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Language: en
welcome back to the gut check series in
partnership with zoe
i'm dr william lee i'm a physician
scientist and author of the new york
times bestselling book eat to beat
disease and today i am
honored and pleased to be joined by dr
sarah barry who is a member of the zoe
scientific advisory board as well as an
associate professor also known as reader
at the department of nutritional
sciences at king's college in london
dr barry is also the lead nutritional
scientists on zoe's predict studies and
she
has a lot of experience with
cardiometabolic clinical trials so the
predict study is one of the largest
nutrition studies
in the world um
uh
please uh welcome sarah
thank you very much for having me today
yeah um sarah it is so great to see you
i and i appreciate you participating in
this series can you start by sharing
how did you get to be passionate about
nutrition sciences
what is your origin story
um so i originally studied physiology
at university but i'm so passionate
about the kind of rapidly evolving side
of nutritional research
and you know now that we know it plays
such a huge role in so many aspects of
good health as well as ill health and so
it's breadth and its real life
application alongside the rapid pace of
knowledge growth i think makes it such
an exciting field to be part of
um and what excites me even more is
being part of these zoe predicts studies
that you mentioned
which are really the forefront of
precision nutrition and pushing the
boundaries on nutritional research and i
often think of them as allowing us to
push the fast forward button on
nutrition discoveries
which for me brings even added passion
to to my involvement in nutritional
research
that sound that is that's very exciting
uh i think you and i share
from a science perspective the idea that
you can we all appreciate the body of
knowledge that came before us
that's really what we spent our
education studying but then the
opportunity to be able to
push that fast forward button to look at
what the future
has to
as is going to bring to us is is
extremely exciting to me
across multiple areas and and i think
that when it comes to
gut health nutrition studies
and and
health itself
the future is exciting indeed can you
tell us a little bit more about um
uh what what the zoe project is all
about and how does it connect to
personalizing uh your nutrition status
and and i i think it has to do with the
microbiome
yeah absolutely so
um the zoe predict program is the
world's largest personalized nutrition
program and it's a whole series of
studies to unravel how we respond to
food what determines our responses to
food and it's capitalizing on some
really exciting times again in
nutritional science with the evolution
of citizen science with our ability to
capture large-scale data from all of
these hundreds of thousands of people
that want to be part of this evolution
of nutritional research and we're also
using latest technologies for remote
testing allowing us to collect really
high precision data so that for the
first time in the
zoe predict program we can look across a
whole wide breadth of health parameters
which is really important in precision
nutrition it's really important that we
don't look at single determinants or
what we call exposures and single
outcomes we know that how we respond to
food is determined by lots of different
factors and so what we can do by
collecting a wide breadth and depth and
scale of data is actually look across a
whole many interrelated factors that
determine how we respond to food
um and i think it's important to mention
kind of why we started out on this
journey as well and why we're so
interested in precision nutrition so
we're really starting to recognize how
complex we are as individuals and how
complex food is and therefore how
variable different people's responses to
food are and how this whole
one-size-fits-all approach that we've
typically taken
in terms of the advice that we give
about food and looking at average
responses
in nutritional research really isn't the
best
approach
and
so a way to kind of explain this i think
to viewers is imagine the thousands of
biological pathways that we all have
that differ for each and every
individual one of us they're involved in
processing the thousands of different
chemicals that are in foods
and then
you know throw these together and you
see that actually how we respond to food
is really complex and each and every one
of us will respond slightly differently
to the same food now
as i said population guidelines take
this one-size-fits-all approach but
within these broad healthy eating
patterns and guidelines there's huge
scope for us to personalize dietary
recommendations based on our unique
biology and i think that we're at this
really kind of exciting transition
nutritional science using these novel
technologies that i mentioned citizen
science so for the first time ever we
can explore
within our zoe predict studies how much
variability there is between us or
what's determining this variability and
we can start to piece together the many
many pieces of the very intricate puzzle
which is us and how we respond to food
so that's very exciting um
what does you know i i am a big fan of
the idea of citizen science
another way of actually thinking about
it is the real world whereas
um
in clinical trials that you would might
see in a drug company for example
pharmaceutical company you really try to
recruit and control and limit the
population you're studying and so in
fact you do get more let's say narrow
uh
you're able to ask narrow questions
within a narrow population and you tend
to get sort of a yes or no answer um
what i love about the idea of real world
is that it's what is actually happening
in all of us in real life
and we're not excluding things we're
embracing and including pretty much
everybody coming in and the fact that
zoe is predict is actually
wading into that with eyes wide open to
be able to gather the information is is
exciting indeed um can you
tell us who can participate and what
technologies do they need in order to be
able to participate in this yeah i mean
i think if i can just take a step back
to one of the points that you made there
is
um a real asset with the work that we're
doing is the fact that we are
looking in that real life setting at how
people respond to food you know i've
spent the last 25 years running very
tightly controlled randomized clinical
trials um in my metabolic research unit
and what we actually need to look at is
the differences between individuals but
we really need to look at also the
differences that we get day-to-day
within an individual so we often refer
to the term inter-individual variability
which is the difference between for
example my response and your response
but
there's another term that's really
important which is intra individual
variability which is how do i respond
day to day and this is really key
because we know that it's not just
us and our own unique biology that's
important but we know that there's many
extrinsic factors and we can touch on
these a little bit later but we know
that how we eat is really important time
of day meal sequence sleep stress
exercise which is key and so
um to move on to what you asked about
the novel technologies and how and what
we're actually measuring
we're trying to capture all of this
we're trying to capture information on
people's biology so we are still doing
quite uh traditional measures so blood
sampling
body composition measures blood pressure
for example but we're also capturing a
lot of data around
meal context and by this i mean how
we're eating so things that i just
mentioned like sleep exercise
um
timing of day and meal sequencing we're
also capturing data on the microbiome
which we can come back and and discuss
in more detail although i know you've
explored this with will as well
um
and we're capturing data on genetics as
well and so we're using a lot of remote
technology so across the predict studies
we've had um predict one and predict two
which was quite intensive and involved
some clinic tests and some and at home
phase but with our predict three study
which is a huge um
study that's ongoing at the moment it's
an exclusively remote study
and i think it's a real paradigm shift
in how we think about conducting
nutritional research and how we think
about also capturing information
about people and about how they respond
to food so we're using wearable
technologies such as continuous glucose
monitors we're using activity monitors
to monitor activity exercise sleep we're
using an app which we developed
specifically for this purpose to monitor
what people are eating and dietary
assessment is often
i think
viewed as kind of the the poor man's
part of nutritional research the boring
part of nutritional research but if
we're not properly capturing what people
are eating how on earth can we
um you know be able to unravel how that
food is
determining their responses
how does that work how do you capture
how does an app capture what people are
eating
good question so this was specifically
designed for the zoe predict studies and
also the zoe product
it's a cool part of this
and it integrates many different ways of
assessing
dietary intake so we use the very
traditional weight food logging that
we've used for many years in nutritional
research but we're also using bar coding
and pictures as well
and what we have is a team of
nutritional scientists that for the
predict studies have in real time been
monitoring
what is actually put into the app by our
participants and they can ensure that
the best quality diet for assessment
data is being logged which means we can
have real confidence in what we're
measuring in terms of what people are
eating which is really important
particularly when we're using this as a
core foundation for the machine learning
and ai that we're building from this
so this is truly having
the
person participating so-called subject
really being the citizen scientist they
just go on about their lives but they're
wearing or carrying the technology
or putting some easy inputs in that
allow the rocket scientists behind the
scenes to be able to crunch the
information into more meaningful ways
that is that is super um that is super
cool
um i want to hear a little bit about the
microbiome how how does the microbiome
play a role in predict how do what do
people need to do how do they
um what they just send samples in how
does that work
so uh participants get centre kits which
includes the different wearables like
the continuous glucose monitors
a pot for their stool sample
and
over two week period we monitor a whole
host of different things and people
record their information on the app and
at the end of the two weeks they send
everything back to us including their
stool sample their continuous glucose
monitor and other devices that they have
and what we then do is we piece together
all these different bits of the puzzle
to look for each individual what are the
key factors determining a given response
to food and what we've seen is that
there's massive variability between
individuals responses to food so we're
seeing about a 20-fold difference for
example between how i might respond to
exactly the same food compared to how
you might respond to exactly the same
food what we're now doing is we're
teasing apart what's causing this
variability what causes this 20-fold
difference between how i respond and you
respond and what's been really exciting
with our predict 1 study is we
predominantly recruited twins so
we
recruited from the twins uk cohort so we
could actually start to discriminate
what's due to genetics what
predetermined by our genes and what's
modifiable
and i think this is a really exciting
part of the research that we found that
actually genetics only played a small
role and i was a child growing up in the
70s at the you know this time of the
explosion of genetic discoveries where i
was told oh well it's all predetermined
by your genes
and i think it's really empowering to uh
viewers that actually we found very
little is predetermined by our genes the
majority of how we respond to food is uh
from modifiable factors such as our
microbiome which is a huge piece of the
puzzle such as what i mentioned some of
these other factors how we eat our body
weight
as well
so you're saying
a set of twins that have the same
genetics
when you actually take a look at uh
feeding them the same thing or they're
eating the same thing you're discovering
that twin uh one and twin two
have different responses to the food and
you're actually discovering that the
microbiome actually plays a role in that
and genetics even though they should be
very similar plays less of a role
is there a number that you can throw out
there like um out of 100 what percent
genetics would play a role is it less
than 20
is it
like and and what how much does a
microbiome play a role that basically
this is an area of running research and
so i know that um i don't want to put
you on a spot with
numerix but really just sort of an i
just for an idea for people listening
how how important is the genetics and
how important is a factory like
microbiome
yeah so it's actually dependent on the
outcome
um and by outcome i mean the health
outcome that we're interested in so
we've been measuring a whole array of
different health outcomes
so we've been looking at the health of
the microphone we've been looking at
blood sugar responses so you will be
familiar with the term postprandial
glycemia which is this
rapid increase in circulating blood
sugar after consuming carbohydrate rich
meal we've also been looking at blood
fat responses which we term post
parental lipia which is this more slow
rise in circulating blood fat after
consuming fat in a meal we've been
looking at inflammatory responses so
we've been looking at circulating
inflammatory markers again in the
short-term period after consuming a meal
the contribution that genetics makes
depends on which of those we're
interested in so to give you a few
numbers because you've asked me um
for circulating blood fats so this
postprandial lipemia that i mentioned we
see that it contributes to less than
about five percent
um of the circulating blood fat for
blood sugar we see that it's nearer
about 40 to 50 percent
when we factor in the microbiome this is
something that we're still exploring
more and more but we see interestingly
that the microbiome actually has quite a
large
proportion um in terms of how it
contributes to the blood fat response
and still contributes a good amount to
the blood sugar response as well
that is
so amazing that
studies like predict
are able to address some of these
fundamental questions um
working with zoe and working with
predicting with your background you you
must have
every time you explore one area
like any good area of science i'm sure
it raises more questions
where are some of the future areas that
you see this going and
and can you share with us some of the
future directions
yeah so we're sitting on a gold mine of
data with the predict program and i'm so
blessed to be involved with it because
it's so exciting um i i stay up very
late into the night crunching the
numbers because i'm so excited by all of
the different questions that are thrown
up and what's really exciting is that um
we have an amazing team of data
scientists that are able to in real time
answer some questions and so we can move
on from there very quickly um in this
rapidly evolving um expansion of our
knowledge
projects that we're currently working on
are around menopause so we're really
delving deep into looking at how
menopausal status impacts our responses
to food because we see a big difference
in risk of chronic diseases particularly
cardiovascular disease between pre and
post menopausal women but it's a really
understudied area of research so we're
doing quite a deep dive into this and um
to give you a sneak preview of some of
our results um we're seeing that
postprandial responses so this
postprandial
blood glucose and this postparental
blood fat response um is very different
even in age-matched menopausal women and
what's also interesting is we're looking
at what determines um someone's blood
fat or blood sugar response or blood
inflammatory response post-menopausally
versus pre-menopausally and we see
there's different determinants so just
to give you a kind of example we see
that sleep is really important in
determining this food-induced
inflammation post-menopausally but that
actually how much sleep you have isn't
that important for pre-menopausal and
this allows us to give that really
targeted personalized advice um
depending for example just on menopausal
status
other areas that we're looking into
asleep
and i know that there's going to be
a kind of deeper dive on this but the
kind of things that we're finding is
that sleep duration sleep quality but
also the midpoint of sleep which is that
the midpoint between when you go to
sleep and when you wake up is really
important and so we're seeing that
actually if you have a later midpoint
you're going to bed later even if you
have the same duration of sleep as
someone else that has um an earlier
midpoint your glycemic controls your
blood sugar levels the next day to the
same standardized meal or worse so again
showing us that just simple changes like
changing the time that you're going to
bed can actually have a big impact
wow
just hearing you talk about that raises
ideas in my head some of them
would be
exposure to blue light from
a mobile device uh whether or not that
has an impact on
those metabolic functions tied to sleep
tied to how food is digested and another
one that actually
i think would be very
exciting to think about is uh
temperature in which you are sleeping
your ambient temperature we know that
you know
high temperatures versus low
temperatures
clearly
influence the quality of your sleep as
well as the quality of your immune
system and since immunity is so closely
tied to microbiome which is then tied to
diet
um i i'm certain you're not only
accumulating a gold mine
but you're furthering the depth of the
mind itself uh in in the work that
you're actually doing um
well look uh we've come to the end of
this program but i i can't wait to see
the research that um the results that
zoe comes up with and i
can't stress enough the importance of
the type of work that you're doing which
is science-backed but really involves
real-world
scenarios and then using the tools
precise tools to be able to query
the data and then being able to do the
type of analysis that essentially up
ends a lot of the ways that we've been
studying
groups of people in the past where you
know we would ask you know yes or no
after a extraordinary
long period of time and and research
moves so much quicker now by being able
to gather the information ask those
questions and iterate and reiterate um
what's going on this is something that i
um
believe in my i built a lot of the
research in my career uh around this and
so uh uh
sarah thank you so much for your time
joining us and also for the
powerful work that you're actually doing
in the nutritional science space
thank you for having me
[Music]
thanks everyone for tuning in
see you soon