Dr. Will Bulsiewicz Links Fecal Transplants to Immune, Cancer, and Brain Health

Will Bulsiewicz 博士探讨粪菌移植与免疫、癌症及大脑健康的关联 抗生素、不良饮食和压力导致的肠道菌群退化会引发慢性全身性炎症与疾病，需要通过膳食纤维、发酵食品和针对性疗法来恢复肠道屏障功能。 胃肠病学家 Will Bulsiewicz 博士深入阐释了肠道菌群、慢性炎症与身心整体健康之间的深层联系。他探讨了腹胀和便秘等常见消化问题，同时澄清了流行的盲目饮食风潮与对麸质的误解。讨论概述了改善肠道健康的实用日常方案——重点关注膳食纤维、多酚、发酵食品、昼夜节律调节以及压力管理——同时重点介绍了粪菌移植（FMT）等治疗手段。Bulsiewicz 博士还分享了个人经历，阐明化解心理创伤与情绪冲突对身体康复至关重要。 超过60%的人长期受胀气与消化不适困扰，肠漏症会导致肠壁通透性增加，使细菌碎片和毒素渗入血液，诱发全身性低度慢性炎症并损害自体组织与器官。 (6:59) 许多人误以为的“麸质不耐受”往往并非源于麸质蛋白，而是对小麦中的果聚糖（fructans）不耐受，或是非有机小麦在收割前喷洒草甘膦破坏肠道微生态所致。 (32:04) 便秘的临床定义是不完全排便（残余粪便）而非单纯的排便天数，长期残留的粪便会导致“肠道拥堵”，使肠道细菌有充裕时间过度发酵并产生持续性胀气。 (23:24) 粪菌移植（FMT）能一次性重建健康的微生物多样性，不仅可快速治愈致命的艰难梭菌感染，还能使黑色素瘤患者对免疫检查点抑制剂的治疗成功率提高一倍。 (16:05)

Gastroenterologist Dr. Will Bulsiewicz contends that systemic chronic inflammation, metabolic disorders, and neurodegenerative decline largely stem from gut barrier disruption and microbial imbalance, which require circadian, nutritional, and emotional interventions rather than quick-fix procedures. The Gut Barrier and Systemic Disease (6:59) The human digestive tract houses approximately 38 trillion microorganisms situated above a fragile, single-cell epithelial layer spanning 20 to 25 feet. When dietary and environmental stressors compromise this barrier—a condition medically termed increased intestinal permeability, or "leaky gut"—bacterial components like lipopolysaccharides (LPS) enter circulation. This triggers a continuous immune cascade that diverts resources away from critical baseline maintenance, such as patrolling the estimated 3.8 million new cells produced every second for cancerous mutations. Dr. Bulsiewicz notes that systemic pathologies often originate in the digestive tract before manifesting elsewhere. In Parkinson's disease, chronic constipation consistently precedes motor symptoms by years, while clinical trials show fecal transplants can yield sustained motor and digestive improvements. Similarly, Inflammatory Bowel Disease (IBD) occurs when the immune system mistakenly attacks commensal gut microbes rather than host tissues, causing severe collateral inflammation and mucosal ulceration. Root Causes of Digestive Distress and Intolerances (23:24) Millions of individuals suffer from hidden constipation defined by incomplete bowel evacuation ("partial poops") rather than low frequency, leaving residual stool to ferment and generate continuous gas and bloating. Dr. Bulsiewicz outlines three primary mechanisms behind digestive distress: sluggish intestinal motility, depleted microbial enzyme capacity (microbes carry roughly 60,000 digestive enzymes humans lack), and the intake of highly fermentable substrates like lactose and fructans. Many patients who believe they are gluten-intolerant are often reacting to fructans or industrial agricultural practices. In a blinded study published in Gastroenterology, self-identified gluten-sensitive participants experienced worse gastrointestinal symptoms from fructan-rich bars than from gluten-containing bars. Additionally, Dr. Bulsiewicz explains that non-organic wheat in the United States is routinely sprayed with glyphosate for desiccation before harvest. While human cells bypass the shikimate pathway targeted by glyphosate, resident gut bacteria cannot, leading to microbial damage that traditional fermentation, such as authentic sourdough preparation, helps circumvent. Nutritional Pillars and Circadian Digestive Rhythms (51:41) With an estimated 90% to 95% of individuals in the UK and US chronically deficient in dietary fiber, gut bacteria lack the substrates required to synthesize short-chain fatty acids (SCFAs). These compounds—acetate, propionate, and particularly butyrate—act as primary fuel for colonocytes, fortifying tight junctions and calming immune responses. Dr. Bulsiewicz's dietary model prioritizes four core elements: plant fiber diversity, fermented foods, healthy whole-food fats, and polyphenols. Notably, roughly 95% of dietary polyphenols require microbial metabolism to become biologically active compounds. Digestive function also relies heavily on the body's 24-hour circadian clock, which governs over 50% of human genes and gut bacteria. Morning sunlight exposure directly stimulates the brain's suprachiasmatic nucleus, elevating the natural cortisol peak by 50%, while light exercise boosts it further. Furthermore, maintaining structured four-hour gaps between daytime meals allows the migrating motor complex (MMC) to clear debris and residual bacteria, while an overnight fasting window exceeding 12 hours facilitates epithelial rest and lining repair. The Gut-Brain Axis, Trauma, and Clinical Interventions (104:05) Digestive pathology is frequently mediated by chronic neurological stress. Prolonged sympathetic overdrive restricts blood flow to the digestive tract and suppresses mucosal regeneration. Dr. Bulsiewicz emphasizes that early psychological trauma keeps the amygdala hyperactive, prompting a sustained release of corticotropin-releasing hormone (CRH) and nocturnal cortisol that actively dismantles the gut lining. In such patients, physical gut restoration remains ineffective without psychological modalities such as cognitive behavioral therapy. While advanced medical procedures like Fecal Microbiota Transplants (FMT) can rapidly restore a decimated microbiome in life-threatening Clostridioides difficile infections by reintroducing diverse microbial communities, Dr. Bulsiewicz warns that FMT is not a universal panacea. He strongly cautions against unscreened DIY at-home transplants, reiterating that long-term microbiome stability cannot be bypassed through shortcuts and requires sustained dietary and behavioral adherence. While Dr. Bulsiewicz presents mechanistic and clinical evidence linking gut dysbiosis to systemic diseases, individual triggers vary across diet, circadian disruptions, and psychological trauma. He emphasizes that clinical procedures such as fecal transplants cannot replace consistent daily lifestyle modifications, leaving long-term recovery reliant on individualized, multi-system management.

胃肠病学专家 Will Bulsiewicz 博士指出，现代社会普遍蔓延的慢性低度炎症根源在于肠道屏障受损与菌群失衡；通过重建匹配昼夜节律的生活方式、摄入多样化植物纤维与多酚，并同步化解心理神经压力，才能有效修复“肠漏”并平息免疫系统的持续过度反应。 肠道屏障破损与全身慢性炎症机制 (6:59) 人类大便干重的约60%由肠道微生物本身构成。在大肠内部，约38万亿个微生物栖息在仅有一层上皮细胞厚（延展约6至8米）的脆弱屏障之上。这层单层细胞如同一座城墙，正常情况下在有益菌滋养下维持紧密连接，阻挡病原体进入血液。然而，当饮食不良与环境毒素破坏菌群时，肠道通透性增加（即“肠漏”），未消化的食物碎屑和细菌成分渗透入体。免疫系统感知入侵后释放细胞因子，将原本用于应对急性外伤的短暂防御转变为持续24小时的消耗战，造成组织与器官的长期附带损伤。 这种不可见的全身性低度炎症不仅引发关节僵硬、脑雾与慢性疲倦，还会严重分散免疫系统巡查突变细胞的精力。人体每秒分裂产生约3.8百万个新细胞，极度依赖免疫监视清除复制缺陷以防癌变。此外，酒精等生活习惯会剧烈加速这一破坏过程：临床数据显示，饮酒后血液中的内毒素脂多糖（LPS，炎性细菌外膜分子）浓度与血液酒精浓度平行飙升，直接破坏肠道屏障并经肠-肝轴诱发肝损伤。神经退行性病变如帕金森病也展现出肠脑轴诱因，几乎所有患者在脑部运动症状出现的数年前便已发生顽固性便秘。 腹胀诱因、隐形便秘与小麦耐受误区 (23:24) 针对常见消化不良（节目调研显示约61%的受众长期受腹胀或胃肠不适困扰），Bulsiewicz 博士强调异常排气与腹胀的首要诱因是常被忽视的“隐形便秘”。便秘的本质并非单纯按排便天数判定，更核心的标准在于是否完全排空。许多人即使每天排便数次，但每次仅排出20%至25%的干硬结块，残存宿便在肠道“拥堵”，为微生物持续发酵产气提供了充足底料。肠道蠕动节律紊乱及菌群酶系缺乏同样会加剧胀气，微生物携带人体缺乏的约6万种酶，菌群耗损必然导致食物代谢不全。 与此同时，公众对“麸质过敏”存在显著认知误区。多数人对小麦不耐受的真正原因并非麸质本身，而是美国农业在收获前普遍对非有机小麦喷洒草甘膦除草剂以加速干燥。尽管人体细胞缺乏草酸/志贺酸途径（shikimate pathway），但肠道共生菌完全依赖该代谢途径合成必需氨基酸，草甘膦残留会大面积杀灭有益菌群。盲试对照实验表明，许多自认麸质敏感者实际上是对高发酵性碳水化合物果聚糖（fructans）不耐受；经过传统长时间发酵制作的天然酸酵面包（sourdough）能预先降解绝大部分果聚糖，因而更容易被敏感肠道消化。 纤维重塑、短链脂肪酸与多酚激活 (51:41) 修复肠道的核心在于利用真实天然食物喂养微生物，而非追随极端的网红节食法。目前美国约95%、英国约90%的人口处于长期膳食纤维缺乏状态。当结肠细菌发酵各类植物纤维时，会产生乙酸、丙酸以及尤为关键的丁酸（butyrate）等短链脂肪酸（SCFAs）。丁酸是结肠上皮细胞的首选能量来源，能直接刺激紧密连接蛋白生成，封闭细胞缝隙以加固肠道防线，并有效抑制过度亢进的促炎免疫反应。 针对备受推崇的抗炎香料姜黄，Bulsiewicz 博士证实其活性成分姜黄素能够阻断炎性细胞因子通路，但反对滥用超大剂量的提取物补剂。植物中赋予食材明亮色彩的多酚类微量营养素，约95%无法被人体直接吸收，必须经过肠道菌群的发酵转化方能转化为具有抗炎活性的代谢产物。因此，健康的膳食模式应建立在植物多样性之上，通过规律摄入全谷物、坚果、豆类、蔬菜与发酵食品，给肠道微生物提供丰富的能量来源。 昼夜节律同步化与神经创伤的心身干预 (69:10) 人体的代谢与肠道菌群高度依赖24小时昼夜节律，约50%的基因与半数以上的肠道菌群活动随太阳周期起落。早晨醒来应优先饮水并补充可溶性益生元纤维，随后通过户外晨光照射激活视交叉上核（SCN）生物钟，将早晨皮质醇峰值提升50%，配合轻度活动可再提升25%至50%，从而在清晨唤醒结肠反射以实现彻底排便。日间正餐之间保持约4小时的间隔，能够促使肠道启动移行性复合运动（MMC）清扫消化碎屑；夜间保持12至14小时的轻断食窗口，则为肠上皮黏膜留出至关重要的休眠与自我修复期。 深层的肠道修复还必须解决神经系统的应激超载。长期的心理压力与未解决的早期情感创伤会使扁桃体持续警戒，促使下丘脑持续分泌促肾上腺皮质激素释放激素（CRH），导致皮质醇在夜间依然无法正常回落。交感神经的慢性亢奋会主动限制肠道血流灌注并阻碍黏膜再生，从神经机制上促成“漏肠”。单纯依赖膳食调整无法彻底解决由创伤驱动的消化疾病，患者必须正视深层心理冲突，借助认知行为疗法（CBT）及冥想、呼吸等副交感神经激活手段，打断恶性身心循环。 Bulsiewicz 博士总结认为，改善肠道健康并非寻找家庭自制粪菌移植（DIY FMT）或极端保健品等快速捷径，而是需要长期坚持植物多样性饮食、进餐节律管理与身心情绪修复的综合治理。尽管粪菌移植在复发性艰难梭菌感染等急性危重病例中展示了生态级重置能力，但普通人群的日常肠道养护仍需因人而异；个体对特定纤维类型和发酵碳水化合物的耐受阈值差异较大，临床实践仍建议借助布里斯托大便分类法进行规律排便自测，并在医疗指导下逐步调整膳食结构。

## Background 本期内容由 YouTube 播客频道《The Diary Of A CEO》（主持人 Steven Bartlett）于 2026 年 1 月 1 日发布。节目特邀知名胃肠病学专家、ZOE 美国医疗总监 Dr. Will Bulsiewicz 担任嘉宾，结合其新书《Plant Powered Plus》，深入剖析肠漏如何引发慢性炎症、脑雾、腹胀及癌症风险，并揭示了快速修复肠道微生态的日常实用习惯。 ## TL;DR 节目围绕肠道微生态与全身健康的核心联系展开，阐释了肠屏障受损（肠漏）如何通过触发免疫系统持续亢奋而演化为低度慢性炎症，进而关联癌症、帕金森病与肠道溃疡等重疾。Dr. Will 厘清了隐形便秘、麸质不耐受与果聚糖消化不良的区别，并用临床救治案例展示了粪菌移植（FMT）的突破性机制。在此基础上，他系统构建了契合昼夜节律的“完美肠道日”作息指南，涵盖膳食纤维、多酚、健康脂肪与发酵食品四大核心基石。最后，对谈深入脑肠轴与心理创伤的深层交织，通过嘉宾直面童年创伤与父亲达成的感人释怀，生动诠释了身心整体疗愈的真谛。 ## Atmosphere & style 整场对话在科学的严密求证与人性的温情共鸣之间游刃有余，既有医学专家拿着人体与大便模型层层剖析生理机制的生动风趣，又有一针见血拆解极端饮食伪科学的从容自信。Steven Bartlett 敏锐而充满共情的提问，与 Dr. Will 毫无保留的坦诚分享形成极佳互动；随着话题从冷峻的细胞生化反应转向早年家庭破碎的阵痛与初为人父后的释怀，气氛由紧凑热烈的科学探索自然沉降为深沉动人的精神救赎，带给观众强烈的心灵触动与知行合一的启发感。 ## Bulletin - [06:03](https://www.youtube.com/watch?v=5Tr7AhkOEj4&t=363s) 肠漏与慢性炎症的连锁机制：结肠寄居约38万亿微生物，粪便干重的60%是菌群本身；薄如单层细胞的肠黏膜屏障一旦受损，毒素与未消化大分子渗漏入血，迫使免疫军队全天候待机开火，诱发波及全身的低度慢性炎症。 - [34:51](https://www.youtube.com/watch?v=5Tr7AhkOEj4&t=2091s) 大众所谓的“麸质敏感”多为果聚糖不耐受：顶级医学期刊双盲对照实验证实，许多自认麸质不耐受者对提纯麸质并无反应，真正的胀气元凶是小麦、大蒜和洋葱中伴随存在的果聚糖；酸种面包经漫长乳酸菌发酵大幅降解了果聚糖，因而更易耐受。 - [59:48](https://www.youtube.com/watch?v=5Tr7AhkOEj4&t=3588s) 酒精不存在安全剂量：临床检测显示血液酒精浓度与肠道内毒素（脂多糖 LPS）入血浓度严格平行波动；酒精直接破坏肠上皮紧密连接引发急性肠漏，直至体内酒精完全代谢归零，内毒素渗漏与免疫炎症才会停止。 - [01:54:48](https://www.youtube.com/watch?v=5Tr7AhkOEj4&t=6888s) 修复肠道微生态的四大饮食基石：Dr. Will 指出极端纯肉或极端果汁断食均背离健康法则，现代人重塑菌群与平息炎症的核心在于补齐极度匮乏的四大营养基石——膳食纤维、植物多酚、健康脂肪与发酵食品。 ## Key takeaways - [02:20](https://www.youtube.com/watch?v=5Tr7AhkOEj4&t=140s) 慢性低度炎症是席卷现代人的隐形危机，疲劳、脑雾、失眠与关节隐痛等非特异性症状多源于此，且身材健美、体脂极低者同样可能饱受其害。 - [06:03](https://www.youtube.com/watch?v=5Tr7AhkOEj4&t=363s) 肠道微生态与黏膜屏障是人体的最前线防线，单层肠上皮细胞每3至5天自我更新一次，微生态修复能迅速重建屏障并让过度亢奋的免疫系统重新“冷却”。 - [18:06](https://www.youtube.com/watch?v=5Tr7AhkOEj4&t=1086s) 神经退行性疾病如帕金森病极可能始于肠道而非大脑，顽固性便秘常在典型运动障碍症状出现数年甚至数十年之前发生，肠脑轴是病理侵袭的关键通路。 - [23:24](https://www.youtube.com/watch?v=5Tr7AhkOEj4&t=1404s) 每日排便并不等于没有便秘，“隐形便秘”表现为排空不完全和频繁排出硬块；未排净的粪便滞留在结肠中，数十万亿微生物拥有无限时间发酵残渣，形成持续恶性腹胀。 - [31:21](https://www.youtube.com/watch?v=5Tr7AhkOEj4&t=1881s) 常规非有机小麦在收割前常被大面积喷洒草甘膦（农达）催干，草甘膦阻断莽草酸途径，人体细胞虽具备替代旁路，但大肠内的有益益生菌群缺乏代偿机制而遭受严重杀伤。 - [41:04](https://www.youtube.com/watch?v=5Tr7AhkOEj4&t=2464s) 抗生素使用会使随后一年内罹患炎症性肠病（IBD）的风险翻倍，服药期间肠道屏障功能下降50%；而粪菌移植（FMT）已在难辨梭状芽孢杆菌感染的危重救治中展现出立竿见影的逆转效果。 - [51:41](https://www.youtube.com/watch?v=5Tr7AhkOEj4&t=3101s) 英美超过90%的人群面临严重“纤维饥荒”，纤维发酵生成的丁酸是结肠上皮细胞首选能量底物，直接负责诱导紧密连接蛋白合成以修补肠漏并调节免疫细胞。 - [01:07:44](https://www.youtube.com/watch?v=5Tr7AhkOEj4&t=4064s) 植物中多达95%的多酚无法被人体小肠直接吸收，必须依赖大肠微生物代谢发酵后才能转化并“激活”为具有系统抗炎与抗衰老活性的分子。 - [01:12:01](https://www.youtube.com/watch?v=5Tr7AhkOEj4&t=4321s) 依循昼夜节律激活肠道：清晨接触自然光并配合温和运动，能双重杠杆拉升健康皮质醇峰值50%至100%，不仅提升全天认知与代谢效率，更直接锚定夜间深度睡眠。 - [01:20:32](https://www.youtube.com/watch?v=5Tr7AhkOEj4&t=4832s) 婴儿生命早期前3年是免疫系统“受训”的关键窗口，剖宫产、早期抗生素暴露以及缺乏母乳低聚糖（HMOs）喂养会导致产丁酸菌匮乏，显著推高童年期湿疹与过敏发病率。 - [01:34:43](https://www.youtube.com/watch?v=5Tr7AhkOEj4&t=5683s) 保持餐与餐之间约4小时的无零食进食间隔，能让小肠启动“移行性复合运动”（MMC）清道夫波，规律推走食物残渣与菌群，有效预防小肠细菌过度生长（SIBO）与饭后胀气。 - [01:44:45](https://www.youtube.com/watch?v=5Tr7AhkOEj4&t=6285s) 未解的心理创伤会导致交感神经过载与下丘脑CRH持续释放，夜间反常居高的皮质醇会直接撕裂肠道屏障完整性，创伤性肠病的康复始于勇敢指认心理根源。 - [01:53:21](https://www.youtube.com/watch?v=5Tr7AhkOEj4&t=6801s) 布里斯托大便分类法中的“4型香肠状”为排便黄金标准；面对坚硬兔粪状便秘，盲目狂补膳食纤维只会加重梗阻，必须配合氧化镁等渗透性引水成分协同软化。 - [02:04:49](https://www.youtube.com/watch?v=5Tr7AhkOEj4&t=7489s) 身体的物理疗愈与心理和解深度共振：修复家庭亲情裂痕、解除内心长期创伤，往往能从根本上重塑自律掌控力，促成饮食生活方式与肠道微生态的彻底好转。 ## Detailed walkthrough ### [00:00](https://www.youtube.com/watch?v=5Tr7AhkOEj4&t=0s) 粪便移植、被忽视的肠道与身体的隐形警报 在节目的开篇，胃肠病学家威尔·布尔谢维奇博士（Dr. Will Bulsiewicz）用一个极具震撼力的临床案例直观解释了什么是“粪便微生物群移植”（Faecal Microbiota Transplant，简称粪便移植）：即从健康人身上提取粪便，转移至患病个体的肠道中。他曾接诊过一名因服用抗生素而导致肠道菌群被全盘摧毁的患者，病情恶化到危及生命，当时面临的医疗抉择只有两种——切除结肠，或者尝试粪便移植。布尔谢维奇博士为她实施了移植，仅仅到了第二天，整个致命的感染完全被平息遏制。这个奇迹般的病例揭示了肠道微生物群的至关重要性，因为人类粪便干重的 60% 实际上全是微生物群。遗憾的是，大众和医学界对其关注度依然远远不够。 主持人史蒂芬·巴特利特（Steven Bartlett）指出，当前大约有 60% 的听众正饱受某种形式的肠道问题困扰。这些隐患往往以极其微妙、容易被忽视的方式表现出来：腹胀、疲劳加剧、注意力难以集中、夜间失眠以及各种皮肤问题。因为缺乏剧烈疼痛，人们常任由其在雷达之下潜行，最终却演化出更严重的全身性慢性疾病。在谈到最普遍的“腹胀”症状时，布尔谢维奇博士直言其头号元凶是便秘；同时他严正警告那些易腹胀的人群：切勿使用吸管喝水、饮用碳酸饮料或嚼口香糖，因为这些坏习惯会吞入大量气体，让腹胀雪上加霜。 童年早期的健康决策同样会为一生的肠道功能埋下伏笔。布尔谢维奇博士解释道，人类在 3 岁左右，肠道微生物群的构成和规模就已经基本达到成年人水平。然而，童年期滥用抗生素、完全采用配方奶喂养（瓶喂）以及剖宫产（C-section），都与肠道菌群失调有着明确关联，会显著增加日后罹患过敏性疾病、自身免疫性疾病及代谢紊乱的风险。但好消息是，肠道具有极强的自愈与再生能力——人体的肠道屏障每隔 3 到 5 天就会整体更新一次。只要掌握现代饮食中普遍缺失的 4 种核心要素并养成科学的日常习惯，就能彻底重塑微生物群。 - **粪便成分比例**：粪便干重的 60% 是肠道微生物。 - **腹胀恶化行为禁忌**：用吸管饮水、饮用碳酸饮料、咀嚼口香糖。 - **幼儿菌群成熟期**：3 岁时肠道微生物群基本达到成年人水平。 - **破坏早期菌群三大因素**：滥用抗生素、非母乳喂养、剖宫产。 - **屏障自我更新周期**：肠道上皮屏障每 3 至 5 天完全更新一次。 --- ### [02:20](https://www.youtube.com/watch?v=5Tr7AhkOEj4&t=140s) 慢性低度炎症：潜伏在现代人身体里的暗火 当主持人问及布尔谢维奇博士为何对他的新书《Plant Powered Plus》怀有如此强烈的激情时，博士由衷表示，现代社会中绝大多数人表面上的症状千差万别，根源却都在与同一种病理机制搏斗，那就是“炎症”（Inflammation）。它是我们这个时代最具决定性却又最被低估的健康议题。 为了让每个人都能理解，布尔谢维奇博士用给十岁孩子讲故事的方式拆解了炎症的本质：人体拥有一套保卫健康的免疫系统，炎症就是将这套免疫防御机制“激活开机”的状态。在急性状态下，炎症是生命的守护者——如果你吃坏肚子感染了肠胃炎，免疫系统需要消灭病原体；如果你摔破了皮，它需要赶来修复创口。然而现代生活带来的致命问题在于，人们的免疫系统在不需要战斗的时候被错误地激活，并且陷入了一周 7 天、每天 24 小时永不停歇的“全天候待机与攻击”状态。 针对主持人关于“炎症是不是听起来就像身体某处肿胀发泡”的疑问，博士厘清了概念：红、肿、热、痛确实是急性炎症的经典特征（例如膝盖扭伤），但当下席卷大众的却是“慢性低度炎症”（Chronic low-grade inflammation）。这种炎症狡猾而隐蔽，既不产生剧烈红肿，常规体检也极难察觉，患者自身与医生常常一头雾水。患者只会反复向医生抱怨：“为什么我整天无精打采？”“为什么我总是脑雾、注意力不集中？”“为什么我睡眠质量很差、醒来浑身关节酸痛？”医生面对这些非特异性症状往往束手无策，然而其幕后推手正是这种如影随形的低度慢性炎症。更颠覆大众认知的是，慢性炎症绝非超重人群的专利；即便是一个身材健美、体脂极低的竞技健美运动员，外表看起来无懈可击，身体内部却可能早已千疮百孔，饱受肠道功能紊乱与慢性炎症的折磨。 --- ### [06:03](https://www.youtube.com/watch?v=5Tr7AhkOEj4&t=363s) 免疫军队的附带损伤与肠漏症的连锁反应 既然慢性炎症是免疫系统的持续亢奋，为什么它会带来如此巨大的破坏，又该如何关闭它？布尔谢维奇博士将免疫系统比喻为驻扎在体内的正规小军队。当军队奉命开拔、全面投入战争交火时，战场周围的区域必然会遭受毁灭性的打击与附带损伤（Collateral damage）。问题在于，这支军队打仗的战场不是荒郊野岭，而是宿主自身的肉体；所谓的附带损伤，就是人体自身的细胞、血管与器官组织在持续的炮火中被逐步摧毁与纤维化。 博士耗费了整整 3 年时间深入钻研文献与临床数据，梳理出一条无可辩驳的核心链路：**免疫系统的失控源于肠道屏障的失守**。在人体的结肠（大肠）内，寄居着大约 38 万亿个微生物，其中包括细菌、真菌酵母、早在地球上生存了 40 亿年的古菌（Archaea）以及共生原虫。这支庞大生态系统的核心使命之一，就是滋养并维护长达 20 至 25 英尺（约 6 至 8 米）的整个肠道防线。令人惊叹的是，隔绝肠道内海量毒素与人体内部循环系统的防线，仅仅是一层薄薄的单层上皮细胞（Epithelial layer）。这层屏障宛如城堡的外墙：它必须精准防守，将有害物质与毒素阻挡在外，同时又要保持通透，允许营养成分顺利吸收入血。 ```mermaid flowchart TD accTitle: 肠漏与慢性炎症的发生机制 accDescr: 展示从肠道菌群失调、肠屏障受损到免疫系统被持续激活引发全身慢性炎症的病理过程。 subgraph GutLumen["肠道微环境 (Gut Lumen)"] A["38万亿微生物失衡 / 屏障滋养不足"] B["单层肠上皮细胞连接松动 (城堡外墙受损)"] A --> B end subgraph Leakage["病理渗透 (Leaky Gut)"] C["肠道通透性异常增高 (肠漏症)"] D["未消化物质 / 毒素 / 细菌抗原渗透过隙"] B --> C C --> D end subgraph ImmuneResponse["免疫与全身反应"] E["黏膜下免疫系统识别异常入侵物"] F["免疫大军全天候激活 (进入交火状态)"] G["慢性低度炎症: 组织与器官产生附带损伤"] D --> E E --> F F --> G end ``` 当结肠微生物无法获得充足养分来维护这道墙体时，这层极其脆弱的单层细胞就会发生破损与间隙扩大，医学上称为“肠道通透性增加”（Increased intestinal permeability），也就是民间俗称的“肠漏”（Leaky Gut）。原本应当被隔离在消化道管腔内的未消化大分子、毒素与细菌成分，会乘隙渗漏穿透这层屏障，直接暴露给驻扎在黏膜下方的免疫大军。免疫系统一旦侦测到这些绝不该出现在体内的外来异物，便会立即拉响最高警报、全面开火围剿。这种永不熄灭的战火，正是点燃全身慢性炎症的真正导火索。 ### [09:29](https://www.youtube.com/watch?v=5Tr7AhkOEj4&t=569s) 肠道防御的三道防线与细胞因子级联反应 肠道健康本质上依赖于一个环环相扣的三层防御体系：第一道防线是肠道微生物群落（Microbiome），中间层是物理性的肠道屏障（Gut Barrier），而最底层则是待命的免疫系统。当不良饮食和外界有害物质破坏了微生物群落时，肠道屏障随即受损，导致不该进入血液的异物“潜入”体内，迫使免疫系统全面拉响警报。然而，最令人振奋的医学机遇在于这个过程是完全可逆的——一旦修复了肠道微生物，微生物就会立即投入工作，重新加固并修补肠道屏障；而坚固的屏障一旦建起，原本被过度消耗的免疫系统便能“冷却下来”，从疲于奔命的应激状态转变为更加从容、精准且高效的战术防御。 ```mermaid flowchart TD accTitle: 肠道微生态与免疫炎症级联反应机制 accDescr: 展示微生物受损如何导致屏障破坏、细胞因子释放及全身组织损伤的连锁过程 subgraph S1["肠道前沿防御"] A["肠道微生物受损\n（菌群失调）"] --> B["肠道屏障破坏\n（肠漏/异物渗漏）"] end subgraph S2["免疫系统激活"] B --> C["免疫细胞拉响警报\n释放细胞因子（Cytokines）"] C --> D["细胞因子风暴级联\n招募更多免疫细胞"] end subgraph S3["全身组织损伤"] D --> E["肝脏炎症\n（肝炎）"] D --> F["神经退行/情绪障碍\n（抑郁/阿尔茨海默/帕金森）"] end ``` 针对史蒂文关于“免疫系统全天候过载如何破坏自身”的疑问，威尔博士用战争中的“军队内耗”作比：当免疫细胞进入战斗状态，它们不仅在局部反抗，还会向全身释放被称为细胞因子（Cytokines）的化学通信信标以呼叫增援。这种信号会引发连锁反应，刺激更多免疫细胞释放更密集的细胞因子，掀起席卷全身的炎症浪潮。长此以往，身体的正常组织便成了附带损伤的受害者——若炎症发生在肝脏，医学上称为肝炎；若蔓延至大脑，便会造成神经炎症（Neuroinflammation），并被现代科学证实与重度抑郁等情绪障碍，以及阿尔茨海默病、帕金森病等认知衰退疾病存在极深关联。 ### [12:04](https://www.youtube.com/watch?v=5Tr7AhkOEj4&t=724s) 粪菌移植（FMT）：向肠道“重新空投整个亚马逊雨林” 虽然并非所有疾病都直接源自肠道，但免疫系统与肠道微生态的紧密共生已达到“无法割裂”的地步。医学界既能用抗生素彻底摧毁这个生态系统，也能通过一种激进而立竿见影的技术——粪菌移植（Fecal Microbiota Transplant, FMT）——对其进行快速重建。所谓粪菌移植，就是将健康捐赠者的粪便微生物悬液移植入病人体内。在威尔医生的临床生涯中，这项操作通常在结肠镜检查（Colonoscopy）过程中实施：当患者处于深度镇静状态时，医生操控一根食指粗细的长软管贯穿约 5 至 6 英尺长的全部大肠，甚至深入到位于右下腹的回肠末端（Terminal Ileum），精准注入健康的菌群生态。 粪菌移植最经典的救命场景是治疗难辨梭状芽孢杆菌（C. diff）感染。这种恶性细菌往往能扛住常规抗生素的轰炸，导致致命性肠炎。抗生素的传统逻辑往往是“消灭所有细菌”，却往往彻底摧毁了本土地盘；而粪菌移植的逻辑则是“以善治恶”，一次性将数百种健康、均衡配比的菌种重新种植到位。威尔医生形象地比喻道：“这就像一片已经濒临枯死的林地，我们直接把一整座生机勃勃的亚马逊雨林移植了过去。所有适应这片土地的物种瞬间归位，整个生态森林便在一夜之间重新恢复了葱郁和繁盛。” - 结肠镜管长约 5 到 6 英尺，不仅能检查整段大肠，还能到达小肠末段的回肠末端。 - 难辨梭状芽孢杆菌（C. diff）感染具有极高的复发率和致死风险，是粪菌移植目前被官方高度认可的黄金适应证。 - 传统的“杀菌思维”在面对失调时往往适得其反，而“生态系统移植”通过恢复多样性迅速打破致病菌的垄断。 ### [14:34](https://www.youtube.com/watch?v=5Tr7AhkOEj4&t=874s) 现代生活的代价：慢性低度炎症的“永恒战争” 从肠道受损到免疫应激的链条清晰地指向一个残酷的现代现实：我们每天摄入的超加工食物和不当生活方式，正让肠道长期处于微观破损中。为了不停地“灭火”修补这些屏障，免疫系统不得不持续维持在最高战备级别。史蒂文总结指出，如果你因为吃进去的东西而让肠道陷入永久破损的境地，那么在理论上，你也将被迫生活在一种永久的慢性炎症状态中。 威尔医生对这一核心命题表示高度认同：“现代社会及其生活方式正在不断摧残我们的肠道与微生物群，而我们正在承受这一代价——肠屏障被彻底撕裂，免疫系统深陷于一场永无止境的低度慢性炎症‘永恒战争’（Forever War）中。” ### [15:14](https://www.youtube.com/watch?v=5Tr7AhkOEj4&t=914s) 肠道微生态与癌症治疗：免疫检查点抑制剂与粪菌移植的惊人效果 当话题切入癌症时，威尔医生揭示了一个惊人的生理数据：人体每秒钟都在制造多达 380 万个新细胞。在如此庞大的细胞更迭速度下，几乎不可能不产生具有致癌潜力的基因突变。免疫系统的核心职责，就是在我们生命中的每一天保持“绝对完美”的监视状态，在新生的异常细胞演化成真正的恶性肿瘤之前将其无情清除。然而，癌细胞极其狡猾，现代肿瘤学在黑色素瘤（Melanoma）的治疗研究中揭开了一项革命性的免疫机制：T 细胞表面存在一个名为 PD-1 的“紧急刹车受体”（Kill Switch），而恶性肿瘤细胞会特异性分泌一种蛋白质强行扣动这个刹车开关，直接把免疫杀伤系统“关机”。 现代医学研发的免疫检查点抑制剂（Immune Checkpoint Inhibitors）正是为了撬开这个刹车，重新唤醒免疫细胞去识别并撕碎癌细胞。然而临床医生们发现了一个令人困惑的现象：如果在接受免疫检查点抑制剂治疗前使用了抗生素，患者的治疗效果就会大打折扣。这一线索直接将科学家引向了肠道菌群——如果摧毁菌群会废掉抗癌免疫疗法，那么反过来，用粪菌移植修复菌群能否创造奇迹？后续的多项临床研究证实了这一假说：研究人员将那些对免疫疗法产生积极反应的“超级应答者”的粪菌移植给即将接受治疗的晚期癌症患者，结果显示其癌症缓解率和治愈预期竟然翻了一整倍。 - 人体以每秒约 380 万个细胞的惊人速度自我复制，免疫系统承担着全天候剔除异常突变细胞的重任。 - PD-1 受体相当于免疫细胞的“自毁/熄火开关”，癌细胞正是借此逃避巡警追杀。 - 接受抗生素治疗会严重削弱免疫检查点抑制剂的抗癌疗效，反之，来自应答者的粪菌移植（FMT）可让某些晚期黑色素瘤患者的战胜癌症几率提升一倍。 ### [18:06](https://www.youtube.com/watch?v=5Tr7AhkOEj4&t=1086s) 帕金森病始于肠道：隐藏在顽固便秘背后的肠脑轴真相 肠道微生态的深远影响不仅限于癌症和消化系统，前沿医学已正式将目光投向了神经退行性疾病——尤其是帕金森病（Parkinson's Disease）。传统医学一向将帕金森病视作纯粹的脑部中枢神经病变，但威尔医生在现场摘下了人体解剖模型的头盖骨，指着裸露的大脑模型打趣道：“我就像《汉尼拔》里的莱克特医生一样掀开了他的头骨。”他严肃指出，经典认知需要被彻底改写：帕金森病极有可能并非始于大脑，而是先从肠道生根发芽，通过错综复杂的“肠脑轴”（Gut-Brain Axis）一路向上侵蚀中枢系统，大脑病变不过是这场漫长侵袭演变到后期的更严重恶果。 威尔医生分享了他在消化科临床行医多年的震撼观察：“我见过的每一个帕金森病患者，无一例外，全都有便秘的毛病。所有人都是如此。”流行病学与神经科学的前沿研究如今已经证实，顽固性便秘的出现往往比帕金森病典型的震颤、肢体僵硬等运动障碍症状早数年甚至数十年。虽然威尔医生也立刻严谨地澄清，这绝不意味着每一个便秘的人都必然会罹患帕金森病（毕竟饱受便秘折磨的人群基数极大），但这一铁证无可辩驳地揭示出：肠道与中枢神经系统之间，存在着一条远超常人想象的致命通道。 ### [19:41](https://www.youtube.com/watch?v=5Tr7AhkOEj4&t=1181s) 粪菌移植对帕金森病的惊人突破与DIY的危险误区 dr. Will Bulsiewicz 指出，帕金森病等神经退行性疾病的病理表现，往往早在波及大脑之前的数年甚至数十年，就已经在消化系统悄然萌芽。在一项针对帕金森病患者的临床突破性研究中，科研人员为患者实施了粪菌移植（FMT，俗称“便便移植”）。令人震惊的是，在整整一年后的随访中，患者在运动障碍方面依然展现出持久且稳定的改善。不仅如此，后续多项针对帕金森病的研究不仅证实了其对大脑神经症状的缓解，还同步解决了困扰患者多年的顽固性肠道症状——慢性便秘。 面对这一惊人效果，主持人 Steven Bartlett 随即提出大众最关心的问题：“普通人是否也能去做一次粪菌移植？”Dr. Will 对此给出了极其谨慎且严肃的警告。他特别提到 Netflix 曾有一部纪录片让观众误以为“可以在自家厨房 DIY 粪菌移植”，他急切呼吁：“千万别这么做，请绝对不要尝试。”医学界目前仍在系统评估粪菌移植的潜在风险与未知病原体传播隐患。很多人误以为这是一种“一次性搞定所有健康问题”的神奇捷径，但它绝不可能替代通过饮食与健康生活方式重塑菌群的长期功课；唯有日积月累的可持续调整，才能带来真正深远的心身改变。 - **帕金森病临床新证**：接受粪菌移植的帕金森病患者，其运动症状与神经系统获益持续至少一年以上，同时严重便秘得到显著逆转。 - **严正安全警示**：医学级 FMT 需极其严苛的供体筛选与实验室处理，私自在家尝试存在严重的致命感染风险。 --- ### [21:10](https://www.youtube.com/watch?v=5Tr7AhkOEj4&t=1270s) 超过六成人群的肠道困扰：千人千面的根源与创伤影响 现代人的肠道健康危机早已不再是个例。Steven 分享了一项来自《The Diary Of A CEO》听众的真实调查：超过 61% 的受访者表示自己正长期饱受腹胀、肠胃不适或排便不规律等消化问题的困扰，其中约 14% 至 15% 的人甚至自行诊断患有肠易激综合征（IBS）。Steven 困惑于这 61% 的人群究竟是因为千奇百怪的诱因致病，还是背后存在某几个核心祸首。 Dr. Will 坦言，这正是他在撰写新书时面临的最大课题——肠道健康没有“一刀切”的万能公式。每个人的病因拼图都截然不同，读者在获取科学信息时，必须寻找专属于自己的“顿悟时刻”（Aha moment）。从人群统计学来看，现代典型的“标准美国饮食”（SAD）充满加工食品、缺乏膳食纤维，这无疑是绝大多数人最大的修复切入点，现代生活节奏与祖辈童年时相去甚远。但更不可忽视的是，对于某些人群而言，问题的根源根本不是饮食、睡眠或昼夜节律紊乱，而是深层未解的“心理创伤”（Trauma）。肠脑轴对情绪创伤的高度敏感性，往往直接投射在消化道的严重紊乱中。 - **高发病率现状**：调查显示 61% 的现代人受困于腹胀与排便紊乱，近 15% 怀疑自己患有 IBS。 - **非饮食性诱因**：消化道症状并非单纯由食物引起，童年逆境或长期心理创伤（Trauma）是常被医学忽视的关键致病因子。 --- ### [23:24](https://www.youtube.com/watch?v=5Tr7AhkOEj4&t=1404s) 隐形便秘：每天排便也可能处于“未排净”状态 针对偶发性与慢性肠道不适的界限，Dr. Will 澄清道：偶尔受凉或吃错东西引起的轻微腹胀是完全正常的生理反应。但如果这种不适演变成慢性状态——例如每天早晨睁开眼，第一反应是忐忑不安地祈祷“希望今天会是个好日子，希望今天那该死的肚子痛/腹胀别再发作”——这就意味着肠道已处于严重功能障碍中，必须采取系统性干预手段。 在排查腹胀和多屁（排气频繁）的元凶时，Dr. Will 直言排名第一的绝对诱因是“隐形便秘”。无数人坚信自己绝不可能便秘，因为他们“每天都有排便”，但排便频率根本不能代表真实的肠道排空状态。真正的便秘定义是肠道未能充分、彻底地排空残留物。有人可能两天排便一次，但排出顺畅彻底、身心舒畅，这完全健康；反之，许多人每天清晨在马桶上痛苦挣扎，费尽九牛二虎之力只排出一小块坚硬的“小硬块”（Nugget），排便后毫无舒畅感，腹部依然胀满。过了三四十分钟，他们又不得不跑去厕所再排一点点——这种单次只排空 20% 到 25% 的“零星排便”，即便一天去三四次厕所，本质上仍然属于深度的隐性宿便潴留与便秘。 ```mermaid flowchart TD accTitle: 假性正常排便与隐形便秘对比 accDescr: 对比完全排便与零星不完全排便导致肠道滞留的机制流程 subgraph Normal["真正健康的肠道排空"] A1["排便频次适中 (每日1次或隔日1次)"] --> B1["排便顺畅且彻底"] B1 --> C1["无残留感与腹胀"] end subgraph Constipated["隐形便秘 (频繁但未排净)"] A2["排便用力、费劲"] --> B2["仅排出少量干结粪块 (约20%-25%)"] B2 --> C2["短时间内反复有便意"] C2 --> D2["肠道深处大量粪便积压堵塞"] end ``` - **便秘误区澄清**：不能仅凭排便次数排除便秘，排空不完全、粪便干结、需要反复排解均属于便秘范畴。 - **心理预警信号**：晨起时对当天胃肠症状感到焦虑和恐惧，是病理性慢性肠道功能紊乱的核心指标。 --- ### [26:27](https://www.youtube.com/watch?v=5Tr7AhkOEj4&t=1587s) 粪便的60%是肠道菌群：肠道大塞车如何酿成胀气风暴 为了生动揭示排气和腹胀的生理机制，Dr. Will 提出了一个颠覆认知的核心事实：气体总是伴随着粪便移动的。很多人清晨起床时会剧烈排气，而一旦完成了一次畅快的晨间大便，气体便奇迹般地完全消失，整个人倍感轻松。这是因为大便并非单纯由食物残渣构成——**粪便干重的 60% 全都是微生物（细菌）本身**。 为了形象说明这一点，Dr. Will 举例：如果在水中加入完全看不见颗粒、尝不出质感的可溶性益生元膳食纤维，第二天排出的粪便体积会明显增大。这并不是因为纤维本身的体积，而是益生元在肠道内滋养了有益菌群，使微生物以指数级疯狂繁殖增重。然而，如果肠道处于“交通大瘫痪”（Gridlock）的便秘状态，积存的粪便无法及时推进，数十万亿的微生物就会在肠道里无限期停留。它们拥有近乎无限的时间去疯狂发酵沿途遭遇的任何物质——无论是纤维甚至没消化的蛋白质，发酵产生的副产物便是源源不断的大量气体，从而诱发持续性的腹部膨胀与排气过频。 - **粪便微生物含量**：粪便重量的约 60% 由肠道微生物菌体构成，而非未吸收的食物渣滓。 - **发酵气体的根源**：粪便滞留形成肠道“大堵车”，为微生物发酵各种底物提供了充沛的时间窗口，最终酿成剧烈腹胀。 ### [28:49](https://www.youtube.com/watch?v=5Tr7AhkOEj4&t=1729s) 胀气与腹胀的三大核心根源 很多人误以为胀气只是偶尔吃多了，但 Dr. Will 指出，腹胀和排气异常通常由三大核心因素驱动。首要原因便是肠道蠕动功能（Motility），尤其是便秘。肠道蠕动本质上是肠壁推进食物残渣的节律运动。如果肠道运动过快且紊乱，就会导致腹泻；若蠕动过于缓慢、停滞迟钝，就会演变成便秘。就像心脏一样，肠道需要维持平稳、可预测的节律，最理想的状态是保持每日规律排便，而这一过程与人体的昼夜节律深度绑定——每天早晨一次畅快的排便，正是健康生物钟的重要表现。 第二个根本原因在于肠道菌群受损。人类自身并不具备分解膳食纤维所需的消化酶，未被小肠消化的纤维进入大肠后，完全依赖肠道微生物进行处理。人体微生物群拥有多达 60,000 种人类自身没有的消化酶，它们以精密协作的“团队”方式分解膳食纤维，将其转化为对全身有益的短链脂肪酸（SCFA）。然而，当肠道微生态受损、有益菌群处于虚弱状态时，面对涌入的膳食纤维便无法正常负荷，导致所谓“草率且不完全的消化过程”（sloppy digestion），进而产生大量气体和顽固腹胀。 第三个原因源于日常饮食成分。除了众所周知的乳制品中乳糖发酵产生气体外，人们常归咎于麸质（Gluten）的消化不良，其实另有隐情。麸质本质上是一种蛋白质，它并不是大肠发酵产气的主要原料；真正引发腹胀的，是小麦、大麦和黑麦等含麸质食物中伴随存在的长链碳水化合物——果聚糖（Fructans）。果聚糖本身是非常优秀的益生元，但若人体肠道菌群长期匮乏此类底物，或一次性摄入过量，便会引发剧烈的胀气与消化道不适。 - **肠道蠕动失衡**：过快失序导致腹泻，过慢迟滞引发便秘，破坏肠道基本排空节律。 - **微生态酶系缺失**：人体无法消化膳食纤维，依赖肠道菌群的约 60,000 种特有酶将其发酵转化为短链脂肪酸。 - **发酵底物超负荷**：乳糖与果聚糖（Fructans）易在肠道被微生物快速发酵并释放气体。 --- ### [31:21](https://www.youtube.com/watch?v=5Tr7AhkOEj4&t=1881s) 为何人人觉得自己麸质不耐受？美国小麦与草甘膦的真相 史蒂文分享了自己的切身经历：年轻时吃意面毫无负担，如今只要吃一顿意面，接下来的整整两天身体都会感觉沉重不适；然而当他改吃无麸质意面或无麸质面包时，体感明显改善。他提到，目前似乎有大量人群自认为存在“麸质不耐受”（Gluten Intolerance）。Dr. Will 直言，在洛杉矶这类城市，多达 80% 的人都自称在践行“无麸质饮食”，但实际上真正患有乳糜泻（Celiac disease）或真正麸质过敏的人极少，盲目切断所有麦类食物不仅没有必要，若不配合合理的营养替代反而可能损害健康。 对于许多美国人“在国内吃面食腹胀，去意大利度假吃意面却安然无恙”的奇特现象，Dr. Will 揭示了隐藏在农工业加工背后的真相：草甘膦（Glyphosate，即农达除草剂）。在美国的小麦工业化种植中，农场主在小麦收获前往往面临两种选择：要么花费数周时间等待麦穗在田间自然风干并仓储，要么直接对整片麦田喷洒草甘膦，使其在次日彻底枯干以便立即收割运输。除购买有机认证产品外，普通食品标签上绝不会标明草甘膦残留。 ```mermaid flowchart TD accTitle: 草甘膦对人体与肠道微生态的差异化影响机制 accDescr: 解释草甘膦如何通过抑制莽草酸途径影响植物与肠菌，以及人体与细菌的差异响应。 subgraph Exposure ["农残摄入"] A["非有机小麦预收割喷洒草甘膦催干"] --> B["微量草甘膦进入消化道"] end subgraph Impact ["莽草酸途径抑制与响应机制"] B --> C["阻断关键生物合成路径（莽草酸途径）"] C --> D["人体细胞：具备替代途径可自主合成氨基酸（无即时致死性）"] C --> E["大肠有益菌群：缺乏替代机制，生长受到严重抑制"] end subgraph Outcome ["微生态失衡与临床反应"] E --> F["有益益生菌急剧减少"] F --> G["耐受性较强的促炎细菌过度繁殖"] G --> H["肠道微生态失调与消化道不适症状"] end ``` 监管机构之所以批准草甘膦的使用，是因为其毒理机制是阻断植物的“莽草酸途径”（Shikimate pathway）以合成必需氨基酸，而人体细胞不依赖此途径，存在自身的氨基酸代偿机制。然而监管盲区在于：生活在人体大肠内的数万亿微生物并没有这一代偿旁路。即使极其微量的草甘膦残留，也会对有益菌产生杀伤效应，破坏微生态平衡，使更具耐受力的促炎有害菌占据优势，从而在摄入后迅速诱发腹部不适。 - **催干工艺（Desiccation）**：非有机常规小麦在收割前常被大面积喷洒草甘膦以加速干燥，标签往往不予标注。 - **莽草酸途径盲区**：草甘膦通过破坏莽草酸途径抑杀植物，人体自身具备氨基酸代偿旁路，但肠道益生菌群缺乏该旁路，因而遭受严重抑制。 - **菌群倾斜**：农药残留选择性杀伤有益共生菌，促炎致病菌借机滋生，导致微生态失衡（Dysbiosis）。 --- ### [34:51](https://www.youtube.com/watch?v=5Tr7AhkOEj4&t=2091s) 不是麸质的问题？果聚糖耐受与酸种面包的秘密 在排除了农残因素之后，Dr. Will 引导史蒂文审视另一个关键变量：面包的类型。当史蒂文承认自己平时几乎不碰普通面包，但食用酸种面包（Sourdough bread）却完全没有不适感时，核心机制浮出水面——发酵过程极大地改变了食物中的“果聚糖”含量。果聚糖是小麦、大麦和黑麦中天然存在的一种长链低聚糖，与麸质蛋白并存于麦类之中。传统酸种面包经过漫长的乳酸菌和酵母缓慢发酵，微生物在发酵阶段预先分解并大幅降低了面团内的果聚糖含量，使得受损肠道能够轻松耐受。 Dr. Will 援引了发表在消化领域顶级医学期刊《Gastroenterology》上的一项里程碑式双盲对照研究：研究人员招募了一批没有乳糜泻、但坚信自己存在“非乳糜泻麸质敏感”的受试者，给他们分发外观与口味完全一致的三种特制能量棒： 1. **安慰剂能量棒**（无额外添加成分的标准棒）； 2. **高纯度麸质能量棒**（加入大量提纯麸质蛋白）； 3. **高纯度果聚糖能量棒**（加入高浓度果聚糖碳水化合物）。 实验结果出人意料：当这些受试者在不知情下食用高麸质能量棒时，其胃肠道症状甚至比食用安慰剂棒还要少；然而一旦食用含有果聚糖的能量棒，所有人均被显著触发了剧烈的腹胀、痉挛和消化道症状。这项试验证实，大众普遍指责的“麸质不耐受”，绝大多数情况下在临床上其实是**果聚糖不耐受**。 除了麦类外，大蒜与洋葱也是果聚糖浓度极高的典型食材，这也是为什么许多人一吃大蒜和洋葱便会剧烈腹胀的原因。对于果聚糖不耐受人群，如果希望在不摄入麸质与果聚糖的前提下补充优质全谷物纤维，苔麸（Teff）、苋籽（Amaranth）、高粱（Sorghum）以及藜麦（Quinoa）是理想的选择。 | 食物类型 | 麸质含量 | 果聚糖含量 | 消化道耐受度特征 | |:--- |:--- |:--- |:--- | | **常规白面包/意面** | 高 | 高 | 易引发非乳糜泻人群发酵产气与腹胀 | | **酸种面包 (Sourdough)** | 存在（部分降解） | 极低（发酵分解） | 菌群脆弱人群通常耐受良好 | | **大蒜 / 洋葱** | 无 | 极高 | 极易在结肠发酵诱发胀气反应 | | **苔麸 / 藜麦 / 高粱 / 苋籽** | 无 | 无 | 无麸质低果聚糖全谷物，刺激性极小 | --- ### [38:06](https://www.youtube.com/watch?v=5Tr7AhkOEj4&t=2286s) 肠道受损后需要多久才能修复？ 面对史蒂文提出的“肠道受损后究竟需要多久才能修复并恢复菌群”这一问题，Dr. Will 强调，修复周期完全取决于个体的病理起点和黏膜微生态的受损深度。轻度的饮食失衡引起的刺激，与严重的器质性炎症不可同日而语。在所有肠道病变中，诸如溃疡性结肠炎（Ulcerative Colitis）和克罗恩病（Crohn's Disease）等炎症性肠病（IBD）患者，其体内的菌群失调（Dysbiosis）最为根深蒂固，黏膜屏障损毁最为严重，因而这类患者的修复与微生态重建将是一个更为漫长而复杂的系统工程。 ### [38:39](https://www.youtube.com/watch?v=5Tr7AhkOEj4&t=2319s) 肠道受损的可逆性与炎症性肠病的本质 针对受损严重的肠道是否能够逆转，Dr. Will Bulsiewicz 解释说，医学上完全有可能让患者进入深度缓解期（remission），以至于不再复发。Steven Bartlett 拿起桌上的大肠解剖模型询问发作时的具体状态，Dr. Will 向听众与观众描述了模型上一处血肉模糊的区域：黏膜溃烂、剥落且渗血，极其脆弱敏感，哪怕只是受到轻微碰触就会大量出血。 在 Dr. Will 看来，炎症性肠病（IBD，如克罗恩病和溃疡性结肠炎）是典型的肠道炎症反应。但从病理机制来看，它在技术定义上并非真正的“自身免疫病”（Autoimmune disease）。自身免疫病是指人体免疫系统攻击自身的器官和细胞，而 IBD 发生的实质，是免疫系统将生活在大肠腔内的肠道微生物群（Microbiome）误认作敌人并对其发起排斥与围攻，而夹在两者之间的肠道组织不幸沦为了双方交火的战场。 ```mermaid flowchart TD accTitle: 炎症性肠病免疫失衡机制 accDescr: 展示免疫系统攻击微生物群导致肠壁受损的过程 subgraph Normal ["婴幼儿期免疫训练（0-3岁）"] A["婴儿初生微量菌群"] --> B["环境接触与经验累积"] B --> C["3岁达到成人水平菌群"] C --> D["免疫系统识别有益微生物"] end subgraph Disease ["失衡状态（IBD发病机制）"] E["免疫系统发生识别混淆"] --> F["将肠道菌群判定为入侵敌军"] F --> G["发起猛烈免疫攻击排斥菌群"] G --> H["肠壁夹在中间受到严重溃疡破坏"] end Normal -.->|后天干扰破坏| Disease ``` 人出生时体内微生物极少，但在生命的最初三年里，人类通过生活经历逐步建立起菌群，到三岁左右菌群规模与复杂度就已基本达到成年人水平。在此阶段，免疫系统正与这些微生物相互学习、共同演进。健康的幼年菌群能够塑造稳固的免疫耐受机制。一旦这个过程出现差错或后天平衡被打破，免疫系统不再承认菌群是友军，就会为了消灭它们而不惜重创肠道壁。 --- ### [41:04](https://www.youtube.com/watch?v=5Tr7AhkOEj4&t=2464s) 工业化、抗生素滥用与急剧升高的患病风险 讨论转向这些消化道溃疡和肠道病变的诱因。Dr. Will 坦承遗传基因扮演了明确的角色，这是个人无法完全左右的先决条件。Steven Bartlett 指出，从进化生物学的角度来看，人类不可能演化出一套让自己消化道严重溃烂的自毁机制。Dr. Will 对此完全赞同，并指出这类病症在过去十分罕见。 现代流行病学提供了强有力的证据：在当今第三世界国家（如非洲大陆大部分地区），克罗恩病和溃疡性结肠炎的发病率依然极低；然而，一旦国家走向工业化，其病例就会呈现爆发式增长。仅在 1970 年至 2010 年的 40 年间，美国的溃疡性结肠炎和克罗恩病确诊病例就激增了高达 55%。这类疾病可以在人生任何年龄段发生，即便眼下完全健康，某些后天行为也能迅速诱发病变。 - **抗生素的巨大冲击**：服用抗生素之后，患者在接下来一年内患上炎症性肠病的风险直接翻倍。 - **肠道屏障破坏**：抗生素会极速摧毁肠道菌群的多样性，在服药治疗期间使肠道屏障功能下降 50%，进而猛烈激活免疫系统。这种因抗生素诱发的肠道炎症风险在成人和儿童群体中均表现显著。 --- ### [43:02](https://www.youtube.com/watch?v=5Tr7AhkOEj4&t=2582s) 生死攸关的艰难梭菌感染与粪菌移植拯救案例 为了具象化肠道菌群失衡的致命危险，Dr. Will 分享了他救治一位名叫 Michelle 的女患者的惊险经历。Michelle 此前服用了克林霉素（Clindamycin，一种常用于治疗皮肤感染的抗生素）。克林霉素对肠道常驻菌群具有近乎毁灭性的清除作用，一旦原本被压制的致病菌——艰难梭菌（*C. diff*）乘虚暴增，就会引发殃及全结肠的恶性感染与剧烈肿胀。 当时 Dr. Will 正在值班室写会诊报告，突然接到紧急传呼，称刚从外院转来一名垂危患者。他扔下键盘狂奔至病房，看到 Michelle 紧抱腹部蜷缩在床上痛苦呻吟。她面色惨白、大汗淋漓、呼吸急促且心率狂飙，甚至已经出现意识不清的谵妄状态。Dr. Will 上前进行查体，只是轻轻碰了一下床架，Michelle 便因剧痛尖叫着整个人弹跳起来——这是发生急性腹膜炎（Acute abdomen/peritonitis）的典型征兆。当时她的抗生素疗法已全部耐药失效，摆在医疗团队面前的仅有两条路：立刻推入手术室切除整个大肠，或者紧急实施粪菌移植（FMT, Fecal Microbiota Transplant）尝试保住结肠。 ```mermaid flowchart LR accTitle: Michelle 紧急救治与康复流程 accDescr: 从重度艰难梭菌感染到粪菌移植后康复的过程 subgraph Crisis ["危急发病"] A["服用克林霉素"] --> B["菌群遭灭顶之灾"] B --> C["艰难梭菌暴增暴发"] C --> D["全结肠急性重度腹膜炎"] end subgraph Treatment ["紧急介入"] D --> E["弃常规手术切除方案"] E --> F["选用5-6mm超细内窥镜"] F --> G["右侧结肠精准注入粪菌悬液"] end subgraph Recovery ["惊人转机"] G --> H["菌群生态瞬间重建"] H --> I["次日神志恢复自如交谈"] I --> J["术后48小时完全达标出院"] end ``` 由于肠壁炎症极其严重，常规像食指粗细（约 1 厘米宽）的肠镜极易导致穿孔，Dr. Will 破例选用了一根仅 5 至 6 毫米宽的小号细镜。他小心翼翼地经由直肠一路深入穿过整段受损大肠，将细管送至大肠右侧回盲部，精准灌注了健康供体的粪便微生物群。治疗效果令人震撼： - 移植次日，Michelle 就彻底脱离谵妄状态，神志清醒地靠在病床上与人正常交谈。 - 仅仅两天之后，她恢复得如常人一般，顺利办理出院手续回家。 - 注入的健康菌群重新构筑起生态防线，迅速压制了艰难梭菌，使失控的免疫风暴彻底平息，结肠溃烂炎症迅速消退。 针对医院如何获取健康粪便样本的疑问，Dr. Will 透露大部分医院并不会自备冰柜储藏，而是直接从位于马萨诸塞州的专业机构调配标准化处理好的样品。此外，目前制药界正在加速研发源自这一理念的全新药物衍生物，通过非传统灌注的温和方式在肠道极度脆弱时保护并重建微生物屏障。 --- ### [47:34](https://www.youtube.com/watch?v=5Tr7AhkOEj4&t=2854s) 社交媒体极端饮食风潮的误导与迷思 话题随后延伸到当今网络文化中泛滥的饮食乱象。Steven Bartlett 询问，现在各种网红播客和博主大肆兜售果汁排毒法（Juice cleanses）及各类所谓“神奇饮食”，Dr. Will 身为消化专科医生最排斥哪些流行趋势。 Dr. Will 批判了大众健康趋势的剧烈摇摆与盲目跟风。他举例指出，2020 年前后全网几乎言必称纯素饮食（Vegan diet）；而仅仅到了 2023 年，风向就彻底倒向了几乎完全由肉类构成的纯肉饮食（Carnivore diet）。这两种饮食模式在生理机制和营养构成上完全针锋相对，却在短短两三年内先后成为大众狂热追逐的对象。普通大众渴望解决身体困扰，一旦打开社交媒体，就极容易被算法推动的极端潮流裹挟。Dr. Will 强调，与每过两三年就大幅翻转的网红饮食噱头相比，真正的肠道与营养科学在过去五年内从未发生过这种颠覆性突变，科学界对肠道健康的真实认知一直建立在严谨、稳健且循序渐进的实证基础之上。 ### [48:41](https://www.youtube.com/watch?v=5Tr7AhkOEj4&t=2921s) 极端饮食的伪科学与肠道黏膜的更新奇迹 针对大众经常在各种流行饮食指南之间被耍得团团转的现象，Dr. Will Bulsiewicz 直言，医学界对生物学核心机理的认知从来没有发生过急剧动荡的“过山车式转向”，人类的生物学构造在过去五年间也并未改变。他首先真诚地肯定了每一位敢于为了身体健康而主动调整饮食的人，认为这种探索的精神值得敬佩；但他随即指出，当下网络上流传的许多饮食流派已经走火入魔。无论是走极端的 100% 纯肉或纯动物内脏饮食（Carnivore Diet），还是另一极端的全水果饮食（Fruitarian），都彻底打破了生理平衡，绝不是延年益寿的良方。饮食越是极端苛刻，人们就越背离了最朴素真切的健康基石——“均衡摄入天然全食物（whole food in balance）”。 面对 Steven Bartlett 关于 7 天果汁排毒（Juice Diet）或清水断食（Water Fasting）的提问，Will 医生解释道，当存在肠道疾病或长期胀气不适时，这种极端断食确实会让人短时间内感到好受一些，因为你暂时撤掉了所有刺激肠道的复杂物质，然而这只是暂时减轻负担的错觉，并不代表肠道微生态得到了实质性的修复。真正令人振奋的反而是肠道超强的宽容度与自我修复速度：肠道微生物的超能力在于其惊人的增殖速度，每隔短短 20 分钟左右，它们就能完成一代细菌的繁衍；这意味着“你今天所做的饮食选择，明天就会直接映射在你的微生态中”。加之人体肠道屏障的上皮细胞每隔 3 到 5 天就会整体脱落并重建一次，只要用正确的营养原料去喂养它们，肠道健康就能以极快的速度展现出惊人的改善。 - **微生物繁衍周期**：特定肠道益生菌分裂生成新一代最快仅需约 20 分钟，调整饮食可在 24 小时内改变菌群活跃度。 - **肠道屏障更新周期**：人体的肠黏膜上皮细胞平均每 3 至 5 天完全更新换代一次，提供了快速逆转局部炎症的生理窗口。 - **极端断食的实质**：果汁断食带来的舒适感主要源自消除了促炎和刺激性食物的被动缓解，而非菌群的主动修复。 --- ### [51:41](https://www.youtube.com/watch?v=5Tr7AhkOEj4&t=3101s) 社交媒体上的“膳食纤维极致化”与三大短链脂肪酸 在谈及当下社交网络上充斥的健康误区时，Will 医生坦言自己并不热衷于刷短视频平台，但他惊喜地发现，近期 TikTok 上竟然流行起了一个非常科学且积极的健康风潮——“纤维极致化”（Fibermaxxing）。在公众忽视膳食纤维数十年之后，年轻人终于开始重新审视纤维的巨大价值，试图通过在每一餐中拉满高纤维食材，大幅突破每日推荐摄入量。Will 医生对此趋势深感欣慰，但也温馨提醒大家必须“循序渐进”，如果肠道菌群尚未适应就突然暴增纤维摄入，很容易引发剧烈胀气腹部不适，导致很多人因误解“纤维不适合我”而半途而废。 ```mermaid flowchart TD accTitle: 纤维代谢与肠道三道防御体系 accDescr: 展示摄入植物纤维后经由肠道微生物发酵转化为短链脂肪酸并全面支持人体三道防御屏障的机制流。 subgraph INTAKE ["营养摄入阶段"] A["多样化全植物食物\n(蔬果/豆类/全谷/坚果)"] -->|抗胃酸消化到达结肠| B["大肠/右半结肠微生态"] end subgraph FERMENTATION ["细菌发酵转化"] B -->|益生菌群分解纤维| C["短链脂肪酸 (SCFAs)"] C --> C1["乙酸 Acetate"] C --> C2["丙酸 Propionate"] C --> C3["丁酸 Butyrate ★"] end subgraph DEFENSE ["加固三道人体防线"] C3 --> D1["第一道防线：支持共生益生菌群繁衍"] C3 --> D2["第二道防线：合成紧密连接蛋白\n修护肠黏膜屏障"] C3 --> D3["第三道防线：安抚与调控肠壁免疫细胞\n平息慢性系统性炎症"] end ``` 这种营养意识的觉醒之所以至关重要，是因为工业化社会正面临着毁灭性的“纤维饥荒”：目前全美有高达 95% 的人群、全英有超过 90% 的人群根本达不到每日最低纤维摄入标准。膳食纤维是肠道益生菌最核心的“口粮”；当纤维与肠道微生物相遇发酵时，会生成人体内最强大的抗炎物质——短链脂肪酸（Short-Chain Fatty Acids, SCFAs），主要包括乙酸（Acetate）、丙酸（Propionate）和丁酸（Butyrate）。Will 医生引用了 1970 年代医学界著名的“泡泡男孩”（Bubble Boy，因重症联合免疫缺陷而生活在无菌隔离罩中的孩子）作为生动比喻：如果一个人体内完全无菌，吃再多纤维也无法转化出短链脂肪酸；而当今现代人的悲剧恰恰相反——我们体内坐拥着数以万亿计的微生物，却残酷地将它们活活“饿死”，没有纤维原料，它们根本“巧妇难为无米之炊”。 - **现代人群纤维缺乏现状**：美国约 95%、英国约 90% 的成年人日常膳食纤维摄入严重不足。 - **三大核心短链脂肪酸**： - **乙酸（Acetate）**：占比最高，参与全身能量代谢与外周循环调节。 - **丙酸（Propionate）**：主要参与肝脏糖异生调控与脂质代谢。 - **丁酸（Butyrate）**：结肠上皮细胞首选能源，具有最高效的抗炎和屏障修复特异性。 --- ### [54:36](https://www.youtube.com/watch?v=5Tr7AhkOEj4&t=3276s) 肠道防线运作机制：从高纤植物到丁酸的神奇抗炎力 Steven 看着录制现场餐桌上摆放的各色食材，询问哪些食物才是获取膳食纤维的最佳来源。Will 医生现场做了一个趣味互动，让 Steven 猜测满桌食材中唯一完全不含纤维的东西是什么。Steven 犹豫地排除了姜黄，Will 指出正确答案其实是“油脂”——无论是特级初榨橄榄油还是葵花籽油，由于它们是 100% 的纯脂肪提取物，按定义天然不含任何纤维（尽管特级初榨橄榄油中富含对微生态极其有益的多酚类抗氧化物质）。除油脂之外，原则其实极其清晰明了：只要是植物——水果、蔬菜、全谷物、坚果、种子以及豆类，都天然含有纤维；即使是生物分类学上属于真菌的蘑菇，也拥有类似植物的高纤维与多酚特性；而任何肉类、动物制品以及精炼纯油脂，纤维含量统统为零。 Will 医生再次串联起贯穿始终的人体“三道防御系统”模型，深入拆解了高纤食物如何拯救肠道： 1. **第一道防线**：肠道表面的共生微生物群落（即此前抗生素病例中遭受毁灭性打击的防护层）； 2. **第二道防线**：肠道屏障黏膜，由单层上皮细胞紧密咬合构成的物理长城； 3. **第三道防线**：驻扎在黏膜下方的庞大免疫系统，我们理想的状态是前两道防线固若金汤，根本无需轻易唤醒免疫军队。 当高纤维全食物滑入大肠、尤其是发酵最为活跃的盲肠与右升结肠时，细菌将其“拆解开箱”，释放出乙酸、丙酸与丁酸。在这三者之中，Will 最偏爱的正是**丁酸（Butyrate）**。丁酸是肠黏膜细胞赖以生存的核心养分，人体必须依赖丁酸的信号传导，才能足量合成缝合细胞间隙的“紧密连接蛋白”，真正焊死肠漏的缝隙；同时，丁酸能直接与免疫细胞对话，抚平其过度激惹的亢奋状态。现代社会中层出不穷的慢性炎症性疾病，其深层根源正是工业化饮食将高达 90% 到 95% 的现代人推入了无纤维供应的营养绝境，直接摧毁了体内自愈防线的能量供给。 ### [58:04](https://www.youtube.com/watch?v=5Tr7AhkOEj4&t=3484s) 纤维、原始部落研究与衰老炎症的真相 现代工业化社会中的人群摄入的膳食纤维量，甚至远远达不到身体所需的基础标准。威廉·布尔西维奇博士（Dr. Will Bulsiewicz）引用了一项极具震撼力的跨国对比研究：研究人员分析对比了意大利、新加坡这两个高度现代化地区人群与玻利维亚亚马逊流域、马来西亚两个保持狩猎采集生活方式的原住民部落的肠道微生物组。结果显示，两者之间存在着翻天覆地的差异——原住民肠道菌群的多样性极其丰富，产生短链脂肪酸（SCFA）的能力也大幅领先。 这项研究直接挑战了现代医学关于“衰老”的核心假设。通常人们认为，随着年龄增长，体内的慢性炎症水平上升是不可避免的生理自然规律。然而，在这两个原住民群体中，研究人员惊讶地发现这种现象完全不存在：无论年龄多大，原住民体内的炎症水平始终维持在极低状态。这种抗炎保护机制不仅源于他们摄入的天然完整高纤食物，更植根于整体生活方式——“日出而作，日落而息”，与部落族人保持亲密的情感连接，并且“完全不需要刷 Instagram”。反观工业化世界，严重匮乏这类滋养肠道菌群的食物，直接导致了系统性慢性炎症的蔓延。 - **对比研究样本**：工业化代表（意大利、新加坡）对比原始猎采部落（玻利维亚亚马逊原住民、马来西亚原住民）。 - **颠覆性发现**：衰老伴随炎症上升（Inflammaging）并非人类不可避免的宿命，原始部落老年人依然享有免受慢性炎症侵袭的生理保护。 - **保护性生活支柱**：极高纤维多样性、顺应昼夜节律的睡眠、紧密的部落社交支持，以及零社交媒体干扰。 ### [59:48](https://www.youtube.com/watch?v=5Tr7AhkOEj4&t=3588s) 酒精如何瞬间瓦解肠道屏障：内毒素血症实验 主持人史蒂芬·巴特利特（Steven Bartlett）顺势提问：除了饮食匮乏纤维，西方世界普遍存在的饮酒与电子烟文化对肠道微生物到底有何危害？毕竟在大众讨论中，极少有人将酒精与肠道菌群直接联系在一起；史蒂芬甚至打趣道，往嘴里倒伏特加是不是相当于把口腔菌群全灭了。布尔西维奇博士对此表示赞同，指出这就像使用含酒精漱口水一样有害，而医学界如今早已不再推荐使用此类漱口水。 博士透露，正是一项极其扎实的临床研究彻底颠覆了他对饮酒的看法，促使他几乎戒掉了所有酒类（如今仅在与妻子共进特别晚餐时偶饮一两杯）。在该实验中，研究人员让受试者饮用一定量的烈酒，并随后每隔 30 分钟同步监测两项关键指标：血液酒精浓度，以及血液中的脂多糖（LPS，Lipopolysaccharide）。脂多糖是肠道内炎性革兰氏阴性菌外壁的成分，在健康状态下绝不可能穿透肠壁进入血液循环。人体免疫系统早已被进化设定为将脂多糖识别为“头号公敌”，一旦其漏入血液，就会立刻引爆全身性免疫警报与炎症级联反应。 实验记录下了令人心悸的平行曲线：随着血液酒精浓度上升，血液中的脂多糖浓度呈现出完全一致的飙升走势；当酒精浓度达到顶峰，脂多糖浓度也同时见顶。甚至在实验过程中出现了一个奇特波折——受试者的酒精浓度在开始下降后出现了一次微小的反弹回升，而血液中的脂多糖浓度竟然丝毫不差地同步发生了二次反弹。最终，直到受试者体内的血液酒精浓度彻底归零，血液中的脂多糖才重新恢复到正常水平。这项实验铁证如山地表明：酒精会直接诱发肠漏（Leaky Gut），而且只要血液中存在可测量的酒精，肠道屏障的失调与内毒素渗漏就会持续存在。正因如此，布尔西维奇博士坦言：“我不认为存在任何安全的饮酒量。” ```mermaid flowchart TD accTitle: 酒精导致肠漏与全身炎症的过程机制 accDescr: 流程图展示了从摄入酒精、肠壁受损、内毒素入血到引发全身免疫炎症的完整链路。 subgraph GutProcess["肠道屏障受损"] A["摄入酒精"] --> B["削弱破坏肠壁紧密连接"] B --> C["诱发严重肠漏状态"] end subgraph ToxinTranslocation["内毒素入血"] C --> D["炎性菌外壁脂多糖 (LPS) 渗透"] D --> E["LPS 浓度与血液酒精同步波动"] end subgraph SystemicImpact["全身反应与清除"] E --> F["免疫系统拉响警报（视 LPS 为公敌）"] F --> G["触发全身性慢性炎症"] H["酒精代谢归零"] -.-> I["肠道屏障逐步自我修复恢复"] end ``` ### [01:02:33](https://www.youtube.com/watch?v=5Tr7AhkOEj4&t=3753s) 从肠漏到肝硬化：海绵变塑料的致命演变 史蒂芬进一步总结道：酒精入体引发肠道屏障崩溃，导致肠道功能紊乱，而这种紊乱会伴随酒精代谢持续存在。布尔西维奇博士确认了这一核心机制，并指出酒精诱发肠漏的程度与血液酒精浓度严格成正比。对于长期重度酗酒者而言，其肠道微生态和肠壁屏障往往处于被“彻底摧毁”的状态。在病理学上，肠道屏障的瓦解是通往酒精性肝病以及最终发展为肝硬化（Cirrhosis）不可逾越的必经阶段。 博士向史蒂芬深入剖析了肝脏的解剖学位置与生理防线作用：肝脏位于人体右上腹，是血液循环的核心解毒器官。从人体消化道吸收的所有静脉血液，经由门静脉系统回流至心脏之前，第一站必须先流经肝脏。这一人体解剖设计极其精密高明，目的就是设立一道防火墙，阻止任何消化吸收过程中混入的毒素直接进入心脏并循环泵向大脑。 为了形象地解释肝硬化的本质，布尔西维奇博士打了一个精妙的比喻：正常的健康肝脏质地柔软、富有弹性且多孔，就像一块放在水龙头底下的海绵，水流注入一端后，能顺畅地穿透过滤并从另一端流出；然而一旦发展成肝硬化，这块柔软的海绵就会纤维化、彻底硬结，变成一块“毫无通透性的实心塑料块”，任何血液都无法正常穿透流过。博士强调，包括肝硬化在内的所有肝纤维化疾病，本质上都是慢性炎症催生的恶果，属于与炎症相关的 130 多种健康疾病之一；而最新科学数据清晰地证明，要引发导致肝硬化的严重肝脏炎症，前端肠道微生物组与肠道屏障的失守是不可或缺的起点。 - **肝脏门静脉守卫机制**：肠道吸收的所有血液首先泵入肝脏解毒，严防肠道毒素直通心脏与大脑神经系统。 - **生动器官比喻**：健康肝脏如同湿润柔软的多孔海绵，而硬化病变后的肝脏宛如坚硬致密的实心塑料。 - **致病因果逻辑**：长期酗酒引发肠道微生态崩解与慢性肠漏，内毒素随血流源源不断冲击肝脏，最终促成不可逆的纤维化与肝硬化。 ### [01:05:22](https://www.youtube.com/watch?v=5Tr7AhkOEj4&t=3922s) 中场商业赞助：Stan 与 Adobe Express 播客在此处切入商业赞助环节。首先，主持人史蒂芬介绍了自己共同持股的创作者变现平台 Stan。他提到当前许多人都在寻求副业和被动收入以应对经济账单，Stan 为想要自主创业的人群提供了极简工具，支持销售数字产品、在线课程及会员订阅服务。史蒂芬同步预告了即将上线的“敢于梦想”（Dare to Dream）挑战赛，鼓励用户将脑海中的想法付诸行动，发布视频分享自己的创业梦想即有机会赢取 10 万美元大奖。 随后，史蒂芬分享了他使用赞助商 Adobe Express 制作第三本新书封面的创作体验。他表示自己虽然尚未敲定书名，但已在利用该工具微调排版、字体、颜色以及文字布局等常人看似琐碎、实则至关重要的设计细节。史蒂芬提到，他在 Adobe Express 中搭建了“One Better Guide”，将业内顶尖团队的设计经验与原则提炼为易操作的实用方法，听众可访问专属链接下载体验。 ### [01:07:11](https://www.youtube.com/watch?v=5Tr7AhkOEj4&t=4031s) 争议抗炎香料：姜黄素（Turmeric）的真相与误区 回归节目录制现场，史蒂芬将视线转向演播室桌面餐盘里放置的一种橘黄色香料——姜黄（Turmeric）。史蒂芬坦言，在当今探讨对抗全身炎症的话题时，姜黄几乎是出镜率最高、被宣传得最神奇的超级成分，但他始终摸不清关于姜黄与抗炎之间究竟有多少是真凭实据，又有多少是夸大宣传。 布尔西维奇博士微笑着肯定了姜黄的独特性，但一开口便给出了出人意料的审慎警告：“你必须保持一点谨慎，因为在这个成分上你很容易摄入过量。”史蒂芬闻言大感意外。博士解释道，关于姜黄的真实抗炎效力，关键在于公众应当以科学、聪明的方式去对待它；大众真正需要厘清的，是在日常长期稳定摄入的场景下，如何平衡其效用与身体负荷。 ### [01:07:44](https://www.youtube.com/watch?v=5Tr7AhkOEj4&t=4064s) 姜黄素与多酚：肠道微生物如何激活天然抗炎力量 谈及对抗慢性炎症性疾病，姜黄（Turmeric）是一种常被提及却往往被误解的天然香料。针对“姜黄究竟如何降低炎症”的疑问，Will Bulsiewicz 博士用之前的“对讲机与拔电池”比喻进行了解释：免疫细胞通过细胞因子进行通信，而姜黄中的有效成分正是通过阻断某种特定的促炎细胞因子，起到拔掉对讲机电池的作用。 严格来说，姜黄本身是一种植物根茎，而真正发挥生物活性的植物化学物是**姜黄素**（Curcumin）。姜黄素属于**多酚**（Polyphenols）类化合物。面对桌前摆满的五颜六色的植物性食物，Bulsiewicz 博士强调，正是多酚赋予了植物缤纷的色彩，并深远影响着肠道健康。例如，洋葱和大蒜富含广为人知且有益长寿的槲皮素（Quercetin），不同颜色的食物对应着不同类别的多酚。 至关重要的一点在于：植物中 **95% 的多酚无法被人体直接吸收**，必须依赖肠道微生物的代谢与发酵才能被真正“激活”并转化成具有抗炎、抗衰老作用的活性分子。与此同时，博士也特别提醒，使用姜黄素高剂量补充剂时务必谨慎，过度摄入反而可能对身体带来负担或引发不良反应。 ```mermaid flowchart TD accTitle: 多酚在肠道中的激活与抗炎机制 accDescr: 展现植物多酚进入人体后经肠道菌群转化代谢为抗炎活性物质的生化路径 subgraph Intake ["植物性摄入"] A["摄入富含多酚的天然食物<br/>(姜黄/洋葱/大蒜/彩虹果蔬)"] end subgraph GutActivation ["肠道微生态加工"] B["95% 多酚无法直接吸收<br/>抵达结肠"] C["肠道有益微生物群菌群发酵代谢"] B --> C end subgraph Action ["全身效应"] D["产生活性抗炎代谢产物"] E["阻断特定促炎细胞因子通信<br/>(类似于'拔掉发炎对讲机的电池')"] D --> E end A --> B C --> D ``` --- ### [01:09:10](https://www.youtube.com/watch?v=5Tr7AhkOEj4&t=4150s) 昼夜节律与肠道：开启“完美肠道日”的早晨节律 随后，Steven Bartlett 拿出一份日程表，请博士一步一步拆解如何度过一个“完美的肠道日”（Perfect Gut Day）。Bulsiewicz 博士指出，要优化肠道微生态，首先必须理解人类与生俱来的**昼夜节律**（Circadian Rhythm）。人类的身体是在与太阳升起和落下的协同中演化而来的，大自然万物都与太阳的运转规律紧密相连。 人体的生物钟深刻支配着内部的生理运转： - 人体内约有 **50% 的基因表达**会根据昼夜节律在每天的特定时间段开启或关闭。 - 超过 **50% 的肠道微生物**丰度与活性在一天中会随着时间规律性地起伏波动，以适应当下的身体代谢需求。 - 人体的免疫与代谢系统极度依赖“规律性”（Consistency）。构建一个能够最大化肠道菌群活力的日常作息，关键就在于守住稳定的节律。 以早晨 7:00 太阳升起、自然醒来为例： - **07:00 - 07:05**：刚醒来的前 5 分钟，博士建议不要急于跳下床或翻看手机，而是保持平静，在脑海中梳理并构想即将展开的新一天。 - **07:05 - 07:15**：唤醒肠道的第一步是**补水**，而非咖啡。“起床后切勿立即喝咖啡。”在醒来后 5 分钟左右，应当摄入一杯温水，迅速启动脱水一整夜的肠道、大脑与肾脏。最理想的做法是在水中加入一勺益生元纤维粉（例如他参与创办的 38 Terra 或其他优质纤维补充剂），在身体刚苏醒的时刻直接为肠道有益菌群提供优质“饲料”。 --- ### [01:12:01](https://www.youtube.com/watch?v=5Tr7AhkOEj4&t=4321s) 唤醒大脑主钟与皮质醇高峰：阳光与晨间运动的双重杠杆 到了早晨 07:15，必须为身体按下“新的一天正式启动”的物理开关。博士坦言，如果整套日常习惯中只能让大家带走一条建议，那就是在这个时间节点利用好激活昼夜节律的两大终极杠杆：**光照**与**运动**。 人脑中负责统一协调全身生物钟的指挥中枢是**视交叉上核**（Suprachiasmatic Nucleus，简称 SCN）。光线穿过眼睛投射在视网膜上，视神经收集左右眼视野信息的交汇核心点正是 SCN。博士打了个生动形象的比方：“这就像我们小时候上学，每个人手腕上都戴着一块手表，这好比你的心脏、肝脏、肠道以及半数以上的微生物，它们各自揣着小手表感知大概的时间。但真正决定全校步调整齐划一的，是教室走廊里上下课打响的中央电铃——SCN 就是那口总铃。” 晨间光线激活 SCN 后，会促发体内的连锁神经内分泌反应，使早晨的**皮质醇**（Cortisol）迎来健康的高峰峰值： - 皮质醇作为“清晨激素”，负责调动细胞能量、促进蛋白质可用性、提高大脑专注力与警觉度，并适度暂时抑制免疫系统的多余消耗。 - **杠杆一：清晨阳光**。仅需接受户外的自然光照（即使是阴天），体内的晨间皮质醇峰值就能**提升约 50%**。如果佩戴近视眼镜或太阳镜，应暂时摘下镜片，无需直视太阳，让自然散射光线充分进入视网膜。若在阴暗寒冷的冬季（如 1 月份）无法出门，可以使用强度达到 **10,000 勒克斯（lux）的光照疗法灯箱**作为替代。 - **杠杆二：轻度运动**。在 07:15 至 07:35 的 20 分钟内，结合温和运动（例如在好天气里穿上负重马甲 Ruck Vest 户外散步，或在室内灯箱前做自重深蹲、箭步蹲、俯卧撑、开合跳或瑜伽），运动能使皮质醇水平在光照基础上**再额外提升 25% 至 50%**。 这种双重叠加效应能帮助机体建立高耸且规律的晨间皮质醇峰值，不仅能成倍提升白天的认知耐力与专注力，更会在当天入夜后直接转化为高质量的深度睡眠，“只要试上一天，当晚就能立刻感受到睡眠的显著改善”。 --- ### [01:15:59](https://www.youtube.com/watch?v=5Tr7AhkOEj4&t=4559s) 切换副交感神经与清晨第一餐：咖啡、冥想与早餐策略 在完成了 20 分钟的晨光沐浴与轻度身体活动后，时间来到 07:35。此时返回室内，才是享用当天第一杯咖啡的绝佳时机，同时这也是一天中必不可少的“静心时间”（Quiet Time）。 现代社会的生活节奏极度紧张，人们的大脑几乎全天处于过载状态。人体的自主神经系统包含两个对立统一的分支： - **交感神经系统**（Sympathetic Nervous System）：好比汽车的“油门”，负责应对压力、提高心率与进入战斗/逃跑状态。 - **副交感神经系统**（Parasympathetic Nervous System）：好比汽车的“刹车”，负责消化吸收、组织修复、心神宁静与休息恢复。 早晨 07:35 至 07:45 这 10 分钟里，应当有意识地踩下刹车，主动激活副交感神经。可以一边品尝咖啡，一边进行呼吸练习、正念冥想、阅读圣经或写感恩日记。 到了 07:45，正式进入**早餐**时间。Steven Bartlett 追问是否必须吃早餐、早餐该怎么吃以及采用何种策略，Bulsiewicz 博士斩钉截铁地回答：“绝对应该吃早餐！”因为人体的代谢能力具有鲜明的时间生物学特性，在一天的不同时段，身体处理卡路里、胰岛素敏感度以及肠道蠕动吸收效率截然不同，而早晨正是开启全天代谢和摄入核心膳食补充剂的黄金窗口。 ### [01:17:41](https://www.youtube.com/watch?v=5Tr7AhkOEj4&t=4661s) 早餐代谢黄金期：高纤维、适度蛋白质与告别精制碳水 人体代谢能力在清晨处于一天中的巅峰状态。这意味着即使在早晨 7:45 和下午 3:00 摄入完全相同的食物，早晨进食也能带来显著更优的血糖控制与血脂调节能力。这种代谢优势决定了健康饮食的核心策略之一：尽可能将摄食窗口向一天中的早起时段前移。 关于早餐的具体构成，Dr. Will 倡导“高纤维、适度蛋白质、极低糖或无糖”的组合，并坚决排除精制碳水化合物（如精制面粉与添加糖）。当主持人询问各种常见早餐时，Dr. Will 明确表示应放弃各类烘焙糕点，就连可颂面包他也风趣地评价道：“它们确实很美味，但我还是选择不吃。”唯一的折中方案是选用天然酸酵面包制作鳄梨吐司。高纤维与适度蛋白质的黄金搭配能带来长久饱腹感，既满足肌肉组织对蛋白质的需求，又为肠道菌群注入充足燃料。关于燕麦，鉴于草甘膦农药残留的隐患，必须优先选择有机且加工度最低的原粒燕麦，尽量避免过度加工的速溶燕麦。 - 早餐代谢机制：清晨同等热量食物诱发的血糖与血脂波动明显低于午后。 - 营养黄金配比：高膳食纤维 + 适量优质蛋白 + 极低/零游离糖。 - 碳水避坑指南：坚决摒弃精制面粉与烘焙甜点；燕麦需认准“有机”与“非速溶”。 --- ### [01:19:27](https://www.youtube.com/watch?v=5Tr7AhkOEj4&t=4767s) 给孩子的健康早餐：言传身教与规避“糖水陷阱” 谈到儿童早餐时，主持人分享了自己的童年经历——长辈过去总以为喝橙汁很健康，直到长大后才意识到市售橙汁本质上就是一整杯高糖水。Dr. Will 对此深表认同，并指出引导孩子建立健康饮食习惯最核心的法则在于父母的言传身教：“你必须亲自为孩子示范一顿健康的早餐是什么样子，因为如果你自己都不吃，就绝不能指望孩子会主动去吃。” 作为四个孩子的父亲，Dr. Will 分享了自家餐桌上的健康常客：孩子们非常喜爱的鳄梨酸酵吐司、无糖酸奶配新鲜浆果与坚果碎，以及隔夜燕麦杯和奇亚籽布丁。这些食物不仅准备简单，而且天然富含多样化的植物化学物质与益生元纤维，能从小培养孩子的天然味觉偏好，避免高糖加工食品对幼小肠道菌群与代谢机能的早期冲击。 - 育儿首要准则：父母自身践行健康饮食是培养孩子良好习惯的前提。 - 儿童优质早餐备选：鳄梨全麦/酸酵吐司、无糖原味酸奶搭配低糖浆果与坚果、奇亚籽布丁、隔夜冷泡燕麦。 - 警惕果汁误区：过滤掉纤维的鲜榨或浓缩果汁属于高吸收率的游离糖，与饮用含糖饮料无异。 --- ### [01:20:32](https://www.youtube.com/watch?v=5Tr7AhkOEj4&t=4832s) 肠道与免疫的最初三年：母亲、分娩与母乳中的 HMOs 人体肠道与免疫系统的紧密联结早在出生前便已奠定，婴儿生命最初的 1000 天（前 3 年）更是一生免疫健康的决定性窗口。研究表明，分析母亲孕期的肠道菌群样本，便可预测其子女未来罹患过敏性疾病的风险轨迹；而孕期增加膳食纤维摄入的母亲，其新生儿日后出现过敏反应的概率大幅降低。 婴儿早期的三类常见经历会对肠道微生物与免疫发育造成深远冲击：抗生素暴露、配方奶人工喂养以及剖宫产分娩。Dr. Will 坦言虽然并非初衷，但自己的四个孩子都是剖宫产出生。剖宫产剥夺了婴儿经由产道获得母亲阴道及肠道菌群垂直传递的机会，而母乳喂养则能为婴儿接种母亲皮肤表面的微生物。更为关键的是，人类母乳在进化中孕育了 200 多种母乳低聚糖（HMOs）。这些复杂的寡糖对婴儿身体没有任何直接营养价值，大自然设计它们的唯一目的，就是充当极其精准的“专属益生元”，定向培育婴儿肠道中的有益菌。相比之下，配方奶粉即使额外添加纤维，也通常只是单一维度的添加剂，完全无法匹敌天然 HMOs 的多样性。 ```mermaid flowchart TD accTitle: 婴儿期肠道免疫发育通路 accDescr: 展示影响婴儿肠道菌群发育的关键环境因素及其对短链脂肪酸生成和过敏风险的后续影响。 subgraph Inputs["关键早期暴露因素"] C["分娩方式<br/>(自然分娩 vs 剖宫产)"] F["喂养方式<br/>(母乳200+种HMOs vs 瓶喂单一配方)"] A["药物暴露<br/>(1岁以内抗生素使用)"] end subgraph GutImpact["12月龄肠道菌群状态"] Microbiome["微生物多样性建立"] SCFA["产短链脂肪酸菌群<br/>(丁酸/乙酸/丙酸)"] end subgraph HealthOutcome["5岁期临床结局"] Immune["免疫耐受失调<br/>(过敏性鼻炎/湿疹/食物过敏/哮喘)"] end C --> Microbiome F --> Microbiome A --> Microbiome Microbiome --> SCFA SCFA -- "丁酸水平匮乏" --> Immune ``` 芬兰一项追踪约 1100 名儿童长达 5 年的里程碑式队列研究证实了这一机制。科研人员在婴儿 3 个月和 12 个月大时采集粪便标本，并持续追踪其湿疹、食物过敏、哮喘及过敏性鼻炎等病症的发展。研究发现，一岁内使用抗生素和完全配方奶喂养是预测过敏性疾病发生的核心危险因素。在 12 个月大且尚未表现出任何临床过敏症状的幼儿粪便中，研究人员就已经能清晰辨别出发病儿童的特殊微生态特征：他们普遍极度匮乏能够发酵纤维并生成短链脂肪酸（尤其是丁酸、乙酸和丙酸）的有益细菌，粪便中的丁酸浓度显著低下。肠道菌群过早缺失代谢关键营养素的能力，最终导致免疫系统陷入混乱状态。 - 关键窗口期：生命早期前 3 年是肠道微生物架构和免疫系统“受训”的核心阶段。 - HMOs 进化奇迹：母乳含有 200 余种不同结构的母乳低聚糖，专职喂养婴儿肠道益生菌，不供给婴儿本体能量。 - 芬兰 1100 人队列数据：1 岁内接触抗生素及缺乏母乳喂养，直接导致 12 月龄粪便中产丁酸菌匮乏，显著预测 5 岁前湿疹与哮喘发病。 --- ### [01:25:09](https://www.youtube.com/watch?v=5Tr7AhkOEj4&t=5109s) 完美晨间闭环：抗炎补剂、昼夜节律与关键的清晨排便 早晨 7:45 享用完高纤维无糖早餐后，正是一天中随餐补充抗炎补剂的黄金时机。Dr. Will 推荐的三大具备坚实科学证据支持的晨间补剂为：维生素 D、Omega-3 脂肪酸以及姜黄素。他特别强调，营养补充不应盲从，有条件者应先行接受血液或生物标志物检测，仅在确认缺乏时再针对性补充。更重要的是，补剂的摄入必须遵循严格的昼夜节律，在每天固定的时间点服用，因为人体细胞与肠道微生物的生理代谢机制均高度依赖规律与秩序。 早餐与补剂摄入完毕后，正值起床后约一小时——这是一天中最适宜完成一次畅快排便的时刻。Dr. Will 将早晨这次高质量的排便形容为前序所有努力的“终极成果体现”：晨起的第一缕自然光照、适度运动的机械刺激、早餐后激发的胃结肠反射，以及晨间咖啡的生理促动，诸多元节律叠加共同促成了肠道的顺畅蠕动。一次规律顺畅的排便，正是肠道菌群与内脏神经系统节奏协调一致、机能健康的最好证明。至此，一个充满活力的早晨正式收官，紧接着便可开启专注的工作，并在中午 12:00 步入午餐时段。 - 晨间循证抗炎补剂：维生素 D、Omega-3 不饱和脂肪酸、姜黄素（建议按需检测，避免盲目过量）。 - 昼夜节律同步法则：固定时间服药与补充营养剂，契合菌群代谢周期。 - 晨间完美排便四联动力：晨光照射调相 + 唤醒运动 + 咖啡刺激 + 早餐触发的胃结肠反射。 ### [01:27:10](https://www.youtube.com/watch?v=5Tr7AhkOEj4&t=5230s) 社交连接、孤独感与脑肠轴的隐形杀伤力 现代人往往习惯一边低头刷手机一边草草把饭咽下，彻底丧失了在餐桌上面对面交流的机会。Will Bulsiewicz 博士指出，这种与他人的社交联结绝非可有可无的消遣，而是直接关乎肠道炎症与生命周期的关键机制。早在疫情暴发之前，全美就有高达 50% 的人饱受孤独感困扰，而疫情无疑让这一危机雪上加霜。从流行病学和健康寿命（Longevity）的角度来看，“孤独对健康和长寿的破坏力，几乎超过了其他任何事物”，其危害程度已被证实完全等同于长期抽烟。 当 Steven 澄清孤独应被定义为“内心与外界失联的疏离感”，而非单纯“物理上的独处”时，Bulsiewicz 博士深表赞同，并从人类进化史拆解了其中的生理学渊源。在数百万年的漫长岁月中，人类以狩猎采集者的部落形式生存繁衍。彼时世上根本没有金钱，“财富的真正货币就是你与他人建立的纽带”。家族越大、部落成员协作越紧密，生存几率就越高。部族并非社交媒体上成千上万的虚拟符号，而是由几个家庭组成的真实集体，成员之间有着同生共死的防御默契。 倘若一个人脱离群体陷入孤立，身体就会启动原始的自保警戒机制：你无法安心进入深度睡眠，必须时刻警惕四周潜伏的危险。这种深刻的脆弱感和不安全感会诱发强烈的皮质醇应激反应，通过“脑肠轴”（Brain-Gut Axis）直接重创肠道菌群，激化全身慢性炎症。人类对社交连接的渴求如此深入骨髓，以至于在被剥夺社交时，禁闭独处成了最严酷的酷刑；甚至在斯德哥尔摩综合征中，被绑架者为了生存也会本能地主动去与绑架者建立情感纽带。 ```mermaid flowchart TD accTitle: 孤独感与脑肠轴影响路径 accDescr: 展示从孤独感知到皮质醇分泌、肠道菌群失衡及全身炎症的因果演变链条。 subgraph Mind["心理感知与本能反应"] A["缺乏面对面社交联结<br/>（内心断联与孤独感）"] --> B["激活原始自保机制<br/>（感觉脆弱、不安全）"] end subgraph StressAxis["神经与内分泌级联"] B --> C["下丘脑-垂体-肾上腺轴激活<br/>（皮质醇持续飙升）"] C --> D["脑肠轴信号传导失调"] end subgraph GutImpact["生理与肠道病变"] D --> E["肠道菌群紊乱与屏障受损"] E --> F["全身慢性炎症上升<br/>（健康危害堪比每日吸烟）"] end ``` --- ### [01:30:48](https://www.youtube.com/watch?v=5Tr7AhkOEj4&t=5448s) 完美的午餐与餐后漫步：控糖、血清素与抹茶策略 基于孤独感的流行病学危害，Bulsiewicz 博士建议将午餐打造为一个真正的社交节点，而非 10 分钟匆匆打发的任务——腾出大约 45 分钟，坐下来与同伴边吃边聊。用餐完毕重返工位之前，务必走到户外散步 10 到 15 分钟。这看似简单的习惯蕴含着巨大的生理重塑作用： 正午到午后的阳光光谱与清晨有所不同，能够更有效地刺激机体合成并在稍后释放血清素（Serotonin），从而提振情绪、强化专注力，并二度锚定昼夜节律（Circadian Rhythm）。在代谢方面，饭后哪怕仅仅散步 10 分钟，双腿大肌群的收缩就能像海绵一样将葡萄糖直接从血液中抽离，带来 30% 到 40% 的血糖控制改善。如果某顿饭不小心吃撑了，千万不要瘫倒在沙发上，强迫自己出门走走是快速摆脱不适的最佳方法。此外，漫步能物理性地带动肠道律动，显著消除餐后腹胀。 回到办公室进入下午（约下午 1:00）时，他强烈推荐饮用一杯抹茶（Matcha Green Tea）。在所有茶饮中，抹茶的多酚（Polyphenols）含量首屈一指，不仅是肠道有益菌群极佳的能量来源，还能为下午的清醒状态提供温和而持久的支撑。 - **45 分钟社交午餐**：远离手机屏幕，通过面对面对话缓解心理孤立与压力水平。 - **10–15 分钟午后户外漫步**：调节生物钟、提升血清素，并将餐后血糖峰值降低 30% 至 40%，有效缓解腹胀。 - **抹茶多酚补给**：以自然界最高浓度的茶多酚滋养肠道菌群，提供平稳提神效果。 --- ### [01:33:06](https://www.youtube.com/watch?v=5Tr7AhkOEj4&t=5586s) 运动的黄金窗口与深宵训练的代价 谈到运动时机，Bulsiewicz 博士指出下午 3:00 至 6:00 是全天锻炼的黄金窗口期。这背后是核心体温（Core Body Temperature）的周期节律在起作用：人类体温在夜间降到最低，清晨开始稳步回升，并在下午 3 点至 6 点之间达到全天顶峰。这一时段肌肉弹性、神经反应与力量表现均处于最佳状态，是进行大重量力量训练或高强度冲刺的理想时段。 Steven 苦笑着坦白自己被博士书中的一段话“精准冒犯”：书中严正告诫切勿在深夜进行剧烈运动，因为这会大幅激活交感神经系统（Sympathetic Nervous System），严重破坏迅速入睡的能力。Steven 承认自己前一晚正是从晚上 11 点练到午夜，导致睡眠彻底崩盘。 Bulsiewicz 博士强调，剧烈力量训练或高强度有氧至少要在睡前两小时彻底结束，给交感神经向副交感神经转换留出缓冲期。如果是轻柔的舒展或散步则无伤大雅，但高负荷训练若堆积在深夜，代谢亢进与心率飙升必然会让睡眠质量全面溃败。 --- ### [01:34:43](https://www.youtube.com/watch?v=5Tr7AhkOEj4&t=5683s) 四小时进餐间隔与肠道“清道夫波”（MMC） 博士为一天构建了规律的饮食时间轴：早晨 8:00 左右早餐，中午 12:00 午餐，傍晚 5:00（在下午 4 点完成一小时高质锻炼后）进食晚餐。这三餐之间均自然隔开了约 4 个小时，而这正是肠道消化生理学上的关键间隔。 在非进食的空窗期，小肠会自发启动一种鲜为人知却至关重要的运动模式——**移行性复合运动**（Migrating Motor Complex，简称 MMC）。MMC 宛如小肠内的“自动清扫巡逻车”，会通过周期性、强有力的推进性蠕动波，将上一餐未消化的食物残渣、脱落细胞和多余的共生细菌彻底清扫下行推入大肠，保持小肠环境的相对纯净。 然而，一旦在两餐之间随意抓取零食咀嚼吞咽，哪怕只有几口，进食信号就会立刻掐断 MMC 的运作，清扫程序随即停摆。长此以往，残渣与细菌在小肠滞留，极易诱发小肠细菌过度生长（SIBO）以及饭后腹胀不适。只要坚定保持每餐之间 4 小时的空白窗口，肠道便能遵循固有的节律完成自洁，消化感受会迎来立竿见影的改观。随着下午 5 点晚餐结束，晚间 7 点夜幕降临，居家环境便应随之调暗灯光，向身体发出准备进入夜间修复的生理信号。 ### [01:36:03](https://www.youtube.com/watch?v=5Tr7AhkOEj4&t=5763s) 晚间节律：光线、褪黑素与睡前准备流程 在建立完美肠道日的一天中，晚间的安排对于整体健康至关重要。Will Bulsiewicz 医生指出，进入夜晚的第一步是主动减少个人的光线暴露。很多人并不在意家里的日常照明，但即使是室内普通的灯光，也足以让体内的褪黑素水平骤降 30%。褪黑素作为掌管睡眠的核心激素，与早晨主导清醒的皮质醇形成鲜明对比。早晨通过接触阳光和进行晨练，不仅能激发早期的皮质醇高峰，还能大幅提升血清素（serotonin）水平。血清素作为带来愉悦与专注的“快乐激素”，正是褪黑素的生物合成前体。因此，早晨在光照和运动上的投入，实际上是在为 14 小时后的优质深度睡眠做准备。 随着夜幕降临，体内的褪黑素本应自然攀升，因此我们必须主动保护这一机制。如果设定的就寝时间是晚上 10:00，那么最迟在晚上 8:00 就应该开始调暗全屋的灯光，减少电子设备的使用，或者佩戴防蓝光眼镜（blue light blocking glasses）来阻隔光线干扰。到了大约晚上 8:30 至 9:00，则是补充晚间营养补剂的最佳窗口期——早晨补充的是维生素 D、Omega-3 和姜黄，而晚间则应摄入锌（Zinc）和镁（Magnesium），若有需要也可在此刻服用褪黑素或其他助眠补剂，因为这些补充剂通常需要 60 到 90 分钟才能真正发挥效用。 ```mermaid flowchart TD accTitle: 晚间就寝准备时间线 accDescr: 展示从晚上8点调暗光线到晚上10点入睡的具体时间节点与对应行动。 subgraph EveningRoutine["晚间节律推进（以22:00就寝为例）"] A["20:00 减少光照<br/>调暗灯光 / 远离屏幕 / 佩戴防蓝光眼镜"] --> B["20:30 - 21:00 晚间补剂<br/>摄入锌、镁或褪黑素（需60-90分钟起效）"] B --> C["21:00 晚间仪式<br/>独处放松，激活副交感神经系统"] C --> D["21:30 睡前准备<br/>热水澡或桑拿（促使核心体温下降）"] D --> E["22:00 准时就寝<br/>保持卧室凉爽黑暗，维持固定作息时间"] end ``` 到了晚上 9:00，必须启动专属的晚间仪式。正如早晨需要一段安静时光来开启一天，夜晚同样需要一段宁静的独处时间，有意识地激活副交感神经系统（parasympathetic nervous system），让身心完全松弛下来。9:30 左右可以洗个热水澡或蒸桑拿，这种看似让身体发热的行为，实际上通过体表血管扩张加速散热，反而能促使人体核心体温下降，而偏凉的核心体温正是诱发深度睡眠的关键。最后，在凉爽且黑暗的卧室中于 10:00 入睡。Bulsiewicz 医生特别强调，10:00 本身并非具有魔力的绝对数字，真正的核心在于“一致性”（consistency）——无论是选择 10:00、10:30 还是 11:00，只要长年累月在同一时刻入睡，身体节律就会形成完美的稳态。 - **光照干扰**：室内普通照明即可让褪黑素分泌量锐减约 30%。 - **生化链条**：早晨光照与运动促进血清素合成，而血清素随后在夜间转化为褪黑素。 - **补剂分工**：早晨使用维生素 D、Omega-3 和姜黄，晚间换用锌与镁（及适量褪黑素）。 - **睡眠环境**：利用睡前热水浴降低核心体温，并确保卧室环境“黑暗且凉爽”。 --- ### [01:39:10](https://www.youtube.com/watch?v=5Tr7AhkOEj4&t=5950s) 限时进食与肠道休息的真相 当 Steven 问及是否推荐每日三餐以及断食窗口的意义时，Bulsiewicz 医生从消化生理学层面解析了限时进食（time-restricted eating）的价值。如果一个人在晚上 6:00 结束晚餐，次日早晨 8:00 吃早餐，便自然形成了 14 个小时的断食窗口。对于肠道而言，只要断食时间超过 12 小时，就能给予消化系统充足的休整与修复时间。在这个过程中，Bulsiewicz 医生明确指出，断食时长本身可以讨论，但唯一的绝对底线是“杜绝深夜进食”（late-night eating）。 深夜进食在代谢层面对身体造成的打击是极其沉重的。深夜摄入的能量不仅会打乱代谢机制并持续波及次日全天的状态，还会严重破坏睡眠架构。很多时候人们在深夜感到饥饿，往往是因为早晨跳过了早餐、进食时间整体后移所导致的连锁反应。按时吃一顿优质的早餐能为全天的能量和食欲定下平稳的基调。此外，限时进食最被低估的一大益处是它能倒逼人们保持规律的就餐时间。昼夜节律的核心法则就是“一致性”，每天在固定时间吃饭，肠道消化机能的改善会立竿见影。 在谈及自身习惯时，Bulsiewicz 医生坦承自己也并非完人，平时由于工作节奏极快，早晨常常在做完晨间流程、喝完咖啡后就直接投入高强度工作而略去早餐，有时甚至会采用一日一餐（OMAD）模式。但他发现，在周末或者像录制这期重要节目的当天，一旦认真吃了早餐，全天的饥饿感会明显减弱，整个人处于更加充沛和平衡的状态。 - **肠道休整底线**：超过 12 小时的断食窗口即可为肠道提供至关重要的修复间隙。 - **深夜进食代价**：扰乱代谢稳态、降低睡眠质量，并对次日的生理机能产生持续负面影响。 - **规律进食效应**：限时进食最核心的价值在于规范每日就餐节点，建立稳定的消化生物钟。 --- ### [01:42:08](https://www.youtube.com/watch?v=5Tr7AhkOEj4&t=6128s) 赞助商与特别项目播报 在节目的中插环节，主持人 Steven Bartlett 介绍了近期团队的内部创新实践以及播客特别周边的最新动态。 - **Fiverr Pro 合作项目**：Steven 分享了上个月为内部创新团队“Flight X”设立的挑战，旨在打造一款能自动扫描、打分并筛选前沿 AI 工具的系统，以节省试用新技术的筛选成本。通过与赞助商 Fiverr Pro 平台上的专业 AI 人才合作，团队在短短几周内成功上线了该自动化工具，大幅节省了工时，使核心人员得以专注于更高价值的业务研发。 - **DOAC 话题卡牌（Conversation Cards）新版发布**：Steven 提到了本节目中嘉宾间深度真诚对话的感染力，并以此为灵感推出了升级版对话卡牌。新版本融入了增加对话趣味度的“扭转卡”（twist cards），并在首发批次中限量加入了由 Steven 亲自撰写独家问题的“金卡”（gold card）。 --- ### [01:44:05](https://www.youtube.com/watch?v=5Tr7AhkOEj4&t=6245s) 心理创伤与肠道健康的神经联结 话题重新切回健康领域，Steven 提到了开篇曾简要涉及的一个震撼观点：心理创伤（trauma）与肠道功能存在着密不可分的病理关联。针对这一现象，Bulsiewicz 医生通过自主神经系统（autonomic nervous system）的失衡给出了深刻的生理学阐述。自主神经系统由交感神经（sympathetic）与副交感神经（parasympathetic）共同构成，两者如同跷跷板的两端。 现代人长期生活在交感神经过度激活（sympathetic overdrive）的状态下，其生理表现等同于大脑和身体持续感知到生存威胁。在这种“战斗或逃跑”的应激模式下，心跳加速、血压飙升、注意力高度聚焦。然而，为了向肌肉和大脑优先供应血液与能量，人体最先被牺牲掉的就是肠道系统。长期的交感神经亢进会导致肠道血流减少、蠕动紊乱、黏膜修复停滞。而现代人日常又极度缺乏主动激活副交感神经（即休息与消化状态）的手段，从而使心理层面的创伤和持续压力在肠道内具象化为实打实的慢性消化系统疾病。 - **自主神经对抗**：交感神经主导应激与防御，副交感神经主导消化、吸收与组织修复。 - **肠道牺牲机制**：身体处于威胁感知状态时，血液与资源会迅速从肠道抽离以供给应激器官。 - **创伤的生理代价**：长期未解决的心理创伤会导致交感神经系统慢性过载，直接阻断肠道的自愈机制。 ### [01:44:45](https://www.youtube.com/watch?v=5Tr7AhkOEj4&t=6285s) 创伤与脑肠轴：身体如何替你铭记伤痛 Dr. Will Bulsiewicz 首先阐释了副交感神经系统（parasympathetic nervous system）的重要性——当人们放慢生活节奏、展开深层对话、牵手、拥抱、祈祷、写日记、冥想或蒸桑拿时，副交感神经就会被激活，身体得以进入修护与放松状态。紧接着，话题转向了心理创伤对身体生理机制的深远影响。Dr. Will 坦言，自己也是经过多年的学习与临床观察才明白一个残酷的事实：人们常误以为孩子太小时经历创伤不要紧，因为他们“长大后根本记不住”，但经典心理学著作《身体从未忘记》（The Body Keeps the Score）所揭示的真理完全属实。即使创伤发生在两岁之前，尽管大脑皮层无法形成显性记忆，这种早期创伤依然会重塑大脑的神经网络与运作机制。研究显示，那些经历领养、在生命最初两年生活环境极度不稳定的儿童，成年后罹患各种慢性躯体疾病的概率要高得多。 创伤本质上会将个体长期困在“战斗或逃跑”（fight-or-flight）的交感神经亢奋状态中。Dr. Will 解释，大脑深处掌管恐惧的杏仁核（amygdala）通常在受到惊吓时才被触发——比如身处鬼屋，或是半夜听见灌木丛中有诡异响动；然而，长期经历创伤的人，其杏仁核处于“永久开启”的过载运转状态。Steven 随即提问，是否生活中的重大打击会导致交感神经过度激活、释放某种激素，进而破坏肠道蠕动和肠道屏障？同时，他分享了身边朋友的真实经历：有朋友被确诊为某种严重重疾后，身体竟接二连三爆发看似毫无关联的其他健康危机，医生均将其归咎于巨大的心理压力。 Dr. Will 证实了这种因果级联反应正是“脑肠轴”（brain-gut axis）的典型病理表现。当大脑遭受创伤应激时，下丘脑会大量释放促肾上腺皮质激素释放激素（CRH）。这不仅标志着交感神经系统的全线拉警报，更会引发全身连锁反应。Dr. Will 细致剖析了皮质醇（cortisol）的微妙规律：皮质醇本质上是“起床行动激素”，清晨出现的浓度峰值是人体苏醒所必需的健康现象；但如果到了深夜十点、十一点乃至凌晨一两点，体内的皮质醇依旧居高不下，它就会变成破坏昼夜节律与睡眠质量的宿敌。持续超标的皮质醇会直接瓦解肠道屏障的完整性，诱发肠漏与广泛的慢性炎症。 ```mermaid flowchart TD accTitle: 创伤通过脑肠轴破坏肠道的神经生理路径 accDescr: 展示心理创伤如何激活杏仁核与CRH，导致夜间皮质醇升高，最终破坏肠屏障并引发全身炎症。 subgraph Brain["中枢神经系统反应"] A["未解决的心理创伤 / 早期逆境"] --> B["杏仁核持续过度激活"] B --> C["释放促肾上腺皮质激素释放激素 (CRH)"] end subgraph StressHormone["内分泌失调"] C --> D["交感神经长期亢奋"] D --> E["皮质醇昼夜节律紊乱<br/>(夜间持续处于高位)"] end subgraph GutImpact["肠道病理表现"] E --> F["破坏肠粘膜屏障 (肠漏)"] F --> G["肠道菌群失调与慢性炎症"] end ``` ### [01:49:22](https://www.youtube.com/watch?v=5Tr7AhkOEj4&t=6562s) 创伤源头性肠病的疗愈第一步 面对因心理创伤而饱受肠道功能紊乱折磨的患者，Dr. Will 指出，康复历程中最为关键、也最具决定性的一步是：“直面并承认创伤才是所有躯体症状的根本病因”。大多数人在经历创伤后的本能反应都是逃避与粉饰太平——人们习惯将那些不堪回首的痛苦经历踢到房间阴暗的角落，假装它们从未发生，即便心知肚明它的存在，也绝不肯多看一眼。然而，只要这种潜意识的压抑还在继续，身体的神经内分泌轴就无法走出应激循环。 因此，真正的疗愈始于勇敢地把目光转向创伤本身，并在受过严格训练的专业心理医疗团队协助下展开系统治疗。Dr. Will 强调，尽管诸如认知行为疗法（CBT）等专业干预手段不属于肠胃科医生的处方范畴，但作为临床医生，他的首要使命是帮助患者刺破迷雾，指认那个盘踞在疾病深处的真正根源，从而为跨学科的心理与躯体综合康复打开大门。 ### [01:50:29](https://www.youtube.com/watch?v=5Tr7AhkOEj4&t=6629s) 布里斯托大便分类法与 14 万人的排便现实 访谈现场摆放了各种形态逼真的大便模型，Steven 笑着回忆起两人上次一起用道具探讨排便时的场景，并拿起桌上的模型询问究竟哪一种才是理想的健康形态。Dr. Will 拿起一块状如士力架巧克力棒的模型，幽默地宣布：“这根甜美的‘巧克力棒’就是大名鼎鼎、至高无上的‘布里斯托 4 型’（Bristol 4）。” Dr. Will 借此科普了医学界通用的“布里斯托大便分类法”（Bristol Stool Chart）。该量表将人类的粪便归纳为七种独特形态： - **布里斯托 4 型**：公认的黄金标准便型，外观如同一根香肠或光滑的蛇形，质地柔软但成型良好。 - **布里斯托 3 型**：表面带有轻微裂痕或呈现凹凸不平的香肠状，临床上大多数人也视其为正常或可接受的形态。 - **布里斯托 1 型与 2 型**：表现为坚硬离散的颗粒或干结结块的香肠状，属于典型的便秘范畴。 - **布里斯托 6 型与 7 型**：呈现糊状蓬松块状直至完全无固体颗粒的液体，属于腹泻范畴。 Dr. Will 提醒公众切勿听信“便便肮脏、冲走就好、没什么好看的”这一陈旧观念。事实上，人体粪便湿重的 60% 都是肠道微生物及其代谢产物，马桶里的排泄物就是一面直观反映肠道菌群健康状况的镜子。他回顾了历史背景：该分类法最初源自英国布里斯托市于 20 世纪 90 年代初针对约 2,000 名受试者开展的单中心流行病学调查；而在当代，ZOE 在全英范围内发起了一项覆盖 140,000 人的国民级排便习惯调研，建立了全球规模最大的人类排便数据库。初步数据揭示了一个严峻的公共卫生现状：全社会约有高达 40% 的人群正在与不同程度的排便及肠道功能异常苦苦挣扎。 ### [01:53:21](https://www.youtube.com/watch?v=5Tr7AhkOEj4&t=6801s) 兔粪颗粒与严重便秘：为什么单纯补纤维并不管用 针对各类不健康的排便形态，Steven 追问哪一种最值得警惕。Dr. Will 指出，最令人担忧且痛苦的形态之一便是像小石子一样的“兔粪状硬球”（布里斯托 1 型），这往往代表着深度的重度便秘。面对这种情况，许多人会草率地归咎于膳食纤维匮乏，但现实中的肠道动力学远比社交媒体上鼓吹的简单化言论要复杂精细得多。 Dr. Will 严正指出，“便秘就盲目大量狂补膳食纤维”是一个极具误导性的误区。纤维的主要生理作用在于构建便便的骨架与体积；但如果肠道本身蠕动迟缓，大量干硬的纤维反而在肠腔内越积越死，加剧梗阻与胀气。要解决这一困境，关键在于“软化”环节，而这正是镁（Magnesium）制剂不可替代的临床价值所在： - **渗透引水机制**：高生物利用度的镁补充剂进入肠道后，能产生温和的渗透压效应，将体液源源不断地吸附进肠腔内部。 - **刚柔并济的黄金组合**：膳食纤维负责提供成型的体积与结构支架，而镁补充剂带来的充足水分则赋予其柔软湿润的质地。唯有纤维与镁二者协同配合，才能将坚硬结块的顽固便秘转化为柔软、顺畅且成型的布里斯托 4 型排便。 ### [01:54:00](https://www.youtube.com/watch?v=5Tr7AhkOEj4&t=6840s) 镁剂补充策略与严重腹泻背后的隐患 在探讨肠道调理时，夜间补充镁剂是一个常见的话题。针对不同诉求，选择的镁形态完全不同：如果目标是促进睡眠与身心放松，甘氨酸镁（Magnesium glycinate）是非常出色的选择；但如果是为了缓解便秘，甘氨酸镁则起不到任何通便效果。 针对便秘问题，临床上通常首选氧化镁（Magnesium oxide），此外硫酸镁（Magnesium sulfate）和柠檬酸镁（Magnesium citrate）也是有效的备选项。同时，排便形态需要密切关注，如果排便达到布里斯托大便分类法（Bristol Stool Form Scale）中的第 7 型，即完全的水样便，说明肠道处于极不健康的状态。值得警惕的是，部分严重慢性便秘患者会出现腹泻表象，这在医学上实际上是粪便嵌顿导致的“充溢性腹泻（Overflow diarrhea）”，绝不能简单按普通腹泻对待。 - **助眠与放松**：推荐甘氨酸镁（Magnesium glycinate）。 - **通便与缓解便秘**：推荐氧化镁（Magnesium oxide）、硫酸镁（Magnesium sulfate）或柠檬酸镁（Magnesium citrate）。 - **布里斯托第 7 型大便**：水样无固体块，需排查是否为严重慢性便秘引发的充溢性排便。 --- ### [01:54:48](https://www.youtube.com/watch?v=5Tr7AhkOEj4&t=6888s) 《Plant Powered Plus》核心哲学：补齐饮食中缺失的四大基石 很多读者容易被新书书名《Plant Powered Plus》所束缚，误以为这是一套严苛的、100% 纯素的教条方案。健康没有单一的标准路径，地中海饮食、鱼素饮食（Pescatarian）或弹性素食（Flexitarian）都可以非常健康，最关键的是找到真正适合自己且能长期坚持的饮食模式。比起盲目做减法或排斥特定食材，更应该聚焦的是现代人饮食中普遍严重匮乏的四大核心元素。 ```mermaid flowchart TD accTitle: 现代健康饮食四大基石 accDescr: 展现修复肠道微生物组和降低炎症所需的四种核心营养素及其主要食物来源 subgraph Core["饮食四大缺失基石"] F["1. 膳食纤维 (Fiber)"] P["2. 多酚类物质 (Polyphenols)"] H["3. 健康脂肪 (Healthy Fats)"] FE["4. 发酵食品 (Fermented Food)"] end subgraph Sources["典型营养来源"] F --> S1["全谷物、豆类、蔬菜"] P --> S2["丰富多样的深色蔬菜与水果"] H --> S3["鳄梨、坚果种子、三文鱼 Omega-3"] FE --> S4["酸奶、泡菜、发酵腌菜"] end ``` 这四大不可或缺的饮食成分包括： 1. **膳食纤维（Fiber）**：全美高达 95% 的人群摄入不足，它是肠道有益菌赖以生存的能量底物。 2. **多酚类物质（Polyphenols）**：几乎鲜有人达到蔬果推荐摄入量，多酚对抗炎与肠道屏障至关重要。 3. **健康脂肪（Healthy Fats）**：重点补充鳄梨、坚果、种子中的单不饱和脂肪，以及来自三文鱼或贝类的 Omega-3 脂肪酸。关于特级初榨橄榄油等食用油需注意：油是整个地球上能量密度最高的物质，没有任何物质的热量高于油脂。对于肥胖或正在减重的人群，即便成分健康的油脂也需适量控制，优先从完整形态的天然食物中摄取脂肪。 4. **发酵食品（Fermented Food）**：绝大多数现代人的日常发酵食品摄入量基本为零，顶多偶尔吃一次酸奶。斯坦福大学的研究团队（Christopher Gardner 与 Justin & Erica Sonnenburg 夫妇）通过临床研究证实：受试者仅需在日常饮食中加入发酵食品，在短短 8 周内就能显著提升肠道微生物多样性，并直接降低体内的炎症水平。 改善健康不应是简单地把已有的东西吃得更多，而是精准找到饮食中严重缺失的这四块拼图，将其逐一补齐。 --- ### [01:58:42](https://www.youtube.com/watch?v=5Tr7AhkOEj4&t=7122s) 身体蜕变背后：向内疗愈与家庭创伤的和解 面对三十岁出头与四十岁前后的对比照片，十年的跨度不仅没有显出老态，反而呈现出体脂显著下降、肌肉线条清晰且年轻十岁的惊人逆生长状态。外在的巨大转变不仅源于从垃圾食品转向全食物饮食和系统的力量训练，更关键的转折点在于内心深处长期积压的创伤得到了愈合。 三十岁出头的博士曾深陷内心的阴暗低谷，这种痛苦不仅源于不健康的饮食，更源于家庭关系的破裂。2012 年，妻子的出现宛如天使降临，她从未强行要求他改变，但那种包容坚定的陪伴成为了他重塑生活与饮食习惯的动力，并推动他鼓起勇气拨通了整整十年未曾联系的父亲的电话。 长女的降生更是一次震撼的心灵洗礼。初次将婴儿抱在怀中的瞬间，人生意义与责任感被彻底重塑，这种从未体会过的无条件之爱，终于让他理解了父亲当年对自己的爱，并放下了执念与怨恨。 - **童年家庭破裂**：七岁时父母经历了一场非常难堪痛苦的离婚，作为三兄弟中的老大，年幼的他感到必须在父母之间“选边站队”。 - **长达十年的隔阂**：大学毕业前后，因无法理解“父亲作为成年男人为何任由家庭分崩离析”，他选择与父亲断绝一切联络。 - **独行顶峰的孤独**：在与父亲冷战的十年间，他独自完成了乔治城大学医学院学业，并在西北大学担任总住院医师（Chief Medical Resident），甚至斩获了住院医师最高荣誉，但内心始终无法释怀。 - **文字里的救赎**：新书第八章是他撰写过的所有文字中最骄傲的杰作（Masterpiece），详细记录了这段直面童年创伤、原谅父亲并最终达成父子和解的心路历程。 ### [02:03:36](https://www.youtube.com/watch?v=5Tr7AhkOEj4&t=7416s) 成为人父后的顿悟：读懂沉默如山的父爱 即使在学业与职业生涯中攀上顶峰、赢得了外界认可的一切成就，Dr. Will Bulsiewicz（威尔·布尔谢维奇医生）坦言自己当年内心深处其实极其悲伤。他生命拼图中缺失的最关键一块，正是他的父亲。直到女儿降生，抱起孩子的那一瞬间，初为人父的本能爱意如潮水般涌来，他才在电光石火间彻底理解了当年父亲对自己的深沉爱意。 Dr. Will 回忆起成长中的点点滴滴。在他年少时，父亲常常一个人带着他们三兄弟去野营，没有任何其他人随行，全程只有父亲和三个调皮的小男孩。每一次家庭度假、每一场体育赛事，父亲从不缺席。然而年少无知的他，未曾把这些日常陪伴视作爱的表达。直到如今自己养育子女，深切体会到做父母有多么艰难困苦，他才猛然惊醒：一个成年男人独自带三个小男孩去野营简直是件“近乎疯狂的壮举”。直到这一刻，他才真正读懂父亲当年付出了多少竭尽全力的爱。 ### [02:04:49](https://www.youtube.com/watch?v=5Tr7AhkOEj4&t=7489s) 献给父亲的悼词：未能亲手递出的第一本书 主持人 Steven Bartlett 提到 Dr. Will 在 2020 年出版的畅销著作（《Fiber Fueled》），书的开篇有一段极度私人且感人的献词，并邀请 Dr. Will 亲自朗读这段文字。Dr. Will 动情地念出了献给父亲的篇章： > “在筹备这本书的过程中，我失去了我的父亲。这发生得猝不及防，完全出乎意料。我曾无比迫不及待地想与他分享这本书。寄一份电子版其实轻而易举，但我极度渴望他的第一次阅读，能捧着一本封面印着他儿子姓名的精装实体书。 > > 在过去的几个月里，父亲一再对我说，他为我感到多么骄傲。他告诉我，我的祖父母 John 和 Helen Bulsiewicz 如果看到我以家族之名为大众所做的工作，一定会无比欣慰。我无法用言语形容这些话对我有多重要。他不再陪伴在人世间，这让我心碎。因为有他，才有今天的我。我将永远感激我们曾经共度的珍贵时光。爱你，爸爸。我们会永远想念你。这本书是献给你的。” ### [02:06:08](https://www.youtube.com/watch?v=5Tr7AhkOEj4&t=7568s) 关系的疗愈与肠道康复的奇妙共振 Steven 感慨道，人人都容易陷入让人际关系恶化的泥潭，因未曾说开的怨恨与误解而白白荒废数年甚至数十年。正因如此，Dr. Will 的经历令人深受触动。Steven 特别称赞了 Dr. Will 的妻子，正是她的敏锐与坚持，才促成了父子在老人离世前重归于好、修复了裂痕。 Dr. Will 总结道，疗愈从来都有很多种面相。有时它是我们在餐盘中对饮食做出的微小改变，而有时它则是我们与他人修复关系的勇气。饮食与心灵是深刻绑定的：当一个人在内心与自己、与至亲达成和解时，往往会发现掌控自己的饮食与生活方式也变得顺理成章、水到渠成，"这一切就会彻底契合（Then it all clicks）"。 ### [02:07:20](https://www.youtube.com/watch?v=5Tr7AhkOEj4&t=7640s) 认知拼图的拼合与新书发布 Steven 强烈推荐读者阅读 Dr. Will 即将面世的新书《Plant Powered Plus》（该书定于周二在美上市、周四在英发售）。在对本期节目的受众调查中，有 61% 至 70% 的人表示自己正备受肠道问题困扰。Steven 评价这本书既专业前沿又通俗易懂，并把探索肠道健康比作“拼图游戏”——每一次关于肠道、微生物群与免疫大脑关联的深度对谈，都像是在拼图上补全一块关键碎片，为生活带来如同“重新点亮灯火”般的剧变。 Dr. Will 介绍了获取科学健康知识的渠道与平台： - **YouTube 频道与社交平台**：通过 `@TheGutHealthMD` 获取日常短内容与深度科普。 - **官方枢纽网站**：登录 `theguthealthmd.com` 可免费订阅他的电子邮件时事通讯（Newsletter）。该平台类似于免费版 Substack，用于打破主流算法限制，直接向公众拆解最新医学文献、临床新观察以及日常生活实践。 ```mermaid flowchart TD accTitle: 肠脑与身心治愈循环图 accDescr: 展示心理和解、肠道改善与生活自律之间的正向反馈循环 subgraph Mind["心理与关系层"] A["修复家庭关系与消除心结"] B["解除长期心理创伤与压力"] end subgraph Body["生理与肠道层"] C["肠道微生态平衡与减轻炎症"] D["获得生活与饮食自律掌控力"] end A --> B B --> C C --> D D --> A ``` ### [02:09:22](https://www.youtube.com/watch?v=5Tr7AhkOEj4&t=7762s) 最后的遗憾与跨越生死的对白 按照节目的闭门传统，上一位嘉宾留下了一个交给 Dr. Will 的问题：“为了弥补你人生最大的遗憾，你今天能做的一件事是什么？” 面对这个问题，Dr. Will 先是发出一阵夹杂着感叹的苦笑，随后坦言自己的故事是一个关于希望与乐观的见证，因为他在很大程度上已经通过与父亲生前的重聚化解了大部分遗憾。但父亲的离世极为突然，他甚至没能来得及好好道别。Dr. Will 坦承，是内心的信仰让他确信——不是自我安慰的假装，而是发自内心地坚信——那些未曾来得及当面说出口的话，未来终有一日还能亲口告诉父亲。 当 Steven 追问“你会对他说什么？”时，Dr. Will 眼含深情地回答： > “我会告诉他，我好恨自己花了这么长的时间才终于明白，他曾经是一位多么伟大的父亲。大人们之间或许会有摩擦冲突，那正是他们当年离婚的原因；但他作为一名父亲，是极其非凡卓绝的。而我直到自己成为了父亲，才真正看清并读懂这一切。” ## Notable quotes > [12:04](https://www.youtube.com/watch?v=5Tr7AhkOEj4&t=724s) 这就像一片已经濒临枯死的林地，我们直接把一整座生机勃勃的亚马逊雨林移植了过去。所有适应这片土地的物种瞬间归位，整个生态森林便在一夜之间重新恢复了葱郁和繁盛。 — 威尔·布尔谢维奇博士 > [14:34](https://www.youtube.com/watch?v=5Tr7AhkOEj4&t=874s) 现代社会及其生活方式正在不断摧残我们的肠道与微生物群，而我们正在承受这一代价——肠屏障被彻底撕裂，免疫系统深陷于一场永无止境的低度慢性炎症‘永恒战争’中。 — 威尔·布尔谢维奇博士 > [18:06](https://www.youtube.com/watch?v=5Tr7AhkOEj4&t=1086s) 我见过的每一个帕金森病患者，无一例外，全都有便秘的毛病。所有人都是如此。 — 威尔·布尔谢维奇博士 > [19:41](https://www.youtube.com/watch?v=5Tr7AhkOEj4&t=1181s) 千万别这么做，请绝对不要尝试。 — 威尔·布尔谢维奇博士 > [48:41](https://www.youtube.com/watch?v=5Tr7AhkOEj4&t=2921s) 你今天所做的饮食选择，明天就会直接映射在你的微生态中。 — 威尔·布尔谢维奇博士 > [59:48](https://www.youtube.com/watch?v=5Tr7AhkOEj4&t=3588s) 我不认为存在任何安全的饮酒量。 — 威尔·布尔谢维奇博士 > [01:19:27](https://www.youtube.com/watch?v=5Tr7AhkOEj4&t=4767s) 你必须亲自为孩子示范一顿健康的早餐是什么样子，因为如果你自己都不吃，就绝不能指望孩子会主动去吃。 — 威尔·布尔谢维奇博士 > [01:27:10](https://www.youtube.com/watch?v=5Tr7AhkOEj4&t=5230s) 孤独对健康和长寿的破坏力，几乎超过了其他任何事物。 — 威尔·布尔谢维奇博士 > [01:49:22](https://www.youtube.com/watch?v=5Tr7AhkOEj4&t=6562s) 直面并承认创伤才是所有躯体症状的根本病因。 — 威尔·布尔谢维奇博士 > [01:50:29](https://www.youtube.com/watch?v=5Tr7AhkOEj4&t=6629s) 这根甜美的‘巧克力棒’就是大名鼎鼎、至高无上的‘布里斯托 4 型’。 — 威尔·布尔谢维奇博士 > [02:04:49](https://www.youtube.com/watch?v=5Tr7AhkOEj4&t=7489s) 在过去的几个月里，父亲一再对我说，他为我感到多么骄傲。他告诉我，我的祖父母 John 和 Helen Bulsiewicz 如果看到我以家族之名为大众所做的工作，一定会无比欣慰。我无法用言语形容这些话对我有多重要。他不再陪伴在人世间，这让我心碎。因为有他，才有今天的我。我将永远感激我们曾经共度的珍贵时光。爱你，爸爸。我们会永远想念你。这本书是献给你的。 — 威尔·布尔谢维奇博士 > [02:09:22](https://www.youtube.com/watch?v=5Tr7AhkOEj4&t=7762s) 我会告诉他，我好恨自己花了这么长的时间才终于明白，他曾经是一位多么伟大的父亲。大人们之间或许会有摩擦冲突，那正是他们当年离婚的原因；但他作为一名父亲，是极其非凡卓绝的。而我直到自己成为了父亲，才真正看清并读懂这一切。 — 威尔·布尔谢维奇博士 ## Mentioned 威尔·布尔谢维奇博士 (Dr. Will Bulsiewicz), 史蒂芬·巴特利特 (Steven Bartlett), ZOE, The Diary Of A CEO, Plant Powered Plus, Fibre Fuelled, Christopher Gardner, Justin Sonnenburg, Erica Sonnenburg, 38 Terra, Stan, Adobe Express, Fiverr Pro, TikTok, Netflix, 布里斯托大便分类法 (Bristol Stool Chart), 乔治城大学 (Georgetown University), 西北大学 (Northwestern University), 《身体从未忘记》 (The Body Keeps the Score) ## Video description Tired of your health issues? Top gastroenterologist DR WILL BULSIEWICZ reveals NEW information about how leaky gut drives inflammation, cancer risk, bloating and brain fog, and the daily habits to heal FAST. Dr Will Bulsiewicz is one of the world’s leading experts on the gut microbiome. He is the US Medical Director at ZOE, founding director of The Gut & Microbiome Center for Excellence and bestselling author of “Fibre Fuelled” and the upcoming book, “Plant Powered Plus”. He explains: ◼️Why inflammation is driven by the gut, not just genetics ◼️How leaky gut triggers bloating and immune dysfunction ◼️The gut-immune link behind cancer and chronic disease ◼️Why fermented foods and fibre rebuild the microbiome ◼️How the gut-brain connection shapes mood, focus, and longevity 00:00 Intro 03:15 What Is Inflammation? 05:23 Can You Be Thin and Still Have Inflammation? 05:58 Why Does Chronic Inflammation Happen? 06:59 The Shocking Link Between Inflammation and Gut Health 10:34 Chronic Inflammation Causes These Diseases 12:04 The Importance of a Healthy Gut 12:39 Faecal Transplants to Heal the Gut 15:14 Link Between Gut Microbiome and Cancer 18:06 Parkinson's Could Start in the Gut 20:28 Can Anyone Get a Faecal Transplant? 21:10 A Lot of Us Have Gut Issues 23:24 Does Gas and Bloating Indicate a Health Issue? 31:21 Everyone Thinks They're Gluten Intolerant 32:23 Processing Issues With Gluten 34:51 Is Sourdough the Best Bread? 36:01 Your Gluten Intolerance Might Be This Instead 38:06 How Long Does It Take to Repair the Gut? 41:04 What Causes Bowel Diseases? 42:29 Antibiotics Double Your Risk of Bowel Disease 43:04 Fixing a Chronic Gut Issue With a Fecal Transplant 47:34 What Diet Trends Spread Misinformation? 51:41 Fibremaxxing and the Importance of Fibre 54:36 Best Foods to Eat for Fibre 58:58 How Fibre Affects Immunity and Ageing 59:48 This Is What Alcohol Does to the Gut 1:05:22 Ads 1:07:11 Benefits of Turmeric 1:09:10 Dr Will's Perfect Gut Day 1:19:27 Good Breakfast for Children 1:20:32 What Would Impact Your Child's Gut Health? 1:25:09 Dr Will's Perfect Gut Day 1:33:06 Optimal Time to Workout 1:34:43 Perfect Time Between Meals 1:35:41 Perfect Evening Routine 1:39:10 Would You Recommend Fasting? 1:42:08 Ads 1:44:05 Trauma Impacts Gut Function 1:49:22 How Would I Heal My Trauma-Related Gut Issues? 1:50:29 Stool Test – Is Your Gut Healthy? 1:53:21 Magnesium for Constipation and Sleep 1:54:51 This Is Easier Than You Think – 4 Things You Need 1:58:45 Dr Will's Transformation 2:04:49 Message to My Dad 2:09:22 Your Biggest Regret Follow Dr Will: Instagram - https://bit.ly/457iRAx The Gut Health MD - https://bit.ly/4p2svLU Youtube - https://bit.ly/4aGQJrKl Dr Will Bulsiewicz’s upcoming book, ‘Plant Powered Plus: Activate the Power of Your Gut to Tame Inflammation and Reclaim Your Health’: UK Version: https://amzn.to/45hIcb1 US Version: https://bit.ly/49hpCAZ Independent Fact Check: https://stevenbartlett.com/wp-content/uploads/2026/07/DOAC-Will-Bulsiewicz-Independent-Research-further-reading-.pdf The Diary Of A CEO: ◼️Get the 2026 Goal Setting Guide - https://bit.ly/ytgoalsettingguide ◼️Join DOAC circle here - https://doaccircle.com/ ◼️Buy The Diary Of A CEO book here - https://smarturl.it/DOACbook ◼️The 1% Diary is back - limited time only: https://bit.ly/3YFbJbt ◼️The Diary Of A CEO Conversation Cards (Second Edition): https://g2ul0.app.link/f31dsUttKKb ◼️Get email updates - https://bit.ly/diary-of-a-ceo-yt ◼️Follow Steven - https://g2ul0.app.link/gnGqL4IsKKb Sponsors: Stan: NO PURCHASE NECESSARY. VOID WHERE PROHIBITED. For Official Rules, visit https://DaretoDream.stan.store Adobe - https://Adobe.Ly/OneBetter Fiverr: https://fiverr.com/diary and get 10% off your first order when you use code DIARY [Source](https://www.youtube.com/watch?v=5Tr7AhkOEj4)

[12:04] 威尔·布尔谢维奇博士: 这就像一片已经濒临枯死的林地，我们直接把一整座生机勃勃的亚马逊雨林移植了过去。所有适应这片土地的物种瞬间归位，整个生态森林便在一夜之间重新恢复了葱郁和繁盛。 [14:34] 威尔·布尔谢维奇博士: 现代社会及其生活方式正在不断摧残我们的肠道与微生物群，而我们正在承受这一代价——肠屏障被彻底撕裂，免疫系统深陷于一场永无止境的低度慢性炎症‘永恒战争’中。 [18:06] 威尔·布尔谢维奇博士: 我见过的每一个帕金森病患者，无一例外，全都有便秘的毛病。所有人都是如此。 [19:41] 威尔·布尔谢维奇博士: 千万别这么做，请绝对不要尝试。 [48:41] 威尔·布尔谢维奇博士: 你今天所做的饮食选择，明天就会直接映射在你的微生态中。 [59:48] 威尔·布尔谢维奇博士: 我不认为存在任何安全的饮酒量。 [79:27] 威尔·布尔谢维奇博士: 你必须亲自为孩子示范一顿健康的早餐是什么样子，因为如果你自己都不吃，就绝不能指望孩子会主动去吃。 [87:10] 威尔·布尔谢维奇博士: 孤独对健康和长寿的破坏力，几乎超过了其他任何事物。 [109:22] 威尔·布尔谢维奇博士: 直面并承认创伤才是所有躯体症状的根本病因。 [110:29] 威尔·布尔谢维奇博士: 这根甜美的‘巧克力棒’就是大名鼎鼎、至高无上的‘布里斯托 4 型’。 [124:49] 威尔·布尔谢维奇博士: 在过去的几个月里，父亲一再对我说，他为我感到多么骄傲。他告诉我，我的祖父母 John 和 Helen Bulsiewicz 如果看到我以家族之名为大众所做的工作，一定会无比欣慰。我无法用言语形容这些话对我有多重要。他不再陪伴在人世间，这让我心碎。因为有他，才有今天的我。我将永远感激我们曾经共度的珍贵时光。爱你，爸爸。我们会永远想念你。这本书是献给你的。 [129:22] 威尔·布尔谢维奇博士: 我会告诉他，我好恨自己花了这么长的时间才终于明白，他曾经是一位多么伟大的父亲。大人们之间或许会有摩擦冲突，那正是他们当年离婚的原因；但他作为一名父亲，是极其非凡卓绝的。而我直到自己成为了父亲，才真正看清并读懂这一切。

[2:20] Dr. Will Bulsiewicz: If there's a war occurring, of course there's decimation and damage that occurs and it's brutal. And the problem is that if we're activating the immune system... the decimation and destruction that's occurring is within your own tissues, within your own organs. [43:04] Dr. Will Bulsiewicz: By the next day she was a normal human being. She was laying in bed. She was able to have a conversation. And after 2 days she was so normal that we were able to send her home. [114:51] Dr. Will Bulsiewicz: If you think about your diet, this shouldn't be an exercise in more of the thing that you already have. This should be an exercise of what is the thing that's missing that we could add that could transform our health? [124:49] Dr. Will Bulsiewicz: I lost my dad during the preparation of this book. It was sudden and completely unexpected. I couldn't wait to share this book with him... Over the past few months, my dad repeatedly told me how proud he was of me... I am who I am because of him. But I will forever be grateful for the special times that we shared. Love you, Dad. We'll always be thinking of you. This book is for you. [129:22] Dr. Will Bulsiewicz: I hate the fact that it took me so long to figure out that he was a great dad.

[0:00] What's a fecal transplant? You take a [0:02] healthy person's poop and you transfer [0:03] it into the person who's sick. [0:06] For example, a patient of mine took an [0:07] antibiotic which wipes out your gut, [0:09] which became life-threatening. Our [0:11] choices were to remove the colon or to [0:13] give her a fecal transplant. And so, I [0:14] delivered the fecal transplant to her. [0:16] By the next day, the entire infectious [0:19] issue got shut down. So, this is a great [0:21] example to show how important our gut [0:23] microbiome is because 60% of the weight [0:26] of your stool is your microbiome. [0:27] >> Really? [0:28] >> Yes, but it's not getting enough [0:29] attention and we need to talk about [0:31] that. [0:31] >> World-renowned gastroenterologist Dr. [0:33] Will Bulsiewicz is back. This time he's [0:36] sharing brand new information regarding [0:38] the gut microbiome [0:39] >> and how poo might actually be the key to [0:42] your health. [0:42] >> 60% of people that listen are currently [0:44] struggling with some kind of gut [0:46] problem. [0:46] >> And it manifests in these subtle ways, [0:48] like bloating, [music] increased [0:49] fatigue, difficulty concentrating. You [0:51] don't sleep well at night, skin issues. [0:53] So, it flies under the radar, but [0:55] ultimately leads to other health-related [0:57] problems afterwards. [0:58] >> So, I've got so many questions. [0:59] >> Totally. [1:00] >> What is the cause of bloating? [1:01] >> So, constipation is the number one [1:03] cause, but people who are bloated, [1:05] please don't sip through straws, drink [1:06] carbonated drinks, chew on gum because [1:09] you just make it worse. [1:10] >> Next, are there decisions that you make [1:12] as a parent that will have a lasting [1:14] impact on their kids' gut function? [1:15] >> Yeah, by 3 years of age, you are [1:17] basically fully adult-sized in terms of [1:19] your microbiome. But, antibiotics, [1:21] bottle-feeding, and birth by cesarean [1:22] section are associated with an impact on [1:24] the microbiome such as an increased risk [1:26] of allergic, autoimmune, and metabolic [1:28] diseases. And I'll explain why. [1:30] >> And then, can I repair the gut? [1:32] >> Yeah, 100%. In every 3 to 5 days, you [1:34] build a new gut barrier. And so, I've [1:36] identified four things missing in our [1:38] diet as well as a daily routine that can [1:40] optimize our microbiome. And when you do [1:42] [music] these, you will thrive, and you [1:43] will live longer, and you will have less [1:44] disease. And I'm going to take you [1:46] through all of these steps right now. [1:49] >> I see messages all the time in the [1:51] comment section that some of you didn't [1:52] realize you didn't subscribe. So, if you [1:54] could do me a favor and double-check if [1:56] you're a subscriber to this channel. [1:57] That would be tremendously appreciated. [1:59] It's the simple, it's the free thing [2:01] that anybody that watches this show [2:02] frequently can do to help us here to [2:04] keep everything going in this show in [2:05] the trajectory it's on. So, please do [2:07] double check if you subscribed and thank [2:09] you so much because in a strange way you [2:11] are you're part of our history and [2:13] you're on this journey with us and I [2:14] appreciate you for that. So, yeah, thank [2:16] you. [2:17] >> [music] [2:20] >> Dr. Will, [2:21] before we started recording I asked you [2:23] about this new book that you've written [2:26] and the way that you spoke about it was [2:29] incredibly passionate. [2:31] Why? [2:32] >> I I sincerely believe that [2:35] if people take the advice that's in this [2:37] book and they actually follow it, which [2:39] is the hardest part, I'm completely [2:41] convinced that it will transform your [2:42] life. [2:43] And that's because we all are struggling [2:46] with the same problem. We manifest it in [2:48] different ways, [2:49] but there's this common issue [2:51] which is inflammation. [2:54] And it's the health story of our time. [2:57] It's not getting enough attention and [2:59] this book is not only about shining the [3:02] light on that, it's about providing [3:03] people with the evidence-based tools [3:06] that they need in order to be successful [3:09] and to live an anti-inflammatory life [3:11] and when you do that, you will thrive [3:13] and you will live longer and you will [3:14] have less disease. [3:15] >> Can you explain inflammation to me like [3:16] I'm a 10-year-old? [3:18] >> Steve, you have an immune system that [3:20] protects your body. [3:22] >> Mhm. [3:22] >> And inflammation is when we turn that [3:26] immune system on. We make it active. [3:28] And sometimes that's a good thing. [3:30] Right? If you had a if you had a tummy [3:32] bug, [3:33] you want to clear that infection. Right? [3:35] If you hurt yourself, [3:37] you want to heal that wound. [3:39] That's when your immune system is really [3:40] good. It's working for you. [3:42] But the problem that we have these days [3:44] is that we're turning on the immune [3:46] system when we don't need to and it's [3:48] staying on 24 hours a day, 7 days a week [3:52] and that ultimately creates problems [3:54] because it leads to [3:56] new issues, new health conditions. [3:59] >> But what inflammation sounds like [4:00] something has inflated or become [4:01] swollen. [4:03] >> Yeah. Well, that is a part of the [4:04] process. For example, [4:06] if you hurt your knee, right? There [4:08] there will be inflammation in your knee [4:09] and it will get red, it will get [4:11] swollen, it will become tender, and it [4:13] like those are the typical [4:14] characteristics of inflammation when it [4:17] arrives. But what we're talking about is [4:20] chronic low-grade inflammation and this [4:22] is a tricky thing because it can fly [4:24] below the radar. It can fly below the [4:26] radar where you don't realize that it's [4:27] there. Your doctor may not realize that [4:30] it's there. [4:31] And it's and it manifests in these [4:32] subtle ways where it's like you have [4:34] increased fatigue, you have difficulty [4:36] concentrating, [4:38] you don't sleep well at night, you wake [4:40] up with aches and pains, or you have [4:43] joints that hurt a little bit, or you've [4:45] had skin issues, right? And it's like, [4:47] well, we all have those problems. [4:50] But that's inflammation. Inflammation is [4:52] driving many of those issues. [4:54] And so it's important for people to be [4:57] aware that, you know, you may like these [5:00] there's so many patients that go to [5:01] their doctor complaining of these [5:02] symptoms. [5:04] And the doctor is kind of not really [5:06] sure what to do about that. [5:07] And I think it's time for us to like [5:09] open our mind and bring awareness to the [5:12] possibility that there is this issue, [5:14] inflammation, that's driving that [5:16] problem, the symptoms, the health [5:18] conditions of which there are many. [5:21] And ultimately we need a plan to address [5:22] that. [5:23] >> And is can you be like skinny and in [5:25] shape and still have inflammation? [5:27] >> 100%. [5:28] >> So it's not just a weight thing. [5:30] >> No, it's not just a weight thing because [5:31] if you if you think about, you know, [5:33] people who are competitive bodybuilders, [5:38] they look amazing on the outside [5:40] and they're falling apart on the inside. [5:43] And these people often suffer with [5:46] digestive health problems. I know [5:47] because they reach out to me. Including [5:49] many people that are well-known who look [5:51] incredible. [5:52] And they're suffering with gut issues. [5:54] And then ultimately they're at risk for [5:56] other health-related problems [5:57] afterwards. [5:58] >> So when this point of inflammation is [6:00] when your immune system kind of stays [6:01] on, why does it stay on? [6:03] >> [clears throat] [6:04] >> And uh I mean, how do I turn it off? [6:06] >> Well, we have we have to start with uh [6:07] acknowledging that the reason why this [6:09] causes problems is that it let's like [6:12] sort of use an analogy of the immune [6:15] system is your small army. [6:19] And they're there to defend you. [6:21] And when we activate the army and [6:22] they're actually going to war, [6:24] you have to expect that there's going to [6:26] be damage to the surrounding areas. Mhm. [6:29] Right? Like [clears throat] if peop- if [6:30] if there's a war occurring, of course [6:32] there's decimation and damage that [6:34] occurs and it's brutal. [6:36] And the problem is that if we're [6:38] activating the immune system, the the [6:40] areas that are surrounding it, that's [6:41] your body. [6:43] Right? And the decimation and [6:44] destruction that's occurring is within [6:46] your own tissues, within your organs. As [6:48] I was researching this book, I I I [6:51] actually took 3 years to understand this [6:53] topic. And what I discovered is a [6:56] connection between your immune system [6:58] and your gut that is undeniable. [7:01] And that connection becomes the powerful [7:03] fact- factor [7:05] that allows you to understand why it [7:07] happens and how we can fix it. [7:10] We have [7:12] uh [7:12] our gut microbiome. And there are 38 [7:15] trillion microbes that live inside of [7:17] our large intestine. [7:19] And they include bacteria and yeasts and [7:22] and archaea, which are these things that [7:25] have been on the planet for 4 billion [7:26] years. [7:27] And possibly parasites. [7:29] And so in this entire community of [7:31] microorganisms, [7:33] they're there with a purpose. [7:35] And that is to support you and your [7:36] physiology. [7:38] One of their key jobs is actually to uh [7:42] basically feed the gut barrier that [7:45] lines your entire intestines. [7:46] >> So, let me show me on using this. [7:48] >> Sure. [7:48] >> Is this a [7:49] the right part of the body? [7:51] >> So, now the large intestine [7:53] is the home to your microbiome. So, [7:57] these 38 trillion microbes, this is [7:58] their this is their residence, this is [8:00] their domain where they live. [8:02] Now, this entire system [8:04] which is like on the order of 20 or 25 [8:08] ft, so like something on the range of 6 [8:10] to 8 m, [8:12] it's [8:13] coated with a single layer of cells, [8:16] which we call the epithelial layer. [8:19] And that is your gut barrier. [8:21] And it's a quite fascinating part of [8:23] your body because this is like the [8:24] castle wall and keeps the bad stuff out, [8:28] but simultaneously needs to allow the [8:29] good stuff in. [8:31] And these cells, they turn over every 3 [8:34] to 5 days. [8:35] So, [8:37] it's a beautiful thing actually because [8:39] every 3 to 5 days, you have an [8:41] opportunity to create a brand new gut [8:43] barrier. [8:44] So, within the system, the microbes that [8:46] live inside your colon, their job is to [8:49] basically repair and restore [8:51] the gut barrier. [8:53] And when the gut barrier is intact, [8:56] it's going to do its job of protecting [8:57] the immune system. [9:00] And when the gut barrier starts to break [9:01] down, [9:03] then things can sneak across, [9:05] which we would refer to as increased [9:08] intestinal permeability, but the common [9:10] language is leaky gut. [9:12] The immune system will see [9:15] and recognize things that aren't [9:16] supposed to be there. [9:18] And so, the immune system then steps up [9:22] and wants to take it out. And that [9:24] basically means it needs to get [9:25] activated and attack. [9:28] And that is inflammation. [9:29] So, the breakdown of these three systems [9:32] that start with the microbes, microbes [9:34] are actually your first layer of [9:36] defense. [9:38] And then leading to the breakdown of the [9:39] gut barrier [9:41] is what ultimately activates the immune [9:43] system when we have things that are [9:45] sneaking across that are not supposed to [9:46] be there. [9:47] The reverse [9:49] can also be true. [9:50] And that to me is where the exciting [9:52] opportunity exists is that [9:54] if you can heal the gut microbes, then [9:56] the gut microbes can get back to work [9:58] and do their job of repairing and [10:00] restoring the gut barrier. And when you [10:02] create a strong gut barrier, then [10:05] basically you're protecting the immune [10:06] system. And then what you see actually [10:08] is the immune system cools off and it [10:10] becomes more tactical and capable of [10:12] doing its job. [10:14] >> Okay. And when we're [10:16] eating lots of bad stuff and you know, [10:18] many of the things we're going to talk [10:19] about today are causing a breakdown in [10:22] those microbes, which is causing the gut [10:24] barrier to worsen, which is causing [10:26] the immune system to kick in, which is [10:28] causing the inflammation, and the [10:29] inflammation is therefore causing our [10:31] cells to be [10:33] damaged. [10:34] What's the immune system over [10:37] functioning causing? [10:39] Like you're you're you're talking about [10:41] the army analogy where there's an army [10:42] and they're at war and some of them are [10:44] damaging the surroundings. [10:46] >> Mhm. [10:47] >> How is it damaging my surroundings, my [10:49] immune system being [10:50] on all the time? [10:52] >> Well, so what ends up happening is it [10:54] sets off this sort of chain reaction [10:57] which can have an effect throughout your [10:59] entire body where the immune cells, it's [11:02] not just a couple of immune cells, they [11:03] start to basically send out signals. [11:06] And these signals, we call them [11:07] cytokines. So you can measure those [11:09] cytokines and those are basically [11:11] communication tools that the immune [11:13] cells are using with each other to [11:14] basically call for help. [11:16] So and as they get revved up, these [11:19] cytokines start to go out and then this [11:22] leads to a cascade of even more immune [11:24] cells releasing even more [11:26] cytokines. And so and then kick off this [11:29] wave. [11:30] And it this is what ultimately you can [11:32] feel throughout your entire body. [11:34] Um and it and it has these consequences [11:36] of basically causing damage to these [11:38] individual tissues. So, it depends on [11:39] which tissue we're referring to. [11:42] Inflammation in the liver we would call [11:43] hepatitis. [11:44] Right? But at the same time we have [11:46] overwhelming evidence at this point that [11:49] inflammation in the brain [11:51] which we call neuroinflammation [11:53] has been associated with mood disorders. [11:55] So, like major depression. [11:57] Inflammation in the brain has been [11:58] associated with cognitive disorders like [12:00] Alzheimer's disease, Parkinson's [12:01] disease. [12:02] So, and it's not to claim it's not to [12:04] claim that all disease [12:07] literally is related or caused by the [12:09] gut microbiome. That's not the call. [12:12] It's more so to say that we need to [12:14] understand that our immune system is so [12:17] powerfully connected to our microbiome [12:19] that you can't separate the two. [12:22] And there's evidence to suggest that we [12:24] can we can manipulate. So, whether it be [12:27] antibiotics which decimate the gut [12:30] or the alternative, the the opposite [12:32] would be a fecal transplant. [12:34] Which rapidly reinvigorates the gut and [12:36] restores that gut architecture and [12:38] ecosystem. [12:38] >> What's a fecal transplant? [12:40] >> So, fecal transplant is where you take a [12:42] healthy person's poop and you transfer [12:44] it into the person who's sick. [12:47] >> And where are they administering it? [12:49] >> The way that I've always done the fecal [12:51] transplant cuz I've done many throughout [12:52] my career is during a colonoscopy. [12:55] So, if in theory I were to [12:58] >> what's a colonoscopy? [12:59] >> Yeah. So, a colonoscopy is is a medical [13:02] procedure [13:03] where typically you would be asleep and [13:07] while you're asleep I take a long [13:09] flexible tube that is about the size of [13:11] my index finger [13:13] and I can pass that with control [13:17] all the way through [13:18] the entirety of your large intestine [13:21] which is about 5 or 6 ft long [13:24] and I can actually dip into the last [13:26] part of the small intestine, which we [13:28] call the terminal ileum, which is down [13:30] here in the right the right lower part [13:32] of the abdomen. [13:33] You're administering the fecal [13:34] transplant because they they have this [13:36] vicious infection called C. diff. [13:38] And and again, those infections this [13:41] infection can be life-threatening. And [13:43] you're administering the fecal [13:44] transplant because the antibiotics are [13:46] not working. [13:47] So, you need an alternative [13:49] where the idea and goal is to restore [13:53] balance within the gut ecosystem. [13:56] >> Yeah, you're putting good bacteria in, [13:57] not taking bad bacteria. [13:59] >> Yeah. [13:59] >> Not taking all bacteria out, I guess. [14:01] >> So, you put then you put the good [14:02] bacteria in [14:04] and when this happens, you're actually [14:06] all at once [14:08] reinstalling [14:10] potentially hundreds of species [14:12] in balance in the right amounts. [14:15] So, it's like an entire ecosystem [14:16] transplant. It would be like us being [14:18] like, "Okay, [14:20] uh here's this forest that's not doing [14:22] well. [14:23] We're going to take the Amazon and we're [14:25] going to transplant it into the space [14:27] and now that we have all these animals [14:29] that like do well in this space, the [14:31] forest is washing and it's vibrant [14:33] again." [14:34] >> So, going back to our point about the [14:35] immune system, the reason why the immune [14:36] system is staying on is because I have [14:40] damaged my gut and it's essentially [14:42] trying to repair my gut. And so, if I [14:44] live in a permanent state of a damaged [14:45] gut because of what I'm consuming, then [14:48] I'm going to live in a permanent state [14:49] theoretically of inflammation. [14:51] >> The thesis from my perspective is that [14:54] the modern world [14:56] and the way in which we live [14:58] is damaging our gut, damaging our [15:00] microbiome, and then we're suffering the [15:03] consequence of that, which is disruption [15:05] of our gut barrier and ultimately the [15:07] activation of our immune system in this [15:09] forever war, which is chronic low-grade [15:11] inflammation. [15:13] >> How is cancer associated with this? We [15:15] you talked about 130 different diseases [15:17] and then your book I think it's around [15:19] page 22, you mention I think it's [15:21] chemotherapy [15:23] where you're making an analogy between [15:25] how chemotherapy kind of wipes [15:26] everything out and how [15:28] a poorly kept gut is associated with an [15:31] increase in cancer likelihoods. [15:34] >> Let's start with this. [15:36] Your body produces 3.8 million cells [15:40] every second. Your immune system has the [15:43] responsibility of identifying where [15:45] there's a problem and taking it out. [15:48] You can't possibly create 3.8 million [15:51] new cells and not have some genetic [15:53] abnormality [15:54] that could turn into the cancer. [15:56] Right? So, the responsibility of the [15:58] immune system is to basically be perfect [16:01] every day of your life and remove those [16:03] problematic cells before they turn into [16:05] something bigger and better. [16:08] It's an impossible task. There's an [16:10] entire story that's unfolding now in [16:12] this conversation about how the gut [16:14] microbiome is connected to our immune [16:17] system and the way in which we treat [16:18] cancer. [16:20] And it's it's started really in [16:22] melanoma. We have been using sort of [16:25] immune manipulations for a very long [16:27] time [16:28] to treat melanoma. [16:30] But, what changed is they were using [16:32] these things called immunotherapy. [16:35] To be more specific, [16:37] immune checkpoint inhibitors. [16:39] So, it turns out that your immune cells [16:42] have like basically a kill switch. If [16:45] there was a problem, you could like flip [16:46] it off immediately. [16:48] And that specific receptor is called [16:50] PD-1. [16:52] And the tumors, [16:54] they're so nasty because they produce [16:57] this protein that basically activates [16:59] the kill switch. [17:00] >> Turns off your immune system. [17:01] >> And it turns off your immune system. [17:04] So, the immune checkpoint inhibitor, the [17:06] idea [17:07] is to basically flip that switch back [17:09] on. [17:11] And by flipping it on, activate your [17:13] immune system, which will then wake up, [17:16] see this cancer, be like, "Okay, that [17:18] needs to be taken out." [17:20] and go after it. If someone received [17:22] antibiotics before the immune checkpoint [17:24] inhibitor, they didn't do well. So, then [17:26] it raised the question, maybe this is a [17:28] microbiome thing. [17:29] So, they said, "Okay, well, if [17:30] antibiotics do this, what happens if we [17:32] move in the opposite direction and [17:34] basically act like restore the [17:36] microbiome with a fecal transplant?" [17:39] And what they discovered was incredible [17:40] results. There's now multiple studies in [17:43] melanoma where they take people and they [17:45] give them a fecal transplant from [17:47] someone who was a responder [17:50] and give it to the person who's about to [17:51] go get treated. [17:53] And that's what they did and and with [17:56] incredible results, like literally twice [17:59] as many people [18:01] were beating cancer [18:03] relative to the expectation. The [18:05] fascinating thing about that [18:07] is that [18:08] it's not just the cancer story. [18:11] There's research now in Parkinson's [18:13] disease. So, Parkinson's disease is a [18:16] neurocognitive disorder. So, that means [18:19] basically it's a it's a brain condition. [18:22] Mhm. Well, it turns out [18:24] that [18:26] Parkinson's probably starts in the gut. [18:29] And this is actually a disorder of the [18:32] gut-brain connection because both parts [18:35] are involved. It's not just the brain [18:37] condition. [18:39] The brain condition is actually [18:42] the more severe part. [18:44] So, [18:47] for the people who are listening at [18:48] home, we have a model out and I have [18:51] just lifted their skull like uh Hannibal [18:54] Lecter and exposed their brain tissue. [18:57] And what we want to talk about is the [18:58] brain-gut connection, the connections [19:00] between the brain and their intestines. [19:02] And so, we have classically thought of [19:05] Parkinson's disease as being a brain a [19:07] brain health problem, but I'm here to [19:09] tell you that this problem begins down [19:11] here in the gut and involves the [19:13] connections between the two. [19:15] Because every single person that I've [19:16] ever seen with Parkinson's disease, [19:18] they're constipated. [19:21] All of them. [19:23] And what's interesting is that they've [19:26] now shown that the constipation [19:29] comes before the Parkinson's disease. [19:33] So now this doesn't mean for people who [19:35] are constipated, there's a lot of you [19:36] out there, this doesn't mean that if [19:38] you're constipated, you're going to [19:39] develop Parkinson's disease. There's a [19:41] very small percentage of people. [19:43] But it's important to understand that [19:44] the the manifestations of this health [19:46] condition actually start in the [19:47] digestive system before they actually [19:49] transfer up to the brain. [19:52] And so now in this study, Steve, what [19:54] they did is they took these people who [19:56] have Parkinson's disease, they gave them [19:57] a fecal transplant. They gave them a poo [19:59] transplant. They gave them a poo [20:00] transplant. [20:02] And [20:04] what they found was a year later [20:09] they had a durable, continued benefit in [20:12] terms of their movement issues. [20:16] There are now other studies with [20:18] Parkinson's disease that are showing [20:19] benefit both for the brain [20:22] and the symptoms of Parkinson's disease, [20:24] but also for the gut in terms of that [20:26] constipation that I was talking about. [20:28] >> I mean, it begs the question. These poo [20:29] transplants sound great. [20:31] Can the average person go and get one? [20:33] >> Well, I think we need to talk about [20:34] that. [20:35] >> Mhm. [20:35] >> Yeah, we need to talk about that cuz [20:36] there was a Netflix special where they [20:38] made it sound like uh [20:40] you should just do it at home. Do not do [20:42] that. Please do not do that. So, number [20:45] one, we need to study [20:48] and adequately understand what the risks [20:49] are. The fecal transplant makes it sound [20:52] like this is like the quick easy thing [20:54] that you do and you fix your entire [20:55] life. [20:56] But that's not the same as rebuilding [20:59] your microbiome using the lifestyle and [21:02] diet tools that actually are going to [21:05] give you the meaningful health impact [21:06] that you're searching for. [21:07] >> Over the long term. [21:08] >> Over the long term. [21:09] A huge percentage of the population [21:11] struggle with gut problems. We asked the [21:14] Diary of a CEO audience and roughly it [21:17] was over 60% of people that listen said [21:20] that they're currently struggling with [21:21] some kind of gut problem, whether it's [21:22] bloating or some kind of discomfort or [21:25] just [21:26] digestion issues generally. [21:29] Now that's 61% of people responding to [21:30] those three words, bloating, discomfort, [21:32] irregular digestion. Then about 15% of [21:34] people said that IBS, like 14 15% of [21:38] people said self-diagnosed that they [21:40] think they have irritable bowel [21:41] syndrome. [21:42] >> [clears throat] [21:44] >> Am I right in thinking [21:46] the causes of what they're saying they [21:49] have are wildly different potentially or [21:52] is it like one or two things? [21:55] Cuz I'm trying to figure out how I help [21:56] those 61% of people that like me have [21:59] eat something sometimes and then feel [22:01] and then not really sure what it [22:03] is, [22:04] feel a little bit bloated, might feel a [22:05] bit gassy, um might have strange [22:07] digestion but not necessarily sure [22:10] what's causing it and when. [22:11] >> Yeah. I mean this is the same issue that [22:13] I struggle with, right? So I I I wrote a [22:15] book with the goal of trying to help as [22:17] many people as possible knowing that you [22:19] can't there's no one-size-fits-all. [22:22] Right? So ultimately it's about [22:23] empowering people with the right [22:24] information and helping them to identify [22:27] I literally wrote about this in my [22:28] author's note right in the front of the [22:29] book which is basically to say you're [22:31] all going to read the same book but the [22:33] way in which this book touches you is [22:35] going to be unique to you. There's going [22:37] to be something in there that you're [22:38] going to find that you're like that's my [22:40] moment. That's my aha moment. Right? And [22:43] for many people like just looking [22:44] statistically, looking at the average [22:46] American diet, there's a huge [22:48] opportunity when it comes to diet. [22:50] And that is where I put a lot of energy [22:52] and attention because I just I know what [22:54] the stats say. So I know America needs [22:56] this. [22:57] But at the same time there's a [22:59] conversation that gets into other topics [23:01] that look, the way that we live is [23:04] different than the way that our [23:06] grandparents grew up when they were [23:07] kids. [23:08] To me, it's more about like helping [23:10] people to see like what is that one [23:11] thing for them. There's some people who [23:13] are going to be listening to this that [23:15] it's not their diet. It's not sleep. [23:17] It's not circadian rhythm. It's trauma. [23:20] And I think that these are things that [23:21] need to like we need to shine a light on [23:22] that. [23:23] >> We'll do all of that. On this point [23:25] about bloating, discomfort, irregular [23:26] digestion, if I have one of those [23:28] things, does that theoretically mean [23:30] that something is not right? [23:33] >> Everyone gets bloated once in a while. [23:34] So, I think I think it would be unfair [23:37] to make it sound like you should never [23:38] have any adverse symptoms at all. [23:41] >> But if it's prolonged? [23:42] >> But if it's prolonged, if it's a chronic [23:43] health issue, if you're the type of [23:44] person who you wake up in the morning [23:46] and you say, "I hope today's going to be [23:47] a good day. I hope I don't have to deal [23:49] with that specific issue." You are you [23:51] have a problem. [23:53] Like we already know and then we have to [23:55] work on that to address that issue. [23:57] And how we go about that, I think needs [23:59] to be on some level personalized. [24:02] But the tools that are at our disposal [24:06] remain the same. So, it's just a matter [24:07] of like let's put it on the table. [24:10] Here are your choices. [24:11] You pick which ones are most applicable [24:13] to you. Where are the opportunities for [24:15] you? And I I can't tell you that without [24:16] knowing more about you. [24:17] >> What about this issue of people getting [24:18] gassy, like farting a lot? [24:20] >> Yeah. [24:20] >> Is that typically associated with one [24:22] particular gut issue? Or is that again, [24:25] could that be a plethora of issues? [24:26] >> So, it could be a it could be a plethora [24:27] of issues. This is [24:29] This is a common [24:31] If I have to like start with what is my [24:33] number one thing, it's constipation. [24:35] For sure. [24:36] 100%. There are so many people who are [24:39] listening right now that are constipated [24:41] and they don't even know it. [24:43] Because they poop every day and they [24:45] think that how often they poop is the [24:48] definition. [24:49] And that's not true. [24:51] So, constipation is what happens when [24:53] you're not adequately emptying your [24:55] bowels. [24:58] And that could be a frequency problem, [25:00] but it could also be that it's a partial [25:03] poop. [25:04] >> Oh, okay. Cuz I thought constipation was [25:06] if you just haven't been to You can't go [25:08] You go to the toilet and nothing comes [25:08] out. [25:09] >> Look, don't get me wrong. If you If you [25:10] don't poop for a week, I know you're [25:11] constipated. I don't need to ask any [25:13] more questions. If you go a week But if [25:15] it's [25:16] There are people who they poop every [25:17] other day. [25:18] That's their normal. They feel fine. [25:21] They don't have any gut symptoms. They [25:22] don't have a constipation problem. We're [25:23] okay. [25:25] >> Right. So, frequency is not the be-all [25:27] and end-all. [25:27] >> It's part of the It's part of the [25:28] equation, right? [clears throat] But [25:30] there's also people who they poop [25:34] and I I want to sort of paint the [25:35] picture and [25:36] forgive me. Like, I feel very [25:37] comfortable talking about poop. This is [25:39] what I've done for a living. [25:41] But [25:42] they they go to the bathroom in the [25:44] morning. They struggle. [25:46] It's not satisfying. [25:48] They had to work really hard to get a [25:49] little nugget to come out. [25:52] And then they feel like they still have [25:53] to go. [25:55] And maybe 45 minutes 45 minutes later, [25:57] they poop again. [25:59] Okay, that's not a new poop. [26:01] You're doing partial poops. You're [26:02] probably doing a 20 or 25% poop. [26:05] So, you could poop three, four times [26:07] during the day. You might not still be [26:09] fully emptying your bowels. [26:11] Right? And so that So, that's an example [26:14] of a person who can actually be [26:15] struggling with bloating and [26:16] constipation and not think because [26:18] they're like, "Doc, I'm pooping three [26:20] times a day." [26:21] >> Where is the gas coming from in that Why [26:24] Why do people [26:25] You eat something and then you fart a [26:26] lot. What's going on? [26:27] >> So, gas So, gas travels with poop. Um [26:30] uh [26:31] you may I don't mean you specifically, [26:33] Steve. People listening may notice this [26:36] that you wake up in the morning and [26:39] you're farting like crazy. [26:41] And that farting continues until you [26:44] actually have your morning bowel [26:45] movement. And then once you have your [26:47] good, healthy morning bowel movement, [26:49] you feel solid and you're not farting [26:51] anymore. Right? The gas travels with the [26:53] poop. [26:54] So, and the reason why this happens is [26:55] because first of all, your poop is not [26:58] just the leftover remains of your food. [27:01] Actually, your poop is predominantly [27:03] your microbiome. [27:05] 60% of the weight of your stool is [27:08] microbial. [27:09] >> Really? [27:10] >> Yes. [27:12] >> When you say microbial, you mean like [27:13] the bacteria? [27:14] >> The bacteria. [27:14] >> 60% of it [27:15] >> Let me give you an example. If I took [27:17] your drink and I added [27:19] some soluble fiber, which is prebiotic, [27:22] into your drink. [27:23] >> Yeah. [27:23] >> There's no grit. [27:25] There's no roughage. You don't even know [27:27] it's there. [27:29] And you're going to have a bigger, [27:30] healthier bowel movement tomorrow as a [27:32] result of what I just did. Why? Because [27:34] I fed your microbes and they grow [27:36] stronger and then they multiply and [27:38] because they multiplied, you have a [27:40] bigger bowel movement. [27:42] Right? That's the way that that works. [27:44] Now, don't get me wrong. You eat, you [27:46] know, a salad, [27:47] you're going to end up with a bigger [27:48] bowel movement as well, but a big part [27:51] of that is the fiber within that salad [27:53] that's feeding these microbes. They [27:54] multiply, they grow and you have a big [27:56] bowel movement. [27:56] >> So, if that was my if that was my my [27:58] stool, my poop, I'm holding a chocolate [28:00] bar here. [28:01] 60% of that would be [28:04] the microbes. [28:04] >> 60% of that would be the microbes. Yes. [28:07] So, for that person, when the poop is in [28:11] gridlock and it's not moving through, [28:14] then those microbes are basically [28:16] sitting there with unlimited time [28:19] to ferment [28:21] and produce gas. [28:22] >> Okay. [28:23] >> So, anything they come into contact [28:24] with, they're just going to start [28:25] working on it. So, it and it's not just [28:27] like a fiber thing. [28:29] Anything they come into contact with, it [28:30] could be protein, they will ferment it, [28:32] they will produce gas. So, this is a big [28:35] part of the reason why constipation is [28:36] so strongly associated with gas and [28:38] bloating. [28:39] >> When people eat dairy and things like [28:40] that, I think some people that have [28:42] gluten, they they often tend to get a [28:44] little bit gassy. [28:44] >> Yeah. [28:46] >> Is that constipation? [28:48] >> Gas and bloating is not just a [28:49] constipation issue. I would argue that [28:51] constipation is the number one cause of [28:54] that particular issue, but there's many [28:55] potential causes. Number one could be [28:57] motility, that's constipation. [28:59] >> What's motility? [29:00] >> Motility is the way in which your [29:01] intestines move. [29:03] So, if the intestines move too fast and [29:05] out of rhythm, you get diarrhea. [29:07] If the intestines slow down too much, [29:10] sluggish, [29:11] you get constipation. We want the [29:14] intestines in a rhythm because when [29:16] they're in a rhythm, just like your [29:17] heart, [29:18] that's when they perform their best. [29:20] So, in a rhythm basically means [29:22] predictable, consistent, daily bowel [29:25] movements. [29:26] That's ultimately where we would love to [29:27] be. [29:28] Right? And that in a way taps into like [29:30] an entire circadian conversation that we [29:32] can have later. [29:33] This is a part of your circadian rhythm [29:36] is a fantastic morning bowel movement. [29:38] Motility is just one of the causes of [29:40] gas and bloating. [29:41] The second is the microbiome. [29:43] If you have a microbiome that's damaged [29:45] and struggling, [29:47] it's not going to be able to do its job [29:48] the way it's supposed to. [29:51] And part of its job is processing and [29:53] breaking down fiber [29:56] because the fiber in our diet, we don't [29:58] have the enzymes to digest it. [30:00] So, it works its way through the [30:01] intestines, comes into contact with the [30:02] microbes, and the microbes, they have [30:05] literally 60,000 enzymes [30:07] that we don't have as humans. [30:10] They go to work [30:11] as [snorts] teams. [30:13] Fiber stops being fiber, [30:15] produces short-chain fatty acids. This [30:17] is the way that it's supposed to work. [30:20] When your gut is not happy, they're [30:22] weak, the microbes are weak, [30:24] and you're asking them to do work, [30:27] and they can't handle that. [30:29] And you end up with sloppy digestion, [30:31] and that's gas and bloating. [30:33] The third thing can be your diet. [30:35] So, you just mentioned dairy, [30:38] which contains lactose. [30:39] Lactose can be easily fermented to [30:42] produce gas. [30:44] You mentioned gluten. [30:46] Gluten itself is a protein. So, can [30:49] gluten technically be fermented? Yes, it [30:51] could be technically fermented, but [30:52] that's not really the that's not really [30:53] what's going on. [30:55] What's happening [30:56] is that gluten-containing foods, [30:59] which are wheat, barley, and rye, [31:02] also contain these carbohydrates called [31:05] fructans. [31:07] And fructans are actually really good [31:09] for our microbes. They're prebiotic. [31:12] But, if you consume a very large amount [31:14] of them and you're not used to eating [31:15] these foods, [31:18] it can cause gas and bloating. [31:19] >> These days, when I was younger, if I had [31:22] uh if I had pasta, [31:23] I was fine. If I have pasta these days, [31:25] I'm going to feel it for the next like [31:26] two two days. [31:28] >> Really? [31:28] >> Yeah, I don't know. And I didn't even [31:29] know what's going on. But, then other [31:30] people can eat pasta [31:32] as much as they want, it seems. [31:34] >> Out of curiosity, can you go to Italy [31:35] and eat pasta and be okay or no? Same [31:37] thing? [31:38] >> I've not really not really tried. Um I [31:41] >> Okay. [31:41] >> anecdotally, I think when I remove [31:44] when I have like non-gluten [31:47] bread or non-gluten pasta, I I think I'm [31:50] I feel much better. But, I but I'm well [31:52] aware from speaking to people like [31:54] yourself that such a small percentage of [31:56] the population is actually gluten [31:57] intolerant. But, we all kind of think we [31:59] are to some degree. I think it's what's [32:01] what's the the numbers? Is it like 20% [32:03] of people think they are or something? [32:04] >> So, like here in Los Angeles, it's um [32:07] like probably 80% of people think they [32:10] are gluten-free. Well, like almost [32:11] everyone's gluten-free, yeah. Right? [32:12] >> Which [32:13] >> they don't need to be. [32:15] And and actually it can cause problems. [32:17] It can it can cause problems to be [32:18] gluten-free [32:19] unless you know what adaptations to [32:22] make. [32:23] >> So, what do you when you ask that [32:24] question about Italy, what are you [32:25] getting at? [32:25] >> There's a processing issue [32:28] in the United States [32:30] involving wheat, [32:32] which is that they allow the wheat to be [32:35] sprayed with glyphosate, [32:37] which is Roundup. It's a weed killer. [32:39] And you they do that to basically dry it [32:42] out as quickly as possible. So, imagine [32:43] for a moment that you're a farmer [32:46] and you have this this field of wheat, [32:48] you harvest it. Okay? Here are your [32:50] choices, Steve. You can wait a couple [32:52] weeks and let it dry out naturally in [32:54] the air and store it somewhere or you [32:57] can spray it with this chemical and it [32:59] will be dry by tomorrow and then you can [33:00] ship it out. [33:01] >> Yeah. [33:02] >> Right. And the problem is that [33:03] glyphosate is not on the label. [33:06] You would never know whether it's [33:07] sprayed or not sprayed unless you're [33:08] buying organic. If you buy organic, then [33:10] by definition they're not allowed to [33:12] spray it. [33:14] You would never know if it's there. [33:16] The The The thing about glyphosate is [33:18] that [33:20] it's been approved [33:22] to exist in our food system under the [33:25] assumption of safety [33:28] because [33:29] what it does is it shuts down this thing [33:31] called the shikimate pathway. [33:34] And that kills weeds or it kills plants. [33:37] And we have a workaround. [33:40] And it has to do with basically amino [33:42] acids. We have a workaround where we can [33:44] basically create those amino acids as [33:46] humans. [33:48] But the plants can't. So, the plants [33:49] die, we live. [33:51] But there's a problem. [33:53] Which is that the microbes [33:55] that live inside of our large intestine, [33:59] they don't have the workaround. [34:02] So, that microscopic amount of [34:05] glyphosate, you would say, "Well, us big [34:08] humans, that's so small." [34:09] Yeah, but what do you think happens when [34:11] it comes into contact with them? [34:14] We know that glyphosate disrupts the [34:16] microbiome. [34:18] That it depletes the beneficial [34:20] bacteria. [34:21] And the ones that tolerated it the best [34:23] are the inflammatory ones. The bad [34:25] bacteria. The bad bacteria. So, you're [34:26] shifting the balance. [34:28] And this is this is a small thing, but I [34:30] hear from people, Steve, that go to [34:32] Italy, they say, "I can't eat wheat in [34:34] the United States." [34:37] And then they go to Italy and they're [34:38] fine. [34:38] >> And you think it's that glyphosate? [34:40] >> Yeah, they don't do that there. [34:41] >> So, if I tried I'll try organic pasta [34:44] tonight. [34:46] And maybe that will be better. [34:47] >> Yes, and then like the alternative [34:48] choice is how do you do it bread? Are [34:51] you okay? [34:53] >> Uh not [34:55] all bread. [34:57] My my generally I stay away from bread. [34:59] >> Okay. Do you ever eat sourdough? [35:00] >> Yeah. [35:01] >> Do you do okay with sourdough? [35:02] >> Yeah. [35:02] >> There we go. So, here's the here's the [35:04] second part of this equation. Put the [35:06] glyphosate put that to the side for a [35:07] moment. Let's talk about the fructans [35:09] that we were talking about a moment ago. [35:11] When you ferment [35:13] your uh your wheat, when you ferment [35:15] your dough [35:17] you actually reduce the fructan content. [35:20] >> What's fructan? [35:21] >> So, these are the the long-chain [35:23] carbohydrates [35:24] that exist in wheat, barley, and rye. [35:26] So, if it contains gluten [35:27] it also contains these fructans. So, [35:29] gluten is not the the only thing in [35:30] wheat. [35:31] >> Right. [35:32] >> And these fructans, again they're good [35:34] for you. [35:35] They're good for your microbiome, but [35:37] people who have a slightly damaged gut, [35:40] they struggle to process and digest [35:42] them. [35:43] So, this would explain why some people [35:45] they eat they eat, you know, [35:47] wheat-containing gluten-containing foods [35:50] and they struggle, but they do okay with [35:52] sourdough. Because if you ferment the [35:54] the bread, it takes it reduces the [35:56] fructan content and actually then you [35:57] can tolerate it. [35:58] >> Oh, okay. So, you think it might be the [36:00] fructan in the bread that I have an [36:01] issue with and sourdough doesn't have [36:03] fructan in it. [36:04] >> Yeah, there was there was a study that [36:05] was in gastroenterology a few years ago. [36:06] Gastroenterology is the top journal in [36:08] my field. [36:09] Where basically they they sent people [36:11] home with a bunch of breakfast bars. [36:14] All right, not chocolate, but [36:15] nonetheless. They sent people home with [36:17] a bunch of breakfast bars, three of [36:18] them. [36:19] One of them was a placebo bar. So, they [36:22] didn't add anything special. [36:23] One of them contains a very large [36:26] concentration of [36:28] And then the third one contains the [36:30] fructans. [36:31] And the placebo is our standard. We're [36:34] going to compare it to that. [36:36] When people ate the gluten-containing [36:37] bar, and these were, by the way, people [36:38] that um they did not have celiac [36:40] disease, they did have gluten problems, [36:44] according to them, right? So, like this [36:46] is like the 20% of people that you [36:48] mentioned a moment ago who think they [36:49] might have a gluten problem. [36:51] When they eat the gluten-containing bar, [36:54] they actually had less symptoms [36:57] than the placebo. [37:00] So, in other words, the gluten is not [37:02] the problem. [37:05] But when they ate the fructan-containing [37:06] bar, [37:08] they were triggered. [37:10] So, [37:12] basically what this said is that we have [37:14] been taking this concept of gluten [37:16] intolerance, [37:18] and we've we've misnamed it. It's not a [37:19] gluten intolerance, it's a fructan [37:21] intolerance. These are people who are [37:22] tend tending to struggle with these [37:23] particular parts of that food. [37:25] >> What foods contain fructan? [37:27] >> So, uh wheat, barley, and rye. [37:30] >> Okay. [37:30] >> And different there's there's many [37:33] different types of fructans, by the way. [37:35] So, you may not react to all of them. [37:39] You may react to just some of them. [37:42] But like garlic and onions are also [37:43] classic. So, you hear people who are [37:46] like, "I can't eat garlic. I feel it's [37:47] horrible." Right? That's a That can be a [37:49] fructan issue. Teff, amaranth, sorghum, [37:52] um quinoa, [37:54] these are These are whole grains that [37:57] don't contain gluten, [38:00] and they also don't contain fructans. [38:03] >> Mhm. [38:04] How long does it take to repair the gut [38:08] when you have [38:09] done damage to it? That's a very broad [38:12] question intentionally, but generally [38:13] for the average person who's done his [38:15] sort of irritated that gut, how long [38:17] does it take to restore it for those [38:18] microbes to go back? [38:20] >> It really depends. You have to start [38:23] with Okay, what's your starting point? [38:25] Right? Like how deep is the damage? How [38:27] bad is it? [38:28] Because for the people who have [38:29] ulcerative colitis or Crohn's disease, [38:31] those are forms of inflammatory bowel [38:33] disease. [38:35] Those people have the deepest dysbiosis. [38:37] Dysbiosis is the word that we use for a [38:39] damaged gut. [38:40] >> Is it possible to reverse that? [38:42] >> Um it's possible to put them [38:45] into remission [38:47] so deeply [38:48] that they don't have a flare. [38:50] >> Is that what the flare looks like on [38:52] this little model that I have in front [38:53] of me? [38:53] >> Yes. So So going back, for the people [38:56] who are listening and not on YouTube, [38:58] you can flip over to YouTube if you're [38:59] interested, but what I'm showing here is [39:02] the model of the large intestine and the [39:04] model includes a little area that it [39:06] looks raw. [39:07] >> Mhm. [39:08] >> Ulcerated, it's bleeding. It It if you [39:11] if you were to bump up against it, it's [39:13] going to start to you'll start to see [39:14] blood coming out. So it's like a It's a [39:16] very vulnerable, sensitive [39:19] uh area. [39:20] >> Now these inflammatory bowel diseases, [39:21] Steve, I have an interesting study on [39:23] this topic. [39:24] >> They are to me the classic gut [39:27] inflammatory health condition. [39:30] And what's happening is the immune [39:32] system [39:34] is attacking the microbiome. [39:36] So technically, it's not actually [39:38] autoimmune. [39:40] Because autoimmune would be you're [39:42] attacking your own body. [39:44] The immune system's not attacking your [39:45] intestines. The immune system is [39:46] attacking your microbiome and rejecting [39:48] it. [39:50] And because that's happening, your [39:52] intestines are stuck in the middle. [39:54] >> So this here is the immune system [39:57] attacking the microbiome. [39:58] >> It's attacking the microbiome, which is [40:00] in the tube of the large intestine. [40:03] And the immune system is trying to get [40:05] at it and kill it. [40:06] >> Why? [40:06] >> And because it's decided that it's the [40:08] enemy. [40:09] So the immune system is confused because [40:11] when we're born [40:13] we don't have much of a microbiome at [40:15] birth. It's the closest that we will get [40:17] to not really having anything. [40:20] And then during the first 3 years of [40:21] life, [40:22] you build your microbiome through your [40:25] life experience. And by 3 years of age, [40:27] you are basically fully adult-sized in [40:29] terms of your microbiome. During this [40:31] time, your immune system is learning [40:35] from [40:36] and with those microbes. [40:38] So, there's this interplay between the [40:40] two that is undeniable. [40:43] Where when the microbiome is healthy [40:45] during childhood, during those first 3 [40:46] years, [40:47] it results in a healthier immune system. [40:50] >> So, what's going on here? [40:51] >> So, the immune system is supposed to [40:53] acknowledge your microbiome as being [40:56] friendly, and it does not. It decides [40:59] that your microbiome is the enemy, and [41:01] so it's taking it out. [41:03] >> So, what what what do you think is For [41:05] someone that has like irritable bowel [41:06] syndrome or Crohn's disease, and they or [41:09] they you know, they have one of these [41:10] big sort of ulcers in their small or [41:12] large intestine, [41:14] is it because of their lifestyle? [41:16] Typically. [41:17] >> So, [41:17] >> lifestyle change or [41:20] or is it lots of things? What's the [41:21] number one perpetrator? [41:22] >> Okay. There's clearly a genetic [41:24] component. [41:25] >> Okay. [41:25] >> Okay. So, we have to we have to be up [41:26] front about that. They're like, these [41:28] are these are things that are not [41:29] necessary within a person's control [41:31] entirely. [41:32] >> Because I mean, there's no evolutionary [41:34] reason why this would happen. [41:35] Like, there's no evolu- evolutionary [41:37] reason why you'd have severe gut [41:39] digestion problems. [41:40] >> No, it's not doing it. There's no [41:41] advantage to it at all. And and these [41:43] things that [41:45] uh that occur, they were quite rare [41:49] years ago. In fact, in third-world [41:51] countries [41:52] today, there's not much inflammatory [41:54] bowel disease. There's not a lot of [41:56] Crohn's disease and ulcerative colitis [41:57] in third-world countries. If you go to [41:58] Africa, there's very little. [42:01] And what then what you see though is as [42:02] countries industrialize, there's a [42:04] takeoff. And they start ramping up. So, [42:07] within the United States, over the [42:09] course of 40 years from 1970 to 2010, [42:12] ulcerative colitis and Crohn's disease [42:13] cases were increasing by up to 55%. [42:17] >> And you can get that at any age. [42:20] >> You can get that at any age, yeah. [42:21] >> if I'm healthy right now, [42:23] I could do a set of things that would [42:24] give me this. [42:25] >> Yes, in fact, if you take So, back to [42:28] our conversation about antibiotics, if [42:29] you take antibiotics, [42:31] your risk of developing an inflammatory [42:34] bowel disease in the next year just [42:36] doubled. [42:36] >> Oh, gosh. [42:37] >> If you disrupt the gut with antibiotics, [42:39] which the antibiotics do, [42:40] there's nothing that will basically like [42:43] decimate the gut faster, reducing gut [42:45] diversity, [42:47] disrupting the gut barrier by 50% during [42:49] the course of antibiotics, [42:51] and activating the immune system. It [42:53] really speaks to that like if you take [42:54] antibiotics, these risks of inflammatory [42:57] health conditions really start to go up. [42:59] We see this in both adults and kids. [43:02] >> You had a patient of yours called [43:03] Michelle who took [43:05] antibiotics and had a life-threatening [43:08] swelling of her colon. [43:10] This is This is the colon, right? [43:12] >> The [43:13] >> Show me where the colon is. [43:14] >> So, the colon is the large intestine. [43:15] >> Okay, fine, yeah. Okay. And so, she took [43:17] an antibiotic and had a life-threatening [43:18] swelling of the of her large intestine. [43:21] >> So, she took an antibiotic, she took [43:23] clindamycin, [43:24] which is a classic skin antibiotic. [43:28] >> Okay. [43:29] >> And the problem is that clindamycin [43:31] wipes out your gut, like hard. [43:34] And when that happens, there's a risk [43:36] that this [43:38] pathogenic like bad bacteria called C. [43:41] diff, [43:42] if it's in there, it can multiply, [43:45] and then you get it this infection, the [43:46] C. diff infection, [43:48] that causes inflammation of the entire [43:50] colon. [43:51] So, this patient, Michelle, what [43:53] happened I was on call [43:55] and I get this text, and they say, "You [43:57] got to come to this room right now, this [43:58] patient is sick." And she had just been [44:00] transferred in from an outside hospital. [44:02] So, I was in the middle of typing up a [44:03] consultation, drop that, run through the [44:07] hospital, walk into the room, she's [44:09] clutch clutching her belly and she's [44:11] moaning and groaning and she has no clue [44:15] where she is. She's sweaty, she's pale, [44:18] her vital signs are completely out of [44:20] whack, her heart is racing, she's [44:22] breathing really fast. [44:24] And um and I [44:27] did a a little test, which is that I [44:30] gently bumped her bed just like that. [44:34] And if a person has severe inflammation [44:37] of their intestines, [44:40] they will jump if you do that [44:43] because they have peritonitis. [44:45] Right? Or you could call it an acute [44:47] abdomen. [44:49] So, just by bumping the bed like that [44:51] was enough FOR HER TO [44:53] AND SHE'S SCREAMING, RIGHT? And [44:54] clutching her belly and she has no clue [44:56] where she is [44:57] or what is going on. She's completely [44:59] delirious. [45:01] Uh she was maxed out on antibiotics. [45:04] Our choices [45:06] were to rush her to surgery, remove the [45:08] colon, [45:09] or alternatively to give her a fecal [45:11] transplant and give her a shot at [45:13] keeping her colon. [45:15] So, I take her down to the operating [45:17] room and I actually um used a I mean I I [45:21] won't bore you with the details, but I [45:22] used a special technique that's atypical [45:24] for what I would normally do [45:26] because the inflammation was so severe [45:28] to pass a scope. [45:31] So, the scope that I used was a smaller [45:33] scope to be more gentle. [45:34] >> A scope being a tube. [45:36] >> is a tube and I mentioned that if you [45:38] get a colonoscopy, it's the size of my [45:40] index finger. So, that's like probably [45:43] about a centimeter across, but I I [45:45] instead went with a smaller scope that's [45:47] more like 5 mm, 6 mm across. It's more [45:50] gentle. [45:51] And it just makes it harder to do, but I [45:53] I basically passed the scope through her [45:56] rectum and all the way through her [45:58] intestines to get it over here on the [46:01] right side. So, that's basically like I [46:03] have now passed all the way through her [46:04] large intestine. [46:06] And in that location [46:08] I delivered the fecal transplant to her. [46:11] And so the amazing thing [46:14] is that number one that procedure went [46:16] really well. [46:18] By the next day [46:20] she was a normal human being. [46:23] She was laying in bed. She was able to [46:24] have a conversation. [46:26] And after 2 days she was so normal that [46:29] we were able to send her home. [46:32] So the entire [46:34] severe infectious issue that she was [46:37] facing [46:39] got shut down [46:41] and corrected [46:42] by restoring her microbiome. And then [46:44] when you restore the microbiome the C. [46:47] diff basically gets suppressed [46:49] and the immune system falls back into [46:51] balance. The inflammation washed away. [46:54] >> So do you have like a [46:55] like a fridge full of these fecal [46:57] matters that you can like just tap into [46:59] and when you need it? [47:00] >> No, but there's a company in in [47:01] Massachusetts that does. [47:03] >> Okay. [47:03] >> Um and so and that's what most hospitals [47:05] use is they'll basically have this sent [47:07] in. But it's actually kind of [47:08] interesting cuz there's there's new [47:10] development in this space where [47:13] for the first time drug companies are [47:16] actually identifying how to manipulate [47:18] the microbiome using things that are not [47:21] actually a fecal transplant but sort of [47:23] derived from the idea. [47:25] >> Mhm. [47:25] >> Now what [clears throat] they're [47:26] developing is a way to rebuild the gut [47:29] and protect it during this period of [47:31] vulnerability. So that's the new thing [47:33] that's coming. [47:34] >> You must hear about so many different [47:36] types of diets and juice cleanses and [47:40] whatever else that influences and [47:43] podcasters uh promote [47:46] that you absolutely hate because you [47:48] have a deeper understanding of the [47:49] consequences on the gut. [47:51] What are some of the biggest diets or [47:53] I don't know these sort of trends [47:55] that you absolutely despise because they [47:58] are misinforming people about how to [47:59] create healthy gut. [48:00] >> Well, I think the thing from my [48:01] perspective is that [48:05] trends fluctuate hard. [48:07] >> Yeah. [48:08] >> Right? In 2020 [48:09] it was like the vegan diet was in. [48:13] In [clears throat] 2023, it was the [48:15] carnivore diet. You couldn't have more [48:17] diametrically opposed diets. [48:18] >> Yeah. [48:19] >> Right? And And so the problem is that to [48:22] the person who's at home and they're [48:23] trying to get this figured out, it's [48:25] very easy to get sucked into whatever [48:27] the trend is because that's what you're [48:28] hearing about when you open up your [48:29] social media. [48:31] Right? Whereas as I sit here [48:34] the science has not changed that [48:36] dramatically in the last 5 years. We are [48:39] working on this, but these are small [48:41] fluctuations in terms of our [48:42] understanding of things. It's not a [48:43] radical We don't whiplash like that. [48:45] >> Mhm. [48:46] >> Right? So nor has your biology. You have [48:48] the same biology 5 years ago. So this [48:50] entire concept of like whipping people [48:52] over the place is total from my [48:54] perspective. [48:56] I want to start by saying that [48:59] any person who has the audacity to [49:01] change their diet in the interest of [49:03] their health [49:05] like I actually I actually think that's [49:07] incredible. [49:08] And it doesn't matter what your choice [49:10] is because you're just trying to figure [49:11] it out. [49:12] And ultimately I just want people to be [49:14] better. [49:15] But the problem is that there's a lot of [49:17] dietary advice that's insane and it [49:19] comes on both sides, Steve. [49:21] So absolutely I don't believe that a [49:23] 100% meat or organ only diet is in [49:28] balance [49:29] or the optimal solution for longevity. [49:33] But on the flip side, like a fruit only [49:35] diet, I would never support or recommend [49:36] either. That's completely insane. What [49:38] are we doing? [49:40] So I think that like these highly The [49:41] more restrictive that you get the more [49:44] that I think you're drifting away from [49:45] what is quite simple [49:47] which is whole food [49:49] in balance. [49:50] >> What about these like juice diets and [49:52] stuff like that people do? People do [49:53] like a 7-day juice diet or a water diet [49:57] or whatever. [49:58] >> So, you will you will often feel better [50:03] if you have gut issues and you take away [50:05] the stuff that's irritating your gut. [50:09] And so simplifying your diet and doing [50:11] something like that, you can make [50:12] yourself feel better on a temporary [50:13] basis and think that you did something. [50:16] Generally speaking, that's not really [50:17] doing much of anything at all. [50:20] >> How long does it take to both kill and [50:22] then create new new gut microbes? [50:24] >> Well, so the beauty of it is that your [50:26] gut is very forgiving. So, the choices [50:28] that you make today will be reflected in [50:30] your microbiome by tomorrow. The beauty [50:33] of it is that these microbes like their [50:34] superpower [50:36] is that they are able to procreate so [50:39] fast. [50:40] >> Procreate meaning [50:41] >> making babies. [50:43] So, they can make they can create new [50:44] generations like estimates are [50:47] potentially as quick as 20 minutes. [50:49] And so we can use that to our advantage [50:51] because if we actually support them with [50:53] what they need, change can come real [50:55] quick. And you know, I get back to every [50:58] 3 to 5 days, [51:01] you build a new gut barrier. [51:03] So, there's an amazing opportunity that [51:06] we have to actually see some quick [51:09] health effects. [51:10] >> Are there any big sort of health myths [51:12] or diet myths that you're concerned [51:14] about that people are currently [51:15] following or believe in particular? Is [51:18] there anything you look out into the [51:18] world and think, "Oh god, that's going [51:20] to be awful for the gut." [51:21] >> Oh, gosh. It's not something that I pay [51:24] a ton of attention to cuz I'm not on [51:25] TikTok to be honest with you. [51:27] So, um it's I find it interesting that [51:30] actually like TikTok, some of the trends [51:32] that have come more recently are [51:33] actually on point. [51:35] So, which feels great because I love it [51:37] when like people are getting excited [51:38] about stuff that's good like the fiber [51:40] maxing trend. [51:41] >> I've not heard about that one. [51:43] >> So, fiber maxing [51:45] it feels like [51:48] after not really talking about fiber for [51:51] a really long time, people are starting [51:53] to come around to the benefits that come [51:54] from fiber. [51:57] And this was really exemplified on [51:59] TikTok with this fiber maxing trend [52:01] where people are basically trying to [52:03] increase their fiber [52:04] profoundly. [52:07] So, the issue though is that you have to [52:08] ease your body into it. So, I think the [52:10] idea is the right idea of where people [52:12] are trying to go, but the execution [52:15] I just want people to do it in a way [52:17] where they feel okay. Cuz if they don't [52:18] feel well, they're going to bail, [52:20] and then they're going to think, "Well, [52:21] fiber's not for me." [52:23] >> And what was this trend? It was people [52:24] trying to just get above that up and [52:26] above that [52:27] daily recommended dose of fiber by [52:29] eating high-fiber foods. [52:31] >> Yes, and acknowledging that 95% of [52:33] people in the United States and 90% of [52:35] people in the UK [52:37] are deficient in fiber as we sit here [52:38] right now. [52:39] >> And what complications or implications [52:40] does that have for the one's gut [52:41] microbiome? [52:43] >> Massive. [52:44] >> Because fiber is feeding the good [52:45] bacteria. [52:46] >> Fiber is the principal food for the good [52:49] bacteria. [52:50] And it is the precursor to short-chain [52:52] fatty acids. [52:54] So, the short-chain fatty acids are what [52:56] we create when fiber comes in the [52:58] contact with microbes. [53:00] >> Short-chain fatty acids are the thing we [53:01] create when fiber comes in contact with [53:04] the gut microbiome. [53:05] >> Yes. [53:06] >> Bacteria. Okay. [53:08] And the short-chain fat fatty acids are [53:09] really good. [53:10] >> They're so good. In fact, of all the [53:13] things that I've studied and learned [53:15] about, these are the most [53:16] anti-inflammatory thing that I've ever [53:18] come across. [53:20] So, there's three of them. Three main [53:22] ones. [53:23] Acetate, [53:24] propionate, and butyrate. [53:27] They all have their own distinct effects [53:29] within the body. [53:31] They have effects right there in the [53:32] gut, [53:33] on the microbes, on the gut barrier, on [53:36] the immune system. [53:37] >> And these are produced these three [53:38] things you just named are produced when [53:40] fiber comes in contact with the gut [53:41] microbiome. [53:42] >> Yeah, so like if you were sterile, if [53:43] you didn't have if you were born without [53:44] a microbiome [53:45] >> Mhm. [clears throat] [53:46] >> Um like you ever hear about bubble boy? [53:48] >> Oh yeah, there there was a film or TV [53:50] show, wasn't there? [53:50] >> Yeah, it was like a documentary in the [53:51] 70s of this kid who was he was born with [53:55] this rare genetic immune disorder. [53:58] And so his family in order to try to [54:00] protect him, they isolated him thinking [54:01] if if no bad stuff can get in [54:04] then he would be fine. Right? So like [54:07] he lived in a sterile bubble. [54:10] So in theory if you were sterile, you [54:12] would never get the benefits of these [54:13] short-chain fatty acids. [54:15] >> Because you don't have bacteria. [54:16] >> Because you don't have bacteria. [54:18] >> Okay. [54:18] >> So but we have the the opposite of that [54:21] problem, which is that we have bacteria, [54:23] but we don't feed them. We don't give [54:24] them fiber. [54:25] You can't create something from nothing. [54:28] So you have to give them the fiber in [54:30] order to allow them to create the [54:31] short-chain fatty acids from it. [54:33] >> And these short-chain fatty acids so [54:34] I've got my gut microbiome in my gut [54:37] here. I put fiber in there [54:40] in the form of what foods are the best [54:42] foods for fiber? [54:43] >> Okay, so what we have here is an entire [54:46] array of choices and [clears throat] the [54:48] beauty of it is that there's only [54:51] one thing that I can spot on these two [54:54] plates that does not contain fiber. Do [54:56] you want to guess? [54:57] >> I guess that it is [55:01] Okay. [55:01] >> Do you want to give it to you? [55:02] >> it does. [55:04] Is it the It's not the turmeric, is it? [55:06] >> No, but the turmeric probably probably [55:07] doesn't have very much. [55:08] >> Okay. [55:09] >> No, it's the oil. [55:11] Because the issue is that this is 100% [55:13] fat. [55:14] So you by definition cannot have any [55:18] fiber [55:19] inside of an oil. [55:20] >> Okay. So it's like sunflower oil or [55:22] olive oil. [55:23] >> So yeah, whatever whatever type. Now you [55:25] could have polyphenols like extra virgin [55:27] olive oil has polyphenols that are [55:29] really good for the microbiome. [55:30] >> Mhm. [55:31] >> Extra virgin olive oil is actually [55:32] incredibly good for the microbiome, but [55:33] it doesn't have fiber. [55:35] Everything else [55:36] has fiber. So we have all these [55:37] different plant-based foods. And the [55:40] beauty of it is that it doesn't have to [55:41] be complicated. [55:43] Fruits, vegetables, whole grains, seeds, [55:45] nuts, and legumes, they all have fiber. [55:48] Meat, anything that's not a plant, does [55:50] not have fiber. [55:51] >> Okay. So, if it grows in the ground, it [55:53] has fiber. [55:54] >> So, if it comes if it comes from a [55:55] plant, it has fiber. And that includes, [55:57] by the way, the mushrooms. So, the [55:59] mushrooms are technically fungi. [56:02] Um but they share a lot of the same [56:05] characteristics that the plant-based [56:06] foods do. So, there's fiber, there's [56:08] polyphenols. All of these things we want [56:10] to include in a healthful diet. [56:12] >> So, if I eat these high-fiber foods, [56:14] they go into my gut, the microbiomes [56:16] produce this thing called short-chain [56:17] fatty acids. And the short-chain fatty [56:19] acids, they produce more good bacteria, [56:22] but also they help my immune system calm [56:25] down? [56:26] >> Yes. So, if you think about let's go [56:28] back to the model that we led off with, [56:31] which is that there's these three parts [56:32] to your immune system. Or actually your [56:35] I should call it your defense system. [56:37] Because your gut microbes are the first [56:39] layer of defense, right? That was what [56:40] was broken down by the antibiotics in [56:42] Michelle. [56:42] >> Mhm. [56:43] >> [clears throat] [56:43] >> The second layer of defense is your gut [56:45] barrier, which is the lining of your gut [56:47] that protects the immune system. [56:48] >> Mhm. [56:49] >> And then the third part is the actual [56:50] immune system itself. We don't even want [56:52] to have to activate that. We'd rather [56:54] the first two parts take care of it for [56:56] us. [56:57] Right? So, the beauty of this is that [56:59] you eat you consume these high-fiber [57:00] foods, they come in the contact with [57:03] your microbes right here in the large [57:05] intestine, specifically the right colon [57:07] is the classic spot. [57:09] And they they unpack them and they [57:12] release the acetate, propionate, and [57:15] butyrate. [57:17] And those three things impact your [57:19] microbes, [57:20] impact your gut barrier, [57:23] impact your immune system. Now, of the [57:25] three, [57:26] my favorite is butyrate. [57:29] Because it's the butyrate that has the [57:30] biggest effect on the microbes, on the [57:32] gut barrier. Like you literally need [57:34] butyrate in order to produce the [57:36] proteins [57:37] that holds your [57:39] uh your gut lining together. [57:41] Um and the butyrate has a direct effect [57:44] on our immune cells. [57:46] So, these are again the most [57:48] anti-inflammatory thing that I've come [57:49] across. And part of why we're suffering [57:51] with these, going back to the original [57:53] conversation about these chronic [57:54] inflammatory health conditions, and you [57:56] asked me, "Where do they come from?" [57:58] We live in an industrial world [58:01] where 95% of us, at a minimum 90% of us, [58:04] are not getting even close to the amount [58:06] of fiber that we need. [58:08] And when we compare this to other [58:10] places, [58:11] so there was an interesting study [58:14] that came out recently [58:16] where they looked at the microbiome [58:19] of people in Italy, [58:21] Singapore, [58:23] and then they had native tribal people [58:25] in the Bolivian Amazon, [58:29] and native tribal people in Malaysia. [58:32] So, two indigenous tribes living a, you [58:35] know, hunter-gatherer lifestyle [58:38] against Italy and Singapore. [58:41] And what they discovered is that there's [58:43] these radical difference in terms of the [58:45] diversity of the microbiome. There's a [58:47] difference in terms of um [58:49] their their ability to produce [58:51] short-chain fatty acids. [58:54] And there's this question that comes up [58:57] about aging. [58:58] Because as we age, [59:00] inflammation increases. [59:03] Is that inevitable? [59:06] Are we stuck in a position where, like [59:08] based upon our age, we should just [59:10] expect that we're going to have more [59:12] inflammatory issues? What they found in [59:14] the tribal populations is that [59:18] actually, that's not true at all. [59:20] So, they were protected against [59:22] inflammation regardless of their age [59:25] because of their lifestyle. [59:28] But they were living and it's not just [59:29] what they eat, it's they they wake up [59:31] when the sun comes up, they sleep when [59:33] the sun goes down, they're connected to [59:35] their tribe. [59:37] They're not looking at Instagram. [59:39] Like [59:40] there's so much to that story. The point [59:42] being though that [59:44] in the industrial world like we're not [59:45] consuming a sufficient amount of these [59:47] types of foods. [59:48] >> I guess then also [59:50] drinking alcohol and vaping. [59:52] >> No. [59:53] >> Which we, you know, do a lot more in the [59:55] western world. [59:55] >> Yeah, we do. [59:57] >> What impact does that have on the gut [59:58] microbiome? Cuz I don't typically hear [60:00] people talking about alcohol and the gut [60:01] microbiome. [60:02] >> What we know [60:04] is that it definitely affects the gut [60:06] barrier. [60:07] >> I guess it's [60:08] wiping up my my oral microbiome as well [60:10] to some degree if I'm pouring vodka into [60:12] my [60:12] >> be the same as it would be the same as [60:13] using an alcohol-based mouthwash. [60:16] >> Mhm. [60:16] >> Right, which which now we don't [60:18] recommend anymore. [60:20] And so yeah, so alcohol [60:23] there was a study actually that changed [60:24] my mind when it comes to alcohol. [60:26] So I actually don't drink hardly at all [60:28] anymore. Like very rarely I'll have a [60:30] glass or two with my wife if we're on a [60:32] special dinner. [60:34] And in this study [60:35] they [60:37] they basically gave people a significant [60:39] amount of alcohol and then they tracked [60:42] every 30 minutes [60:44] the measure of their blood alcohol level [60:46] and simultaneously the measure of [60:49] what's called lipopolysaccharide. [60:52] So it's it comes from the inflammatory [60:54] bacteria that live inside of our [60:56] microbiome. [60:57] It's not supposed to be in your [60:58] bloodstream. [61:00] If it's in your bloodstream [61:02] that generally indicates that your gut [61:05] barrier [61:06] is insufficient and weak. [61:09] Because it's able to get across. And the [61:10] problem is that [61:12] the immune system [61:15] has been trained [61:17] to identify that lipopolysaccharide [61:21] as the enemy. [61:23] And so it gets activated. [61:25] So and this is where inflammation comes [61:27] from. So in this study [61:29] they had people have a number of drinks [61:32] and they start tracking every 30 [61:33] minutes. [61:34] And what you saw [61:36] was that as the blood alcohol level goes [61:39] up [61:41] in parallel [61:43] the lipopolysaccharide [61:45] goes up. [61:46] When the alcohol peaks [61:48] so did the lipopolysaccharide. [61:51] There was this weird thing that [61:52] happened. I don't I can't explain why [61:54] but [61:55] the alcohol level peaked, it started to [61:56] come down and then actually bumped back [61:58] up. [61:59] And when that happened the [62:00] lipopolysaccharide followed the exact [62:02] same pattern. [62:04] And [62:06] the lipopolysaccharide [clears throat] [62:08] did not return to normal [62:11] until the alcohol level was zero. [62:13] So when I saw this from my perspective [62:17] to be clear, it wasn't a study of one [62:20] drink. [62:21] Although we do know that one drink is [62:22] sufficient to disrupt your sleep and [62:25] cause other health issues. But [62:28] when I saw this, I saw enough to say I [62:31] don't think there's any amount of [62:32] alcohol that's safe. [62:33] >> To summarize what's going on there, the [62:35] alcohol's coming into the body. It is [62:37] impacting the gut in some way which is [62:39] making the gut [62:41] go into dysfunction and that dysfunction [62:46] lasts for a little while. [62:50] Cuz I'm trying to understand why you you [62:51] looked at that and thought you know [62:52] what, absolutely not. I'm not going to [62:54] drink as much as I was. [62:56] >> Yeah. So basically alcohol was causing [62:58] leaky gut. [62:59] >> Oh, leaky gut. Okay. [63:00] >> Yeah. So alcohol was causing leaky gut. [63:02] That's what That's what we saw in that [63:03] study. And the fact that [63:06] the [63:07] amount of leaky gut was proportional to [63:10] the amount of alcohol in the blood and [63:12] that the leaky gut did not return to [63:13] normal until the alcohol level was zero [63:16] says to me [63:18] that [63:20] any amount of alcohol that's detectable [63:21] in the bloodstream can create this [63:23] problem. [63:24] >> Which is going to cause inflammation. [63:25] >> Which is going to cause inflammation. We [63:27] know with total clarity that people who [63:29] are heavy drinkers [63:31] their gut is totally destroyed. [63:34] And that that's actually a requisite [63:36] step on the pathway towards developing [63:38] cirrhosis and alcoholic liver disease. [63:41] So there are some people who seem to get [63:43] away with it. [63:45] Where they can be a heavy drinker and [63:46] they never actually get cirrhosis. [63:49] And it [63:49] >> Cirrhosis is [63:51] >> Cirrhosis is the [63:53] So the liver [63:55] sits in your right upper abdomen. [63:57] And its job is to detoxify [64:01] your bloodstream. [64:03] And all of the blood that goes to your [64:05] gut [64:07] the first place that it goes after your [64:09] gut as it returns to the heart is your [64:12] liver. [64:13] And it's actually a smart setup [64:15] anatomically cuz we don't want toxic [64:18] blood to get access to the heart and [64:21] then circulate and ultimately get back [64:23] to the brain. [64:24] So we allow the liver to protect and [64:27] defend it. [64:28] But the cirrhosis, what's happening is [64:30] that basically the liver, which is soft [64:33] and spongy, like imagine a sponge that [64:36] you can put it under a faucet, the water [64:39] goes in one end, well this is way [64:40] through, comes out the other end. [64:42] Okay? Instead of that [64:44] it's just a piece of plastic. [64:47] Right? It's hard. [64:48] It's not letting anything through. [64:51] That's what That's what happens when a [64:52] person develops cirrhosis. [64:54] >> Mhm. [64:54] >> So and there's many causes of cirrhosis. [64:56] Cirrhosis comes from inflammation. So [64:58] all [64:59] all cirrhosis health conditions [65:01] ultimately are inflammatory health [65:02] conditions. They're all part of the 130 [65:05] health conditions associated with [65:07] inflammation. [65:08] But in this particular setting, but [65:10] talking about is alcohol. [65:12] And what I'm saying [65:13] is that to create that inflammation in [65:15] the liver, [65:16] based on the available data, it seems [65:18] you have to disrupt the gut microbiome [65:20] in order to get there. [65:22] >> So many of us are pursuing passive forms [65:24] of income and to build side businesses [65:26] in order to help us cover our bills. And [65:28] that opportunity is here with our [65:30] sponsor Stan, a business that I co-own. 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So you can train yourself to [66:57] create exactly like the best performing [66:58] teams in the world do. Just head over to [67:00] adobe.ly/onebetter [67:03] to download Adobe Express now. And make [67:05] sure you visit the learn tab to discover [67:08] how you can become one better than the [67:10] rest. There's a [67:12] orangey looking chemical on the uh [67:15] plate over there, turmeric. [67:17] People talk about turmeric a lot when [67:19] they're speaking about inflammation. [67:21] >> Yeah. [67:21] >> I'm not really sure what the truth is on [67:24] turmeric and inflammation. [67:25] >> Yeah. You have to be a little bit [67:27] careful [67:28] because you could easily overdo it. [67:30] >> Oh, really? [67:31] >> So, well, so we just have to be smart [67:34] with the way that we approach cuz the [67:36] [snorts] turmeric that we're really [67:37] talking about is if you were to take it [67:39] on a consistent daily basis, [67:41] which actually from my perspective makes [67:44] a ton of sense for people that have [67:45] chronic inflammatory health issues. [67:47] >> So, tu- turmeric is helping inflammation [67:49] go down somehow? [67:50] >> It turmeric is helping inflammation to [67:52] go down because it blocks another one of [67:55] the cytokines. So, in the same way we're [67:57] talking about those walkie-talkies and [67:58] like basically pulling the batteries [68:00] out, [68:00] >> Mhm. [68:01] >> turmeric helps to accomplish that. [68:03] So, there's a specific cytokine that [68:04] that turmeric has that effect. And so, [68:07] is the you mentioned curcumin. So, [68:08] curcumin [68:10] is the phytochemical [68:13] found in turmeric. Turmeric is the root. [68:15] >> Okay. [68:16] >> Curcumin is the chemical [68:17] >> Okay. [68:17] >> that actually does the thing. [68:20] And it turns out that curcumin is what [68:22] we call a polyphenol. [68:24] So, polyphenols as we sit here and we [68:26] look at this beautiful array [68:29] of all these colors, [68:31] every single one of these foods contains [68:34] polyphenols [68:35] that define the color [68:38] and that impact the gut. [68:40] Like the onion here would have [68:42] quercetin, and many people have heard of [68:43] quercetin as being beneficial for [68:45] longevity. Same would be true for the [68:46] garlic. [68:47] So, there's different polyphenols for [68:49] different colored foods, [68:51] and 95% of them [68:53] require our gut microbes [68:56] in order to be activated. [69:00] So, with turmeric, you just need to be [69:01] careful with supplements because if you [69:03] overdo it, if you take too much, that [69:05] could create an issue though. [69:07] >> Here in front of me, I have a I guess a [69:10] I guess this is a perfect gut day. [69:13] Have you seen this? [69:13] >> Yeah. [69:15] >> I wanted you to explain to me [69:18] step by step how to have a perfect gut [69:20] day. [69:22] And this? [69:23] >> All right. [69:25] So, I'm going to I'm going to define for [69:28] people the way that I would approach the [69:30] perfect 24-hour rhythm. [69:32] We have an innate circadian rhythm. [69:34] Circadian rhythm basically means that [69:36] our body functions on a 24-hour clock. [69:39] Why? Because we evolved with the sun. [69:42] The sun goes up and it comes down, and [69:44] that is one of the most powerful things [69:46] that defines everything that exists both [69:49] for us as humans [69:50] and in our entire environment, right? [69:52] So, everything around us also evolved [69:54] with the sun [69:55] and is connected to it. [69:57] Around 50% of our genes are turned off [70:02] or on at specific times of day based [70:05] upon our circadian rhythm. [70:08] More than 50% of our microbes [70:10] rise and fall [70:12] during the course of our day to meet the [70:14] moment. [70:16] Our body thrives on consistency. So, [70:18] what I want to talk about is how do we [70:21] create a consistent daily routine [70:24] that can optimize our microbiome. And [70:26] I'm going to take you through all the [70:27] different all the different steps. Let's [70:29] imagine that the sun comes up and it's [70:32] 7:00 in the morning. [70:33] >> Yeah. [70:33] >> All right? And you naturally wake up and [70:35] you are consistent about it. You're off [70:37] to a great start. Consistency with the [70:39] time that you wake up is a fantastic way [70:42] to start your day. [70:43] And what I want you to do in the first 5 [70:46] minutes of your day [70:47] is I want you to [70:50] initially just focus on [70:52] um waking up and thinking about your day [70:56] and how you're going to approach it. [70:58] Because starting at 7:05, [71:01] you're going to wake up your microbes. [71:03] You're going to wake up your body [71:05] with hydration. [71:07] So, we're going to opt [71:09] for water. [71:11] And in a perfect world, I would love to [71:14] add a prebiotic fiber supplement to that [71:17] water. [71:18] So, like our company is called 38 Terra, [71:20] you can add that there or you can add an [71:21] alternative. [71:24] This is the hydration, the water, [71:26] turns on your gut, [71:28] turns on your brain, turns on your [71:31] kidneys. [71:32] So, no coffee straight away. No. So, [71:34] pause the coffee. [71:36] Start with hydration, [71:38] and we're waking up your gut with the [71:40] water and also with the prebiotic fiber. [71:42] That's going to feed those microbes in [71:44] your gut. Okay? So, that's at 7:05. [71:47] And let's pretend that takes you 10 [71:48] minutes. And so, now [71:51] it's 7:15, [71:52] and we're going to basically flip the [71:55] switch to tell your body it's time to [71:58] go. [71:59] That we're starting a new day. [72:01] And this is actually the most powerful [72:03] moment. So, if there's only one thing [72:05] that everyone takes away, I want it to [72:07] be this. Cuz I'm giving you the two most [72:09] powerful levers [72:11] in terms of activating your circadian [72:12] rhythm. [72:14] Number one, sunlight. [72:17] Or at a minimum, bright light exposure. [72:21] So, what happens is that light [72:24] passes through our our eye [72:27] and hits the retina in the back of the [72:29] eye, [72:30] enters into the body detects this, and [72:32] it enters into the optic nerve, [72:35] and right at the very first spot where [72:38] you could collect information from both [72:39] your left eye and your right eye, [72:42] sits this part of your brain called the [72:43] suprachiasmatic [72:45] nucleus, the SCN. [72:48] And the SCN [72:50] is the orchestrator that is the master [72:52] clock [72:54] of your circadian rhythm. [72:55] So, like I would think about it like [72:57] school. [72:58] So, when we were kids and we went to [72:59] school, we might have all been wearing a [73:01] watch [73:02] and that watch gives us a general idea [73:04] of where we are in our day. [73:06] All your organs, all your tissues, more [73:08] than half your microbes, they have their [73:10] watch. They have a feel for where they [73:12] are in the day. [73:14] But, it's the alarm that goes off [73:15] between classes that ultimately is what [73:18] matters the most. That's the central [73:20] clock. [73:21] That's your SCN. Your SCN is basically [73:22] managing all of that. And there's an [73:24] entire cascade of things that follows [73:28] from when you tell the SCN [73:30] today started. [73:32] So, that light exposure is what [73:35] basically activates the SCN [73:37] to release cortisol through a through a [73:40] series of events that releases cortisol. [73:42] All right? Cortisol [73:45] is the morning hormone. [73:47] It is it it allows us to get activated. [73:50] It makes protein and and energy [73:54] available to our cells. [73:55] It makes us focused. It actually [73:57] suppresses our immune system. [74:00] In that moment, you want more cortisol [74:02] and by getting morning light exposure, [74:04] you can bump it by 50%. [74:07] Mhm. [74:08] >> [clears throat] [74:08] >> So, we're off to a good start. The [74:10] second lever that we can pull with [74:13] our outdoor time [74:15] is exercise. [74:17] You don't need to do like a full-scale [74:19] workout. I'm not talking about the most [74:20] vigorous exercise your day. I'm talking [74:22] about light exercise. [74:24] But, if you just move your body, [74:26] right? Which [74:28] during the summertime, [74:30] what you would do is like you might go [74:31] outside and you might have a ruck vest [74:34] and you take a walk, right? When the [74:35] weather is good. [74:37] And when it's January and the weather [74:39] isn't so hot, [74:41] you might actually have a light box. [74:43] The light box allows you to stay inside. [74:47] You just got to make sure it's 10,000 [74:48] lux [74:49] is what you're looking for. [74:51] So, the light box is the substitute for [74:53] the sun. [74:55] And then you could do any form of [74:57] exercise. You could do squats, you could [74:58] do lunges, push-ups, whatever it may be. [75:00] You could do jumping jacks. You could do [75:02] yoga. [75:03] Right? So, during this period of time, [75:05] if you get light exposure [75:08] and you exercise, the exercise can add [75:10] another 25 to 50%. [75:14] This is a compounding effect that's [75:16] going to give you the ultimate morning [75:18] cortisol peak. [75:19] And then this is essential [75:22] to propel your day. [75:24] Because by getting this, you will be [75:25] more focused. [75:27] You will be able to do more from a [75:28] cognitive perspective, like your [75:29] endurance will be enhanced. [75:32] Um you also will uh sleep better [75:35] tonight. [75:37] And you will you will notice this on day [75:39] one. [75:40] I promise you. [75:41] So, all right. So, and you're going to [75:42] do that for about 20 minutes. So, from [75:43] 7:15 until 7:35, [75:46] you're going to be [75:48] doing your light and exercise, okay? [75:51] Ideally outdoor light whenever possible. [75:53] If you wear glasses, by the way, take [75:54] off your glasses. [75:55] You don't have to look directly at the [75:57] sun. At 7:35, [75:59] we're going to basically come back in. [76:02] And this is a time for us to now have [76:04] our coffee. [76:06] And also quiet time. [76:09] So, like to me, we don't have enough [76:12] time in our day the day is so [76:13] fast-paced. [76:15] Right? We need to be intentional [76:18] about creating opportunities to like [76:21] activate our parasympathetic nervous [76:22] system. [76:23] >> Which is [76:24] >> So, there's two sides to our autonomic [76:26] nervous system. Autonomic is just like [76:28] you have like you you can't totally [76:30] control it. It's just going. [76:33] One side is sympathetic. Sympathetic is [76:36] the part that gets you going fast. Like [76:37] this is your accelerator. [76:39] All right? And the other side [76:41] is your parasympathetic, which is your [76:43] break. [76:44] It's your rest and recovery. [76:47] So, now that you've done your outdoor [76:49] time and your exercise, you come in [76:51] and we want to give you 10 minutes of [76:53] just like quiet, low-key sympathetic [76:55] time. [76:56] So, that could be meditation, [76:59] breath work, [77:01] could be reading your Bible, [77:03] could be journaling. [77:05] Right? Whatever it is that works for [77:07] you. [77:07] So, you do that with your coffee for 10 [77:10] minutes [77:11] and that brings us to 7:45. [77:15] And then you have breakfast. [77:17] All right? So, and breakfast [77:19] um is the perfect opportunity to take [77:21] your supplements. [77:22] >> Okay, so what breakfast, what [77:23] supplements? [77:24] >> Okay, so your breakfast [77:25] >> And what is my breakfast strategy? Am I [77:27] going for a lot of food? Do I need to [77:28] have breakfast? Why do I need to have [77:29] breakfast? [77:30] >> have breakfast. You should definitely [77:32] have breakfast. Yeah. [77:33] So, [77:34] um [77:35] your metabolism [77:38] changes during the course of the day. [77:41] Your strongest metabolism is first thing [77:43] in the morning. [77:45] And so, what that means is that you [77:47] could literally eat the exact same food [77:50] at 7:45 [77:53] or at 3:00 in the afternoon [77:56] and when you eat it at 7:45, you will [77:58] get better blood sugar control. [78:00] You will get better blood fat control. [78:03] So, those are those are manifestations [78:05] of our metabolism and when they're under [78:07] control, that's actually really good for [78:08] our body. [78:11] So, whenever possible, we want to shift [78:14] our food towards earlier in the day. [78:16] >> And what kind of foods? [78:17] >> I would argue that we go high fiber [78:20] and moderate protein. [78:22] >> Low sugar. [78:23] >> No sugar. Yeah, or low low sugar. Right? [78:26] >> Low and no sugar. [78:27] >> Refined carbohydrates should get left [78:29] out as much as possible. [78:31] >> What's a refined carbohydrate? Give me a [78:33] >> Flour or sugar. [78:34] >> Okay, so no [78:36] >> No baked goods. [78:37] >> No eggs benedict. [78:38] >> Uh so the exception from my perspective [78:40] would be if you're going if you want to [78:41] have avocado toast, [78:44] then a sourdough. [78:45] >> Croissant? [78:47] >> Prefer not. [78:49] They're delicious, [78:50] but no, I prefer not because [78:53] ultimately what we want is we want we [78:54] want high fiber and moderate protein. [78:57] And by doing that combination, [79:00] it's maximum satiation, so you're going [79:02] to feel full. [79:03] You're giving your body what it needs [79:05] from a protein perspective, [79:07] and you're simultaneously giving your [79:08] gut what it needs from a fiber [79:09] perspective. [79:10] >> Oats? [79:11] >> So, I mean you could do oats to [79:13] for the reasons that we were discussing [79:15] glyphosate earlier, [79:17] the oats should be organic. [79:19] And if you were to do them, do them as [79:21] minimally processed. So, like I don't [79:23] really love instant oats. [79:25] >> What about for kids? If I'm, you know, [79:27] giving my kids a breakfast, should I be [79:30] thinking about anything in particular? [79:31] Cuz you know, a lot of a lot of parents [79:33] I've talked about this quite a few times [79:34] before, but when I was younger, I'd I'd [79:36] get a lot of orange juice. [79:38] And I didn't realize that orange juice [79:39] was just like sugar water. [79:40] >> Yeah. [79:41] >> Is there anything that parents should be [79:43] thinking about when they're giving kids [79:44] their breakfast? [79:45] >> Of course. [79:46] Um and I think that the most important [79:48] thing is that you need to model for your [79:50] kids [79:51] what a healthy breakfast looks like. [79:52] >> By having it yourself? [79:53] >> By eating yourself. [79:54] Because if you don't do that, then there [79:57] you can't expect them to. [79:59] So, um healthy breakfasts my kids, I [80:02] have four kids. [80:03] So, my kids love avocado toast. They [80:05] love avocado toast. [80:07] Um you could absolutely do yogurt with [80:10] berries, [80:11] right? You could do berries and nuts. [80:13] There's a lot of different choices in [80:14] that regard. So, overnight oats, chia [80:16] pudding, [80:17] these are different choices that you [80:18] could do, for sure. [80:19] >> On this point of kids, before we carry [80:20] on with our perfect morning and day [80:22] routine, [80:23] are there decisions that you make as a [80:25] parent to give your kids certain things [80:28] that will have a lasting impact on their [80:31] immune and gut function. [80:33] >> 100% [80:35] Yes, and the I think it opens up a [80:37] discussion about where the connection [80:40] between our gut and immune system [80:42] starts. It starts before birth. [80:46] The first 3 years are critical. [80:49] So, let me unpack that just a little [80:52] bit. [80:54] Steve, they have studies [80:56] where they look at mom's microbiome [80:58] during pregnancy. [81:00] All right, so like mom poops, [81:03] they analyze her poop, [81:06] and they're able to basically identify [81:08] patterns that are associated with the [81:10] kid [81:12] developing allergic diseases later on. [81:15] >> Oh, okay. [81:15] >> They also have studies where moms who [81:18] increase their fiber intake [81:20] during pregnancy [81:22] reduce the likelihood of their kids [81:24] developing allergic diseases later on as [81:26] well. [81:27] >> What about kids taking antibiotics? Does [81:29] that have a when you're forming your gut [81:31] microbiome at a young age, does that [81:33] have a consequential impact? [81:34] >> 100% Antibiotics, [81:37] uh bottle-feeding, [81:39] and birth by cesarean section, and by [81:41] the way, all of my kids were born by [81:43] C-section. It's not what we wanted, but [81:44] it's what happened. [81:46] But those three things [81:48] are associated with an impact on the [81:50] microbiome and the immune system, and if [81:53] you look downstream over the course of [81:54] the first 5 years, increased risk of [81:57] allergic diseases, [81:59] increased risk of autoimmune diseases, [82:02] increased risk of metabolic diseases. [82:04] >> Because in a C-section, the baby didn't [82:06] pass through the birth canal. [82:08] >> The birth canal, and the birth canal [82:09] would have given the baby some of the [82:11] mother's microbiome. [82:12] >> Yes, so [82:13] >> And then breastfeeding does the same. It [82:14] gives the baby microbiome. [82:16] >> Breastfeeding gives them access to mom's [82:18] skin microbiome, [82:19] >> Oh, okay. [82:20] >> but also breast milk contains these [82:22] things called HMOs, human milk [82:24] oligosaccharides. It's quite fascinating [82:26] to consider this. [82:29] We evolved where mom's breast milk [82:31] contains these things, human milk [82:33] oligosaccharides. There's over 200 [82:35] varieties. They have no nutritional [82:37] value to the child directly. [82:40] So why do we why do we have them? [82:42] Because they're prebiotic. [82:44] So these human milk oligosaccharides in [82:46] breast milk were basically designed to [82:49] feed the developing baby microbiome. [82:52] So and this is part of why we get into [82:54] some challenges where when you replace [82:56] it with with a bottle, [82:58] the formula, you might put fiber in [83:00] there, but it's like a mono fiber. [83:03] It's not the same as the 200 plus [83:05] varieties of human milk [83:06] oligosaccharides. [83:08] So there was a study that was done out [83:10] of Finland [83:11] where they looked at roughly 1,100 kids. [83:15] And they tracked them for 5 years. [83:18] And during this time, 5 years, [83:20] they got a microbiome specimen, poop [83:22] specimen from the kid, [83:24] at 3 months [83:26] and 12 months of age. [83:29] And they looked at okay, so some of [83:31] these kids develop allergic diseases. [83:34] So eczema, [83:35] food allergies, [83:38] asthma, [83:39] um [83:40] rhinitis, allergic rhinitis. [83:43] All right, those are the classic [83:44] allergic diseases. [83:47] And what they found is okay, there were [83:50] certain factors that predicted [83:52] who was going to develop allergic [83:54] diseases by the age of five. [83:57] Number one, [83:58] exposure to antibiotics in the first [84:00] year of life. [84:01] Number two, [84:03] being bottle-fed. [84:06] All right, then they looked at the [84:07] microbiome [84:08] at 12 months. [84:10] So and just to be clear, [84:12] these kids, [84:13] they they had not developed [84:16] the allergic disease yet. [84:18] That comes later. [84:20] But they looked at the microbiome at 12 [84:22] months. [84:23] And they could tell who was going to [84:24] develop the allergic diseases later on. [84:28] Because there was a specific pattern. [84:31] What was missing were the bacteria that [84:33] produce short-chain fatty acids. [84:35] >> And the short-chain fatty acids are that [84:36] chemical we talked about earlier on that [84:38] that you get from fiber. Which produces [84:40] those three things? [84:41] >> Yes. [84:42] >> Butyrate. [84:43] >> Butyrate, acetate, and propionate. [84:45] And and in in fact, when they checked [84:48] the poop for butyrate levels, the [84:50] butyrate levels were low. [84:52] So, in essence, what they discovered in [84:54] the study that was quite fascinating is [84:56] that you can look at the microbiome and [84:59] predict who will later on go on to [85:01] develop these the confused immune system [85:06] with these allergic diseases. [85:07] >> So, going back to our daily routine. [85:10] >> Yep. [85:11] >> Where are we going to? [85:12] >> Yes, we're at 7:45. And you So, you want [85:14] your high-fiber, moderate-protein [85:18] as little shark sugar as possible [85:20] breakfast. [85:21] And this is the perfect time to take [85:22] your morning supplements. [85:24] Because the morning supplements, the [85:25] ones that I recommend that are [85:26] evidence-based, are vitamin D, [85:29] omega-3s, [85:31] and turmeric. [85:32] >> That's for inflammation. [85:34] >> So, these are for inflammation. [85:35] >> Okay. [85:35] >> Yeah. [85:36] So, now [85:38] I also believe that we should test [85:40] whenever possible. There's a test for [85:42] vitamin D. There's a test for omega-3s. [85:45] If you have enough, you don't need to [85:46] take the supplement. [85:48] But if you're deficient, that's where [85:49] supplements play an important role. [85:51] So, I believe that the supplements [85:53] should be taken consistently in a [85:56] circadian fashion. [85:58] So, that means that we take our morning [86:00] supplements at the same time every day. [86:02] >> Why? [86:03] >> Because basically everything about our [86:06] microbes and our body and the way that [86:08] it works [86:09] thrives on consistency. So, supplements [86:11] would be the same. [86:13] And when we do this, [86:14] so it's It's 7:45. We've had our [86:16] breakfast. We've taken our morning [86:17] supplement stack. [86:19] And now it's been an hour since we woke [86:22] up. [86:23] And it's time for a fantastic bowel [86:25] movement. [86:27] And that is the manifestation [86:29] of all of the work that you've done. [86:31] Because when you get your morning light [86:33] exposure, that helps to contribute to [86:34] that bowel movement. When you exercise, [86:36] that contributes to that bowel movement. [86:39] When you drink your coffee, that [86:40] contributes to that bowel movement. All [86:41] these different things ultimately lead [86:43] to this to this place where you're [86:45] having that good healthy bowel movement. [86:46] And that's indicative [86:49] of a gut that's in rhythm [86:51] and doing well. So, that's your morning. [86:54] Now you're going to go to work. [86:56] And I want to circle back to roughly the [86:58] lunchtime hour. [86:59] So, you it gets to be lunchtime. [87:02] And it's 12:00 noon. And basically [87:06] I would advocate for people to have [87:08] lunch with another person, like the way [87:10] that you and I are sitting here at this [87:11] table right now. [87:13] So, because we don't do that enough. [87:15] Like way too much. We're on our phone [87:17] like this and eating at the same time [87:19] that we're flipping and scrolling. [87:21] >> How is that good for my gut inflammation [87:22] though? [87:23] >> So, feeling socially bonded to another [87:25] person, [87:27] 50% This is by the way statistics that [87:30] come from before the pandemic. [87:33] Right? So, the pandemic made this worse. [87:35] 50% of people in America were lonely [87:39] before the pandemic even started. [87:42] Loneliness is the Loneliness will [87:45] destroy your longevity faster than just [87:48] about anything. [87:50] Loneliness is has been shown to be on [87:52] par with smoking cigarettes on a routine [87:54] basis in terms of the impact that it has [87:57] on your health and your longevity. [87:58] >> And you're quite clear there that you [87:59] define loneliness as the [88:01] feeling of disconnection versus being [88:03] alone. [88:04] >> Right. [88:05] Yes. [88:05] >> Okay. [88:06] >> So, but being alone, there [88:09] you have to think about where we we [88:10] from. [88:11] So, [88:13] um [88:14] are tribal by our nature. Like, you have [88:16] to understand that for [88:19] millions of years, [88:21] humans lived the specific lifestyle of [88:24] being hunters-gatherers in our tribe. [88:27] There was no money. [88:30] The currency of wealth was your bonds to [88:33] other people. [88:35] That's what allowed you to survive and [88:37] thrive. [88:39] Your family was like basically the the [88:42] measure of wealth. The bigger the [88:43] family, the more wealthy you were [88:45] because you would work together to [88:47] support one another and take care of [88:48] each other. [88:49] But then the broader tribe, which is not [88:51] 300 people, let alone hundreds of [88:53] thousands on social media, [88:55] the broader tribe, which was this like [88:57] family of families, [88:58] we were in it together. If you and I [89:00] were in the same tribe, if someone [89:01] attacked us, I know that you would step [89:03] up to defend me, and I would do the same [89:05] for you. So, this is causing some kind [89:07] of cortisol [89:09] >> issue? Stress issue? That's then [89:10] impacting the gut microbiome and causing [89:12] inflammation? [89:13] >> If we want to torture a person, [89:15] like literally, [89:17] the easiest way to do it is to put them [89:19] in solitary isolation. [89:22] That's literally torture. We're so [89:24] social that we need that. [89:25] >> And is it the cortisol response that [89:27] that's going to cause that that's that [89:28] then causes inflammation? [89:29] >> That is correct. So, ultimately, that is [89:31] a manifestation of the brain-gut [89:33] connection. [89:33] >> Okay. [89:34] >> We have a we have an innate need of [89:37] human bonding, and when that innate need [89:39] is not met, then it's actually quite [89:41] stressful for us because we feel [89:43] vulnerable and unsafe. [89:45] >> Mhm. [89:46] We sleep worse as well. I I was reading [89:47] about some stuff around um when people [89:49] feel lonely, they go into [89:50] self-preservation, which is kind of like [89:52] I guess the the analogy would be if you [89:53] drifted off from your tribe, [89:55] >> Yeah. [89:55] >> you would have to be a bit more alert. [89:57] You have to be on edge. You'd have to be [89:58] wait you know, you couldn't sleep for 8 [90:00] hours in peace because you you're in [90:02] danger now. Yeah. You don't have that [90:04] sort of insulating factor of a group of [90:06] people. [90:06] >> It's it's so interesting to think about [90:07] like there's a condition called [90:08] Stockholm Syndrome. [90:10] And Stockholm Syndrome is what happens [90:12] if you take a person hostage. [90:15] And in that scenario, you're the person [90:17] who's taken hostage, you have a choice. [90:20] You can reject the person who's taken [90:22] you, or you can actually find the good [90:24] in them and bond with them. [90:26] >> Mhm. [90:26] >> And it's actually a survival mechanism [90:28] that within that context of being taken [90:30] hostage, people have a tendency to bond [90:33] with their captor. [90:35] And have sympathy for them. [90:36] >> Mhm. [90:37] >> And that's And we think that's a defense [90:39] mechanism because we're so social, we [90:40] need that. As opposed to like being [90:42] alone and being held captive. [90:45] >> Okay, so there So we socialize at lunch, [90:46] we have dinner with other people. [90:48] >> Yes, so I want people to socialize at [90:50] lunch to address this epidemic of [90:51] loneliness that I think is highly [90:52] problematic and not and not to be [90:54] underrated because again, that's like [90:56] smoking a pack of cigarettes. [90:58] So let's imagine that we have a nice [91:00] lunch time. We're not talking about 10 [91:01] minutes, we're talking about 45 minutes [91:04] that includes conversation, right? [91:07] And we get to the end. [91:08] And now what I would encourage people to [91:10] do before you go back to work is to get [91:12] outside and take a walk. [91:14] So there's two advantages to this. We [91:16] talked earlier about the benefits of [91:18] sunlight [91:19] in the morning and also the benefits of [91:21] exercise in the morning. [91:23] We're circling back to that. [91:25] But things are a little bit different [91:26] this time. [91:27] By getting outside, you're getting [91:28] different rays of sun. So the actually [91:31] the types of rays that we get from the [91:33] sun are slightly different and they're [91:34] more likely to boost our serotonin [91:38] later in the day. [91:40] And that serotonin is what lifts our [91:42] mood, [91:43] gives us focus, helps us to get to to [91:46] get things done. [91:47] So this reinforces our circadian rhythm [91:50] when we take a walk and we get outside a [91:52] second time. [91:54] Also, the exercise, a 10-minute walk, [91:58] just 10 minutes of simple walking is [92:00] enough to get 30 to 40% improvement in [92:03] your blood sugar control. [92:06] Because when you activate the big [92:07] muscles in your leg, [92:09] it helps to draw the blood sugar out of [92:11] your bloodstream. [92:13] So, like it's uh [92:16] the messaging there is if you just ate [92:18] too much and you don't feel well, force [92:20] yourself to take a walk. [92:22] >> [clears throat] [92:22] >> As opposed to laying on the couch. [92:25] All right, so um an outdoor walk also [92:28] activates our gut [92:30] and helps our gut to get into rhythm and [92:31] that reduces bloating after a meal. [92:34] Okay. [92:35] So, and then [92:38] you do that for 15 minutes, it's 1:00, [92:40] you're back to work. I encourage people [92:42] to have a matcha green tea. Um I'm a big [92:45] matcha believer. [92:46] This is of all the teas that exist, it [92:49] has the highest polyphenol content [92:52] and it's phenomenal for the microbiome. [92:55] So, and it gives you a nice boost to [92:58] your afternoon. [93:00] Okay, let's accelerate to 4:00. [93:04] >> I saw you um I think it was in your book [93:06] that I read this. Yeah, in your book it [93:08] talks about how the gap between sort of [93:09] 3:00 and 6:00 is the optimal time to [93:12] exercise. [93:13] >> That's right. [93:14] Yeah, so [93:15] >> 3:00 and 6:00 p.m. [93:16] >> The reason for that has to do with our [93:19] core body temperature. [93:21] So, our temperature cools off at night, [93:23] our body temperature lowers at night, [93:25] and then during the day it starts to [93:27] rise in the morning. [93:28] Exercise, by the way, in the morning [93:30] helps to accelerate that. But, our peak [93:33] is 3:00 to 6:00 p.m. [93:35] >> I felt attacked on page 159 of your book [93:37] where you said, "My one request is that [93:39] you do not have a heavy exercise late in [93:41] the evening as this activates the para- [93:43] sorry, the sympathetic nervous system [93:45] and can negatively affect your ability [93:47] to quickly fall asleep." [93:48] >> Yeah, what what time are you working [93:49] out? [93:49] >> I mean, last night it was like bloody [93:51] God, 11:00 till midnight. [93:52] >> Oh, no. [93:53] >> That's like quite typical though because [93:54] I I know, I just it's when I get my [93:56] time. [93:57] >> How's your sleep? [93:58] >> Last night not great, but I mean [94:00] a series of issues took place. [94:01] >> 2 hours, so okay, fair enough. [94:03] >> No, like a series of like my [94:05] >> Other issues. [94:05] >> The time I ate was bad and [94:08] the time I went to the gym was bad and [94:09] so [94:10] >> It was a mess. [94:11] >> It was it was it was a mess. [94:12] >> Yeah. Well, ideally 2 hours before [94:15] bedtime. [94:15] >> Okay. [94:16] >> At least 2 hours [clears throat] before [94:17] bedtime. So, and like especially when [94:19] it's vigorous exercise. If it's light [94:21] exercise, it's not a big deal. [94:22] >> Mhm. [94:22] >> But vigorous [clears throat] exercise is [94:23] a different story. [94:25] >> Okay. [94:25] >> So, yeah, so three three to six This is [94:26] more from like an exercise performance [94:28] perspective. Like that's the best time [94:30] if you want to lift heavy weight. [94:31] >> Okay. [94:32] >> 3:00 to 6:00 p.m. So, let's imagine that [94:34] we go and we get we smash a workout at [94:35] 4:00. [94:37] Right? And so, I'm going to give us an [94:39] hour to smash that wonderful workout. [94:41] And then now it's 5:00 and it's the [94:42] perfect time for dinner. I want to point [94:44] something out real quick. I We had [94:46] breakfast around 8:00. [94:48] And we had lunch around noon. [94:50] And we had dinner around 5:00. We've [94:52] spaced things out by about 4 hours. [94:55] And that's actually the perfect time [94:57] from from the perspective of your [94:59] digestive rhythm. [95:01] So, there's this thing this this concept [95:04] within the the gut that many people [95:06] haven't heard of called the migrating [95:08] motor complex. [95:10] Where between meals [95:12] your gut has this entire thing that it [95:14] does. [95:15] And it basically is like sweeping [95:17] through and reorganizing itself. [95:21] But it gets disrupted if you eat. [95:24] >> Okay. [95:25] >> So, it's ideal to give a 4-hour space [95:28] between these meals. [95:30] And that if you do that, you will [95:32] actually notice a difference in terms of [95:33] how you feel with your digestion. [95:36] So, because you've allowed your gut to [95:37] fall into a rhythm. [95:40] All right. [95:41] So, we have our dinner. It's 5:00. We're [95:43] moving into the evening. [95:45] And now it's going to be 7:00 at night. [95:48] And let's imagine I know this time of [95:50] year the sun is going down much earlier [95:52] than this in most places. [95:55] Um but imagine that it's 7:00. Look, [95:57] when the sun goes down, [96:00] you want to start to dim the lights in [96:01] your house. [96:03] You want to start to reduce your [96:05] personal light exposure. [96:07] Because light exposure, just casual [96:10] lights within your home, can cut your [96:12] melatonin down by 30%. [96:17] Melatonin is the sleepy time hormone. [96:21] So, in the morning it's cortisol, [96:24] and in the evening it's melatonin. [96:27] And it's interesting [96:29] because [96:30] what we did in the morning with both [96:32] exercise and with light exposure, it was [96:35] designed not only to enhance that that [96:37] cortisol peak, [96:39] but it also increases our serotonin. [96:42] Serotonin, the happy hormone, [96:45] that keeps us focused. Well, serotonin [96:47] is actually the precursor to melatonin. [96:50] So, when you make the investment of [96:51] morning light, morning exercise, [96:54] you're setting yourself up for excellent [96:56] sleep in 14 hours. [96:59] So, [97:01] and we want to protect that. Melatonin [97:03] is going to start to rise when it gets [97:04] dark outside. [97:05] And so, we want to dim the lights within [97:07] our home, [97:09] and we want to really be cautious [97:13] as we move towards 8:00. If our [97:14] bedtime's going to be 10:00, [97:17] forgive me if that's too early for some [97:18] people, but I think it's like nice to [97:20] have a consistent bedtime. [97:22] If our bedtime is 10:00, [97:24] then by 8:00, like we want to be sort of [97:26] dialing back on our devices [97:29] or wearing blue light blocking glasses. [97:32] The blue light blocking glasses can help [97:33] to protect us. [97:35] And then, [97:37] roughly 8:30, [97:38] take your evening supplements. So, we [97:40] had our morning supplements, which were [97:41] vitamin D, omega-3s, and turmeric. [97:44] Now, Now want to take our evening [97:45] supplements, which are zinc and [97:47] magnesium. [97:49] And if you take melatonin, that would be [97:50] the time to do it. Or if you take a [97:51] different sleepy time supplement, that [97:53] would be the time to do it. [97:54] Roughly 8:30 to 9:00. [97:56] Somewhere in that range. [97:58] So, cuz it's going to take about 60 to [98:00] 90 minutes to really kick in. [98:04] Around 9:00, [98:06] we want to activate our evening ritual. [98:09] And so, in the morning we had our quiet [98:11] time. [98:13] We should have a quiet time in the [98:14] evening, too, to intentionally activate [98:15] our parasympathetic nervous system. [98:18] And get like relaxed before bedtime. [98:23] So that at 9:30, [98:25] we [98:26] uh basically are preparing for bedtime. [98:29] And that might mean a hot shower. Like [98:30] actually like heat at night, hot shower, [98:34] sauna is perfect. [98:36] Because actually [98:38] it cools off your inner core [98:39] temperature, believe it or not. [98:42] So, and that's exactly what we want. We [98:44] want a cool room. We want a dark room. [98:47] And that will help us to sleep better. [98:48] Because then at 10:00, we want to go to [98:50] bed. And 10:00, like it could be [98:52] whatever time, but I would argue that we [98:54] should be consistent. It could be 10:30, [98:55] it could be 11:00. Whatever time you [98:56] choose, adopt to it. [98:58] But the point from my perspective is not [98:59] so much 10:00 is the magic number. It's [99:01] more so that [99:02] 10:00 is the magic number if you always [99:03] do 10:00. 10:30 is the magic number if [99:05] you always do 10:30. Consistency is key. [99:08] >> And you would recommend three three [99:09] meals a day. [99:10] >> I think that you could do three meals. I [99:11] think that you like the way that we [99:12] structured this [99:14] is that if you were done eating at 6:00 [99:17] at night and then you're having [99:18] breakfast around 8:00, you have a [99:20] 14-hour fast. [99:22] >> Do you think that fasting window [99:23] matters? [99:25] >> That specific number, 14, or in general? [99:26] >> like generally, generally having sort of [99:28] a big intermittent fasting window where [99:31] you're you haven't eaten for 16 hours or [99:32] whatever it might be. [99:33] >> I think that there's So, I think that [99:34] there's two parts to the value that we [99:36] get from time-restricted eating. [99:38] So, the first is we we our gut a time to [99:41] rest. [99:42] >> Mhm. [99:42] >> So, when you when you particularly [99:44] eating late at night like I honestly the [99:46] timing of it all could be debated. The [99:48] one spot where it's a total [99:50] non-negotiable from my perspective is [99:52] late-night eating. [99:53] So, I mean, no offense like sometimes [99:55] we're busy, right? But, [99:58] when you eat late at night, it hits you [100:00] different metabolically. [100:03] And then it carries and it lingers into [100:05] the next day. [100:05] >> Mhm. [100:06] >> And it will affect your sleep. [100:07] >> Yeah. [100:09] >> So, we really as much as possible want [100:11] to opt for early dinner time and then [100:13] shut it down for the evening. [100:16] As much as possible. [100:17] >> People will be saying, "Yes, but I'm [100:18] hungry." [100:19] And I think part of the reason that [100:20] they're hungry from what you've [100:21] explained is probably because they [100:22] didn't have breakfast. [100:24] Yeah, they like started eating later. [100:25] That's what typically what I find is if [100:27] I have breakfast, I I'm typically not [100:28] hungry late at night. [100:29] >> Yeah. Yeah, I think that I think that [100:31] breakfast helps to sort of set the tone [100:33] for the rest of the day in a in a [100:34] specific way. So, the two the two [100:36] advantages of time-restricted eating are [100:38] that you get that you get that gut rest, [100:40] which anything over 12 hours is good for [100:42] the gut. [100:43] And then the second part is I think it [100:45] just [100:46] the underrated thing that no one talks [100:48] about is it helps us to get more [100:52] consistent with our meal times. [100:54] So, this entire conversation about [100:55] circadian rhythm [100:57] can be summarized in one word, [100:59] consistency. [101:01] If you ate at the same time every single [101:03] day, you would feel the difference in [101:04] terms of your digestion. I promise you. [101:07] And so, the advantage of time-restricted [101:08] eating is it brings attention to what [101:11] time am I eating dinner? What time am I [101:12] eating breakfast? And then you end up [101:14] being a lot more consistent about it as [101:15] opposed to just flying by the seat of [101:17] your pants. [101:17] >> Do you fast ever? [101:19] Do you try and [101:19] >> Like long fast? [101:20] >> Long fast or just sort of most [101:23] time-restricted eating so I suppose [101:24] >> I do I do time-restricted eating all the [101:26] time. In fact, I most days like [101:28] I uh first of all [101:30] um I'm imperfect. [101:32] >> Mhm. [101:32] >> And so, what that means is [101:34] I don't perfectly follow all of advice I [101:35] give. So, like I don't eat breakfast [101:37] most days. [101:37] >> Yeah. [101:38] >> Cuz I'm going hard. So, like, I wake up, [101:40] I do my morning routine, I get I get to [101:42] the coffee stage, and then I jump into [101:43] the work. [101:44] >> Same. [101:45] >> So, but [101:46] >> But not today. Not today. [101:47] >> Today I did. Yeah, yeah. Today I had my [101:49] breakfast because I wanted to be [101:50] >> Okay. [101:51] >> on my game. But, on the weekend I I have [101:53] my breakfast. I notice the difference. [101:55] Actually, like, I'm I'm less hungry [101:57] during the day [101:58] when I have that breakfast. That sort of [102:00] just keeps it balanced. [102:03] Um [102:04] So, yeah, I Sometimes I do one meal a [102:07] day. [102:08] >> Last month I told you about a challenge [102:10] that I'd set our internal Flight X team. [102:12] Flight X team is our innovation team [102:13] internally here. I tasked them with [102:15] seeing how much time they could unlock [102:16] for the company by creating something [102:19] that would help us filter new AI tools [102:21] to see which ones were worth pursuing. [102:23] And I thought that our sponsor Fiverr [102:25] Pro might have the talent on their [102:26] platform to help us build this quickly. [102:29] So, I talked to my director of [102:30] innovation, Isaac, and for the last [102:31] month my team Flight X and a vetted AI [102:34] specialist from Fiverr Pro have been [102:36] working together on this project. And [102:39] with the help of my team, we've been [102:40] able to create a brand new tool which [102:42] automatically scans, scores, and [102:44] prioritizes different emerging AI tools [102:46] for us. Its impact has been huge. And [102:49] within a couple of weeks, this tool has [102:50] already been saving us hours trialing [102:52] and testing new AI systems. Instead of [102:54] shifting through lots of noise, my team [102:56] Flight X has been able to focus on [102:58] developing even more AI tools, ones that [103:00] really move the needle in our business, [103:02] thanks to the talent on Fiverr Pro. So, [103:04] if you've got a complex problem and you [103:07] need help solving it, make sure you [103:08] check out Fiverr Pro at [103:10] fiverr.com/diary. [103:13] >> If there's anything we need, it is [103:15] connection, especially in the world [103:16] we're living in today. And that is [103:18] exactly why we created these [103:19] conversation cards, because on this [103:21] show, when I sit here with my guest and [103:23] have those deep, intimate conversations, [103:26] this remarkable thing happens time and [103:27] time again. We feel deeply connected to [103:30] each other. At the end of every episode, [103:32] the guest I'm interviewing leaves a [103:34] question for the next guest, and we've [103:35] turned them into these conversation [103:38] cards. And we've added these twist cards [103:40] to make your conversations even more [103:41] interesting. And there are so many more [103:43] twists along the way with the [103:45] conversation cards. This is the brand [103:46] new edition, and for the first time [103:48] ever, I've added to the pack this gold [103:50] card, which is an exclusive question [103:52] from me. But, I'm only putting the gold [103:55] cards in the first run of conversation [103:57] cards. So, get yours now before the [103:59] limited edition gold cards are all gone. [104:01] Head to the link in the description [104:02] below. [104:04] One of the things you we touched on [104:05] briefly at the beginning was this [104:07] concept that trauma is linked to gut [104:11] function. [104:12] Powerful. In what way? [104:14] We were We were talking a moment ago [104:15] about the autonomic nervous system, [104:17] which is sympathetic versus [104:18] parasympathetic. [104:20] We live our lives on sympathetic [104:22] overdrive, [104:23] which basically is the equivalent of [104:25] constantly feeling threatened. [104:27] Right? Heart rate Heart rate pumping, [104:30] blood pressure up, [104:32] more focused, [104:35] but then you suffer the consequences [104:36] within your gut. The gut gets sacrificed [104:38] when we are activating our sympathetic [104:40] nervous system. [104:43] We don't do enough to do the opposite, [104:45] which is the parasympathetic nervous [104:46] system, which is what happens when we [104:48] when we slow down. [104:51] Conversations, holding hands, hugs, uh [104:55] prayer, journaling, meditation, sauna, [104:59] that's parasympathetic. [105:01] Okay. [105:03] So, to the trauma question. [105:06] It's been shown that And this is [105:07] something that I had to learn, not only [105:09] myself, but I had to see that [105:15] I always thought that kids, [105:18] if they were young enough, they wouldn't [105:20] remember. [105:21] And what I've realized is actually this [105:23] idea of like the body keeps the score is [105:25] so well said. It's so true. [105:28] The body does keep the score. You can [105:29] have trauma that occurs before the age [105:31] of two. There's no way you remember [105:32] that. [105:34] And yet, it will manifest later on in [105:37] adults. And this has been shown actually [105:39] in kids that are um adopted. [105:44] And like have an unstable first 2 years [105:46] of life, [105:47] they are more likely to suffer with [105:49] health-related issues later on. This [105:51] this issue of trauma, [105:53] what happens is that it restructures the [105:56] brain and how your brain functions. [105:59] >> And it keeps you sort of trapped in that [106:01] fight or flight state. [106:02] >> Keeps you trapped. Yeah. So, there's a [106:04] part of our brain called the amygdala. [106:06] >> Mhm. [106:07] >> And the amygdala is what gets activated [106:09] if you like [106:11] go to a haunted house. [106:12] You know, like if you get scared of [106:13] something, right? Or like [106:15] it's the middle of the night and [106:18] you hear something creepy in the bushes [106:20] and you're not sure what's going on. [106:21] Okay. So, that's the activation of your [106:23] amygdala. Well, the the issue for people [106:25] that suffer from trauma [106:27] is that they live with the amygdala [106:30] perpetually turned on. [106:31] >> So, if something's happened to me in my [106:32] life that's caused some form of trauma, [106:35] there's an increased probability that [106:36] I'm going to be in a more sympathetic [106:38] state in terms of my nervous system, [106:40] which is going to activate a hormone, [106:42] which is then going to disrupt my gut [106:45] motility and all the other things we [106:47] talked about. [106:48] Um [106:50] like the [106:51] gut barrier [106:53] and other dysfunction across the gut. [106:57] What is the link there? Is it Is it the [106:58] hormone that's produced when I'm in that [107:00] stress state that is impacting my immune [107:02] system, which is then having the impact [107:04] on my gut? [107:04] >> Yeah, so this is all a manifestation of [107:06] the brain of the brain-gut connection. [107:08] So, the [107:12] what's happening is that your brain [107:16] has the ability to release a hormone, [107:18] corticotropin-releasing hormone, CRH. [107:21] And CRH is this that's [107:24] effectively your sympathetic nervous [107:26] system getting activated, turned on. [107:29] In a person who's had trauma and to be [107:32] clear like not everything that's bad is [107:33] trauma, right? It's possible to have [107:35] things that are bad that are not actual [107:37] trauma. Trauma is the thing that sticks [107:39] with you. [107:40] It's it's when you have something occur [107:42] that overwhelms your ability to cope [107:44] with it. [107:46] >> [clears throat] [107:46] >> And so and then it has this lasting [107:48] effect. [107:49] >> I was thinking as you're speaking about [107:50] some of my friends that have had some [107:51] bad diagnoses recently. Got a friend [107:54] that got diagnosed with something very [107:56] very serious. [107:57] And what I then noticed is after that [107:59] diagnosis [108:01] they had lots of other health related [108:02] issues that seemed to be unconnected. [108:04] But the doctors associated with stress. [108:07] >> Yeah. [108:08] >> And maybe the traumatic news of that one [108:09] thing has caused this cascade of other [108:11] issues downstream. [108:13] >> Yeah, 100% and and that's all a [108:14] manifestation of the of the brain gut [108:16] axis. So the brain gut axis [108:18] is how we think about the brain being [108:20] connected to our gut and how they're in [108:22] communication with one another. [108:23] And within that context the brain [108:25] releases this hormone the CRH [108:27] corticotropin releasing hormone that has [108:29] an effect throughout the entire body. It [108:31] puts them on edge. [108:34] And the consequence is that that CRH [108:37] that's like um [108:38] so [108:40] this is a bit nuanced but let me clarify [108:42] something about cortisol. [108:44] Cortisol is the morning hormone. [108:47] When you get that spike in the morning [108:48] it's perfect. It's exactly what your [108:50] body needs. [108:52] What you don't need [108:53] is you don't need cortisol to still be [108:55] elevated at 10:00, 11:00, midnight, 1:00 [108:59] in the morning. [109:00] Cortisol is the get up and go hormone. [109:03] Right? Now it's disrupting your sleep. [109:05] Now it's actually the adversary of your [109:07] of your circadian rhythm. [109:09] And that's what's happening in these [109:10] people is that through that the brain [109:12] gut axis they're activating the cortisol [109:15] and the cortisol then disrupts their gut [109:17] barrier [109:18] and leads to inflammation. [109:20] >> Where does healing from that trauma [109:22] start in your view? If a patient were to [109:24] come to you [109:25] >> Yeah. [109:25] >> and they were they had loads of [109:27] complications with their gut [109:29] >> Yeah. [109:29] >> but you were able to identify that [109:30] trauma was playing a role. Where would [109:32] you start with with their healing [109:34] journey? [109:34] >> The most important thing is to is to and [109:36] I think this is the [109:38] the moment that will be most impactful [109:40] for some of the listeners, not all but [109:42] some. [109:43] The most important thing is to [109:44] understand that the trauma is the root [109:46] of the issue. [109:47] Because most people, the way that we [109:50] react to trauma is the part that we [109:52] don't want to talk about. [109:54] Right? So, we push it into the corner [109:57] and we pretend that it's not there. [109:58] We're not like we know it's there, but [110:00] we're not going to even look at it. [110:02] And so, the solution is to accept and [110:06] acknowledge that the trauma is the root [110:08] of the problem. [110:09] Because then you need to actually turn [110:10] towards it and that's under professional [110:12] that's with professional help. [110:14] >> Mhm. [110:14] >> So, there's different things that you [110:15] can do, different approaches including [110:17] cognitive behavioral therapy. They're [110:19] all administered by trained health [110:21] professionals. That's not what I do, but [110:24] step one is the acknowledgement and [110:25] understanding that's the problem. [110:27] >> Remember last time we made lots of uh [110:30] different shapes of poop. [110:32] I think we were using what's the the [110:33] Bristol stool. [110:35] There we go. [110:35] >> Yeah. [110:36] >> We have this Bristol stool [110:37] [clears throat] thing here, which is the [110:38] different types of poop that people [110:40] produce. [110:41] Um [snorts] and on this table I think we [110:43] have a variety of different styles. [110:45] Just to remind me once again, [110:47] if I was guessing, I would assume [110:51] that [110:52] maybe this one is healthy or this one. [110:55] >> Yeah. [110:56] >> Which one is healthy? [110:58] >> The chocolate bar is your is your So, [111:00] this [111:01] sweet chocolate bar right here is your [111:04] glorious Bristol 4. [111:07] >> What's a Bristol? [111:07] >> Right. A Bristol 4 So, the Bristol stool [111:09] scale [111:10] is seven unique types of poop. [111:14] And you can tell by looking in the [111:16] toilet bowl. We have been told, don't [111:18] look, there's nothing to see there. But [111:20] what I'm saying is, we discussed this, [111:22] that [111:23] 60% of the weight of your stool is your [111:25] microbiome. That's the microbiome story [111:27] right there in the toilet bowl. [111:29] And so the Bristol 4 is the normal bowel [111:32] movement. And it should be it it [111:35] shouldn't be a rectangle, [111:37] but um it's soft, [111:40] but formed like a sausage. [111:42] >> And the word Bristol is coming from this [111:45] thing called the Bristol stool chart. [111:47] >> Yeah, so the Bristol stool chart [111:48] actually comes from Bristol in the UK, [111:52] right, the city of Bristol, [111:53] um where they did a study in the early [111:55] '90s. [111:56] And what came of that study was the [111:59] discovery of these seven unique stool [112:01] types. [112:02] So and four is normal, and three many [112:05] people would consider normal. Three is [112:07] just sort of lumpy bumpy like this. [112:09] Um but and many people would consider [112:11] that to be normal. [112:13] But type one and two are constipation. [112:17] And [112:18] uh types [112:19] six and six and seven [112:22] are diarrhea. [112:23] Now, what's interesting is that the [112:25] Bristol study was [112:27] one location in the UK, 2,000 people. [112:30] Actually at Zoe, we did a a nationwide [112:33] survey in the UK and we had 140,000 [112:36] people tell us about their poop. So we [112:40] actually have we're working on [112:41] publishing the papers that came from [112:42] this, [112:43] but we have the largest survey on bowel [112:47] habits that's ever been done in the [112:48] world. [112:49] >> And how many people's poop was healthy? [112:52] >> Well, based upon the actually it was [112:54] interesting cuz the results were about [112:56] what you expect. [112:57] There's a disproportionate number of [112:59] people that are struggling with [113:00] bowel-related issues. So it's probably [113:02] about 40% of people that are struggling [113:04] with bowel-related issues. [113:06] >> Of all the different types of poop one [113:08] could have, is there any that I should [113:10] be most concerned about? [113:11] >> If you have these like [113:14] >> little pellets [113:14] >> Rabbit pellets? [113:16] That's severe constipation. [113:18] >> And is that a lack of something, a lack [113:20] of fiber or [113:20] >> Well, it can be a lack of fiber for [113:21] sure. [113:22] >> Okay. [113:22] >> But sometimes it's a stool softening [113:24] issue, too. So, like for people that [113:26] have severe constipation, [113:28] fiber is more nuanced than than people [113:32] are willing to discuss on social media. [113:34] Everyone makes it sound like the simple [113:36] solution is just increase your fiber. [113:37] It's not necessarily that simple. So, [113:39] sometimes you have to add magnesium. [113:42] Magnesium supplements are great with [113:44] fiber. [113:45] >> What do they do? [113:46] >> So, they help to draw water into the [113:48] intestine, and that water softens up the [113:51] stool. So, if you have the fiber for the [113:53] form, [113:54] and you have the magnesium to make it [113:55] soft, this is how you get a soft formed [113:58] bowel movement. We talked a moment ago [114:00] about taking a nighttime magnesium [114:01] supplement. [114:03] Okay. [114:04] If your goal is to sleep [114:06] or to relax, [114:07] magnesium glycinate is a phenomenal [114:09] choice. [114:10] But if you're constipated, that's not [114:12] going to do anything. [114:13] So, don't don't do that. [114:16] Uh for constipation, magnesium oxide is [114:19] the one that I would typically go with, [114:21] but there's also magnesium sulfate and [114:23] magnesium citrate. Those are the [114:24] choices. [114:25] >> Okay. [114:26] >> Yeah, and if you get to a Bristol 7, [114:27] which is just [114:30] >> Like diarrhea, I would say. [114:31] >> That's just Yeah, it's just liquid. [114:33] Um you're not in a good place. And [114:37] so, obviously, that needs to be [114:38] addressed as well. And be aware of what [114:40] we talked about earlier, which is that [114:42] there are some people who suffer from [114:43] chronic constipation, [114:45] and then they start having diarrhea, and [114:47] actually that's overflow. [114:48] >> Dr. Will, what's the most important [114:50] thing we haven't talked about as it [114:51] relates to all that is in your new book [114:54] um [114:55] that you think we should have talked [114:56] about. I mean, we've probably covered a [114:57] tiny tiny tiny fraction of all the [114:58] things in there, but [115:00] it gives people a flavor. Is there one [115:02] other thing that you think is the most [115:04] important thing that we haven't talked [115:05] about? [115:05] >> Here's what I really feel compelled to [115:06] say to be totally honest with you. [115:09] You're holding the book. The book is [115:10] called Plant Powered Plus. [115:12] I don't want people to be intimidated by [115:15] the title of my book. Let me explain [115:17] this. [115:18] I believe that there are many paths to [115:20] healing. [115:21] There are many different dietary [115:22] patterns. [115:24] The one that's going to work the best [115:25] for you is the one that you're actually [115:27] willing to do. [115:29] Right? So, this book is not about a [115:31] one-size-fits-all approach, nor is it [115:33] 100% plants. That's not what the book is [115:35] about. [115:37] So, instead, the conversation and what [115:39] we haven't discussed [115:41] is what's missing in our diet that we [115:44] really need. [115:45] And we've kind of started to touch on [115:47] this. I've identified four things. [115:49] And these four things you find in all of [115:52] the healthy dietary patterns. [115:54] So, whether it's Mediterranean, [115:55] pescatarian, flexitarian, [115:58] if you do it right, you're going to have [115:59] these four things. Number one, fiber. [116:03] Number two, polyphenols. [116:06] Number three, healthy fat. [116:08] So, healthy fat is the extra virgin [116:11] olive oil. Healthy fat is this avocado [116:14] right here. Healthy fat are these [116:17] seeds and nuts right here. Okay? They [116:20] all have healthy fat. And And in whole [116:23] form, you should consume these whole [116:26] form foods without restriction. If you [116:28] are obese and you're trying to lose [116:30] weight, the problem with any oil, [116:33] not just not just seed oils, [116:36] also including extra virgin olive oil, [116:38] is that this is the highest calorie [116:39] thing that exists on the entire planet. [116:42] You cannot create something with a [116:43] higher calorie content than oil. [116:46] So, [116:48] it's not to your advantage to really [116:50] focus on oil. If anything, you should be [116:52] limiting your oil intake. [116:55] But, these healthy fats, the [116:57] monounsaturated fats that you get from [116:58] nuts, from avocado, if we had fish, like [117:01] a salmon or shellfish, the omega-3s that [117:04] you get from those things, [117:06] there's tremendous benefit to those [117:07] healthy fats. [117:08] >> That was the third one? [117:09] >> And then the fourth is fermented food. [117:11] >> Okay, which is [117:12] >> So, which we don't actually see, we kind [117:14] of see here. We got the pickles. [117:15] All right, we got some pickles here. Um [117:18] but, the thing about fermented food [117:21] is most of us are not eating fermented [117:22] food. So, [117:24] the average intake of fermented food in [117:26] the United States is zero. And if any, [117:29] maybe once in a while yogurt, that's it. [117:32] We have tons of choices that are [117:34] available to us. And the key that people [117:36] need to know [117:37] is a Stanford study done by some of my [117:39] friends, [117:40] Christopher Gardner and um Justin and [117:43] Erica Sonnenburg. [117:46] And what they showed is that in just 8 [117:49] weeks, [117:50] by adding fermented food to their diet, [117:52] people could increase the diversity of [117:54] their gut microbiome. [117:55] That means a healthier gut. And they [117:57] lowered inflammation. So, as the gut [118:00] gets healthier, [118:01] inflammation goes down. And they did [118:03] that just by adding fermented food. [118:06] So, Steve, the these four things, fiber, [118:08] 95% of Americans are deficient. [118:11] Polyphenols, almost no one is getting [118:13] the recommended amount of fruits and [118:14] vegetables. [118:16] Healthy fats, we're not opting for the [118:18] types of fats that we're talking about [118:20] right now. I want people to get more [118:21] omega-3s and more monounsaturated fat. [118:24] And finally, fermented food, no one's [118:25] really consuming. If you think about [118:27] your diet, this shouldn't be an exercise [118:29] in more of the thing that you already [118:31] have. This should be an exercise of what [118:33] is the thing that's missing [118:35] that we could add that could transform [118:36] our health? [118:38] Because that's the real opportunity. [118:40] So, that's what the nutrition program is [118:41] about. [118:42] >> When I look at these uh this photo of [118:44] you before and after, I think this one's [118:47] probably sort of during medical medical [118:48] school, was it? Or was it just after [118:49] medical school? [118:50] >> No, so I was actually that's in my early [118:51] 30s on the left. Yeah. [118:54] >> And then [118:55] this photo here which I'll put up on the [118:56] screen is you at what age? [118:58] >> Yeah, about 40. [118:59] >> Okay, well you 10 years has passed and [119:01] you look 10 years younger. [119:02] >> Yeah. [119:03] >> And you look pretty ripped. [119:04] >> Yeah. [119:05] >> What changed in your life [119:08] between these two photos? What what was [119:10] different in one's mind, knowledge, [119:12] mentality, psychology? What was [119:13] different? [119:16] >> So, the [119:18] the easy answer is I changed my diet, I [119:21] changed my lifestyle. [119:22] I grew up eating junk food. I grew up [119:24] eating fast food. We celebrated that [119:25] sort of diet. [119:27] And I shifted towards eating the way [119:29] that I'm describing to you today. [119:31] Right? I obviously started going to the [119:33] gym and working out. I think everyone [119:34] should be going to the gym and working [119:35] out. I don't think that's to be [119:36] underestimated. That's an important part [119:38] of the program that I'm proposing for [119:39] people. [119:41] Right? So, there's those things, but the [119:42] part that you don't get on the surface [119:45] that I don't really talk about that much [119:47] is I also need to heal on the inside. [119:50] So, I was in a dark place. [119:53] And I wasn't in a dark place just [119:55] because of my diet. [119:56] There were issues that existed within [119:58] our family. [120:00] I had issues with my dad. [120:03] And I needed to resolve those. [120:05] And what happens? A few things. [120:08] One, [120:10] literally an angel came into my life. [120:12] That's my wife. [120:13] Right? She came into my life in 20 in [120:15] 2012. [120:17] And she never pushed anything on me. [120:21] But just seeing her and having her as a [120:23] presence in my life was what I really [120:24] needed to change myself in terms of my [120:27] diet, [120:28] in terms of my lifestyle, but also to [120:30] pick up the phone and call my dad who I [120:31] hadn't talked to in 10 years. [120:34] >> You'd fallen out? [120:35] >> Totally fallen out. [120:37] And there's an entire story that goes [120:39] into that. [120:40] And I have to own my own mistakes [120:43] because I'm as guilty [120:45] as anyone for the issues that existed [120:47] between us. [120:49] But I picked up the phone and I called [120:51] him. [120:52] And [120:54] you know, the other thing that happened [120:55] in my life that really changed [120:56] everything was the birth of my daughter. [120:58] So, my oldest I have four kids. My [121:00] oldest is now 11. [121:04] And when you hold that child in your [121:05] hands, [121:08] you're a different person instantly. And [121:10] I can't describe this to a person to to [121:12] someone who's never experienced this, [121:14] but you have a purpose that you didn't [121:15] have prior to that day. [121:17] You've experienced love that you never [121:20] understood. And the love that I had for [121:22] my daughter [121:23] helped me to understand the love that my [121:25] own dad had for me. [121:28] But I could never accept that. [121:31] And so, the complexity of it all is yes, [121:33] I changed my diet. [121:35] My lifestyle. Yes, I started working [121:36] out. [121:37] But I also needed to forgive my dad [121:41] for the things that happened [121:43] when I was a kid. [121:46] And reconnecting with my dad was [121:48] actually one of the most important and [121:49] powerful things that happened for me. [121:51] >> He was vacant? He was absent? Or was it [121:54] something [121:55] >> No. My [121:57] When I So, this is something that um [121:59] chapter eight of my new book [122:02] to me is my masterpiece. [122:04] Um of all the chapters This is my third [122:07] book. Of all the chapters I've written, [122:08] it's the one that I'm most proud of by [122:10] far. [122:11] And if you if people get the audio book, [122:14] they're going to hear it in my voice. [122:16] So, there were some things that I needed [122:18] to talk about. And you'll find them in [122:20] that chapter. And basically, [122:22] the story is that our family [122:26] we went through a [122:27] really hard time. And [122:29] um my parents got divorced. [122:33] And I was seven. And I was the oldest of [122:35] three boys. [122:36] It was not a nice divorce. [122:39] And when that happens, [122:42] you feel like you have to choose a side. [122:45] And [122:47] from my perspective, again, like [122:50] you know, I was a kid. [122:51] But [122:53] there was a part of me that [122:55] said [122:58] Dad [123:01] you're a man. [123:05] Why did you allow this to happen? [123:08] Why did you allow this to happen to our [123:10] family? [123:11] Why didn't you fix this? [123:13] And [123:15] eventually I stopped talking to him. [123:18] And that was around the time that I [123:19] graduated from college. [123:22] And so [123:24] for 10 years I [123:27] was [123:28] uh [123:29] like I went to medical school at [123:30] Georgetown. I went to Northwestern. I [123:32] was the chief medical resident there. [123:34] I won the highest award in my residency [123:36] class. I was fully accomplished. I was [123:38] like [123:39] accomplishing everything. [123:41] Um I was very, very sad inside. [123:44] And what was missing was my dad. [123:47] And I needed him there. And so having [123:51] my daughter [123:53] and feeling [123:55] uh the love that I felt instantly from [123:57] my daughter [123:58] helped me to understand the love that my [124:01] dad had for me. [124:03] And ultimately what I realized, Steve, [124:05] is that cuz [124:07] the thing you have to [124:08] know that's hard to explain [124:11] in short order is that [124:14] with I had two brothers my dad used to [124:16] take us camping [124:18] three boys, no one else, just him. [124:22] He took us camping all the time. [124:24] He took us to on vacation all the time. [124:27] If there was a sporting event, he was [124:28] always there. [124:29] Right? But I wasn't able to see that all [124:31] of that was really an act of love. [124:34] And now having kids myself and [124:37] understanding how hard it is [124:40] to be a parent and raise these kids, the [124:42] idea of taking three boys camping by [124:44] yourself is insane to me. I now [124:46] understand how hard my dad was trying. [124:49] >> And in your book published in [124:51] 2020, I believe 2020, you you wrote this [124:55] for him. [124:56] Could you read that in your own voice [124:58] cuz I was going to read it but it's [124:59] very personal. [125:01] You wrote this in the front of the book. [125:02] >> Yeah, I lost my dad during the [125:04] preparation of this book. [125:06] It was sudden and completely unexpected. [125:10] I couldn't wait to share this book with [125:11] him. [125:13] It would have been easy to just send an [125:14] electric electronic copy but I really [125:17] wanted his first read to be a physical [125:19] book with the hard cover, all the pages, [125:21] and his son's name on the front. [125:25] Over the past few months [125:27] my dad repeatedly told me how proud he [125:29] was of me. [125:30] He told me that my grandparents, John [125:32] and Helen Bolsover, would have been so [125:34] proud of the work I was doing in the [125:35] name of our family. [125:37] I can't tell you how much it means to me [125:39] that he said all that. [125:41] It breaks my heart that he's not here [125:43] anymore. [125:45] I am who I am because of him. [125:48] But I will forever be grateful for the [125:50] special times that we shared. [125:53] Love you, Dad. [125:55] We'll always be thinking of you. [125:58] This book is for you. [126:08] >> You know, we're all susceptible for [126:10] letting a relationship sour and then [126:12] losing a lot of time and I think that's [126:14] why your story is so inspiring because [126:15] it reminds us that [126:17] I guess what matters most in the end and [126:19] sometimes we can lose, I don't know, [126:20] decades, years because of grudges or [126:22] because of misunderstandings that have [126:24] never been addressed. So [126:25] I mean, it's a huge compliment to your [126:26] wife that she [126:28] had the wherewithal to to try and get [126:29] you guys to reconnect so that you could [126:32] reform that relationship before he did [126:33] pass away. [126:35] And I'm I've no doubt that he was would [126:37] be incredibly proud if it's if he was uh [126:39] watching over us now and had seen what's [126:41] happened in the [126:42] in the last 5 years in your life because [126:44] it's been incredible. Absolutely [126:46] incredible. [126:48] >> Healing comes in many forms. [126:50] And sometimes it's the changes that we [126:53] make to our diet. [126:55] And sometimes it's the changes we make [126:57] in our relationships with other people. [127:01] There's different opportunities you and [127:03] I talked about like what is the thing [127:05] for every person is something different. [127:07] >> And it's funny how they're both [127:08] inextricably linked. [127:10] Because when one gets right with [127:12] themselves and others they often find it [127:14] much easier to [127:16] get control of their diet and their [127:17] lifestyle. [127:18] >> And then it all clicks. [127:20] >> I highly recommend everybody goes and [127:21] gets this book. It's um it's going to be [127:23] published in the US here on the 13th of [127:25] January and in the UK on the 15th. [127:27] >> That's right. Yeah, Tuesday in the US, [127:29] Thursday in the UK. [127:30] >> So I'm going to link it below. [127:32] Um we've just touched on a fraction of [127:34] it and we haven't gone into much of the [127:35] details, but if you are someone that is [127:36] struggling with your gut, [127:39] you know, one of the 61% or 70% of [127:41] people that told me ahead of this [127:42] conversation that you were, [127:44] I highly recommend this book because [127:45] it's incredibly accessible in the way [127:47] that it's written, but also it's in [127:49] incredibly comprehensive and up-to-date. [127:50] And then as you said, the science on the [127:52] gut and all of the related gut-related [127:55] sort of issues and symptoms that we have [127:57] is always evolving. So I I love having [127:59] these conversations is almost refreshes [128:01] and updates to me because [128:03] every single time I learn something new [128:05] and I get more of the sort of jigsaw [128:07] puzzle of my gut health and as it [128:09] relates to like my brain and my immune [128:11] system filled in. And it's having it's [128:13] really remarkable how much of a [128:14] real-world impact these conversations [128:16] have had on me. They don't think people [128:17] know this enough, but they often ask me [128:19] like which conversations had an impact [128:21] on you. The way that I view it is it's [128:22] almost it is like a jigsaw puzzle. And [128:24] each conversation is adding a piece and [128:26] I can see since we had that last [128:28] conversation about poop and the gut and [128:30] the microbiome and all those things, [128:32] there's been radical changes I've made [128:33] to my life that have had a radical [128:34] impact. It's like the lights have been [128:35] turned on, and that's a really good [128:37] example of what this book does when you [128:38] read it. It turns on the lights. So, [128:40] highly recommend people go check it out. [128:41] You are launching a YouTube channel, you [128:43] said? [128:43] >> Yeah, I'm launching a I'm launching a [128:44] YouTube channel. It's um [128:46] The Gut Health MD, and that's also my [128:48] social hashtag on my social social [128:50] handle, so you can find me [128:52] on those locations. But, my home base is [128:55] my website, the guthealthmd.com, and if [128:57] you come there, I highly encourage [128:59] people to register for my email [129:01] newsletter, because it's a completely [129:03] free resource, basically a Substack for [129:05] free, that's designed This is where I [129:07] love to like really have these [129:09] conversations with people about, "Hey, [129:11] there's this new study, let's talk about [129:12] it. Hey, there's this thing that I'm [129:14] seeing, let's talk about it, right? Hey, [129:16] this is what I'm doing right now." [129:18] Right? So, it's a it's an opportunity [129:19] for sharing that goes beyond like the [129:20] limitations of social. [129:22] >> I'll link all of that below, everything [129:23] we've mentioned in the last 30 seconds, [129:25] so everyone can check you out. We do [129:26] have a closing tradition where the last [129:27] guest leaves a question for the next, [129:30] and the question that has been left for [129:32] you is, "What is one thing you could do [129:35] today to help rectify your life's [129:38] biggest regret?" [129:40] >> [laughter] [129:42] >> Isn't that funny? [129:45] Um [129:48] well, [129:50] I think that the good news, this is to [129:51] me uh if anything, a story of of hope [129:55] and optimism, [129:57] because [129:59] on many levels I did. Um so, [130:02] reconnecting with my dad was key. [130:05] But, I think that the other piece is [130:06] when you when you lose a person [130:09] the way that we lost my dad, he's gone, [130:11] right? And it happens real fast, and I [130:12] didn't get to say goodbye. [130:15] I will say it's my faith that allows me [130:19] to know, [130:21] like not to pretend to know. [130:24] To actually know [130:26] that [130:27] these things that I need to say to him [130:29] that I never actually got a chance to [130:30] say that I wish I did. [130:34] I'll have a chance to do that. [130:36] >> Mhm. [130:36] >> And I look forward to the day when I see [130:38] him again. [130:40] >> What would you say? [130:43] >> I would tell him that [130:46] I hate the fact that it took me so long [130:48] to figure out [130:50] that he was a great dad. [130:53] And [130:55] you know, adults [130:56] may have conflicts. That's what the [130:58] divorce was. [131:00] But he was a phenomenal dad and I [131:04] didn't see that or get that until I had [131:06] my own kids. [131:09] >> Dr. Phil, [131:10] thank you. [131:13] >> [music] [131:19] [music] [131:30] [music]