both physical and mental that have origins or at least contributing factors from the gut, why would you go to a GP who gets no nutritional training or maybe two weeks at best and gets no training on the microbiome whatsoever and you know, are not incentivized to do ongoing learning for this. I mean, I mean there are a bunch of doctors who do. The ones who are at the actum conference. You know, there's a whole bunch of doctors there when we were there. But your traditional GP or the traditional medical system is really not well equipped for diseases that have a gastrointestinal origin of which we are seeing more and more right now. I think my eyes got opened to this area big time. It would have been a decade or maybe a little bit more ago. I saw Professor Thomas Barodi, who you will be very aware of, runs the center for Digestive Diseases in Sydney.

Yeah. And like worldwide trendsetter in fecal microbial transplant research.

Yeah. So just tell our listeners actually that you can tell that story about what the kind of early fecal transplant stuff was showing for things like C. Difficile and other stuff. Just give our listeners a bit of a sense of that.

Yeah, I mean my. Probably our take on that will be obviously nowhere near as detailed as someone like Dr. Bordy who's like the driver of that. But I do think that, you know, we have a condition C. Difficile or clostride facilitate super infection. That happens not uncommonly after a course of antibiotics. Some antibiotics have higher risk, not uncommonly after going into hospital settings because it turns out that C. Diff spores are everywhere throughout hospitals and that people are given antibiotics often in hospital. And that combination is particularly bad. And because of the fact that antibiotics are the driver of the condition. Essentially antibiotics that cause massive microbiome disruption allow the C. Diff to actually grow and thrive in the environment. Then people can get immensely unwell from, you know, moderately moderate symptoms like, you know, diarrhea and discomfort. So actually dying, it can be very severe infection and its success rate with treating with more antibiotics is not great for obvious reasons in some respects. Like you're not.

That was very kind of you, Jason, when you said not great. It's pretty pathetic really. The conventional medical treatment of C. Diff is piss poor.

Yeah. And then they were like, okay, well maybe it's a dyspotic state. Maybe we need to encourage that ecosystem back to a healthier state. And the quickest way of doing that, I mean, there has been some research on probiotics, which is where you're giving one or two or three different types of bacteria. And the research in C. Diff is hit and miss depending on the combination. But again, that's, that's a relatively small thing given that the typical EcoSystem will have 160 different species of bacteria and you just add some Lactobacillus in there. It's like not a huge restoration approach versus fmt, where you're taking poo from a healthy person and you're adding 150 or 200 species into that ecosystem. So it helps restore that ecosystem, essentially would be the way best way of looking at it. And you're getting phenomenal success rates with C. Diff, and so much so that you, you wonder why on earth that isn't first port of call by, at the convention of medicine, whenever anyone has C. Diff, that FMT should be the first particle. It's not even now they will still do a couple course antibiotics first. Then maybe it might be third down the line in most sort of guidelines about when you give fmt, which I think is ludicrous given the success rate and low risk of toxic side effects with, with fmt, assuming of course that we screen donors well. And I think there have been lessons learned in this because there were cases where people became obese after fecal transplant when the donor was an obese person. Or people could get depressed or anxious after a fecal transplant because the donor happened to have, you know, depression. You know, we've learned from some of those experiences about what things we should be looking at besides just they don't have a range of diseases. It's just like they can't be overweight, they've got to be medically well, they've got to have good mood. There's other criteria we look at to find when I say good donors, there's less risk of any unwanted disease pass on because I think that's the amazing thing that's changed in the last 20 years is you kind of alluded to is the number of diseases we now associate with dysbiotic or negative alterations in the microbiome composition. Even things like hypertension. I would not have thought even someone who spent years admiring in wonder the microbiome thinking that, that hypertension was a disease of dysbiosis. But we can take poo transplants from people who have low blood pressure, normal blood pressure, and give it to people with high blood pressure and their blood pressure will normalize, you know.

Holy shit. Excuse the pun. Exactly. So just. I just need to double click here. For some people who might be going fmt fecal transplants. Just, just to clarify, for some people who may not be familiar with it, this is where you get, as you said, a healthy donor and you get some of their poo and then it goes into a big syringe and goes up their jaxi.

Typically, yeah, Sometimes they're even in capsule form too. But yes, it's the medical term.

Oh yeah, crapsules. Yes, they're now being called.

Yeah, well named.

Yeah. And. And basically what happens is, is that donor's microbiome repopulates the colon of the. The unhealthy person. But as you said, I didn't know we'd actually seen that in humans. Right. Because years ago I remember reading this stuff that from animal studies, you could take a perfectly healthy mouse and give it a fecal transplant of a mouse with depression or anxiety or obesity or diabetes, and within a couple of weeks, with no change in the environment, that mouse would develop those conditions and, and then they could reverse it as well. So now you're saying that we've seen it in humans with people getting depression or obesity from on screen donors. Right. So this is a do not do.

At home people for those reasons.

Yeah, lots of other reasons.

Right, yeah. But it's been interesting because I think you go back to, I think it was 2000, end of 2005, that first paper was published where they gave poo from obese mice to thin mice and those mice got obese despite no change in caloric intake or output. You know, they weren't exercising any less, they were eating the same amount of food and just became grossly obese just from a poo transplant. That was a game changer in the. And not say, broader understanding of the importance of the gut metabolic axis, but also that how important gut microbiome is in that. Because before that we were like, yeah, the gut microbiome matters in IBS or inflammatory bowel disease, like these gut conditions, but maybe not outside that, but that blew it open going, oh my God, you know, if we can pass on obesity by doing poo transplants, that opened the Door to. Yeah. Now there's research looking at depression, anxiety, hypertension, as I mentioned before, diabetes, so many things we can. Disease that we would have not thought of as like, you know, transmissible. We can transmit via food trims, even Alzheimer's. You know, we can, we can take, you know, poo from adults with Alzheimer's and give it to rats and they develop essentially Alzheimer's disease. It's crazy.

Is that right?

Yeah.

Wow. So I'd seen some stuff obviously about Parkinson's disease. There's a, there's quite a strong theory that it starts in the gut now, but that Alzheimer's one is, wow, that is interesting. And it just opens up a whole world. So that I think that's a really good segue into the gut brain microbiota axis. So just give people a bit of an overview of, of the current state of play. Like how, how's the communication happening between the gut, the brain and the, and the microbiome, you know, this whole idea of the second brain. Just, just give, give people a two or three minute overview of what we currently know.

Okay. I might even take it further, step back into scope. Like the gut microbiome.

Some people may be totally aware of.

This, but it's essentially, generally when we say the gut microbiome, we're talking about the microbes growing in the colon. We will have a different microbial ecosystem in the small intestine and far less diverse in the stomach, for example. But when we say microbiome, we're generally talking about colonic ecosystem or large intestine, but 100 trillion microbes living in that environment. And there's some debate about Whether there are 10 times the number of microbes in our gut as there is human cells, or two times or three times. But either way, we have. There's, you know, considerable amount of us is actually composed of microbe. And I think that's that other change in thinking from just sort of segue to, you know, again, going back 20 some years ago, these researchers who were looking at the microflora at the time were like, you know, we should. We need to look at this as an initial human organ, just as important as the liver or the small intestine to human health. And I think that shifting is finally taken on board in many circles, but has even moved beyond that to actually we are whole bion, which is a term just meaning that we are composed of microbes and non microbe cells. Yeah. And all, Both. All of which is important. So when we kind of take that on board, we have you know, 100 trillion cells in our gut that actually influence every single system of our body is influenced by that ecosystem in our gut. That's what we've found out now. How your immune system works, how your metabolic, metabolic system work, metabolism works, how your brain works, you know, all that is related how your mitochondria working are related to that ecosystem in our gut. And typically we have For Westerners about 160 different species present in your gut. But that's far, far less than we traditionally had and far less than what we see in hunter gatherer societies or like the hana. Yeah, that's right. You know even like I do microbiome assessments with I have for many years to thousands of patients now and you know, lowest I've seen on a microbot assessment was 12 species and someone who was on vancomycin.

Jesus.

All of them were pathogenic.

12 species.

12 species, yeah. And they're all bad. You know, there's not, not a good one to be seen. And the Conversely I've seen 430 genera so, so we didn't go into species but genera level was just, I was huge. That was someone who grew up in rural Mexico and no antibiotics. They're you know, born boner home and you know, they were breastfed. You know it's just like that's the contrasting things that I was seeing in my clinical practice. But a lot of you know, things that we get exposed to in western nations have caused a massive reduction in diversity of our ecosystem. So that, that is antibiotics, that is proton pump inhibitors are the class medications we use to treat reflux turn out to be quite potent antibiotic like agents too. You know I think 20% of microbes in the gut are sensitive to and are damaged by proton pump inhibitors. Yeah. So we see massive loss of diversity and these medications are given like candy to, you know, geez, even in Australia it's like 10 million scripts or something for PPIs per, you know, per year and we only have 25, 27 million people or something. You know, give some context on that. Then we, and we have western diet and we have the crap that's in our diet too like emulsifiers, artificial sweeteners, all these things kill our beneficial bacteria and damage the ecosystem.

I think Jason, just on that to jump in there, there was an umbrella review published quite recently around ultra processed food foods and showing that increasing consumption they had Class 1 evidence of a 50% increased risk in cardiovascular deaths, 48% increased risk of anxiety and 53% increased risk of Common mental health disorder like this is the nail in the coffin of ultra processed foods. Right. This shit should be banned.

Yeah, I know. And you dig into this and you're like, how are you we allowed to be selling this stuff? Why are we allowed to get exercise? Because, I mean, our health problems, you know, you and I are old enough to, to have seen this huge increase in Alzheimer's and type 2 diabetes and obesity. Like you take photos of beaches in the 60s and 70s, they're not the same as now.

It's like a different species, isn't it? Yeah. And just on that point, in the next couple of years, they reckon that dementia is going to be the biggest killer of all Australians. Right. Just now, number two. It's number two and it's the biggest killer of females currently.

Yeah. And going back on the ultra processed food, like I was reading some research showing that in America, 70, some, some studies have shown 70% of their dietary supply for some people is ULTRA Processed food. 70%. You know, in Australia we're better off, but cheese, you know, not dramatically better off. When you look at what people put in their shopping trolleys at the supermarket, you're like, my God, so many people are making, choosing those foods.

We are in the top six countries of global ultra processed food sales. Um, so I think we're, we're not that far. And, and, and you're right. At both the UK and in the United States, especially teenagers, almost 70% of their diets ultra processed foods. And when we think about what that does to the microbiome. So you talked about emulsifiers having an issue, but it's also preservatives and flavor enhancers and things like that. Right. That just. Do we know how these things impact.

The microbiome now we're teasing some of this stuff out now and even I would argue agricultural chemicals too, like common things like glyphosate, but others, you know, and those forever chemicals kill good bacteria as well. It's like all of a sudden we're living in this toxic soup where almost everything people are eating tends to be killing beneficial bacteria. It's kind of the state that, that many Westerners are in. There's been a lot more research delving into emulsifiers since 2014. I think the first paper was done looking at that going, because, you know, people had not thought, thought of it before. Then it turns out like, oh, look, it kind of strips away your protective gut lining. You can induce type 2 diabetes and metabolic syndrome in animal models is by giving them dietary emulsifiers at the high end of what humans could consume on a ultra processed diet. You know, and you're like, okay, look at that. And it changes the microbiome. We get reductions of beneficial bacteria and we get these blooms of Proteobacteria. Typically in Proteobacteria is a, you know, a phylum of bacteria in the gut. All of us will have some there, but it varies dramatically how much is there. And one of the key attributes that all protobacteria shares, they contain this very pro inflammatory bit of their cell wall called endotoxin or lipopolysaccharide. LPS for short. Yeah. So when we eat these foods, LPS levels go up and it just turns out the lps, just to be clear here, they just grow it. Like, you know, we grow hair, we grow nails, they grow lps. They're not trying to make us unwell by secreting a toxin in this instance, they're just growing the stuff. So when they live, they're constantly shedding it. When they die, they shed it. So the more protobacteria we have in our gut, the more endotoxin or LPS we have in our gut. And you know, we have got some detox mechanisms to deal with some of that, but, you know, we've got so much more getting into our system now that the lps, I think, is really one of the causative ways of, in which the microbiome alters, I would say, everything in a negative way. You know, we know that LPS actually damages the blood brain barrier, causes neurological inflammation. Interesting research in Alzheimer's patients where people with Alzheimer's, they have three times more LPs in their bloodstreams than age match. Healthy controls, they have between 3 and 26 more times in their brain on autopsy than compared to healthy control bodies. Autopsies, it's just like, it's crazy. And where that is, the plaques build.

Up around the amyloid plaques. Yeah, Because a foreign invader. Right. So the amyloid plaque is laid down to protect against damage.

Yeah. And it's this LPS that's coming from the gut that's actually driving this. Yeah.

So this is why and the mechanism. Jason. Sorry. So the lps, did you say? Did I hear you say that? It basically degrades the mucous membrane.

It does, we call, say leaky gut or enhanced permeability. So it definitely causes that, it drives inflammation body wide.

Okay.

But we also know that it actually directly damages the blood brain barrier. It causes, you know, neurological inflammation. It changes our neur, neurotransmitters too. You know, there's studies where they've given happy, healthy people a shot of endotoxin and they get anxious and depressed for hours afterwards. You know, before birth, body kind of clears it out. And we know that it actually is able to get into the brain and actually change what neurotransmitters reproduce. You know, we get less, you know, serotonin, happy, happy compounds. When we have more otoxin in our, our system. They've done brain scans of people after give them a shot of endotoxin, their brain just turns bright red everywhere. But we live in a, we're eating this dietary approach. For many Westerners who had just have this LPS leaking into their bloodstream 24 hours a day, seven days a week, that's driving the chronic disease that we see from obesity to type 2 diabetes to Alzheimer's, you know, these are all LPS driven conditions. Anxiety and depression be too, for that matter.

Let's talk about the mechanisms here because I really want people to understand the structure of the colon and why mucous membrane is so important. I mean, most people are shocked when I tell them that at least 80% of the immune system resides in the gut. So talk us through what actually is happening when this mucous membrane is being degraded, then the implications of that, like what we know happens with a leaky gut.

Yeah. And we see this as a very, essentially the consequence of a western diet. The western diet, we know contains these chemicals which actually strip away your protective mucus layer, but also don't feed your, your benjobacteria that are protective and help protect your, your mucosa as well. So we have this double whammy that's going on. So essentially we're getting this penetration of bacteria and bacterial byproducts that wouldn't normally get through. There's normally a thick mucus layer and even if they're there, they just can't contact the cells themselves. But when we thin out that mucus layer, we enable that contact between bacteria and their LPS to actually directly cause inflammation and that causes leakiness. Then that LPS gets in the bloodstream. And we do have methods to try to deal with that. Like our liver is quite adept at dealing with LPS for a certain period of time at a certain amount. It's just that when it becomes overwhelmed, then it's, it reaches the body wide circulation and that's where it starts causing havoc everywhere. And this is where we see like, you know, alcoholic liver disease is like, it's the endotoxins that are causing liver damage. Yeah. It's just alcohol causes the leaky gut. Alcohol causes, you know, damage to mucosa that allows the endotoxin through alcohol causes blooms of protobacteria in the gut. Yeah. And that allows the endotoxin to come through and cause damage to the liver and even, you know, what we call non alcoholic fatty liver disease. It's the. Got a recent updated name. But it's. That is damage is driven by endotoxins as well. Primarily.

Interesting that alcohol causes a leaky gut. I did not know that. And this is, this is a ver verging on oversharing right here. Because I had some bowel issues a few years ago and was a little bit concerned about. Just had diarrhea in. In the mornings. Not all the time, but I went and I ended up having a colonic. Not a colonic. I ended up having a endoc. Endoscopy. Yeah. And it was all clear. And then what I worked out is it was after I drunk alcohol. And that now makes perfect sense. So I. I just sort of worked it out. Jesus. It's after I drank the night, the next morning, that's the only time that I have that diarrhea. And now it makes sense.

Yeah. And I think even like the, the hangover effect, I think is because of the endotoxin that's in part to the endotoxins that. That come into your brain, inflaming your brain from that alcohol ingestion too. Yeah.

Wow.

Yeah. And alcohol also slows down your small bowel transit too. So you get this sort of extra effect of extra capacity to absorb stuff through that. That damaged small bowel too, because microbes aren't moving. Things aren't moving through in the same way because I treat a lot of patients with overgrowth of bacteria in the small intestine. Sibo. Small intestinal bacterial everywhere. Alcohol is a common reinducer of sibo. Sometimes you'll clear sibo, it's gone. But then it might be, you know, Christmas New Year time and they. They end up drinking heaps. And sibo return as a consequence of that alcohol ingestion too.

Interesting.

Stops movement.

So you add alcohol, you add alcohol, significant alcohol to a typical SAD diet, the standard American or the standard Australian diet, or it's the standard Western diet. But the standard Western diet on its own is shithouse for your microbiome. Just to recap for people, it basically encourages these LPs which degrade your mucous membrane. And I. And also if you're not having a lot of fiber. My understanding is the fiber munching bacteria in your gut that thrive off fiber, they turn into cannibals when you don't have enough fiber and they do. So we have then a double whammy from that. Plus you're not supporting your healthy microbiome. Then you get an unhealthy one, you get leaky gut, then you get LPS getting into the bloodstream triggers an immune response and then gets into the brain. And what other impacts does that have metabolically? I think you mentioned the mitochondria earlier on. Yeah.

Because LP LPS is also mitochondrial toxins to add, add to the mix of everything else it's actually doing impairs insulin sensitivity too. So it drives, you know, blood glucose levels to go up too by impairing your insulin capacity to, to bring levels down. It's, it's a really horrific substance. The more you look at it, you're like, my God, I do not want this stuff in my bloodstream. You know, eat the best diet possible to prevent that LPS load getting into my gut and to reduce levels of LPS reducing bacteria in your gut. Because it really is, I think it, you know, it's being seen as a very core driver of Alzheimer's. And it's funny, you look at the research, it's all very clear out there. But then like there should be people who, you know, Alzheimer's specialists who just still have no idea of any of the stuff around gut that'd be good in other areas. But completely ignorant of things like that, which I still find problematic means the end result of people aren't getting proper care. And we're ignoring a core underlying driver that, that, that needs to be addressed. If we wanted to, to prevent this sort of Alzheimer's epidemic that we're seeing and it's only going to be getting worse too that you see, you look.

At the rates of it, the increasing rates in lots of Western nations are scary. And I'd encourage anybody, Australia just to look at the Australian Institute of Health and Welfare and the deaths, the causes of deaths in Australia. And you just see, because they have it mapped out for the years, you just see like dementia was way down the bottom and it's just gone boom, shot way up, right. So they, they, they bring Alzheimer's into.

That umbrella and these things should worry us. Like I sometimes find amazing that we don't seem to be too bothered by, you know, this huge rate of obesity in our kids body using kids or this huge boom of Alzheimer's nearly as much as we should. I mean, there'll be people like you or I who are like, this is incredible stuff. We need to be worried about the people that are making decisions around what, what's allowed in our food supply, which we know there's a huge correlation here. Like it's mind blowing that we're not making deeper changes in terms of what's allowed to be put in our food. What can we label as food, you know, because all these pseudo foods that people are consuming that are actually directly causing this are totally loud in our current health system, you know.

Yeah. And yeah, this, this, this whole thing, if it looks, if it doesn't look like it's been alive recently and minimally interfered with by humans, then don't eat the bloody stuff. Or it's. I, I talk about the 80, 20 word, right. So 20% treat stuff, but 80% of the stuff that goes into your gulp on a daily basis should have been alive recently and minimally interfered with by humans. Because I am a big believer. And it's Professor Felice Jacka who is the driver of the nutritional psychiatry movement. She said that the ultra processed food system or the food global food industry is the biggest driver of chronic disease in the world, without exception. And I think she's absolutely right. You only have to look at like, what has changed from. I saw a photograph the other day of bathurst in the 1970s, the crowd. And there's a huge amount of people in it, just as you mentioned earlier on. Not one obese person there. Not one. Right. And that was in 1977. And you look back and you can just look at old photographs of people at beaches in the 50s, the 60s, the 70s. It just, we didn't have hardly any of it. And now it is the norm to be overweight or obese. What has changed? The big thing that changes our diet and all the plastics, these forever chemicals that you talked about. Right. Which go hand in hand with the diet and the food packaging and all of that. Exactly.

Because when they're buying the processed food, it's going to be covered with plasticky stuff too. So we get extra doses of plastic too. Yeah. So it's.

And do we know anything about the role of these forever chemicals in the gut? Because we have now found, I saw some research the other day, 100% of placentas that were tested in the United States had got forever chemicals, microplastics in the placenta. Right. We now know we've seen it in the human brain as well. And we've Seen it in other organs. Do we know the role that they play in the gut yet?

I would argue it's under research, but that's again probably last hinder years people have started to look at that and it looks like there's a pretty common pattern that those sugary chemicals harm beneficial microbes and increase levels of proteobacteria. Yeah, and this is kind of the same pattern we see with, with the ultra processed food diets too. They increase protobacteria, reduced levels of beneficial bacteria. You know, some of the, even the stuff we had, like triclosan is a compound, this anti, antiseptic is added to toothpaste in some parts of the world. It's classic the carcinogen, not a loud. But in other parts, like Australia, add it to toothpaste, we can brush our teeth with it. Actually again, it kills, kills our bench bacteria and causes these blooms of protobacteria. Even in the doses we're getting from toothpaste. It's just like, why is this stuff allowed? You know, it's just crazy. So it's like we're being bombarded on all sides from cosmetics to our food supply. These things that are causing microbiome harm that don't necessarily get the airplay of antibiotics. More people are aware of causing harm and they do, but at least they have some therapeutic benefit in certain situations versus other things do not, you know, and there's no reason why that we should be consuming them.

Yeah. So let's talk about antibiotics right now. So we just had a chat before we came on. So I am currently on a course of antibiotics. I'm not happy about it. I mean there is very compelling research about the amount of courses of antibiotics that you're on throughout your life has a significant impact on, on the healthier gut microbiome and all sorts of other health conditions, particularly obesity and diabetes. Now I had to have one because I had an infection in a tooth. And I was saying to you, the doctor did a 3D X ray which actually showed the infection had penetrated through the roof of my mouth into the sinus. And it was amazing. You could see that the immune system had dumped all this inflammation on it. Right. So this was a no brainer. This is a case in point where antibiotics can be lifesavers. Right. Because if I was a caveman that shit could kill me. So what, what do we do when we're on a course of antibiotics? Is it because I've heard conflicting evidence about whether or not you should take probiotics? Some people say it's no point in doing it until you finish the course. Other people have said a couple of hours after your antibiotic, then take a probiotic. So what, what, what is your understanding of it and what particular types and does it depend on the antibiotic that you're on? What do we know about this?

Yeah, good question. I think the first thing is just making sure you need it, the antibiotic. And I always suggest people really question their prescriber for something like you're dealing with. Yeah, you know, for a bone infection or something. Yeah, totally. You know, patient week that, that feller broke the wrist and had to have, you know, surgery and the metal bits in their arm to think safe. Yeah. They need antibiotics to, to prevent any sort of bone infection. No doubt. But we also know that, I think for Australian data show that just a couple years ago for viral bronchitis, 80% of people who went to their GP were prescribed antibiotics for viral.

And they do nothing, they do nothing for a virus.

It's not harm, you know, so just be aware of that, that. One, don't request them for viral infections. Two, question whether they're really needed in this case, because some, sometimes they are and they are. They've been life saving. We need them. So when you do need them, the research is very clear. If you take the right probiotic during the course, you get less side effects and you get less microbiome harm and you get better restoration of the ecosystem afterwards. Okay, so that, that is clear. And the idea that you should wait till afterwards is kind of not based on evidence anymore. I think it was a theoretical concept from 40 years ago before we had studies showing that the opposite. We get better outcomes. It's not to say that every probiotic can be helpful because there was one study that made huge worldwide airplay. It was an Israeli study where they found a one particular probiotic supplement on the Israeli market that when given alongside a course of antibiotics, actually slowed down the microbiome restoration compared to doing nothing at all. Yeah. And it turns out that the lactobacilli in that specific supplement, so it created compounds that prevented the growth of good bacteria. Okay. There's potential for harm if you just take a random probiotic supplement with no evidence on it. I think it's relatively small, but there is, but we have, you know, you know, I've got a website called Probiotic Advisor, which is actually an evidence based database where you can actually look at probiotic research. You can type in antibiotics and it comes up with the probiotic strains that have been used in Human clinical trials and the effects in those studies and the level of evidence, whether it's meta analysis or randomized controlled trial or open label trial to try to make this, this easier to prescribe it probiotics in an evidence based way and using the right one for the right condition. And there is a bug, Lacrucilis rhamnosis GG that has meta analysis level data for prevention of adwalker associated side effects. Or Saccharomyces cereviaceae variety Blardi.

Is that Sarcomyces boulardi, its nickname?

Yeah.

Right. Okay.

It's not its proper name, I don't bit proper names but it also has meta analysis level data where we have a number of clinical trials showing it works. Yes, we can't have any debates about this because evidence shows it works alongside antibiotics. Ideally. Yeah. You want to space out the bacterial ones by probiotics by two hours from the antibiotics. They're not rolling around in your stomach at the same time. With a saccharomythesis it doesn't matter because it's not going to impact.

Yeah, okay.

Yeah. And, and then for six, during the course and for six weeks afterwards is key because that's where the major disruption is. And after that point there's a bit of stability but back in that ecosystem. But I also want to make the point too that this reduces some of the harm to your microbiome. It reduces the side effect rate you're going to get from the antibiotic, but it doesn't stop the perhaps extinction level events.

Is carpet bombing your microbiome really is what's happening in my body right now, unfortunately I'm too aware of this is my microbiome is being carpet bombed.

Yeah. There was one study that was published in GOT a couple years ago where they showed that with single quartz antibiotics, nine species were lost forever from that person's ecosystem. And this was with IV antibiotics too. So it wasn't like orally. It was iv. Nine species completely lost first couple days afterwards. Like they're doing pre samples every single day. There's this massive completely derangement. And this bacteria that was like 0.0 something percent that they had never even seen before went up to 96% of the ecosystem for the first couple days afterwards because it had antibiotic resistance to that antibiotic. They actually named it Bork folkii ceftriaxensis because it was ceftriax in the antibiotic that actually induced this bloom of this bacteria and then the pattern kind of fall back down. But the ecosystem was clearly different. You could see it afterwards, never, ever again the same. And there's nine species that were lost. So I think it's also important, parent, that we know that we can't just pop a probiotic and re. Inoculate a recede or eat some sauerkraut or kimchi afterwards and go, oh, it would be great. It's like, no, these things are microbiome altering agents in a, in a permanent sense. Yeah. Not just in a short term sense like we once believed. You skip back, you know, when I started in this field 20 some years ago, the data at that point, using culturing studies, which is really insensitive to see anything, was like, ah, four weeks after antibiotics, your gut looks fine again, you know, but since, since that, since we started using, you know, DNA technology to do is to assess the microbiome and we can see properly, we're like, actually four years afterwards, it doesn't look the same. And there's species lost with each culture.

Jesus.

Yeah. Wow. And this is why Western has such a depleted microbiome, because, you know, antibodies did I take, I grew up in the 70s, it's like, oh, you got a cold, take antibiotics? I would have taken probably three or four courses a year most years when I was a kid. And I had a typical, you know, I grew up in Canada eating a pretty westernized diet as well, you know, so my microbiome was smashed during that time and I was lucky that I was born vaginally, so at least I wouldn't be given the full sort of cohort of microbes from my mom. And those kids born by C section, don't, you know, and those kids, this.

Is another thing that plays into it, right. And actually I want to come back to what we can actually do because Melbourne has got the highest rate of C sections anywhere in the world. Right. So voluntary C sections. And when my wife was, was having a baby, the, the obstetrician told her that her pelvis was too small and that she had to come in for a C section. And I'm like, what are you basing that on? Right. And she ended up having a vaginal birth.

Right.

But they just want to schedule it. Like, this is the thing. So it's got the highest rate of C section. It's just convenient. Highest rate of C sections anywhere in the world and the highest rate of allergies anywhere in the world. Right. And we know that those two are causally linked.

Yeah, right, we do.

And so this starts from. And then breastfeeding is hugely, hugely important for that Microbiome, we see C section kids. You know, they, they're much better at it now. Right. But in the old days of the C section, what they find is that the, the child's microbiome in early life was reflective of the skin. Skin microbiome of the doctors and the nurses. Right. Which is just fragging whenever we now understand the impact of your microbiome. So let's talk about what people can do to diversify their microbiome, whether or not they've just had a course of antibiotics or they're listening to this and going, jesus, my diet's a bit chithe. Or even if it's not cheat house. I want to improve my diet because I, I want to improve my gut microbiome because of all the things that Jason has just said. So.

Yeah, yeah, because we've talked about things that are quite depressing today, but there's stuff, positive steps we can take. Like I can think of mine where, you know, I did not have a, a great upbringing from a microbiome perspective in terms of antibody exposure and Western diet. But then, you know, at, at 19, 18, 19, I discovered eating well and living well and my microbiome has, has bloomed beautifully. I'm still lacking like in richness in terms of, you know, that early market harm that was caused by antibiotics, I can't fix in that way. But I can do the best. I can still have good health, despite the fact that I hammered my microbiome when I was young. I suppose is what I'm trying to illustrate here. And you're right. What, diversity is one of the key things we look for for a healthy microbiome. Yeah. So diversity's got two aspects to it. One is the richness. So how many different species there are in that ecosystem. And the second aspect, that is eco evenness. Yes. We don't want one species to dominate at 70 or 80% or 50%. You don't want it to look like a plantation. It should look like a really, like a tropical rainforest where there's 100 different species all intermingled so you're not seeing the same tree everywhere. Yeah, that's what we're aiming for. So how do we induce that even if we have been hammered by antibiotics and had a C section birth or formula fed, you know, like I was formula fed too. We do that by the techniques we know that have the biggest impact on an enhancing diversity are eating more plant foods and more fibers more. And a diversity of plant foods too. You know, we know if for people who can handle 30 to 40 different plant foods per week in their diet. We have a massive improvement in diversity. And that may sound scary, but if you start including Granny Smith apple, Red Delicious apple, Fuji apple are three different foods. Black rice, red rice, brown rice, three different whole foods foods, you know, black quinoa, red quinoa, white quinoa. So often when I'm cooking rice, I'll make the tri color rice or I'll make three different types of quinoa. So therefore I'm getting three foods in. In one. You know, make sure buy a variety of apples. And it's because the different colors, compounds of slightly different fiber portions actually feed different microbes. And the idea with having 30 to 40 whole sort of different plant foods per week is that, that we have so many different types of fiber, so many different types of polyphenol and polyphenols. For those who aren't familiar, you're best off thinking of it as like the colorful compounds in berries and an eggplant skin. And you know, those things are usually not. But not always polyphenols. Yeah, they also feed your benefic too. So we have a diet that's colorful, rainbow, natural color, not. Not synthetic dye color, but natural.

Yes.

And as much, you know, diversity of a whole plant foods, you're going to get a more diverse ecosystem. We also know that spending time in nature too. And I think this is something that we're often missing too. The modern world diversifies our ecosystem and that's just going for a walk in nature. Will that work in a park? Yes. Will it work better in a national park? Yes. You know, the more diverse the ecosystem you're in, lovely rainforest environment, national park is going to be better than the playground down the street. But the playground down the street is better than being in your apartment, you know, or in your house. You're still going to pick up microbes from that.

So I'll just add in there. And the ocean as well. You can actually pick up microbes. Because I live near the beach and I did a podcast on that. Like being spending time in nature, whether it's in trees around a beach, you actually absorb some of those microbes and coculate it into your microbiome. It's cool shit, right?

It's really amazing. And following on that too, they've looked at people's gardens and I'm not even talking here about food gardens, but we will later. But just the number of ornamental plants you have growing in your yard, the greater diversity of ornamental plants you have growing the more diverse you got microbiome because they, each of those ornamental plants has its own microbiome. So you're interacting with those plants. You're weeding, you're pruning, you're touching, smelling, you're actually in getting more microbes in your ecosystem. And we take that another level in terms of we're able to grow our own food too, even if it's some of those foods because we actually get soil bacteria, we get the microbes on those foods in a very natural, lack of a better word, natural way. You know, we, there's, I was at a conference in Italy just while I was there and in July and there's a microbiome conference and one of the researchers there was talking about the microbiomes on plant foods and the importance of microbiomes in plants too. We always talk about human microbiomes. Well, it turns out plant microbiomes are just as important to them as they are to us. But they did research on cold stored apples versus local apples and the cold stored apples had the same number of microbes on them, but diversity was almost minimal. So the cold stored microbiome had very low, low diversity. Whereas your fresh, your local apple was full of a wider diversity of microbes. And they found that across different foods. Yeah, foods that were grown organically had again the number of microbes on them. It wasn't different, it was the diversity of the microbe. The richness of the ecosystem was completely different with organic foods versus conventionally grown food. Completely different. If you bought at your farmer's market versus the supermarket.

Yeah, I was about to say don't buy your friggin fruit and veggies in the supermarket if you can, if you can avoid. Farmers markets are the way ahead because.

It turns out that the supermarket microbiome that goes across plants. So if we're buying cauliflower, broccoli, eggplant, apple from the supermarket, their ecosystems are on those foods are essentially the same. Whereas in the real world each of those foods has got a completely different microbiome. And when we're consuming those foods we get those microbes too. Some will be temporary visitors, some will be longer term inhabitants from that. But obviously if you're eating them a lot, then they kind of play the same role as a commensal microbe would as well. It's really, it's fascinating. It really illustrates the importance of buying local, buying your supermarket, growing at least some of your own food getting in nature, you know, because I think those are things that we sometimes have dropped away. And I think industry has been somewhat to blame for this too, because they just like, just take a pro product. It's like, no, yeah, yeah, I hate to do it. You're trying to improve your diversity. Probiotic supplements have a minimal impact. Yeah.

And they're transient, Right. Probiotics are mostly transient.

Most people don't know that either. You're right. With the odd exception studied over the last 40 years have shown that they stick around for 1, 2, 3, 5 to 10 days. That's it. After you stop taking, they're gone.

And isn't there an issue, Jason, with people who over consume probiotics can in some cases get sibo, small intestinal bacterial overgrowth? Or is that.

I think that was overplayed. No, I think that would be very unlikely scenario because the one study that purported to show correlation between probiotic use and brain fog in sibo, when they did, if you look in the fine details of that paper, which I have, they actually sampled the microbiome in the small bowel of these people, and they did not have bifidobacteria, which you find in probiotic supplements. And almost none of them had lacubcili growing there. What they had with streptococcus growing there, the vast majority of them, which comes from our spit primarily. But also some mugurids might contain a lot of streptococci, but it really, it did not correlate with. With probiotic use in terms of what microbes were in their small bowel.

Okay, so we'll just explore. We've exploded that myth. I read the paper. The lesson. Read the paper in detail.

Well, yeah, don't listen to the headlines. That would have been totally the head. It's true. Because I think he missed. Sometimes when you're writing up a paper, there are certain bits you can take out that'd be more headline grabbing than other bits. Yeah. And if you actually look at the microbiology component, it does not support that underlying.

And sometimes researchers give a conclusion which when you look at the data, is actually not supported. I've talked about that before. Right, okay.

Even though as someone who's tried to get research published, sometimes we had to tone down. You know, we first did a systematic review looking at a particular probiotic for antibiotic associated diarrhea. I think we had nine studies. All of it showed it worked. And so I wanted to say it worked. And the peer review is like, no, you still can't say it worked. You have to say it might work. You know, need lots more studies. I'm like, what's the risk in this situation if people just start taking this, reduce diarrhea, reduce side effect, et cetera. Anyway, but sometimes, you know, peer reviewers do force us to change our statements when we get things published too.

We are a little running out of time, which is unfortunate. But I, I do want to talk about aging and the microbiome. Right. Because aging well is, is a big thing now and rightly so. And you know, I've seen a fair bit of research that when people age, their microbiome changes, it becomes narrower and, and, and it changes. What do we know about coincidence versus cause and effect? And just give us the state of play on all of this.

Listen, in Western nations where I'd say we age in general poorly, we do see a change of the microbiome. We see a lacking in changing diversity, reducing in diversity that you mentioned before, decreased level of beneficial microbes. That would be bifidobacteria, for example, butyrate producing microbes, Faecalibacterium, which is a microbe we haven't talked about much, but is it actually lovely Microbe will tend to go down and we see these blooms of protobacteria that I mentioned before, like E. Coli and also another group of bacteria that produce hydrogen sulfide gas, one called Bilophylla sulfur vibrio. That's going into more specific detail. They tend to bloom in the last. As we age. Yeah. And, and those pet populations do age well, those microbes bloom much later. So for us in western nations it might be this change occurs in our 60s. But those people who are in those sort of maybe blue zones or people age well, those same changes occur within their 90s. And to give some context, we see the same changes, but it happens at a different, different time point. Yeah. And that's where lifestyle, dietary factors I think are key. You know, we, you know, I think they are more contributory to the, to what we see the aging microbiome changes than aging physiology. I think there's a component of that like there is some research showing we might have, you know, we make less mucus, know, as we age. And that can mean that, you know, more can change what microbes are being fed, can change what microbe components get into our bloodstream from that. But I think more research is focused on. Okay, well it's actually as people age, they tend to eat more crap food. You know, they're not preparing food in the same way that they had before because that maybe they have less energy to do so or there's less reason to do. So like once your kids leave home, you know, I'm, you know, finding it like when, like I don't have a family to cook for. I don't cook nearly as much as I do when I've got, you know, three, my three kids to cook for. Like I make this huge feast with, with amazing yummy food, you know.

So older people tend to have much narrower diets as well, don't they? Because they become creatures of habits. And then, Jesus, you go into, you, you go into a retirement village and old people's home and they just feed you cheap shit.

Yeah. Process ultra processed food, you know, and that, that hastens the, the, the whole aging process. Yeah, yeah. So I do think there again we can be proactive by those strategies we talked about before. Getting nature and eating a diversified, you know, plant rich diet. Yeah. So I had lots of legumes, lots of whole grains.

Do what they do in Japan. The icky guy. Grow your own vegetables, grow your own food. Right. As you, as you have a bit more time instead of sitting watching a frigging tv.

Yeah, yeah, indeed. And then even just go strolls in nature, you know, stroll down to the beach, you got, you know, we should have more time to actually enjoy nature at that age. You should. But often if we haven't taken care of ourselves adequately in earlier years, you're sometimes not as physically able to get out into nature at that point. Which is one of those horrible conundrums that we find ourselves in western nations.

Yeah, absolutely. And I think to underscore, just as we were talking for the couple of minutes before we came on air, there was a pretty seminal paper released, I think it was 2014, about the major hallmarks of aging. And they identified nine different hallmarks of aging, such as telomere shortening and DNA damage, inflammation, proteostasis damage, all of these things. But just last year an update was released and added two more hallmarks of aging. One of which was the changes in the gut microbiome being causative for aging and actual process that's, that's causative. So.

And again, talking about going back to the fecal transplants, there's been so many studies now in mice where they can take a poo transplant from an old mouse, give it to a young one, and they essentially age quickly. You know, they get, they can develop like the brain patterns changes, the brain chemistry changes, the metabolites in their bloodstream changes. They essentially age immensely quickly. And conversely, they can take a poo transplant from a young, healthy one and give it to a older one. And it actually again, it reverses the aging process to a certain degree. You know, so there's enough evidence around the causation and stuff with the microbiome in terms of speeding up the aging process or slowing down the aging process. It really does need to be on our radar. And as someone like I'm 51 now, it's like a totally on my radar that, you know, that I want to age well, have a good health span. I don't want to be someone who's stuck in bed for the last 20 years of my life. I want to be hiking mountains up until I'm 90, you know, and I be able to do everything I want to do. And part of that is definitely microbiome support, you know, looking after the good bacteria as best we can and support suppressing levels of those, you know, pro inflammatory pathobots or proteobacteria specifically. And that means which we can do through lifestyle and dietary choices. I think that's the thing. Fecal transplant studies are cool because they can show these really quick changes. But we don't need fecal transplants to change the microbiome. You know, getting in nature, eating the right food, I use for medicines, I use lots of prebiotics to help speed that process along too. There's so much we can do that don't. We don't need the big of a fecal transplant, you know, know, it's a very quick way of doing it versus, you know, changing your diet and lifestyle will take more work and take more time, but you get profound changes in the microbiome.

And also managing, managing stress is, is important as well because stress can change the microbiome too. So it's a two way interaction, right?

Yeah. Well, I had a patient just this week who stressful job situation brought on a flare of their, their Crohn's disease. And that's. It's not uncommon in the Crohn's literature, but it's essentially through microbiome changes, at least one of their mechanisms for which is going on. Because there are again those protobacteria, their populations go up when exposed to stress hormones. Yeah. And our good bacteria populations go down. That's was shown Even in the 1970s and 80s and 90s we had research showing the negative impact of stress on microbiome composition.

Yeah. Wow. Jason, this has been a tour de force of the microbiome. So I know you consult with patients and I think you're still open to taking on patients, but you Also have a whole heap of online educational courses both for clinicians and probably for interested end users. So where do people go a if they want to. Presumably you'll do microbiome testing and then interventions with your patients.

Yeah, microbiome work is a core aspect of my clinical practice these days.

So where do people go for that and then where do they go if they are interested more and want to take some of your online courses?

Yeah, so I've got probably three, three different umbrellas. My clinic is the Horwell, I like GUT and Microbiome Clinic and I've got a number of microbiome trained clinicians who work with me to satisfy the desire to have, you know, microbiome clinicians to work with for range of chronic diseases or just for optimizing health. I've got the Microbiome Restoration center which is my sort of main educational center platform where we have courses primarily for health professionals to upskill them both in terms of. We did have a advanced microbiome manipulation course which is about making people microbiome analysts. At the end of going, let's do 10 weeks of intense training on microbiome analysis. You become proficient at this task and another course on sort of treating gastroenterology conditions like IBS and reflux and things with evidence based natural medicines and lifestyle and dietary modifications. And then the Probiotic Advisor is my other sort of umbrella where we have that probiotic evidence based database and we do have some. The odd course more for the general public too. Like the media Microbiome course is designed for the general public. But most my offerings these days are geared in for health professionals because I mean I've been teaching health professionals probably from 2001 when I first started teaching. So long time. I love it. It's like my preferred sort of teaching population. But I also, I've been working with patients for, you know, nearly 25 years too. So I absolutely love being in the trenches and actually prescribing things, doing microbiome work and seeing the before and after on tests and how they feel. You know, the number of times you change the microbiome. Oh, they've got more energy. Oh, the brain fog's gone. Oh, they're no longer depressed or anxious. It's just like, you know, some of those things that seem so core ingrained that we can just change through changing the microbiome composition, making the gut function better. It's just amazing to see in real life practice.

It is pretty amazing. Jason, you are on the, the, the forefront of the what I think is probably a next frontier in medicine. And those traditionalists who think that the gut microbiome has got no role to play in medicine need to get their heads out of their arses.

They totally do. And even I keep on hearing people say, oh, we don't know enough to move yet. I'm like, oh, my God, like, how many more cities do we need? And they're like, and it's because you don't know enough doesn't mean other people don't. Yeah, that's the thing too. I agree. You don't know enough to make any changes here. But there are people who do. There are people who've spent 20 years researching this or more, and they do know how to change the microbiome and they do know how to actually get positive health changes from that. Yeah. So I think ignore those naysayers there too.

One last question now that I've wrapped up, but how far away do you think that we are from personalized diets based on the microbiome?

I mean, you can do a degree of that now for sure. Yeah. We can do a microbiome picture going, eat more of these foods, eat less of these foods, and we'll generally see the changes we want to see. Okay. But some people react uniquely to things and don't react as in typical. So I think there are some exceptions to that about that. That, as a clinician can be challenging because it's like research tells me this, what this substance does, it does this in 90 of my patients. Totally fine, as it does in the research. But the occasion person, it doesn't. And then you have to try to work out why that.

Well, we have outliers, right?

Exactly. Yeah. So. So I think we're already there to a certain degree. Yeah. I think again, as research moves into greater detail with the microbiome will become better with us even still than what we are now. But I think there's still enough there now that we, we can, we can put together, you know, individualized dietary prebiotic sort of regime to optimize your ecosystem based on your initial picture. Yes.

Awesome. Good stuff. Thanks, man.

That's right.