Functional Foods for Improving Gut Health and Metabolism with Chris Damman, MD

Welcome to The Perfect Stool: Understanding and Healing the Gut Microbiome. This is your host, Lindsey Parsons, and today I'm talking with Dr. Chris Damon, MD, who is the Chief Medical Officer and Chief Scientific Officer of UR Labs and a Clinical Assistant Professor of Gastroenterology and Medicine at University of Washington. He previously led the Gut Health, Microbiome, and Functional Food Initiative at the Bill and Melinda Gates Foundation. His research interests have focused on the role of diet and microbiome-targeted therapies in treating gastrointestinal, metabolic, autoimmune, and neurologic disease. Chris earned his MA from Wesleyan University, MD from Columbia University, and is board certified in gastroenterology. This podcast is sponsored by Muniq, and Dr. Damon is going to tell us at the end about their yummy shakes that provide 15 grams of fiber each. It's a fun and interesting conversation, so stay tuned. But before I get started, if you haven't yet followed or subscribed to the show, be sure to do so. And if you want to get transcripts of the podcast, podcast, pop over to my website, HighDesertHealthCoaching.com, and sign up for my newsletter. You'll also get my free ebooklet called Finding Your Root Cause Through Stool and Organic Acids Testing when you sign up. And if you haven't yet done my quiz on which stool test would help you get to your root cause, you can find a link in the show notes and take that. Now on to the show.

Welcome to the podcast, Dr. Damon.

Well, it's a pleasure to be joining you. Great honor and super happy to be talking with you today.

Yeah, thanks for coming on. So nice coincidence, I actually am a Wesleyan University alum as well. Did you do your undergrad there or just your master's?

It was actually both combined. Yeah.

Oh, okay, cool. What year did you graduate?

Let's see, it would have been '99 for my master's, '98 for undergrad.

Oh, okay.

How about yourself?

'91 was my undergrad, so. A little distant.

Okay.

It's a great place though, isn't it?

Oh, I loved it. Yeah. It's a campus that embraces diversity and has a wonderful science program. I was pretty fortunate to be able to get involved in science pretty early, starting with just washing glassware and working my way up in the Hall Atwater. So yeah, indebted to my mentors there and the wonderful faculty.

Yeah. My only relationship with science there was studying in the science library because I was at, uh, in Clark, which is right across the street from it.

So it's a good quiet place to go.

Yeah. My, my interest in science came much later. So anyway, I would love to hear more about your work with the Bill and Melinda Gates Foundation on the Gut Health Microbiome and Functional Food Initiative. Can you tell me a little bit about that and the kinds of microbiome-targeted therapies that were developed under your tenure?

Yeah, absolutely. So first of all, it was amazing opportunity of 5 years. I'm indebted to my mentors there as well at the Bill and Melinda Gates Foundation, but also particularly indebted to the folks I was working with in low and middle income countries like Tamir Ahmed and Asad Ali at the Center for Diarrheal Research in Bangladesh and at Aga Khan University. And just really want to highlight the in-country perspectives that were so important. But with that said, in collaboration, we, I think, made some really important strides in malnutrition. And I think historically we have thought of malnutrition as a condition that's impacted by food, naturally, and by bad microbes or bugs or, you know, things like E. coli that cause diarrhea. The new lens that we brought to the field was looking at the microbiome and the gut in order to provide a new lens for understanding how malnutrition works. And we came to realize just how important the healthy bugs are as well and how they were depleted. In the intestines of children in low and middle-income countries and how the lack of those bugs was also very profoundly contributing to malnutrition. So that was the new lens that allowed us to develop some really powerful new therapies.

Cool. So I'm curious though, because when I think about people in lower-income countries, the one thing I don't think about is a depleted microbiome. I think about, geez, there, you know, the, the lack of sanitation is leading to a lot more bugs, or, you know, close— living closer to nature.

100%. And, you know, as, as we understood the impoverished microbiomes, it's— you can kind of think of a visual, like, uh, look at a vibrant coral reef. Imagine that in your mind, and then think of one that has been bleached or devastated. And that's essentially what's happening in the guts of folks that have imbalances or dysbiosis, or in this case, malnutrition. What we were able to do is use that understanding in order to come up with new ideas for therapies that actually, in well-designed studies, panned out to be impactful. And we're actually following up on those studies right now. But one of the, the new approaches was a very special probiotic that we were using in children, actually infants, very young children, and that helped them actually grow better. And then another intervention where—

Before you go on, let me ask you, what strain?

Oh yes, absolutely. This is a strain of Bifidobacterium longum infantis, and not all bugs are to be created equal. Not all bifidobacterium are to be created equal, and this one has machinery within it that helps it digest the fiber that's present in mom's milk.

HMOs.

HMOs, you got it. Yep. Human milk oligosaccharides. And these bugs are particularly facile at bringing those HMOs inside and consuming them. A lot of other bugs are kind of messy eaters and a bit like Cookie Monster, they might leave a lot of crumbs around for pathogens to consume. B. longum infantis is different. It brings those HMOs inside and keeps it all for themselves. And then produces healthy factors that help contribute to the child growing.

That's awesome.

Yeah, no, that's the strain that I have handed off to every person I know who has had a baby, especially if their baby was born by a C-section.

Yeah, yeah, yeah. There's some great companies that are working on strains just like this and are actually making a big impact in the field.

Now, was there a specific strain, like down to like the number, or just any Infantis would be, would be?

Yeah, it's, it's a great question and it's one that's unanswered at this point. I think the way we need to characterize strains is by their functional capacity, which basically means the genes that they carry for taking in fibers and converting those fibers to things like short-chain fatty acids and B vitamins and even neurotransmitter precursors. And if we can understand that capacity, then that will help us know whether this B. infantis is good and this B. infantis may not be as good for consuming those HMOs.

Right, right. Okay. Is there a particular brand that they sell here in the US that you are a fan of?

Yeah. So the strain that we were working with in Bangladesh at ICRB was a strain that a company called Evolve has developed, and that is actually available here in the US. It's available direct-to-consumer online.

Great.

And yeah, it's— there's a lot of great research that's been done now that supports the benefit of this specific strain. So the other major category of intervention that we're working on was food, but not food with sort of a conventional approach, but food in order to grow the right bugs in our gut and for those bugs then to provide factors that help us grow. And this other approach was in collaboration with Jeff Gordon at Washington University, and it was a so-called microbiome-directed complementary food, or MDCF. It's a pretty amazing line of research that led us to a very specific combination of locally sourced foods from Bangladesh that grew the microbes in positive ways associated with health, and then when validated in a clinical trial, did in fact improve the growth of the children as well. And this approach is one that we've taken for slightly older children, so not breastfeeding children or children that are consuming mother's milk, but rather children that are starting to consume complementary foods.

And were these probiotic strains or prebiotics exclusively in this food?

Great point. So there were no live bacteria. It was purely a prebiotic approach and it was a whole food approach and basically combined things like green banana and different types of legumes, garbanzo beans. And it was the full component of those foods, but probably if one were to distill it down to the essence of what those foods were doing, it may actually be the fibers that are present in those foods that are most specifically growing the healthy bacteria in the gut.

And what kind of food did you make out of those?

Excellent. So there are two major categories of, of foods for malnutrition. There's these so-called ready-to-use therapeutic foods and ready-to-use supportive foods. They essentially come in a little foil pouch and it is sort of the consistency of a peanut butter. It's given to the child. And yeah, so these, these were the foods that we were, we were developing.

And I assume you made it more palatable than the combination of chickpeas and green banana flour, I would imagine to be.

Exactly. So, I mean, there were some other things added. Vegetable oils and a little bit of sugar. And yeah, there was work that went into making it organoleptically favorable for the child. In other words, make it taste good.

Yeah. And so when you give it to the child, is that enough to help pull them out of a cycle of diarrhea and malnutrition, or do you also have to give antibiotics?

Excellent. So antibiotics are part of the standard of care in some cases of malnutrition. And so those were given upfront prior to starting therapy. In fact, most children with malnutrition actually do have active concurrent infections that bring them into the hospital in the first place. And we were exclusively focusing on children that were admitted. But Beyond the antibiotics, the prebiotics in the ready-to-use therapeutic foods then help promote the growth of the good bacteria over the bad bacteria and reestablish a healthy community or a group of organisms in the gut.

Okay. And so they were— were they receiving the therapeutic food at the same time or after the antibiotics? And do you think that makes a difference? Or, you know, what's your thoughts on, on the combos?

Yeah, that definitely after the antibiotics, 'cause the antibiotics, you know, most antibiotics that we have are broad spectrum.

Right.

And, and so, you know, equally contribute to decreasing the good bugs as well as the bad bugs. Yeah.

Okay. So when you're done, then you get started. So is there something that you think that people should be taking while they take antibiotics in a developed world context?

Yeah, that's, that's a great question. And there is quite a bit of debate in the field right now as to whether a probiotic approach in the context of antibiotics is a good thing, or perhaps, uh, may be best to be avoided. There's some work that's come out of Israel in the last few years that suggests that taking pretty diverse probiotic at relatively high concentrations actually impedes the reestablishment of a healthy gut ecosystem of organisms that are normally present there after antibiotics. And that was a big eye-opener to the field. That said, I think The best approach is to basically provide prebiotics for the natural bugs that are present in the gut. And that can happen at the same time as taking the antibiotics and beyond. And so that is essentially foods that are high in dietary fiber.

And what do you think about butyrate while people are taking antibiotics?

As a concomitant therapy, like tributarate?

Yeah.

I'm intrigued by the possibility of giving butyrate, which is essentially one of the major end products of the bacteria, one of the major things that they're contributing to the body and health. One of the tricks with butyrate is it exists in the context of other short-chain fatty acids and the healthy state. So that's propionate and acetate. And a balanced ecosystem is going to provide these short-chain fatty acids in a balanced way and in the right spots. So, you know, distal small intestine and colon is generally where they're produced at highest concentrations. When one takes tributarate, that is one of the components, and one of the components that is probably most depleted. And so it may be therapeutically advantageous to do it, but I just think it's important to think of the whole context of what a healthy microbiome is producing. And I think the closer we can get to recreating what happens naturally, we may be that much further ahead in preventing and addressing disease.

It's just that I, you know, of course in my work, I come across so many people who are suffering from having taken antibiotics and their problems started at that point. And so, you know, just sort of thinking back, you know, if you can prevent the problems, maybe, maybe it's, it's giving a good prebiotic with the antibiotics.

Yeah. And I think the other thing to think about is if you're starting with a healthy, healthy state, promoting that healthy state is very different from being in that sort of devastated coral reef already and reestablishing a healthy state. And if you're caught in the trench of inflammation and imbalance, sometimes you need a little jumpstart. And it may be that things like butyrate actually help. And that jumpstart while at the same time starting to reintroduce healthy prebiotic foods.

Yeah, and I'm a big fan of butyrate right now. It's my, my current fascination cuz it's the only thing.

I wanna hear more about your fascination.

Well, it, it's the only thing that kind of helps me just stay solid. So, so I, for me it's like a miracle drug.

That is so exciting to hear.

Because I have post-food poisoning IBS.

Post-infectious.

Yeah, post-infectious. Positive vinculin antibodies.

So yeah, interesting.

It's taken me a while to figure it all out, but I think I've got it under wraps now with the butyrate.

That, that's brilliant. And here's, here's another thing perhaps you've already tried, but to consider adding to the armamentarium. There's some really fascinating research that's just come out on Psyllium.

Oh yeah, I used to take that all the time. It's just disgusting.

It's just disgusting. Oh yeah, it's like drinking sludge.

Yeah.

And you have to actually drink quite a bit of it.

Yeah.

But what's fascinating is there's a paper that just came out of the British Medical Journal that suggests, well, first of all, a large portion of folks that have IBS, it's actually an intolerance to a certain prebiotic, inulin or fructans, which is kind of the overarching category. And these are things that are found in onions and garlic and actually added to a lot of processed foods. And when one follows the low FODMAP diet, it's one of the major things that's removed. And a lot of people have benefit. Now, I think we're in this sort of paradigm right now in medicine, especially food is medicine, of taking things away in order to achieve a therapeutic effect. I think where we could move and ultimately need to move is how we can add things back that are missing. Because that's how that healthy ecosystem is going to be reestablished. If you take things away, yeah, you might have improvement in your symptoms, but it's going to further entrench you in a low diversity dysbiotic state. So what this paper shows is if you combine psyllium with inulin, the symptoms of inulin go away. So it's a new, perhaps very exciting approach to treating inulin-specific IBS. And it, it's actually not that new. There's, there's plenty of studies that have looked at the impact of, of psyllium and IBS and shown benefit before. It's just now there's this new understanding of how it might be working.

Interesting. And how much psyllium was it?

Very good question. I would have to take a look at the study again, but most, most of the, the studies I think have been 10 grams twice a day or something around there.

Is that like a tablespoon or more?

Yeah, a tablespoon.

Okay. Yeah, that sounds about right. Okay. And yeah, I would love to see the paper if you can send me a link for it.

Yeah, absolutely.

Okay, cool. So tell me what you think we now know about the microbiome and its role in the body that we didn't know 5 or 10 years ago.

Yeah, it's a very good question. And I would say 10 years ago we were very much stuck in the correlation phase where every study said, you know, microbiome is connected to the brain or microbiome is connected to inflammation, on and on and on. But it was just connections, just correlation, not causation, not certainly moving in the direction of therapies. I think now in the field we're actually starting to move in that direction. And the first shots on goal were big guns like fecal transplants. And now we're moving in the direction of greater sophistication and more nuanced, fully defined therapeutic bacterial approaches and companies that are leading the charge here where, you know, they're collecting a handful up to even hundreds bacterial species in a completely defined approach. So I think that's a very exciting step forward.

So are the— like, I know that there are purified fecal transplants that have been used in some studies and that there was a company working on those, but it sounds like you're talking more about a probiotic that's just very diverse.

It's kind of like a probiotic that's very diverse. The, the term that's used in the field is a live bacterial product, and this is regulated very differently from a probiotic by the FDA, much like a drug. And they're basically, rather than either whole stool or purified stool, these are strains that are grown in the laboratory and then combined. And so you, The problem with whole stool and even processed stool is, you know, it's there, but you don't know entirely what's there. And so there's the possibility of transmitting infections or of transmitting bacteria that are associated with long-term adverse outcomes.

Right, right. Yeah. No, I occasionally work with people who want to do a fecal transplant from a, a relative or that sort of thing. Inevitably they get them tested. And they have C. diff, they've got H. pylori, you know, and they're perfectly healthy. But I'm like, I couldn't recommend that you use that stool.

Yeah. Yeah. There's, there's certainly a lot of asymptomatic carriage of these pathogens and some call them actually pathobionts because in some contexts they're benign, like in asymptomatic carriage. And it's only in the context of say an infection or inflammation that they rear their ugly heads.

So a lot of my audience, as you can imagine, is composed of people who have issues like IBS and H. pylori and Crohn's and colitis and gastritis, the whole gamut. And many of them have already seen gastroenterologists and have not been able to resolve their issues within the traditional medical system.

Mm-hmm.

And of course, some of them have been given suggestions on dietary changes, but more often than not, especially like with inflammatory bowel disease, I hear a lot more about pharmaceutical interventions coming from their doctors. So I'm wondering what kind of dietary changes and nutritional interventions are becoming more standard of care in traditional gastroenterology? And then beyond that, what nutritional interventions you'd recommend for various conditions that aren't within the standard of care?

Yeah, yeah. Great question. And right now there aren't dietary therapies in the context of controlled disease that are necessarily within the standard of care, if you can believe it. It's surprising. When one is having a flare, it's actually recommended that somebody go on very low fiber, low roughage diet.

For IBD in particular?

For inflammatory bowel disease, yeah. Which seems, you know, very counterintuitive. And so that sort of often carries through to dietary recommendations in the context of controlled disease where maybe low fiber, low roughage diets are preferable. There is actually, for ulcerative colitis specifically, very different from Crohn's disease, you know, affecting just the colon but not the small intestine as well, subtype of inflammatory bowel disease. There are a handful of studies that support the benefit therapeutically, not just by association, of increasing fiber in the diet. So I find that intriguing.

And any particular kind of fiber or just from foods?

Yeah, so from foods, but also Maybe specifically from psyllium.

Okay.

Yeah.

About psyllium. You know, it's funny, I kind of started there and it's like we're coming full circle. That was one of the first things I did to try and turn things around for myself. And then, you know, one of the first things I recommended to people when I first started doing my podcast and it's like, its grossness kind of got me off it for a bit.

Completely. Yeah. No, it's definitely not the most palatable and there's actually, you know, even choking hazards associated with it and folks that have difficulty with swallowing because it becomes so thick.

Yeah, I would just add it to a smoothie, but by the time I'd have to add it like at the absolute last moment and then try and drink it really fast so it didn't gum up.

Yeah, yeah, absolutely.

It's also somewhat palatable if you throw it in some orange juice and again just chug it really quick and then just drink more liquid afterwards.

I need to take some notes here.

My husband takes it twice. I think he takes it like at least once a day, once or twice a day. With water. Like, he's learned to just drink it with water.

Yeah, yeah.

But not me.

I will say there's, there's other approaches to dietary fiber using different fibers that aren't as viscous or sludgy and that are a lot more palatable and put in the context of a pretty delicious delivery system that, that are being developed that I think are really exciting and that might make it more accessible and palatable to people to consume fiber beyond whole foods, which at the end of the day is the best way to go. But what I learned importantly at the Foundation is not always possible to go that way. It's quite a luxury to be able to eat whole foods, and these ready-to-use therapeutic or supplemental foods are incredibly valuable for their shelf life and for their, quite frankly, cost of good profile. And that's relevant here in the US as well for certain segments of the population below the poverty line.

Yeah, yeah, for sure. So tell me about those, those other fibers and and what those look like.

So I would say, you know, two of the other fibers that I think are most exciting are one, resistant starch, and two, beta-glucan. Uh, resistant starch is found in a lot of different foods, but is perhaps in highest concentration in, of all things, green bananas, but also found in beans and, you know, even potatoes and wheat. The other one is beta-glucan, and that is found also in a lot of foods, but specifically in oats. And a company that has been leading the charge on some of these other fibers has brought the two together to achieve synergy because they are very specific in the types of bugs that consume them in order to sort of maximize the opportunity for producing downstream short-chain fatty acids like butyrate.

And what bugs consume them?

So it depends on the fiber. It's, it's actually amazingly targeted. And each of the fibers, it's, it's really only 2 or 3 bugs are the primary consumers. And so for resistant starch, it's Ruminococcus bromii and Bifidobacterium, various subspecies. And for beta-glucan, it's, it's slightly different bugs. But what's, what's interesting is the secondary consumers. So those primary consumers essentially in some ways kind of poop out certain products, and then the secondary consumers will eat those, and they're the ones that are producing the butyrate and propionate. And those are pretty consistent across individuals. It's just the primary consumers that are the front men in consuming those fibers that are very specific.

And who are the secondary consumers?

Ah, yes. So the secondary consumers, they fall into the class largely of what are called Clostridium cluster IV and XIVa species. So probably heard of Fecalibacterium prausnitzii, Roseburia. Yeah, these are the so-called Firmicutes of the gut.

Are those Clostridia?

Those are Clostridia.

Oh, okay.

So if you go back to the childhood playgrounds and playing tag with your friends and saying, "You're it, you've got cooties," well, you're actually quite right on. You got Vermicooties.

That is the worst microbiome joke I've ever heard. Congratulations.

Stick with me. Yeah, one of my hallmarks. I embrace it fully.

You're what?

I embrace it fully. I've got 3 daughters at home and so the bad dad joke is a hat that I wear proudly.

Yeah. My kids don't want to talk much about the microbiome. And they're just like, stop talking about fecal transplants.

Well, we'll have to invite you and your family over for dinner some night and we can definitely indoctrinate them.

Or like terrorize them. So what dietary changes would you recommend for the average person who's eating a standard American diet and just, you know, might have some mild gut issues?

Yeah. Well, I mean, it goes without saying, increase fiber in the diet. So the USDA in 2020 came out with their dietary guidelines, and I was shocked to see that only 5% of people meet the dietary guidelines of around 30 grams. It's a little bit different for men and women per day, and it's probably the most efficient nutrient in our diet. And now we understand what it's doing and how important it is, more than just helping you have a good bowel movement, but incredibly important for your mental health and your inflammatory health and quite frankly, your metabolic health. So how you process nutrients and whether or not you gain weight and what your cholesterol is and whether you have high blood pressure and how your blood sugars are controlled.

Yeah.

An old friend just sent me a study about black beans, half a cup of black beans, you know, bringing down your, your blood sugar and as well as Yeah. Helping restore your microbiome and the good bugs.

Nice. Absolutely.

Yeah.

So I, I, I think fiber is, is incredibly important and legumes, beans are, are underrecognized and valuable.

Yeah. You just can't get your bang for the buck on fiber with anything else. I mean, you could eat, you know, 4 cups of lettuce and you probably only get like, I don't know, 5 grams of fiber or something.

Yeah. Yeah. No, that's, that's so true. But you know what's really interesting specifically in terms of metabolic disease, if you look at the association with different types of plant-based foods. It's strongest for grains and for fruit, but less so for other categories. So I think that speaks to how different fibers are important for different aspects of health. And for diabetes and blood sugar control, it may actually be that the fibers that are taken off of whole wheats when they're turned into white wheat or brown rice when it's turned into white rice are particularly important for your metabolic health.

Now, I know you can get your resistant starches from the diet, and one of the ways is cooked and cooled rice and cooked and cooled potatoes.

Yes.

This applies to white rice as well, though, doesn't it?

100%. Yeah.

Because we have a lot of rice in my family, and then there's a lot of leftover rice, and I reheat it, but not, you know, Extreme. Am I still getting my resistant starch?

Yes. Resistant starch is definitely increased in cooled foods, even after they're reheated. I will say that rice may not still be the greatest source of resistant starch. You know, potatoes are good and green bananas too, but I don't think many of us are gonna go out and, and start eating. Yeah.

Green bananas are not only disgusting, but they also make me feel pretty sick. So tell me why. Green banana powder doesn't make you feel sick because I've never eaten a green banana and not felt disgusting afterwards.

Ah, but when you have green banana powder, you feel okay?

Well, I can't say I've done a lot of experimentation with green banana powder. I do own some and sometimes add it to recipes.

Yeah, yeah, I, I don't have a good answer for you there.

Maybe it's quantity.

It could be quantity. It could be all the other things that are present in green bananas that are not present in the powder. So the powder actually is refined to concentrate for the resistant starch.

Okay, got it. Yeah, yeah. Because I guess an entire green banana may have a lot of resistant starch in it.

Yeah, yeah. You know, surprisingly, it depends though on that specific type of green banana and how early it's been harvested. And, you know, most of the green bananas that you'd find in the store actually are not a good source of resistant starch.

Oh, okay.

Yeah, yeah. You know, it has to be harvested and processed in a very specific way in order to maximize the resistant starch that's present.

Yeah, no, I think the stuff I have might be green plantain flour.

Interesting. Yeah, yeah, yeah. No, it's plantains, bananas. They're quite related and resistant starch is present in both.

Okay. Well, so this is, this is a sponsored podcast from Unique and they have products involving this green banana powder and such. So Can you tell me a little bit to tell us a little bit more about those products and, and what they're, what they're good for?

Yeah, absolutely. So pretty exciting. And, and this hearkens back to the comment that I made that whole foods are great and they should be an important part of the diet, but there is a role for processed foods. And I think that as we understand the microbiome better, we can actually make those processed foods healthy. I'm a firm believer in that. That's what I learned at the Foundation. And the value of a processed food is it's convenient, off the shelf, good cost of goods. And that's the niche that Unique is, is filling. We've been messaging for the last 10, 20 years longer of the importance of whole foods, and yet the population continues to increase in obesity and diabetes. Things haven't changed. And so I think there's an incredible opportunity here for meeting people where they're at and their busy lifestyles. And that's exactly what I think we need to do. And so this is a shake that incorporates two of the most powerful prebiotic fibers, and that's resistant starch and beta-glucan. It's quite delicious. It's very, very low in sugar and total digestible carbohydrates and super high in fiber. So 15 grams per dose or per serving. Yeah, super high.

That would get me to my 30 or 40 a day because honestly, I'm not hitting it. Yeah. No.

So that's just— I mean, it's convenient.

Yeah.

We have a number of consumers that take a shake a day and, and that is sufficient to get them to that daily requirement of 30 grams and pretty amazing results in terms of their gut health and in terms of their metabolic health that we've seen anecdotally. And, and what we're doing right now, unlike perhaps a lot of other food companies, is we're taking that next step in validation and taking a gold standard approach, you know, above and beyond all of the amazing consumer experience. Let's validate this in the most scientific, rigorous way possible. And that's through a randomized placebo-controlled trial that you'd see in biotech or in pharma. And that trial is actually ongoing and super excited for those results.

And what conditions are you studying it with?

Good question. Yeah. So we use these technical terms, so inclusion criteria in medical trials. And in this case, two major inclusion criteria, the people that we're evaluating this in are folks that have diabetes. And folks that are overweight.

Type 2 diabetes.

Type 2 diabetes, indeed.

Okay.

So you're looking at it as a potential weight loss aid as well as bringing down blood sugar.

100%. And we're also super keen in this trial to look at other health parameters. And so we are looking at things like gut health and mental health, not in as concentrated a way as we're focusing on, you know, metabolic health and weight and diabetes. But there will be some information that comes out there for future uses.

Is there a before and after microbiome sequencing?

100%. So we're, we're super excited to be working with one of the leaders in food and microbiome, and that's Justin Sonnenberg, who will be analyzing the microbiome data.

Nice. So are you doing like a metagenomic sequencing?

Yes. So a lot of the historical studies have been mired in 16S RNA, which doesn't get you down to strain level specificity. And as we were talking about before, that is so important and even beyond that, understanding the metabolic capacity of the microbes. And metagenomics does just that. And so we'll be able to know who's there and what they have the potential to do as well. And that's so critical in taking these next steps forward in sort of next-generation microbiome work.

Awesome. And, you know, back when we were talking earlier, you were mentioning these live bacteria prep products. And I'm curious whether any of those have anaerobic strains in them, or are they all aerobic strains?

Yeah, no, actually it's mostly anaerobic strains that are present in these live bacterial products, and this makes them particularly tricky to work with. But a number of companies that are leading the charge here, and some really exciting proof-of-principle trials that have reported out in the last year of some more defined or processed live bacterial products that have been effective for C. diff, Clostridium difficile, and ongoing trials for inflammatory bowel disease.

Nice. Yeah, no, I've been taking Akromancia muciniphila. Nice. For the last few months, seeing how that works out.

Yeah.

Hoping I can eventually get off the butyrate.

That would be nice. Well, you should give Meneeka a try.

Well, I'm, I'm waiting for my shakes. I saw that chocolate— my, my mouth was watering when I saw that chocolate shake picture and I'm just like, and there was one that was dairy-free and I was so excited. So I'm like, I would like to try that one.

Yes, there's both vegan and non-vegan versions and some pretty tasty flavors. My personal favorite is the chocolate, but there's also vanilla and a mocha, which is—

mocha.

Oh, nice. It's got some caffeine in it, so it gives you that little, little coffee-type pep in the morning.

Okay, well, where would people go to find these Munich shakes?

Yeah. So it's online, direct to individual and through Munique spelled M-U-N-I-Q life, no space, dot com.

MuniqueLife.com. Okay, well, I'll put a link in the show notes for that. Anything else you want to say about those shakes and what they're— how they're helping people? Or I know you can't, like, claim medical things being addressed, but—

Yeah, I just think it's super exciting for all the reasons that we discussed. And I think it's one of the few companies that's really leading the charge in the area. And it's a company that's very interested in impact and connecting with the consumer like I've never seen before. I mean, this was the reason that I was so at ease joining forces with Mark, who's the founder. And pretty amazing story too as to what inspired him to start the company in the first place. And it's, it's on the website in his own words. And a very moving story of his sister who passed away from complications of metabolic disease. And that was kind of his wake-up call to use his gift in life for reaching the consumer and his backgrounds leading a large nutrition company to create a product that can really make impact.

Wow.

Yeah. And I joke, I worked at the foundation before. And, you know, there it was all about taking the latest and the greatest technology and applying it to underserved communities. And that's exactly what we're doing as well. There's a huge underserved community of folks with diabetes and obesity, and we're making real impact in their lives.

That's wonderful. What's his full name? Mark?

Mark Washington.

Okay. So the C. Okay. And is Younique going to be sold in stores at any point?

It's a great question. Right now, the approach that we're taking is direct-to-consumer approach through the website. But I, I wouldn't rule out the possibility of ultimately products being available in the big box stores, but not where we are currently.

Okay, great. Well, I'm really excited to hopefully try those soon. And, you know, it was really interesting talking with you. This was fun.

I had a lot of fun too. And that invitation stands anytime you want to join us at the dinner table.

Okay, you're in Portland?

No.

Where are you?

I'm up in Washington State, in Seattle.

In Seattle. Okay. I don't know why I thought Portland. Okay. Well, if we're up there, I'll be sure to get in touch. If you're ever coming through Tucson, look us up.

Okay. Look forward.

Okay. Thanks so much.

Yeah. Thank you, Lindsey Parsons.

That was a fun and very informative conversation. I really enjoyed that. Again, if you want to try the ImmunIQ shakes, that's at ImmunIQlife.com, M-U-N-I-Q-life.com. And a link is in the show notes. And if you're struggling with your gut health, that's my specialty. You can set up a free 30-minute breakthrough session from the link in the show notes, and I can see if I think I can be of assistance to you. I coach people with more severe and long-standing problems in 5-appointment packages, or also offer one-off appointments for simpler issues. If you'd like to connect with me online, you can follow my High Desert Health Facebook page, join my gut healing Facebook group, or join my newsletter list at highdeserthealthcoaching.com. And while I'm not terribly active in the other forms of social media, you can find me on Twitter, Instagram, and Pinterest, and links for those are in the show notes. Thanks for joining me today, and here's wishing you all the perfect stool.