Ben Greenfield's Viome Test Results

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Welcome to your VIOME results and recommendations. My name is Ali Perlina and I'm the Chief Translational Science Officer here at viome, and I would like to introduce you to your scores and your microbiome results that are used to give you all of these different food recommendations and also supplements. Right now in the app, what we show you is actually a very unique perspective that we derive from our metatranscriptomics technology that allows us to see what is actively happening. So it's a very unique perspective where actually your microbes are telling us what is going on. The activity is what is measured when DNA is transcribed into rna. RNA is exactly what we measure the with metatranscriptomics technology. And the reason why that's important is because only living active organisms can make RNA from DNA. So because what we sequence, the data that we get from your stool sample is all metatranscriptomics, everything that we see is what is actively going on. And that is the most exciting part. But the next thing that we do is we actually assess specific functional activities. So you will see in your results that there are things like overall scores like inflammatory activity or digestive efficiency, and you will also see very specific molecular biological themes like butyrate production or putresine production. And you may be wondering, what is that? And those are all different nuggets of information that tell us this is what your microbes are doing. And we're the only ones that are able to deliver you information like this in something like a gut microbiome or any microbiome, direct to consumer test. What we do with this information is we look at your specific pattern of activities that are associated with certain wellness areas. So, for instance, inflammatory activity, it can be even in the same score of the same level for different people, but each one has a personal story with personal functional blocks that are active or inactive for you versus someone else. So we take your unique pattern of these pathway functions and activities and we look at it integratively in order to drive your food recommendations. So same goes for metabolic fitness and digestive efficiency. We also look at your overall microbiome richness, and we'll look at specific precise signaling and metabolic pathways that are taking place to see if some foods need to be minimized or even avoided for you, whereas for someone else, it will be in a superfood area. And you will see that in your recommendations with actual reasons pointing you to the score. So it could be very clear which foods specifically address this, this, this score, and it will call out those scores where you need improvement. So when you have this entire profile of your functional activities and you know what is actively going on, only then you can really be empowered to take this biologically informed action on your body and follow the plan, see if you improve these scores. And I hope you enjoy your wellness journey with Biome.

Hi Ben. My name is Ali Perlina. I'm a chief translational science officer for viome and I'm grateful to be here and thank you for being open to sharing your results of VIOME test with your audience. So let's get into it. So, in summary, I just want to get right to it. I want to tell you what are the areas that you absolutely need to focus on. Then we will actually peel it back and I will explain little by little how all of these different insights even come together to affect the recommendations that you see in your app.

So we've done this analysis and actually dug behind the scenes and look at the raw data and analyzed beyond what the app is showing. The reason we did that is because we want to share the concepts and the thinking that went into the type of scores that you see in your results and how this drives your recommendations. So all these bullet points are actually based on manual expert analysis. That's one of the main things that my team does. We take all kinds of different data and we derive insights and connect them to recommendations. That's the translational part, I guess, of translational science.

What you really need to address based on what the microbes are telling us are some of the specific themes within the digestive area.

What I mean by that is that there are many things that can affect your digestive system. Digestive system basically covers everything, starting when the food enters your mouth and all the way through. So digestive system has many different aspects that can make it not function very well. So if everybody said, I need some digestive help, it probably wouldn't be the same for everybody because everybody needs some specific piece or several parts to be addressed. So we will cover those parts, those themes that need to be addressed based on your GI test. I always say this. This is what the microbes are telling me because this is a very unique perspective from your gut microbiome that we sequence and we look at all of the activities and they're actively telling me stuff, even right now. I wanted to say that the digestive themes that we will address will probably be the most important ones. Then it would be also very good for you to take a look at your sources of probiotics and fermented foods. I know that you already take some good probiotics and it shows in your test. We will get to that. But still it's very important to support richness and diversity of your microbiome because the more of that you have, the more resilient your microbiome will be for you, the better it is for the host. That's the second.

Major point.

You do have a few viruses. Even by probably reading the names, it could be inferred what kind of foods you may see affected by them. Prunus necrotic green spot virus is the reason that you have plum on your avoid list. Pepper Mild model virus is the reason you have pepper on your avoid list. There are associations in the literature between these viruses and inflammatory response and for that reason we recommend that people avoid these foods and you don't have to avoid them indefinitely. It could be three to four weeks. So what we usually see is that after retest these viral activities clear completely after our customers avoid virus affected foods.

Now let's look at your actual app screens that showed us the breakdown of your results. This one is microbial richness. Microbial richness score is something we've offered it for a very long time. It's like the summary. How many microbes do you have active? Who showed up and was active? That's really important. It's not the same as composition because compositionally many things can be there and they may not even be alive anymore. But because we measure rna, we sequence rna. That's why our technology is called meta transcriptomics and only live organisms can transcribe RNA from DNA. Then just the mere fact that we see it means it's active. Remember that we see it, therefore it's active. So here it says you have 134 active microbial species. So that means that you literally have 134 species level organisms that are actively transcribing RNA from DNA. So they're alive, they live there. Some of them are very good, some of them are kind of so so. And some are, we call them opportunists. They wait for the right opportunity to do something that is not very good and they will be naughty and they can cause some chaos. But what you do about that is first you take care of your microbial richness and then we will address all these other functions that will assure that all of these opportunists and other themes are in check.

So when you have 134, that puts you kind of on the lower side of medium or average zone. So you see in the app it will show a face like this. It neither smiles nor frowns. With your microbial richness, it's on a lower side of average. That's why you have this purple face that says average. Average just means that this is on average. This is the range where we see results fall.

Just like microbial organisms themselves. When you see these average range results, it's not necessarily by itself good or bad. I want to go back to that point about the microbial organisms, the good ones, the opportunists. If you just focus on just one organism and you have to go and Google and ask is it good, is it bad, you're ultimately trying to make a final statement that supposedly will mean something for your entire health just based on that one guy. But what we do is we focus on active functional themes. So it's the overall microbial or microbiome wide activity and the functional profile of these activities that tell us what's going on. We'll get to that in a lot more details right now. I wanted to say that falling on this lower side of average means that yes, your microbial richness can use a boost. But it's nothing too alarming. If you want to know more about the distributions, we always provide our reference ranges. For example here, when we really think that you need improvement, it's when we see it usually I would say less than 100. But actually our range here goes up to 108 microbial species present and average is all the way between 109 and 217. But I would say if you're closer to 200, you're doing really, really good.

The excellence range, we call it good. But in this case I think it's, it's a very excellent score to have 218 and above. If you see it actually says that it represents 95th percentile and higher of the population, 95th to 100 percentile of the entire biome population. Of course it's quite remarkable if you get there. But if you're anywhere closer to 200, that's really great.

What can we do for your microbial richness? Here's an example. This is taken straight from your recommendation screen and you could see sauerkraut. You will also see other fermented foods. The reason why they're there actually could be many reasons, but one of the reasons is that it will help enrich and diversify your microbiome. You see some of that is highlighted. But actually I want to make.

An introductory point about all of the recommendation text that you see. You see these paragraphs it says sauerkraut is a superfood for your microbiome and gives you explanation. This is just one or two nuggets of information that actually went into the reasoning in our recommendation engines logic. When you see this, just know we could only highlight so much. But the complexity of the logic is such that we take so many different factors, it would probably be too lengthy to actually spell it all out and outline it. But we highlight what we think is the important one. One or two nuggets of information, sometimes three. Depends on their importance. You could see that here diverse microbiome importance is emphasized. But there could be many other reasons why sauerkraut is on your superfood list.

In general. And this is not so general that it's not yours anymore. It's actually still your recommendations. But in general, when you see recommendations here, there's another main reason that may be highlighting walnuts is because of the beneficial fatty acids. Like it has ala. It has other benefits, of course. And there's also olive oil. So there's multiple things that are high, There are multiple things that are highlighted telling you why the foods are there. But also these foods happen to improve your microbial richness and diversity. So if we know that that's the case and we try to highlight that as much as possible for you, and you can see that in the text and that's with the red highlights. So back to your microbial richness. Something that you can also notice is that in your supplement section under your recommendations, it will say my recommendations. So Ben Greenfield's recommendations say supplements and there's probiotics. Actually, there are more than one type of probiotic you can take, but it lists a specific Lactobacillus. There are different kinds of Lactobacillus that may be beneficial for you. I will talk about another one a little bit later. But probiotics is a way to introduce more organisms into your system. Probiotics come in and hopefully if they stay, they will enrich your microbial ecosystem. Your richness score will probably go up. Hopefully when you retest. We could check it out. Polyphenols. So polyphenols, it looks like a separate category. In a way it is. Depends how you think about it. Polyphenols is more of a chemical umbrella term for the types of compounds with these aromatic rings. A polyphenol that we may all have heard about is resveratrol, or maybe somebody heard of curcumin or subclass of polyphenols called flavonoids. So polyphenols even though it's in its own class, actually, they can really feed the microbes and promote the type of environment that will help them thrive. In a way, it's also something that can help your microbial richness and diversity. I will talk more about why we specifically said that cranberry containing polyphenol supplements could be good for you specifically. So all of this is very much, very highly personalized. Now, the digestive support is blank here, but we will get to it. This screen is where we just want to address your richness, your entire ecosystem and what it's made up of.

Next score. And this is also a score that we've offered for quite some time. It's called Metabolic Fitness Score.

Your metabolic fitness score is a microbiome score. Still, these are all microbiome scores. Everything that goes into these scores is from the NGS data. So it's something that came directly from sequencing, directly from your sample. But then again, you have to remember that this is what came from the stool sample. So we're not measuring.

How athletic you are and how much you're running or how much intensity training you're getting, or what's the percentage of your body fat or lean muscle. What we're measuring in terms of metabolic fitness, it's a microbiome's perspective on those things that are important for the host metabolic fitness that includes, as you can see in the text, that includes glycemic control. So things that help us control blood sugar response when we eat different foods. And you actually have some really good results in that category. So some of the foods that are glycemic for a lot of people, for you, are predicted to be just fine. Your metabolic fitness is great. It's really good. Moreover, it actually improved. What the microbes are telling us are those things that are associated with glycemic response or with weight gain control, insulin sensitivity and lean phenotype. That is very much in line for you.

It's also good to see that you've improved since last year. Not that it was bad last year. It was average in the average range. But you could see it refers to the previous result. Here it says September 2018. That's from your previous kit. The current one says it's in the good range. And that's because your metabolic fitness score is high, means there's high level of those really beneficial activities, the pathways. And we'll talk more about that. And also the microbes that are just associated with more fit, more metabolically fit individuals.

That's really Great. And that represents. The good score, represents 18% of ION population. So only 18% of our reference population score as good as you did. So good job on that one.

Moving on to our next score. It's also something that our customers are very familiar with. It's called inflammatory activity. Inflammatory activity score. It's really the cornerstone of this whole thing we're doing here.

We talk about microbiome, or you even Google it right now. You'll see it's about controlling or mitigating or causing or something to do with inflammation and how inflammation starts in the gut. I don't need to talk about why that's important. But inflammatory activity score that we have here, it's actually a microbiome score. Again, all of these are microbiome scores and it's a huge compilation of sub scores that go into this score. We've been showing this for quite some time as well as the metabolic fitness microbiome score. But we never actually showcased all of the different components that have to get scored individually before they come together with different weights and different criteria and different decision trees and the logic to make up your inflammatory activity score. We described some of that in your guide to results, but we haven't shown that in the app. But then we introduced more of these scores that reveal some of these functional patterns behind the scenes. So, for example, your inflammatory activities is, okay, it's average, but these are the subjects, subscores, I should say, or the different components of the score that make up the overall inflammatory activity of your gut microbiome. So why it's important is because if you, you know, if you have too much inflammatory activity, then you may see some things either disrupting the lining and leaking out or causing immune response, or some things that may just make it unfavorable for the beneficial organisms to thrive. And you don't want that. So it could be about the bad guys or the opportunists suddenly taken over. It could be something that tells you that there's a hostile environment in your gut which makes it more favorable for the opportunists to come out and thrive. And not so much for your probiotics that you're taking and getting through your diet. So. So inflammatory activity has all of these scores and you should see them in the app. One of them is LPS biosynthesis pathways, and that is a known inflammatory immune system trigger. LPS is this polysaccharide. It's called lipopolysaccharide. It has a lipid part and the sugar parts and they come together and make this big molecule. There are different kinds of. And LPS is something that microbes have kind of like on their outer coat. And a lot of times the pro inflammatory LPS is something that the bad guys have. So the opportunists who.

You don't want to basically have them get out of control, those are the guys that are known to have the most pro inflammatory LPS molecules. And so they're making these molecules because that's just part of. That's what they wear, that's what they do. And they can leak out, especially if you have a leaky gut. They can leak out through the intestinal lining. And if they do, these molecules can cause immune response. And we really don't want that. So you have that at an average zone, which is okay. But I want to highlight why we even give you such score. That's a very important part of inflammatory activity. So all the scores here are just some of the pro inflammatory activities that we take into account. It's actually a balance between pro inflammatory and anti inflammatory activities. And overall I'd like to just emphasize that.

It'S about keeping that balance. But it's not just about the balance of who is there, it's about the balance of what are the activities, what's going on. So if what they're doing, there's something that could be, I could do without it. But there's a lot of good things that they're doing. It's that balance of activities and functions that is important. And we really believe that and we see it with our customers and our data. These are more of the pro inflammatory ones. And these are not all of the scores that go into the pro inflammatory section of this overall score. But LPS is one of them and a very important one. Then there's a couple of gas production scores. We'll go back to those when we talk about your digestive efficiency.

Methane gas production. Actually, you've tested with us so many times and I always looked at your data and you always had high methane gas production. I just remember that it's almost like you should probably know this. In our translational science team, you are the methanogenesis guy. We analyze a lot of data and we look at different people and sometimes we do these really deep dives and we have our flagella guy, I won't say who it is, but has the highest, most, the brightest flagella. We'll talk about that score too. You are our methane gas production guy. You have the highest methanogenesis. And we don't know why, but consistently, time after time, it's all lit up. The entire pathway that leads to. Well, it's not just one. Multiple pathways that lead to methane production are completely active, overly active, more so than what we see in our usual customer database. So it's not a terrible thing to have. But too much gas production can lead to some of the disturbances in your GI tract and it can also be irritating to the gut lining. It can even end up being pro inflammatory to your gut lining. And that is why this is part of the pro inflammatory activity. So too much methanogenesis, which is the same as methane gas production or too much sulfide gas production, it's something that could disrupt ultimately. But we know that when we see more of that activity than what we usually see, then we may want to take some action with that. And you will see that reflected in your recommendations. Besides sulfide gas, there's also ammonia gas, but you scored quite fine in that. So we didn't highlight that here. But sulfide gas production is something we'll talk about more because it's not only part of inflammatory activity score, it's also part of the protein fermentation, which is part of the digestive efficiency score. It's also part of the gas production. It's something that in different compilations and with different impact with different weights, it contributes to multiple overall areas. So when you see something like this, this slide, it's not the ultimate mapping of all of the different scores and sub scores and how they come together. It's just a small slice of those things that I think are important to highlight in your case. So you might think, well, if this is average, why is it highlighted? In my case.

Because we took a deeper dive and a look behind the scenes. We kind of looked at all of the different ways that your pro inflammatory activities are manifesting. And just based on this, more of an expert view. With everything that we can see right now, it's like on the higher side of average. So because a lot of these things, even when they say average, the expert opinion is that it would be kind of almost borderline high, which would be when it needs improvement. We would say, we believe in making illness optional. So you want to be preventative, so you want to take action before it becomes bad and needs improvement. Especially if it's an area called pro inflammatory, meaning promoting inflammation. So this is why when we looked at it, you'll see some of the pathways, I will show them to you, you will see biofilm and chemotaxis and flagella it's not too bad, but just something to keep in mind. You will see that in the slides that follow. Now, if we step back and look at this, there's one major thing that I did not cover. These are some themes that are part of pro inflammatory category of the inflammatory activity score. But they all have all of these ones. At least on the screenshots from your results. They have this word pathways at the end. And I have not explained it yet. We will actually see some images of your pathways. But what I want to say in general is that we are measuring activities or activity levels of biological pathways. These biological pathways are kind of like the sequence of events that end up resulting in something that manifests physiologically, biologically, as a final function. So, for example, gas production, or there could be something like mucus degradation. So something with a real functional outcome function, as in, like activity. So you think it's. You think of it as what is functionally going on. We use gene expression data to light up all of these different sequences of events. Like this step goes to this step and with this it produces butyrate, or this, with this, with this makes flagella come together and activates it. All of these things are pathways. To put it in nutshell, pathways are the one way and maybe the only way available right now to understand what the microbes are doing. Understanding pathway activities is the same as understanding what your microbiome is doing, what is actually going on. Without seeing these activity levels, it would be very hard to take any kind of action. Because if you don't know what is actively going on, then how would you take action with your personal diet and supplement plans, if you're not even sure if you're being a good host, if you're stimulating the right beneficial activities and functions, and if you're keeping those opportunistic ones or inflammatory ones in check. Pathways, in a nutshell is basically a perspective that we offer into what the microbes are doing, what is actively going on.

I think we'll move on to actually see some of those. Now we have this flagellar structure and we measure with all of the different gene expression data that we have from our meta transcriptomics sequencing from your sample, we measure the overall activity that leads to this biosynthesis and assembly and even transport of this flagellar structure. Because it's like. Imagine it's like an army. And somebody says, the general of.

A specific general says, okay, we have to start making some of this hook protein or some of the filament proteins. Like we got the Hooks, we don't have enough of the filaments or we don't have enough of the ring that will hold it in a specific place or the motor switch. So there's a signal that's sent. Then all of these different genes start firing up. And these genes encode proteins that are structural proteins. It's not about this enzymatic pathway, it's not about metabolic pathway, like digesting something, converting something into something. No, this is actually all of the signals and all of the actual particles that are needed to make a flagellar structure. And flagellar structure is that tail that, that helps them swim and they have many, many tails. You probably have seen a lot of cartoons of microbes. If you've seen a cartoon of E. Coli, it has a lot of these different spaghetti looking things, usually depending on if you get it in the form of a toy or if there's a better cartoon out there. Those are flagella. So flagella structures, when they need to be made, there's all this signaling. And we measure the gene expression. What you see here is your actual data in your data shows. Think of it as the color warmth scale. When it's blue, like deep blue, it means it's active, but it's underexpressed. When it's orange, or if you ever see red, like here, it means it's really overexpressed, highly expressed, more expressed. These genes, these particular genes are more expressed than what we usually see. Yellow is slightly overexpressed. Here you see that there are quite a number of those flagellar assembly genes that are overexpressed but not too highly overexpressed. And some of them are there but underexpressed. So it's definitely not enough to make you the flagella guy you don't want to be in the sense, because flagella is usually a sign of something pro inflammatory happening, either pro inflammatory or reaction to some threat in the environment. Because if your microbes have to move more than they usually do in people's microbiomes, everybody's microbes move. But if your microbes have to move more than usual, then there's either some threat or they are the threat. Okay, so they could be the opportunistic guys and they want to move and take over and fight their turf wars. Or they're the good guys that some of the good ones have flagella and they're swimming away or swimming towards some alternative sources of food or alternative places to stay, actually. So in either case, flagellar assembly pathway activity is not a thing that you want to have really high. Okay, so in this case, it's good that you're not our flagella guy, but you are our methanogenesis guy.

This is the methanogenesis pathway, part of the pathway of you. Ben Greenfield. Methane production. Right here. It's circled right here actually. There are multiple sources that can yield methane. You have a lot of these overexpressed genes. The genes that are expressed, they encode enzymes. And some of these enzymes are needed for this final conversion of, let's say methyl co M methyl coenzyme M molecule to methane. That is a very directional and committed and critical step in this pathway. Also the step that is right next to it, that is also very important in this coenzyme shuttling that happens is, is also very lit up. So you could see, yeah, okay, some genes are underexpressed because they're blue, but there's so many that are there. A lot of people don't even have a single one. So there's so many that are there. And some of them are yellow and some are orange means that they're either slightly or more than twofold overexpressed and the red means that they're very, very unusually overexpressed.

What I want to say is.

In some of the literature, it points to pro inflammatory potential and things that could be disruptive to the gut lining. Also, methane and other gas production by your microbiota can cause some of the motility issues, which means how the food moves along. So it could exacerbate things like constipation and other issues that you would actually literally feel. And I guess sometimes that you confirm that that may be true for you, for your case when we spoke. So in general, okay, so methanogenesis has a bad rep and it's known to be not a good thing to have. But at the same time, we do see methanogenesis in people who are more athletic. We haven't figured out exactly.

If this is always a true pattern, what is the cause, what is the effect. But maybe for you and your microbiome, especially with your metabolic fitness that you have going on, for you, this may be okay, maybe not so bad, still something to keep an eye on because gas production, if excessive, can cause some trouble. But this is your methanogenesis pathway, something that I will point out here. It's called trimethylamine metabolism. You see that this is just a little section of a pathway. It's not the actual final curated pathways that we use for scoring, but because it has this part, I think it's important to mention Trimethylamine, also known as tma, is yet another score that we have for you. That score is average. It's there trimethylamine production pathways.

But it's kind of average. And trimethylamine production is associated with not so beneficial effects because it can be converted to TMAO in the liver and lead to more of the fatty liver infiltration and some of the cardiovascular effects. But in your case, you have trimethylamine used, at least some of it is used up to make methane, you see. So TMA trimethylamine metabolism is carried out by your microbes. So your microbes are making tma, but they're also, or the other guys are taking the TMA and converting it to methane. So that's another point why your methanogenesis may not necessarily be like this alarming theme, but it's an interesting one, right? So it's, it's good to have this perspective and this kind of thinking is exactly what goes into our scoring. When I was hovering over these different genes and I was saying that they code for enzymes, we actually go through all the literature and we see the functional significance of every single gene, every single enzyme, what it means for the host and what actually the gut microbes do and how that applies to the, the lower gi, lower gastrointestinal tract microbiota. And based on all of that curation and the topology, the proximity of how they're arranged in the biochemical or molecular pathways, we assign specific weights and specific decision trees that take into account all that gene expression and give you a score. So that is the type of thinking that goes behind automation of the scores that everybody sees. So that's end to end, automated. And our customers are all able to see something that would otherwise take maybe months and months for humans to go through. But now that we've automated it, we kind of front loaded all of these insights and all of that literature curation so that anyone can have their overall pathway activity levels assessed for all of these different pathways.

Besides methanogenesis, here you have some of these chemotaxis and biofilm and quorum sensing themes that show that maybe there's some communication between the microbes that say, hey, there may be something alarming going on. Maybe for some microbes it's alarming. It doesn't mean that across the board there's something to really worry about because let's go back for one second. This score that talks about biofilm, chemotaxis and virulence pathways, this score is average for you. So it's not something to worry about, but it's just a combination of all of these things in our sort of a deep dive expert view puts you in a slightly higher side of this average range for inflammatory activity. And that's why we want to do something about your inflammatory activity, even though that's not the main area, because we're going to get to the digestive area, which is definitely the top focus for actionability for you. But you'll see that they're actually interconnected as well.

Here I'm showing your score for butyrate production pathways. The way it goes together is that it's actually anti inflammatory. So butyrate production activity is a well known microbial theme that is something that provides anti inflammatory effects. So in a way it either compensates for the inflammatory activity that is already there or it protects your gut lining, your colon, epithelial cells from the disturbance that they may get from all of this chemotaxis and virulence factors being fired at each other by your microbes. So the gut lining stays unharmed. Butyrate is really good for nourishing your gut lining and your intestinal barrier, your colonocytes, the cells in your epithelial layer, really love butyrate. They use it for energy and it gets easily absorbed. And also butyrate is good for various functions like your metabolic fitness. One of the reasons why it's so high and it's so good is because you have high production of butyrate. Because butyrate regulates your satiety. That's the metabolic fitness connection to your weight gain and weight control. Also, butyrate production is good for insulin sensitivity. That's the connection between metabolic fitness score and your glycemic response and sugar response control. Butyrate production is overall very beneficial. And these are just some of the wellness areas that I mentioned that it's good for. But it's across the board a very beneficial nutrient that your microbiome can produce for you. You just need to know how to keep it up. I think you do know you're doing something right. And to incentivize your microbes to keep doing this and do it even more. This goes with the inflammatory theme because we actually reconcile all of the pro and anti inflammatory pathway activities and the microbes themselves to come up with this final microbiome score called inflammatory activity, butyrate production. You're doing good. You see this green smiley face?

These are some of the actually if you search Google it, butyrate pathways, literally you will see something, maybe even this image will come up and you just Google image search and you will see that there's so much work that's been done and it's amazing what the microbes can do. So some of this well known kind of chain of carbohydrate metabolism events like pyruvate metabolism, acetyl coa is something that a lot of us learn in school without any specialization. I mean, I'm talking just like in high school, kids learn about that. But what's amazing is that the microbes, they drive these pathways up and down in ways that we didn't even learn in school. And they make some products and byproducts that we didn't learn about because they're quite esoteric. We're just still discovering this. It's a new science. But if you do Google some of this and you want to know or you want to look up this paper, you will see that there's so many different pathways that have already been elucidated to short chain fatty acid production. Butyrate is this short chain fatty acid. It's a type of fat molecule that is not too long. It's a short chain fatty acid. Short chain fatty acid is associated with mostly beneficial functions for us, the hosts. And you can see how these microbes are driving it from lactate. They can go back and forth from different sources that contribute to pyruvate metabolism. They can even acetyl coa is a molecule that can come from so many different other sources. Even proteins can be substrates for ultimate butyrate production by some of the microbes. Microbes. Now the beneficial microbes, they usually preferentially make butyrate from carbs, the kinds of carbs that we call.

Either starches or fibers. And people have different names. And it's usually the kind of carbs that are not easily absorbed right away into our circulatory system. So we're not talking about eating some sugar because your butyrate producers won't even get the message that there is going to be something for them to even do because we will immediately absorb it and we might have that glucose spike which may not be so good for you. So I'm not talking about the carbs that are syrup and honey and things that are easily absorbed, but more of these polymers. So more complex carbohydrates that you can find in a lot of the, let's say leafy greens, a lot of the vegetables, you see a lot of them in your superfood list. And the beneficial butyrate producers are the microbes that prefer that and one of these types of carbs is known as resistant starches or resistant fibers. The reason they're called resistant is because they are resistant to our digestion. So they don't get digested by the host. But guess what, they make it all the way down so that finally the microbes can get the message there's something for us to eat and something for us to do. And butyrate producers, that's what they do really well, they produce butyrate. So one of the ways is to keep doing what you're doing with all of the leafy greens, the vegetables that you're eating, because that really seems to be keeping them happy and keeping your butyrate production up.

So in your data we see that there's short chain fatty acid production beyond butyrate. It's not just butyrate, there's also other ones you can see. Here's your acetate propanoate. It's all very active. That's pretty good. It means you're getting a lot of that complex carb input in your diet. Based on what you shared with us about your diet three days prior to the test, it really seems to match. And you seem to have a very good, sensible and healthy diet.

Partly because of that, maybe partly because of the choice of your foods and probiotics. You have an active probiotic in your sample. When we see a well known beneficial probiotic, we call it out. And in your list of microbes you will see a little P next to it. It says Lactobacillus reuteri. It's a probiotic. The reason why I started even talking about it right now is because it's a star butyrate producer. It's a really well known producer of butyrate that is actually available in some of the kefir type of drinks and probiotic supplements as well. It's always good to have a variety of different probiotics that you're taking or switching between. But when you have al reuterize one of them, that's usually a good idea when you want to keep up your butyrate production pathways. Signaling and going and making butyrate by your gut microbiome. Here's your butyrate. It's also called butanoate. You see, in your very immediate conversion steps that lead to butyrate, you have all of these active genes, the genes that are expressed that code for these enzymatic reactions. They are either at average levels or even overexpressed and sometimes more than one that is needed for that conversion. To finally make butyrate. This is again, just a partial cartoon. It's not everything that we take into account for the score, but this is the part that really lit up for you. Wanted to include that in your slide. You can see that there are different routes to butyrate production. That's why in our scores, you always see something that's called pathways. You might be thinking, why is it plural? It's just butyrate. So why is it plural? It's because there's so many different routes, there's so many roads that lead to butyrate. It's the overall assessment of pathway activity levels of all of the different roads. So it's all of the different butyrate production pathways that lead to butyrate. So that's what this is about. And you're doing really well in that. So that could help with preventing your inflammatory activities to go any further and to stay at least at average or even become better.

So when it comes to your recommendations, there are several things that are highlighted here, but there are many, many more that you'll find on your superfood and enjoy food list that deal with inflammatory activity. So I want to say so you see like bone broth, for instance, that is related to your inflammatory activity in the sense that it helps keep your gut lining intact and have your mucus layer happy there and everything nice and patched up and thick so that it doesn't become a leaky gut. And then there is jicama that feeds the butyrate producers, by the way, and can keep your El reuteri still active and happy there. Maybe some more that you're taking with your yogurt and things like that. You can see that there's anti inflammatory polyphenols like turmeric.

Turmeric is a source of anti inflammatory polyphenols. That's a source of curcumin. Then you can see also oregano. Oregano is something that has antimicrobial activity. For all these opportunists, oregano will help keep them in check. The reason why I actually don't have a title for this slide is because this deals with inflammatory activity. But it's not like this is the set of recommendations that just goes to everybody that has average or higher than average levels of inflammatory activity. This is very personalized to your specific patterns of inflammatory activity. This is still the Ben Greenfield slide. It's not the overall volume inflammatory activity slide. I was struggling how to name it, so I decided to just make these squares bigger so you can read what it says strengthening the mucosal barrier, that's the bone broth and jicama. This is keeping your opportunists in check, keeping your pro inflammatory activity still well balanced, balanced out by the anti inflammatory activities and having all of these good guys or the beneficial microbes, having them happy and thriving and feeding them what they need to give you the most benefit. So that's the type of recommendation that we make. It's always based on your specific pattern of inflammatory activities. So we could all have the same average inflammatory activity altogether. But the ways for me, for instance, to keep it average or even good and prevent it from going bad can be completely different than for you. It's always a specific activity pattern that gives us this insight into what are the functional interventions that are available here. That is what you see reflected in your Ben Greenfield recommendations. That's what these are. That's why I didn't name this slide.

And another thing that helps with pro inflammatory activities and first of all balances out your microbiome, second of all actually helps to protect your gut lining as well, are the different phytometabolizers which include polyphenol metabolizers, polyphenols like we saw before in previous slides. Those are types of supplements. But you don't have to necessarily take supplements to get your polyphenols. A lot of these red berries and dark red or dark colored berries have a ton of polyphenols that have this anti inflammatory antioxidant content. And in your pathways we actually see there are many pathways that show that you're getting your polyphenols. So that's great. But we actually see, see this riboflavin and production and consumption of molecules that are also used for energy. So this may or may not be related again to your athletic Ben Greenfield fitness profile. So wanted to highlight this specific pathway because this may have to do with the types of polyphenols called flavonoids. So that's where you get this riboflavin shuttling. And when it's more active than usual and you can see to some degree it is, then who knows, maybe this is actually you exerting a specific type of pressure on your microbiome to provide energy for you. Could be, it's a hypothesis, but it may be something to do with that. It's a good thing. Now we're on to digestive efficiency. Digestive efficiency is a microbiome score and it's not about necessarily your microbes digesting. It has to do with that. The way to think of digestive efficiency is to imagine microbiomes reflection on the host digestion. If you can think of all of these different digestive processes and then imagine how we can read the imprint of that in the active themes of your microbiome, then that is what goes into compilation of this digestive efficiency score. It's a big score, over a year in the making. So many different perspectives and avenues, pathways, microbes, different functional groups had to be addressed and really well curated. With all of the literature to date and the data set that we have at hand, which is a very unique meta transcriptomics data set, to come up with a score. Digestive efficiency for you is in the average range. Manual expert curation and analysis actually says that it's on the lower side, and the lower side means it's less optimal. So you want digestive efficiency to be good, meaning that as far as the microbes tell me or tell us, your digestive system is very efficient. If it's on the lower side, then it's suboptimal and you may see something that says that you need improvement. You don't see that right now. It's still in the average range, but it's enough.

For us to dig deeper and to take action on it. And I will explain actually more about why even having average score overall, we still need to take action. Some of it is preventative and some of it could be to ameliorate some of the symptoms that you have already experienced that you shared with me. So digestive efficiency in the average range actually for you.

Is comprised of all of these different scores that do need improvement. For someone else, these scores, maybe three of them would not need improvement, but two of them would need improvement. Even with the same overall digestive efficiency score, someone else may have different recommendations.

Of course it's good to have your digestive efficiency score on the good side. But if you think of measures, everything from the gas production that we touched on a little bit already, from that to the movement of the food, how you're doing with specific macronutrient groups like proteins versus fats, there is a reflection that we can see in the activities of the microbiome that tell us how well your digestive system is working with respect to those very specific molecular functions. This is what I want to dig into right now. What you have is first it's a score called protein fermentation that needs improvement. That in itself actually has multiple, multiple components that go into that to assess the overall microbial protein fermentation. But first you May ask, what is protein fermentation? Again, it's a microbiome score. It's purely from the sequencing data, and it's telling us how your microbes are processing protein. So protein fermentation is, in a way, a fancy word for microbial metabolism of proteins. So if your metabolism of proteins in the microbiome is higher than what we usually see, then it means your microbes are working overtime to digest your protein. So why are they digesting your protein and working so hard? And what we see, what we've learned, is that this means that you are not digesting it well enough. Maybe you're digesting it partly, but a lot of undigested protein makes its way to the lower colon, where we get your sample and we see that your microbes are actually finishing that work. What that tells us is that maybe there are some enzymes that you need more of. Maybe it's about the hydrochloric acid, the stomach, stomach acid, for efficient digestion of proteins. But one way or another, there's something to do with your protein digestion, which is why we see that your protein fermentation score needs improvement, meaning you have too much protein fermentation done by your microbes instead of you. So that's one of the areas. The other area is gas production. In that area, we have more than just the scores that we went over. The sulfide and methanogenesis, the methane and sulfide gases. There is ammonia gas. There are the microbes that are specifically known to produce gases. And altogether, this is our overall gas production score for you. And the fact that it says it needs improvement, I think that that very well goes with what you shared with me and with recommendations that you receive. That's, of course, part of your digestive efficiency, because gas production can definitely impact some of your digestive processes.

Now, these three scores are actually specific pathway scores. And that's why, you see, these are all of the different pathways that lead to methane. We went over some of those. That's your methane gas production. Then you have your sulfide gas production. We'll look at that in more detail. And then you also have putrescine production pathways. Putrescine, just like it sounds like something putrefying. It's a byproduct of protein fermentation that is not very good for you and may be harmful if too much of it is produced. So if protein fermentation is something that leads your microbes to making too much of these kinds of byproducts, then you may want to do something about that. So Again, your ammonia overall wasn't too high, so that's why it's not listed here for somebody else. It may not be about methanogenesis at all because that's actually kind of on the rare side. But they might have a lot of ammonia gas production. We see that quite often. You don't have that in the high range, which is why you need improvement in these specific areas for your digestive efficiency. So again, just like inflammatory activity, there's always a specific pattern that everybody has. Everybody's functions need to be addressed in a very personalized way. It's like your own stacking of different functional blocks. And you have this one that's too much, this one not enough. Everybody has a unique one. Your unique combination says that these are the five important scores that you need to address. These are the five areas, the five major digestion related functions that you need to address in order to improve your digestive efficiency overall. Microbiome score.

Here we have some scores that are good. We already talked about butyrate, the beneficial short chain fatty acid. We'll also talk about salt stress pathways. That's a fun one.

Now back to digestive efficiency. We talked about protein fermentation and gas production. Those are scores that are compiled of multiple components themselves. You have protein fermentation and that is where that byproduct that we don't like, called putrescine. That is where it actually belongs. Putrescine production pathways is one of the components that weighs into protein fermentation. Microbiome score. We also know some protein fermenters and it's not just putrescine. There are other scores, even to some degree. A smaller degree, your methane gas production and sulfide gas production can also feed into protein fermentation. Because one of the sources for methane and sulfide gas production could be from amino acids, the components of protein. But it's not the only source, which is why these components are important to look at by themselves, not just as part of the compilation score. Gas production because this is quite obvious. You see methane gas, sulfide gas are the two gases that tilted your gas production overall score to the suboptimal side that says you need improvement in that.

So when we look at the actual data here is your putrescine production. You may still be wondering, so what about that putri thing? So it's a byproduct of protein fermentation that usually has the kind of protein source that is rich with arginine and your microbes are metabolizing arginine and it often goes through ornithine to putresine, or it can go through agmatine, which by itself is not so bad at all. It's one of the pretty good products of protein fermentation. But the fact that you have so many routes lit up that lead to putrescine, your overall putrescine production pathways, again, it's multiple pathways that lead to putrescine. They are so active, there's so many of these genes that are overexpressed that this is what made that score become suboptimal and say it needs improvement.

You see also another thing called cadaverin, which sounds no less morbid than putresine. Everybody's thinking of putrefying cadavers, but yeah, that's what it's about. Some product of decomposition of something. So that actually does go hand in hand, conceptually. So cadaverine is also not a very favorable byproduct of protein fermentation. And that is something that's usually made from lysine. So it's a type of amino acid. So arginine, lysine, those are amino acids that can come from your food and when your microbes are digesting them, having those microbes really be focused on making putrestine and cadaverin is not a very favorable profile. Some microbes can make overall protein fermentation products that are not so bad, and that would be a good outcome. Like some of the indoles or indole acetate that's produced from tryptophan, you have a little bit of that, that's not so bad. But if you have a lot of putrescine and cadaverin, then it means that protein fermentation is an area that needs to be addressed for the sake of your overall digestive efficiency.

Here we also see this is called urea cycle. It's a very canonical pathway. Pretty much the same way that we learned it in school, different iteration. Except here it's your data, it's Ben Greenfield's data that shows that these things are overexpressed. And this is where it's showing this is coming from. Aspartate can feed into this particular loop. There's your ornithine that can come from arginine. And actually more upstream, there's some glutamate, which in general is pretty good. And some of it is also converted into urea at the end of it all as the final product of urea cycle. So you have some activity there. It's not overly excessive. But it also goes with the theme of protein fermentation. We don't have a urea cycle score that we show to the users, but we do measure it because it depends. When we say it depends, it means that by itself, it's not enough to showcase it as a score, but as part of a specific theme. It goes in the back end, it goes into this generation of the overall score. Because in the context of protein fermentation, this urea cycle, it depends. And in this case, it goes very well with the protein fermentation theme, but for something else, it may be neither good nor bad. So this is why there are a lot of scores. There are actually about 200 scores right now that we've generated, but there's so many scores. But we only show those that are most telling and most actionable and hold a lot of weight in and of themselves. This is the urea cycle and this is your ammonia production. In this particular excerpt, you can see it looks like there's a lot of it from nitrile, and here's your glutamate and glutamine. But actually it's not excessive overall. We actually compare.

Hundreds of reactions and expression of the genes that code for the enzymes for these metabolic reactions that lead to ammonia production. So we cannot show all these hundreds of reactions. But just to let you know that your ammonia production overall for the entire microbiome is not excessive. It's. It's within the average range. Still something to keep an eye on. And that's part of the protein fermentation theme. In this case, we don't necessarily have to go and focus on just addressing ammonia or urea cycle, like I said, because it depends, or just cadaverin or just putresin in this case, to address it all, we just need to address protein fermentation. And that's going to help your digestive system.

How we address it. Here we have recommendations related to protein fermentation. This is definitely not all of them. You will see a lot more references to digestive health and digestive functions, specifically in your summaries of the reasons why we recommend some of these superfoods for you. But here are the superfoods that talk about enhancing your digestion, specifically dealing with protein fermentation and how this is going to help improve your protein fermentation score. You might think, what do these sprouts have to do with it? Actually, one of the reasons is that you can take your protein in a way that is more bioavailable elementally. Instead of very dense protein sources, you can sprout some of the nuts and seeds and legumes or at least soak them. Not all of them can be easily sprouted. You can enjoy those sprouts that give you those amino acids that you need for your performance, for your energy, for a lot of things, and for your digestive system lining as well. And you can get them through sprouts. So you can buy sprouts, of course, and you can sprout things yourself. And that can create this more elemental amino acid availability from something that was a densely packed protein that is much harder to digest, that can make it down your GI tract undigested and result in microbial protein fermentation, which we want to minimize now. That's why you see these sprouts. Recommended for you. In general, for your overall digestive processes. Grapefruit and other bitter foods that you'll see, there's like dandelion greens, they have these properties that overall will promote your digestion, not just for protein side of things, but overall your digestion. So that's why grapefruit, I highlighted it kind of in this orange color. It's not specific to just protein fermentation function, but this is an example to where it can help your overall digestion. Whereas the other ones are more of an example for where we're trying to say something to you. Do this for the sake of your protein fermentation function. So we take actionability from the overall scores, depending on what they tell us, plus the very specific molecular themes, the pathways themselves, the molecules that come up, or these functions like protein fermentation. I said we'd go back to hydrogen sulfide gas production.

This is your score. And you have hydrogen sulfide gas production pathways. Very active, highly active, more than what we usually see. Because it's such high levels of these pathway activities. We say that you need improvement in terms of your sulfide production.

Here's some of the background on hydrogen sulfide production. It's something that is a known function that your microbes do. You do have these microbes that perform this function, and it's something that's well known in the literature. It's. You can have sulfide produced from your amino acids, which is why it's part of the protein fermentation theme. But you can also have it coming from other sources. And we'll touch on that in just a little bit. What's wrong with sulfite? Just to reiterate again, besides the discomfort of gas itself, it's also something that could be disruptive to the gut lining. If we see that it's something that is more active that the Sulfite production activities are more than what we usually see, then it needs addressing.

So dietary protein contributes to sulfite production, among other things, which is why it's part of protein fermentation theme. But it's not only part of protein fermentation theme like we showed before. It is also part of your pro inflammatory theme because of the disruption to the gut lining. And you do have the organisms that go with that. You have other pro inflammatory organisms and you have these sulfide producing organisms that are kind of opportunistic. They're not pathogens or anything. But it's something that is an active theme that may be easily addressed.

Another source of hydrogen sulfide production is sulfate. That comes directly from some of the sulfate sources. Sulfate is. It's not the same as the protein fermentation, the amino acid sources you may be ingesting actually something that has sulfate or sulfite. Here you see this particular picture is showing your data in the context of sulfate. And then sulfite that can be converted to sulfide. That's where you get the sulfide gas. You can see a lot of these oranges and reds. So all these genes that are behind those boxes, these enzymatic reactions are overexpressed. And they may be coming from some of the foods that you are taking that you've shared with us in your food diary. And thank you again for doing that. You have these very active organisms, like 20 of them, that are known as sulfide producing ones. They're sulfite producers. And among them we have those that are called disulfovibrio, different species of disulfavibrio. You may want to pay attention to both the protein sources. So it's a protein fermentation that we already addressed, plus the sources of sulfite and sulfate, which could be different sources that also exacerbate your microbial sulfite production. There are also other sources that are known for microbial sulfide production to be enhanced. Some of them are actually in those foods that we refer to as the superfoods. We as not biome, but they're generally thought of as such health foods. They are the superfoods. If you look them up right now, they're from this cruciferous vegetables family. A lot of these vegetables, they have these compounds in a class called glucosinolates. Actually it's a class of classes of compounds. They are the types of compounds that are organosulfur compounds. So glucosinolates in general, they're pretty good for you. They can help you detox. And your microbes can also, by the way, help you detox. And they do. But glucosinolates, as good as they are, may not be as good for you if your microbiome is showing too much of that sulfide gas production, because it will use those metabolic intermediates that come from glucosinolates from your food to produce sulfite gas. What we see in you, Ben, is that there are also some themes that go with these high fermenting microbes. High fermenting means both things, high as in very fast and also high as in higher in gi. When you have that, if you have them high fermenting, then you don't want to stimulate gas production because in the colon it's one thing. But if it does happen anywhere higher up in the gi, it could be pretty uncomfortable pain and bloating, something that may go with kind of like a small intestinal bacterial, bacterial overgrowth type of profile. And we want to prevent that from happening or exacerbating because some of these symptoms are in line with what you shared with me when we talked.

As much as it's a health food, glucosinolate and other organosulfur compound rich foods are on either minimize or avoid even list of foods for you from viome doesn't mean that you have to avoid them indefinitely. But we do see quite remarkable results from, from people who have these types of discomforts and have already tried eliminating gluten and lectins and dairy. And they think, what else can I take out? I only have health foods left in my diet. Well, what happens is that they have nothing but broccoli and brussels sprouts left in their diet and they're overdoing it. And if they have that specific profile with high sulfite production and especially with high fermenters, types of microbes, then they suffer even more. So they're exacerbated. So too much of a good thing for them. It's actually not good at all. So what we've seen is that just getting rid of for some time, getting rid of all of these cruciferous vegetables and other sources of high organosulfur compounds in foods made a huge difference for them. It actually makes a big difference. And it's something that they never thought of because it just seems like these are just the health foods. I eat nothing but health foods. So for this reason, our recommendations say to avoid broccoli and brussels sprouts if you do want to. There's actually more, there's Cabbage, and there's a few more there. You will see it on your recommendations list. But if you do want to enjoy some of it, sometimes moderation is key. First of all. Second of all, we always say, listen to your body. Don't take it as like the final mandate and you cannot step anywhere left or right outside of it. If your body is absolutely happy and perfectly great with a specific food, then you are your own best judge or consult with your healthcare practitioner to see what's appropriate. But we recommend that broccoli, Brussels sprouts, cabbage, you'll see a few others are to be avoided. Or if you want to enjoy them, at least from time to time, it's best to at least steam or saute those types of vegetables because it neutralizes some of the effect. It actually will take the glucosinolates and convert them in a way neutralize and make that class of compounds into different compounds. But it will not completely get rid of the sulfur that is still in the food. It's not going to suddenly just completely negate all of the organosulfur that is in there that in one way or another, depending on what kind of microbiome pattern you have, can be used by your microbes to actively produce sulfide gas. Again, only from time to time. And if you think it's appropriate.

Steaming would be good. That's one of the recommendations tips that that we offer in our app.

You have a few specialty organisms, so oxalate metabolizers, you have them present. That's really good. And oxalate is something that can contribute to kidney stones. When you have your microbes helping you metabolize oxalate, it's a really good thing, which is why you're able to see things like spinach and almonds in your enjoy list. So these are your oxalate metabolizing pathways. And you have the organisms themselves, like Oxalobacter, it goes with the name, is known to metabolize oxalates for you. So that's really good. You also have soy metabolizers. You have the kinds of soy metabolizers that metabolize some components of soy compounds like Daiden and other isoflavonoids into things like equal. And one of the things that you have is actually called Adler Kreutzia equalifasciens. It's even in the name. So it's a good thing. It gives you benefit from eating foods like soy foods and miso. You'll see miso in your enjoy list. And by the way, as fermented foods, they go back to where we started. Your richness, it can help you improve your microbial richness score. That's another example to where one food can be on enjoy or superfood. But there's actually many, many reasons why it's there where it is, and it's good for you.

You also have really good signatures of fiber degradation. If you have a lot of this insoluble fiber, you probably get a lot of your prebiotic content from your foods and supplements. We see that and the microbes are telling us that you have all of these complex carbohydrates coming through. You're doing well with that. And these are some of the active microbes listed here.

You also have the type of active carbohydrate metabolism that points to pectin that you're probably getting from the fruit that you eat. This higher up set of molecules, these polymers right here, that's actually a signature of microbial metabolism of pectin. And you have the genes that go with that very much. Highly overexpressed in general. That's a very, very good thing. Some of the organisms that go with that and are active are listed here.

Your microbes are also producing some good vitamins for you. Just some of them to list. There's thiamine, there's biotin and menaquinol. That's part of the vitamin K.

Another name for K, vitamin K2. I believe.

You also have your microbiome doing detox for you. You're taking something with selenate or you may be eating Brazil nuts or other sources of selenium. You could see there's very highly active selenate metabolism. And also seleno protein incorporation is something that is known to be a beneficial theme. That's part of a good signature that goes with the detox pattern. You also have glutathione metabolism and production and utilization. Glutathione is going everywhere and being made everywhere. And I think it's not surprising because as you shared with us, you take some glutathione. And so your microbes can use glutathione, but they can also make glutathione from some of the components. You have glutamine and glutamate. And then what this is showing us is that glutathione is actually being used to carry out the detoxification for you. So your microbes are quite busy doing the detox. Glutathione is one of these very beneficial sulfur compounds, by the way. So some of that is very Good for you. Moderation and balance is what it's all about. Some of the other beneficial nutrients or products that are made by your microbiome, I just wanted to highlight a few. So branch chain amino acids are good for your metabolic balance because they can be beneficial for sugar metabolism and also indole acetate. It's something that is known to be anti inflammatory and good for your gut lining and intestinal barrier support. But it is also something that is significant in terms of regulating blood sugar. Actually together these different features came out as significant in our glycemic response prediction model that we've developed with our data science group as a result of a really big study where hundreds of individuals had continuous glucose monitoring in response to different foods. We also had their microbiome data. So so now we can see how these different pieces and patterns and the overall functions in the microbiome can help us and serve to predict which foods will you have high sugar spike to and which? Not so much. So you don't need to worry about it. For instance, for you, you can enjoy banana. Not so many people can enjoy banana by prediction of the model and that's because it does have a lot of sugar. We have, I mean quite a few people that are predicted to have a high glycemic response to banana. But you can enjoy banana. That goes really well with your high good metabolic fitness profile. Your microbiome may have something to do with that. That means you're being the good host to your microbiome.

Just an overview of the overall active themes and what we've covered in terms of actionability. So we have the digestive theme which overall isn't so bad. But the components of it like protein fermentation and gas production can be addressed with many of these recommendations. Some of the pro inflammatory pathways may need to be addressed even though you do have some of these anti inflammatory ones active as well. So we talked about your butyrate, you've always had actually really good butyrate producing capacity and your butyrate producers like Rosburea and Dorea and other ones, they've always been pretty active and you always have a lot of clostridia that are known to produce butyrate. And so you have very active butyrate production pathways which is really good. And you can still give them more inulin and altogether balance out your microbiome with the point of controlling these pro inflammatory pathways and pro inflammatory activities from organisms that you have that are part of the Gamma Proteobacteria class that some are opportunist that you want to keep at bay right now. They're not causing too much trouble or anything, but you want to keep it that way. That's why we want to address the pro inflammatory pathways from the start. We talked about your richness. It's good to improve the richness and diversity of your microbiome. Specifically about gases. We talked about hydrogen sulfide and why some of these cruciferous vegetables are on avoid why some of the foods are on your superfood list, for the overall digestive efficiency, some of the bitter foods and for your protein fermentation, how to handle your dense protein. By the way, another thing you can do is think about when you eat your protein because a lot of people, especially paleo diet lovers, they like to have a big steak late at night or maybe it's not too late, but still it could be a lot for our bodies to handle. So then microbes do their protein fermentation thing and we want to minimize that. So it's how you process your protein, whether animal or not, and how you consume it and how you even chew it to digest it, right? So that's another big part of it. We talked about your active polyphenols and flavonoid pathways and we provided some various new options, maybe different options for you with explanations why things like cranberry could be especially good for you. And you see turmeric on your superfood list. You have your microbes making some good vitamins and doing some of the detox or just overall known as antioxidant type of functions for you. So we have that covered. That's really good and keep that up. This is just an interesting bit that came up that I wanted to check with you so maybe you can comment or email me about the circadian rhythm. So we have this circadian rhythm pattern which we have not yet closed the loop on conclusively, but we're tracking that when we have this circadian rhythm pattern, sometimes it's in people that have either more anxiety or issues with sleep, like insomnia. If that is true. Right now we don't have statistical evidence to show that with any validation, but if that's true, I'd be just curious to know then foods that you see on your recommendation lists that are there for other reasons may also help with things like insomnia. Oats, walnuts and salmon may actually help improve insomnia symptoms. You have good fiber metabolism pathways like I just mentioned, and you can keep improving or having more variety with your sources of.

Say Inulin to boost and support your butyrate and short chain fatty acid production, and also just a variety of fibers. So you have a lot of pectin. But it could be good to diversify with other things that you'll see in your superfood list, like some of the leafy greens, which you already do a lot of, but just good to keep the diversity going there. What you also see in your recommendations is the supplement section. I touched on that earlier when we talked about richness. But I want to say that for digestive support, which is your number one area that we need to address, there's a few things that you can do. If you feel like just different ways of preparation and processing of proteins is not enough, then that is when you may have seen in your recommendations as needed, you would take a motility agent, something like Iberagast, there's others, and a digestive enzyme complex. You can get some of this digestive enzyme capacity from the foods that we recommend and you will see that there and the explanations are available for you. But as needed, if you need it, and if it makes sense to you and your health care practitioner, then see if some of these digestive enzyme complexes could help you and be good for you because it will minimize some of that harmful byproduct production from your microbiome polyphenols. We covered that with cranberry and the Gardanibacter and some other specialty organisms that you have that help you get extra benefit from things like urolithins that your Gordanibacter will produce for you. In general, polarise viritrol or other polyphenols may be good for you. For probiotics, we talked about a different Lactobacillus, but here I just wanted to highlight, with respect to your digestive health, that this specific Lactobacillus may help counter the effects of those bacteria that are known to produce a lot of gas, especially like methane. So if you do have those issues, which seems like you do from time to time, based on what you shared with me, maybe choosing a probiotic that has this specific Lactobacillus species may be beneficial for you. And as you know, it's always good to mix it up and keep the variety going in your overall food and supplement recommendations to have your microbiome more resilient and provide better health for the host who is you? Ben Greenfield, thank you so much. Thank you for having me review your results and sharing it all with everybody. I wish the best of luck and health all the way to you and all of the listeners.