Latest / F*ck, I’m Nearly 50! / Gut Health: Shall We Talk About Poo Transplants? | Dr Craig Haifer | F*ck, I’m Nearly 50!

Transcript

Gut Health: Shall We Talk About Poo Transplants? | Dr Craig Haifer | F*ck, I’m Nearly 50! · F*ck, I’m Nearly 50!

• 0:00
  Speaker 1: Hi, I'm Dom Hind and, fuck, I'm nearly 50.
• 0:03
  Speaker 1: Actually I'm 47 and a half, but who's counting?
• 0:06
  Speaker 1: When I first met today's guest, I was deep in the middle of investigating my own health, trying to figure out what was going on with my liver.
• 0:14
  Speaker 1: And in the middle of all the medical jargon, the tests and the uncertainty, I met someone whose work absolutely fascinated me.
• 0:23
  Speaker 1: Dr Craig Hafer is a gastroenterologist, a researcher and one of the most forward-thinking minds when it comes to gut health.
• 0:31
  Speaker 1: He splits his time between private practice, public practice and academic research, and he also somehow finds the time to run two events at Gwingana every year.
• 0:43
  Speaker 1: But here's the thing that really got me hooked into his research poo transplant.
• 0:47
  Speaker 1: You're right, poo transplants.
• 0:50
  Speaker 1: I didn't even know that that was a thing that existed.
• 0:53
  Speaker 1: We're talking about potential game changer for everything from mental health to autoimmunity.
• 0:58
  Speaker 1: So today we're diving into it all gut health, the future of medicine, and why what happens in your gut might just be the key to everything in your body.
• 1:10
  Speaker 1: Because, fuck, I'm nearly 50, and isn't it amazing?
• 1:14
  Speaker 1: Most people don't spend a lot of time thinking about their gut health until something goes wrong.
• 1:29
  Speaker 1: But what if we've been thinking about health the wrong way this whole time?
• 1:34
  Speaker 1: What if our gut is actually the command centre for everything?
• 1:38
  Speaker 1: Dr Craig Hafer is at the forefront of gut health research, exploring everything from the impact of gut bacteria on our mood to the potential of fecal microbiota.
• 1:51
  Speaker 1: How do you say it, fecal microbiota?
• 1:55
  Speaker 2: Okay, yes, or FMT Okay, okay.
• 1:58
  Speaker 1: Yes, that is poo transplants to treat chronic disease.
• 2:02
  Speaker 1: Today we're breaking down the science, the myths and what happens in your gut that doesn't stay in your gut.
• 2:10
  Speaker 1: Dr Craig Hafer, welcome to Fuck.
• 2:13
  Speaker 1: I'm Nearly 50.
• 2:14
  Speaker 2: Thank you, Tom.
• 2:14
  Speaker 2: It's great to be here.
• 2:15
  Speaker 2: It's always an exciting conversation, even better over dinner, but this will do.
• 2:21
  Speaker 1: Before we get into the details.
• 2:23
  Speaker 1: If you had to introduce yourself at a dinner party, how would you do it?
• 2:28
  Speaker 2: Ah, good question.
• 2:29
  Speaker 2: So I guess, first and foremost, I'm a dad.
• 2:32
  Speaker 2: I'm a dad of two boys Slightly depressing, but I still don't quite know what I want in life.
• 2:37
  Speaker 2: It's also a big thing, but Particularly with what you're doing now.
• 2:41
  Speaker 2: Exactly, but it allows me to go on very big tangents where if I find something I'm interested in, I'll research it to the nth degree.
• 2:52
  Speaker 2: I want to understand it and want to figure out how I can do it better.
• 2:55
  Speaker 2: And that's led me down all these different pathways that we can talk about a few of them today.
• 2:59
  Speaker 1: Yeah, Amazing and I love that because it means that you're not in that, you're in that growth mindset and you're always looking for something else.
• 3:06
  Speaker 1: Yeah exactly, I'm always looking for something else as well, which is why it was when I was sitting as a patient of yours, sitting there, and you started saying that you were into well, in my simple book, poo transplants.
• 3:20
  Speaker 1: I was like what.
• 3:21
  Speaker 1: I didn't even realise that that was a thing, so it's fascinating.
• 3:25
  Speaker 1: Yeah, okay, we hear so much about gut health these days, but why does it actually matter and what's the big picture?
• 3:37
  Speaker 2: So we always thought that kind of everything in your gut was completely separate to the inside of your body, right?
• 3:42
  Speaker 2: We thought it was two separate things.
• 3:44
  Speaker 2: You had this wall, you had this wall in between and what happened on the inside was different to the inside of your body, right, we thought it was two separate things.
• 3:46
  Speaker 2: You had this wall you had this wall in between, yes, and what happened on the inside was different to the rest of your body.
• 3:49
  Speaker 2: But there's more and more research in all fields both in the wellness industry been going on this for a long time that it's all connected, that your gut is this window to the outside world, right?
• 4:02
  Speaker 2: So there's this I kind of always bring this up where we always thought, like your eyes are the windows to the soul, but really, let's call it what it is your arseholes, your window to this soul, right?
• 4:13
  Speaker 2: And that everything outside will impact your gut microbiome, which will therefore have some impact on the rest of your body.
• 4:18
  Speaker 2: And so we can do all we can to try and treat chronic illness.
• 4:23
  Speaker 2: But we say, well, what's driving that chronic illness in the first place?
• 4:26
  Speaker 2: Why is there increasing rates in every illness under the sun?
• 4:30
  Speaker 2: And it's generally related to what we eat, the environment we live in and everything else around it.
• 4:36
  Speaker 1: Yeah, wow, okay, then that is an interesting way of thinking about it Like it really is change.
• 4:43
  Speaker 2: That's the things that have changed over years.
• 4:45
  Speaker 2: It's not your genetics.
• 4:46
  Speaker 2: Your genetics haven't changed.
• 4:47
  Speaker 2: What's changed over the last 10 to 15 years is our environment and everything we put in our mouth.
• 4:52
  Speaker 2: And I think that is it everything you put in your mouth, exactly yeah.
• 4:56
  Speaker 1: When did you first get interested in the micro Bio Bio?
• 5:01
  Speaker 2: Yes.
• 5:02
  Speaker 1: Was there a moment you thought this is where medicine needs to go?
• 5:15
  Speaker 2: Yeah, it's a great question.
• 5:15
  Speaker 2: So I did my general medicine type training and then I just got into gastroenterology.
• 5:17
  Speaker 2: And I got into gastroenterology because I've got a lot of family members with inflammatory bowel disease so Crohn's disease, osteoc colitis, and I've seen a lot of them go through a lot of shit and a lot of bad kind of things on lots of different medicines.
• 5:30
  Speaker 2: And it was always, I remember, talking to a family member and they were saying well, actually my naturopath said this, but I haven't told my doctor.
• 5:37
  Speaker 2: And that's a classic, classic story.
• 5:41
  Speaker 2: And it seems to be separate.
• 5:42
  Speaker 2: And you can say well, why can't we do, why can't they do both?
• 5:46
  Speaker 2: Why can't they work complementary rather than alternatively?
• 5:50
  Speaker 1: Yeah.
• 5:51
  Speaker 2: And so it was an interesting time with fecal transplants.
• 5:54
  Speaker 2: Fecal transplants or poo transplants, whatever they are, they've been around for a little while.
• 5:59
  Speaker 2: They've actually you go back through the 14th century Chinese medicine.
• 6:02
  Speaker 2: They used to use this green soup, the documented green soup, to treat various ailments, so this is not new.
• 6:08
  Speaker 1: This has been there forever.
• 6:11
  Speaker 2: The first case was documented, at least in literature, back in the 80s by a gentleman here in Sydney.
• 6:16
  Speaker 2: But it was kind of going through this phase of there was increasing evidence for its use in certain conditions.
• 6:23
  Speaker 2: And suddenly you're saying, well, actually you know what, we can do something to the microbiome and actually treat these illnesses that kill people every year.
• 6:31
  Speaker 2: So surely we have some way of harnessing it and doing it better, not just with pre-transplants, with everything else you can do, and particularly with things like Crohn's disease or inflammatory bowel disease where it impacts the gut.
• 6:44
  Speaker 2: Surely there's your first point of call.
• 6:46
  Speaker 2: They say, well, it's in the gut, how do we actually stop that happening?
• 6:50
  Speaker 2: And so that was at the end of my training.
• 6:52
  Speaker 2: I kind of I was deciding what to do.
• 6:54
  Speaker 2: My wife had just had a baby and she was going back into training and we were trying to figure out what I do and I decided to do a PhD.
• 7:01
  Speaker 2: And so I did my PhD looking at fecal transplants in the microbiome to treat ulcerative colitis, which is a form of inflammatory bowel disease, and that's kind of where it all stemmed off from there.
• 7:14
  Speaker 2: Were you early on in that, yeah, so I wasn't by no means I was early on, but we started putting larger scale research to an area that was really considered witchcraft and wizardry, right.
• 7:28
  Speaker 2: So we started.
• 7:29
  Speaker 2: We said well, how do we put this into practice?
• 7:31
  Speaker 2: How do we actually get this used in day-to-day practice rather than just used in the when people got unhappy with traditional medicine?
• 7:40
  Speaker 1: Yes.
• 7:40
  Speaker 2: That they left their doctor.
• 7:41
  Speaker 2: They disappeared for six months.
• 7:43
  Speaker 2: They came back either in a better or worse state down the track.
• 7:47
  Speaker 2: How can we use this alongside with what we do?
• 7:50
  Speaker 2: And it was a really interesting stage because we were we had to convince our several ethics company through our university said hell, no, we're not letting you do any of this kind of work.
• 8:01
  Speaker 2: So it was a really, and even the TGA, our Therapeutics Goods Administration, were like you do any of this kind of work.
• 8:04
  Speaker 2: So is it really?
• 8:04
  Speaker 2: And even the TGA like the TGA, our Therapeutics Goods Administration like you can't do this research.
• 8:08
  Speaker 2: And so we ended up working with the TGA trying to define what actually is a pre-transplant, how do you do this safely?
• 8:13
  Speaker 2: And that was a lot of part of my work trying to say, well, how do we actually get this into practice, how can we actually use this?
• 8:20
  Speaker 2: And then you can do proper research to say, well, does it work?
• 8:31
  Speaker 2: It does not work, that's amazing.
• 8:32
  Speaker 2: So you actually helped.
• 8:33
  Speaker 2: Yeah, it was really as a quite a young phc.
• 8:33
  Speaker 2: So I remember being in new zealand on holiday and I get this message from the teacher.
• 8:34
  Speaker 2: So we've got a meeting tonight to kind of figure this out.
• 8:36
  Speaker 2: And next thing, I'm on this zoom call with there's three or four people from the tga and next thing, um, the head of the t, who was then moved on to become one of the deputy chiefs during COVID to the government, was on this call and I'm sitting there saying, well, this is what I think it is, and they were listening and they're actually trying to actually work with it.
• 8:54
  Speaker 2: It was a really exciting kind of time.
• 8:55
  Speaker 2: I was like I'm very underqualified to do this, but I guess I was more qualified than most and also qualified than them, exactly, exactly.
• 9:02
  Speaker 2: So it was a really exciting kind of time to be able to try and define those regulations and legislations and things like that.
• 9:07
  Speaker 2: That's amazing.
• 9:08
  Speaker 1: Like that is actually.
• 9:10
  Speaker 1: Like I think that is amazing.
• 9:11
  Speaker 1: Well, done you for doing it, and you know it would have taken some guts, yeah Well, yeah, time to time.
• 9:17
  Speaker 2: Yeah, it was.
• 9:18
  Speaker 2: Yeah, it was really kind of and it enabled us.
• 9:20
  Speaker 2: It was driven initially because we wanted to do the research.
• 9:23
  Speaker 2: Yeah, yeah but actually it enabled us to do what we want to do, and it's it's.
• 9:26
  Speaker 2: It set the groundwork to actually start using this in practice.
• 9:29
  Speaker 2: Yeah and yeah.
• 9:31
  Speaker 2: So it's, it's really, it was really, and I learned a lot during the process about all these things I never knew about.
• 9:36
  Speaker 1: Yeah Well, I mean just in the legislation or what can and can't do.
• 9:39
  Speaker 2: Exactly how it works, exactly how you can push it, no, not that I've said that.
• 9:42
  Speaker 2: Well, no, you know, it's how you can push it, but how you can push it safely and appropriately.
• 9:47
  Speaker 2: Yes, yeah.
• 9:48
  Speaker 1: Not ridiculously.
• 9:49
  Speaker 2: Exactly.
• 9:50
  Speaker 1: Like push gummies from.
• 9:51
  Speaker 2: New Zealand yes, yeah, they're a great team.
• 9:53
  Speaker 1: Anyway, we often think of digestion when we hear gut health, but it impacts so much more Our immune system, mental health, even our weight.
• 10:09
  Speaker 1: Can you?
• 10:09
  Speaker 2: break down what the micro I can't even say Microbiome, microbiome, microbiome, microbiome, okay.
• 10:13
  Speaker 2: Biome is.
• 10:16
  Speaker 2: I guess it's an environment, it's an ecosystem, and microbes, which are organisms.
• 10:20
  Speaker 1: Okay, right, so it's okay, All right.
• 10:21
  Speaker 2: Microbiome.
• 10:22
  Speaker 1: Microbiome actually does.
• 10:24
  Speaker 1: What does it do?
• 10:26
  Speaker 2: So look, microbiome is actually.
• 10:27
  Speaker 2: When people say the microbiome, they're generally referring to the gut microbiome, but it actually.
• 10:32
  Speaker 2: You've got a microbiome on your skin, you've got a microbiome in your lungs and they're all very different, but when most people talk about the microbiome, they're talking about the microbiome, the organisms.
• 10:42
  Speaker 1: Yes.
• 10:42
  Speaker 2: So you've got billions of different organisms.
• 10:44
  Speaker 2: Think of it like your rainforest.
• 10:46
  Speaker 1: Yeah.
• 10:49
  Speaker 2: You can break them down in lots of different ways.
• 10:50
  Speaker 2: You can think about good ones, bad ones, pro-inflammatory, anti-inflammatory.
• 10:53
  Speaker 2: You can think about it's not just bacteria.
• 10:55
  Speaker 2: So there's viruses, there's fungi, okay, there's all these other things that are there and they all live in this harmony.
• 11:02
  Speaker 2: And traditionally what you're referring to is within your large bowel, which is the most steady state microbiome and that's got the largest kind of mass of organisms that are there, and so that's what the microbiome actually is.
• 11:16
  Speaker 2: That will change over time, right, and it generally always fluctuates over time and then.
• 11:24
  Speaker 2: But that then has a link with the rest of your body.
• 11:26
  Speaker 2: So what I was talking about before in the past we thought that there was this your gut lining was this kind of solid state that never there was nothing happened with, there was no crosstalk.
• 11:36
  Speaker 2: But there's always crosstalk between the microbiome and the within your body itself.
• 11:41
  Speaker 2: That's, and that would be traditionally your immune system.
• 11:43
  Speaker 2: Yeah, um, there's the whole concept of leaky gut, where there's an increased kind of crosstalk, but everyone has some form of crosstalk.
• 11:52
  Speaker 2: It's your body.
• 11:53
  Speaker 2: Sensing what's going on within your gut and that can lead and drive to either a reduction in your immune system or an increase in your immune system is one way, but also the microbiome you mentioned digestion.
• 12:07
  Speaker 2: Your microbiome breaks down a lot of food products and produces other metabolites.
• 12:12
  Speaker 2: That has impact everywhere else and you mentioned mental health as a prime example.
• 12:16
  Speaker 2: Like a large portion of these neural we call neurotransmitters, these metabolites that work in your brain, so things like serotonin, most of it, 90 plus percent of it, gets made by microbiome, by organismally gut.
• 12:30
  Speaker 2: So it is directly entirely linked and it makes sense why, if you can get some of your diet right, your lifestyle right, how that can have a huge impact on the rest of your body and a lot of it will have lots of pathways.
• 12:42
  Speaker 2: But a lot of it does impact your microbiome and therefore downstream should help the rest of your body and a lot of it will have lots of pathways but a lot of it does impact your microbiome and therefore downstream should help the rest of your body.
• 12:50
  Speaker 1: So if gut is so important, obviously it is.
• 12:52
  Speaker 1: What are some of the things that you never put in your mouth?
• 12:56
  Speaker 2: I think never is a strong word.
• 12:57
  Speaker 2: I think let's call it what it is we all have to leave is probably our first number one right so never is a strong word.
• 13:06
  Speaker 1: And that's what I love about you.
• 13:07
  Speaker 1: Even when I came to you with my liver thing, I was like no drinking, no, nothing like just clean.
• 13:12
  Speaker 1: And you were like it's not practical.
• 13:15
  Speaker 2: It's not sustainable.
• 13:16
  Speaker 2: You can do something, you can do something a hundred percent.
• 13:19
  Speaker 2: But if you're having as big an impact on your mental health about and I think we've talked about this before, but you've got this whole world called gut-brain interaction, you've got all these other things on the outside of your gut that will have as big a feedback onto the gut composition.
• 13:34
  Speaker 2: So if something causes more stress and we can talk a little bit more about it, but if it causes more stress, it'll have more impact on your gut health and more impact on the rest of your body too.
• 13:43
  Speaker 2: So in terms of I never say, never right, everything in moderation, everything in moderation, but ultimately kind of a few things that I always talk about is, if something looks too good to be true or lasts longer than it should.
• 14:00
  Speaker 1: Like the 24 year McDonald burger Any of those.
• 14:04
  Speaker 2: Even I talk about some of the bread products that you think about your nice icky sourdough down the road.
• 14:10
  Speaker 2: It'll last three days on your kitchen counter before going rock solid.
• 14:13
  Speaker 1: Yes.
• 14:14
  Speaker 2: But a bread in a bag will last you a week and the first thing you notice is a bit of mold.
• 14:17
  Speaker 1: Yes.
• 14:18
  Speaker 2: It's got something in there to do it and even things like that will have as big an impact.
• 14:23
  Speaker 2: It will have more impact than people get worried about gluten and dairy.
• 14:26
  Speaker 1: Yeah, yeah.
• 14:27
  Speaker 2: It's actually probably more the preservatives in it than anything else, so if something has, yeah.
• 14:32
  Speaker 1: And is that why the wine, then the preservatives in the wine, like I can't drink wine anymore because it just makes my nose?
• 14:37
  Speaker 2: Yeah, I think so.
• 14:38
  Speaker 2: The wine thing is an interesting one, and not all preservatives I've kind of put it as a blanket term and there's not even things like emulsifiers, which also come give a really bad rap.
• 14:47
  Speaker 2: They're the thing that keep things together.
• 14:49
  Speaker 2: So things like mayonnaise, it keeps things together.
• 14:51
  Speaker 2: And again, something that looks too good to be true has got things in it, but not all emulsifiers are as bad as each other.
• 15:00
  Speaker 2: It's the same thing with preservatives, but yes, I think that part of the rationale with wine is it's got other preservers in it and some people swear by these organic or the yes, yeah, yeah.
• 15:11
  Speaker 2: But even how do you define organic?
• 15:12
  Speaker 2: It's complex.
• 15:13
  Speaker 2: Yeah it is but the low preservative type wines, you'll do better than some of the other wines that you'll get Okay.
• 15:19
  Speaker 1: So you're saying there's never a never, never a never, but saying there's never a never, never a never.
• 15:22
  Speaker 2: But If you can minimize things in a packet, yeah, Okay, great, yeah.
• 15:26
  Speaker 1: So the Iggy's.
• 15:27
  Speaker 1: And why so?
• 15:28
  Speaker 1: Is it sourdough then?
• 15:30
  Speaker 1: I guess that was an example.
• 15:31
  Speaker 2: but it's more whole.
• 15:32
  Speaker 2: It was fresh, it was made, it was fresh yeah yeah, yeah, and like you think about pasta and you can buy pasta in the fridge section of Coles.
• 15:38
  Speaker 1: Yes.
• 15:45
  Speaker 2: Versus.
• 15:45
  Speaker 2: You don't need to be in a fridge as opposed to a box that can sit in your drawer for six months and survive, but the one in the fridge.
• 15:48
  Speaker 2: As soon as you take it out of the fridge, it has less things in there, so it has to be kept cool.
• 15:50
  Speaker 2: It has to be used within a certain shelf life.
• 15:53
  Speaker 1: Okay, I'm throwing out a few boxes of pasta.
• 15:55
  Speaker 2: We get everything in moderation.
• 15:56
  Speaker 2: And again, we all you've got kids as well.
• 15:59
  Speaker 1: I've got kids as well.
• 16:00
  Speaker 1: You as well.
• 16:00
  Speaker 1: You've got to pick your battles.
• 16:02
  Speaker 2: You've got to make it sustainable, because you can do something for a week and throw it out the window and it's not going to get you any benefit.
• 16:07
  Speaker 1: Yeah, true, Okay, all right.
• 16:08
  Speaker 1: Good, all right.
• 16:10
  Speaker 1: Let's talk about the thing that blew my mind the poo transplants.
• 16:26
  Speaker 2: What exactly is fecal microbiota transplant and why is it so powerful?
• 16:27
  Speaker 2: Okay, so let's call it.
• 16:27
  Speaker 2: We'll call it FMT.
• 16:28
  Speaker 2: Okay, easy to say, easy to do Yep.
• 16:28
  Speaker 2: So we've just we talked about how your microbiome drives a lot of things in your gut and when, something the term dysbiosis refers to, when that ecosystem goes out of balance.
• 16:43
  Speaker 1: Yep, okay.
• 16:44
  Speaker 2: So fire goes through your rainforest Best way to say it Most of the trees go down and you've got this kind of instead of have these beautiful lush rainforest, you've got these little shrubs that are growing everywhere.
• 16:53
  Speaker 2: That isn't quite right, yeah, and that's the thing that drives what we think drives a lot of chronic illness.
• 16:59
  Speaker 2: So you can do lots of things to change your microbiome.
• 17:03
  Speaker 2: It's impacted by the air you breathe, the medicines you take, the diet you have.
• 17:08
  Speaker 2: Exercise will have an independent effect on that type of exercise too, but I guess the pre and probiotics can have an impact in some way or form on that ecosystem.
• 17:22
  Speaker 2: But again it's got millions of different things.
• 17:23
  Speaker 2: So you think about your fecal transplant is as your ultimate pro body so you're taking an entire ecosystem from someone who's healthy, and that is through their poo yes they donate poo, like you can go donate blood.
• 17:37
  Speaker 2: Yeah, you can go donate poo and is there like a requirement?
• 17:40
  Speaker 1: yes, really, strict requirement, oh really so one.
• 17:44
  Speaker 2: You want someone who's healthy.
• 17:45
  Speaker 2: There's no point of taking someone who's got an unhealthy microbiome or who's got diseases to transfer to.
• 17:50
  Speaker 2: You also want to make sure there's no infections to transfer you also we don't, and this is part of those long-term effects.
• 17:58
  Speaker 2: We don't know if someone is a donor and they are going to develop a disease down the track.
• 18:03
  Speaker 2: Can you transfer that predisposition?
• 18:05
  Speaker 2: So they're really heavily screened and a lot of our work early on was when we were trying to find our own donors.
• 18:11
  Speaker 2: Our data showed that about 3% of donors are actually eligible to donate.
• 18:16
  Speaker 2: So it actually was really hard to find these donors and that was one of the hardest troubles because we used to get it from relatives.
• 18:22
  Speaker 2: You say well, if you needed this for, say, an infection like we used to treat we still do clostridium difficile infection, it's a really severe infection they would have to find their own donors.
• 18:33
  Speaker 2: We would screen them and that's how we did it.
• 18:36
  Speaker 2: Nowadays, since there's been the whole TGA overhaul, there is stool banks.
• 18:41
  Speaker 2: So if you need a blood transfusion, we call the Red Cross and the Red Cross sends it along.
• 18:53
  Speaker 2: There is two national stool banks.
• 18:54
  Speaker 2: So if we need a poo transplants, there's the Red Cross.
• 18:56
  Speaker 2: Now have a stool bank as part of it.
• 18:56
  Speaker 2: So they've got breast milk and they've got poo and they've got blood.
• 18:59
  Speaker 2: So, they supply some.
• 19:02
  Speaker 2: And there's a company in Adelaide called Byron Bank which was actually set up by colleagues of mine, gastroenterologists as well, who set up and again I need poo.
• 19:11
  Speaker 2: I give them a call and it's a rise on my doorstep whenever you need it and do you then just go?
• 19:15
  Speaker 1: I need poo from someone that is this.
• 19:19
  Speaker 2: Or is it like a that's one of the good things is what makes a good donor.
• 19:22
  Speaker 2: So you have to make what makes a safe donor versus what makes a good donor.
• 19:25
  Speaker 2: So all the screening that gets done about history what their past history is, any medications, any of that kind of things is all about safety and that's all our number one concern in anything you do.
• 19:42
  Speaker 2: You don't want to do anything that could put the patient at risk, so you're transferring any infections or predispositions.
• 19:44
  Speaker 2: There's still a lot of debate about what makes the good donor.
• 19:48
  Speaker 2: Is there a super donor, a super poo donor?
• 19:50
  Speaker 2: And there's been a lot of work gone into that place and, to give an example, there probably is super donors.
• 19:56
  Speaker 2: An example in our trials that I mentioned before with ulcerative colitis, we used two donors.
• 20:02
  Speaker 2: We screened their microbiome.
• 20:04
  Speaker 2: We did in-depth looking at their microbiitis.
• 20:05
  Speaker 2: We used two donors.
• 20:05
  Speaker 2: We screened their microbiome, so we did in-depth looking at their microbiome.
• 20:07
  Speaker 2: We found two that we really liked.
• 20:10
  Speaker 1: And when you did that, do you look at their poo?
• 20:12
  Speaker 1: Yeah, we take their poo.
• 20:15
  Speaker 2: we do microbiome analysis, so it gives you a full composition of everything that goes on.
• 20:19
  Speaker 2: And, using our knowledge from previous studies, we have various criteria, which ones we took Because, again, you don't want to embark on a multiple year study, a lot of effort, and then you get a negative result and it's because you picked the wrong donors.
• 20:32
  Speaker 2: Yes, so we did this and then, and we thought we picked two really good donors, we used two donors and at the end of it, one donor had 100% success rate for patients doing really well and the other donor had 30% success rate.
• 20:45
  Speaker 2: So there is still, but that's in one condition.
• 20:49
  Speaker 1: So you can't extrapolate to everything.
• 20:50
  Speaker 2: But yes, what makes a safe donor, what makes a good donor is two separate things.
• 20:54
  Speaker 2: We know what makes a safe donor.
• 20:56
  Speaker 2: We don't know entirely what makes a good donor.
• 20:59
  Speaker 2: Okay, and that's still a work in progress.
• 21:02
  Speaker 1: Okay, and I'm sure that's something that you are focused on.
• 21:04
  Speaker 2: Yeah, I think a lot of people are trying to understand what makes a good donor.
• 21:07
  Speaker 2: Yeah, but saying, and it depends a little bit on what you're trying to treat as well.
• 21:16
  Speaker 2: Okay, and that also changes.
• 21:16
  Speaker 2: So if we're trying to treat Crohn's disease or subcolitis, is that different to someone trying to treat a skin condition or-?
• 21:21
  Speaker 1: Or depression, or depression or something else Exactly.
• 21:24
  Speaker 2: So they're all very different things, but you really.
• 21:26
  Speaker 2: What happens then is you get the donor, you get the poo and you have to give it in some way or form.
• 21:31
  Speaker 2: So traditionally, what we do now is you do a colonoscopy, so you do a colonoscopy, yes, and then we put the poo down the colonoscope into the end of your colon.
• 21:41
  Speaker 1: Yes.
• 21:41
  Speaker 2: There's no science behind it.
• 21:43
  Speaker 2: We give people gastrostop or like something to slow you down, to keep it in there for as long as we can, yeah, and we keep people in bed for about an extra half an hour, an hour after, just trying to keep gravity coming out of the picture.
• 21:55
  Speaker 2: Yeah, so there's no.
• 21:56
  Speaker 2: This is it just stays still.
• 21:58
  Speaker 2: It stays still, and that's how we do it traditionally.
• 22:00
  Speaker 2: And that's how we do it traditionally.
• 22:01
  Speaker 1: You can do it and does it like do you do that in a capsule?
• 22:03
  Speaker 2: No, so this is all that's, all liquid down through the colonoscope.
• 22:06
  Speaker 2: Yeah right, okay, we were part of my PhD.
• 22:09
  Speaker 1: We were making capsules where you could freeze dry the poo.
• 22:14
  Speaker 2: Yeah, you freeze, dry it so it turns it into a powder.
• 22:17
  Speaker 2: No longer looks or smells like poo, yeah, and then you can put it in capsules and it's suddenly stable at room temperature and it is your ultimate probiotic.
• 22:26
  Speaker 2: And so, therefore, you can take them as capsules and you can suddenly opens up to the door of using it a bit more longer term to cleave chronic illness, and we showed that it's probably.
• 22:35
  Speaker 2: I'd much prefer doing it that way.
• 22:37
  Speaker 2: There's no TGF repress we don't need to do the colonoscopy which is again, less procedures the better.
• 22:46
  Speaker 2: But also the other problem with the colonoscopy is that most chronic illness you're probably going to need some sort of intervention longer time and doing colonoscopies regularly.
• 22:54
  Speaker 2: You just can't do.
• 22:55
  Speaker 2: Yeah yeah, you can do by enemas, so literally a syringe that goes in your bottom and it squirts it up.
• 23:02
  Speaker 2: That's what an enema is.
• 23:09
  Speaker 2: That probably has a role in maybe in those longer term.
• 23:10
  Speaker 2: But really the only practical way is either regular capsules or having some other interventions.
• 23:13
  Speaker 2: So I use a combination of different prebiotics after.
• 23:17
  Speaker 2: Again, we're trying to put some evidence to that, but it has very little harm and I think we'll have to feed the right microbiome after.
• 23:24
  Speaker 2: So the prebiotics, prebiotics things, the prebiotics feed the right microbiome.
• 23:28
  Speaker 2: It's like pouring fertilizer and water on your garden bed as opposed to throwing seeds on it every day.
• 23:33
  Speaker 2: And can that kind of feed the bugs that you've just introduced to allow them to grow and do what they need to do in a graft and whatever they need to?
• 23:42
  Speaker 1: So at the moment I'm on antibiotics because I've had this cold that just won't go away and I've been tested for everything.
• 23:48
  Speaker 1: The antibiotics in my gut are killing everything down there.
• 23:54
  Speaker 1: Yeah, what do I need to do?
• 23:56
  Speaker 1: Yeah, it's a really good question.
• 23:58
  Speaker 2: And this is where there's a bit of debate about the use of probiotics prebiotics.
• 24:02
  Speaker 2: The other thing is, when you say probiotics or prebiotics, you're talking about a hundred different products.
• 24:10
  Speaker 1: Oh, yes, all have different effects.
• 24:11
  Speaker 2: Yeah, yeah, and which one's the right one?
• 24:13
  Speaker 2: And efficacies Exactly, and so we don't routinely necessarily say take probiotics after, unless, though, saying that, though, that's what is a routine.
• 24:22
  Speaker 2: Yes, it can stop getting people getting diarrhea from antibiotics, okay.
• 24:27
  Speaker 2: It can stop people getting thrush after antibiotics, yeah.
• 24:31
  Speaker 2: So it can stop problems that can come after antibiotics.
• 24:33
  Speaker 2: Okay so if you're one of those people that do get it, there's very little harm in using it.
• 24:41
  Speaker 2: But if you find and you bounce back after antibiotics, your gut's pretty resilient, it'll kind of bounce back and maybe you're just better off sticking to those whole foods, giving it all the right bugs that it needs to actually recover From food.
• 24:52
  Speaker 1: Food is medicine.
• 24:52
  Speaker 1: If you can, yeah, yeah, okay.
• 24:53
  Speaker 2: So, yeah, we don't routinely recommend it, unless there's something else that comes from the antibiotics.
• 24:59
  Speaker 1: Okay, so what do you think about yogurt?
• 25:03
  Speaker 2: Again, not all the yogurts the same.
• 25:04
  Speaker 2: Yeah, um, in terms, there's a lot of really good properties about it, but there's a lot of good properties about it and I think it's it's again, it's a whole food.
• 25:10
  Speaker 2: It's good, it's so interesting.
• 25:12
  Speaker 1: It always is like when I, when you give like a general, what about this?
• 25:16
  Speaker 1: It's like well, what's in it?
• 25:17
  Speaker 1: Yeah, what's in it what's in it.
• 25:19
  Speaker 1: Like it can't be the sugar-based one, it needs to be.
• 25:22
  Speaker 1: The fewer ingredients, the better.
• 25:24
  Speaker 2: And this is where I would say I think I would have told you as well.
• 25:28
  Speaker 2: But as a probiotic, the products that you will see are the products that have the best marketing budget, not necessarily the ones that have had the best evidence, yes, so you have to learn to look at the labels.
• 25:41
  Speaker 2: What's in these things and why is it being advertised to me?
• 25:44
  Speaker 2: Is it better than anything else?
• 25:45
  Speaker 2: Yeah, or is the company behind it have got the best marketing budget?
• 25:49
  Speaker 2: Yeah, and that's a really important thing to think about.
• 25:52
  Speaker 1: Yeah, and see, that's the hard thing is what is like.
• 25:56
  Speaker 1: How do you know what is the best Exactly and?
• 25:58
  Speaker 1: I struggle with it and if I, struggle with it, then how, yeah, if I struggle with it.
• 26:02
  Speaker 2: Then how?
• 26:03
  Speaker 2: Yeah, and that's one of the what we're trying to do now particularly.
• 26:05
  Speaker 2: There's a lot of really interesting work in prebiotics.
• 26:07
  Speaker 2: So again, let's come back to prebiotics.
• 26:08
  Speaker 2: I much prefer using prebiotics for fiber and other types of things rather than probiotics.
• 26:14
  Speaker 2: Yes, they cheaper.
• 26:15
  Speaker 1: Yes, well, I think you recommended to me the psyllium husk.
• 26:18
  Speaker 2: Yeah.
• 26:18
  Speaker 1: Like the psyllium husks with a cheer or just to.
• 26:21
  Speaker 2: So I've always taken the tact If a product is still being used and no one's making money from it, then it's a win.
• 26:27
  Speaker 2: Right, and that's a slightly cynical approach, but it's a win.
• 26:33
  Speaker 2: So look, psyllium husks, by definition, doesn't have a lot of prebiotic properties.
• 26:37
  Speaker 1: Okay, all right.
• 26:40
  Speaker 2: But flow comes into play and I don't know where this kind of slide again going off tangent and everything else, but flow is as important as so.
• 26:49
  Speaker 2: Getting that you're emptying your bowels working properly is as important as actually the products that you actually put in.
• 26:57
  Speaker 1: Yeah, wow, and that is what to just clean it out and make it regular.
• 27:00
  Speaker 2: Best way to think about it.
• 27:01
  Speaker 2: Your gut is one long tube, from your mouth all the way through to your bottom.
• 27:05
  Speaker 2: Think of it like a river system.
• 27:07
  Speaker 2: If you get a nice, healthy, flowing river system, you get nice, healthy drinking water.
• 27:12
  Speaker 2: If something impacts flow of that river system, you'll get a buildup of moss and dirty water all the way throughout the system.
• 27:18
  Speaker 2: You can chuck chlorine tablets in there, you can do what you like, but unless you get the flow flow right, it isn't going to get better.
• 27:23
  Speaker 2: Your gut is exactly the same.
• 27:25
  Speaker 2: If you get something that impacts flow and we talk about pelvic floor, talk about kind of constipation you get to build up a poo.
• 27:32
  Speaker 2: We also get to build up a different organisms yes and that's not just in your large bowel, all the way up.
• 27:37
  Speaker 2: And of course troubles with reflux, of course troubles with lots of other but it will also cause troubles with behaviour as well.
• 27:42
  Speaker 1: Everything.
• 27:43
  Speaker 2: Everything, and so you can use certain diets, you can use probiotics, you can even use FMT.
• 27:49
  Speaker 1: Yeah.
• 27:50
  Speaker 2: But unless you fix the underlying flow issue, it'll be transient because it will just go back to kind of where it is.
• 27:55
  Speaker 2: So you can't just think when I use faecal transplants and I will always do it in conjunction with whatever else they're doing but also it has to be as part of a greater plan.
• 28:06
  Speaker 2: Why is your microbiome like this in the first place?
• 28:09
  Speaker 2: And unless we fix up at the same time, whatever we do is less likely to be log-lived.
• 28:16
  Speaker 1: That's really interesting.
• 28:16
  Speaker 1: So a friend of mine, their child was constipated like really constipated and I think it's not only.
• 28:25
  Speaker 1: I think it's more environmental than what's going in, but it's interesting that everything impacts.
• 28:33
  Speaker 2: And you think about it.
• 28:33
  Speaker 2: You talk about the kids, right, I know this is not our of the podcast.
• 28:38
  Speaker 1: Well, everyone does?
• 28:39
  Speaker 1: Well, not everyone, but you know there's a lot of percentage.
• 28:43
  Speaker 2: I'd take my.
• 28:44
  Speaker 2: My eight-year-old son won't poo at school, for example.
• 28:48
  Speaker 2: If my eight-year-old boy won't poo at school, how do you expect a 13-year-old female to poo at school?
• 28:52
  Speaker 2: And then, if you think about there's normal physiology poo enters the colon in the morning, sorry, in the pelvis.
• 29:01
  Speaker 2: In the morning You'll get that urge to go to the toilet.
• 29:04
  Speaker 2: If you miss that urge to go, you won't get it again until the next day.
• 29:08
  Speaker 2: Oh, really, and if you I say if you suddenly start mucking around with missing your body's cues and not listening to your body, then you'll start changing your.
• 29:18
  Speaker 2: Your pelvic floor comes into play, and it's not.
• 29:21
  Speaker 2: Most people think pelvic floor is post-babies and all this but it's actually a problem with lack of relaxation of the pelvic floor and that starts as a teenager and that, well, if you lose that ability to fully empty your bowel, therefore it's going to impact that flow, come back to that flow Right, and so if you can start getting that by listening to your body going when you're to the toilet, that will have a bigger impact over time to your microbiome than any product that you'll buy in the shelf.
• 29:44
  Speaker 1: Isn't that interesting?
• 29:45
  Speaker 1: Because, even like with kids, I need to go to the toilet.
• 29:48
  Speaker 1: It's like, oh, wait until we've got to do something, but we should actually be going.
• 29:52
  Speaker 1: Okay, let's go to the toilet, let's have some time.
• 29:54
  Speaker 2: Yeah, and like I was talking about whether I try to implement something at my kid's school, to say well, actually, just let them go, make sure the toilets are clean.
• 30:01
  Speaker 2: I think that's the first thing Give them peace and quiet to actually go.
• 30:04
  Speaker 2: Yeah, and in fact, actually the Queensland not just for kids the Queensland government spent a lot of money recently on an advertising campaign and it was literally with a bright-coloured dolphin poo at work.
• 30:15
  Speaker 2: Right, and it's the exact same thing.
• 30:18
  Speaker 2: And it's probably the biggest thing is listen, find yourself a nice toilet where you, yeah, and don't be afraid to use it, just go for it.
• 30:28
  Speaker 2: But it's simple.
• 30:28
  Speaker 2: Things like that can make as big an impact on your gut microbiome, just thinking about getting that flow right.
• 30:33
  Speaker 2: And that's why psyllium husk I find work, yeah, because a small amount of it helps you go.
• 30:37
  Speaker 1: It's cheap, you can use it every day exactly, put it in a smoothie, exactly.
• 30:41
  Speaker 2: You can do however you want to do it and just it doesn't have the prebiotic properties itself but it will have a prebiotic benefit because it will just getting that flow right.
• 30:50
  Speaker 1: And yeah, okay, and the flow to prepare your gut so that it can take everything.
• 30:55
  Speaker 2: And help you empty when you need to go to the toilet.
• 30:57
  Speaker 1: Yeah, okay, what about chia seeds then?
• 31:04
  Speaker 2: Again, same kind of thing.
• 31:05
  Speaker 2: It has that same potential benefits with emptying and yeah so yeah, anything like that I'm very happy with.
• 31:08
  Speaker 1: Great Tick, done that.
• 31:09
  Speaker 1: Do you think this is the future of medicine, or do we have a long way to go before it's mainstream?
• 31:17
  Speaker 2: I think it's a ready mainstream, because every person who it's no longer the doctor tells the patient what to do.
• 31:26
  Speaker 2: The patient takes it with a grain of salt or takes everything, listens to it, does it 100% yeah, yeah, we've gone to the days of that, yeah, yeah, I think you put it.
• 31:33
  Speaker 2: Unless the older generations, like my nan, she will listen to everything yeah, yeah, yes, you're right, but the older generation also comes with their daughter into it, and then you go and google everything as well.
• 31:43
  Speaker 2: No but the but this and but we should.
• 31:45
  Speaker 2: You should be like.
• 31:46
  Speaker 2: Everyone should be taking control over their own health I could not agree more with that, and so I think there was a study from a few years ago that said that.
• 31:53
  Speaker 2: Um, as an example, 25 of the us population was taking probiotics in 2019 so a quarter of the population as a way of some way taking control over their gut health.
• 32:02
  Speaker 2: Right, right At that time, 45% were thinking about starting one, and I guarantee if they redid that study now, it would flip the numbers around the other way.
• 32:10
  Speaker 2: So close to half the population will be doing something to help their gut, microbiome, yeah, wow, so I think it already is mainstream.
• 32:18
  Speaker 1: Yeah, yeah, okay, mainstream.
• 32:20
  Speaker 2: What is probably better is that you can't open a medical journal in any specialty without seeing a paper on the gut microbiome and looking at how that will impact in some way treatment outcomes.
• 32:33
  Speaker 2: Whether it be from cancer space, whether it be your gut microbiome, there's some really fascinating stuff in the cancer world.
• 32:39
  Speaker 2: That's what a lot of our research is in now at the moment, world.
• 32:45
  Speaker 2: That's what a lot of our research is in now at the moment how your gut microbiome can influence how you respond to different therapies, how it can cause different things side effects and so therefore, you suddenly got this interplay between the wellness world and medicine where you can have everything you do will not just work.
• 32:59
  Speaker 2: It shouldn't be alternative.
• 33:00
  Speaker 1: It should be.
• 33:01
  Speaker 2: I don't like this medicine that doctor's given me.
• 33:02
  Speaker 2: I'm going to go to my naturopath.
• 33:04
  Speaker 1: It should be.
• 33:04
  Speaker 1: How can they two work together?
• 33:06
  Speaker 1: And I think that's the amazing thing is, if you are taking ownership of your health, you are getting your team of specialists, whether they are the naturopaths or the wellness space or the medical space, and they're working together.
• 33:21
  Speaker 2: And you're an active part of that.
• 33:22
  Speaker 2: Yeah, you have to be, because everything you do will have an impact.
• 33:24
  Speaker 1: Yeah, and everything you eat Exactly as you get older.
• 33:27
  Speaker 1: What changes to your gut?
• 33:31
  Speaker 2: So naturally, over time your diversity changes.
• 33:38
  Speaker 1: So how many different types of plants?
• 33:39
  Speaker 1: If you can come back to our, I think the rainforest of thinking about your gut like that is brilliant, because you've got the tall tree like everything.
• 33:45
  Speaker 2: And brain for us and think about your gut as like.
• 33:46
  Speaker 2: That is brilliant because you've got the tall tree, like everything, and so the number of different types of plants start to drop, your tree heights start to get shorter.
• 33:51
  Speaker 2: Yes, not quite as luscious, and that's just one of those things that come with aging.
• 33:55
  Speaker 1: Yeah.
• 33:55
  Speaker 2: Hormones play a role in that too.
• 33:56
  Speaker 2: So menopause is another kind of change.
• 33:58
  Speaker 2: It changes everything, yeah.
• 34:00
  Speaker 2: So all these things start to kind of have an impact and you recover quicker from after an anti-course of antibiotics.
• 34:11
  Speaker 2: Things take longer to recover and probably again it's hard to get the right evidence.
• 34:14
  Speaker 2: But there probably is more crosstalk between that gut and your rest of your immune system and I think that's why one of the many reasons why the rates of chronic illness start to go up around that time as well and I know you had a great podcast on inflammation.
• 34:29
  Speaker 2: I listened to it and there's a lot of again.
• 34:31
  Speaker 2: There's a lot of crosstalk between that because part of that driver is not just your immune system changing it, but it's that gut microbiome changing it.
• 34:38
  Speaker 1: What should we be doing as we get older?
• 34:40
  Speaker 1: To make sure that it is healthy.
• 34:42
  Speaker 2: It is, I think we've got to be.
• 34:43
  Speaker 2: We talked about the what never should put in your mouth anyway, I often talk about it in moderation, but maybe that moderation needs to be a slightly tighter moderation, yeah, and so maybe we have to be that little bit more careful about keeping more to that whole food type diet, less preservatives, be a little bit more careful with the antibiotic use, if we can do that focus a bit more on exercise and making sure that balance is there and doing, adjusting what you're doing a little bit, being a little bit more careful as we get on.
• 35:13
  Speaker 1: Yeah, okay.
• 35:13
  Speaker 1: So I think this again comes back to you owning it.
• 35:16
  Speaker 1: It's you being mindful about what you put in your mouth, about what you're doing in the environment around you, and just making sure that you can actually control it Exactly.
• 35:26
  Speaker 2: Well, not control it, but like impact it and listening to your own body's cues, your body is really good.
• 35:31
  Speaker 2: There's a whole concept of interoception which was coined by, or talked about by, a neuropsychologist I've forgot his name, but it's a great book.
• 35:40
  Speaker 2: Actually I can send it through.
• 35:41
  Speaker 2: But looking at those own body's cues, you think about even things like when your tummy rumbles telling you that it's hunger.
• 35:47
  Speaker 2: It's that link between what's happening inside with what you can feel on the outside.
• 35:52
  Speaker 1: Yeah.
• 35:53
  Speaker 2: And it's we live in society at the moment that eats when they're not hungry.
• 35:57
  Speaker 2: They ignore, they don't poo when they need to.
• 36:00
  Speaker 1: Need to.
• 36:00
  Speaker 2: Try to do things when they don't need to do it yeah, yeah.
• 36:02
  Speaker 2: And so we're not listening.
• 36:04
  Speaker 2: We're so busy in doing so, and so maybe it's sometimes what I think it's taking it that little bit of a step back and saying well, what does your body listen to?
• 36:12
  Speaker 2: Your body listen to those cues, respond, understand what's happening in your own body, Don't fight it, Go with it.
• 36:19
  Speaker 1: So when Amelia, who was talking about the information, was on, she said something like one of her tips is stop eating when you think you're hungry and actually wait until your stomach is hungry or starts to rumble, and I think we've got to be doing that more.
• 36:36
  Speaker 2: Exactly so.
• 36:36
  Speaker 2: It's listening, understanding, yeah, understanding what your body needs.
• 36:39
  Speaker 1: Yeah.
• 36:40
  Speaker 2: Understanding and stop forcing it to do what you want it to do.
• 36:45
  Speaker 2: Sometimes it's not the right thing.
• 36:47
  Speaker 1: Yeah, I think that is so.
• 36:49
  Speaker 1: There's so much talk about and we've talked about it the gut-brain axis.
• 36:53
  Speaker 1: How much of our mood is actually controlled by our gut?
• 36:59
  Speaker 2: Yeah, look, it's a great question.
• 37:01
  Speaker 2: So gut-brain axis.
• 37:03
  Speaker 2: So we know everyone knows the best way to think about it is that everyone knows about the nervous poos.
• 37:09
  Speaker 2: You're anxious you're nervous, you've got to the toilet, you may have more bloating, you may have troubles, and that's just that gut-brain interaction that's constantly working, and it's not just one-way traffic, it's both ways.
• 37:22
  Speaker 2: So the way I like to talk to people about bloating right.
• 37:26
  Speaker 2: Bloating is a common symptom.
• 37:28
  Speaker 2: Half the world's population have some form of irritable bowel.
• 37:31
  Speaker 2: Yes, which?
• 37:32
  Speaker 2: The new term for irritable bowel is actually disorders of the gut brain interaction.
• 37:36
  Speaker 2: So it's actually they've changed the terminology of it.
• 37:38
  Speaker 2: It's no longer.
• 37:39
  Speaker 2: And also irritable bowel is such a terrible term.
• 37:42
  Speaker 2: It's so long been used as a throwaway.
• 37:45
  Speaker 2: Yeah, yeah, it's nothing wrong with it, but half the world's population, more than half, have some form of it and will have as big an impact on someone's life than some other chronic illness, and there's so many things you can actually do to treat it.
• 37:57
  Speaker 2: But that comes down to that gut-brain interaction.
• 38:01
  Speaker 2: So why I describe this?
• 38:03
  Speaker 2: You've got all this almost second brain on the outside of your gut that senses part of a sense of what's going on in the inside.
• 38:09
  Speaker 2: That sends messages back up to the brain.
• 38:11
  Speaker 2: The brain interprets those messages in some way or form and then sends other messages and hormones back down to the gut and that is a cycle and so something can trigger that cycle off.
• 38:22
  Speaker 2: Whether it be an illness, whether it be a stressful event, something turbocharges that cycle and then it's really hard to kind of wind that cycle back down.
• 38:31
  Speaker 2: So we know your brain, like in people with symptoms for example, will have more activity in the certain parts of the brain to normal stimulus.
• 38:40
  Speaker 2: So where other people won't even have any activity, they'll be reacting to things that are going inside the gut.
• 38:46
  Speaker 1: So if you are living in constant fight or flight, that's obviously extremely bad for your gut.
• 38:52
  Speaker 2: Exactly exactly.
• 38:53
  Speaker 1: And is that then at that point where you need to stop and just take a breath or try and get the nervous system under control?
• 39:01
  Speaker 2: Exactly, exactly right, and so there's something called gut hemotherapy.
• 39:05
  Speaker 2: I don't know if you've no.
• 39:07
  Speaker 1: What is?
• 39:08
  Speaker 2: that Exactly so it recognizes that whole link, that whole gut-brain interaction that's constantly on firing Gut.
• 39:15
  Speaker 2: Hemotherapy was designed by the same people that made the FODMAP diet down in Monash University.
• 39:19
  Speaker 1: Yes, okay.
• 39:19
  Speaker 2: It brings in mindfulness, meditation, other energy techniques.
• 39:23
  Speaker 2: It works as well as diet in bloating pain and changing bowel habits.
• 39:27
  Speaker 2: A six-week program will have this prolonged benefit and so I spend my life actually liberalizing people's diet because I think that no one needs to be on a long-term restrictive diet.
• 39:37
  Speaker 2: And they say well, actually, whatever we do with probiotics, with diet, even with poo transplants, it's treating one side of the picture.
• 39:47
  Speaker 1: Yeah, yeah, but it's neglecting everything else.
• 39:49
  Speaker 1: Yeah, yeah.
• 39:49
  Speaker 2: So if you can do it, you can micromanage what goes in your mouth to the tea, but you're not going to get very far.
• 39:55
  Speaker 1: But that's not the environment Exactly.
• 39:56
  Speaker 1: And see, this is like a great thing is if you think about you and you own you and your health.
• 40:00
  Speaker 1: It's not only what goes in, but the environment you're in.
• 40:05
  Speaker 2: And there's a really nice thing with exercise, so we know that exercise will.
• 40:08
  Speaker 1: Oh, and also movement, yeah, so it is like food, movement, environment, exactly, yeah, yeah, and so a lot of the mind that gut hemotherapy.
• 40:15
  Speaker 2: It works in various different ways but it starts to switch off that cycle and, like you can supercharge it, it could all.
• 40:22
  Speaker 2: It takes a little bit to start winding it back.
• 40:24
  Speaker 1: Yeah.
• 40:24
  Speaker 2: Okay, and it works.
• 40:25
  Speaker 2: It works really, and there's randomized trials that show that it works.
• 40:28
  Speaker 1: And the exercise.
• 40:29
  Speaker 2: Yeah.
• 40:30
  Speaker 1: What is the best exercise for your gut?
• 40:32
  Speaker 2: So it's a really so there was actually.
• 40:34
  Speaker 2: I found a study.
• 40:35
  Speaker 2: It took people take the exact same exercise.
• 40:38
  Speaker 2: So say running, running as an example same intensity, same diet.
• 40:43
  Speaker 2: One group ran inside on a treadmill, the other group ran in a forest or in a rainforest, somewhere outdoors, and the rainforest or the outdoors group had a better impact on their microbiome for the exact same amount of exercise, energy, diet than the group running inside.
• 40:59
  Speaker 2: That is fascinating and they called it nature size or something of the sort.
• 41:03
  Speaker 2: But it was a great concept.
• 41:05
  Speaker 2: It was showing that actually that outdoor environment, that fresh air, everything around it, has an independent improvement in your microbiome.
• 41:13
  Speaker 2: That's not just all the other health benefits but actually changes your microbiome regardless of the same diet.
• 41:18
  Speaker 1: It's so interesting, it's so fascinating that it's holistic, like it is actually holistic in the way that we need to approach it.
• 41:25
  Speaker 2: But I think what's the best?
• 41:26
  Speaker 2: Best exercise is probably one that you enjoy doing.
• 41:29
  Speaker 1: Yeah.
• 41:30
  Speaker 2: Actually going to do that.
• 41:31
  Speaker 2: You can actually start to switch off.
• 41:33
  Speaker 2: Yeah, um, and I found I do exercise.
• 41:35
  Speaker 2: I took away my headphones and started actually I don't use the headphones anymore and I actually found that that had an improvement on my mental health as well.
• 41:43
  Speaker 2: But just that, switching off, slowing down I found I was more effective at the gym and doing other things when I actually took away some of that the noise, the noise.
• 41:51
  Speaker 1: It's funny, Even like cause I was always on, always on, like always having to learn something, listen to something, do something in the car, had to like just be listening to a podcast or something or an audio book or something, and I've just stopped because the noise like it's just nice having nothing sometimes.
• 42:10
  Speaker 2: And I think we think, I think it's probably will tone down all those kind of we talk about gut brain attraction, all those kind of.
• 42:16
  Speaker 2: All that noise is probably have an impact, the stimulus that by definition will hopefully should feed back down to your gut and have that image.
• 42:23
  Speaker 1: Yeah, okay.
• 42:23
  Speaker 1: So something that I found fascinating, which is when we started talking, was you're involved in academic research.
• 42:30
  Speaker 1: What are the most exciting developments in gut health right now?
• 42:34
  Speaker 2: Yeah, so I think that you can talk about yeah, no, no, no.
• 42:39
  Speaker 2: Of course, there's so many great things.
• 42:42
  Speaker 2: I do research because I'm interested by research.
• 42:47
  Speaker 1: Yes.
• 42:47
  Speaker 2: I don't care too much about papers that come out.
• 42:49
  Speaker 2: I want to see change, I want to see things that I want to do something that can change patients sitting in front of me.
• 42:55
  Speaker 2: Because that's who I am.
• 42:56
  Speaker 2: I'm inclusion at heart, yes, and that is my goal.
• 43:00
  Speaker 2: That is my kind of world.
• 43:01
  Speaker 2: And then everything else comes around there.
• 43:03
  Speaker 2: So where, as an example, what's really exciting is that there is acceptance of the microbiome in every different specialty, that it can help disease.
• 43:12
  Speaker 2: And a prime example of that is in the cancer space.
• 43:15
  Speaker 2: We know that, for example, immunotherapy yes, we know that.
• 43:19
  Speaker 2: For example, immunotherapy yes, immunotherapy was designed many years ago.
• 43:22
  Speaker 2: That turns on someone's immune system to fight cancer.
• 43:26
  Speaker 2: It is a game changer for melanoma.
• 43:28
  Speaker 2: It's a game changer for a lot of other cancers, yes, but there's still portions of people.
• 43:44
  Speaker 2: Someone doesn't respond to their cancer immunotherapy with melanoma, you could take poo from someone who had melanoma that responded to the immunotherapy.
• 43:50
  Speaker 2: You give it to the patient that isn't responding.
• 43:54
  Speaker 2: You don't change anything else and suddenly their cancer switches off, and so it shows that it's whilst you're just turning on the immune system.
• 44:01
  Speaker 2: There's more drivers, and so it shows that it's whilst you're just turning on the immune system.
• 44:02
  Speaker 2: There's more drivers, there's more drivers, and so you can suddenly change outcomes, and amazing outcomes.
• 44:08
  Speaker 1: Yeah, yeah.
• 44:09
  Speaker 2: So one of the trials that we're running at the moment is using fecal transplants by capsules in patients that get a lot of side effects from the immunotherapy.
• 44:18
  Speaker 2: So some patients will develop this bowel inflammation that looks a lot like Crohn's disease, and we've got a randomized trial using these capsules to treat their cellulose.
• 44:28
  Speaker 2: But what's even more exciting, even that'll answer one question about preventative.
• 44:33
  Speaker 2: So you can suddenly say at the start of their cancer journey can you do something to improve their microbiome?
• 44:39
  Speaker 2: And there's simple, like even some research showing that the amount of fiber in your diet, every five gram increase I think it's five gram will improve your success rates from cancer therapy by a certain percentage.
• 44:55
  Speaker 2: That's not controlled data, that's just questionnaires, but it's such a simple thing that the person can take control of, rather than the doctor taking control of.
• 45:04
  Speaker 2: Say, well, what can I do to improve my diet?
• 45:06
  Speaker 2: What things can I do to have a measurable and beneficial impact?
• 45:11
  Speaker 2: And that's probably the exciting bit is how can you do it to empower the patient to take control and to actually improve your outcomes?
• 45:20
  Speaker 1: Yeah, I think the empowering a patient that's amazing.
• 45:22
  Speaker 1: Yeah, what are the biggest misconceptions you hear about gut health that drive you crazy?
• 45:30
  Speaker 2: Okay, slightly polarizing, kind of yeah, I've got to bite my tongue a little bit.
• 45:35
  Speaker 2: Don't, don't bite your tongue.
• 45:37
  Speaker 2: I'm a big advocate of no long-term restrictive diets, so gluten and dairy, for example, has been demonized by everyone.
• 45:47
  Speaker 2: I'm not saying everyone should go for gold with all these kind of things.
• 45:51
  Speaker 2: Everyone's circumstances are different.
• 45:53
  Speaker 2: But there's very few people that need to be on a no gluten or no dairy diet.
• 45:57
  Speaker 2: You can do low gluten, low dairy, yeah, yeah, yeah.
• 46:01
  Speaker 2: But as soon as there's that think of I actually I'm going to pose this a little bit quickly Say you have high blood pressure, yes.
• 46:08
  Speaker 2: Or talk about cholesterol.
• 46:09
  Speaker 2: Yeah, yeah, you go on a cholesterol drug.
• 46:11
  Speaker 1: Yes.
• 46:12
  Speaker 2: If it's causing you trouble.
• 46:14
  Speaker 1: Yes.
• 46:14
  Speaker 2: Or if it's not dropping your cholesterol.
• 46:16
  Speaker 2: Yes, you're not going to continue taking the drug.
• 46:17
  Speaker 2: No, yes, you're not going to continue taking the drug.
• 46:23
  Speaker 2: No, yes, people get put onto a gluten-free diet or dairy-free diet as a way of treating something, whether it be their skin, their bloating.
• 46:28
  Speaker 2: There's something else, but if it doesn't improve their bloating or it doesn't improve their skin, they're on it seemingly forever.
• 46:36
  Speaker 1: Yeah, okay.
• 46:36
  Speaker 2: They don't stop that diet.
• 46:37
  Speaker 2: Then, more importantly than that, then suddenly it starts to impact when they go out for dinner.
• 46:43
  Speaker 2: Yeah, okay, they don't stop that diet.
• 46:44
  Speaker 2: Then, more importantly than that, then suddenly it starts to impact when they go out for dinner.
• 46:46
  Speaker 2: They're worrying about what they put in their mouth, even though it probably has no difference to anything else.
• 46:49
  Speaker 1: Yeah, yeah.
• 46:50
  Speaker 2: But that psychological impact has a bigger impact on their life than anything it was trying to treat.
• 46:55
  Speaker 1: Yeah right.
• 46:56
  Speaker 1: And it's really I talk to people.
• 46:58
  Speaker 2: That's such an interesting way of thinking, yeah.
• 47:00
  Speaker 2: And so I talk to people and say I actually really want to liberalize your diet and I want we can talk to a dietician and help you do it slowly.
• 47:06
  Speaker 1: Yes, being on this road, yeah, yeah, yeah, not something going.
• 47:08
  Speaker 1: No, no, you can.
• 47:09
  Speaker 2: And people burst into tears when they say it because it's actually people, yeah, people.
• 47:13
  Speaker 2: We all know this.
• 47:15
  Speaker 2: We're all really good at putting on facades and everything else but it has a huge impact on someone's life.
• 47:20
  Speaker 1: Yeah.
• 47:20
  Speaker 2: And just that food choices.
• 47:22
  Speaker 2: So if something causes more grief than benefit, then there's no point of continuing.
• 47:27
  Speaker 2: We have to think of it another way of doing it.
• 47:28
  Speaker 2: So and again, a lot of the time it's not the gluten, it's the preserve we talked about the preserve in the packets, yeah.
• 47:43
  Speaker 2: Most people all the as much beer and beer as you like and they're perfectly fine.
• 47:45
  Speaker 2: So the same amount of gluten content.
• 47:45
  Speaker 2: It's often just a different form of yeast or a different something else with less preservatives, and always have to be clear what are you trying to achieve?
• 47:47
  Speaker 2: with any intervention, whether it be diet, medication, supplement If it doesn't, if it's causing more grief, whether it be psychologically, financially, anything else, or if it's not meeting those goals, then reassess whether it's necessary.
• 48:01
  Speaker 2: So I think that's probably the biggest thing that I find is that, yeah, for every.
• 48:05
  Speaker 2: It's not a one size fits all.
• 48:06
  Speaker 1: Yeah, and you're, I mean, as you've kept saying, the never, never like never, never, never, never, never.
• 48:12
  Speaker 2: Say never, yeah, yeah.
• 48:15
  Speaker 1: Is there anything you've changed about your own health approach as you've learned more about your gut health?
• 48:25
  Speaker 2: Yeah, also a good question.
• 48:26
  Speaker 2: I guess more recently in the last few years, as my kids are slowly getting a little bit bigger, I looked at my kind of own life and health and when I finished my PhD and trying to find again what I want to want in life and that balance.
• 48:41
  Speaker 2: I took on a few things and again I like to research a lot of these things too and other factors.
• 48:48
  Speaker 1: So we can learn Exactly.
• 48:51
  Speaker 2: So certain things like I realised that I exercise not just good for my own body, it's very good for my mental health too.
• 48:57
  Speaker 2: And so I've shifted starting my consulting sessions at 8.30 instead of to 9.
• 49:03
  Speaker 2: And so I know I can have time in the morning to do some exercise.
• 49:05
  Speaker 1: Yes.
• 49:05
  Speaker 2: And that way it gets me off on a great day.
• 49:07
  Speaker 1: Yeah, yeah.
• 49:08
  Speaker 2: And that's kind of one of those.
• 49:08
  Speaker 2: Really, it's nice to get you up for the best day.
• 49:10
  Speaker 2: I use Pruzilium on my breakfast every morning, oh really, and I try to sneak it into my kids.
• 49:15
  Speaker 2: This if I can.
• 49:16
  Speaker 1: Yeah, okay, and it always in the morning rather than and it's not morning, or night I think about it and say, well, what is your biggest source of whole?
• 49:23
  Speaker 2: So not all five is equal.
• 49:24
  Speaker 2: So come back to that question.
• 49:25
  Speaker 2: There's a lot of subtypes of it, but if it's simplest way, you've got your fruit and veg fiber and you've got your whole grain type fiber.
• 49:31
  Speaker 1: Yeah.
• 49:31
  Speaker 2: When do most people have their whole grains?
• 49:33
  Speaker 2: It's usually cere, that's all.
• 49:36
  Speaker 2: You don't need very much.
• 49:39
  Speaker 2: Yeah, a teaspoon of psyllium every morning, with the whole lot of other stuff like berries and a few things, and that's, that's one of the things I've done.
• 49:46
  Speaker 1: Okay.
• 49:46
  Speaker 2: We get the cheap and cheerful.
• 49:47
  Speaker 1: Yeah, yeah.
• 49:48
  Speaker 2: From Woolies yeah, bag will cost you $6 or last you six months and that's, that's all we get, and is it organic of a?
• 49:55
  Speaker 2: Husk.
• 49:56
  Speaker 2: It's a, it's a tub of husk.
• 49:57
  Speaker 2: There's not, there's not much, not much organic things about it, right?
• 50:01
  Speaker 2: So again, you can't, you can't change everything.
• 50:03
  Speaker 1: Yeah, yeah, okay.
• 50:08
  Speaker 2: As long as you're having it, I'm doing it, Sorry.
• 50:10
  Speaker 2: So that's one of the things that I have done, and and but it's also and that and again.
• 50:14
  Speaker 2: Yeah, starting late and then thinking, listening more to my own body.
• 50:16
  Speaker 2: So on the way that I was going to grab a cup, I picked up a cup of coffee.
• 50:18
  Speaker 2: Instead, I'll sat down and I'll just sit down and enjoy the cup of coffee and just just wind down, put it down the phone, yeah.
• 50:23
  Speaker 2: So those kinds of things just switching off a little bit, yeah, and winding back, listen to my own self.
• 50:28
  Speaker 1: I think, yeah, it is because we're always on.
• 50:30
  Speaker 2: Yeah, like always on, always on.
• 50:31
  Speaker 1: Always on, yeah.
• 50:36
  Speaker 2: And it's never solid.
• 50:37
  Speaker 2: No, no, no I know, Outsides, outsides, yeah, and that's why it's I I've we've talked a bit about before I speak at.
• 50:46
  Speaker 2: Gwingana and run a retreat, but I actually really I use that as my own also, the retreat of myself.
• 50:53
  Speaker 2: So it's just switching off.
• 50:54
  Speaker 2: It's switching off from reality.
• 50:56
  Speaker 2: I can actually tell work.
• 50:58
  Speaker 1: call me if there's an emergency, otherwise I'll be back next week and your Gwingana retreat you do with a cardiologist, yeah, Like can you just talk about that.
• 51:06
  Speaker 2: So I was on, I'd never heard of Gwingana before I was asked to go down, and I was asked to go down by yeah, up, sorry up.
• 51:12
  Speaker 2: Yeah, I was asked by the cardiologist to go and talk.
• 51:18
  Speaker 2: He's been going there for eight plus years talking about heart health, and he used to do it with a neurologist at one stage and there was obviously now with gut health.
• 51:26
  Speaker 1: And.
• 51:28
  Speaker 2: I went down there once and it was really interesting talking to everyone there.
• 51:31
  Speaker 2: There was a few people there that were there for the first time.
• 51:35
  Speaker 2: You'll never see someone say this is my last time I'm going to be here there's always something to look at.
• 51:41
  Speaker 1: Oh, what about that?
• 51:42
  Speaker 2: Yeah, and what I loved about it was the phone there's no, reception no.
• 51:48
  Speaker 2: There's no laptops.
• 51:49
  Speaker 2: It's a structured kind of semi-structured kind of yes.
• 51:59
  Speaker 2: Work show.
• 51:59
  Speaker 2: So you don't do dairy and gluten-free, it's whole foods.
• 52:01
  Speaker 2: I have meat and a few things there too, and so I felt refreshed.
• 52:07
  Speaker 2: So I remember calling him up a few days later.
• 52:11
  Speaker 2: I was like I'm coming back, I don't care if you want me or not, I'm coming back.
• 52:15
  Speaker 2: And I said that same thing to the owner and I'm like I'm coming back, I don't really care what happens, and I love it for me.
• 52:20
  Speaker 2: And so we go down there and it's now my wife goes down there regularly.
• 52:25
  Speaker 2: It's such a lovely.
• 52:27
  Speaker 1: It's just a reset.
• 52:28
  Speaker 1: It's a reset, it is a reset, and you do need a reset, just to go.
• 52:31
  Speaker 1: Ah, take breath, deep breath.
• 52:34
  Speaker 2: And what I actually found.
• 52:35
  Speaker 2: Every time I come back, I've got all these great ideas about what to do with other things, because I've had time to kind of process what I want in the next little while.
• 52:43
  Speaker 2: Yeah, okay, good, that is good.
• 52:47
  Speaker 1: If you could only do one thing in your career from now on private practice, research, education what would you choose?
• 52:59
  Speaker 2: That's the hardest question of the lot.
• 53:01
  Speaker 2: I still don't know.
• 53:04
  Speaker 2: That's my biggest thing.
• 53:05
  Speaker 2: So there's all this saying in medicine is that whenever you ask someone how do you find that balance between public work at the public, hospital, private practice and academia, they say one of four things will fail the public work, the private work, the academia or your family.
• 53:20
  Speaker 2: Right, and that's the saying.
• 53:22
  Speaker 1: Yeah, yeah.
• 53:23
  Speaker 2: And so I know inevitably at least not the family bit at least one of those other three other three will fall away, and I don't know which ones they are.
• 53:31
  Speaker 2: Yeah, and actually I use things like Wingana or something as a way of saying well, what do I want?
• 53:37
  Speaker 2: What balance do I want?
• 53:38
  Speaker 2: Take that break, take a switch off from everything.
• 53:41
  Speaker 2: And so I use those kind of days to kind of figure that out.
• 53:44
  Speaker 2: But if I, I think it would end up being being a clinician.
• 53:48
  Speaker 2: I love working with patients and you kind of.
• 53:51
  Speaker 2: I don't get over-involved, but I'm invested in them.
• 53:54
  Speaker 2: I want to see them succeed, I want to see them feeling better, and that's that's uh.
• 53:59
  Speaker 2: Yeah, I've been.
• 53:59
  Speaker 2: I'm a doctor at foremost.
• 54:01
  Speaker 1: I think out of one of those things.
• 54:02
  Speaker 1: Yeah, I think you'd miss the research, though I would, I think you would.
• 54:06
  Speaker 2: I would.
• 54:07
  Speaker 2: Um, yeah, I would, yeah, I would.
• 54:09
  Speaker 2: What, what, what?
• 54:10
  Speaker 2: What?
• 54:10
  Speaker 2: What's really nice about the public system is that we were linked at some instance with the Garvin Institute, unsw.
• 54:16
  Speaker 2: So there's a lot of, a lot smarter people than I am that sit in the lab that do all these things, that they need access to patients, and so there's.
• 54:23
  Speaker 2: We do a lot of collaborative research where they we have questions that need to be asked.
• 54:28
  Speaker 2: So all the my inquisitive mind they can say, oh great, we can do X, y and Z to try and figure this out, tease this out, and then so there's a lot of it's collaborative work.
• 54:36
  Speaker 2: So it's no longer me on the ground doing lots of things.
• 54:39
  Speaker 2: I don't spend any time in the lab, but we've got lots of students and lots of collaborators that do it, and so you can still stay in academia without being too heavily invested in academia.
• 54:52
  Speaker 1: Which is probably where your four things you know.
• 54:54
  Speaker 1: Yeah, yeah, okay.
• 54:55
  Speaker 1: Good, if you could put one message about gut health on a billboard, what would?
• 55:04
  Speaker 2: it say I reckon poo at work Don't be afraid to poo when you need to poo.
• 55:12
  Speaker 2: Yeah, don't be afraid to poo when you need to poo, okay.
• 55:15
  Speaker 1: I think that it's so interesting because there's so many people that do holiday meetings about it.
• 55:20
  Speaker 2: And no one talks about poo.
• 55:21
  Speaker 2: No one talks about poo.
• 55:22
  Speaker 2: But I guarantee you next time you're at a dinner party you bring up poo.
• 55:25
  Speaker 2: Everyone else at the dinner party will tell you all about their kind of gut troubles.
• 55:29
  Speaker 2: You're all in the same boat.
• 55:31
  Speaker 1: Yeah, but everyone poos, exactly Everyone poos.
• 55:36
  Speaker 2: Exactly, yeah.
• 55:37
  Speaker 2: And if you don't talk about it, then you miss other things.
• 55:39
  Speaker 2: Like we haven't talked a lot about screening, and that's actually really, really, really important to remember.
• 55:44
  Speaker 2: But if something's not right and you don't talk about it, you don't know what's normal versus abnormal or what things change.
• 55:50
  Speaker 2: So don't be afraid.
• 55:52
  Speaker 2: And if you don't want to talk to friends and family, talk to your doctor.
• 55:55
  Speaker 1: Yes, talk to your doctor.
• 55:59
  Speaker 2: Don't sit on something, literally no.
• 56:01
  Speaker 2: But don't sit on something if something's not right.
• 56:03
  Speaker 1: Yeah, okay, let's talk about the screening thing then, because I think that is really important.
• 56:08
  Speaker 2: Yes.
• 56:09
  Speaker 1: So you know, I think you can now, because even I did.
• 56:13
  Speaker 1: I requested you can request a screening kit from the government from 45.
• 56:16
  Speaker 1: Yes, yes, you can.
• 56:17
  Speaker 2: So there's two.
• 56:18
  Speaker 2: So bowel cancer is a really fortunately it's actually there's a lot in the news about it, which is really important because people need to be aware of these things.
• 56:29
  Speaker 2: Bowel cancer is one of those cancers that is preventable, which is a really exciting thing, because cancers don't just appear.
• 56:35
  Speaker 2: They grow from little polyps.
• 56:37
  Speaker 2: So polyps if you think about your bowel, think about little moles on your arm.
• 56:41
  Speaker 2: It's the same kind of thing that comes up.
• 56:43
  Speaker 2: You can get these little polyps, these little growths in your bowel that aren't a problem in their own right, but if left alone they will grow and when they get to a certain stage they'll start to turn into a cancer.
• 56:53
  Speaker 2: So cancers most cancers appear from these polyps.
• 56:56
  Speaker 2: That process takes 10 years to go from nothing to a cancer.
• 57:00
  Speaker 2: So you've got this window of opportunity to intervene Right and so the bowel.
• 57:06
  Speaker 2: There's two ways you can screen for bowel cancer.
• 57:08
  Speaker 2: There is those poo kits that, when they turn 50, will start getting every two years in the mail, where you poke your poo and it looks for tiny traces of blood.
• 57:16
  Speaker 2: So if you see blood then you need to go see your doctor, but if it will see, it's for someone who doesn't have any problems with their bowels.
• 57:24
  Speaker 2: You poke it and it starts to look for any polyps that are starting to change and turn into a cancer.
• 57:30
  Speaker 2: That has to be done regularly because they're not designed to look for polyps.
• 57:34
  Speaker 2: It's designed to look for polyps that are changing.
• 57:36
  Speaker 1: And they've also changed it now.
• 57:37
  Speaker 1: So it's you do do two three days apart.
• 57:40
  Speaker 2: Yes, you actually do three, there's three little pokes and it doesn't matter whether one's positive or three positives, it's considered the same Okay.
• 57:46
  Speaker 2: They're very sensitive, so they are designed to pick up more things that are there.
• 57:51
  Speaker 2: So if you take a positive test with no other history, 60% will have a normal colonoscopy, 38% will have polyps and just under 2% will have an early cancer.
• 58:04
  Speaker 2: And the key bit is early.
• 58:04
  Speaker 2: A lot of cancer we can treat at the time of colonoscopy or it's a minor surgery and you move on with life as opposed to more later.
• 58:10
  Speaker 2: By the time it presents, it's often too late, and so there's a big push, because young people are now getting bowel cancer.
• 58:18
  Speaker 1: Well, one of my friends she was 35 and she had bowel cancer.
• 58:23
  Speaker 2: We see it every week, unfortunately.
• 58:25
  Speaker 2: We see young people getting bowel cancer.
• 58:27
  Speaker 1: And what like.
• 58:29
  Speaker 2: Yeah, there's a lot of questions about why is that happening?
• 58:31
  Speaker 2: It's part of it.
• 58:32
  Speaker 2: Each generation gets that little bit younger.
• 58:34
  Speaker 1: Yeah.
• 58:34
  Speaker 2: But there is.
• 58:35
  Speaker 2: We talked about environment and everything.
• 58:37
  Speaker 2: There's something in your microbiome that is changing.
• 58:39
  Speaker 2: There's a lot of work trying to understand it, so the government's now pushed that screening program to 45, but you have to request it from your doctor.
• 58:49
  Speaker 1: I requested it online.
• 58:51
  Speaker 2: Online, yes it won't come to you automatically.
• 58:53
  Speaker 1: No, no, no yes.
• 58:53
  Speaker 2: And you can even get it done younger with your GP.
• 58:56
  Speaker 2: So it's a different type of test, but it's.
• 58:58
  Speaker 2: You can get it.
• 59:00
  Speaker 2: And who should do it younger?
• 59:01
  Speaker 2: No, yeah, that's a big question, I think.
• 59:04
  Speaker 2: When it comes down to it, if there's ever concern about family history, your own symptoms, a conversation is the first step.
• 59:11
  Speaker 2: So sitting down with your GP and saying what is my risk, my individual risk, what can I do to kind of change it?
• 59:17
  Speaker 2: And am I going to start screening now?
• 59:20
  Speaker 2: And if not now, when am I going to start screening?
• 59:22
  Speaker 2: And that's a very appropriate first step.
• 59:24
  Speaker 2: Not everyone needs to have a screening test or a colonoscopy, but it's saying let's have a game plan in place, and so if you're 30,.
• 59:33
  Speaker 2: A lot of people come to see me and say should I be screening at 30?
• 59:35
  Speaker 2: And I say, well, what's your history?
• 59:37
  Speaker 2: If this is the risk of doing a procedure, or this is the risk of doing those screening tests versus the positives, and it depends on how much sleep you're losing over.
• 59:44
  Speaker 2: This is the downsides.
• 59:45
  Speaker 2: And if we're not going to do it now.
• 59:47
  Speaker 2: Come back at 40 and we'll talk about it yeah, yeah, but it's interesting.
• 59:51
  Speaker 1: So my friend, no family history like none.
• 59:55
  Speaker 1: And she's actually in Germany now because there was another thing where she's actually getting.
• 1:00:01
  Speaker 1: They've taken like a tumor and they're creating a vaccine for that to treat it.
• 1:00:09
  Speaker 1: I've told her she needs to come back and talk to you when she gets back.
• 1:00:12
  Speaker 1: Yeah, there's some really fascinating things about it, exactly.
• 1:00:14
  Speaker 2: And there's so much.
• 1:00:15
  Speaker 2: If found early enough, it's very treatable.
• 1:00:19
  Speaker 2: And I think that's the really kind of key bit.
• 1:00:21
  Speaker 2: So if there's any changes to your bowel habits, any bleeding, anything that doesn't feel right, don't just say, oh, it's nothing.
• 1:00:30
  Speaker 2: If it's just go talk to your GP and it could all just be, all it may need to be is a conversation and then you walk away.
• 1:00:36
  Speaker 2: But have a talk better talk You're going to.
• 1:00:41
  Speaker 2: Yeah, there's no point looking back saying I wish I did speak about it six months and it literally can just be a conversation.
• 1:00:46
  Speaker 2: It doesn't necessarily mean you need to have a colonoscopy.
• 1:00:48
  Speaker 2: Those kits are really good.
• 1:00:50
  Speaker 2: As soon as there's symptoms, the kits are kind of a mute point.
• 1:00:54
  Speaker 2: So if they're designed for a healthy population with no symptoms.
• 1:00:57
  Speaker 2: So as soon as there's symptoms, everyone talks about a risk-first benefits approach.
• 1:01:02
  Speaker 2: But we talk about a colonoscopy to kind of find these things and if there are polyps there they get snipped off at the time.
• 1:01:08
  Speaker 1: Yeah, okay.
• 1:01:09
  Speaker 2: And you move on and you say come back in five years, ten years yeah okay, good.
• 1:01:14
  Speaker 1: What's the biggest thing?
• 1:01:16
  Speaker 1: People don't realise about their gut health.
• 1:01:21
  Speaker 2: I think that everything you do will change something about your gut health.
• 1:01:26
  Speaker 1: Yeah, I think the fascinating of the three things what you put in your mouth, your environment and the movement, yeah, Everything you do have an impact on your gut health.
• 1:01:34
  Speaker 1: Yeah.
• 1:01:35
  Speaker 2: And again, you fix the things you can't fix.
• 1:01:38
  Speaker 1: Yes.
• 1:01:39
  Speaker 2: You pick one thing to change, see how it goes before trying to change everything.
• 1:01:43
  Speaker 2: If you try to change everything and it doesn't fit within your lifestyle it doesn't work.
• 1:01:46
  Speaker 1: It was actually really interesting.
• 1:01:46
  Speaker 1: So Amelia said that one of the things she does is she focuses on one thing for a term.
• 1:01:51
  Speaker 2: Yeah.
• 1:01:52
  Speaker 1: Because like.
• 1:01:53
  Speaker 2: I love that One little thing, just one thing.
• 1:01:54
  Speaker 1: Turn it into a habit and next, and then every term, like by the end of the year, you've got four things that you've fixed.
• 1:02:00
  Speaker 2: I like to.
• 1:02:01
  Speaker 2: I talk to people.
• 1:02:02
  Speaker 2: I say, well, okay, what is?
• 1:02:03
  Speaker 2: Everyone can improve something in their diet.
• 1:02:05
  Speaker 2: And so, classically, you have the question saying I struggle to lose weight.
• 1:02:08
  Speaker 2: And you get that question all the time.
• 1:02:10
  Speaker 2: And again, I'm not a dietitian.
• 1:02:12
  Speaker 2: I send people to the dietitian.
• 1:02:13
  Speaker 2: You say, well, write down everything that you put in your mouth for 48 hours and you'll actually start to see trends.
• 1:02:19
  Speaker 2: And if you're going, the prime example you don't have people get hungry, tired and bored in the afternoon, don't need to get home.
• 1:02:27
  Speaker 2: Your kids are eating dinner.
• 1:02:29
  Speaker 2: You end up eating half of their dinner too, without even realising it, and then you have your dinner, where a lot of it can actually be if you know it's happening.
• 1:02:38
  Speaker 2: You have a snack before going home, and so you don't get to that stage.
• 1:02:40
  Speaker 2: So A lot of it can actually be if you know it's happening.
• 1:02:42
  Speaker 2: You have a snack before going home, and so you don't get to that stage.
• 1:02:43
  Speaker 2: So find the one or two things that you can change.
• 1:02:45
  Speaker 2: There's no point in changing everything else, or if you can substitute something for something else.
• 1:02:49
  Speaker 2: So I like to think if you reach for a bag of chips, you reach for something else.
• 1:02:55
  Speaker 2: Grab for a banana instead, or grab somebody.
• 1:02:58
  Speaker 2: So pick the one or two things that you're not going to notice if you don't have it.
• 1:03:02
  Speaker 1: Yeah, yeah.
• 1:03:03
  Speaker 2: But it will have added benefits over time.
• 1:03:05
  Speaker 1: Okay, all right, craig.
• 1:03:08
  Speaker 2: Yeah.
• 1:03:08
  Speaker 1: This is always fascinating to talk to you.
• 1:03:10
  Speaker 1: I've learnt a lot and I still continue to question you going what, what, huh, tell me.
• 1:03:16
  Speaker 1: And it does make me think and rethink about what is happening in my gut and how so many things impact it, and it's not just what you put in.
• 1:03:25
  Speaker 1: Before we wrap up, I've got one question for you.
• 1:03:29
  Speaker 1: Uh, before I turn 50, what is one thing yeah, you think I should do?
• 1:03:36
  Speaker 2: oh, oh, good question, I get no.
• 1:03:42
  Speaker 2: Can I suggest that there's two things?
• 1:03:43
  Speaker 2: Yeah no, it's the first thing I'll say get yourself screened, which yeah?
• 1:03:48
  Speaker 2: Yeah, which you've done your speak to you to say that's the number one thing before you turn 50, think about bowel cancer screening something simple, lazy and thing to do.
• 1:03:58
  Speaker 2: the second thing is I'd almost yeah, no, it's my second thing to do.
• 1:04:02
  Speaker 2: The second thing is I'd almost yeah, no, it's my second thing to do is stop and listen to what your body wants.
• 1:04:07
  Speaker 2: So if you're rushing out the door with a coffee cup, a takeaway coffee cup, I don't drink coffee, Okay Well let's say there's an.
• 1:04:15
  Speaker 2: If you're running out the door with a banana in your hand, ready to go somewhere, just take a seat down for a few minutes on your own and kind of listen to your body's cues.
• 1:04:21
  Speaker 2: If it needs to go to the toilet, you go to the toilet.
• 1:04:23
  Speaker 2: If it needs to just chill out and relax that five minutes, you're not going to notice it later in the day.
• 1:04:28
  Speaker 1: No, that's a good point.
• 1:04:29
  Speaker 1: And you know what?
• 1:04:30
  Speaker 1: Even before picking the kids up, sitting in the car for five minutes and just breathing.
• 1:04:36
  Speaker 2: I tell people with the gut chemotherapy yeah, it's a great time, Get to school 15 minutes earlier to end on pickups, Because as soon as you get home it's over.
• 1:04:43
  Speaker 1: You can't, yeah, you can't Like.
• 1:04:44
  Speaker 1: Yeah, as soon as you've got another human Sit in the car put your headphones in.
• 1:04:47
  Speaker 1: Oh, you've got radio good radio in the car, put it through on there, put your seat back and just that there early and just put on an eight-minute body scan because I knew it was going to be a stressful day and I was like I'm just going to let it be.
• 1:05:07
  Speaker 1: And it was amazing.
• 1:05:08
  Speaker 2: It's a changed mindset.
• 1:05:08
  Speaker 2: You're never going to notice it eight minutes later in the day and it just sets you up for such a great kind of afternoon evening, whenever it may be.
• 1:05:16
  Speaker 1: Yeah it does yeah.
• 1:05:17
  Speaker 1: Whenever it may be, it does yeah, it helps Just calm, calm.
• 1:05:19
  Speaker 2: Calm.
• 1:05:20
  Speaker 1: Okay, good, I like those two things and I do like the.
• 1:05:24
  Speaker 1: If you're grabbing a banana to eat in the car like even eating in the car or drinking in the car.
• 1:05:29
  Speaker 1: Just stop and just don't do it Exactly.
• 1:05:32
  Speaker 2: Sit down at the coffee shop, sit down somewhere, just even for two minutes, just sit down and have something to do it out.
• 1:05:37
  Speaker 2: Yeah, yeah, okay, good, okay All right, craig, thank you.
• 1:05:40
  Speaker 1: Thank you very much for sharing your expertise, your research and your passion for gut health.
• 1:05:45
  Speaker 1: Um, I know it was when I sat down with you first.
• 1:05:49
  Speaker 1: I was just fascinated and I needed to know more and more.
• 1:05:52
  Speaker 1: Um, and I do feel like we have only just scratched the surface, like I think there's so much more that we need to understand.
• 1:06:00
  Speaker 1: But by thinking about what you put in your mouth, your environment and the movement, I think the holistic approach is such a great way to make sure your gut is actually okay.
• 1:06:13
  Speaker 1: So thank you for that.
• 1:06:15
  Speaker 1: If you want to learn more about Craig's work, I'll link everything in the show notes and if you've enjoyed this episode, hit, subscribe, share with a friend and continue to chat about poo, because we all need to talk about poo.
• 1:06:31
  Speaker 1: It can't be a taboo topic.
• 1:06:32
  Speaker 1: And before you go, try craig's, try this before you're 50.
• 1:06:36
  Speaker 1: Have a poo scan or the bowel scan, and also take the time to listen to your body.
• 1:06:42
  Speaker 1: Give it a go, see how it changes what you're doing and let me know, because, fuck, we're nearly 50, and isn't it amazing?