[00:00:00] Carl Lanore: [00:00:00] welcome back to another episode of super Yuma radio. Today is Monday, April 13th, 2020 for those of you listening to the show a hundred years from now and you realize how far ahead of the curve this audience was. We're going to talk about the microbiome today. Fascinating. We are always fascinated about the microbiome.

[00:00:20] Before we do that, I have to thank our title, sponsor legendary foods. The legendary foods makes the best. Snacks that are actually good for you. Uh, take for instance, they're tasty pastry. It's a pop tart, uh, with, uh, less than one gram of sugar and nine grams of high quality, high leucine protein by and for your kids when they start going back to school.

[00:00:43] Slip them in their lunch boxes. Uh, and they'll think they're eating something bad for them, but they're not. But legendary also make some other ma amazing things. They make fantastic nut butters and they have seasoned nuts that are out of this world. I love them. They are a great snack. And right now, [00:01:00] if you go to eat legendary.com and use the code relief 15.

[00:01:04] You'll get 15% off all orders over $100 a more. But however, this doesn't include the tasty pastry because they can't even keep those in stock. And so, but check them out. The nut butters and the season nuts are amazing. You'll love them, I promise you. And tell them Carlson cha, and now we'll be joined by my two guests and that is, Oh, sorry about that.

[00:01:29] Here we go. Hello, Dr. Lee frame and Dr. Scott Jackson. How are you guys doing? Hello? Good, good, good. So let's talk about this study. We're talking about the microbiome and you two just published a really interesting paper where you kind of, uh, this, was this considered a, uh, a review of the existing literature, correct?

[00:01:51] And, and, and you're, you looking at the role of nutrition and the microbiome. Why this study? What, what studies have been [00:02:00] done before this that needed this one to be done?

[00:02:04] Dr. Leigh Frame, PhD : [00:02:04] A great question. I think, uh, there's been a fair amount of research done actually, um, on the role of nutrition and the gut microbiome in recent years.

[00:02:14] Um, but not a lot of looking at how it all interconnected. And we also were concerned that some areas were being neglected, but it was unclear exactly what areas, those words, that's why we tried to systematically look at everything that had been done and categorize it and catalog it. So now you know what has been done and what hasn't.

[00:02:34] So as we move forward planning, research studies, hopefully we're making them more educated to them.

[00:02:39] Carl Lanore: [00:02:39] So what, what do we know affirmatively about the microbiome? Do you want to take that, Scott?

[00:02:45] Dr. Scott Jackson, PhD: [00:02:45] Sure. Um, you know, this hype around the human microbiome is probably, um. 1215 years old now. Um, it was really born around NextGen sequencing.

[00:02:59] Once we could [00:03:00] sequence DNA rapidly and cheap, uh, it allowed people, as I like to say, to shove gobbledygook into their sequencing instruments and Marvel at what comes out the other side. Um, so there's been a lot of research on the microbiome, its importance in health and, um, disease. Um, you know, our gut microbiome affects us neurologically, hormonally.

[00:03:21] Um, immunologically and metabolically. And those four things are pretty much linked to everything, you know. So, depression, uh, metabolic diseases like diabetes, um, the gut microbiome has a huge impact on our health and disease. And what impacts our gut microbiome more than anything is our diet. Our diet is the source of, and the food for the bugs that live in our gut.

[00:03:46] So. Just a quick train of logic. If you eat, the things you eat will affect your gut microbiome, which in turn will directly affect your health and disease state.

[00:03:57] Carl Lanore: [00:03:57] When we talk about nutrition, after doing this show now [00:04:00] for 14 years, I used to have very strong feelings about things. The only strong feeling I have about nutrition now is that it's very individual.

[00:04:11] You know, this whole, uh, this is the human, the perfect human diet. Kedo. Vegan, you know, carnival or paleo. It's like, and what I've come to understand is that that may be the perfect diet for you, but not necessarily for me. Does this come down to the uniqueness of each of our own microbiome?

[00:04:34] Dr. Leigh Frame, PhD : [00:04:34] That's a very good point and I would absolutely agree with you.

[00:04:37] It's actually what I teach my students in the integrative medicine program at GW. So you are, are well ahead of the curve. Um, and yes, part of it is the microbiome. So if you don't have, um, a certain type of bacteria that helps. Take resistance, starch and process it, then you're going to react very differently to resistant starch than someone that does have this bacteria.

[00:04:58] Obviously your own genetics [00:05:00] make a difference too, but it's a combination of that.

[00:05:05] Dr. Scott Jackson, PhD: [00:05:05] Everyone's gut microbiome is unique and very different. Um. You know, only 20 or 30% of our microbiomes are shared. The, you know, the other 70% is, is considered individual. So are personalized. So, um, you know, what I eat affects my microbiome in a different way than how the same food might affect Lee's microbiome.

[00:05:28] Carl Lanore: [00:05:28] Are we getting closer to saying epigenetics is actually a result of. The diversity of the microbiome. Cause we talk about epigenetics, like it's this nebulous thing out there that, Oh, what you do and, and, and your lifestyle affects your genes, but does it affect your microbiome and then your microbiome affects your genes.

[00:05:51] Dr. Scott Jackson, PhD: [00:05:51] I think they can be independent. Certainly your environment can epigenetically change. You. Um, [00:06:00] your gut microbiome can change as well. And in fact, there's epigenetics within bacteria, so the bacterial environment can epigenetically change the bacteria themselves, which then behave differently. And obviously that might have physiological ramifications for the posts.

[00:06:15] Dr. Leigh Frame, PhD : [00:06:15] Yeah. Basically it's, it's really complicated, but you could see how quickly something she could get shifted, right? If it's changing, the gut microbiome is epigenetics, then it's changing their composition and that's changing the way they react to you or food, which is changing how your body does its epigenetics, and you can really quickly get pushed in the right or wrong direction.

[00:06:34] Carl Lanore: [00:06:34] Okay. Now, most of the research done on the microbiome seems to focus on fiber. Does it not? And the fiber's role. And you know, a long time ago I had a con conversation, uh, with Leslie Aiello when she ran the winter green foundation. I don't know if you're familiar with the winter grant foundation in New York, but they are an

[00:06:57] They are an evolutionary ancestral kind [00:07:00] of a group that look at, uh, how we've evolved and the influence of food and environment and weather and everything on evolution. And I remember her telling me that, um, that our ancestors were able to eat fiber. They had bigger jaws, they had different guts, um, actually distended and that we evolved to eat less and less fiber.

[00:07:28] And that actually was a good thing cause our guts got smaller, our brains got bigger, blah, blah, blah. And she, when I got, when I got off the phone, I thought to myself, you know, we're all going crazy about fiber. Like, Oh, you know, you need 30 grams of what if we're wrong about that? What if we really don't need all that fiber?

[00:07:43] What if all that fiber is actually not good for us? What do you think.

[00:07:48] Dr. Leigh Frame, PhD : [00:07:48] That's a great question. Um, I think it's greatly gonna depend on who you're talking to. Do. Um, cause at someone like yourself who's nutrition minded is probably getting sufficient fiber. I'm assuming you're not having [00:08:00] any GI upset, which would say maybe you're getting too much fiber, right?

[00:08:03] If you're having gas, bloating, constipation or diarrhea, then you aren't getting too much fiber. But I do think that the average American is in no danger of getting too much fiber because. You know, white bread and things that are processed that don't contain any fiber. So I think it's, it does have to be personalized, but it also is about getting that the Goldilocks amount of fiber, right.

[00:08:23] Not too little, not too much. And what that is, is going to depend on your person independent on microbiome that you have. And it does take a little bit of experimentation, which sometimes people find frustrating that we can't just give you an answer, that yes, you need 30 grams of fiber. Um, you have to see where you are now.

[00:08:39] How do you feel? Try increasing it a little bit. Do you feel better? Do you feel worse?

[00:08:43] Dr. Scott Jackson, PhD: [00:08:43] Yeah. What combinations with other macronutrients as well about balancing it, but it was a balance,

[00:08:49] Dr. Leigh Frame, PhD : [00:08:49] right? Exactly. And not doing it too quickly to videos. If you introduce too much fiber too quickly, you will get negative side effects.

[00:08:55] Dr. Scott Jackson, PhD: [00:08:55] That's a common side effect of these prebiotics that you're seeing, which are essentially just fiber [00:09:00] supplements.

[00:09:02] Carl Lanore: [00:09:02] So I have said for a long time on this show. That your microbiome, each what you eat and then either poops out stuff that's good for you or bad for you. Is that like a accurate, in a dumbed down way?

[00:09:20] Dr. Scott Jackson, PhD: [00:09:20] Yeah, I think so. And the reason that you hear so much about fibers, because fiber is probably the most impactful thing on the gut microbiome, and that is because we can't digest fiber, as you've pointed out, but our bacteria can. So we're feeding them specifically, we're feeding our gut microbes by eating fiber.

[00:09:36] And you're right, they do spit out things that are good for us, like short chain fatty acids, acetate, propionate, . And you know, these things have known important properties. They're fuel for the Filio sales that liner colons, and they have other beneficial properties like antiinflammatory properties. Um,

[00:09:57] Dr. Leigh Frame, PhD : [00:09:57] and that's part of the reason, the reason which focuses so much on [00:10:00] fiber cause we actually know the mechanism and the benefit.

[00:10:02] Um, it's these short chain fatty acids that are actually required by your colonocytes for fuels. So they cannot regenerate themselves without some of these short chain fatty acids. Now, too much of them is also not a good thing. But that's really where the research kinda got carried away with fiber and forgot about some of the other elements of nutrition.

[00:10:20] Dr. Scott Jackson, PhD: [00:10:20] And that's what really a motivating factor for Lee and I to do this because so much of the literature is dominated with fiber, fiber, fiber, short chain fatty acids, short chain fatty acids. That's all you see in. And we both were just scratching our head. There's gotta be more to it than this. Yes, short chain fatty acids

[00:10:36] Carl Lanore: [00:10:36] and fiber are important, but that's not

[00:10:37] Dr. Scott Jackson, PhD: [00:10:37] a hit.

[00:10:37] It's not the whole story. So we wanted to sort of, you know, look at it in a more granular, um, granular way to find out, you know. Well, mechanistically, how things are happening,

[00:10:48] Carl Lanore: [00:10:48] and we're going to, we're going to dive into the study now, but, uh, Jeff Clifton says, what's your opinion of inulin? He's been dropping five grams in a smoothie twice a day.

[00:10:59] So

[00:10:59] Dr. Leigh Frame, PhD : [00:10:59] in [00:11:00] Nolan is one of the most studied fibers. Um, and that's part of the reason it's made it into the food system because we know a lot about it. Um, it has some benefits, but it could also have a lot of side effects. So if you are having five grams of inulin and not having any digestive upset. Then, wow, good for you.

[00:11:17] But that would probably give me digestive upset, especially if you're having it all in one sitting. I'm putting it out throughout the day would probably be better. The other thing is, with fiber, it's about variety. So if you're only getting one kind of fiber, you're only feeding certain elements of the bacterial or the viruses or the fungi in the microbiome.

[00:11:37] Whereas if you get all of the different kinds of fibers, you're more likely to have a well balanced that microbiome. So that's my other concern about these high. Supplementation of diff, of a sinkful type of fibers. You're really limiting the types of fiber that you're getting in your diet.

[00:11:54] Dr. Scott Jackson, PhD: [00:11:54] I personally started trying a, an inulin FOS supplement, and it was very [00:12:00] discomforting for me and I had to stop it.

[00:12:01] Even I think I was taking a one gram supplement a day.

[00:12:04] Dr. Leigh Frame, PhD : [00:12:04] It wasn't even a lot.

[00:12:05] Dr. Scott Jackson, PhD: [00:12:05] Yeah, so

[00:12:07] Dr. Leigh Frame, PhD : [00:12:07] you are hyper diet, so maybe that's part of it too.

[00:12:10] Carl Lanore: [00:12:10] A Hiwatt. Hi,

[00:12:12] Dr. Leigh Frame, PhD : [00:12:12] he's already on a relatively high fiber diet, so maybe adding that one ground was pushing him over the limit.

[00:12:17] Carl Lanore: [00:12:17] Um, there was a study, I want to say, published several, maybe four, three or four years ago, that looked at inulin.

[00:12:24] Uh, that's already mixed into like ready to drink meals and stuff like that. Undergoes a process of hydrolysis and turns into a fruit type of fructose or something like that. Have you seen that.

[00:12:37] Dr. Leigh Frame, PhD : [00:12:37] I have not seen that particular study. Uh, and again, this is going to probably depend on what type of bacteria are and your microbiome, exactly how your body's going to process these times.

[00:12:46] Um. There's been some research showing that these types of supplements to a diet can actually decrease hunger and if you feel more full, and so this can lead to weight loss. Um, that's really, I think where a lot of the, the inulin [00:13:00] in particular research leads us, but we don't know other than short chain fatty acids, what else is being produced and is there some sort of.

[00:13:08] Strata of people who are at high risk and maybe shouldn't be exposed to large amounts of this. We don't know that.

[00:13:13] Carl Lanore: [00:13:13] See, from an evolutionary perspective, to me, fiber is a bad idea. And so before, before, you know, agrarian and we're growing our own food and we have refrigerators and fast forward, right? But when we had to be Hunter gatherers, right?

[00:13:28] If we ate high fiber, we had to consume, let's say 3000 calories in a day. And if our first meal was high fiber, it's like, God, I'm so full. I can't eat. You're screwed. Now. Like the whole idea of fiber. Works well in this sick population who were trying to slow down gastric emptying. We're trying to make them feel full longer because they would devour the whole refrigerator if they were given the opportunity.

[00:13:51] So then it works. But from an evolutionary perspective, fiber doesn't sound like a good idea to me. Am I off on that?

[00:13:57] Dr. Leigh Frame, PhD : [00:13:57] You're not off. But I would say that a lot of the [00:14:00] things that Hunter gatherers ate were roots and tubers and berries, which actually are high fiber foods, but different kinds of fiber. Um, so this is again, where the type of fiber probably matters.

[00:14:11] We're probably used to being exposed to those types of fibers and not so much to massive amounts of whole grains and not the whole grade pad for you. But. We definitely wouldn't have traditionally had a lot of those

[00:14:23] Carl Lanore: [00:14:23] at our disposal. Well, we wouldn't have been able to. Okay. Grains needed to be processed.

[00:14:27] Let's, first of all, like, you know, I always like to talk about corn and wheat and say, you know, wild dogs have access to corn fields and wheat fields, but they never bother eating it because it's, you can't eat it without machination. You have to use a machine to pulverize it and, and make powder out of it.

[00:14:46] So chances are we probably didn't eat a lot of whole grain back then.

[00:14:49] Dr. Leigh Frame, PhD : [00:14:49] Right.

[00:14:51] Dr. Scott Jackson, PhD: [00:14:51] They get a lot of fiber was probably fruits and vegetables that Hunter and gatherers got, and you know, part of that's mother nature that you can't help but get fiber. If you want to eat a [00:15:00] Tangerine or an Apple, you're going to get fiber.

[00:15:02] Dr. Leigh Frame, PhD : [00:15:02] Right. Exactly. Or broccoli, or almost anything that's plant-based has some sort of fiber, but not necessarily the same type or amount of fibers you might find in what you're talking about in inquiry and society.

[00:15:15] Carl Lanore: [00:15:15] So let's talk about the study. So what, what, did you have end points in mind that you wanted to discover or did you kind of go into this and say, let's just see where it takes us.

[00:15:26] Dr. Leigh Frame, PhD : [00:15:26] So I think we approach this in a very experimental way. We really wanted to see what was out there and try and categorize that as best we could. Uh, we did hope that this would be able to provide something for the research community in terms of guidance for where, uh, what's really been established. And, you know, maybe we don't need to research this topic quite as much and we should shift some of our attention over there.

[00:15:47] And I'm hoping that this will serve as a way that researchers can actually apply to grants and cite this paper. You know, this, this paper shows that there's not been enough done in this area, but there's some promise and sometimes that's the [00:16:00] hardest part about getting a research study is convincing your granting organization to give you the funds to do the research.

[00:16:06] Carl Lanore: [00:16:06] Yeah, I get it. So in a lot of previous research, and I don't understand why. But you point this out in the, in the beginning of your paper, it protein promotes microbial protein metabolism. Well, sodas, fiber to a certain degree, right? Fiber metabolism, but they, they, they list potentially harmful byproducts is produced by a protein like a T.

[00:16:29] what was it? A TM TMG was disease. So really, I don't understand why protein is bad when we talk about the microbiome and fiber is good.

[00:16:40] Dr. Leigh Frame, PhD : [00:16:40] So I wouldn't put it that way at all. Um, protein is not bad. What is bad is having large amounts of undigested protein in your gut that is not normal.

[00:16:50] Dr. Scott Jackson, PhD: [00:16:50] It should have been absorbed in the smaller testing before it got to your colon or your large intestines.

[00:16:55] Dr. Leigh Frame, PhD : [00:16:55] Right. And, and one of the issues with these harmful byproducts is not necessarily [00:17:00] that just having them there is bad for you. It's that if, say you on a extremely low fiber diet. There's not that fiber in there to cause the bulk formation to clean out the colon to get those five products out. And so they sit there for a very long time.

[00:17:15] That's really where the problem comes in. Um, so you, if you are having, you know, lots of fruits and vegetables and, and meat, you're probably okay. It's the people who are eating a McDonald's hamburger without any of the vegetables every day that we would be concerned

[00:17:31] Carl Lanore: [00:17:31] about. And that's what. And in fact, many autoimmune disorders are now being tracked back to, uh, undigested proteins that are then because of, uh, you know, phenomenons of the lining of the intestines literally getting directly into the bloodstream and the immune system going, Hey.

[00:17:54] That's an enemy. Let's kill it, and boy, that looks like thyroid tissue too. Let's kill that at the same time. [00:18:00] So I, you're right. I mean, the undigested proteins are starting to come become more of a discussion, but I don't think the answer is don't eat protein. I think we have to start to address why. Why are people not digesting protein?

[00:18:14] Is it because of the sheer volume of protein they're eating? Or is it because. The innate systems, the pancreatic enzymes and hydrochloric acid that is supposed to be doing a better job at preparing this protein to be digested is failing. You have any opinions on that?

[00:18:33] Dr. Leigh Frame, PhD : [00:18:33] I think it's probably more of the latter, but it's also in how we eat our food too.

[00:18:39] Now, the average American eats a very large portion of meat at dinner. I maybe not so much protein throughout the day. Um, and it may be easier for someone who has digestive issues to have smaller amounts of protein throughout the day and they can absorb them better. So that's one issue. Um, and then you're right, if people have people.

[00:18:57] A lot of people have got issues. If you have a gut issue, [00:19:00] you are not digesting things properly, and if you're not digesting it properly, then it couldn't be sitting somewhere where it doesn't belong and causing these negative side effects.

[00:19:10] Carl Lanore: [00:19:10] This

[00:19:10] Dr. Scott Jackson, PhD: [00:19:10] reminds me, I was watching a forensic show on TV last week, and they're referring to a pathologist and they look in the stomach contents of, um, suspicious, uh, courses, and they can tell what the last meal was, which sometimes helps the investigation.

[00:19:26] What they can only find is fibrous material, because even in the stomach before it's gotten into the small intestines, the proteins have already been broken down to amino acids,

[00:19:36] Carl Lanore: [00:19:36] which that's it. That's a good thing, obviously.

[00:19:38] Dr. Scott Jackson, PhD: [00:19:38] Yeah.

[00:19:40] Carl Lanore: [00:19:40] So one of the things that I've always, uh, asked whenever I've had people on the show to talk about nutrition, and again, going back, I'm a big fan of evolution.

[00:19:48] I keep looking to evolution for what we're doing wrong today. And so, um. You know, it wasn't until gastronomy, and probably we could blame this on the French and the Italian, which I'm [00:20:00] Italian. Uh, you know, we, we didn't eat, uh, like, like when we, when we killed a mammoth or a Buffalo, we ate Buffalo. We didn't, no one said, you know what tastes good with this?

[00:20:12] Some broccoli, go get some broccoli. So we, we ate one food at a time. And I sincerely believe that there's something to this, because when you mix meat. And vegetables, they break down a different rates, they require different enzymes, and all of a sudden I think it gives rise to the body being less efficient than if you ate your meat first, maybe ate your vegetables later.

[00:20:35] Am I off on that? You got any theories?

[00:20:38] Dr. Leigh Frame, PhD : [00:20:38] It was really interesting you mentioned that. So some of my background is in, um, working with patients who have their after surgery. And one of the things we tell them is to do exactly that, is to eat all your protein first. And then eat your, your vegetables and, and it is easier for them to digest.

[00:20:57] So that logic would say that [00:21:00] perhaps that's true for someone who hasn't had bariatric surgery as well. Um, they're just an extreme case of that. So,

[00:21:07] Carl Lanore: [00:21:07] uh, what did you see in your research that gave you an aha moment? You're like, wow, I didn't, I didn't think we would find that. Anything like that.

[00:21:17] Dr. Scott Jackson, PhD: [00:21:17] I'll say almost from an in a negative way.

[00:21:21] What we found, and I'm trying to phrase this carefully, is that you can really can't make anything from the research. So far. There's nothing clinically actionable yet. We can't define what a healthy gut microbiome is. We can't say that your is right and yours is wrong. Um, you know, the metrics that we have to describe a healthy microbiome are really, um.

[00:21:42] Two things. One is lack of pathogens, which obviously, um, and the second is richness in taxonomy or diversity. So the more diverse the genre of bacteria that exists, that's a sign of, um, a healthier gut microbiome and it's a direct product of a, of a diverse diet as [00:22:00] well. Um, so other than that, you know, all of these studies that I said, most of these studies are DNA based metogenomic measurements and you reading the DNA sequences, the genetic signatures from all the bacteria.

[00:22:10] Um. We haven't been able to come up with a repertoire of genetic signatures that defines good or bad.

[00:22:19] Carl Lanore: [00:22:19] I know, because if we, I once said on this show, probably a decade ago when we were talking about one of these brilliant stud studies about the microbiome, I said, you know, you know, every year I kill my grass and I received it.

[00:22:33] Why can't I just do that to my gut? And it's because we really don't know. We don't have a good assay of what. People's guts even have. And then when you combine the fact that, you know, I was a C-section baby and I got formula cause I was born in 58 so my microbiome was already jacked. And then, you know, all the things I've come into contact with throughout my life, which have left some sort of watermark or imprint [00:23:00] on my microbiome, either contributory or, or removing a, you know, it's like how do we, we don't even know what the plant, even if we did kill everything.

[00:23:10] Dr. Scott Jackson, PhD: [00:23:10] Yeah. You see a lot of products now that are good for your microbiome. And,

[00:23:15] Carl Lanore: [00:23:15] um, these

[00:23:17] Dr. Scott Jackson, PhD: [00:23:17] are typically foods like fibers and fiber supplements that we know have impact on your digestive processes, and that's what they're assuming is good for your microbiome. But, um, you're, you're right, Carl, that people have asked, how do I change my microbiome?

[00:23:33] And I say, well, what do you want to change it to? Like, you know, something that we own.

[00:23:39] Carl Lanore: [00:23:39] Well, I guess, I guess we have to look at disease States too, right? We know that people who have autoimmune issues, when they change their diet, you know, they eliminate certain foods. Like I just went through this cause I was suffering from some hard autoimmunity and I started to eliminate literally everything.

[00:23:56] And quite frankly, the thing that had the greatest impact on my [00:24:00] gut right now is I eliminated coffee, which I really, you know. I, like I said, I've been doing the show for 14 years and I've been watching, and I know people who have certain markers of health problems, you know, peripheral neuropathy. They're not diabetic, you know, uh, certain things that I see in the population that are widespread.

[00:24:21] And then I look at, you know, I lift weights. And, and I eat right and I sleep my, I'm a militant about getting good sleep and all this other stuff. And then I see somebody who is just reckless with their life and we both have neuropathy. And I go, what is the one thing? And I'm looking for the lowest common denominator.

[00:24:38] And for the past six or seven years, I kept thinking coffee and, but now I've given up coffee and caffeine entirely. And I can tell you that I had silent GERD for a long time where I would just have this tastes coming back up. You know, it wasn't Frank GERD. I didn't get the burning sensation, but it was like, what's that taste?

[00:24:56] It's literally like 90% better since I've given up [00:25:00] coffee and my neuropathy is getting better since I've given up coffee, and I really think, you know, PR coffee has an average cup of coffee is about three to 8% protein. And I'm like, maybe it's the, you know, plus the coffee that my mother and father drank.

[00:25:19] And your parents drank isn't the coffee we drink today. That coffee was almost see through. It was like a rusty water. It didn't have all this, this turbidity and this, this, this, uh, this emulsion of, of particles that you drink down. And who knows if those particles are into interfering with digestion. So coffee is one big one for me, but I, I look at the population and when you start looking at autoimmunity, they start removing things.

[00:25:45] They get better. That has to be the microbiome that's getting better.

[00:25:50] Dr. Leigh Frame, PhD : [00:25:50] It's an interesting point. Yeah. So there's definitely a lot to food sensitivities. Food intolerances. Um, and autoimmunity.

[00:25:57] I

[00:25:57] Carl Lanore: [00:25:57] mean, there's

[00:25:58] Dr. Leigh Frame, PhD : [00:25:58] a lot coming out about that. [00:26:00] Um, but you're right in saying that maybe it's beyond that and it's actually, it's shifting your microbiome.

[00:26:05] Um, and you could see where putting something into your gut that either doesn't make your gut microbiome heavy or doesn't make you work out happy, it's going to cause inflammation. That's going to cause leaky gut. That's going to lead to autoimmune reactions. Um, it all makes sense. We don't have a lot of great research showing that to be true though, and that's something I would love to see people work on it if we could actually figure out, I know I have people asking all the time like, how do I get tested for food sensitivities?

[00:26:35] And there aren't really any solid scientific. Studies showing that we can use any test to do that right now. Um, a lot of the tests on the market sort of work kind of a little bit. They're helpful for you to think about what your reactions are when you're eating, when they're not really a definitive answer, where, so we could get some of this mechanism behind it.

[00:26:55] It will be come up with a test that you could take that said, you know, you really shouldn't be drinking coffee because it's [00:27:00] going to cause all of these side effects, but maybe it's okay for me to drink coffee or someone who's say Turkish because you know, they're used to drinking very tea. Intense coffee for many, many, many years, and it's probably part of their genetic makeup at this

[00:27:13] Carl Lanore: [00:27:13] point.

[00:27:15] Well, I was allergic to chocolate as a child. Think about a horrible childhood is if you're allergic to chocolate, you can feel sorry for me. And so and, but interestingly, coffee and chocolate have very similar components and that they both, and they both have caffeine. And I've come to the conclusion I'm allergic to caffeine.

[00:27:33] And so I've eliminated all that stuff, but that's a, we have quite a few questions. We're going to get to them after the break. I want to take one quick commercial break. When we come back, we're talking with Dr. Lee frame and we're talking with Dr. Scott Jackson. We're talking about your microbiome and what you need to know about it.

[00:27:48] Stay tuned. This is the superhuman channel evolution. Just got kicked up a notch. Welcome back to superhuman radio. [00:28:00] So we have some questions. Let's get these done. First. Anti-nutrients like lectins. They have been discussed ad infinitum, at least I've been doing shows about them for

[00:28:13] Dr. Scott Jackson, PhD: [00:28:13] a real long

[00:28:13] Carl Lanore: [00:28:13] time. And I had strong beliefs about them before.

[00:28:16] But like I said before, now I'm starting to be come a little bit more balanced with my, my ideas about this. So Jeff Clifton says, electeds, the threat that doctor Gundry, who was on my show, uh, many years ago, uh, believes they are. What do you think.

[00:28:34] Dr. Leigh Frame, PhD : [00:28:34] So I think this is exactly what you're alluding to, that it's a personal issue, that some people are going to have issues with less events, but, um, you say you miss oatmeal.

[00:28:42] I would say go ahead. Have a small portion of the oatmeal. Don't change anything else and see how you react if you don't have any problems, especially if you do it a few days in a row, um, then you're probably okay. Uh, the, the literature is definitely next on lecithins there's, there's sort of camps. [00:29:00] And being more, there are camps, that probably means that it depends, is really the answer.

[00:29:04] Um, because it means that both groups are probably have some fat on their side. Um, but that there's really a more complicated truth and I think this is going to be one of those cases.

[00:29:14] Carl Lanore: [00:29:14] Yeah. Because I mean, lectins overall are proteins. First of all, gluten is elected and it's a protein that's a nother one of these proteins.

[00:29:20] And I was just texting with somebody. Everything has protein in it. Broccoli, coffee. You know, everything. So it's, it's one of these proteins. But, um, from science, we learned that, you know, since, since plants can't run, fight or bite, they increase things that make them less preyed upon by animals. I went to a lecture 10 years ago that proposed, this is why we have phytoestrogens in soy, because animals that would.

[00:29:53] Uh, eat a lot of soy, it would change their mating cycles and they'd literally just, you know, stop having babies and [00:30:00] disappear. So it's really a phenomenal and interesting concept. But I, I can't believe that all lectins should be avoided, uh, because if that's the case, then, you know, we're saying that all proteins should be avoided.

[00:30:14] And now where's B fall? You know, where his chicken fall. So. Yeah. I mean,

[00:30:20] Dr. Leigh Frame, PhD : [00:30:20] a good point. Anything that's found in a large proportion of food is probably not something most people are going to be sensitive to. I'm glad you picked up the example of gluten cause I think that's a really great example of where people maybe went a little bit crazy.

[00:30:32] Um, so I actually have celiac disease, so I do avoid gluten and I wish I didn't have to. I am all half Italian. So that's where I got that from. But there are a lot of people out there who are just terrified of gluten and maybe don't need to be right. They, they could have. Small amounts of it. Um, don't eat, you know, two pounds of pasta in one meal, but there'll be okay.

[00:30:52] And I think that gluten has really been demonized in a way that's not necessarily true for everyone. I am terrified of it.

[00:31:00] [00:31:00] Carl Lanore: [00:31:00] Scott is not, I take it right. I'm not afraid of voting. You know, it's funny, I made pizza when I was a kid. When I was in college. I worked at my cousin's pizzeria on in long Island.

[00:31:13] And now that I know what gluten is, but back then I used to grip the F the the flour that we use to make pizzas called high gluten flour, because that's what makes it stretchy and pliable. So you can, and it's like I'm thinking, Oh my God, I used to eat so much pizza and there's so much gluten in it. It didn't bother me back then, so.

[00:31:31] Dr. Leigh Frame, PhD : [00:31:31] Right, right. And you do change every time. So it may be, it does actually bother you now, or if it's just the amount.

[00:31:39] Carl Lanore: [00:31:39] What, and what is it about the buy? And so I keep coming back to, it's the microbiome changes over time because let's, let's, let's, let's also attach another component to this. Um, one of the mantras that my audience has heard me say over and over again is when we talk about.

[00:31:56] The gut. We're talking about the immune system, and when we talk about the immune system, [00:32:00] we're talking about inflammation because inflammation is the army of the immune system. So these are all tied together. When people talk about chronic inflammation, think about the gut, think about the immune system and so on.

[00:32:11] So we know that the immune system changes as we get older. What if it's just the microbiome that's changing? And if we could figure out, you know, if we had not so much what a healthy microbiome is. If we had an imprint of our microbiome when we were young and we can compare it to one, we're old. We could go, Oh shit, Oh, excuse me.

[00:32:29] Or optical wave that now all those are gone now and it's been replaced by these. What do you think. I think

[00:32:36] Dr. Leigh Frame, PhD : [00:32:36] you are spot on. Um, there's been a fair number of said that there haven't shown a, a major difference when looking at younger people versus older people. But I think it's exactly the point that you're making out.

[00:32:46] It's not about young versus old. It's about you at young versus you at Olin. And how that changed. Um, and maybe in some cases for the better. If you didn't, you were not leading a healthy lifestyle when you were younger. You know, say you've lost 300 pounds. And [00:33:00] your gut microbiome now might be better off.

[00:33:02] Um, that's where having an, a knowledge of what a healthy microbiome would be really useful,

[00:33:07] Carl Lanore: [00:33:07] you know,

[00:33:08] Dr. Scott Jackson, PhD: [00:33:08] add to that, that, you know, we typically describe a microbiome in terms of taxonomic nomenclature, right? Escherichia coli.

[00:33:17] Carl Lanore: [00:33:17] Uh. Proteobacteria, et

[00:33:19] Dr. Scott Jackson, PhD: [00:33:19] cetera. These are just names like homosapiens, right, or genus species, taxonomic designations.

[00:33:25] Um, another question, probably more informative question. Uh, our measurement is that of metabolic activity. So two

[00:33:34] Carl Lanore: [00:33:34] identical,

[00:33:35] Dr. Scott Jackson, PhD: [00:33:35] well, let me, let me say this another way.

[00:33:37] Carl Lanore: [00:33:37] There's a thought

[00:33:38] Dr. Scott Jackson, PhD: [00:33:38] in the theory in the community that vastly different microbiome may functionally be very similar. And as if you measure the metabolic output of two distinctly different microbiomes, the metabolic output might be very similar.

[00:33:51] So. We need to begin looking at things in a different way. And of course, looking at metabolites, you know, the science, [00:34:00] metabolomics, um, it gives you a direct readout of what metabolic processes are happening. And, um, that's really in its infancy in terms of, you know, scientific research because it's not as, it's not as easy as throwing some DNA on a sequencing instrument and then reading what comes out the other side.

[00:34:18] Carl Lanore: [00:34:18] I, I would've thought metabolic Omix would've been way farther ahead. We talked about metabolic probably about eight or nine years ago, and I thought this is going to be the game changer, and I don't see nearly as many studies coming out in that group as I would have hoped for. It's,

[00:34:33] Dr. Scott Jackson, PhD: [00:34:33] it's shifting because people like myself, who had been doing DNA base measurements for 10 15 years are realizing that we can't extract useful information from it.

[00:34:43] You know, we don't have clinically actionable. Um, things that we can do that are related to the microbiome because again, we don't know how to move it, what to move it to. And people are realizing that there's only so much information you can get from reading DNA, genetic signatures. So they are [00:35:00] moving towards metabolomics and maybe, you know, in another 10 years of metabolomics research, we'll have some better answers and indications on what is healthy and what isn't

[00:35:10] Carl Lanore: [00:35:10] I, because at the end of the day, what is healthy.

[00:35:13] For you is a diet that doesn't produce any type of symptoms of disease States. Right. Or

[00:35:21] Dr. Scott Jackson, PhD: [00:35:21] inflammation. Yeah,

[00:35:22] Dr. Leigh Frame, PhD : [00:35:22] exactly. And that's where metabolomics would really come in handy because we could see what products are being produced by the gut microbiome, what your reaction to it is. Cause we can look at it with elements of the blood and really start to put the puzzle together.

[00:35:35] Whereas now we're kind of just looking at, you know, what, what bacteria are in your gut? And then trying to. Correlate them with disease outcomes is that they don't really correlate so perfectly because there's variation among those individuals in the, in the bacterial community,

[00:35:53] Carl Lanore: [00:35:53] you got, of course, that company came, what was that company?

[00:35:55] You buy ohm. They hit the market like, uh, seven years ago, six years ago, and [00:36:00] everybody goes, this is going to be a game changer. I'll be able to know what, what my microbiome looks like and okay, so I know what it looks like now. But what does that mean? Oh, we don't know. It's like, well, why? Why should I care about what it looks like if we don't know what that means?

[00:36:14] Dr. Leigh Frame, PhD : [00:36:14] Yeah,

[00:36:15] Dr. Scott Jackson, PhD: [00:36:15] yeah. And it could have been a game changer if it had been done correctly,

[00:36:20] Carl Lanore: [00:36:20] because how would it have been done correctly?

[00:36:24] Dr. Scott Jackson, PhD: [00:36:24] It was as soon as the sloppy science poor measurements, um. You know, when you read about these large cohort studies, you know, in an academic journal, you might have 30 or 40 people in your cohorts.

[00:36:37] Um, there've been some other, um, public, um, efforts like the American gut project, which last I heard they had like 12,000 samples or so. And um, compare that to you by on which, when they went under, they had about 300,000 samples analyzed. That's a huge cohort. You know, you can. Extract information, the metadata about the people, their diet, their disease [00:37:00] States.

[00:37:00] They had the tools in place to really be able to link microbiome measurements to health and disease outcomes. And very little came out of that. Um, despite,

[00:37:15] Carl Lanore: [00:37:15] where is that data now? Is it, where is it.

[00:37:19] Dr. Leigh Frame, PhD : [00:37:19] It's for sale. Um, but I know people who have looked at it and if it was not properly maintained, and so while it could have been a game changer, it was not done in a way that's going to allow us to use the data.

[00:37:30] Dr. Scott Jackson, PhD: [00:37:30] I thought, I thought when that company went under, I said, you know, they've got this gold mine of data and it's going to go to the highest bidder. And I'm, you know, friends, colleagues with some of the people in the industry that would be purchasing this. And they said they had no interest in it. Once they got us sort of a peak behind the, behind the doors.

[00:37:48] Carl Lanore: [00:37:48] So I have a good friend, Ron Penna, who believes that the microbiome will never give us any information about diseases because it's just a remnant of your diet. Change your diet, change your [00:38:00] microbiome, change your health. Everything comes down to the diet that works for you. All we making much to do about nothing by focusing on the microbiome.

[00:38:07] If we really should just be looking at diets and outcomes.

[00:38:12] Dr. Leigh Frame, PhD : [00:38:12] Well, that's probably would have been my biased response several years ago that a lot of it is, if not all of it is due to the diet. However, recent studies have shown that that's probably not the case. Um, it is definitely one of the largest contributors, but, um, other factors, um, and many of them are not well studied.

[00:38:32] So I have a hard time even kind of buying into it fully yet. But, um, other factors such as, you know, if you already had an autoimmune. Does he seem to be larger contributors? But then you get into the argument of which came first, right? Did the, um, autoimmune disease come or did the bad, bad, unhealthy microbiome come and that caused the autoimmune disease?

[00:38:53] So it's a little bit unclear, but there is, I would say, in the field, most people now would not say that diet is, [00:39:00] is everything to the gut microbiome.

[00:39:03] Carl Lanore: [00:39:03] Acro my C's is all the rage because Metformin seems to shift the gut. To a higher degree of . I'm not sure what  does for you. That's so beneficial. But I also know that high protein diets seem to reduce the amount of  in the gut.

[00:39:20] What, what, what the deal with acromegaly should? We want more of it.

[00:39:24] Dr. Leigh Frame, PhD : [00:39:24] So from what we know today, it does seem to correlate with people who are healthier versus people who are disease. But like we were saying, um. Does that mean that if you have too much of it or too little bit that you are going to fit into one of those categories?

[00:39:39] Not necessarily. Um, they could be metabolically different. Um, then the people who were being studied in these research studies also, it doesn't matter how much Akkermansia you have or how much Akkermansia versus proteobacteria you have. And it's all about the balance, not just narrowly any one bug. And it is hard to believe anyone [00:40:00] bug can make that much of a difference when you have this massive community.

[00:40:03] Um. So, I don't know that it's really that important to look at any one individual bug.

[00:40:10] Carl Lanore: [00:40:10] It's acro sacral man. You've corrected me. I was saying  it's Akkermansia good. I'm sorry, Scott. Oh,

[00:40:16] Dr. Scott Jackson, PhD: [00:40:16] I was just gonna say that, um, you know, within a species of bacteria like Escherichia coli,

[00:40:20] Carl Lanore: [00:40:20] you could have a huge amount of genetic

[00:40:22] Dr. Scott Jackson, PhD: [00:40:22] diversity within a species.

[00:40:23] You know, for example, any Colet two strains could differ by up to 50% of their genome. And if you look at bacteria as being little tiny metabolic factories. Um, the term big molecules and

[00:40:34] Dr. Leigh Frame, PhD : [00:40:34] small molecules,

[00:40:35] Dr. Scott Jackson, PhD: [00:40:35] um, you know, that that two strains be cool. I can have very different metabolic outputs and I would imagine that's probably also true for Akkermansia.

[00:40:44] So,

[00:40:45] Dr. Leigh Frame, PhD : [00:40:45] yeah, I think it's helpful if you think about them, like the human species, right? If you like saying having humans in your garden is helpful for the garden, it would totally depend on the human. If they knew how to garden, then yes, it would be helpful. But if it was someone who had no idea what they [00:41:00] were doing, they'd probably just be trampling the garden.

[00:41:02] And I think that's how we need. That's good. That's really good. I like

[00:41:05] Carl Lanore: [00:41:05] that. I love analogies because they, they crystallize concepts for people. They go, Oh yeah, that's great. I want to take our last commercial break. When we come back, I want to talk about, um, latitude and, uh, the microbiome because we know that when you get into the hotter latitudes, the, there's a shift between, uh, Firmicutes and, and bacteria Dietz, and there's some assumptions that one is better.

[00:41:31] Because of energy consumption and blah, blah, blah. So let's talk about that when we come back. Okay, sounds good. I stay tuned. We'll be right back. This is the superhuman channel where we use oxygen for the power of good

[00:41:46] back. We're talking with Dr. Lee frame and Dr. Scott Jackson from George Washington university, and we've been talking about diet and nutrition, how it affects the microbiome. So last two questions I want [00:42:00] to ask you and then Jeff , I'm gonna just going to put Jeff Clifton's comment up here. He says, biome has a ton of data in regards to their reports.

[00:42:08] The reports give information regarding butyrate and intestinal permeability, which can lead you to make decisions about food choices. What do you think of it?

[00:42:20] Dr. Scott Jackson, PhD: [00:42:20] Um, I don't know much about biome, if I remember correctly. They are measuring the transcriptome rather than the metagenome, which means that they are measuring gene expression.

[00:42:29] And a, it's

[00:42:31] Carl Lanore: [00:42:31] hypothesized

[00:42:32] Dr. Scott Jackson, PhD: [00:42:32] that you can make more informative decisions, uh, about function based on the transcriptome. Um, as far as. A ton of data. I don't have any idea how many samples they've managed to collect and analyze. If they are making, giving information about beauty rate. Um, and intestinal permeability.

[00:42:56] I mean Buter it's a small molecule, so they, if they're measuring that [00:43:00] directly, it would be like a mass spec metabolomic type of measurement. And I don't know, maybe maybe they have a biomarker that's an indicator of intestinal permeability.

[00:43:11] Dr. Leigh Frame, PhD : [00:43:11] Yeah. Tesla permeability markers are not fantastic. Um, we, we have some and we can use them, but they're not fantastic.

[00:43:21] Um, but the, the one about butyrate is really interesting. If they were directly measuring it, then potentially that could be informative. But again, we don't have a great idea of what the optimum amount is. So what are you optimizing it to? That would be the question.

[00:43:35] Carl Lanore: [00:43:35] Well, and especially now with the ketogenic diet movement, people almost, uh, it's like a contest, you know, Oh, I'm four millimoles of ketones.

[00:43:43] It's like, yeah, that's not necessary. Unless you've, you battling, you know, glioma, like maybe you don't want to do that, you know? I mean, it says, I wake up, I look, I stop eating at 6:00 PM every night and I wake up in the morning. And I generally, I won't eat, which [00:44:00] one of my questions going to be fasting. I won't eat until after today's show.

[00:44:02] And then I have this window of time while eat a couple meals. And that's it. And by the way, I eat a hundred grams of animal flesh,

[00:44:09] Dr. Scott Jackson, PhD: [00:44:09] uh,

[00:44:09] Carl Lanore: [00:44:09] with those two meals. So I get at least 200 grams of protein. But with that being aside, um, you know, what about fasting, this fasting help hinder, I mean, cause everybody's doing intimate and fasting today.

[00:44:25] Dr. Leigh Frame, PhD : [00:44:25] That's a great question. We're actually having Valter Longo come and talk at our annual symposium in a few weeks, so I'm going to ask him exactly that question. Um, but what we do know is that the gut microbiome is fairly resilient. So if you don't eat for 12 hours, it's not like it's going to die off. Um, it will probably just go back to where you were.

[00:44:44] Um, so I wouldn't worry about that in terms of fasting. But what fasting does do is it decreases inflammation, allows the body to fix things that have been broken. Um, and so that [00:45:00] process could potentially be beneficial to the gut microbiome in terms of decreasing inflammation and the immune response to the members, the gut microbiome, which could be incorrect.

[00:45:09] And allow them to bounce back to a healthier version. And so I would think that fasting would probably be beneficial for the gut microbiome, but that hasn't been scientifically shown.

[00:45:19] Carl Lanore: [00:45:19] And by bed, you know, supposedly the bad actors in the gut have the ability to spore. I've been told, so like they don't die from you starving them.

[00:45:29] They just go into suspended animation. And then when their preferred food shows up, they go, Oh, well let's wake up and eat now. So I know that fasting. Is it necessarily a good idea? If you think you're going to kill something that you don't want in your stomach, it doesn't work.

[00:45:45] Dr. Scott Jackson, PhD: [00:45:45] Yeah. If

[00:45:46] Carl Lanore: [00:45:46] I,

[00:45:47] Dr. Scott Jackson, PhD: [00:45:47] I know there's four formers in the guy.

[00:45:49] I haven't heard that connection about that, but it would be interesting to know fasting increased the onset of Clostridium difficile because. Typically found in spores and healthy guts and they remain a spores. And it's only after [00:46:00] you take a, you know, a Bose of antibiotics that kills off the good bacteria and the spores come out and do your thing, and then they, you've got C diff.

[00:46:07] Um, but if somehow that were correlated with fasting, I don't know,

[00:46:12] Dr. Leigh Frame, PhD : [00:46:12] you'd have to use that thing for a long period of time. So not sort of the time restricted eating that, that we were disgusting, but that would have to be more of a prolonged fast, I would think.

[00:46:20] Carl Lanore: [00:46:20] Dr. Sanders. Dr Satish Rao came on my show a few years ago when he published that study about, um, D lactic acidosis.

[00:46:28] People who take way too much probiotics, they actually seed this a lactic acid producing. Uh, microbes, and then they wake up in the morning with brain fog, achy joints. And what he discovered in his study that we just, we talked about was they gave the, uh, patients, um, the antibiotic that's used for Traveler's distress, uh, is, is, is, is a, I can't think of it.

[00:46:50] What is it? Is he back? No, no, no. I actually have some laying on my desk because I took them for a while. 50 to do an experiment. I'm, I'm like a 250 [00:47:00] pound Wistar rat. I try everywhere. So, um, uh, but anyway, it was w Faxon for Faxon. It's an antibiotic given to people when they go to Mexico and they get the diary Montezuma's revenge.

[00:47:14] You take it for three days and your gut is fine, but they take it, what does it  yes. So they took, they, he, so he gave people 42 days, 500 milligrams. Two to three times a day and their D lactic acidosis went away. But what he discovered was when they refrained from eating the foods that fed the lactic acid bacteria.

[00:47:39] The, the antibiotic didn't work as well, and he postulated that the antibiotic goes into S, I mean the, the micro goes into suspended animation. So you want the antibiotic to be there when it's eating its favorite food because then it can eat the antibiotic as well. That's, that's your reason why.

[00:47:54] Dr. Leigh Frame, PhD : [00:47:54] Yeah. And then a lot of them antibiotics actually work by interfering with the reproduction of bacteria.

[00:48:00] [00:47:59] So if they aren't actively reproducing, and then a lot of them will not work. And I'm going to guess that's the method of action for that particular antibiotic

[00:48:06] Carl Lanore: [00:48:06] summit. Rifaximin yeah. So. Last thing. Latitude effect. We know that people in Brazil have vastly different gut microbiota then say the people in Alaska, and it's, it's not just attributed to changes in diet.

[00:48:21] We know that environmental things have an effect. We even are learning now that RF from our cell phones are having an effect on the microbiome. But what, what do you think about that? Warmer temperatures shift the microbiome. Anything about that? Certainly

[00:48:36] Dr. Scott Jackson, PhD: [00:48:36] when you moved from a latitude from Alaska to Brazil, you're going to have vastly different diets, most likely based on, you know, what is grown in the animals, etc.

[00:48:46] Um.

[00:48:48] Dr. Leigh Frame, PhD : [00:48:48] Yeah. I feel like that's a really difficult one to tease out because there's so many differences between those, those areas. One of which actually you're going to hit up my favorite nutrient, vitamin D. um, super [00:49:00] important for your immune system and how it's functioning. And so people with the equator are probably getting enough of it and people would, Alaska are probably not.

[00:49:07] Um, so that may actually be the connection with the gut microbiomes. I would hypothesize that that would be

[00:49:12] Carl Lanore: [00:49:12] important. So, so the two file back, bacteria, deets, and, and Firmicutes, one, uh, one shifts the gut to not. Extracting as much nutrition from the meal. At the same time, it shifts the body to greater energy utilization, producing a leaner person and the other one extracts more nutrition from the food you eat and also slows down.

[00:49:39] Uh, energy utilization, so you get fatter. And so they found that, you know, when you look by the equator, the further away you went to the, from the equator, the one that is a slower and at each more seem to populate to a greater degree. I don't remember which is which, but that, that was what the study was definitely

[00:49:57] Dr. Leigh Frame, PhD : [00:49:57] Bacteroidetes are the one that we historically [00:50:00] thought, um, increased your metabolism and decreased your, your hunger.

[00:50:04] Um, and Firmicutes being the opposite of that. And a lot of the obesity literature and the work in, in bariatrics focused very heavily on that. And the gut microbiome of, however, when we start looking at, um, a broader population, it doesn't seem to correlate quite so tightly to that behavior. Um, and I think this gets back to the fact that we're looking at, you know, this species of Bacteroidetes and there's a lot of different variation inside them that we're, we're missing.

[00:50:33] Dr. Scott Jackson, PhD: [00:50:33] Well, those designations are at the Fila level, which is the highest, second highest tax non AKI rank. So it's just a little bit better than saying they're bacteria. Um, and yet the, this idea that, you know, they're prepared of ratios, backdoor, Bacteroidetes and Firmicutes. Um,

[00:50:50] Carl Lanore: [00:50:50] you know, a lot of that

[00:50:52] Dr. Scott Jackson, PhD: [00:50:52] has been, um.

[00:50:54] Debunked. You know, one study might show up in another study might show that it's not. Um, there's been a lot of [00:51:00] back and forth there. And you know, I mentioned it earlier, you know, if you read through our paper, uh, you know, Lee compiled a lot of the information on the studies that have been done. And in this study, they looked at this and they found this.

[00:51:12] And like, for example, you know, at this cohort they had a high fiber diet. They had a high ratio of bacteria Royce. And you're like, okay, well actually everybody's as good then. And then the next paragraph, it's like, well, then, you know, they have this cohort that had. Horrible diet and they had a hybrid ratio in vector.

[00:51:26] Everybody's like, well, wait a minute. I thought that was the good thing. Right, and this is why at the end of the day, it's kind of frustrating because you can't pull anything out of it. You don't know what's up and what's down.

[00:51:35] Dr. Leigh Frame, PhD : [00:51:35] Yeah. It's missing the detail that we need to really make a difference, which is, again, what we're hoping to push with this paper is that the research needs to look at more detailed.

[00:51:47] Levels of data for the, the microbiome and also for the people. Um, what are they eating? A lot of times they're not even collecting information about diet from these studies. And that's just alarming to me. Um, when we do these [00:52:00] microbiome research studies, and we don't even know what people are eating because maybe something actually does work, but you need to have.

[00:52:06] Some certain element in your diet and then people were missing it. And that's why we think this treatment doesn't work very well.

[00:52:11] Carl Lanore: [00:52:11] Well, I know that people, people as a rule under-report which they think is bad behavior and over-report what they think is good behavior. So if you're collecting the data that way, you're already kind of screwed.

[00:52:23] You know?

[00:52:23] Dr. Leigh Frame, PhD : [00:52:23] It's true. That, and then that is an inherent problem in studying nutrition. Unfortunately, a lot of times we have to take self report data. Unless we physically feed them ourselves, which as you can imagine, is very difficult to do. And people don't like to be told what to eat.

[00:52:37] Dr. Scott Jackson, PhD: [00:52:37] And you certainly can't do that with large cohorts, especially if it's an inpatient type thing where you're really controlling everything that they eat.

[00:52:43] Right. Um, so you know, we, in our conclusions, you know, yes, we didn't. We do need better controlled and more powerful studies, more powerful being larger. Cohorts, but also on the technical side, it's a measurement problem. You know, saying Firmicutes infect your roadies. This is [00:53:00] not

[00:53:00] Carl Lanore: [00:53:00] descriptive at

[00:53:00] Dr. Scott Jackson, PhD: [00:53:00] all. Um, they're just names.

[00:53:03] It's like if I were to describe you, um, you know, by just saying your first name, Carl,

[00:53:09] Carl Lanore: [00:53:09] you don't know anything about me. Right, right.

[00:53:11] Dr. Scott Jackson, PhD: [00:53:11] It's just a name. So we need, um, a better molecular understanding of what the microbiome is and not just naming Fred, Joe, Tom, and

[00:53:20] Carl Lanore: [00:53:20] Sam. This has been good. I want to thank you so much for making time to, uh, to come on the show and talk about your research.

[00:53:28] Dr. Scott Jackson, PhD: [00:53:28] This has been fun.

[00:53:30] Carl Lanore: [00:53:30] All right, well, uh, just stay with me for a second. That's it for today. Tuesday, we were supposed to have coach Rob registrar for. The blueprint power, but it doesn't look like it's going to happen cause he has a doctor's appointment tomorrow. So we may be off tomorrow or we may find the show.

[00:53:43] But either way, we have great shows planned all week, so be sure to tune in. Thanks a lot guys for being here and thank you to the audience that participated with your questions and we will see you soon. Tell you what [00:54:00] .