Watch the full interview below or listen to the full episode on your iPhone HERE.
Guy: Make no mistake, the importance of gut health is becoming more paramount than ever and it’s something I believe should not be ignored. So who better to ask than a board-certified neurologist who truly understands the gut, brain and health connection!
Our fantastic guest today is Dr David Perlmutter. He is here to discuss his brand new book ‘Brain Maker’ – The Power Of Microbes to Heal & Protect Your Brain For Life.
The cornerstone of Dr. Perlmutter’s unique approach to neurological disorders is founded in the principles of preventive medicine. He has brought to the public awareness a rich understanding that challenging brain problems including Alzheimer’s disease, other forms of dementia, depression, and ADHD may very well be prevented with lifestyle changes including a gluten free, low carbohydrate, higher fat diet coupled with aerobic exercise.
Full Interview: The Key to a Healthy Gut Microbiome & the ‘Brain Maker’
In This Episode:
Why gut health and microbiome is critical for long lasting health
The quick ‘checklist’ to see if you have a healthy gut
What to eat daily to nurture your gut health
David’s daily routines to stay on top of gut & microbiome health
Guy:Hey, guys. This is Guy Lawrence of 180 Nutrition. Welcome to today’s health sessions. This is a podcast I certainly thoroughly enjoyed recording and it’s one I’m definitely going to listen to again. There’s a lot of information on here that I’ll need to go over, but ultimately, I think it’s a podcast that if you take the time to understand what’s been spoken about and actually apply the things that are said, it can make a dramatic change to one’s health, to your own life and of course your longevity and quality of life moving forward. I think it’s that big a topic. The topic at hand is going to be pretty much with the microbiome, gut health. Our awesome guest today is Dr. David Perlmutter.
If you’re unaware of David, David is a board-certified neurologist and a fellow of the American College of Nutrition. I almost didn’t get my words out there. He’s been interviewed by many national syndicated radios and television programs, including Larry King Live, CNN, Fox News, Fox and Friends, the Today’s Show. He’s been on Oprah, Dr. Oz, the CBS Early Show. He is actually medical advisor to the Dr. Oz Show. Yes, we were very grateful for David to come on and give up an hour of his time and share his absolute wealth of knowledge with us today. He’s written a couple of awesome books in Grain Brain. He’s got a brand-new book out called the Brain Maker which is what we generally talk about today. That’s obviously the brain and gut connection.
The cornerstone of Dr. Perlmutter’s approach to neurological disorders has been founded in the principles of you could say preventative medicine, which is why we’re super excited to have him on. He has brought public awareness now to a rich understanding that challenging brain [00:02:00] problems include Alzheimer’s disease, other forms of dementia, depression, ADHD may very well be prevented … All these things with lifestyle changes. Think about that for a moment, including a gluten-free, low-carbohydrate, high-fat diet, coupled with exercise and aerobic exercise.
Anyway, strap yourself in. This is fantastic. For all you guys listening in the USA, if you haven’t heard, you might have heard me speaking on a couple of podcasts, but 180 Nutrition and now superfoods are now available across America wide which is super exciting for us. If you haven’t heard about it, you can literally just go back to 180nutrition.com and it’s a very simple way of replacing bad meal choices. If you’re stuck and you’re not sure what to do, we encourage a smoothie and a scoop of 180 with other things. It’s the easiest way to get nutrient-dense foods and fiber-rich foods really quickly. All you have to do is go back to 180nutrition.com and check it out. Let’s go over to David Perlmutter. Enjoy.
Hi. This is Guy Lawrence. I’m joined by Stuart Cooke. Hi, Stewie.
Stuart:Hello, Guy. How are you?
Guy:Our fantastic guest today is Dr. David Perlmutter. David, welcome to the show.
David:I’m delighted to be here, gentlemen.
Guy:It’s fantastic. We’ve been following your work for some time now and be able to expose us to the Aussie audience, I’m very excited about. With that mind, would you mind, for our listeners if they haven’t been exposed to your work before, just sharing a little bit about yourself and what you do?
David:I’d be delighted. I’m a brain specialist. I’m a neurologist, and that probably doesn’t explain what I do. I’m very much involved in various lifestyle factors as they affect the brain, as they affect human physiology, and really have begun exploring well beyond the brain, [00:04:00] what are we doing to ourselves in terms of the foods that we eat, both positive and negative? More recently, how are our food choices and other lifestyle choices affecting the microbiome, affecting the 100 trillion organisms that live within us because we now recognize that those organisms are playing a pivotal role in terms of determining whether we are healthy or not. That’s pretty much in a nutshell what I do.
Guy:There you go.
Stuart:Fantastic. We first heard about you, David, when you wrote the book, Grain Brain which was fantastic. For me, I think it was important because we heard a lot of stories and press about grains and how they’re making us fat and they’re ruining our health. Other ways made the connection of it’s grains … I’m okay with grains. I don’t get any gut ache. I don’t get any gastrointestinal issues, but I never thought about it from a brain perspective. I just wondered if you could share just a little bit about why you wrote Grain Brain, what inspired you to write it?
David:Stuart, the real impetus behind Grain Brain was for the very first time, I thought it was critical for a brain specialist to take a position of prevention, of looking at the idea that these devastating brain conditions that I’m dealing with on a daily basis, autistic children, adults with Alzheimer’s, Parkinson’s, MS, you name it, that some of these issues are preventable, and that really flies in the face of pretty much mainstream doctrine. It is going against the grain, if you will which it seems to fit. It became very clear to me that our best peer-reviewed, well-respected literature [00:06:00] has been publishing information not only about gluten but about more generally, carbohydrates and sugar for a couple of decades, and no one has paid any attention.
It’s been published, but I really found that somebody needed to step forward and make that information known to the general public. I began implementing these practices in my clinical practice in treating patients day to day and began seeing really remarkable results. That is what got behind me writing the book, Grain Brain, really exploring how sugar, carbohydrates and gluten are absolutely toxic for the brain. Ultimately that book was translated into 27 languages and is published worldwide. The message has really gotten out there. I’m very proud of that. These are people reading the book that I will never see and yet, I know the information that they’re gleaning from reading this book is going to help them, and it makes me feel good at the end of the day in terms of what I’m doing.
Guy:Yeah, that’s fantastic.
Guy:Awesome. It’s interesting about grains because people seem to have a real emotional attachment to sugar and grains. The moment you ask them to start cutting down, reducing, removing, it can be quite challenging.
David:People have a religious connection to grain. It’s in the Bible. Give us this day our daily bread. For somebody to come along and say, you know, maybe that’s not what you should be eating, it challenges people on multiple levels. Number one, bread and carbs and grains are absolutely comfort foods that we all love. We all got rewarded as children by having a cookie or a piece of cake on your birthday. We love those foods. We love sugar. We are genetically designed to seek out sugar. It’s allowed us to survive.
The reality of the situation is we’ve got to take a more human approach to this in terms of our higher level of understanding and recognize that we [00:08:00] as a species have never consumed this level of sugar and carbohydrates, and that gluten-containing foods are in fact challenging to our health in terms of amping up inflammation, which is the cornerstone of the diseases I mentioned: Alzheimer’s, Parkinson’s, autism, even cancer and coronary artery disease. In that sentence, we’ve covered a lot of territory.
You mentioned grains, and I want to be very clear. There are plenty of grains that are around that are not necessarily containing gluten; and therefore, my argument against them doesn’t stem from the fact that they contain this toxic protein called gluten but rather because they’re a very concentrated source of carbohydrate. Rice, for example, is gluten-free and you could have a little bit of rice. There’s nothing wrong with a little bit of rice, but you have to factor the carb content of that serving of rice into your daily carbohydrate load and don’t overdo it. I’m not coming down on grains across the board, but I’m really calling attention to the fact that these grain-based foods are generally super concentrated in terms of sugar and carbs.
Guy:I understand your carbohydrate tolerance. You answered the next question where I was going to speak, like, should we limit it to all grains or just the heavily refined and processed carbohydrate kind of …
David:See answer above.
Guy:Yeah, there you go.
Stuart:What about the [high street 00:09:28] gluten-free alternatives where people are saying, well, look, it’s grain-free, gluten-free?
David:Again, Stuart, exactly my point. People walk down the gluten-free aisle thinking, hey, I’ve got an open dance card here. It’s gluten-free. How about it? That opens the door to the gluten-free pasta, pizza, bread, you name it, flour to make products, cookies, crackers and you name it. Again, the issue is that one of the most devastating things that’s happening to humans today [00:10:00] is that our blood sugar is rising. There is a very direct correlation between even minimal elevations of blood sugar and risk for dementia. That was published in the New England Journal of Medicine in September of 2013 where they demonstrated that even subtle elevations of blood sugar well below being diabetic are associated with a profound risk of basically losing your marbles.
Please understand, when we’re talking about Alzheimer’s and dementia, there is no treatment available for that issue. Having said that, then this whole notion of prevention and preventive medicine as it relates to the brain really takes on a much more powerful meaning and urgency.
Guy:Would glycation pop in there as well then where you’re speaking … Would that all stem then from the processed carbs and the fact the brain is …
David:That’s right. Guy, you bring up a very good point, and that is this process of glycation. Just for your viewers, let me just indicate what that is. Glycation is a biochemical term that deals with how simple sugars actually bind to proteins. That’s a normal process, but when it gets out of hand, it changes the shape of proteins, amps up inflammation and amps up what are called free radical production.
We measure glycation really very simply in the clinic, and I’m certain that’s done worldwide, by looking at a blood test called A1C, hemoglobin A1C. Diabetics are very familiar with this term, because it’s a marker of the average blood sugar. A1C is a marker of the rate at which sugar is binding to protein. The higher your sugar, the more readily that process happens. What we’ve seen published in the journal, Neurology, is a perfect correlation between levels of A1C or measures of glycation [00:12:00] and the rate at which the brain shrinks on an annual basis. There’s a perfect correlation then between higher levels of blood sugar through glycation that you bring to our attention and the rate at which your brain will shrink.
Well, you don’t want your brain to shrink, I can clue you. A smaller brain is not a good thing. That said, you’ve got to do everything you can, and that is to limit your carbs and limit your sugar. What does it mean? It means a plate that is mostly vegetables, above ground, nutrient-dense, colorful, fiber-rich vegetables, as well as foods that actually are higher in fat. That means foods like olive oil. If you’re not a vegetarian, that would be fish, chicken, beef that is preferably not grain-fed but grass-fed, fish that is wild as opposed to being farm-raised, like the chicken being free range.
This is the way that we actually give ourselves calories in the form of fat calories that will help us lose weight, help reduce inflammation, help reduce this process of glycation that we just talked about, and in the long run, pave the way for both a better brain but also a better immune system and really better health all around.
Guy:That’s a fantastic description of glycation as well. I appreciate it. Would you recommend everyone to go and get that tested once?
David:Yes, absolutely. In fact, in Grain Brain, I present a chart that demonstrates what I just talked about, the degree of glycation plotted against the shrinkage of the brain’s memory center called the hippocampus. In our clinic, hemoglobin A1C is absolutely a standard test just like fasting blood sugar, and also fasting insulin, the degree of insulin in your body. The level of insulin in your body is really a marker as to how much you’ve challenged your body with sugar and carbohydrates in the past. You want to keep [00:14:00] insulin levels really low.
When insulin levels start to climb, it’s an indication that your cells are becoming less responsive to insulin, and that is the harbinger for becoming a diabetic. Why am I fixated on that? It’s because once you are a diabetic type 2, you have quadrupled your risk for Alzheimer’s. That’s why this is so darn important.
Guy:They start just growing and growing, especially with diabetes as well.
Stuart:In terms of the growing number of people that are suffering neurodegenerative diseases like Alzheimer’s and Parkinson’s and the like, is it too late for those guys or can they …
David:Not at all. I recently gave a presentation with the director of the Alzheimer’s Research Program at UCLA here in the states. We gave a talk, an evening talk at a place called the Buck Institute. This individual, Dr. Dale Bredesen, is actually using a low-carbohydrate diet, gluten-free, normalizing vitamin D levels, getting people to exercise, and actually put together a program of 36 different interventions, has now reversed Alzheimer’s in 9 out of 10 of his original patients. Only 10 patients, it’s not a large number, I admit that, but it is a start.
We are in western cultures so wedded to the notion of monotherapy; meaning, one drug for one problem. You say high blood pressure; I give you a drug. You say diabetes; here’s a pill. You say Alzheimer’s; here’s a pill. Well, the truth of the matter is there is no pill, despite the fact that there’s something on the market, but there isn’t a pill that will cure Alzheimer’s or even have any significant effect on treating the disease and its symptoms. That’s where we are as we have this conversation.
Now, it looks like the work [00:16:00] of Dr. Bredesen is showing that Alzheimer’s is a multifactorial event, and that to cure it or at least turn it around, you have to hit this problem from multiple angles at the same time. It’s happening. It’s not happening through somebody owning the rights to a specific medication.
Stuart:That’s fantastic. That’s radical.
David:I’ll send you the link to the lecture that we gave.
Stuart:Yeah. That was my next question. I would love to find out.
David:Consider it done.
Stuart:Thank you. In your new book, Brain Maker, you dig even deeper and talk about the connection between the gut and the brain. I wondered if you could share a little bit about that as well, please.
David:I will. Let me just take a step back. Last weekend, I went to University of California San Diego, and I met with, of all people, an astrophysicist who is actually studying the microbiome. If you think a neurologist paying attention to the gut is a stretch, how about an astrophysicist? It turns out that he is probably one of the most schooled individuals on the planet in terms of using a supercomputer technology to analyze data, and they drafted him there to look at data that deals with the microbiome in that they have probably the world’s most well-respected microbiome researchers there. They brought Dr. Larry Smarr on board to help Rob Knight really work with the data.
The things going on in the gut in terms of just the information are breathtaking for sure. We now understand that in one gram, that’s one-fifth of a teaspoon of fecal material, there are 100 million terabytes of information. This is a very intense area of research just because of the sheer amount of data [00:18:00] and information that it contains.
We recognize that these 100 trillion organisms that live within each and every one of us have a direct role to play in the health and functionality of the brain, moment to moment. They manufacture what are called the neurotransmitters. They aid in the body’s ability to make things like serotonin and dopamine and GABA. They directly influence the level of inflammation in the body. As I talked to you about earlier, inflammation is the cornerstone of things like Parkinson’s, MS, Alzheimer’s and even autism. The gut bacteria regulate that, and so it’s really very, very important to look at the possibilities in terms of affecting brain health by looking at the gut bacteria.
Having said that, one of the patients that I talk about in Brain Maker, a patient with multiple sclerosis named Carlos came to me and his history, aside from the fact that he couldn’t walk because of his MS was really very profound in that he had been challenged with respect to his gut with multiple courses of aggressive antibiotics. Why would I be interested in that? I’m interested because the gut bacteria control what’s called immunity, and MS is an autoimmune condition. At that point, I began reviewing research by a Dr. Thomas Borody who happens to be in Australia.
What Dr. Borody did, who is a gastroenterologist, a gut specialist, is he performed a technique on patients called fecal transplant where he took the fecal material with the bacteria from healthy individuals and transplanted that into people with various illnesses. Lo and behold, he noted some dramatic improvements in patients with multiple sclerosis. Think about that: [00:20:00] Fecal transplantation for patients with MS. His reports are published in the journal, Gastroenterology. I sent my patient Carlos to England. He had a series of fecal transplants and regained the ability to walk without a cane. He sent me a video, and I have that video on my website. This is a real person who underwent this procedure.
I just took it to the nth degree. The question was how do we relate the gut to the brain? Now we’ve realized how intimately involved brain health and brain dynamics are with respect to things that are going on in the intestines. It’s a very empowering time.
Guy:Yeah, that’s huge. Regarding gut health, and let’s say somebody is listening to this and they’re relatively healthy and they’re going about their day, but they might be curious to know if their gut integrity is good or isn’t. Are there telltale signs that your gut might not be quite right?
David:Absolutely. As a matter of fact, if you turn to page 17 in Brain Maker, I have a list of over 20 questions that you can ask yourself to determine if in fact you are at risk for having a disturbance of your gut bacteria. There are laboratory studies available of course, but these questions are things like were you born be C-section? Did you have your tonsils out as a child? Do you take antibiotics fairly frequently? Are you taking non-steroid anti-inflammatory drugs for inflammation? Are you on an acid blocking drug? Do you have an inflammatory condition of your bowel? Are you suffering from depression? Are you more than 20 pounds overweight?
The reason these questions actually have traction when it comes to their inference with reference to the gut is because these are situations which really point a finger at disturbance of the gut bacteria. I open the book with those questions [00:22:00] because many people are going to answer a positive on multiple parameters and then I indicate to them that that’s not uncommon, but the rest of the book, the rest of the 80,000 words is all about, okay, we’ve all made mistakes in our lives. We all have taken antibiotics. Many of our parents had our ear tubes put in or we were born by C-section or who knows what? The important empowering part about the rest of that book, Brain Maker, is, okay, we messed up. How do you fix it?
That’s what I really spend a lot of time doing in that book, and that is talking about those foods that need to come off the table, those foods that you need to put on the table, fermented foods, for example, that are rich in good bacteria: foods like kimchi and cultured yogurt and fermented vegetables, sauerkraut, for example. How do you choose a good probiotic supplement? What about prebiotics? What about this type of fiber that we consume that actually nurtures the good gut bacteria within us? That’s contained in various foods like jicama, Mexican yam, Jerusalem artichoke, asparagus, garlic, onions, leeks, dandelion greens, etc. These are foods that are really rich in a specific type of fiber that then goes ahead and amplifies the growth of the good bacteria in your gut.
I really wanted to write that book in a very empowering way for all of us living in western cultures where we’ve messed up. The evidence is really quite clear when you look at the microbiome, at the gut bacteria in western cultures and compare what those bacteria look like with more agrarian or more rural cultures, less developed countries.
Stuart:We’ve gone to page 17 and we’ve filled out the checklist and now we’re concerned. How can we test [00:24:00] the diversity or the quality of our gut bacteria?
David:That’s a very good question. There are tests that are available and they are improving year by year, and you can have them done. I’m not sure what you have available to yourselves in Australia, but there are several companies that make those tests available here. The real issue though is I don’t think we yet know specifically what a healthy microbiome should look like. We know the broad strokes. We know that there are ratios between two of the larger groups of organisms called Firmicutes and Bacteroidete that tend to be associated with things like diabetes and obesity, etc. We really don’t know what it means to have a good microbiome.
One thing that’s really quite clear is that one of the best attributes for your microbiome is diversity. When you look at rural African population microbiome compared to westernized microbiome, the main thing that really jumps out at you is the lack of diversity in our type of microbiome, the lack of parasites, the lack of a large array of different organisms. You may have raised your eyebrows when I said a lack of parasites, but it turns out that we have lived quite comfortably with a wide array of parasites throughout our existence on this planet.
There is something called the old friend hypothesis, which means that we’ve had these bugs inside of us for a long time and not only have we developed tolerance to things like parasites, but we’ve actually been able to work with them and live with them in such a way that parasites and various worrisome bacteria actually contribute to our health. When we sterilize the gut with over-usage of [00:26:00] antibiotics, for example, we set the stage for some significant imbalances in terms of our metabolism. As we sterilize the gut with antibiotics, we favor the overgrowth of bacteria, for example, that can make us fat.
Why do you think it is since the 1950s we’ve been feeding cattle with antibiotics? Because it changes their gut bacteria. It makes them fat. Farmers who raise those animals make more money because the animals are bigger and they’re selling them by the pound.
Guy:Another question popped in. I don’t know if it’s a stupid question or not. Do you think we’ve become too hygienic as well? If we shower …
David:No question. That is called the hygiene hypothesis. I think that it really has been validated. That was first proposed in 1986 when it got its name. It holds that our obsession with hygiene … I paraphrase a little bit … Our overdoing with hygiene, the sterilization of the human body and all that’s within it, has really paved the way for us to have so much allergic disease, autoimmune diseases, what are called atopic diseases, skin-related issues.
We understand, for example, that autism is an inflammatory condition and really correlates quite nicely with changes in the gut bacteria. There’s an absolute signature or fingerprint of the gut bacteria that correlates with autism. Now there are even researchers in Canada, Dr. Derrick MacFabe is one … I’ve interviewed him … who correlate these changes in bacterial organisms in the gut of autistic children with changes in certain chemicals that have a very important role to play in terms of how the brain works.
This is the hygiene hypothesis. It’s time that we let our kids get dirty and stop washing their hands every time they walk down the [00:28:00] aisle in the grocery store and recognize that we’ve lived in an environment that’s exposed us to these organisms for two million years. It has a lot of merit, the hygiene hypothesis.
Guy:Sorry, Stuart. Another question that did pop in there at the same time.
David:Take your time.
Guy:Stress, worry and anxiety because you feel that in the gut when you’re … Have there been studies if that affects microbiome?
David:Without a doubt. I actually have written about these in Brain Maker. It goes both ways. We know that stress increases the adrenal gland’s production of a chemical called cortisol. Cortisol ultimately begins in the brain. When the brain experiences stress and the hypothalamic-pituitary axis is turned on and that stimulates the adrenal glands from make cortisol. Cortisol does several important things. It is one of our hormones that allows us to be more adaptable momentarily to stress but the downsides of cortisol are many. It increases the leakiness of the gut, and therefore increases the level of inflammation in the body. It actually changes the gut bacteria and allows overgrowth of certain organisms, some of which are not actually even bacteria but even yeast. In addition, cortisol plays back and has a very detrimental role on the brain’s memory center.
By the same token, we know that gut-related issues are front and center now in looking at things like depression. We now understand, for example, that depression is a disease characterized by higher levels of inflammatory markers specifically coming from the gut. Think about that. There is a chemical called LPS or lipopolysaccharide. [00:30:00] That chemical is only found normally in the gut to any significant degree. It is actually part of the cell wall of what are called gram-negative bacteria that live in the gut. When the gut is permeable, then that LPS makes its way out of the gut and you can measure it in the bloodstream.
There’s a very profound correlation between elevation of LPS and major depression. We see this correlation with major depression and gut leakiness and gut inflammation, and it really starts to make a lot of sense when we see such common events of depression in individuals with inflammatory bowel disease like ulcerative colitis and Crohn’s.
Stuart:Back to the balance of the microbiome so gut bacteria. What three culprits, what would be your top three culprits that really upset the balance?
David:Number one would be antibiotics. We are so aggressively using antibiotics in western cultures. I think every major medical journal is really calling our attention to that. The World Health Organization ranks antibiotics among the top three major health threats to the world health of this decade. Antibiotics change the gut bacteria. They change the way that bacteria respond to antibiotics, in the future making it more likely that we’ll have antibiotic resistance, making it more difficult to treat bacterial infections when they should be treated. I think that we really have just begun to understand the devastating role of antibiotics in terms of changing the gut bacteria. The over-usage of antibiotics in children has been associated with their increased risk of things like type 1 diabetes, asthma, [00:32:00] allergic diseases.
You asked for three. The other big player I think would be Cesarean section. C-sections are depriving children of their initial microbiome because understand that when you’re born through the birth canal, right at that moment, you are being inoculated with bacteria, bacteria that then serve as the focal point for your first microbiome. When you bypass that experience, you are born basically with the microbiome that’s made of whatever bacteria happen to be on the surgeon’s hands or in the operating room at that time. Interestingly enough, children born by C-section who don’t have that right microbiome have a dramatically increased risk for type 1 diabetes, celiac disease, autism, ADHD and even becoming obese when they become adults.
We’re just beginning to understand really what an important event that is, and that is when you’re born that you receive genetic information from your mother that is what we call horizontally transferred as opposed to the vertical transfer from mom and dad in terms of their genome. Understand that you’re not just getting the bacteria but you’re getting the bacterial DNA. When you get your arms around the idea that 99% of the DNA in your body is bacteria contained in your microbiome, then the whole process of being born through the birth canal really takes on a very, very new meaning, doesn’t it?
Stuart:It does. It’s massive.
Guy:The thing, again, they almost can be beyond our control as well. Like you mentioned, it could have been given antibiotics as a kid and C-section. I just want to make a point that when you start to repair these things, [00:34:00] it’s not a short-term fix, I’m guessing, that it takes time to repair the gut. If somebody is listening …
David:In our practice, we see improvements happening very quickly. We often see people get improvements in as little as a couple of weeks, especially children. They seem to turn around so quickly. The truth of the matter is that we now see literature that indicates that antibiotics, each time you take them, change your gut bacteria permanently. There may not be a total reversal that’s possible based upon some of our lifestyle choices. That said, we are now seeing some really impressive results from what’s called fecal transplantation where you put in to the gut healthy bacteria from a healthy individual.
One researcher, Dr. Max Nieuwdorp in Amsterdam has recently presented his treatment of 250 type 2 diabetics, giving them fecal transplant, and he basically reversed their diabetes by changing their gut bacteria. It’s pretty profound.
Stuart:It’s quite a hot topic over here, fecal transplants. They ran a story a few weeks ago of a chap who was suffering from an autoimmune disease and he first went out of country and received the fecal transplant and his improvements were off the scale, but he put on huge amounts of weight. He was a skinny guy.
David:It’s not the first time it’s happened. Actually, the main use of fecal transplantation is for the treatment of a bacterial infection called Clostridium difficile or C. diff. Here in America, that’s a disease situation that affects 500,000 American [00:36:00] every year and kills 30,000. The antibiotic cocktails that are used for C. diff. are about 26% to 28% effective. Fecal transplantation is about 96% effective. There was recently a publication of a woman with C. diff. and she elected to undergo fecal transplantation and chose her daughter as the donor. Unfortunately, her daughter was very big. Immediately following the fecal transplantation, this woman gained an enormous amount of weight. I think something in the neighborhood of 40 pounds very quickly.
You’re right. It calls to our attention the work by Dr. Jeffrey Gordon here in the states who has demonstrated in laboratory animals that when you take human fecal material from an obese person and transplant that into a healthy laboratory animal, that animal suddenly gets fat even though you didn’t change its food. We’re beginning to understand the very important role of the gut microbiome in terms of regulating our metabolism, in terms of our extraction of calories from the food that we eat.
So many people tell me, you know, Doc, I am so careful with what I eat and I just can’t lose weight. The reason is because through their years of eating improperly, of having antibiotics, etc., they’ve created a microbiome that is really very adept at extracting calories from food. One of the biggest culprits, for example, is sugar. Sugar will dramatically change the microbiome. What do people do? They begin drinking sugarless, artificially sweetened beverages. It turns out that the weight gain from artificially sweetened beverages is profound and in fact, the risk of type 2 diabetes is much higher in people consuming artificially sweetened drinks than those who drink sugar sweetened drinks.
I’m not arguing in favor of drinking [00:38:00] sugar sweetened beverages. I’m simply saying that there’s no free ride here. What researchers in Israel just published was the explanation. The explanation as you would expect is that artificial sweeteners dramatically change the microbiome. They set up a situation of higher levels of certain bacteria that will extract more calories and will also help code for inflammation. There’s no free ride. You’ve got to eat right. You’ve got to get back to eating the types of foods that will nurture a good microbiome.
Guy:Do you think the local doctor or GP is going to start looking at microbiome in the near future? Because there’s only an antibiotic that gets prescribed when you go there, you’re not feeling well or you get a cut …
David:No, I don’t think so.
Guy:You don’t think so?
David:No. I wish it were. I wish that were the case. Next month, I’m chairing an international symposium on the microbiome with leaders in the field from all over the world, well-respected individuals. The people who are going to attend are really a very few group … a small group … It’s be a big group, but these are people who are really highly motivated to stay ahead of trends, and by and large, this is going to take a long time to filter down to general medicine. It just isn’t going to happen any time soon.
Guy:Proactive approach always seems to be the way.
David:You got it.
Stuart:Say I wanted to be a bit proactive right now and I’m going to jot down to the chemist and think, right, I’m going to ask them for their top pre- or probiotics. Is it a waste of time?
David:No, I don’t think so, especially as it relates to prebiotics. You can’t go wrong by increasing your consumption of fiber, but prebiotic is a special type of fiber that in fact nurtures the gut bacteria. [00:40:00] You can go to your chemist and in fact, they may very well sell you a wonderful prebiotic that’s made from, for example, Acacia gum or pectin or something like that. There happen to be some pretty darn good probiotics on the market as well. I think there are certain things that you have to look for. I’ve written about them in my book. There are certain species I think that are well-studied and there are five specific species that I talk about in the book like Lactobacillus plantarum, Bifidobacterium longum, Lactobacillus brevis, etc.
The point is, hey, we have more than 10,000 different species living within us, so it’s hard to say what’s best. We do know that some of these species have been aggressively studied and do good things in the gut with research now coming out indicating that interventional studies, in other words where they give certain bacteria to people, there are changes that are measurable. Let me tell you about one interesting study that was just published.
A group of 75 children were given a specific probiotic for the first six months of their life; it’s called Lactobacillus rhamnosus. They followed these kids for the next 13 years. What they found was that the children who had received the probiotic, half the group, none of them developed either ADHD or a form of autism. Whereas the group that did not receive the probiotic, there was a rate of autism or ADHD of about 14.2%. What does it say? It says that balancing the gut helps do good things. This study took 13 years to complete, maybe another year or two to publish, but we’re getting to the point where we’re seeing interventional trials of specific organisms having positive effects [00:42:00] on humans. I think that’s what the future is going to open up with. I think we’re going to see much more of that.
Guy:Definitely. Even from us, we’ve been involved in the health industry for quite some time and we’ve seen microbiome, gut health, more and more information is coming out.
David:Yes, you are. It’s time. It’s really going to be very, very empowering.
Guy:Yeah, it’s become a hot topic. Look, I’m aware of the time, David. We have a couple of questions that we ask everyone on the show that they can be non-nutrition-related, anything.
David:Is this the bonus round?
Guy:This is the bonus round, man.
Stuart:I just wanted to pop in, Guy, just before you hit those last ones. I was interested, David, as to do you have a tailored personal daily routine specifically to nurture your microbiome?
David:Yes. It’s what works for me. I’m super careful about what I eat. The truth of the matter is I am at risk for Alzheimer’s. My dad passed away about two months ago with Alzheimer’s so I know I’m at risk. Probably one of the most important nutritional things I do is exercise. It’s nutrition for the soul. I guess I have a little leeway there. It’s really good for the microbiome as well. It really helps protect the ability of that LPS from damaging … ultimately leading to damage to the brain. Exercise actually increases the growth of new brain cells through something called BDNF. My dad is very low in carbohydrate, extremely low in sugar. I use a lot of prebiotic fiber, 15, 20 grams a day. I take a strong probiotic, vitamin D, vitamin E, fish oil, a multivitamin, a B complex. You didn’t ask about supplements but I just toss that in for the heck of it.
I generally, for me, do well with only two meals a [00:44:00] day. I don’t yet know who wrote down that you have to have three meals a day or the world would come to an end, but somebody must have obviously. Because I like the fact that I haven’t eaten from dinner until I have either a later breakfast or an early lunch the next day. That sometimes can be as long as 12 to 15 hours of not eating. It works really well for me because as I wake up in the morning, my brain is sharp and I never really liked exercising with food in my belly. A lot of people have breakfast and go to the gym. Fine. It doesn’t work for me. I like to go to the gym on an empty stomach and then have lunch and then dinner.
Stuart:That’s excellent. Does the type of exercise make any difference to the way you feel?
David:Well, sure it does. The type of exercise I really gravitate to is aerobic because as I talked about in Grain Brain, aerobic exercise is the type of exercise that actually will turn on the genes that will code for this BDNF chemical that will allow you to grow your brain cells. That’s what the studies at University of Pittsburgh have demonstrated. You really need to do aerobics. I do a lot of stretching and I lift weights as well. I think those are good for you, good for a person. I’m prone to back issues. I do a whole routine for my back. The one thing that it’s inviolate in terms of my routine is the aerobics part.
Guy:Fantastic. I appreciate that. That’s awesome. Back to bonus round, have you read any books that have had a great impact on your life that you’d like to share?
David:I have. From a medical perspective, there’s a couple of good books by Gary Taubes called Good Calories, Bad Calories, and another one called Why We Get Fat: And What to Do About It. I would recommend the latter, Why We Get Fat: And What to Do About It [00:46:00] because it is so clear in terms of mechanisms that relate to sugar and weight gain and inflammation.
I’ve read Siddhartha by Hermann Hesse on a number of occasions. I think it has resonated with me on a personal level in terms of my life journey, one of the most perhaps influential books for me. Pardon me?
Guy:Fantastic. You’re not the first person to say that book as well.
David:In fact, I just looked at it earlier today. I love books. I don’t know if you could see [crosstalk 00:46:41]. A lot of people these days send me their books to review so I’ll write a comment on them. I’ve got this really great conduit of new books coming to me, two and three a day now, which is really great. I really am fortunate because I get to see a lot of books before they’re actually even published. I reviewed a book today from a Harvard researcher on what is it that makes us hungry and what to do about it, a really incredible book.
I recently reviewed a book by Dr. Frank Lipman talking about the 10 things to do to stay healthy. Really it was The 10 Things That Make Us Fat and Grow Old, is the title. It isn’t out yet, but I read that book this morning, a very, very powerful, clean-cut, straightforward information that’s totally in line with current science.
There’s another really good book I would encourage people to look at called The Disease Delusion, and it’s written by Dr. Jeffrey Bland. It really is an important book because it talks about where we are in terms of how medicine is practiced, how we look at patients and really paints a good picture in terms of what medicine could look like in the [00:48:00] future. I’d encourage your viewers to take a look at that book.
Guy:Fantastic. We certainly encourage Brain Maker as well which [crosstalk 00:48:07].
David:Thank you. I appreciate it.
Guy:Last question: What’s the best piece of advice you’ve ever been given?
David:My dad used to say no matter how … As you go through life, my friend, let this be your goal. Keep your eye upon the donut and not upon the hole. It always worked for me.
Stuart:I like it.
David:There’s one other, I don’t know if it’s advice, but a statement that was made by Maurice Maeterlinck, a Belgian Nobel Laureate. I first read this when I was visiting a friend, Dr. Amar Bose. He’s the one who has Bose audio, the headphones and speakers. He took me to his laboratory in Massachusetts and I was very impressed, but then we went into his office and on his glass door was the following quote by Maurice Maeterlinck: At every crossway on the road that leads to the future, each progressive spirit is confronted by a thousand men appointed to defend the past. That always meant a lot to me because Dr. Bose really went against the system as he created his audio products. People said it couldn’t be done. You can’t cancel sound, on and on.
I really know what it’s like to be opposed by a thousand men appointed to defend the past because the stuff that we talk about is not status quo. It’s not what everyone is doing. I’m grateful for that. I think that it hopefully is ahead of the curve. Time will tell. We’ll see where we go. When maybe the three of us have a conversation in a couple of years, we’ll see where we are.
Guy:Yeah. Fantastic. We really appreciate it. For anyone listening to this who would like to get more of you, where would be the best place [00:50:00] to go online?
David:My website is drperlmutter.com. That’s D-R, Perlmutter, P-E-R-L-M-U-T-T-E-R, dot-com. Facebook I post every day. Oddly enough, David Perlmutter MD. My books are in Australia. They’re around the world so people can read my books if they like as well.
Guy:Yeah, fantastic. Greatly appreciate you coming on the show today and showing your knowledge and time with us and the listeners.
I could have really done with these delicious low carb treats flying back from the UK this week. Sadly though I’m not sure any airline would know what a healthy high protein low carb recipe would look like! Flying there was fine as I was all prepared with my little low carb protein snacks in the shape of the 180 balls. I then ploughed through the tub I took with me whilst in the UK, leaving me to come unstuck on my flight home… and there’s me thinking I was prepared! More