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Language: en
hello there my name is tim spector
i'm an md and a professor of genetic
epidemiology
at king's college in london where i've
been running twin studies for the last
uh 28 years
and the last 10 years i've
got really into gut health
and nutrition
and written a couple of books on the
subject called diet myth and spoon fed
and have got really interested in
personalized nutrition and helped
co-found the company zoe that's based uh
in both in london and in boston that
provides uh personal uh nutrition and is
available in the us
and it's uh we are a great pleasure to
be here to talk about my favorite
subject
which is all about microbes the gut and
the gut microbiome
and so i'm really looking forward to
this
yes well uh
tim welcome uh and uh those of you who
know me i'm dr william lee i'm a
physician internal medicine vascular
biologist and author uh and it's always
a pleasure to
have an opportunity to speak with
somebody who's
brought worlds together i think that the
medical world the traditional medical
world and the nutrition world have
for too long been separate
entities and um looking at the gut and
looking at the interconnections of the
gut and the immune system in particular
i think are um
it's an opportunity to kind of forge uh
forward um how did you get how did you
with your background how did you
actually come into
interest in nutrition and gut health
well i've been studying twins for
you know 25 years and looking at the
genetics of many conditions about how
similar identical twins were to
non-identical twins we have about 15 000
twins that we study regularly so it's
one of
the biggest data sets in the world
and
it was only really the last 10 years i
started being more interested in why
uh identical twins who are like clones
uh they have a
same genetic material in every bit of
their bodies and
they're raised you know they lived
together for 18 years why ended up
often being different why one would have
cancer the other one wouldn't one would
have an autoimmune disease the other one
wouldn't uh one would be depressed one
happy one overweight one skinny and so
that really got me into this
i'm trying to understand this puzzle uh
saying you know if i can discover that
that really could be a clue to why
everyone gets diseases that we at the
moment we can't explain and so that
journey took me
from genetics where i was you know done
most of my training and found hundreds
of genes and you know helped my cv along
the way with uh all those papers in
nature etc but want to do something a
bit more meaningful to to really tease
this apart and i look to epigenetics
which is how you switch genes on and off
and i thought that might be the solution
but it turned out that was fairly small
effects you know relatively
and it was when i did um
about 10 years ago
uh the first twin study of the
microbiome
that and i did this with a group in
cornell
we discovered that twins had very
different microbiomes
uh
they really were hardly more similar
than the newer eyes so uh that to me was
the aha moment that said ah if that's
true the microbiome could really be this
amazing link between
uh
nutrition
and our health and why
we've got so much of our nutrition facts
wrong for the last uh
20 or 30 years so just this missing
piece of the puzzle
uh like we discovered a whole new organ
in our bodies uh you know i knew like
just finding we had a second liver for
example that suddenly explained all
these amazing things
that is totally new to
to medicine and and science so that
really was that
that was the journey for me and i got
more and more interested in the
microbiome and at the same time
a bit like you i
found that going away for a while and
writing books on the subject really
broaden your mind about the whole area
and
because we as doctors we tend to get
rather narrow in our fields and
specialities and most my colleagues are
extremely narrow and they never like to
go out of that comfort zone
but you go away you write a book for the
public suddenly
there's no limits and it's a very
exciting time and so during that time i
really sort of put some my ideas
together and
and that led to this this whole idea of
the real key importance for me of the
gut microbiome
in uh pretty much all age rate of
diseases and
real the key interaction between
uh our health
with something that unlike genetics
you can absolutely modify
uh and we just got to learn how to do it
and we have the medicine really uh at
our fingertips and and that was what i
was struggling with before
with this genetics and epigenetics so we
all you could do is really blame your
parents and and you could only get so
far that way so that's really where my
passion for uh nutrition came about
because we'd understood this science and
suddenly
it became from the most boring area of
medicine the one that is taught least
in medical school and you know only the
worst people used to go into it to one
of the most exciting
cutting edge areas that we have now
yeah no i mean and i think that you and
i share this uh
versatility of
of interest in science where
uh you know i've worked on vascular
biology and cancer in
vision loss and covid
and and part of
it seems like you know what you and i
share
is this idea of looking for
common threads as the basis to be able
to actually
lunge forward to new discoveries
what's interesting about the microbiome
i think is that it's
one of the common denominators one of
the common factors in
across diseases that might seem
otherwise completely unrelated um you
know whether you're talking about
brain health or mental illness versus
digestive health versus metabolic
diseases versus even something like
cancer uh
when you boil the
pacific ocean away you kind of see how
those islands are interconnected and i
you know the microbiome seems to be one
of these interconnected
pieces of the puzzle
how do you go about studying that you
know twins are a powerful way because
you would think that so much should be
the same certainly from the genetics
perspective
can you talk a little bit about the
tools that you found most
effective in studying microbiome
sure yeah well it all really came from
the genetics revolution so
the uh we were really floating around in
the dark
before genetics came along we
to study microbes as you as you know we
you know
back in the old days we used to culture
stuff in little plates of agar and wait
for wait for bugs to grow and of course
any one in a hundred would grow
and you'd miss
most of them you actually miss all the
interesting ones and just get
these uh really nasty bugs that um
everything else you just know their
commensals we just we don't know what
they are we'll just throw them away
and that's how we were taught in med
school
and it wasn't really until about 10
years ago they had
sufficient genetic techniques to start
pinpointing the genes in the bugs that
you could pick up with the same methods
that we'd look at for genetics of
disease that we started to get this
picture of
all these amazing bugs that are living
inside us
and
what they can do and so
it's only really been the last two or
three years that
full-scale sequencing of every gene in
every bug put together in what we call
shotgun sequencing
has allowed us to get this full picture
that now gives us 80 percent of the bugs
in our guts has been revealed and to do
that you need not only massive
sequencing capacity uh but need to be
scalable and and cheap and you need
massive computers to also do it to like
this giant jigsaw puzzle to to put it
all together so it's like
it's it's thousands of times harder than
doing the human genome because
you you're dealing with thousands of
different species of bugs and parasites
and
and even now viruses and all kinds of
other stuff and fungi so
it's really been that
that is that has helped us uh but it we
couldn't have done it without going
through the pains of the genetic
revolution uh to get there in the first
place but
you know and i went through that so it
was fairly easy for me to convert
from being a geneticist to
a microbiome expert because
uh
you're using the genes to
uh identify them but
you know they're not just their genes
but basically they are chemical
factories so
the way i see the microbiome is this
this series of these amazing chemical
factories that produce
thousands of different
uh metabolites chemicals
vitamins uh enzymes things that just
drive all parts of our body
and
the genes will tell them you know
program of what they do so it's it's
putting all that together in this big
scale with this sort of artificial
intelligence type approach that that is
uh all the technology that only recently
is has become possible and
just i mean just to give people
listening an idea i mean to get your
microbiome fully sequenced with shotgun
sequencing
um probably seven years ago would have
cost you ten thousand dollars something
like that
um you know virtually unaffordable and
you couldn't do big studies at all and
now you know if you do it at scale it's
around 100 bucks
uh it's quite amazing really what what
we're going and you can learn much more
from your gut microbes than you can from
your genes in my view and i'm a i'm
talking as a geneticist so in terms of
your health
much better know what's going on inside
your gut than actually inside your genes
so because nutrition is so
uh
so close to every single individual and
food has immediacy so something that
we share or we learn about a food could
be applied to our health
almost instantaneously with the next
decision do we make
you know what you're talking about is
deep science new science and it's based
on incredible technology based on
genetics artificial intelligence and the
ability to actually
look at small molecules
i'm sort of thinking through to the
listeners and what viewers of this
how how does where does somebody go to
get involved with
microbiome research to figure out how to
actually get their microbiome sequence
like
how do you convert what we're talking
about now into
something that anyone can actually do
something about
well
that's a great question and that's
really what
uh
we did when i i uh founded this company
zoe uh about five years ago now with two
internet
entrepreneurs who came to see me after i
was giving a book talk
and i said listen we can convert
you know this early science into
something people could use but we do
need some money to do it and you guys
have got to find some money otherwise
you know
we need to be based on science not on
marketing and that's
that for me was really crucial and so
amazingly these guys got the money uh
millions of dollars and we did these
amazing studies which were called the
predict studies
which took thousands of people gave them
identical meals and
tested their microbes and looked at
combining their microbiomes
the differences between them plus their
responses to food
and so put that all together with these
new technologies not only in the
microbiome but the technologies of the
uh glucose continuous glucose monitors
that are now suddenly on the market and
give you you know readings every five
minutes in your your blood sugar uh
without pain and blood testing of
metabolites and lipids and things in
your fingers that you can do at home so
all these things now you can do at home
uh this giant science experiment
and the key is you put it together um i
think the mistake is always thinking
there's only one element that is going
to sort everything out but
we all know medicine life's much more
complicated than that and you need all
the inputs and so that's what we've we
learned from our studies is that
everyone responds very differently to
food
so
we you know normal people react eight to
ten times different to the identical
muffin we gave them in terms of their
blood sugar their blood insulin the
amount of
fats floating in their bodies at six
hours and the inflammation that causes
so i know in your book you know you you
talk a lot about inflammation but we
didn't know before that study how much
it varied between people
with an identical meal and i think that
really
that was that aha moment for me that
said we can take the science but then
it's only be useful in terms of
personalizing if everyone is different
and it turns out they're even more
different than we we'd we'd thought and
even identical twins
respond differently to the same food
and i think
that also was
that's a sort of wow moment that
everyone can understand
and say well if identical twins are
different what about me and my neighbor
what about me and my husband uh you know
maybe that's why these diets don't work
for me maybe that's why
i'm getting uh
one one one a risk of cancer and the
other one isn't because we react
differently to the same food and if we
can
unravel that with the microbiome
and these very simple metabolic tests
put together with big computers
then you know suddenly we're in a new
era of medicine where people at home do
these tests nothing to do with doctors
and clinics and expensive equipment
people can do this and then read off
information on their
their mobile phones and suddenly uh you
know it's a it's a game changer and i
think this is this is where we are and
this product you know we've been going
for a few months in the us and so far
the results
are amazing um we're getting incredible
results on the zoe uh product now
both in terms of
uh people not only losing weight once
they control these peaks
and understand more about their
microbiomes but
energy levels particularly are really
high after it as people start to
flatten out and away their metabolism
that
they hadn't really thought about doing
in a way and i don't think we really
realized the potential for it until we
did the studies so i think it yeah it's
opened up whole new
areas and this is really just the start
because we're just scratching the
surface
of what we can do now and
trying to fit the foods
to
optimize the metabolism to then
uh help the microbes also uh you know
continue that whole
feedback loop so it's very exciting
so the idea with the kit
that can be sent to any individual uh
they can
uh
gear up
to be able to
have these non-invasive easy to test uh
systems uh the information comes back to
zoe and then how do you or how do you
make those recommendations i mean do you
look for to try to to lower inflammation
if it's higher do you try to change the
microbiome if it seems to be the wrong
population or the wrong the type of bad
neighborhood
what type of practical information are
you able to feedback
uh to the the individual
well we basically come up with like
three basic scores so we're looking at
foods that are gonna
reduce your sugar peaks and stress of
insulin
foods are going to reduce your
lipid levels after a meal so that you're
not left with lots of fat particles
hanging around in your your blood
vessels for a long time
and both of those are linked to
inflammation so we know that
uh from these studies which you know i
should say we
unlike most other companies we publish
all our studies in major journals and
we've had two papers in you know nature
medicine which is you know one of the
top journals in the world and we've you
know how about 20 uh other papers ready
to go so
we like scientists out there to know
about it we're very transparent so
you've got those two metabolic aspects
which are really
overall we think reducing inflammation
and stress on the body
uh just by giving you different food
choices and then the third one is how to
optimize your gut microbes
so that we can select foods to eat that
will
enhance the
good bugs
that are
associated with good health and
cardiovascular outcomes and to suppress
the pro-inflammatory
bad bugs that we've also shown
are
bad for you so it's it it's those three
elements together that we put together
into summary scores so people can then
look up any food or meal
and
rank it basically so you can start
making choices about
whether you should be eating pasta or
rice or whether you should have
you know like me i used to eat lots of
bananas but you know suddenly found that
apples and pears are much better
score much better for me than bananas
and
um
giving up granola and i have yogurt and
um all kinds of other choices
and does it make you feel better to have
made those choices
it does um i mean i i see
you know i'm testing myself all the time
so i i can see the actual
readouts
but
if i didn't have that i mean i do find
i
after changing my breakfast for example
i've got much more energy
and i'm not hungry like i used to be
11 12 o'clock in the morning and i can
often skip lunch you know if i've got a
busy day in the hospital so um i've
really found it much easier to keep
weight off and
keep my energy levels up
realizing that these foods previously
were giving me these not only these
spikes but also these sugar dips
and
we published a paper in nature
metabolism showing that
it's the dip
that one in four people have that
actually
is driving hunger and
you know fatigue levels in ways we
hadn't
even dreamt about before
and that if you can work out whether
you're a a person that dips and which
foods make you dip
you can understand all that and of
course
just that simple experiment showed us
that
you know two people given identical
muffins
one dips one doesn't one's going to eat
another 300 calories a day compared to
the other one so the idea that all
calories are equal
that single experiment just shows it's
nonsense you've got to work out
what type of person you are
and which foods uh really suit you so
you can
uh start to start eating to to optimize
your metabolism so it's
it's a fantastic experiment um and you
know it's it's so great to be a
scientist um
doing this and seeing it actually
changing people's lives in real time as
well as
everybody contributing to the science
because
the nice thing about these zoe studies
is that everyone who goes in
you know gives their data back to the
research that we rewrite it up we work
with scientists
all across the u.s and the rest of the
world
and you know the more data we get the
better
uh the predictions are the algorithms
are the more precise
uh we can get it so it's a
it's a win-win sort of scenario at the
moment uh
commercial
interest and also science and medicine
and an opportunity to allow
everyone to get involved with the
research and contribute their data uh
for the greater good which is i think
very very exciting have you know
uh since your um background is in
rheumatology and you know the the the
bread and butter of rheumatology has to
do with inflammation
and
uh
the the
of immunity and inflammation
um what have you learned what are you
thinking about in terms of looking at
the microbiome all those factors in
nutrition you just described
in terms of immunity and immune defenses
since that's something that suddenly
unexpectedly has become the kind of
almost the focal point of almost every
doctor
and actually every every person walking
around is now asking questions of their
about their immune system that perhaps
we we wouldn't have before the pandemic
yeah absolutely and i used to be very
blase about patients who used to come
with their various
ideas about which foods made their
arthritis worse or or better and i i
sort of
you know i'll take it all back now if i
could um
but i think we didn't really understand
the personalized nature of it before
that it's quite possible it was
happening but on a very per individual
level rather than everybody so that's
why the studies were never really
clear-cut uh when you looked at you know
food allergies and autoimmunity etc but
we know that the microbiome is
absolutely crucial for
um our immune health and
uh the gut is the center of actually the
immune system i mean it seems strange
uh but
the gut lining you know that's where all
the immune cells are and so they're
interacting with our microbes
and with and the chemicals they're
producing
from the food we is going straight to
these uh immune cells in on our gut
lining and this interaction is
absolutely crucial to
prevent food allergies and
stop us getting autoimmune diseases and
so
we know that all the autoimmune diseases
are related to a dysfunction of the gut
microbes and so
they're all conditions we can improve
with
better diets that are targeted to
improving the gut microbiome and that's
why even
microbial transplants fecal transplants
work in things like ulcerative colitis
quite well which you know is quite
amazing really that they work as well as
the really powerful drugs so i think
we're we're on the tip of this
journey that is really going to start
revolutioning the
the way we we deal with these immune
diseases so it's it's an extremely uh
exciting time
well i you know i i i
am so excited to talk to you because and
our conversations uh opened up so many
ideas in my mind uh but you know
think about the
uh
the
harsh medications
that we as doctors have been taught to
prescribe to patients with autoimmune
diseases some of them are indeed
life-changing in terms of a beneficial
way but many of them actually have some
significant and serious consequences
including bad side effects um and the
the opportunity to be able to um
use a tool
uh that is already part of the body's
toolbox that we just need to understand
better to be able to right-size uh our
microbiome to be able to help immunity
is is so exciting to me the other area
that i
think is very exciting is uh is the is
the emerging interconnection between the
gut microbiome and cancer
and not just the
diagnosis or appearance of cancer the
instance of cancer but in fact the
response to therapy because
immunotherapy
for cancer is one of the
biggest advancements in cancer research
in the last hundred years
and yet not everyone responds to
immunotherapy the same way and this has
thwarted
the practicing oncologists and you know
clearly
there must be some clues within the
microbiome that we can actually try to
take non-responders and help them become
responders
absolutely again
we've just got a paper coming out soon
in in nature medicine on
200 uh people with melanoma who were on
end stage melanoma really severe ones
and
showed that the their response was
directly related to the state of their
gut microbes
and so
response to a checkpoint inhibitor and
immunity to checkpoint inhibitors so
it's the largest study ever done it was
a big consortium across the uk and the
netherlands
um and it it really highlighted exactly
how important this so so knowing about
your gut microbes and knowing about your
diet
um
is literally life you know life-changing
uh it's different for these people
between life and death and so
um that's why in many that the cancer
hospitals they're now taking fecal
transplants giving auto transplants all
this kind of stuff and i think
we we just need to move on as fast as we
can to try and unpick this because
undoubtedly cancer is all related to the
immune system as well and and the
ability if you're if you've got a
healthy gut microbiome that's fed
properly by the right diet for you i
think your immune cells will be fighting
those early cancers off and that we need
to just uh titrate that all together so
it's it's an extremely exciting time and
uh yeah and we we could talk about this
uh for hours um i
yeah no i i i'm i'm it is so profoundly
important from a research perspective
and i think that
you know both you and i uh being
physicians and scientists uh i think
that what i what i
in in just this conversation
i find it incredibly exciting but also
humbling
to realize how much more we have to
learn
and yet uh how we've been uh operating
uh in terms of the practice of medicine
uh without realizing that you know there
are these truths that have been hidden
in plain sight and we just haven't had
the tools to get at them so i
congratulate you for um you know taking
that leap as you have in your career and
from being kind of a skeptic to a leader
a pioneer and also to be able to take
the ideas
and
uh
i would say actualize them with the
assistance of your business partners to
be able to uh scale
the the ideas from you know the
traditional academic pursuit into
something that can really change lives
so
so exciting to have this conversation
with you and i'm looking to continue our
conversation
yeah no it's been great so um
uh
thank you so much for you know uh
allowing us to to chat together um it's
been great i've been a big fan of you
and your your book uh eat to beat
disease um
new york times bestseller uh so it shows
we have very very similar ideas uh along
along these these these thoughts um so i
wanna thank everyone for for tuning in
um
uh enjoying this series if you want to
learn more about
zoe uh do head to joinzoe.com
uh that's the website join zoe j j
and use the code gut checkers
gut check series
so code gut check series one word to get
off this program which is a great offer
and uh yeah and if you want to learn
more um
all our books are out there um spoon fed
is my latest and uh eat to beat disease
if you want to learn more about the
microbiome and aging and all those other
things so thank you very much everybody
and
look forward to chatting to you again