The Vital Connection: Immune Health and Wellbeing

All right. Well, welcome to everybody who's joining us here. I see a lot of people joining the room. I'm Dr. Austin Perlmeter, and thank you all so much for joining. We're going to take a quick moment here while people are coming in because lots of people are joining, which is very exciting. And if you're just showing up here, let us know in the chat where you're tuning in from. We'd be super curious to know where in the world you are and maybe what's interesting to you about the immune system. So lots of people streaming in and I see some chats coming in. We have people coming in from Cape Coral, Florida, which is close to where I grew up. Springfield, Seaverville, Tennessee. We got Oakland. Redmond. Redmond, not too far away from where we are. Sally, in England. That's amazing. Pennsylvania, Spokane, wonderful town. Seattle, very close. Chicago, Melbourne. Melbourne's great. Nice spot in Florida to surf. And for everybody who's just JOINING Now, I'm Dr. Austin Promer. I'm the managing director here at Big Bold Health. Super excited to get to do this presentation for you all today. And just as everybody's kind of showing up in this room, we've got lots and lots of people coming in from all over the place. Comment where you're coming in from, where you're tuning in from, and we'll get started with the official webinar here in just a few moments. But again, yeah, let us know where you're coming from. And maybe if you're interested, what is it about the immune system that's interesting to you? We have Mexico, Columbia, Fort Collins, Lower Manhattan, New York, Buffalo, New York, a lot of New York. St. Louis, Walnut Creek, California, got Scottsdale, Italy. So there's definitely some different time zones here. I'm curious. If you're international, let us know what time it is where you are. Portland, Oregon, a town that's very near and dear to my heart. We got a lot more from New York, some Texas. We have Missouri, Arizona, Waterloo, Ontario. Ontario is amazing. Spent a lot of time there. Lenox, Massachusetts, sunny. San Diego, well, it's not sunny where we are right now. So that's great to hear that you're getting some sunshine. I feel like San Diego is always amazing. 7pm in Liverpool. Okay. Awesome. Thank you, Jen, for tuning in and for letting us know about the time. That's amazing. Bristol, England, also. 7:00pm 8:00pm In Italy, Denver, Colorado. And we still have lots of people who are joining us here. So for everybody who's tuning in, thank you so much for joining. I'm Dr. Austin Perlmutter and I'm the managing director here at Big Bold Health. And so in just a few minutes we're going to jump into this presentation, the Vital Connection, Immune health and well being. And we'll be talking about the links between the immune system and gut state and brain state and energy levels and some of the most interesting new science that connects the immune system to more than just us as people and to look at how the immune system actually links to this planet as a whole and how plants have immune systems and how the microbiome of the plant crazy idea is actually influential in changing the plant's immune system and in doing so changing the way that that plant produces molecules that then impact our immune system. All right, we have a lot of additional people tuning in. So for everybody who's just joining, we are about to go live in just a couple of minutes in this presentation. But just asking everybody to let us know where you're tuning in from and what time it is, where you're tuning in from. So, so we've got again, we've got Italy, we have Denver, we have Colorado, Eastern Virginia, Germany, Bellingham, Washington. Bellingham is an awesome spot. So Margaret, wonderful that you're there. 8am in, I assume that's New Zealand. So New Zealand, that is tomorrow. And then we've got Birmingham in the UK at 7pm Jackson, Wyoming. So lots of different places all around the world. So wonderful. Johannesburg, wow. Got Stockholm, we have Holland. Amazing to see everybody from around the world. And so great to see that you're interested in learning about some of this incredible new science around the immune system and some of what we're doing at Big Bold Health. So one question that just came up that I'll address to everybody who is tuning in is we are going to send out the entire recording from this presentation. So if you miss anything, if you have to jump out for whatever reason, we will be sending you the link to the complete presentation for free and you'll have access to that. So if anything you feel like I go through too quickly or if you want to share it with friends and family, watch it again. You will get access to it. We'll be sending it afterwards. We'll be getting started here, I think just in about one minute. So if you are out there getting ready, settle in, get your cup of coffee. Hopefully not if it's late at night, wherever you are. But where I am it's still early enough for a cup of coffee. So we will just be getting Started here in one moment. Oh, we got Maui. Hawaii. Amazing. Maui is incredible. And then rally, North Carolina, Michigan, so many different places. Okay, so I'm going to assume, based on the comments that I'm getting so far that you're all able to hear me. Okay. That the microphone is on, that you're all able to see me. Okay. That you're all able to see the screen. And so with that said, I'm gonna have one more sip of coffee and we are going to jump in. Okay, let's get started with this presentation. The topic is the vital connection between immune health and well being. I'm Dr. Austin Prominer. I'm an internal medicine doctor. I'm a researcher and I'm the managing director here at Big Bold Health. And Big Bold Health is really unique in that it is a food is medicine company. We have this belief, which is based in science, that food has the ability to heal us when it's used in the right ways. And so our goal has been to look across all of these different foods and nutrient groups and specifically to focus on those that have been shown to be consistently associated with higher levels of wellness through the immune system. And so that's kind of the background that I'm coming into this with, which is I'm an internal medicine doctor, but I also have this belief that food is. Is able to heal us to help prevent problems from happening in the first place. And so it's wonderful to get to team up with a team like Big Bold Health where we actually have farms and fishermen and we're talking about something at a much larger level than a simple quick fix. So we'll jump into this and I would say if people have questions they would like to add, just drop them into the Q and A section on the Zoom toolbar and I will try to get to those as possible. I will say, and just kind of the general disclaimer here is that this is designed for purely educational purposes. I don't have the ability to be your individual doctor, so I can't answer questions that are of a personal medical nature. But I'm happy to answer any questions I can around the science, around what we're doing at Big Bold Health. And if there's anything that you really feel is super interesting but that I didn't get into in as much detail as you would like or topics that you would love to hear, hear me or other people on the Big Bold Health lecture on, teach on. Let us know also in the comments and in the Q and A. And we are planning to do more of these sessions. So the first question I'd like to ask you all is to take a beat, take a moment and ask, what is immunity? We all hear about immunity. We hear about the immune system on tv, in conversations with friends and family, in magazines, on social media. And by and large, the way that we hear about the immune system is that it is something to be boosted. And you've seen these headlines, you've seen these news stories, it's the top foods to boost your immune system. It's the ways to take your immune system from a state of being unwell to being boosted. And the really important thing to know about this is, is that the immune system is not some sort of binary, up, down type of thing. That the immune system is trillions of individual cells, hundreds of different types of cells, hundreds of different types of signals. And to that end, you know, it's not as simple as saying it can just be boosted. I kind of liken it to the idea of saying a person is either happy or sad. That if you ask somebody how they're doing, those are the only two answers. And if they're sad, that they can just boost their way into happiness because it's that straightforward. We're talking about the complexity there of human emotion, of the human brain. And the immune system is the same thing. It is incredibly nuanced. So we know there's more to this picture than simply saying, let's boost the immune system. And at Big bold Health, we believe that we should not actually be focused on, on this boosting of the immune system. The, the boost mentality is really the equivalent of the quick fix. It's saying there is a problem and I should just boost it. And now the problem is solved when the reality is that what we want is a robust, resilient immune system that is, yes, able to defend against problems from the outside world, but is also able to live in harmony with what is happening outside us. And as we'll talk about over the course of this presentation, you'll realize that the immune system does so much more than simply defend against things in our environment. So what we're going to talk about here today in this conversation is we'll go over the basics of immunity so that you understand when people talk about the immune system, what the heck they mean when they're discussing the innate immune system, the adaptive immune system, T cells and B cells. We're going to talk perhaps more importantly, about what immunity actually represents. So where does immunity exist in the body and how does it impact some of These key systems that we all care about so much, our energy levels, how we think, how we act and how we feel. We'll also talk about key strategies to help build resilient immunity. So again, not talking about things we can do to boost immunity, because practically speaking, that's not even a science backed idea, but instead, how do we build a resilient immune system? And then we're going to talk about one of my favorite topics, which is to understand that like so many things in health, it's not just about us. It's not just about us as an individual, that when we really want to change health and understand health at scale, it's really a question of understanding a larger ecosystem and the environment that we live in. So that's why it's important to, for example, support farmers who are engaging in regenerative practices. It's not just because the food itself is better for us, it's because you're supporting the ecosystem for the farmers, for the soil. So we'll get into this specifically as it relates to the immune system. Now before I jump into the next slide, I'll just say if you're watching this later, you know, we really want to be able to do more educational content around this. So if you have ideas or things that you're very interested in hearing more about, feel free to let us know. You can comment on our social media, you can respond to this email. We want to do more to provide education to everyone. So the basics of the immune system. For those of you who have taken an immunology class, this will seem a little bit straightforward. For those of you who have not, which I would argue is probably most people, it's important to know some details. The first of these details is that your immune system contains literally trillions of cells. This is not just the casual. You know, you've got 100 immune cells here, 100 immune cells there. Trillions of cells. Of your body's 38 or so trillion cells, several trillion are immune cells. And so to this end, it's important to appreciate that these immune cells are distributed across your body. You have immune cells basically in every tissue and every part of your body. But the highest concentration of immune cells is located in your GI tract in your gut. Now that'll be really important and we'll get into why in just a moment. But to start understand, you've got lots of immune cells and most of them are located in your gut. Another really, really important point to understand is that the immune system is incredibly dynamic. With each passing moment of Each day, your immune system is reshaping itself. It's turning over millions of cells each minute. It is literally basically converting from one state to another in response to what's happening in your environment, in response to the nutrients you give it, in response to things like stress. We also know that the state of our immune system, our state of relative immune balance and relative immune wellness, is directly related to. To how long we live, directly related to how we think and how we feel, directly related to how our gut works, and so many more ideas. And so one of the things that I appreciate is that when I learned about the immune system, it was kind of this thing that people only paid attention to when things were problematic, when they really said, hey, something's going wrong, or I need to pay attention to this. But when you start to understand what I just described, which is that the immune system influences all these other systems, you appreciate that as we're talking about gut issues, as we're talking about brain issues, we're really talking about immune system issues as well. And so the immune system is kind of a portal into understanding how we think, how we act, how we feel, how our body functions. One other point that I think is very important to understand is that as we get older, as our cells get older, we tend to experience a decline in functional status, and this translates over into the immune system. As we age, our immune system's resilience, its ability to function across all the different things we need it to, tends to decline as well. And so this is really important because each of us can take steps to enhance our immune wellness and our immune resilience. But this may be especially important as we transition into the later decades of our lives, where immune resilience tends to be decreased. So what is the immune system? A seemingly straightforward question. People might say it's a bunch of cells. Maybe they'd say there's some signals. Within your immune system, you are getting the following benefits. You have an incredibly sophisticated defense system. You also have a network that takes data from the outside world and translates it into data for your inside. So it's not just about defense, it's about data transfer. This is an incredibly diverse set of cells, signals that lives in every tissue within your body. And as I've said before, it is influencing all of these other systems. So when people talk about metabolic state, when people talk about lifespan, they're also talking about, even if they don't think about it, the state of their immune. Okay, here's where I give you kind of the test question. Answer if you were going to take an immunology test. If you were taking any sort of a course, you would need to know that your immune system has two major arms. You have the innate immune system. This is known as kind of the quick response branch of the immune system. You've got cells like neutrophils, eosinophils, dendritic cells, natural killer cells. And the innate immune system is concentrated on our barriers. So we think about barriers in the context of the gut. You pro probably heard, you know, you want your gut to be strong so it can fight off whatever's happening in the outside world, but realize you've got a lot of other barriers. So for example, your lung tissue, for example, your skin, these are barriers with the outside world. So this is where these innate immune cells like to hang out. The other branch of the immune system is called the adaptive immune system because it can adapt to threats. It's not just a static system. This is where you have T cells, B cells, where you have what's called immune memory, which is the idea that your immune system can remember things that happened in the past and be more available to respond to them if they happen again. Your adaptive immune system is a little bit deeper in your body, so it's in your lymph nodes, it's in your bone marrow. Now, with this said, we've thought about the immune system as having these two branches that don't really overlap. Research tells us that concept is not correct, that instead of the innate immune system, the quick response immune system actually has a memory itself. And we know that there are cells that kind of play on both sides of this equation, that they participate in the innate immune system and they kind of participate in the adaptive immune system. Maybe the, the key to this entire slide is that the innate immune system can be trained. And what I mean by this is whether it's your innate immune system, your adaptive immune system, your immunity is being changed by the environment in a way that allows it to learn things that then last for months, for years, for decades later. So this is opportunity because we know we can change our immune system. But it's also liability, because if we think about what the modern world looks like, it's probably not changing our immune systems for our benefit. The last point I'll make here is that immunity doesn't just stop where our cells end. And maybe one of the best ways to think about this is through the microbiome. We'll talk about this in a moment. But we're covered in bacteria and we're covered in other microbes. And we know that those microbes change our immune system, and we change those microbes. And those microbes are not part of us necessarily. They're on top of our tissues, but they are still part of how our immune system works. So I'll be hitting this point many times we've got to get outside of this idea that, you know, we are individuals and that in order to enhance health for the planet, we can do that just within ourselves. And that is sufficient. We should be doing that. However, we also need to be thinking about this larger picture of interconnectivity. So, as I said, the key takeaway from the last slide, and really from this whole first section, is that you can train your immune system to enhance immune resilience. It's like exercising a muscle. What you're doing each day is giving your immune system signals that either help increase resilience or decrease resilience. And so we'll be talking about in this presentation, what are each of those signals? What do they look like? What can you do today if your goal is to enhance immune resilience? Okay, the next question that I'd like to pose for you all is, where is the immune system located? And I've, I guess, kind of given you a little bit of this context already, but it's very important to understand where the immune system actually resides within the body. So, as I mentioned before, about 70% of your immune cells reside in your gut, which is incredible if you think about it. Why would your immune system that we usually think about as floating around in the bloodstream so it can defend us against problems. Why would it be located in the gut? And there are a number of really good reasons for this. So one is, you know, what else is located in your gut primarily is your microbiome. You have roughly the same number of microbes on your body as you have cells, your own cells. And the majority of these microbes, specifically bacteria, are located in your large intestine. Now, the reason for this is because that is the environment that is most conducive to these microbes surviving. So it's warm, they have access to a continuous fuel source, which comes in the form of your food, as well as the mucus that your gut cells produce. And your immune system is located in the gut, in large part so that it can learn from the microbiome so that it can learn from the food that you're consuming. Your gut is about 22 to 30ft long, depending on the person, and it covers. This has actually been updated at One point, it was thought to be the size of a tennis court. We now believe it's closer to the size of a studio apartment. But that is still a ton of surface area, and it's a ton of area in which interaction between your microbiome and your immune system can happen. What happens in the gut doesn't stay in the gut. And I recently wrote an article on this because it was thought for a long time that different parts of our body didn't really communicate, that if you had an issue in one spot, stayed in one spot. And now what we understand is that the gut actually translates data, communicates with the rest of your body. So it translates data into your bloodstream, it translates data into your immune system, and it translates data into your brain. And the way that these things are linked include molecules like short chain fatty acids. It also includes immune cells and signals that go from your gut, get into your bloodstream and can influence other parts of the body, including the brain. We also know that the vagus nerve, which is the longest cranial nerve, runs from the brain all the way to the gut. But more importantly, the majority of the fibers run from the gut to the brain. So it's carrying data from your gut, including immune data, to your brain. The gut, basic things that it does is it has to collect nutrients, it has to collect data, and it has to keep things out of your bloodstream. Three very important tasks. And all of this, again, relates to the immune system. So now let's take a beat, and we're going to talk about the gut microbiome. And again, if you're joining US Now, I'm Dr. Austin Prominer. I'm the managing director at Big Bold Health. And today we're talking about the vital connection between your immune system and wellness. And if you have questions, drop them in the Q and A. And depending on how the time goes, I will try to get to them at the end. So let's talk about the gut microbiome. I'm sure that many of you, if not most of you, have heard about this gut microbiome. It is one of the most impressive areas of recent research that has completely transformed how we think about humans. Because what we now realize is that so much of what makes us who we are is actually being driven by the state of the bacteria in our GI tract, which even for me, going to med school not that long ago was certainly not something that was often described. And it is. It's beyond almost biology into understanding philosophically who we are as people. So the gut microbiome is made up of trillions of microbes, bacteria, archaea, protists, viruses, fungi. It is an absolute ecosystem in and of itself, and primarily, again in the large intestine. While there's roughly one to one as far as bacterial cells and human cells in the body, there are about 10 times more genetic material from these bacteria in our bodies as we have genetic material from ourselves. And roughly about a thousand different bacterial species live in the gut, where they influence production of molecules like serotonin and they influence digestion and they produce molecules like short chain fatty acids, which we know have immune active effects. And I think the gut is fascinating. I think the microbiome is fascinating. You've probably heard some ideas around, for example, that the majority of the serotonin in your body is produced in the gut, in part through the gut microbiome. That is true. Where I would caution us all is there are things about the gut microbiome and the gut in general that are unbelievable. And there are also things that can be easily spun to help us explain things that we don't understand but that aren't quite right. So just a quick myth bust here. It is true that the majority of the serotonin in your body is produced in the gut, specifically by gut cells called enterochromafin cells. However, that serotonin cannot penetrate your blood brain barrier. So the serotonin in your gut is involved with motility, so it's involved with food transit, for example, but it's not necessarily involved in mood directly. Doesn't make it any less interesting. But I'm just cautioning you all here that there are certain things that have been blown out of proportion. There are plenty of things that are interesting enough without having to do that. Okay. Your gut microbiome is being regulated by and regulates your gut immune system. This is so important that there is a bidirectional communication between your gut microbiome and your gut immune system. So what happens to the gut bugs influences your immune system and vice versa. We know the gut microbiome is modified by the diet we consume. It's modified by the exercise that we get. It's changed by the sleep or the stress that we experience. Even being in nature, as we'll talk about in a moment, impacts the gut microbiome. So the gut microbiome is also linked to all of these things that we care about so much. General wellness, mood, longevity. And so this has really been deemed one of the principal ways to reconceptualize how we can enhance wellness. And it turns out that of the biggest ways that the gut microbiome can do that is through its effects on the immune system. So when we look specifically at the impact of immunity and the gut, we know that immune state impacts gut state and vice versa. We know that gut microbes impact gut immune systems, gut immune cells, and vice versa. And we know that in order to enhance immune resilience, which, again, is really the goal that we should be looking at here, that we should be paying attention to the state of our gut, the gut cells, the hormones they produce, as well as the gut immune cells and the microbes, we need them all to speak to each other and be on good terms. We need them to engage in constant, positive communication and not allow that communication to break down or go in a unhelpful direction. Some additional things to consider here. This is just going to be my quick moment of hard science for those of you who are out there and hard science to take home. So your gut is coated in a layer of mucus. It's called mu sin. And this mucus later contains antibodies and antimicrobial peptides. What I mean by this is one of the core pathways by which your gut immune system influences the gut microbiome, is the production of these immune molecules that change the populations of bacteria in your gut. We also know that the gut immune system, specifically these dendritic cells, can actually reach their arms in between your gut cells to pick up data from the gut microbiome and from food, and to take that data and teach the immune system about what is happening in the outside world. We know that the microbiome in the gut can program the gut immune system towards a state of balance or imbalance. So our gut immune system listens to the gut microbiome, and depending on the data it receives, it actually changes the makeup of that gut immune system. As I've said before, all of these things are influenced by things that we have control over. The food we eat. I would say stress is a little bit more variable as to how much control we get. But certainly sleep we receive or don't receive, the exercise we get or don't get. So this is kind of a full loop, in my opinion. It's the ability for us to understand that there is good science around the fact that the gut is impacting the immune system and that there are things that we can do to more positively modulate that interaction. Okay, so to this end, what are the things that have been linked to better gut immune balance and just general better gut wellness? Well, a diverse range of foods And I'm going to start here with trying to make some, some science backed references that are a little bit more general. And I know that many of you out there are thinking, oh, but I heard about a lectin. And so there are lectins in those nuts and therefore that can't be something I should consume. I want to try to stick to what do we know across the majority of the research to be linked to beneficial outcomes in the majority of people. So that's where I'll begin and I will say, of course, if you have questions or concerns about this, this is where you really do need to work with a health care practitioner. Because every person's body is unique. But generally speaking, the things that have been consistently linked to gut balance and gut wellness is eating a diverse range of foods and in particular plant based foods. We're learning that fermented foods, so things like kimchi and kefir, that these are things that actually contain microbes, bacteria may be beneficial to people when they consume them for their gut. Again, that may not work for everyone. These are general things that have been shown in the scientific literature. Another trend here, which has been a more recent trend we've seen in the literature, is that consuming polyphenols. And so looking over at this photo here, there's all sorts of colors, right? The broccoli is green, the blueberries are blue, the, the cucumber is green, the orange is orange. The reason that fruits and vegetables are colorful is because of these molecules called polyphenols. Polyphenols are found in nature because plants need a way to signal to other plants, to microbes and also within themselves, and they also allow them to defend against the environment. But it turns out that when we consume polyphenols, which are concentrated in spices and again colorful foods, that this may actually positively impact our gut state by way of the microbiome. Additionally, fiber. And I'm say this one more time, these recommendations or these ideas are not going to work for everyone because every person's body is different. But by and large, when you look at the scientific literature, it supports the idea of a high fiber diet. In the last century, the amount of fiber in our diet has dramatically dropped off. And we can see in cultures around the world that still eat high fiber diets a big difference in the gut microbiome composition. There's also research suggesting that we should limit artificial sweeteners and really just anything that is ultra processed. I'd say sweeteners in general. There's actually more literature, but artificial sweeteners we've learned primarily from the animal based literature may disrupt the gut microbiome. And I would just generally say, I think minimizing exposure to anything ultr processed, in which ultra artificial sweeteners are a great example for the most part of an ultr processed food. Okay, so the key takeaway number two here is that gut immune balance is a major portal to overall wellness and is influenced by our choices, including diet and how we experience stress. A diet that is rich in colorful fruits and vegetables, high in fiber, low in processed food, has been linked to a healthier gut state as well as to a healthier gut immune connection. So what does this actually translate into? Well, people, when you go to the grocery store, when you go to the farmer's market, try to diversify the color, the types of foods that you consume, specifically as it relates to plants. So I'm not saying you have to go out and buy the Jerusalem artichoke or sunchoke every time you go to the grocery store. Um, I'm also not saying you have to like, I am get really interested in Romanesco, which is kind of a crazy cauliflower like plant. But I do think for most people, diversifying your plant intake so you're not just always consuming wheat and corn, soy and rice. These tend to be the major sources of plant calories in people's diet is a good plan. Okay, so that's the idea behind the link between immunity and the gut. Now we're going to go into, I think, my favorite topic, which is brain state. And how in particular does immunity link with brain state? One of the biggest breakthroughs, in my opinion, in the entire realm of neuroscience and brain science in general, is that the brain is not separate from the immune system. In fact, the exact opposite of this is true. The brain has its own immune cells and it participates in systemic immunity. Talk about what that means in a moment as it relates to the cells within the brain that are immune cells. They're called microglial cells, if you've just heard this term. It is a sciencey kind of thing. But the bottom line to this is to know that about 15% of the cells in your brain are immune cells. You know, only about 50% of the cells in your brain are actually neurons, the cells that everyone knows, oh, you have neurons in your brain, look, that's really important. But it's also important to know you have immune cells in your brain. And the, the really, really interesting thing is that the state of these immune cells in your brain, these microglial Cells has been linked to mood, to cognition, to how we think, how we act, and how we feel. So immunity in the body might be linked to whether we have pain in a joint, but immunity in the brain is linked to how we think and how we feel. And that, in my opinion, opens so many doors in reconceptualizing both what is going wrong and is going right within the brain. A balance of microglial cells. And again, this gets a little bit technical, is now being shown across a host of different studies to be a key driver of mental wellness as well as cognitive health. So this is, this is a brand new area for many of you, I'm sure, But the core takeaway here is that your brain's immune system exists and is incredibly important because it changes in response to many of these exact same lifestyle variables in real time. So how does the brain's immune system, or the immune system in general, relate in particular to mental wellness? This area that I publish research on and I think is changing the entire game as it relates to psychiatry and psychology. If you think about mental state, you know, we all have our ideas of the mind and the brain, and there's a concept that the mind is somehow separate, right? The mind is floating around out here, and then you have your brain here. And if you have an issue with the mind, then you have a mental issue. And if you have an issue with the brain, maybe you have trouble thinking straight. I'm here to tell you that's just not the way it works. So the things that we feel are happening in the mind are happening in our body and in our brains. It's not all necessarily in the skull, but these are biological processes. And there's no part of the body more involved in creating our mental state than is our brain. So mental state is a reflection of brain state and brain. Brain immune state is influencing our mental state. We know that when there are changes in the brain's immune cells, it is implicated in people feeling worse, having worse mood. And some of the major pathways to be aware of here include links between the microbiome in the brain, the vagus nerve in the brain, and this barrier called the blood brain barrier that separates the brain from the bloodstream. This is also one of the reasons why, when people are under a great deal of psychological stress, this may actually be linked to a decrease in immune resilience. So, meaning we might come down with something more easily when we're under psychological stress, that suggests that there is a connection between what happens in the brain and the immune state in the rest of our body, which I think is a really interesting link if you consider it. So what do we do about this? This is just a general overview of some of what the research has shown. If you want a balanced brain immune connection, you should be thinking about mitigating psychological stress. And the point I always make here is I am absolutely not going to stand here and tell you not to experience stress. I think that's ridiculous. First, because there are certain things in our lives that are stressful that we just can't not have. And secondly, because we actually do want some stress in our lives. So for example, public speaking is a stress, but it's maybe good for us. So the goal here is to mitigate the unhealthy chronic stress and some of the evidence based ways to do that. Meditation, exercise, nature exposure, mindfulness practice, care for the gut, for all the reasons we've just described, Sleep turns out to be essential for brain state. And it may influence brain immune state, reduce exposure to air pollution. This is one that I've just been learning about a lot recently. So there's a reason I use this little Christmas tree, these little dangly air purifying things that, or air fresheners that people put in their cars are actually a incredibly high source of air pollutants that may damage brain immune state. So a little bit of a, a tip there. If you have that, maybe consider not having it. And then finally, exercise is one of the best studied ways to impact overall immune state. And in particular, it may have a beneficial effect on brain immune state. So key takeaways here would be that our brain state is majorly impacted by our brain's immune state. Specifically these immune cells called microglia, that our gut brain connection as well as the state of the blood brain barrier both impact our brain immune state and that stress may negatively impact immune balance by way of this brain immune link. So now we've covered the gut immune connection and the brain immune connection and I wanted to take a moment here to talk about one that so many people are interested in right now, which is the energy piece of this equation. So here's a statistic that I think is just going to blow your mind. And that is if we consider energy in our bodies and specifically we're talking about, for example, ATP, which is kind of the standard energy currency of the bodies. It's been shown that when our immune system is incredibly revved up, when it's very active, that it can actually suck up more than half of our body's energy needs. So if that isn't a strong statement for the incredible power of the immune system to influence how we feel. I don't know what is. And it's also, in my opinion, an incredible testament to the reasons why bringing immune systems into a state of greater balance is so important. So we usually think about energy and fatigue kind of in our bodies, but the reality of that is that we're just cognitively appreciating this data that's coming in through the rest of our bodies. There's an interesting conversation around why do we get sleepy? Well, why do. Why do we get tired? And one of the kind of core hypotheses right now is that sleep is tethered to a buildup of a molecule called adenosine within the brain. Now, adenosine is also found in ATP. And so when we use up brain ATP, we may produce this adenosine as a byproduct, which then makes us feel sleepy. Just one idea. It's not necessarily fully established why we get tired, but the point is that our feelings of fatigue come from what's happening, in part, in our brains. And this gets back to this idea of what the brain's immune system is doing, because activation state of the brain's immune cells may play a role in whether we're experiencing fatigue. We know that when mitochondria, which are, you know, at a very simplistic level, our body's kind of energy factories, when they're not functioning well, it can actually lead to issues with the immune system. We also know that the basics here, so eating a balanced diet, getting good sleep, getting regular physical activity, these are things that have been linked to better energy levels. And all of these, as we've just discussed, are directly linked to the state of our immune system. So takeaway number four would be energy levels and the immune system are intimately connected, and strategies that help with immune balance are also linked to better energy. So let's transition here out of a couple of these kind of nuanced verticals of the immune system as it relates to these systems in the body and go towards what the research is telling us may be some good steps if we're trying to put together a roadmap for immune resilience. And I'll just say this again, it looks like we are getting a bunch of questions and comments. I will try to get to these at the end, but if you have additional questions, comments, or suggestions for additional lectures and content you'd like to see, drop those into the Q and A or the chat, and we will try to get to Those. Okay, so let's get into the immediate roadmap. What are some of these things? First point, immune balance is not necessarily a static term. The idea here is that we're trying to bring our immune systems closer to a state of resilience, closer to a state of being able to handle what the world is throwing at us. But it isn't as though we achieve it and then we're done. It's not a number that once we've hit it, we're good to go and we should just go back to our unhealthy habits. The goal here is to focus on immune resilience over the course of our lifespans as a way to, of enjoying life a little bit more. To this end, we know we can make decisions each day, little things that can compound and produce substantial impact on our state of immunity and therefore these other states of wellness. So let's get into this a little bit. This is going to be maybe the most kind of dense slide. But one of the questions that we get so often is the question of foods. What about foods? Are there good foods? Are there bad foods? So I wanted to get into this in a little bit of detail. First thing to understand is that food is not just going to program your state of immune balance. Food turns into your immune cells. And just like we would think about with the brain, which is you're building your brain out of your foods. Why would you not build it out of quality foods? We need to be thinking about that as it relates to our immune cells. We also know that food is changing things like the gut microbiome, which as we've described, has a direct impact on our immune system. So I would approach this from the perspective of saying food changes the physical structure of your immune cells, food changes the function of your immune cells, and food changes these other systems within the body that program our immune cells, like the gut microbiome. By and large, what I would say is consistent in the literature is that a plant rich diet, a diet that is rich in plant based foods and a diversity of plant rich foods and is not ultra processed, that's the key. You can have an absolute junk food diet that is rich in plant based foods. If you're eating white bread 24 hours a day, that is a plant based diet, it is not good for anyone. So the point being a diet that is rich in a diversity of minimally processed plant based foods has been linked to better immune balance. Eating more colorful plant based foods rich in polyphenols is a good way to get a diversity of immune related molecules into your day. Minimizing ultra processed food, also a good idea. Prioritizing spices, herbs in your cooking is an amazing way to get additional polyphenols. Um, I will also say here something that we haven't gotten into in as much detail. So when you look at your kind of macronutrient classes as it relates to the immune system, you have carbs, you have fats, and you have proteins. And so carbs are an easy one to kind of villainize because we do know that many of our ultra processed foods are rich in incredibly bioavailable carbs, which we call sugars that don't seem to be doing any of us any services. But fiber is also a carbohydrate, and we know that fiber is actually linked to better wellness outcomes. When we look at fats, for example, we know that certain fats, for example, trans fats, are linked to worse states of wellness. And so we'd say, great, we want to consume less trans fats. But other fats, for example omega 3 fatty acids, have been linked to better immune balance. So the point here being, while it's really easy and potentially alluring to in essence write off certain nutrient groups and say, don't eat carbs, eat a ton of protein, the reality of it is there's a bit of nuance to this. And that's why I go back to this idea of consuming a diet that is rich in minimally processed whole foods is what has been most consistently shown to be of benefit as it relates to these outcomes. All right, what about exercise? So yes, exercise is important, but a caveat to this is that too much exercise, so not trying to take away from people who are ultra marathoners and others who really like to push it as it relates to their movement, but when, when you push your body beyond moderate exercise and into high intensity exercises for too long, that can actually throw immunity out of whack. And we see that as it relates to the scientific literature. It doesn't seem that there is any, you know, dose response negativity around small amounts of exercise. So even yoga and stretching, probably a good idea. But the key here is to find the exercises that you enjoy and that you can feel are doable most days of the week. Habits are key to this. We'll talk about that in just a moment. I have told so many people to exercise more and they don't. And then I say, well, I did my part and you just blame somebody. Let's be honest for just a moment, it's not that Easy for people to just go from non exercising to exercising. So some ideas to do, some basic movement would be just going for a walk with friends, with family, with your pet. Anything that you can do that is enjoyable is going to be far more likely to stick. That is some sort of an incredibly intense workout that you can only stick to for a couple of weeks. And so to this end, I want to take a moment here to highlight the role of habits. Now, you may have heard books like Tiny Habits, like Atomic Habits, the Power of Habit, Good Habits, Bad Habits, these are all wonderful resources. The bottom line here though, is that habits are unconscious behaviors that drive up to 40% of what we do in the day. If you're going to ask a person how much of what you do is unconscious, they might say, oh, not much, I'm always making decisions. But that's not true. So much of what we do is actually driven by these unconscious loops. And so changing your habits is one of the most underutilized ways to improve the kind of benefit of your lifestyle modification. Here's what you do to create a healthier habit. You do the same thing time and time again. You tether your actions to reward and you make these things simple and enjoyable. So instead of saying, I'm going to go for a five mile run every morning, even though I hate it, you say, I'm going to put on my shoes, I'm going to walk out the door and I'm going to do the loop around my neighborhood and I'm going to drink my coffee while I do that. Because you want to make it pleasurable. This is what sticks and this is what leads to long term behavior change. And it takes about two months to form a new habit. So as you're creating these healthier habit loops, think about something that you can stick to for at least two months before you, before you start to get some of these things happening automatically in your brain. Okay, let's talk about stress again. Stress is not a good thing when it's chronic, when it's incredibly high. I'm not going to be able to solve for that for an individual. And I think that that's really an important thing for me to say because I think it's unhelpful to imagine that I can solve for everyone's issues. What I can say is that there are things that we can do to mitigate stress. So mindfulness practice, it doesn't have to be a certain type of meditation. I'm not saying you have to be a transcendental meditation expert, but Find ways to bring more mindfulness into the day where you're focusing your attention on the present moment. That can be going for a walk in nature, that can be going for a walk with your pet. Usually what it's not is scrolling on your phone. It's not watching tv. It's finding things that you can do where you really feel present. I think an easy thing to do is to set aside a little window each day for some sort of a mindful practice. 10 to 20 minutes journaling, breath work, whatever that might be. There are a lot of wonderful ways to make this happen. Now, I can't do a presentation turns out without talking about dachshunds. No, actually talking about sleep. Sleep is, is fundamental. It is one of the most important ways to bring every aspect of our health back into balance. And as it relates to the immune system, it is incredibly cheap, incredibly accessible, and incredibly underutilized. So many people, roughly one in a third, are getting insufficient sleep in the United States. And this is a major, major liability for the immune system. So getting better sleep is linked to better immune balance. 7 to 9 hours of quality sleep a night. What can you do to make this happen? Some of the variables I would highly recommend is to consider lowering your temperature of your room. People sleep better when the temperature is a little bit lower. If you're in the States, that's something around 68 Fahrenheit or lower, trying to decrease the noise. So I like to use a sound machine, but it might just be putting in curtain, putting in a carpet, putting in a tapestry on the wall, if that's what you're into. But the point being, decreasing the noise actually improves the quality of the sleep and then light. Obviously, most people sleep better when it's not bright in their rooms. But something very few people understand is that blue light at night, meaning the TV that you put in your bedroom, the smartphone that you're scrolling on right before bed, these are big liabilities to your sleep quality. Even if you fall asleep, your. Your night may not go that well as far as the sleep quality. So decreasing your light in the bedroom is a great tip. Lastly, alcohol decreases sleep quality. There's no two ways about it. Caffeine can decrease sleep quality if you drink it too late in the day, which is a reminder for me to have one more sip of my coffee because it's getting late. But trying to mitigate caffeine, and specifically after about 2pm, potentially noon, depending on your level of threshold for how much you experience caffeine's effects, and then the nightcap, the nighttime, alcohol, really not a good idea as it relates to quality of sleep. All right, so now we've talked about three areas where the immune system is located and where it impacts our day to day state of wellness. We've also talked about some strategic ideas around a roadmap for ways to bring immune resilience up and to bring immune balance to the forefront of what you're trying to work towards each day. This next part of this conversation is really where I think all of us benefit from taking a moment and reflecting on. Because immunity, as much as we've thought about it as an individual and our own immune systems, is a much bigger conversation. In order for us to achieve resilient immune wellness, we have to be thinking about more than just ourselves. And that means not just being concerned about the state of ourselves, but being concerned about biodiversity within ourselves and within our systems. So let me share with you a really interesting study that speaks to this. We're going to be talking about how in this study exposure to nature impacted the immune system, impacted the microbiome. Study was called regulation of the immune system by biodiversity from the Natural Environment and Ecosystem Service Essential to health. This was a 2013 study. And what they talk about here is that the microbes around us are changing our immune system. And I don't mean just the microbiome within our gut. I'm saying that being in nature and being around the microbes in the soil actually changes our immune system. So this is one of the reasons why green space is so important. And it may help suggest that one of the mechanisms by which green space is linked to better wellness is through the immune system. So what they say here is that green space is, is kind of driving some of these benefits by regulating the immune system through the microbiome, through microbes, and that this is an essential for our well being. So really important if you let this sink in, it is not just a question of are we getting the right carbs, fats and proteins each day, are we exercising enough each day. It's a question of what is the ecosystem that we're participating in and if we really want to go to the larger level, it's how do we support an ecosystem that supports us. To give you an example of where this information is coming from, we know that the microbes around us change the microbes within us and that the microbes within us are being shaped by the microbes in the soil where our food is being raised. There are a couple of concepts around this, some of which you may Be familiar with the old friends biophilia hypothesis or the biodiversity hypothesis. What this is saying is that when we are exposed to microbial diversity, so if we, for example, are on a farm or being exposed to nature and animals, that it increases our internal microbiome biodiversity. And this correlates with our immune state of wellness. And so the environment we find ourselves in and the diversity of our environment correlates with our state of immune balance. Basically, our microbiome is impacted by the biodiversity around us and this impacts the state of our immunity. We've seen a lot of amazing advances in kind of translating this information, meaning understanding how what happens in the soil impacts human wellness. We know that when a soil has a more diverse microbiome, that it means the ecosystem is healthier. So if you're on a farm and that farm has soil that's filled with microbes, that tends to be part of a larger community of an ecosystem that is more balanced, more resilient. We know that when we improve the soil microbiome, it actually improves the nutrient content of the foods that are grown in that soil. And so if we're going to then eat those plants, you see how there's this kind of effect where the biodiversity and the wellness of the soil actually translates into the same benefits for us. So we're talking about here improving human immune resilience by improving the immune resilience and biodiversity of ecosystems. We also know that when we support farms, farmers who are engaging in some of these practices, practices that it decreases the need for supplementary fertilizers, for pesticides, for herbicides, basically the antibiotics that are often used in conventional farming. Why does that matter? Well, you understand that if a person takes a medication that kills microbes that can decrease microbial diversity within us, well, the same thing can be true in soil. And so this is still early research. But the cornerstone of this, the point is that if we're trying to say do these ideas generalize? So do the things that matter for humans matter for plants, matter for soil, matter for animals? The answer seems to be yes. And if we're really invested in what's going to be best for us, it turns out also to be investing in things that are good for plants and animals and planet. So here's the concept kind of in a, in a diagram format. It's what happens in the soil influences what happens in the plants, which influences what happens within us. So a couple of ideas around this concept, around the idea of kind of enhancing the diversity of soil, enhancing the diversity of nutrients within our food and in doing so, enhancing immune resilience. We know that certain plants, certain foods, are richer in diverse nutrients and also tend to support more diverse ecosystems. One of the reasons that we're so invested in Himalayan Tartery Buckwheat at Big Bold Health, because we know that these ancient and heirloom plants are not only richer in a whole host of nutrients, but they actually in many cases, support a healthier soil and environmental ecosystem. We know that when crops are rotated, as opposed to monocrops, which is what we see a lot of in the United States, and looking at some of the countries that many of you are coming from, it is not necessarily foreign to you as well to understand that most of your calories are coming from corn, wheat, soy and rice. So supporting diverse farming is actually a really important way to support diverse nutrients. For us, this means also encouraging diversity of nutrient consumption, eating a bunch of diverse foods. And at a very local level, this means trying to support seasonal eating, trying to support local farmers sustainable practices, and eating foods with diverse nutrient profiles. So one of the things that we are invested in at Big Bold Health is trying to do what we can in our own little corner of this kind of conversation. So we're looking at right now how we get rock certified, which is regenerative organic certified for our Himalayan Tardary Buckwheat. We're already USDA organic certified. And the reason that this matters so much is that, you know, as all of us as consumers, trying to place our vote as to what are the things that are most important to us. It's tough when we are constantly posed with this question of what is the short term gain versus the long term benefit. And I would just say as a moment of my own kind of personal psychological state, that we are in a really challenging place as a planet if we are not willing to invest a little bit more in long term sustainability. When we see that so much of what we do is predicated on the idea of the short term fix, it has already gotten us into a state of incredible liability as far as the future of this planet. So finding ways to make these choices, to vote in a way that votes for long term sustainability, I think is so important. We know that when we promote organic, we are actually voting for richness of soil and richness of ecosystems. So this study shows that organic farming increases species richness by 34% and the abundance of life in that system by 50%. So these are not trivial things when you consider what is happening at the scale of the planet. So in closing here and I'll try to take a couple of questions here at the end. You know, this is, this is what we're interested in here at Big Bolt Health is trying to help to connect some of these dots. Thoughts, trying to link what is happening at the level of the immune system, the immune cell within a person, with what is happening in our food supply, with what is happening in our gut microbiome and what this represents as a larger conversation around where we're going as a planet. So we are committed to enhancing immune resilience not just for people, but for plants, for planet, for animals. Because we think that's really the only way that some of these things can, can go to this level of scale that is both what we desire and what is necessary. So with that I will be ending the presentation there. I'm so thankful for all of you, the many, many people from around the world who have joined us today. And I'm going to jump in here into some of these questions in the Q and A if I'm able to address them. So stay tuned here and we will look at this. So here's a question that I like. Let's talk about alcohol and whether it's good or bad for us. So this is a, a, a common debate. Um, what I would say is the research would suggest that we're a little bit unsure as it relates to kind of low to moderate use, but at high levels it's definitely something that we should be avoiding. Um, I wrote an article on my website, you're welcome to check it out there, that answers that question in a little bit more detail. Um, let's see. So there's some of these questions relates to kind of specific medical questions for individual. And I'm not able to answer that. There's a question here about eating a lot of food, even if in season, could it be bad for you? Could it be bad to consume too much? I mean, again, each person is different. Your GI tract, your needs are going to be different. What I would say is coming back to one of the core themes of this presentation, that diversity of plant based foods seems like it is the key. Now that's not going to mean that every night you're going to the grocery store and shopping for an hour and spending three hours making some sort of a, a gourmet meal made only of heirloom plants grown within two miles of your home or from your backyard. That would be wonderful. That's not viable for most people, it's not viable for me. But it does mean I believe that diversifying and saying, how can I add something new maybe a couple times a week, a colorful plant, a new spice. Spices are incredibly concentrated sources of polyphenols into your diet. And in a perfect world, you're also excluding something ultra processed by bringing in something that is not ultra processed. Let's see some other things. Would eating plant foods that are currently in season also be shown to be more beneficial compared to eating berries year round? Yeah, I mean, there's some interesting work being done on seasonal eating. What I think is great about seasonal eating is that you're supporting your local kind of ecosystem and your local farmers. I would also say though, that as you're looking at sustainable ways to get nutrients, I mean sustainable from a financial perspective, nutrients into your days. You know, frozen berries and vegetables are a great cost effective way to still maintain some of the benefit of seasonal eating because those berries, for example, tended to be harvested at the peak of their season. So for me, I can go to Costco and I can get blueberries from Peru in December. That is maybe not the best use of resources to get those blueberries here. And also they don't taste anything like the blueberries that are local here in the summertime. But if you buy the frozen blueberries at Costco, they come from local farms up in Washington, which means that they are still kind of, I guess in theory supporting local by way of Costco, which is strange. But more importantly, they preserve some of the nutrients that tend to be higher in the right season. But a really interesting question, how to support immune supporting bacteria and metabolites. So let me just do a quick moment here and I'll just say this presentation will be sent out. So anybody who is either tuning in late or wants to get access to it, you'll get access to it. I think we're going to send it out in the next couple of days. But as it relates to the bacterial kind of immune connection. So there has been some research done on specific probiotic strains, meaning consuming specific microbes as it relates to benefiting whatever aspect of wellness. And there are a few. We study one at Big Bold Health called Lactobacillus rhamnosis ARL 1505. But as it relates to food in general, I believe what the research is telling us is that the best bet is to try to consume diversity of nutrients and to consume, you know, diversity of both pre and probiotics. And what I mean to that end is we're now learning it may not be so much about the number of live bacteria that we consume, but about how we feed the bacteria in our gut that makes this big difference. And potentially consuming dead bacteria, which is an interesting thing, or the things that the bacteria made, which are called postbiotics, they're metabolites. So there are all sorts of ways to get into this. But one of the most studied pathways relates to what are called short chain fatty acids. And short chain fatty acids are molecules that are metabolites of bacteria, meaning when a bacterium consumes food that we give turns that food into these metabolites, of which short chain fatty acids probably the best studied. So short chain fatty acids have been linked to a number of wellness outcomes. So we tend to think it's good to produce more. So then you'd say, well, how do I do this? And this gets us to the topic of prebiotics. These are things that we can consume that feed our microbes in a way that supports the balance of microbes. And one of the best studied, no, the best studied way to support the production of these short chain fatty acids by our gut microbiome is to consume dietary fiber. Which is why I think it is important to potentially challenge this narrative that it's a good idea for certain people to just perpetually be eating only animal products. Now again, each person is different. Should work with your practitioner on this topic. But one of the downsides to many restrictive diets is the absence of dietary fiber, which is found in whole plant based foods. And some recent studies came out showing that people who ate more fiber did a lot better across a variety of wellness related outcomes. So, you know, you can go in and talk about specific fibers, you can talk about inulin, you can talk about getting digestible or soluble fiber, insoluble fiber. That's all very interesting, but I do think for most people there's so much to be realized by simply saying, am I eating mostly minimally processed whole foods that are, are one ingredient? There's a huge difference between a broccoli chip and a piece of broccoli. So I know that we are kind of getting to the end of the hour here. And I'm just going to say here that we got lots of questions in the Q and A still and lots of chat here. So we will be sending this out. We have Trish Yuri who's helping here. So Trish, if there's anything that you would like for me to know, just let me know here. Otherwise we're going to be closing this out. And for anybody who wants to get more information on all that we've talked about here, this is the website bigboldhealth.com you can follow Big Bold Health on social media. My social media is on the bottom here. I'm Dr. Austin Perlmutter, and I'm just gonna say this again. I'm so appreciative of all of you from around the world for tuning in on this topic. And I love to have the opportunity to chat about these things. You can probably see that I'm very passionate about it, and it's just great to know that there are all those people out there who are pursuing learning for the sake of science and also for the sake of improving wellness. So thank you all so much. I'm going to stop my share here. And I guess, Trish, we are okay to shut it down. So thank you all so much. Hope you have a wonderful day.