[00:00:00] Carl Lanore: [00:00:00] welcome back to another episode of super human radio. We have a very, very promising show for you today. Uh, we're going to talk about high flavonol diets and how they affect blood pressure during the first hour. And then during the second hour, we're going to talk about pathogens in the mouth that both induce and promote aggressive forms of oral cancers.

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[00:01:26] Just get some of the, uh, branding work up here. Today, I'm talking with, uh, professor Gunter. Coonley right. Did I say that right? Uh, welcome to the show. Uh, you are with the university of California in San Francisco, correct?

[00:01:42] Prof. Gunter Kuhnle, Ph. D.: [00:01:42] I am. Um, well, I am actually at the university of Redding and UK,

[00:01:47] Carl Lanore: [00:01:47] sorry, UC Davis. Oh, you used to be with UC Davis really?

[00:01:52] Prof. Gunter Kuhnle, Ph. D.: [00:01:52] Oh, UC Davis. So one of the, one of the collaborators is at UC Davis.

[00:01:56] Carl Lanore: [00:01:56] No, but you're right. Uh, you're you're with the university of reading and, uh, and, and, [00:02:00] uh, in the UK I've saw that, that was a mistake of mine. I just moved professor, um, all of the contents of a home. With, uh, you know, like 50 years of, of accumulation in two days, I'm still not back to normal.

[00:02:14] I'm exhausted to be honest with you. So anyway, okay. So let's talk a little bit about this research. Why did this study need to be done? Why did you have to look at, uh flavanols and their relationship to blood pressure?

[00:02:26] Prof. Gunter Kuhnle, Ph. D.: [00:02:26] Well, we have known all about, we have suspected that there is a link between flavanols and blood pressure for, for quite some time.

[00:02:33] So in the, in the mid nineties, there were studies and in Panama about, um, And people moving from an, from an isolated Island to Panama city, uh, who changed their diet and change their diet, essentially from a high flavonol to a low flavonol diet and whose risk profile for cardiovascular disease has changed.

[00:02:53] And it was also the time when there was a lot of research into different types of phenolic compounds of its [00:03:00] rich problem, also warm and, um, One focus on flow. A lot of studies on flavanols showed that  can reduce blood pressure and different ways. We still don't know actually how they do it, but we know that if you feed people, Defined amounts of flavanols the blood pressure drops that vascular system becomes more or less thick.

[00:03:21] Now all of these studies were fairly small, the full term, and especially people that are fat, specific foods or flavanols has an isolated compound, but it was never part of the normal diet. An interesting question was of course, what happens if people eat. Flavanols as part of the normal diet and not especially fat, what happens to Norton to normal people.

[00:03:44] And that's the great part of nutritional epidemiology. We can look at large group of people who eat a normal diets who are more specially fit, specific diets. And we can then look at an effect. Now the big problem here is of course, how do we [00:04:00] know what people are eating?

[00:04:02] Carl Lanore: [00:04:02] And I had a tiny note. I noticed that I want to mention something.

[00:04:04] So when I first saw this research, I thought, Oh great food diaries. Once we look at food diaries, you really people have a, a distinct habit. Of over-reporting what they perceive as good behavior. And under-reporting what they perceive as bad behavior. But you guys corrected for that you actually went and looked at blood work for these people to identify metabolites of the flavonols.

[00:04:26] Correct.

[00:04:27] Prof. Gunter Kuhnle, Ph. D.: [00:04:27] So that's, that's exactly what we did. So when, when we planned this study originally many years ago, um, the idea was to do it like everyone else does it. So we use food diaries. We, uh, look, look for intake and then we measure it. But. Obviously, we already knew the limitations of all the, all the problems of recording, what people are eating.

[00:04:48] So we looked for an alternative and nutritional biomarkers. What we've done is this is the best way forward because we actually know what those people have consumed. We don't have to rely on what they tell us. We don't have to [00:05:00] rely on, on, uh, fruit composition tables, but we know exactly what we find in, in that, in the bloodstream.

[00:05:07] Carl Lanore: [00:05:07] Okay. So, so th this is, uh, this is a much more meaningful study than somebody who says, yeah, we, we asked 25,000 people what they eat and here's what we found correlations. And because people lie all the time. So, um, let's talk about the research and, and, and how the data was. Compiled. So did you look at different types of flavanols or did you look at the total flavonol loads?

[00:05:32] So somebody eats berries every day. They drink green tea and we look at the total flavonol load. Or did you look at individual flavonoid flavonols and their unique contributions?

[00:05:42] Prof. Gunter Kuhnle, Ph. D.: [00:05:42] No, we looked at the entire group of flavanols. So we looked at actually, we looked at two groups of flavanols. We looked at total flavanols and we looked at a very specific type of flatter flavonol called Epic category.

[00:05:54] Um, and the reason for this is that, uh, two biomarkers for used one is specific for [00:06:00] total flavanols, it's a specific subgroup of liberals, but most flavanols and the other specific for Epic catechin. Now, the physics on that  one is that the, the time the plasma half-life is the time in the body is too short to get very good data, except for people who really regularly consume it.

[00:06:21] Um, So that was a big limitation versus the other one has a much, much longer, stays much, much longer the body. So we can be more confident that the data is representative of the, of the general intake.

[00:06:33] Carl Lanore: [00:06:33] Okay. And so, uh, what, what did you find when you started to look at these? Uh, first of all, I would imagine you stratified.

[00:06:41] These groups, uh, how did you decide to determine just how to stratify these groups?

[00:06:46] Prof. Gunter Kuhnle, Ph. D.: [00:06:46] So what we have, yeah, we have, uh, conducted a lot analysis with continuous data, so we didn't split them into groups or anything. So the only stratification was what's male or female, uh, because we know from, from previous work that there's [00:07:00] usually a difference between men and women and their response

[00:07:03] Carl Lanore: [00:07:03] to women.

[00:07:03] Let me get some females tend to consume more flavanols than men.

[00:07:07] Prof. Gunter Kuhnle, Ph. D.: [00:07:07] Um, Based on their overall energy intake. Yes. Men tend to, because men tend to be heavier and larger. They're 10 feet.

[00:07:17] Carl Lanore: [00:07:17] I'm going to grab a handful of blueberries and eat them and feel satisfied. And women will because they feel it's not just the, uh, it's not just the satiety.

[00:07:25] Uh, aspect of these foods, it's, uh, women know that these, the, all these are good for us. So we eat more of a men go, nah, I don't want that. Give me beef. You know, so

[00:07:35] Prof. Gunter Kuhnle, Ph. D.: [00:07:35] yeah, it's a UK study. So for us it's mainly tea. So what people drink is tea. So if you have a Haiti intake, um, most of the other foods are more as, as important.

[00:07:47] Carl Lanore: [00:07:47] Yeah. That's interesting. And women do drink more tea than men that's for sure.

[00:07:52] Prof. Gunter Kuhnle, Ph. D.: [00:07:52] I'm not sure here

[00:07:53] Carl Lanore: [00:07:53] again, the UK it's different. Right? Everybody drinks, tea.

[00:07:56] Prof. Gunter Kuhnle, Ph. D.: [00:07:56] I that that's it. I think tea is sort of the stable drink here [00:08:00] and that, that made the study really good because it meant that we have, we have an extremely wide range of intake.

[00:08:06] We have, for those people that drink a lot of DVR, people who drink coffee or no tea at all. So whether you train, whereas the study conducted, for example, in the U S would be different because people tend to drink less tea.

[00:08:16] Carl Lanore: [00:08:16] Yes, that's interesting. Now, is it just green tea that possesses these benefits professor or do all different strains of tea?

[00:08:24] Have some amount of flavanols in them.

[00:08:26] Prof. Gunter Kuhnle, Ph. D.: [00:08:26] It's it's mainly green and black tea. So green tea contains the most, but black tea. Contains

[00:08:32] Carl Lanore: [00:08:32] also quite a lot. Now, now the reality is that both green tea and black tea start from the same plant that just the processing or the, the roasting or the drying that makes one green one.

[00:08:42] So could it be said that the more processed the tea is as in black tea, the more of these flavonols that are lost?

[00:08:51] Prof. Gunter Kuhnle, Ph. D.: [00:08:51] It, it depends on the type of processing in that case. Yes. If they, if they get oxidized, they would, they would. No longer active, but in some [00:09:00] other foods it might well be that the way their process that they released from, from a matrix, which would otherwise not be, not be accessible.

[00:09:06] So it's, it's difficult to sort of say in, in one way, that processing increases yeah. Increases the amount.

[00:09:14] Carl Lanore: [00:09:14] So I realized that you, your, your paper did not attempt to elucidate the pathway of action, just the correlation of this response. But we, we. If we juxtapose this research against the backdrop of what we know about high blood pressure in first world countries, it's usually tied to the onset of metabolic disorders, which start from insulin resistance in the case of high blood pressure, um, high insulin levels.

[00:09:45] Increase angiotensin converting enzyme and this constricts blood vessels, which makes the, uh, blood, um, more pressurized, if you will. And blood pressure rises is there, is it, can we extrapolate anything? Uh, th [00:10:00] I mean, flavonols have been implicated as antioxidants, but they have also been implicated in, uh, insulin receptor sensitizing.

[00:10:10] Could we say that? Oh, you know, we, we, we can, we can guess where this is coming from.

[00:10:14] Prof. Gunter Kuhnle, Ph. D.: [00:10:14] Um, so the one thing is the antioxidant, the idea that it flavanols actors antitoxicant, we were pretty certain, they don't because there are many they're metabolized in the body makes them no longer being able to act as antioxidants.

[00:10:27] So, so we can be fairly certain that they don't act as antioxidants. Um, About all the other pathways. We have some ideas of what is likely to happen. And if it's likely that they affect the elasticity of the vascular system, so they make the muscular system more and more elastic, I'm more flexible. And they probably also deal with blood coagulation and, uh, I'm good Genesis, but it's, it's unfortunately it's too early to really know the, the, the underlying pathway.

[00:10:59] Carl Lanore: [00:10:59] Has [00:11:00] there any, any research out there that correlates with your findings that used say flavonol supplements, devoid of the original tea leaf itself? We just, uh, I know there's epi catechin capsules out there. Now, do we have any evidence that these flavonols act the same, whether they are resident in the original leaf versus, uh, extracted from the leaf and given in capsule form.

[00:11:26] Prof. Gunter Kuhnle, Ph. D.: [00:11:26] Uh, well, so that we have, you have conducted a bit before we have conducted a number of studies for, for a large project, which was funded by the EU, which was called , which was sort of a fairly large project. And there used, uh, extracts and we saw the same effect and the outcomes where people use few efficacy in a pure compounds.

[00:11:48] And, and they see the same effect. So, so the, the effect size we observe in the study is it's very comparable to, to almost all studies we've seen before, which is nice.

[00:11:59] Carl Lanore: [00:11:59] Yeah, no, this is, [00:12:00] this is really exciting. I have to be Frank with you. I've been doing this for 15 years and a lot of the interviews I woke up, I start.

[00:12:06] And I think, well, you know, this is interesting, but now that you're saying that you can use the isolated flavanols. If you don't want to drink green tea, you can take capsules and get a lot of these benefits. Now this becomes. Uh, something that is both, um, uh, measurable, but also, uh, is easy for people to do.

[00:12:26] I don't like green tea. I don't like the taste of it. And the thought of starting to greet, drink green tea to improve blood pressure. Isn't exciting to me, but taking a capsule twice a day is, you know,

[00:12:37] Prof. Gunter Kuhnle, Ph. D.: [00:12:37] well, yes, I think, I think from, from, from, from the, I coming from some, from the nutrition side, interesting side is can you use foods?

[00:12:45] And, and changed the diet. And there are a lot of dietary changes you can make. So tea is one, but it's berries, it's Palm fruits. It's quite a wide range of foods, which you could use to increase flavonoid intake. But the big question of course we have is that we [00:13:00] don't know how much it is. We know that it's in the top 10% of our, of our court, but how much this is going to be converted into.

[00:13:09] Flavanols that, that's sort of the big question we don't know because. We don't have the data to, to investigate this.

[00:13:17] Carl Lanore: [00:13:17] And, and that leads to the question about downstream metabolites. Do flavanols stay in tact or do they trigger downstream stream metabolites.

[00:13:25] Prof. Gunter Kuhnle, Ph. D.: [00:13:25] So some flour. So the flavonols are all. Either taken up, uh, and then metabolized to cloak around nights and sulfates and so on.

[00:13:33] So they stay largely in tech, but they're also metabolized by the microbiome. So they're, they're, they're metabolizing their form of compounds. They form many compounds, but the main compound has started with is called the gamma Vera will come up and they're a lactone, um, I mean, which is also taken up by the 14th.

[00:13:52] Carl Lanore: [00:13:52] Okay. So now you've opened up an entirely new, interesting pathways. So we know that [00:14:00] the gut microbiome diversity is not accidental. It's it's, um, it's, it's actually, uh, effected by diet number one, and we know. That some microbes in the gut make harmful chemicals and some microbes in the gut make helpful chemicals.

[00:14:20] So w w w do we see changes in the gut microbiome shifting to one type of microbe versus another in people who drink green tea longterm?

[00:14:35] Prof. Gunter Kuhnle, Ph. D.: [00:14:35] I have to admit, I don't know. Um, We have to look at changes to the microbiome, but the problem with changes to microbiome is it's very difficult to attribute that, to do, to stay to the change is positive or not.

[00:14:48] It changes in about, based on what you consume, but whether this is changed, it's beneficial or not. It's always very difficult to say, unless it goes to some extreme, uh, [00:15:00] from our compounds, we have not found. That there's a huge difference between individuals. So they sort of develop a lacto instead of formed or formed in virtually all.

[00:15:10] So it's not like, for example, it's sorry, but you have a, a certain group of people who can metabolize it differently from others. Right? We have, we have not found the same for our compounds and we haven't really looked into, um, into, uh, large scale changes of the

[00:15:27] Carl Lanore: [00:15:27] microbiome. Okay. So what, how to, what degree did we see a beneficial change in blood pressure?

[00:15:36] And is it the same change? Whether you are already metabolically, deranged versus healthy.

[00:15:45] Prof. Gunter Kuhnle, Ph. D.: [00:15:45] So, what we have found is obviously we have found changes. We have found differences because of the rate of study, but, and in those with the highest 10% of intake, and those were the lowest 10% of intake, we found a difference of about two millimeters [00:16:00] mercury.

[00:16:00] So between, between roughly one more than three millimeters was what we found. Um, so the, the largest difference we saw in those who are already hypertensive. So in those with blood pressure at 160,

[00:16:14] Carl Lanore: [00:16:14] Now with these changes across the board systolic and diastolic, or was, did you see a better and better increase in one versus the other?

[00:16:20] Prof. Gunter Kuhnle, Ph. D.: [00:16:20] It was stronger for, for systolic blood pressure.

[00:16:23] Carl Lanore: [00:16:23] Interesting. Very interesting. So systolic is when the heart is contracting and diastolic is when the heart is expanding, correct?

[00:16:32] Prof. Gunter Kuhnle, Ph. D.: [00:16:32] Yes.

[00:16:33] Carl Lanore: [00:16:33] Yes. Yeah. Okay. Interesting. So.

[00:16:40] Were there any other correlates that, that jumped out at you? Like I understand that this was the important one, but I'm always suspect. I, um, people who, um, have specific dietary approaches, um, tend to have broad [00:17:00] opinions of different, different dietary items. So maybe somebody who drinks. Uh, green tea, maybe also, um, they eat a certain type of diet, maybe more Mediterranean, or maybe there are non-dairy dietary influences, like, well, people who drink green tea also take yoga.

[00:17:20] Were there any other correlates that you, you could, you could find?

[00:17:23] Prof. Gunter Kuhnle, Ph. D.: [00:17:23] So we have Neil fault about this now. The study was conducted in the 1990s. So it would have to think about,

[00:17:30] Carl Lanore: [00:17:30] well, nobody, nobody was doing yoga back then.

[00:17:34] Prof. Gunter Kuhnle, Ph. D.: [00:17:34] I would see as a, as a standard thing. Well, not really as common then and things which are calm then, uh, All different, but we have, we have looked for a number of factors which might affect it.

[00:17:44] The usual balm is of course health behaviors. So if, if you look at someone who consumes a healthy diet, you would expect the consumer for metals, we would assume that don't smoke. And that day they, they are more physically active. The, the nice thing [00:18:00] with tea as a, as a, as a drink. And that's the main source is that it's not as selective as say very consumption.

[00:18:07] So Mary's like expensive. You have to buy them or you have to forage them, but they're not readily available and in our population. So they usually select the group of people who can afford them. And two can, who are interested enough in consuming them. Tea is in the UK, a staple trait. It's what brings when one gets home.

[00:18:29] So that showed that we didn't find any difference by it by social class. We didn't find any difference by, um, we didn't find any difference based on body mass index. Um, so overall we didn't find many. Differences. The one thing which we were obviously worried about was, and I'm sorry I have just lost you.

[00:18:52] Carl Lanore: [00:18:52] No, no, I can hear you. Can you hear me

[00:18:54] Prof. Gunter Kuhnle, Ph. D.: [00:18:54] now? I can hear you again. Okay. Okay. Microphone, cable dropped out. Um, so the one thing [00:19:00] we were, of course, most interested in all is flowing or simply a molecule for fruit and vegetable intake, because that would be sort of the obvious thing. People eat, large amounts of flour, lows, people eat large amounts of fruit, vegetable, and.

[00:19:14] Because we know it's very difficult to estimate food measuring take. We said, well, they're not looking at the food diaries, but we look at, plus from vitamin C plus of intermittency is not an ideal marker for Metro intake, but it's sort of a reasonable market, which gives us an idea. If it's very high, probable people consume large amounts of food, vegetable.

[00:19:31] If it's very low, probably people consume less. Right. And so we have taken us into our. Multiple, and we couldn't see any difference adjusting additionally for food for, for vitamin C, didn't change our outcomes at all. It's that our flour mills act separately from, from, uh, for Metro intake and more interesting is if we combine the two in a sort of two dimensional model, we can see that hype.

[00:20:00] [00:19:59] Vitamin C intake is associated with a, with a reduction blood pressure. Similar if there's high follow intake is associated with reduction, but if you combine the two, it's actually additive. So it's not that one cancels out the other. And, and that's, that's sort of, we did this as a sort of a sensitivity analysis is really just to show that it's not based on, on, on, on, but yes, we can say that it is actually the compound in there.

[00:20:28] Which which, uh, plays the role. I make that one step further, um, because we thought about. Well, is it just a off tea intake, but obviously it is a Mycoff tea intake, but we know that tea has huge differences in flavonol content. So what we've done is we used the tea intake data from the food diaries, which is more reliable because it's sort of tea it's regularly consumed.

[00:20:52] Carl Lanore: [00:20:52] Yeah, no, no, one's gonna, no, one's gonna lie about how much tea they drink in the UK. That's mine. Right.

[00:21:00] [00:21:00] Prof. Gunter Kuhnle, Ph. D.: [00:21:00] So what extent then is to, um, It just for teen tech. And again, it was like with, with him and see it didn't change. Anything.

[00:21:08] Carl Lanore: [00:21:08] Did you look at, did you look at a blood sugar fasting, blood sugar and or insulin levels in the blood,

[00:21:14] Prof. Gunter Kuhnle, Ph. D.: [00:21:14] right?

[00:21:15] No, we didn't because it wasn't a lot, really off interest for this study. We sort of designed to start developing there's no, Register we could use when we planned this, but the idea was really just to go for blood pressure as the first as the first. Uh,

[00:21:29] Carl Lanore: [00:21:29] did you, did you, uh, do they use body mass index in the UK as an indicator of, uh, of, of obesity or, or leanness?

[00:21:38] Did you, did you look at that? Do you, did you

[00:21:40] record

[00:21:40] Prof. Gunter Kuhnle, Ph. D.: [00:21:40] that? We include, we included body mass index in our model and didn't change anything in general. Flour milk intake increased his body mass index, but it's not really that surprising because the heavier person is the more they consume or the more they consume.

[00:21:54] It's more likely that they consume more flavanols if it's part of the normal

[00:21:57] Carl Lanore: [00:21:57] diet. This is fascinating to me. [00:22:00] This is, you know, there's usually, um, when you see studies like this, there's usually a hole somewhere that makes you go, Oh, well, but this is fascinating to me because even though the moral beast people, um, and they, they probably are the ones that saw the greatest change in blood pressure, beneficial blood pressure.

[00:22:16] Uh, but, but the, the higher, the flavonol intake, uh, correlated with them that that's fascinating to me. So, yes, go ahead. I'm sorry.

[00:22:26] Prof. Gunter Kuhnle, Ph. D.: [00:22:26] No. Yes, no, no. It is. It is. It is quite interesting. Yes.

[00:22:29] Carl Lanore: [00:22:29] So, um, was there anything about this study that jumped out at you that you didn't expect to see besides the actual end point that you were looking at?

[00:22:37] Were there any other things that jumped out at you and went, wow, this is fascinating.

[00:22:41] Prof. Gunter Kuhnle, Ph. D.: [00:22:41] I think the most fascinating thing, uh, was the, when we looked, when we compared the biomarker data and the three data that, that was really. Fascinating. We suspected that there's very little agreement between the two while the study was progressing, but the demos, so little agreement between the [00:23:00] two most quite was quite impressive.

[00:23:02] We never thought that it's going, that the difference is going to be the stick.

[00:23:06] Carl Lanore: [00:23:06] Yeah, that's really. So I would imagine that some people, I know who's going to lie about drinking tea in the UK. I guess people will lie about how much berries and fruit state they consume, because they want to make people feel that well, I'm eating a lot of fruit and vegetables, but.

[00:23:23] But T is like, Oh yeah, I drink 16 cups a day and nobody would bat an eye. Yeah, that's good for you. Okay. So it's fascinating. The tea, the tea component here really kind of washes out the whole, get people under report over report, and obviously verifying that by lining up the actual presence of metabolites in the blood man.

[00:23:45] This is really a good study.

[00:23:47] Prof. Gunter Kuhnle, Ph. D.: [00:23:47] Yeah, thank you. I think it's not so much the misreporting of the tea. It's more that the huge difference in, in the composition of tea, depending on are people naked.

[00:23:57] Carl Lanore: [00:23:57] So did you see any, [00:24:00] even modest, beneficial shifts in people who were already healthy, uh, from their flavonol consumption?

[00:24:07] Prof. Gunter Kuhnle, Ph. D.: [00:24:07] Uh, so if you just use a blood pressure, we didn't see any, any differences in those with the moment blood pressure,

[00:24:14] Carl Lanore: [00:24:14] but we don't know if. The daily dose of tea that they were having already. Was why there were normal to begin with. I mean, you know, there's, uh, you'd have to take, uh, you'd have to almost take a double blinded, uh, approach to this and have people shift halfway through this study to find out if it, if the reason that they have good blood pressure was because of the T Oh,

[00:24:36] Prof. Gunter Kuhnle, Ph. D.: [00:24:36] yes.

[00:24:37] Yes. And, and, um, I think it's the difference is two or three millimeters. So it would melt get someone from 160 to 220. But the, the, uh, I think the, the, the important thing, well, it's of course, to conduct a intervention study of scale.

[00:24:56] Carl Lanore: [00:24:56] I want to take a break. And when we come back, I want to talk specifically about something you just [00:25:00] mentioned, and that is, these are, these are very modest changes, but yeah.

[00:25:03] Uh, Y Y they are in fact statistically significant stay tuned. We'll be right back with more. Is this superhuman channel?

[00:25:17] welcome back.

[00:25:22] We're talking with, excuse me, professor Gunter lane, about how flavonols influence blood pressure. So, this is a very modest change. This, this would not compete with, say an ACE inhibitor or some pharmaceutical therapeutic, but this is considered statistically statistically significant. Why is it, why is it significant if it's only three or four milligrams of mercury

[00:25:52] Prof. Gunter Kuhnle, Ph. D.: [00:25:52] the effect size and the significance?

[00:25:54] Well, you can have a very small effect size, and it's still being significant than the other way round, but, um, [00:26:00] The the, um, the date, the data show simply that we have a small phase, but, but we're very confident that this size is a, is a, is a true effect or is it true? The difference and the, even though it sounds small, One to three millimeters.

[00:26:19] Actually, this is what we find in studies, which look at the Mediterranean diet and the Mediterranean diet is sort of commonly acceptable, accepted as sort of a tie, which is heart healthy and improves cardiovascular health. We also find the similar effect size in the mad men when people reduce sodium intake, sort of to intermediate sodium intake.

[00:26:38] So not, not very low sodium diet, but sort of going from the normal sodium to the end, the meat it's certain diet, which was done in that, in that their sodium trial. So two millimeters are actually quite good for, for nutritional intervention and it's sort of a part of the normal lifestyle changes that that can in the end, provide a beneficial effect on non cardiovascular disease risk.

[00:26:58] Carl Lanore: [00:26:58] So do you suspect that [00:27:00] there could be a dose dependent response here? For instance, let's say, well, I was gonna say it was gonna say, you know how let's say somebody consumes 16 cups of tea a day. There's a limit how much tea you can drink. But now if we turn to these Epic catechin tablets, a green tea, do they have green tea extract capsules?

[00:27:19] Now we can actually deliver super up levels of this compound. Do you think you'd see something different?

[00:27:27] Prof. Gunter Kuhnle, Ph. D.: [00:27:27] So we haven't, we haven't looked at, at, at, at those response at, at that level. So all our data shows that the higher, the pick of the difference between low and high, the peak of the difference in blood pressures.

[00:27:39] But we haven't, if you look at all of that, it a maximum of what our top 10% consumers is about 600 milligrams a day. Um, Now the problem, of course, with especially green tea capsules is that high, high amount of green tea capsules have been linked again with adverse effects. So, so you can easily go into that range of adverse effects and [00:28:00] at least in, I know in Canada and in the EU, that sort of warnings on, on excessive amounts of green tea extract, because not, not a problem, also they have the catechin by the epi Gallo condition can affect the liver.

[00:28:12] So it is, it is very difficult to sort of. Go to, to make sort of the linear dose response there. Well, six milligrams gives the two millimeters 1200 milligrams for a

[00:28:21] Carl Lanore: [00:28:21] couple, right.

[00:28:22] Prof. Gunter Kuhnle, Ph. D.: [00:28:22] Uh, and I think one thing we deliberately decided was to stay with all food and with what people consume and the UK population consumes high amounts of tea, but still much less than say China or Japan by it as much more tea culture based on green tea.

[00:28:40] So it would be interesting to look at those populations, how the difference would look like. And it would also be interesting to look in a population which, which doesn't consume large amounts of tea to see how would this be different if there are different sources? So one interesting population is of course the Mediterranean countries, they don't drink [00:29:00] to eat.

[00:29:00] They have a fairly low flower and take a wall because they have very different sources, but they're not considered to be extremely unhealthy.

[00:29:07] Carl Lanore: [00:29:07] Yeah, it's fascinating. Right? There's a lot of ways to skin, a cat, as they say. So, um, there w I actually have a sponsor, who's introducing an Epic catechin capsule.

[00:29:17] It's just Epic. Catechins. And that is in fact, the, that is the magical component here in the green tea. Right. That's been responsible for this result, or am I wrong about that?

[00:29:29] Prof. Gunter Kuhnle, Ph. D.: [00:29:29] Um, so it's, it's difficult to say because. Most studies that have been conducted, use a mixture, they use Epic

[00:29:41] so they use a mixture. So identifying a specific components is difficult for, I think that's something we couldn't do with it.

[00:29:48] Carl Lanore: [00:29:48] Yeah. Very interesting. So what, what is the next step for you now that you've completed this study? What's the next transitional study that makes sense to, to, to, to proceed with.

[00:29:59] Prof. Gunter Kuhnle, Ph. D.: [00:29:59] Well, the [00:30:00] one thing is we have to notice this large datasets where that a lot of interesting information, especially on the links between diet and metabolism and nutrient nutrient stacks. So what happens if, say you consume large amounts of levels with, with other foods? Is there any difference in there?

[00:30:17] And I'm from, from my research interest? Uh, my, my main research interest is really titrate assessment. Um, As whole can be. How can we link the biomarker information we have with the, with the actual intake? And are there any particular sustaining Raby can we can use the data we have to improve States or assessment.

[00:30:41] Carl Lanore: [00:30:41] Are you drinking green tea right now, professor?

[00:30:44] Prof. Gunter Kuhnle, Ph. D.: [00:30:44] Well, it's true. It's too late for me. For green tea. I tend to drink normally. Great. But,

[00:30:49] Carl Lanore: [00:30:49] uh, Um, and so that, and that's the other challenge with T like I recently gave up caffeine, all caffeine and albeit will be a tea, has less, a lot [00:31:00] less caffeine than say coffee.

[00:31:01] I think it's like some of the macho green teas have as much as 26 milligrams per cup, which is nothing, but I've, I've, I've agreed to stay away from caffeine. And, and obviously that's the other thing that he has. Do you think that the caffeine has any effect in this scenario?

[00:31:19] Prof. Gunter Kuhnle, Ph. D.: [00:31:19] Um, Nope. Rod from walking your phones, um, caffeine is by active, so it's like you definitely

[00:31:26] Carl Lanore: [00:31:26] affect yourself.

[00:31:28] Okay. That's a very powerful, much more powerful than we give it credit for. Um, I want to take our last commercial break. When we come back, I want you to extrapolate. What you hope, but lay people and clinicians take away from this research. Thanks. And we'll be right back.

[00:31:47] welcome back. We're talking with professor  about how flavanols influence blood pressure in a beneficial way. And there's a lot of other benefits of flavanols. I mean, we can talk ad infinitum about all the [00:32:00] different research that have been done on these, uh, Uh, flavonols polyphenols and all of these other, uh, plant-based, uh, components that seem to be beneficial to the human condition.

[00:32:10] What w w what do you suggest with this research? What do you suggest to both clinicians and lay people who are thinking about any additional steps that can help modulate their blood pressure?

[00:32:24] Prof. Gunter Kuhnle, Ph. D.: [00:32:24] I think the important result of our studies is to show that it is, it is easily possible with, with. Fairly minor dietary changes to consume sufficient flavanols to get a lower blood pressure or.

[00:32:38] Let's let's put it better to eat sufficient from loans to achieve the possible effect. I think, I think it's, it's difficult to, I think it's important to say that change about pressure about sort of to get the effect of the Siemens studies and smaller studies. It is perfectly possible to do this with the dietary changes.

[00:32:57] And it's not complex dietary [00:33:00] changes. Yes. If one drinks tea, it's obviously easy, but if it doesn't drink tea, it's a few apples. So it's a handful of berries. So it's, it's, uh, it's not, it's not like say moving to a Mediterranean diet. They won't have to change. One's complete dietary pattern. It's sort of something which can be easy.

[00:33:17] Carl Lanore: [00:33:17] You can edit it. Yeah. You just edit it. If I, if I, if someone is not wanting to drink tea of any type. For whatever reason, what would be the number two and number three, go-to like blueberries and berries in general, or what would you say

[00:33:31] Prof. Gunter Kuhnle, Ph. D.: [00:33:31] berries in general? Vic mill, um, , uh, pump fruits. So apples mainly, but has as well as that.

[00:33:39] So these are, these are fruits and vegetables, which, which work quite, quite well.

[00:33:44] Carl Lanore: [00:33:44] Yeah. And, and, you know, there's a company that just started doing business here in the United States. And I don't know, they could be in the UK by now. But they have two jars of capsules. One is green and one is red and one claims to give you all of the.

[00:34:00] [00:34:00] Uh, recommended dietary, uh, components of vegetables in three capsules or six capsules and the other one of fruits, and it's called fruits and veggies. They they're, they're sold together and, and they they've gone to great pains to make people understand that this is organic. So you can't say, Oh, pesticides are concentrated and they're selling these products.

[00:34:22] Out. I mean, I can't keep them in stock. People are signing up and subscribing to get bottles every single month because they believe that yeah, if they were eating more fruits and vegetables they'd be healthier. But since they're not, they'll just take these pills. I worry about that approach because there are so many other things in fruits and vegetables that we may not realize, have a role in why the magical components do what they do.

[00:34:50] What do you think about that?

[00:34:51] Prof. Gunter Kuhnle, Ph. D.: [00:34:51] I well it's, it's like the question we always have is could you, could you put exercise in the pill? Um, and it's, it's the same thing it's full [00:35:00] dimensional. It's it's so much more than just the compounds. It's. For one thing, of course, if you, if you eat a lot of food metals, you can't eat anything else.

[00:35:09] So it's just simply being the satiety woman gets from, from eating fruits and vegetables, which would have an effect on health by not overindulging other things. And then of course we have things like, like fiber, like the, like the. Act of eating, uh, and that's all very difficult to, to simulate from a capsule.

[00:35:30] And then of course, we don't know what this and food metaphors we have sort of this, we can analyze them. Of course we know a lot of models in there, but the one thing in nutrition is of course it's minute amounts of something can still be very important. And we simply don't know. All of the things in food metals.

[00:35:47] And we have this, this very nice study in the UK. They used to be an Apple research station, um, whatever, come on apples. And they won one year. They took all the apples from a tree [00:36:00] labeled where they were from, and then analyzed all of these apples. And they had two to 300 differences in, in micronutrients, in all of these apples.

[00:36:09] So. It's, it's very difficult to know what is actually in, in these foods and what is actually important, what we need, right. Obviously water is not important, but do we know the type of fiber is properly

[00:36:24] Carl Lanore: [00:36:24] and I've come to a conclusion professor. So we have lots of companies that are now fortifying food with fiber.

[00:36:31] So they'll take a food, a protein bar, whatever, and they'll add 15 grams of, uh,  fiber in there. And, and people complain when they eat these high fiber foods, these high fiber bars that it just doesn't make them feel good. Their stomach feels weird, they just say no. And then people will say, yeah, but you, you get that much fiber.

[00:36:53] If you eat a bowl of brussel sprouts and I've come to the conclusion that. [00:37:00] Like the pharmaceutical companies, they try to isolate something, right? They, they found th th th the may Apple is where SIS plantain was discovered, uh, a key, uh, chemotherapy and the native Americans used to eat the, the may apples and cured their own cancer.

[00:37:15] And they said, Oh, it's this plant in that does that. And we just need this, this plant then, and this, this plant, and doesn't work as good as the may apples did. Now. We don't know when fiber is, is. Part of the matrix of a fruit, you know, it's, it's, it's, it's in there. It's part of it. The body handles it differently than if you just pour a teaspoon of fiber down, you throw than drink water and think that you're getting the same value as eating a bowl of brussel sprouts.

[00:37:42] So I'm with you on that. We, we, we, we, we think we're smarter than nature. For some reason, we think we're smarter than nature.

[00:37:51] Prof. Gunter Kuhnle, Ph. D.: [00:37:51] Yes, I think, I think one point, and that's a big difference between nutrition and the pharmaceutical industry and the pharmaceutical industry. We have one specific target. [00:38:00] We want to address an enzyme.

[00:38:01] We want to tape it and you can work on that. But in nutrition, we have so many. Potential pathways and they never consumed pure compounds. And, um, yesterday there is of course, the way from nutrition to pharmaceutics. If we find compounds that vitamins, for example, we've discovered vitamins, you know, we need them and we can give people a bit of may be told, for example, if they need it.

[00:38:23] But, and if you haven't been, I mean, C deficiency you need for them and see it doesn't matter where it's coming from. But overall for a lot of the beneficial effects we see like fiber fruit and vegetables or other foods, is that it's, it's much more complex than just having to having an extract. It's it's a bit, it's a lot like, like the idea of the exercise pill, um, it doesn't replace going out or doing something or moving or just spending the time doing it.

[00:38:53] Carl Lanore: [00:38:53] You know, it's funny. I had the, uh, I had the author of the study on resveratrol [00:39:00] on this show like eight years ago. So they published a study that showed the resveratrol, caused some of the same adoptations to certain parts of the body as exercise and the. Media took that and said, skip the gym and drink more wine.

[00:39:19] In fact, the daily mail, a tabloid from the UK, published that article, skip the gym and drink more wine. And I had the author of the study on and he was incensed. He said, first of all, we never said anything about wine in this study. We talked about resveratrol, but the media said, well, red, grape skin has resveratrol in it.

[00:39:42] Wine has resveratrol skip the gym and drink more wine. And he said on the show, in order to get the amount of resveratrol that we use to get a therapeutic effect in this study, you would have to drink a thousand bottles a day. And this is, and this is, you know, this is, [00:40:00] this is the problem. You know, companies, uh, they want, they want to make money.

[00:40:03] They don't care if they lie, it doesn't matter.

[00:40:08] Prof. Gunter Kuhnle, Ph. D.: [00:40:08] Yeah, I think it's, it's sort of the type of title, which sort of, I can just see it. It's sort of a great headline. Sure. Drink more wine.

[00:40:17] Carl Lanore: [00:40:17] Yeah. Who wants it? Who wants to go to the gym? I I'd rather, if you tell me I can drink wine all day and live forever and be strong and healthy, I'm going to go that way.

[00:40:25] Why do I want to go to the gym? But you can, it's a joke.

[00:40:29] Prof. Gunter Kuhnle, Ph. D.: [00:40:29] It's I think that's, that's a problem with a lot of nutrition studies is. They, they get very nice headlines because you can sort of twist them a little bit and then make them sound more interesting. And then, um, the original ideas lost and, uh, maybe I felt a lot with journalists and, and, and newspaper people and sort of it's, it's, it's always interesting because they obviously understand it as well, but it's sort of thing in the end, you get the, you get to the, the, um, The editor making a headline and then the headline [00:41:00] has to sell papers and you don't sell a paper on balanced diet of school.

[00:41:04] Carl Lanore: [00:41:04] No, I think this is a fascinating study. In fact, I think I'm going to start drinking green tea because of you. So it's

[00:41:10] Prof. Gunter Kuhnle, Ph. D.: [00:41:10] good.

[00:41:11] Carl Lanore: [00:41:11] And, uh, and I appreciate you coming on the show and talk to you about this. And I find that very, very fascinating. Uh, we're going to let you go now, but thank you. And please feel free to come back on the show as soon as you have more research.

[00:41:22] Okay?

[00:41:23] Prof. Gunter Kuhnle, Ph. D.: [00:41:23] Okay.

[00:41:23] Carl Lanore: [00:41:23] Thank you very much. Take care. Bye. We're going to take one quick commercial break. I'm going to try to get our guests on. We're having a little problem. Um, she's using the wrong browser, I guess, and we may have to reschedule. So we're going to, I'm going to try to do this during the break because I am the all in wonderful Oz stay tuned.

[00:41:41] We'll be right back.

[00:41:50] welcome back. Welcome back. Welcome back now. This is a really good topic. We're being joined by dr. Yvonne Capella. Did I pronounce that [00:42:00] right?

[00:42:00] Dr. Yvonne L. Kapila, DDS, Ph.D.: [00:42:00] That's correct.

[00:42:01] Carl Lanore: [00:42:01] And she is a dentist and a PhD and she has just published a study. Identifying certain pathogens in the mouth that, uh, induce oral cancer, oral cancer is one of the most common forms of cancer on the planet.

[00:42:15] Welcome to the show dr. Kapila.

[00:42:19] Dr. Yvonne L. Kapila, DDS, Ph.D.: [00:42:19] Thank you. You happy to be with you here this morning.

[00:42:21] Carl Lanore: [00:42:21] So why this study? What did you, yeah, it's morning where you are an afternoon where we are. So w w why this study? What, what preceded this, that this pathogen or the identification of pathogens and the ediology of oral cancer, it needed to be elucidated.

[00:42:37] Dr. Yvonne L. Kapila, DDS, Ph.D.: [00:42:37] So there's been a lot of, uh, epidemiological data that has really begun to. Babies basically give us some hints that, that, that there's a connection between a bacteria that causes periodontal disease and various types of cancers. So when you look at large population studies, um, There [00:43:00] are some indications that at that level, we begin to see some connections between people that have periodontal disease and the bacteria that cause periodontal disease and various types of cancers, not just oral cancer, but other cancers as well.

[00:43:13] So it was that sort of initial observation that, that led people to say, well, maybe some of these bacteria are then important in, in the causality of some of these various types of cancers.

[00:43:24] Carl Lanore: [00:43:24] Is it possible that these, uh, so. Saliva is a natural filtrate of blood. And a lot of the things that's going on in the body can be seen in the mouth, not everything, but a lot of things.

[00:43:40] For instance, if someone is prone to developing high, heavy calculus plaque in the mouth, they tend to also correlate with plaque. In the arteries and blood vessels. So is it possible that the [00:44:00] evidence of this bacteria in the mouth is, is just because it's also in the body or is it originating the mouth and getting into the body?

[00:44:12] Dr. Yvonne L. Kapila, DDS, Ph.D.: [00:44:12] That's an excellent question and an excellent place to take us. So anytime you brush your teeth and especially for individuals that have inflammation in the gums, Gingervitis, the gums and the blood vessels in those areas tend to be leaky. And so you get what's called the bacteremia. Basically every time you brush your teeth, when you have inflammation in the gums, And so those bacteria that, that do originate in the mouth, then find theirselves into the systemic circulation and circulate all over the body.

[00:44:43] So, so definitely in the more pronounced the disease you have in your gums, when you have more advanced forms of periodontal disease with bone loss, then you get sort of a lot more inflammation, leak your gums. And then yes, there is a route by which those bacteria then find their way circulating throughout the body.

[00:45:00] [00:45:00] Carl Lanore: [00:45:00] And the mouth is so close to the brain. I have to wonder if anyone's ever done a study about, um, gum disease, the presence of gum disease, the more advanced present and the occurrence of, of say brain tumors.

[00:45:13] Dr. Yvonne L. Kapila, DDS, Ph.D.: [00:45:13] Well, it, one thing that was just recently, uh, that came out in the literature, uh, is the connection between Alzheimer's disease and, and the bacteria that are found in periodontal disease just as you pointed out.

[00:45:26] So we used to think that a lot of these organs were sterile. Uh, and that there was a blood brain barrier. How were we are now discovering that a lot of the, not just the bacteria themselves, but some of the, the really nasty proteins that they secrete actually find their way into a lot of these places that we thought previously were sterile environments, such as the brain.

[00:45:46] And so recently, another high end publication, uh, Discovered that, that some of these bacteria that cause periodontal disease find their way into the brain and also are important in some models that [00:46:00] show the causation with Alzheimer's disease.

[00:46:04] Carl Lanore: [00:46:04] The most valuable service that your dentist provides is that twice a year cleaning.

[00:46:09] And I remember, um, about 10 years ago, my gums. We're starting to bleed. When I would brush them, I use an ultrasonic toothbrush and I went to a very good dentist here in town. He's fantastic, actually. And they did a deep scaling, which no one wants to go for. And he offered me anesthesia. I said, no, I don't need it.

[00:46:33] But they did deep scaling. And I had, uh, some teeth had pockets that were threes and fours. Now there. There's zeros over the course of a couple years. Um, my gum health increased so dramatically and it's so easy to do. And if you have. Health insurance that includes dental. They almost always give you two a year for free to go get your teeth cleaned for crying out loud every year, twice [00:47:00] a year, because what we're learning now is there's a bi-directional transference of what's bad in the body to the mouth, and what's bad in the BA and the mouth back to the body.

[00:47:10] Again.

[00:47:12] Dr. Yvonne L. Kapila, DDS, Ph.D.: [00:47:12] Absolutely. You, you brought another, uh, another really good observation. So we've known this for a very long time with diabetes. So it's a it as, just as you've said, it's a bi-directional relationship. And we know that as you treat periodontal disease, the indices for diabetes improve and vice versa.

[00:47:31] So it's, it's very well established that there is a bi-directional relationship. So that's a wonderful observation. And. For some of these other systemic disease connections that we're finding. I think you maybe alluded to, uh, cardiovascular disease, uh, the, the Alzheimer's observation, oral cancer and other cancers as well.

[00:47:50] We are beginning to see that, you know, it, it is it's, it's a complex relationship. And so yes, uh, in the case, Case of diabetes. We know that if we treat one week, we improve the [00:48:00] situation for the other.

[00:48:01] Carl Lanore: [00:48:01] So I

[00:48:02] Dr. Yvonne L. Kapila, DDS, Ph.D.: [00:48:02] completely agree. Yes. Throwing him for those cleanings twice a year.

[00:48:05] Carl Lanore: [00:48:05] Talk about the study. So how was the study design and what did you learn?

[00:48:10] Dr. Yvonne L. Kapila, DDS, Ph.D.: [00:48:10] So the study was done in animals. Um, and what we found was that, uh, in, when we, when we use this cancer model in mice, when we expose the cancer cells to these bacteria that are normally, uh, causative of periodontal disease, the tumors in the mice were very, very aggressive, more than normal. They became quite large.

[00:48:30] And what was very interesting was. If we applied, um, uh bacteriocin, which is a protein that is made by bacteria to fight off other bacteria. And this bacteria sin is, is quite neat because it's used as a food preservative. It's been around for many, many, many years. It's used to preserve cheeses and other foods.

[00:48:51] So when we use this food preservative called Nissen, Uh, it w we fed it to the mice. Uh, the tumors basically were reduced. [00:49:00] Um, and, uh, so it, it, it presents really sort of a novel paradigm, if you will. The thinking of treating cancer with anti-microbials right. Um, so it's, it's sort of a new, a new way of thinking of cancer.

[00:49:12] We know that cancer treatments have a lot of, uh, uh, very harsh effects on patients. When we, uh, patients have radiation and chemo, uh, they suffer a lot from those treatments. And so potentially opening a new way of thinking of treating cancers with anti-microbials such as this bacteria senescent that we've, we've talked about in, in the publication.

[00:49:36] Carl Lanore: [00:49:36] W w uh, so much has been discussed, studied, and still yet unknown about the gut microbiome, but it is obvious that there's none of partition between our gut and our mouth on my mouth has its own microbiome. Is the microbiome in the mouth influenced or does it influence the gut?

[00:49:58] Dr. Yvonne L. Kapila, DDS, Ph.D.: [00:49:58] There again, we [00:50:00] think that there may be a bi-directional relationship.

[00:50:02] So we do, there are studies that have shown that yes, again, mostly in, in mouse models, in animal models that the oral microbiome does influence the gut microbiome. And we believe that. But also sort of this other end, the other end from the other direction that through inflammatory pathways through inflammation, that then indirectly, the gut also influences the, the oral, the oral microbiome.

[00:50:27] Um, and as you said, it's sort of one tube. And so they are very, very interconnected.

[00:50:31] Carl Lanore: [00:50:31] Well, and also we know from, um, all the studies done on, uh, newborns breastfeeding, uh, and, and their guts. We know that. Um, 60% of the, the microbiome that's introduced to a newborn doesn't come from the milk, but instead the flesh, the Ariola of the mother's skin.

[00:50:54] And so it could be said for people who are [00:51:00] interested in influencing their gut microbiome, that the gateway to changing your gut microbiome is your mouth because that's where it's stuff gets in.

[00:51:10] Dr. Yvonne L. Kapila, DDS, Ph.D.: [00:51:10] That's exactly what I'm always trying to, to preach. And that that's exactly right. And, you know, so the very, uh, first microbiome that's established is absolutely, you know, uh, as, as, as babies nurse, the very first, I mean, obviously as, as they, as they entered the earth, they enter the world, you know, through vaginal vaginal delivery that they get exposed to the microbiome through the vaginal canal.

[00:51:33] And then the next round of exposure is through, through nursing. Breastfeeding and absolutely. And so there is a difference between, uh, uh, breastfed babies and, and, and formula fed babies. There, there is a difference there as well. So we do believe that the very early exposure, uh, is very much influenced by these very first contexts, uh, in, in the infant.

[00:51:54] Very, very important.

[00:51:56] Carl Lanore: [00:51:56] So, so since you are both the physician and enlightened about this, [00:52:00] what do you suggest that people do. For the health of their mouth, but also not just for the health of their mouth, but for the contributory health of their gut, what, what should people do should be people? I like I'm, uh, I don't believe that people should be gargling with Listerine all the time.

[00:52:15] I think that's a bad idea. What do you think?

[00:52:18] Dr. Yvonne L. Kapila, DDS, Ph.D.: [00:52:18] Thank you for bringing that up. So imagine, well, one thing we need to know is that the microbiome, uh, is, is in a steady state, right? So we have microbes that are really important for health. They, these, these are called commensal bacteria. These are the bacteria that help us absorb nutrients.

[00:52:38] These are, uh, bacteria that, that help fight off disease. And so it's really critical that we know that we want to maintain certain microbes in our oral cavity, in our gut. And by using things like mouth washes, uh, some mouth washes, antibiotics, they're sort of a. You know, really removing [00:53:00] everything, um, which, you know, all the microbes, which is not necessarily the best approach.

[00:53:04] So there are needs, there does need to be a balance, you know, where you do retain those healthy microbes. And so picture a situation where you can selectively remove out. Pathogens that that are in that in microbial world. But retaining the commensals is really, uh, maybe an approach that we would want to consider pursuing.

[00:53:27] So you don't wipe everything out because then what you do is you have a fertile ground. For pathogens than to seed into that environment. Um, and we have seen that. So when, when you have individuals that, you know, you completely wake up, wipe out all the microbes, um, that's why people say, well, probiotics is a way to receipt or recolonize, uh, individuals who've lost all the microbes from the body.

[00:53:50] And that that's not a good situation.

[00:53:52] Carl Lanore: [00:53:52] No, because we don't even know. We haven't even. Identified all of the microbes in a person's body. And then depending on the [00:54:00] geography of your origin and all these other things, it changes it's, it's, it's probably more unique than fingerprints when you come to think about it, our own unique microbiome.

[00:54:10] So I, every night I brush my teeth with a, a healthy. Toothpaste that we buy that has baking soda and, you know, sea salt and no, no, um, no triclosan or none of those anti-microbials. And, but I still have these angst feelings that. And I think about Western a price, you know, I think about price and his work with the Aborigines and ancestral people.

[00:54:41] And he said, you know, they didn't brush their teeth. They had no dental caries or cavities. They, uh, you know, they had fantastic breadth from the moment they woke up to the moment they went to sleep. And, and, and it really is the it's what you eat and the terrain that causes this, and I've often thought about not brushing my teeth anymore, or maybe [00:55:00] brushing it, but not with anything but water.

[00:55:03] You have any opinions on this at all.

[00:55:06] Dr. Yvonne L. Kapila, DDS, Ph.D.: [00:55:06] So you've brought it up a lot of really interesting points. Uh, so we have, uh, what's called the natural history of periodontal disease from individuals that don't have access to, to care often from, uh, T labors in, in remote parts of the world. We know that, uh, some people, uh, succumb to periodontal disease.

[00:55:25] There are some people that genetically are predisposed to more aggressive forms of disease. And there are some individuals who are resistant to periodontal disease. So, so that's one thing. The other thing is the diets absolutely are very, uh, an important part of the microbes and the films that form on our teeth, the biofilms.

[00:55:44] And if we look at old historical records before we had farming, for instance, and processed foods and these sorts of things, very different history, different microbes, you know what, when they look at them, Deep sequencing of the, of the bacteria that are there. So the diet that [00:56:00] we very much influences the, the biofilm that's that's code, the coats, our teeth, and with the more processed diets that we have, you know, we, we have these various biofilms that then form plaque and calculus and so forth.

[00:56:13] So yeah, the different diets that we consume also contributes, uh, significantly har uh, high carbohydrate high. Car sugar, carbohydrate, hydrate diet also of course contributes to, to carries as we all know. And so diets absolutely are very important. Uh, part of it, uh, of the equation.

[00:56:31] Carl Lanore: [00:56:31] Is it fair to estimate that it's not the intrinsic effects of sugar that are.

[00:56:38] Corrosive to the teeth, but the fact that they, sugar tends to feed pathogens, pathogens, love sugar. They like fast energy they're hogs for it. So is it the intrinsic effect of the corrosive nature of sugar or the extrinsic effect that it seems to feed and help populate the mouth with more of these pathogens?

[00:56:58] Dr. Yvonne L. Kapila, DDS, Ph.D.: [00:56:58] That's exactly right. That, [00:57:00] that is exactly what you've just said. So it feeds the microbes that then produce acid. That, that then unfortunately, you know, um, you know, then there's the demise of the mineral of the tooth and that's what causes decay. That's exactly right. And, and so there's probably other components in the foods as well, that feed the periodontal pathogens.

[00:57:20] And so it's, it's the diets that we consume, that, that yes are important. And is they retain they're retained in the oral cavity and they're not removed by brushing or rinsing with water. As you've said, then they stay much longer and, you know, promote the, the shift in the microbiome if you will.

[00:57:37] Carl Lanore: [00:57:37] So, so many of us are afraid to tell that one person.

[00:57:41] Like I had a good friend. I did a TV show with, and I love him. He's a wonderful person, but when I would get about three or four feet away from him, I could smell it coming out of his mouth. When someone has bad periodontal disease, it's this, it's this repulsive smell. It really is. It's very, you know what it is.

[00:58:00] [00:58:00] And I spoke to him about it. I said, you know, Bill, I'll say his name is bill. I said, uh, and he says, my wife's never says a word. I said, you need to get to the dentist because there's something in your mouth that's not healthy. And he did. And in about a year, his gums cleared up and he, that went away. But so many of it, in fact, when I was a kid, there was a commercial for some mouthwash, uh, you know, tell somebody they have halitosis.

[00:58:25] Yeah. I'm 62 years old. So this is back in a way. And, and, and I remember, you know, it's always been a thing where people won't tell other people, man, something's going on with your breath. Like, you need to have your. Teeth checked out, but really wouldn't you agree that if it gets to that state where you are now exuding this odor from these microbes that are making stuff in your mouth, that's where that odor is coming from, right?

[00:58:48] Dr. Yvonne L. Kapila, DDS, Ph.D.: [00:58:48] Yeah, exactly. What, there, there are certain, uh, there's certain bacteria that are very well known for producing, uh, certain gases that then produce the, the mal loader. But I think [00:59:00] what you can also tell your friends is it's not just about. The teeth and your oral health, but because of all the evidence we've been describing this morning is that it's very important for their overall health, right?

[00:59:11] If you really care about your friend, you want to let them know that, you know, this chronic time can predispose them to a lot of other, very serious diseases as well.

[00:59:21] Carl Lanore: [00:59:21] So besides the Nissen, uh, which I have seen in cheeses, by the way, you know, a natto coloring Nissin I've always wanted to witness and was, and I didn't, I didn't know.

[00:59:30] But besides these types of things here, getting more of them in your diet, perhaps they could actually suppress the unhealthy pathogens in the mouth. Are there other things that you recommend people do, uh, you know, regularly to keep a healthy mouth?

[00:59:46] Dr. Yvonne L. Kapila, DDS, Ph.D.: [00:59:46] I think we've touched on a lot of the points this morning.

[00:59:49] You'd move mentioned. Diet. Obviously diet is very, very critical. Um, you know, routine normal care brushing and flossing, seeing your dentist regularly, making sure that, you know, you stay [01:00:00] on, stay on top of, you know, cleaning your teeth. As you said, if, if, if you are predisposed to forming more plaque and tartar than seeing your hygienist, your dentist regularly, to making sure that those things are checked and, and, and that, that that's taken care of, uh, healthy, just a general healthy diet, you know, that, that, that really is, it's a very basic.

[01:00:19] Uh, protocol that we need to follow. It's not difficult. It's not complicated. It's flossing daily. It's brushing daily to maintaining good hygiene, a good diet. There's really not much more than that. Um, you know, I, I think. Staying away from harsh things. As we've talked about avoiding, you know, constant, uh, use of antibiotics, you know, things that will really decimate, you know, the microbes of your oral cavity, um, things that have any sort of an extreme, you, you definitely want to stay away from.

[01:00:51] Um, and as you've said, we've had natural populations that do just as fine, uh, with, uh, sticks, cleaning their teeth. A lot of these, um, [01:01:00] populations that just use sticks from the trees stick to clean their teeth, but have a very healthy diet. Um, they do just fine

[01:01:08] Carl Lanore: [01:01:08] cancer that was identified in your study was a squamous cell type.

[01:01:11] Is that correct? That's correct. Is that the most part, is that the most popular type of oral cancer that people get?

[01:01:19] Dr. Yvonne L. Kapila, DDS, Ph.D.: [01:01:19] It is, uh, of the oral cancer, squamous cell carcinomas is the most common. It is the most common and it's worldwide. You know, one of, one of those cancers that's quite high up in terms of mortality and, you know, th th the issue with oral cancer, the problem is that often it's not spotted until it's quite late.

[01:01:37] Um, unfortunately, you know, we, we, um, it, it, it. Whether people don't go to the dentist or don't know to sit or don't, uh, get it checked. Um, early enough, then it leads to, uh, uh, very aggressive forms of cancer that then, um, You know, become where they go into the, to the node, to the [01:02:00] nodes and get to the point where they can't be operated.

[01:02:03] They spread, they metastasize the sorts of thing. And so, and as we know, the morbidity is, is quite, quite severe disfiguring and, um, Can con can be quite traumatic.

[01:02:15] Carl Lanore: [01:02:15] So the, so people don't notice it because they don't pay attention to what goes on in their mouth. Let's face it, their tongue is there, you probably feel a bump on the buckle, you know, or, or, or, uh, on the gum, where do these cancer?

[01:02:30] I have, I have this suspicion that these cancers form on the inside of the mouth, the buccal area, uh, more often than on the gums, is that correct?

[01:02:40] Dr. Yvonne L. Kapila, DDS, Ph.D.: [01:02:40] Actually most of the most often they appear on the floor of the mouth and on the tongue,

[01:02:45] Carl Lanore: [01:02:45] underneath the tongue and on the tongue

[01:02:47] Dr. Yvonne L. Kapila, DDS, Ph.D.: [01:02:47] underneath it and on the tongue,

[01:02:49] Carl Lanore: [01:02:49] that's the safe Harbor for stuff that's safe Harbor down underneath the tongue.

[01:02:53] Right

[01:02:54] Dr. Yvonne L. Kapila, DDS, Ph.D.: [01:02:54] underneath the tongue. And so a lot of people don't often check those areas. Um, you know, and so, so [01:03:00] that's, that's where the primary location for oral cancer is.

[01:03:03] Carl Lanore: [01:03:03] That's why the dentist, when I go get my teeth cleaned, Rachel grabs my tongue with a swath of cloth. And pulls it up to the side and to the side and then lets it go again.

[01:03:13] Now I understand what she's doing, right? Yeah. I thought she was trying to see if my tongue would come off.

[01:03:21] This is fascinating for her.

[01:03:23] Dr. Yvonne L. Kapila, DDS, Ph.D.: [01:03:23] Yeah,

[01:03:23] Carl Lanore: [01:03:23] no, she checks, she checks my thyroid. She's real good. Rachel. I like her. She's fantastic. Dental hygienist. Um, So in summary would consuming more of certain anti-microbials likeness in that seemed to have a targeted effect on just the bad microbes. Be beneficial for people who are worried about even contracting oral cancer.

[01:03:47] Dr. Yvonne L. Kapila, DDS, Ph.D.: [01:03:47] So I'm going to say it's way too early to make those kinds of recommendations, because so far the studies have only been in mice. Right. You know, I have written a clinical trial to test this very question in cancer patients. [01:04:00] Cause that's obviously what we want to know. You know, how, how safe is it to consume it?

[01:04:05] You know, how efficacious is it for cancer patients? And the thing to remember is that these agents don't. Knock out only pathogens. They also knock out the commensals, but not to the same degree. So we have to be careful to make any kind of recommendations, but it's really the beginning of an exploration of this idea.

[01:04:22] You know, we've never really thought to modulate the microbiome to prevent cancer. So it's just sort of the beginning of a new idea. And I think that's why it's exciting. It's just that the very beginning. Um,

[01:04:34] Carl Lanore: [01:04:34] it makes sense because we know that a lot of these rogue microbes, if you will. They actually secrete pro-inflammatory components.

[01:04:46] And we know that inflammation plays a role in the development of all types of cancers. Um, there is an interesting peptide. You may find interesting. We did a show about it a couple of years ago. It's called . [01:05:00] Uh, right now it's a research. Oh, you're familiar with it. It's a human capitalist citizen. Yeah. So I I've, I've used it.

[01:05:06] I had, um, pretty bad case of CBO. Small intestinal bacteria overgrowth. And I used it for about three weeks and it completely changed my gut to the better. And I use it now periodically, um, to try to kind of prune, uh, some of the bad microbes back from time to time. But I did a show about a two years ago and I had people email me saying that they got ahold of it.

[01:05:32] They used the injected a hundred micrograms a day for three months, and even their toenail fungus went away. Which I found fascinating, but yeah, I thought, you know, that could be just squirted right into the mouth. It doesn't have to be injected at all. It could work topically as well.

[01:05:47] Dr. Yvonne L. Kapila, DDS, Ph.D.: [01:05:47] So you bring up another interesting area of what are known as prebiotics.

[01:05:52] And so these are, again, uh, these components that are found in our diet that preferentially, [01:06:00] uh, Promote the growth of commensal bacteria, both oral cavity gut. And so there is a great interest in prebiotics as well. And the thought there is that some of these components contain, um, important attributes of our maybe early diets that are maybe missing in our process diets.

[01:06:18] And so, again, it's this idea that you're preferentially feeding the good or the commensal, uh, Uh, microbes, uh, by these prebiotics. And again, it's an early area, a lot of exploration, a lot of interest in this area. Um, so that you're, you're slowly shaping if you will, the communities so that they preferentially grow maybe naturally by just the diets that you're eating.

[01:06:42] Carl Lanore: [01:06:42] So I, I read a study probably a decade ago when probiotics were really becoming very, very popular. Prebiotics would have to be popular as well because, uh, probiotics take root because of prebiotics. The way, the way I think of probiotics and prebiotics, the coral [01:07:00] is this is this calcification that the coral lives on, but the coral makes that calcification when it eats and poops, the coral itself gets bigger.

[01:07:10] And so it's this yin and yang. They depend on each other for, for life. And you can take all the probiotics you want. If you don't have prebiotics for them to latch onto and, and, and feed off of, then they're just going to pass right through. And I've never made this, but I may make it now that I'm talking about, there was a study done about 10 years ago, where they compared, uh, oral probiotics, very high doses, like 1 trillion, a colony forming.

[01:07:41] Uh, uh, units per packet, three times a day to a soup made from li artichokes and onions. That's it just take leeks, artichokes and onions, put them in water. You can put them in broth. If you want boil it like a soup till everything kind of gets mushy and breaks down. And they fed one [01:08:00] group the soup and the other group, they gave you oral probiotics.

[01:08:03] And then they watched, they were able to estimate how much probiotic material was being consumed. And then how much was being excreted and almost all of the probiotic in the packet was being excreted, but almost all of the probiotic that was being consumed in this leak, onion and artichoke soup remained.

[01:08:25] And that's because the leeks onions and artichoke have a type of fiber that lends itself to be a prebiotic,

[01:08:32] Dr. Yvonne L. Kapila, DDS, Ph.D.: [01:08:32] right. Absolutely that that's exactly. That's exactly right. That, that otherwise you have to give, uh, animal models where this has been done, large amounts of constant exposure of the probiotics.

[01:08:46] Otherwise they do not seed. You have to realize that the lawn has already been established in order to kick somebody out of that lawn. You know, you have to make space for somebody else to colonize, right. And so you have to have significant pressure on [01:09:00] that existing. Uh, lawn, if you will, for somebody new to take root.

[01:09:04] And so, yes, I think you're absolutely right. It is a, it is a, a close relationship having those prebiotics, uh, present in order to preferentially allow the growth of, of new microbes to colonize any microbes.

[01:09:18] Carl Lanore: [01:09:18] There's not only prebiotics and human breast milk, but there's also a type of, um, uh, type of simple sugar.

[01:09:26] That now we know is not for the baby, but for the probiotics and the mother's milk to consume and stay alive as they're being transferred. So it's very interesting. You can, when you start talking about this stuff, you realize how intelligent nature really is and how we, we think we're smarter than nature.

[01:09:44] And we will never be swatted in nature because nature made us, how can we be smarter than what made us? It's just impossible.

[01:09:52] Dr. Yvonne L. Kapila, DDS, Ph.D.: [01:09:52] Absolutely. And so, you know, I think that that's why the Nissen story and, and that excited me for when I first started [01:10:00] working on this and was because it's been around for thousands of years, you know, this, this fungus the way was discovered it was cheese, it was being preserved and people kept wondering, well, what, what was it about the cheese that, that.

[01:10:13] Was allowed to be preserved. And it's this, this growth that was found on the cheese again, that's been around for forever, forever. Cause we've been, you know, uh, milking cows and, and making cheese and stuff. And so, yeah, so again, I think there's something that nature has produced and it was just a matter of figuring out what it was.

[01:10:32] Um, And so time will tell. I think that experiments of nature and learning from nature is very, very important. Um,

[01:10:40] Carl Lanore: [01:10:40] this is great research. I want to thank you so much for taking time to come on the show today.

[01:10:45] Dr. Yvonne L. Kapila, DDS, Ph.D.: [01:10:45] Thank you so much. I enjoyed my time with you.

[01:10:48] Carl Lanore: [01:10:48] We see more research. Come out. We'll have you back on.

[01:10:50] Okay.

[01:10:52] Dr. Yvonne L. Kapila, DDS, Ph.D.: [01:10:52] I'm excited. Thank you so much for the time.

[01:10:55] Carl Lanore: [01:10:55] Take care. You're welcome. All right. So they have it. That's all for today. Uh, we do have a show [01:11:00] tomorrow. Rob does want to do a show tomorrow, right? I thought he wanted to take off because of Thanksgiving, but then Wednesday, Thursday, Friday, uh, we're off at Thanksgiving and back on next Monday.

[01:11:10] And, uh, we hope to see all of you, then please pass the show around. There's lots of great information, this show for lots of people, uh, that can help them. And, uh, Stay super human. We'll see you tomorrow. [01:12:00] .