F*ck, Poo Transplants are a Thing! with Dr Craig Haifer

Episode Transcript
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Speaker 1 (00:00):
Hi, I'm Dom Hind and, fuck, I'm nearly 50.
Actually I'm 47 and a half, butwho's counting?
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.
And in the middle of all themedical jargon, the tests and
the uncertainty, I met someonewhose work absolutely fascinated

(00:22):
me.
Dr Craig Hafer is agastroenterologist, a researcher
and one of the mostforward-thinking minds when it
comes to gut health.
He splits his time betweenprivate practice, public
practice and academic research,and he also somehow finds the
time to run two events atGwingana every year.

(00:43):
But here's the thing thatreally got me hooked into his
research poo transplant.
You're right, poo transplants.
I didn't even know that thatwas a thing that existed.
We're talking about potentialgame changer for everything from
mental health to autoimmunity.
So today we're diving into itall gut health, the future of
medicine, and why what happensin your gut might just be the

(01:07):
key to everything in your body.
Because, fuck, I'm nearly 50,and isn't it amazing?
Most people don't spend a lotof time thinking about their gut
health until something goeswrong.

(01:29):
But what if we've been thinkingabout health the wrong way this
whole time?
What if our gut is actually thecommand centre for everything?
Dr Craig Hafer is at theforefront of gut health research
, exploring everything from theimpact of gut bacteria on our
mood to the potential of fecalmicrobiota.

(01:51):
How do you say it, fecalmicrobiota?

Speaker 2 (01:55):
Okay, yes, or FMT Okay, okay.

Speaker 1 (01:58):
Yes, that is poo transplants to treat chronic
disease.
Today we're breaking down thescience, the myths and what
happens in your gut that doesn'tstay in your gut.
Dr Craig Hafer, welcome to Fuck.
I'm Nearly 50.

Speaker 2 (02:14):
Thank you, Tom.
It's great to be here.
It's always an excitingconversation, even better over
dinner, but this will do.

Speaker 1 (02:21):
Before we get into the details.
If you had to introduceyourself at a dinner party, how
would you do it?

Speaker 2 (02:28):
Ah, good question.
So I guess, first and foremost,I'm a dad.
I'm a dad of two boys Slightlydepressing, but I still don't
quite know what I want in life.
It's also a big thing, butParticularly with what you're
doing now.
Exactly, but it allows me to goon very big tangents where if I
find something I'm interestedin, I'll research it to the nth

(02:51):
degree.
I want to understand it andwant to figure out how I can do
it better.
And that's led me down all thesedifferent pathways that we can
talk about a few of them today.

Speaker 1 (02:59):
Yeah, Amazing and I love that because it means that
you're not in that, you're inthat growth mindset and you're
always looking for somethingelse.
Yeah exactly, I'm alwayslooking for something else as
well, which is why it was when Iwas sitting as a patient of
yours, sitting there, and youstarted saying that you were
into well, in my simple book,poo transplants.

(03:20):
I was like what.
I didn't even realise that thatwas a thing, so it's
fascinating.
Yeah, okay, we hear so muchabout gut health these days, but
why does it actually matter andwhat's the big picture?

Speaker 2 (03:37):
So we always thought that kind of everything in your
gut was completely separate tothe inside of your body, right?
We thought it was two separatethings.
You had this wall, you had thiswall in between and what
happened on the inside wasdifferent to the inside of your
body, right, we thought it wastwo separate things.
You had this wall you had thiswall in between, yes, and what
happened on the inside wasdifferent to the rest of your
body.
But there's more and moreresearch in all fields both in
the wellness industry been goingon this for a long time that

(03:57):
it's all connected, that yourgut is this window to the
outside world, right?
So there's this I kind ofalways bring this up where we
always thought, like your eyesare the windows to the soul, but
really, let's call it what itis your arseholes, your window
to this soul, right?
And that everything outsidewill impact your gut microbiome,
which will therefore have someimpact on the rest of your body.

(04:18):
And so we can do all we can totry and treat chronic illness.
But we say, well, what'sdriving that chronic illness in
the first place?
Why is there increasing ratesin every illness under the sun?
And it's generally related towhat we eat, the environment we
live in and everything elsearound it.

Speaker 1 (04:36):
Yeah, wow, okay, then that is an interesting way of
thinking about it Like it reallyis change.

Speaker 2 (04:43):
That's the things that have changed over years.
It's not your genetics.
Your genetics haven't changed.
What's changed over the last 10to 15 years is our environment
and everything we put in ourmouth.
And I think that is iteverything you put in your mouth
, exactly yeah.

Speaker 1 (04:56):
When did you first get interested in the micro Bio
Bio?

Speaker 2 (05:01):
Yes.

Speaker 1 (05:02):
Was there a moment you thought this is where
medicine needs to go?

Speaker 2 (05:15):
Yeah, it's a great question.
So I did my general medicinetype training and then I just
got into gastroenterology.
And I got into gastroenterologybecause I've got a lot of
family members with inflammatorybowel disease so Crohn's
disease, osteoc colitis, andI've seen a lot of them go
through a lot of shit and a lotof bad kind of things on lots of
different medicines.
And it was always, I remember,talking to a family member and
they were saying well, actuallymy naturopath said this, but I

(05:36):
haven't told my doctor.
And that's a classic, classicstory.
And it seems to be separate.
And you can say well, why can'twe do, why can't they do both?
Why can't they workcomplementary rather than
alternatively?

Speaker 1 (05:50):
Yeah.

Speaker 2 (05:51):
And so it was an interesting time with fecal
transplants.
Fecal transplants or pootransplants, whatever they are,
they've been around for a littlewhile.
They've actually you go backthrough the 14th century Chinese
medicine.
They used to use this greensoup, the documented green soup,
to treat various ailments, sothis is not new.

Speaker 1 (06:08):
This has been there forever.

Speaker 2 (06:11):
The first case was documented, at least in
literature, back in the 80s by agentleman here in Sydney.
But it was kind of goingthrough this phase of there was
increasing evidence for its usein certain conditions.
And suddenly you're saying,well, actually you know what, we
can do something to themicrobiome and actually treat
these illnesses that kill peopleevery year.
So surely we have some way ofharnessing it and doing it

(06:36):
better, not just withpre-transplants, with everything
else you can do, andparticularly with things like
Crohn's disease or inflammatorybowel disease where it impacts
the gut.
Surely there's your first pointof call.
They say, well, it's in the gut, how do we actually stop that
happening?
And so that was at the end of mytraining.
I kind of I was deciding whatto do.
My wife had just had a baby andshe was going back into

(06:58):
training and we were trying tofigure out what I do and I
decided to do a PhD.
And so I did my PhD looking atfecal transplants in the
microbiome to treat ulcerativecolitis, which is a form of
inflammatory bowel disease, andthat's kind of where it all
stemmed off from there.
Were you early on in that, yeah,so I wasn't by no means I was

(07:19):
early on, but we started puttinglarger scale research to an
area that was really consideredwitchcraft and wizardry, right.
So we started.
We said well, how do we putthis into practice?
How do we actually get thisused in day-to-day practice
rather than just used in thewhen people got unhappy with
traditional medicine?

Speaker 1 (07:40):
Yes.

Speaker 2 (07:40):
That they left their doctor.
They disappeared for six months.
They came back either in abetter or worse state down the
track.
How can we use this alongsidewith what we do?
And it was a really interestingstage because we were we had to
convince our several ethicscompany through our university
said hell, no, we're not lettingyou do any of this kind of work

(08:01):
.
So it was a really, and eventhe TGA, our Therapeutics Goods
Administration, were like you doany of this kind of work.
So is it really?
And even the TGA like the TGA,our Therapeutics Goods
Administration like you can't dothis research.
And so we ended up working withthe TGA trying to define what
actually is a pre-transplant,how do you do this safely?
And that was a lot of part ofmy work trying to say, well, how
do we actually get this intopractice, how can we actually
use this?
And then you can do properresearch to say, well, does it

(08:31):
work?
It does not work, that'samazing.
So you actually helped.
Yeah, it was really as a quite ayoung phc.
So I remember being in newzealand on holiday and I get
this message from the teacher.
So we've got a meeting tonightto kind of figure this out.
And next thing, I'm on thiszoom call with there's three or
four people from the tga andnext thing, um, the head of the
t, who was then moved on tobecome one of the deputy chiefs
during COVID to the government,was on this call and I'm sitting
there saying, well, this iswhat I think it is, and they

(08:51):
were listening and they'reactually trying to actually work
with it.
It was a really exciting kindof time.
I was like I'm veryunderqualified to do this, but I
guess I was more qualified thanmost and also qualified than
them, exactly, exactly.
So it was a really excitingkind of time to be able to try
and define those regulations andlegislations and things like
that.
That's amazing.

Speaker 1 (09:08):
Like that is actually .
Like I think that is amazing.
Well, done you for doing it,and you know it would have taken
some guts, yeah Well, yeah,time to time.

Speaker 2 (09:17):
Yeah, it was.
Yeah, it was really kind of andit enabled us.
It was driven initially becausewe wanted to do the research.
Yeah, yeah but actually itenabled us to do what we want to
do, and it's it's.
It set the groundwork toactually start using this in
practice.
Yeah and yeah.
So it's, it's really, it wasreally, and I learned a lot
during the process about allthese things I never knew about.

Speaker 1 (09:36):
Yeah Well, I mean just in the legislation or what
can and can't do.

Speaker 2 (09:39):
Exactly how it works, exactly how you can push it, no
, not that I've said that.
Well, no, you know, it's howyou can push it, but how you can
push it safely andappropriately.
Yes, yeah.

Speaker 1 (09:48):
Not ridiculously.

Speaker 2 (09:49):
Exactly.

Speaker 1 (09:50):
Like push gummies from.

Speaker 2 (09:51):
New Zealand yes, yeah , they're a great team.

Speaker 1 (09:53):
Anyway, we often think of digestion when we hear
gut health, but it impacts somuch more Our immune system,
mental health, even our weight.
Can you?

Speaker 2 (10:09):
break down what the micro I can't even say
Microbiome, microbiome,microbiome, microbiome, okay.
Biome is.
I guess it's an environment,it's an ecosystem, and microbes,
which are organisms.

Speaker 1 (10:20):
Okay, right, so it's okay, All right.

Speaker 2 (10:21):
Microbiome.

Speaker 1 (10:22):
Microbiome actually does.
What does it do?

Speaker 2 (10:26):
So look, microbiome is actually.
When people say the microbiome,they're generally referring to
the gut microbiome, but itactually.
You've got a microbiome on yourskin, you've got a microbiome
in your lungs and they're allvery different, but when most
people talk about the microbiome, they're talking about the
microbiome, the organisms.

Speaker 1 (10:42):
Yes.

Speaker 2 (10:42):
So you've got billions of different organisms.
Think of it like yourrainforest.

Speaker 1 (10:46):
Yeah.

Speaker 2 (10:49):
You can break them down in lots of different ways.
You can think about good ones,bad ones, pro-inflammatory,
anti-inflammatory.
You can think about it's notjust bacteria.
So there's viruses, there'sfungi, okay, there's all these
other things that are there andthey all live in this harmony.
And traditionally what you'rereferring to is within your
large bowel, which is the moststeady state microbiome and

(11:09):
that's got the largest kind ofmass of organisms that are there
, and so that's what themicrobiome actually is.
That will change over time,right, and it generally always
fluctuates over time and then.
But that then has a link withthe rest of your body.
So what I was talking aboutbefore in the past we thought

(11:30):
that there was this your gutlining was this kind of solid
state that never there wasnothing happened with, there was
no crosstalk.
But there's always crosstalkbetween the microbiome and the
within your body itself.
That's, and that would betraditionally your immune system
.
Yeah, um, there's the wholeconcept of leaky gut, where
there's an increased kind ofcrosstalk, but everyone has some

(11:50):
form of crosstalk.
It's your body.
Sensing what's going on withinyour gut and that can lead and
drive to either a reduction inyour immune system or an
increase in your immune systemis one way, but also the
microbiome you mentioneddigestion.
Your microbiome breaks down alot of food products and
produces other metabolites.

(12:12):
That has impact everywhere elseand you mentioned mental health
as a prime example.
Like a large portion of theseneural we call neurotransmitters
, these metabolites that work inyour brain, so things like
serotonin, most of it, 90 pluspercent of it, gets made by
microbiome, by organismally gut.
So it is directly entirelylinked and it makes sense why,

(12:34):
if you can get some of your dietright, your lifestyle right,
how that can have a huge impacton the rest of your body and a
lot of it will have lots ofpathways.
But a lot of it does impactyour microbiome and therefore
downstream should help the restof your body and a lot of it
will have lots of pathways but alot of it does impact your
microbiome and thereforedownstream should help the rest
of your body.

Speaker 1 (12:50):
So if gut is so important, obviously it is.
What are some of the thingsthat you never put in your mouth
?

Speaker 2 (12:56):
I think never is a strong word.
I think let's call it what itis we all have to leave is
probably our first number oneright so never is a strong word.

Speaker 1 (13:06):
And that's what I love about you.
Even when I came to you with myliver thing, I was like no
drinking, no, nothing like justclean.
And you were like it's notpractical.

Speaker 2 (13:15):
It's not sustainable.
You can do something, you can dosomething a hundred percent.
But if you're having as big animpact on your mental health
about and I think we've talkedabout this before, but you've
got this whole world calledgut-brain interaction, you've
got all these other things onthe outside of your gut that
will have as big a feedback ontothe gut composition.
So if something causes morestress and we can talk a little

(13:37):
bit more about it, but if itcauses more stress, it'll have
more impact on your gut healthand more impact on the rest of
your body too.
So in terms of I never say,never right, everything in
moderation, everything inmoderation, but ultimately kind
of a few things that I alwaystalk about is, if something

(13:57):
looks too good to be true orlasts longer than it should.

Speaker 1 (14:00):
Like the 24 year McDonald burger Any of those.

Speaker 2 (14:04):
Even I talk about some of the bread products that
you think about your nice ickysourdough down the road.
It'll last three days on yourkitchen counter before going
rock solid.

Speaker 1 (14:13):
Yes.

Speaker 2 (14:14):
But a bread in a bag will last you a week and the
first thing you notice is a bitof mold.

Speaker 1 (14:17):
Yes.

Speaker 2 (14:18):
It's got something in there to do it and even things
like that will have as big animpact.
It will have more impact thanpeople get worried about gluten
and dairy.

Speaker 1 (14:26):
Yeah, yeah.

Speaker 2 (14:27):
It's actually probably more the preservatives
in it than anything else, so ifsomething has, yeah.

Speaker 1 (14:32):
And is that why the wine, then the preservatives in
the wine, like I can't drinkwine anymore because it just
makes my nose?

Speaker 2 (14:37):
Yeah, I think so.
The wine thing is aninteresting one, and not all
preservatives I've kind of putit as a blanket term and there's
not even things likeemulsifiers, which also come
give a really bad rap.
They're the thing that keepthings together.
So things like mayonnaise, itkeeps things together.
And again, something that lookstoo good to be true has got
things in it, but not allemulsifiers are as bad as each

(15:00):
other.
It's the same thing withpreservatives, but yes, I think
that part of the rationale withwine is it's got other
preservers in it and some peopleswear by these organic or the
yes, yeah, yeah.
But even how do you defineorganic?
It's complex.
Yeah it is but the lowpreservative type wines, you'll
do better than some of the otherwines that you'll get Okay.

Speaker 1 (15:19):
So you're saying there's never a never, never a
never, but saying there's nevera never, never a never.

Speaker 2 (15:22):
But If you can minimize things in a packet,
yeah, Okay, great, yeah.

Speaker 1 (15:26):
So the Iggy's.
And why so?
Is it sourdough then?
I guess that was an example.

Speaker 2 (15:31):
but it's more whole.
It was fresh, it was made, itwas fresh yeah yeah, yeah, and
like you think about pasta andyou can buy pasta in the fridge
section of Coles.

Speaker 1 (15:38):
Yes.

Speaker 2 (15:45):
Versus.
You don't need to be in afridge as opposed to a box that
can sit in your drawer for sixmonths and survive, but the one
in the fridge.
As soon as you take it out ofthe fridge, it has less things
in there, so it has to be keptcool.
It has to be used within acertain shelf life.

Speaker 1 (15:53):
Okay, I'm throwing out a few boxes of pasta.

Speaker 2 (15:55):
We get everything in moderation.
And again, we all you've gotkids as well.

Speaker 1 (15:59):
I've got kids as well .
You as well.
You've got to pick your battles.

Speaker 2 (16:02):
You've got to make it sustainable, because you can do
something for a week and throwit out the window and it's not
going to get you any benefit.

Speaker 1 (16:07):
Yeah, true, Okay, all right.
Good, all right.
Let's talk about the thing thatblew my mind the poo
transplants.

Speaker 2 (16:26):
What exactly is fecal microbiota transplant and why
is it so powerful?
Okay, so let's call it.
We'll call it FMT.
Okay, easy to say, easy to doYep.
So we've just we talked abouthow your microbiome drives a lot
of things in your gut and when,something the term dysbiosis
refers to, when that ecosystemgoes out of balance.

Speaker 1 (16:43):
Yep, okay.

Speaker 2 (16:44):
So fire goes through your rainforest Best way to say
it Most of the trees go down andyou've got this kind of instead
of have these beautiful lushrainforest, you've got these
little shrubs that are growingeverywhere.
That isn't quite right, yeah,and that's the thing that drives
what we think drives a lot ofchronic illness.
So you can do lots of things tochange your microbiome.
It's impacted by the air youbreathe, the medicines you take,

(17:07):
the diet you have.
Exercise will have anindependent effect on that type
of exercise too, but I guess thepre and probiotics can have an
impact in some way or form onthat ecosystem.
But again it's got millions ofdifferent things.
So you think about your fecaltransplant is as your ultimate
pro body so you're taking anentire ecosystem from someone

(17:31):
who's healthy, and that isthrough their poo yes they
donate poo, like you can godonate blood.
Yeah, you can go donate poo andis there like a requirement?

Speaker 1 (17:40):
yes, really, strict requirement, oh really so one.

Speaker 2 (17:44):
You want someone who's healthy.
There's no point of takingsomeone who's got an unhealthy
microbiome or who's got diseasesto transfer to.
You also want to make surethere's no infections to
transfer you also we don't, andthis is part of those long-term
effects.
We don't know if someone is adonor and they are going to
develop a disease down the track.
Can you transfer thatpredisposition?

(18:05):
So they're really heavilyscreened and a lot of our work
early on was when we were tryingto find our own donors.
Our data showed that about 3%of donors are actually eligible
to donate.
So it actually was really hardto find these donors and that
was one of the hardest troublesbecause we used to get it from
relatives.
You say well, if you needed thisfor, say, an infection like we

(18:26):
used to treat we still doclostridium difficile infection,
it's a really severe infectionthey would have to find their
own donors.
We would screen them and that'show we did it.
Nowadays, since there's beenthe whole TGA overhaul, there is
stool banks.
So if you need a bloodtransfusion, we call the Red

(18:52):
Cross and the Red Cross sends italong.
There is two national stoolbanks.
So if we need a poo transplants, there's the Red Cross.
Now have a stool bank as partof it.
So they've got breast milk andthey've got poo and they've got
blood.
So, they supply some.
And there's a company inAdelaide called Byron Bank which
was actually set up bycolleagues of mine,
gastroenterologists as well, whoset up and again I need poo.
I give them a call and it's arise on my doorstep whenever you

(19:14):
need it and do you then just go?

Speaker 1 (19:15):
I need poo from someone that is this.

Speaker 2 (19:19):
Or is it like a that's one of the good things is
what makes a good donor.
So you have to make what makesa safe donor versus what makes a
good donor.
So all the screening that getsdone about history what their
past history is, any medications, any of that kind of things is
all about safety and that's allour number one concern in
anything you do.

(19:42):
You don't want to do anythingthat could put the patient at
risk, so you're transferring anyinfections or predispositions.
There's still a lot of debateabout what makes the good donor.
Is there a super donor, a superpoo donor?
And there's been a lot of workgone into that place and, to
give an example, there probablyis super donors.
An example in our trials that Imentioned before with
ulcerative colitis, we used twodonors.
We screened their microbiome.

(20:04):
We did in-depth looking attheir microbiitis.
We used two donors.
We screened their microbiome,so we did in-depth looking at
their microbiome.
We found two that we reallyliked.

Speaker 1 (20:10):
And when you did that , do you look at their poo?
Yeah, we take their poo.

Speaker 2 (20:15):
we do microbiome analysis, so it gives you a full
composition of everything thatgoes on.
And, using our knowledge fromprevious studies, we have
various criteria, which ones wetook Because, again, you don't
want to embark on a multipleyear study, a lot of effort, and
then you get a negative resultand it's because you picked the
wrong donors.
Yes, so we did this and then,and we thought we picked two

(20:36):
really good donors, we used twodonors and at the end of it, one
donor had 100% success rate forpatients doing really well and
the other donor had 30% successrate.
So there is still, but that'sin one condition.

Speaker 1 (20:49):
So you can't extrapolate to everything.

Speaker 2 (20:50):
But yes, what makes a safe donor, what makes a good
donor is two separate things.
We know what makes a safe donor.
We don't know entirely whatmakes a good donor.
Okay, and that's still a workin progress.

Speaker 1 (21:02):
Okay, and I'm sure that's something that you are
focused on.

Speaker 2 (21:04):
Yeah, I think a lot of people are trying to
understand what makes a gooddonor.
Yeah, but saying, and itdepends a little bit on what
you're trying to treat as well.
Okay, and that also changes.
So if we're trying to treatCrohn's disease or subcolitis,
is that different to someonetrying to treat a skin condition
or-?

Speaker 1 (21:21):
Or depression, or depression or something else
Exactly.

Speaker 2 (21:24):
So they're all very different things, but you really
.
What happens then is you getthe donor, you get the poo and
you have to give it in some wayor form.
So traditionally, what we donow is you do a colonoscopy, so
you do a colonoscopy, yes, andthen we put the poo down the
colonoscope into the end of yourcolon.

Speaker 1 (21:41):
Yes.

Speaker 2 (21:41):
There's no science behind it.
We give people gastrostop orlike something to slow you down,
to keep it in there for as longas we can, yeah, and we keep
people in bed for about an extrahalf an hour, an hour after,
just trying to keep gravitycoming out of the picture.
Yeah, so there's no.
This is it just stays still.
It stays still, and that's howwe do it traditionally.
And that's how we do ittraditionally.

Speaker 1 (22:01):
You can do it and does it like do you do that in a
capsule?

Speaker 2 (22:03):
No, so this is all that's, all liquid down through
the colonoscope.
Yeah right, okay, we were partof my PhD.

Speaker 1 (22:09):
We were making capsules where you could freeze
dry the poo.

Speaker 2 (22:14):
Yeah, you freeze, dry it so it turns it into a powder
.
No longer looks or smells likepoo, yeah, and then you can put
it in capsules and it's suddenlystable at room temperature and
it is your ultimate probiotic.
And so, therefore, you can takethem as capsules and you can
suddenly opens up to the door ofusing it a bit more longer term
to cleave chronic illness, andwe showed that it's probably.

(22:35):
I'd much prefer doing it thatway.
There's no TGF repress we don'tneed to do the colonoscopy
which is again, less proceduresthe better.
But also the other problem withthe colonoscopy is that most
chronic illness you're probablygoing to need some sort of
intervention longer time anddoing colonoscopies regularly.
You just can't do.
Yeah yeah, you can do by enemas, so literally a syringe that

(23:00):
goes in your bottom and itsquirts it up.
That's what an enema is.
That probably has a role inmaybe in those longer term.
But really the only practicalway is either regular capsules
or having some otherinterventions.
So I use a combination ofdifferent prebiotics after.
Again, we're trying to put someevidence to that, but it has

(23:20):
very little harm and I thinkwe'll have to feed the right
microbiome after.
So the prebiotics, prebioticsthings, the prebiotics feed the
right microbiome.
It's like pouring fertilizerand water on your garden bed as
opposed to throwing seeds on itevery day.
And can that kind of feed thebugs that you've just introduced
to allow them to grow and dowhat they need to do in a graft

(23:41):
and whatever they need to?

Speaker 1 (23:42):
So at the moment I'm on antibiotics because I've had
this cold that just won't goaway and I've been tested for
everything.
The antibiotics in my gut arekilling everything down there.
Yeah, what do I need to do?
Yeah, it's a really goodquestion.

Speaker 2 (23:58):
And this is where there's a bit of debate about
the use of probiotics prebiotics.
The other thing is, when yousay probiotics or prebiotics,
you're talking about a hundreddifferent products.

Speaker 1 (24:10):
Oh, yes, all have different effects.

Speaker 2 (24:11):
Yeah, yeah, and which one's the right one?
And efficacies Exactly, and sowe don't routinely necessarily
say take probiotics after,unless, though, saying that,
though, that's what is a routine.
Yes, it can stop getting peoplegetting diarrhea from
antibiotics, okay.
It can stop people gettingthrush after antibiotics, yeah.
So it can stop problems thatcan come after antibiotics.

(24:33):
Okay so if you're one of thosepeople that do get it, there's
very little harm in using it.
But if you find and you bounceback after antibiotics, your
gut's pretty resilient, it'llkind of bounce back and maybe
you're just better off stickingto those whole foods, giving it
all the right bugs that it needsto actually recover From food.

Speaker 1 (24:52):
Food is medicine.
If you can, yeah, yeah, okay.

Speaker 2 (24:53):
So, yeah, we don't routinely recommend it, unless
there's something else thatcomes from the antibiotics.

Speaker 1 (24:59):
Okay, so what do you think about yogurt?

Speaker 2 (25:03):
Again, not all the yogurts the same.
Yeah, um, in terms, there's alot of really good properties
about it, but there's a lot ofgood properties about it and I
think it's it's again, it's awhole food.
It's good, it's so interesting.

Speaker 1 (25:12):
It always is like when I, when you give like a
general, what about this?
It's like well, what's in it?
Yeah, what's in it what's in it.
Like it can't be thesugar-based one, it needs to be.
The fewer ingredients, thebetter.

Speaker 2 (25:24):
And this is where I would say I think I would have
told you as well.
But as a probiotic, theproducts that you will see are
the products that have the bestmarketing budget, not
necessarily the ones that havehad the best evidence, yes, so
you have to learn to look at thelabels.
What's in these things and whyis it being advertised to me?
Is it better than anything else?

(25:45):
Yeah, or is the company behindit have got the best marketing
budget?
Yeah, and that's a reallyimportant thing to think about.

Speaker 1 (25:52):
Yeah, and see, that's the hard thing is what is like.
How do you know what is thebest Exactly and?
I struggle with it and if I,struggle with it, then how, yeah
, if I struggle with it.

Speaker 2 (26:02):
Then how?
Yeah, and that's one of thewhat we're trying to do now
particularly.
There's a lot of reallyinteresting work in prebiotics.
So again, let's come back toprebiotics.
I much prefer using prebioticsfor fiber and other types of
things rather than probiotics.
Yes, they cheaper.

Speaker 1 (26:15):
Yes, well, I think you recommended to me the
psyllium husk.

Speaker 2 (26:18):
Yeah.

Speaker 1 (26:18):
Like the psyllium husks with a cheer or just to.

Speaker 2 (26:21):
So I've always taken the tact If a product is still
being used and no one's makingmoney from it, then it's a win.
Right, and that's a slightlycynical approach, but it's a win
.
So look, psyllium husks, bydefinition, doesn't have a lot
of prebiotic properties.

Speaker 1 (26:37):
Okay, all right.

Speaker 2 (26:40):
But flow comes into play and I don't know where this
kind of slide again going offtangent and everything else, but
flow is as important as so.
Getting that you're emptyingyour bowels working properly is
as important as actually theproducts that you actually put
in.

Speaker 1 (26:57):
Yeah, wow, and that is what to just clean it out and
make it regular.

Speaker 2 (27:00):
Best way to think about it.
Your gut is one long tube, fromyour mouth all the way through
to your bottom.
Think of it like a river system.
If you get a nice, healthy,flowing river system, you get
nice, healthy drinking water.
If something impacts flow ofthat river system, you'll get a
buildup of moss and dirty waterall the way throughout the
system.
You can chuck chlorine tabletsin there, you can do what you
like, but unless you get theflow flow right, it isn't going

(27:22):
to get better.
Your gut is exactly the same.
If you get something thatimpacts flow and we talk about
pelvic floor, talk about kind ofconstipation you get to build
up a poo.
We also get to build up adifferent organisms yes and
that's not just in your largebowel, all the way up.
And of course troubles withreflux, of course troubles with
lots of other but it will alsocause troubles with behaviour as
well.

Speaker 1 (27:42):
Everything.

Speaker 2 (27:43):
Everything, and so you can use certain diets, you
can use probiotics, you can evenuse FMT.

Speaker 1 (27:49):
Yeah.

Speaker 2 (27:50):
But unless you fix the underlying flow issue, it'll
be transient because it willjust go back to kind of where it
is.
So you can't just think when Iuse faecal transplants and I
will always do it in conjunctionwith whatever else they're
doing but also it has to be aspart of a greater plan.
Why is your microbiome likethis in the first place?
And unless we fix up at thesame time, whatever we do is

(28:13):
less likely to be log-lived.

Speaker 1 (28:16):
That's really interesting.
So a friend of mine, theirchild was constipated like
really constipated and I thinkit's not only.
I think it's more environmentalthan what's going in, but it's
interesting that everythingimpacts.

Speaker 2 (28:33):
And you think about it.
You talk about the kids, right,I know this is not our of the
podcast.

Speaker 1 (28:38):
Well, everyone does?
Well, not everyone, but youknow there's a lot of percentage
.

Speaker 2 (28:43):
I'd take my.
My eight-year-old son won't pooat school, for example.
If my eight-year-old boy won'tpoo at school, how do you expect
a 13-year-old female to poo atschool?
And then, if you think aboutthere's normal physiology poo
enters the colon in the morning,sorry, in the pelvis.
In the morning You'll get thaturge to go to the toilet.

(29:04):
If you miss that urge to go,you won't get it again until the
next day.
Oh, really, and if you I say ifyou suddenly start mucking
around with missing your body'scues and not listening to your
body, then you'll start changingyour.
Your pelvic floor comes intoplay, and it's not.
Most people think pelvic flooris post-babies and all this but
it's actually a problem withlack of relaxation of the pelvic

(29:26):
floor and that starts as ateenager and that, well, if you
lose that ability to fully emptyyour bowel, therefore it's
going to impact that flow, comeback to that flow Right, and so
if you can start getting that bylistening to your body going
when you're to the toilet, thatwill have a bigger impact over
time to your microbiome than anyproduct that you'll buy in the
shelf.

Speaker 1 (29:44):
Isn't that interesting?
Because, even like with kids, Ineed to go to the toilet.
It's like, oh, wait until we'vegot to do something, but we
should actually be going.
Okay, let's go to the toilet,let's have some time.

Speaker 2 (29:54):
Yeah, and like I was talking about whether I try to
implement something at my kid'sschool, to say well, actually,
just let them go, make sure thetoilets are clean.
I think that's the first thingGive them peace and quiet to
actually go.
Yeah, and in fact, actually theQueensland not just for kids
the Queensland government spenta lot of money recently on an
advertising campaign and it wasliterally with a bright-coloured
dolphin poo at work.

(30:15):
Right, and it's the exact samething.
And it's probably the biggestthing is listen, find yourself a
nice toilet where you, yeah,and don't be afraid to use it,
just go for it.
But it's simple.
Things like that can make asbig an impact on your gut
microbiome, just thinking aboutgetting that flow right.
And that's why psyllium husk Ifind work, yeah, because a small

(30:36):
amount of it helps you go.

Speaker 1 (30:37):
It's cheap, you can use it every day exactly, put it
in a smoothie, exactly.

Speaker 2 (30:41):
You can do however you want to do it and just it
doesn't have the prebioticproperties itself but it will
have a prebiotic benefit becauseit will just getting that flow
right.

Speaker 1 (30:50):
And yeah, okay, and the flow to prepare your gut so
that it can take everything.

Speaker 2 (30:55):
And help you empty when you need to go to the
toilet.

Speaker 1 (30:57):
Yeah, okay, what about chia seeds then?

Speaker 2 (31:04):
Again, same kind of thing.
It has that same potentialbenefits with emptying and yeah
so yeah, anything like that I'mvery happy with.

Speaker 1 (31:08):
Great Tick, done that .
Do you think this is the futureof medicine, or do we have a
long way to go before it'smainstream?

Speaker 2 (31:17):
I think it's a ready mainstream, because every person
who it's no longer the doctortells the patient what to do.
The patient takes it with agrain of salt or takes
everything, listens to it, doesit 100% yeah, yeah, we've gone
to the days of that, yeah, yeah,I think you put it.
Unless the older generations,like my nan, she will listen to
everything yeah, yeah, yes,you're right, but the older

(31:39):
generation also comes with theirdaughter into it, and then you
go and google everything as well.
No but the but this and but weshould.
You should be like.
Everyone should be takingcontrol 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 saidthat.
Um, as an example, 25 of the uspopulation was taking
probiotics in 2019 so a quarterof the population as a way of

(32:01):
some way taking control overtheir gut health.
Right, right At that time, 45%were thinking about starting one
, and I guarantee if they redidthat study now, it would flip
the numbers around the other way.
So close to half the populationwill be doing something to help
their gut, microbiome, yeah,wow, so I think it already is
mainstream.

Speaker 1 (32:18):
Yeah, yeah, okay, mainstream.

Speaker 2 (32:20):
What is probably better is that you can't open a
medical journal in any specialtywithout seeing a paper on the
gut microbiome and looking athow that will impact in some way
treatment outcomes.
Whether it be from cancer space, whether it be your gut
microbiome, there's some reallyfascinating stuff in the cancer
world.
That's what a lot of ourresearch is in now at the moment

(32:41):
, world.
That's what a lot of ourresearch is in now at the moment
how your gut microbiome caninfluence how you respond to
different therapies, how it cancause different things side
effects and so therefore, yousuddenly got this interplay
between the wellness world andmedicine where you can have
everything you do will not justwork.
It shouldn't be alternative.

Speaker 1 (33:00):
It should be.

Speaker 2 (33:01):
I don't like this medicine that doctor's given me.
I'm going to go to mynaturopath.

Speaker 1 (33:04):
It should be.
How can they two work together?
And I think that's the amazingthing is, if you are taking
ownership of your health, youare getting your team of
specialists, whether they arethe naturopaths or the wellness
space or the medical space, andthey're working together.

Speaker 2 (33:21):
And you're an active part of that.
Yeah, you have to be, becauseeverything you do will have an
impact.

Speaker 1 (33:24):
Yeah, and everything you eat Exactly as you get older
.
What changes to your gut?

Speaker 2 (33:31):
So naturally, over time your diversity changes.

Speaker 1 (33:38):
So how many different types of plants?
If you can come back to our, Ithink the rainforest of thinking
about your gut like that isbrilliant, because you've got
the tall tree like everything.

Speaker 2 (33:45):
And brain for us and think about your gut as like.
That is brilliant becauseyou've got the tall tree, like
everything, and so the number ofdifferent types of plants start
to drop, your tree heightsstart to get shorter.
Yes, not quite as luscious, andthat's just one of those things
that come with aging.

Speaker 1 (33:55):
Yeah.

Speaker 2 (33:55):
Hormones play a role in that too.
So menopause is another kind ofchange.
It changes everything, yeah.
So all these things start tokind of have an impact and you
recover quicker from after ananti-course of antibiotics.
Things take longer to recoverand probably again it's hard to
get the right evidence.
But there probably is morecrosstalk between that gut and

(34:17):
your rest of your immune systemand I think that's why one of
the many reasons why the ratesof chronic illness start to go
up around that time as well andI know you had a great podcast
on inflammation.
I listened to it and there's alot of again.
There's a lot of crosstalkbetween that because part of
that driver is not just yourimmune system changing it, but
it's that gut microbiomechanging it.

Speaker 1 (34:38):
What should we be doing as we get older?
To make sure that it is healthy.

Speaker 2 (34:42):
It is, I think we've got to be.
We talked about the what nevershould put in your mouth anyway,
I often talk about it inmoderation, but maybe that
moderation needs to be aslightly tighter moderation,
yeah, and so maybe we have to bethat little bit more careful
about keeping more to that wholefood type diet, less
preservatives, be a little bitmore careful with the antibiotic
use, if we can do that focus abit more on exercise and making

(35:06):
sure that balance is there anddoing, adjusting what you're
doing a little bit, being alittle bit more careful as we
get on.

Speaker 1 (35:13):
Yeah, okay.
So I think this again comesback to you owning it.
It's you being mindful aboutwhat you put in your mouth,
about what you're doing in theenvironment around you, and just
making sure that you canactually control it Exactly.

Speaker 2 (35:26):
Well, not control it, but like impact it and
listening to your own body'scues, your body is really good.
There's a whole concept ofinteroception which was coined
by, or talked about by, aneuropsychologist I've forgot
his name, but it's a great book.
Actually I can send it through.
But looking at those own body'scues, you think about even
things like when your tummyrumbles telling you that it's

(35:47):
hunger.
It's that link between what'shappening inside with what you
can feel on the outside.

Speaker 1 (35:52):
Yeah.

Speaker 2 (35:53):
And it's we live in society at the moment that eats
when they're not hungry.
They ignore, they don't poowhen they need to.

Speaker 1 (36:00):
Need to.

Speaker 2 (36:00):
Try to do things when they don't need to do it yeah,
yeah.
And so we're not listening.
We're so busy in doing so, andso maybe it's sometimes what I
think it's taking it that littlebit of a step back and saying
well, what does your body listento?
Your body listen to those cues,respond, understand what's
happening in your own body,Don't fight it, Go with it.

Speaker 1 (36:19):
So when Amelia, who was talking about the
information, was on, she saidsomething like one of her tips
is stop eating when you thinkyou're hungry and actually wait
until your stomach is hungry orstarts to rumble, and I think
we've got to be doing that more.

Speaker 2 (36:36):
Exactly so.
It's listening, understanding,yeah, understanding what your
body needs.

Speaker 1 (36:39):
Yeah.

Speaker 2 (36:40):
Understanding and stop forcing it to do what you
want it to do.
Sometimes it's not the rightthing.

Speaker 1 (36:47):
Yeah, I think that is so.
There's so much talk about andwe've talked about it the
gut-brain axis.
How much of our mood isactually controlled by our gut?

Speaker 2 (36:59):
Yeah, look, it's a great question.
So gut-brain axis.
So we know everyone knows thebest way to think about it is
that everyone knows about thenervous poos.
You're anxious you're nervous,you've got to the toilet, you
may have more bloating, you mayhave troubles, and that's just
that gut-brain interactionthat's constantly working, and

(37:20):
it's not just one-way traffic,it's both ways.
So the way I like to talk topeople about bloating right.
Bloating is a common symptom.
Half the world's populationhave some form of irritable
bowel.
Yes, which?
The new term for irritablebowel is actually disorders of
the gut brain interaction.
So it's actually they've changedthe terminology of it.
It's no longer.
And also irritable bowel issuch a terrible term.

(37:42):
It's so long been used as athrowaway.
Yeah, yeah, it's nothing wrongwith it, but half the world's
population, more than half, havesome form of it and will have
as big an impact on someone'slife than some other chronic
illness, and there's so manythings you can actually do to
treat it.
But that comes down to thatgut-brain interaction.
So why I describe this?

(38:03):
You've got all this almostsecond brain on the outside of
your gut that senses part of asense of what's going on in the
inside.
That sends messages back up tothe brain.
The brain interprets thosemessages in some way or form and
then sends other messages andhormones back down to the gut
and that is a cycle and sosomething can trigger that cycle
off.
Whether it be an illness,whether it be a stressful event,

(38:26):
something turbocharges thatcycle and then it's really hard
to kind of wind that cycle backdown.
So we know your brain, like inpeople with symptoms for example
, will have more activity in thecertain parts of the brain to
normal stimulus.
So where other people won'teven have any activity, they'll
be reacting to things that aregoing inside the gut.

Speaker 1 (38:46):
So if you are living in constant fight or flight,
that's obviously extremely badfor your gut.

Speaker 2 (38:52):
Exactly exactly.

Speaker 1 (38:53):
And is that then at that point where you need to
stop and just take a breath ortry and get the nervous system
under control?

Speaker 2 (39:01):
Exactly, exactly right, and so there's something
called gut hemotherapy.
I don't know if you've no.

Speaker 1 (39:07):
What is?

Speaker 2 (39:08):
that Exactly so it recognizes that whole link, that
whole gut-brain interactionthat's constantly on firing Gut.
Hemotherapy was designed by thesame people that made the
FODMAP diet down in MonashUniversity.

Speaker 1 (39:19):
Yes, okay.

Speaker 2 (39:19):
It brings in mindfulness, meditation, other
energy techniques.
It works as well as diet inbloating pain and changing bowel
habits.
A six-week program will havethis prolonged benefit and so I
spend my life actuallyliberalizing people's diet
because I think that no oneneeds to be on a long-term
restrictive diet.
And they say well, actually,whatever we do with probiotics,

(39:41):
with diet, even with pootransplants, it's treating one
side of the picture.

Speaker 1 (39:47):
Yeah, yeah, but it's neglecting everything else.
Yeah, yeah.

Speaker 2 (39:49):
So if you can do it, you can micromanage what goes in
your mouth to the tea, butyou're not going to get very far
.

Speaker 1 (39:55):
But that's not the environment Exactly.
And see, this is like a greatthing is if you think about you
and you own you and your health.
It's not only what goes in, butthe environment you're in.

Speaker 2 (40:05):
And there's a really nice thing with exercise, so we
know that exercise will.

Speaker 1 (40:08):
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.

Speaker 2 (40:15):
It works in various different ways but it starts to
switch off that cycle and, likeyou can supercharge it, it could
all.
It takes a little bit to startwinding it back.

Speaker 1 (40:24):
Yeah.

Speaker 2 (40:24):
Okay, and it works.
It works really, and there'srandomized trials that show that
it works.

Speaker 1 (40:28):
And the exercise.

Speaker 2 (40:29):
Yeah.

Speaker 1 (40:30):
What is the best exercise for your gut?

Speaker 2 (40:32):
So it's a really so there was actually.
I found a study.
It took people take the exactsame exercise.
So say running, running as anexample same intensity, same
diet.
One group ran inside on atreadmill, the other group ran
in a forest or in a rainforest,somewhere outdoors, and the
rainforest or the outdoors grouphad a better impact on their

(40:53):
microbiome for the exact sameamount of exercise, energy, diet
than the group running inside.
That is fascinating and theycalled it nature size or
something of the sort.
But it was a great concept.
It was showing that actuallythat outdoor environment, that
fresh air, everything around it,has an independent improvement
in your microbiome.
That's not just all the otherhealth benefits but actually

(41:15):
changes your microbiomeregardless of the same diet.

Speaker 1 (41:18):
It's so interesting, it's so fascinating that it's
holistic, like it is actuallyholistic in the way that we need
to approach it.

Speaker 2 (41:25):
But I think what's the best?
Best exercise is probably onethat you enjoy doing.

Speaker 1 (41:29):
Yeah.

Speaker 2 (41:30):
Actually going to do that.
You can actually start toswitch off.
Yeah, um, and I found I doexercise.
I took away my headphones andstarted actually I don't use the
headphones anymore and Iactually found that that had an
improvement on my mental healthas well.
But just that, switching off,slowing down I found I was more
effective at the gym and doingother things when I actually
took away some of that the noise, the noise.

Speaker 1 (41:51):
It's funny, Even like cause I was always on, always
on, like always having to learnsomething, listen to something,
do something in the car, had tolike just be listening to a
podcast or something or an audiobook or something, and I've
just stopped because the noiselike it's just nice having
nothing sometimes.

Speaker 2 (42:10):
And I think we think, I think it's probably will tone
down all those kind of we talkabout gut brain attraction, all
those kind of.
All that noise is probably havean impact, the stimulus that by
definition will hopefullyshould feed back down to your
gut and have that image.

Speaker 1 (42:23):
Yeah, okay.
So something that I foundfascinating, which is when we
started talking, was you'reinvolved in academic research.
What are the most excitingdevelopments in gut health right
now?

Speaker 2 (42:34):
Yeah, so I think that you can talk about yeah, no, no
, no.
Of course, there's so manygreat things.
I do research because I'minterested by research.

Speaker 1 (42:47):
Yes.

Speaker 2 (42:47):
I don't care too much about papers that come out.
I want to see change, I want tosee things that I want to do
something that can changepatients sitting in front of me.
Because that's who I am.
I'm inclusion at heart, yes,and that is my goal.
That is my kind of world.
And then everything else comesaround there.
So where, as an example, what'sreally exciting is that there
is acceptance of the microbiomein every different specialty,

(43:10):
that it can help disease.
And a prime example of that isin the cancer space.
We know that, for example,immunotherapy yes, we know that.
For example, immunotherapy yes,immunotherapy was designed many
years ago.
That turns on someone's immunesystem to fight cancer.
It is a game changer formelanoma.
It's a game changer for a lotof other cancers, yes, but

(43:43):
there's still portions of people.
Someone doesn't respond totheir cancer immunotherapy with
melanoma, you could take poofrom someone who had melanoma
that responded to theimmunotherapy.
You give it to the patient thatisn't responding.
You don't change anything elseand suddenly their cancer
switches off, and so it showsthat it's whilst you're just
turning on the immune system.
There's more drivers, and so itshows that it's whilst you're
just turning on the immunesystem.
There's more drivers, there'smore drivers, and so you can

(44:03):
suddenly change outcomes, andamazing outcomes.

Speaker 1 (44:08):
Yeah, yeah.

Speaker 2 (44:09):
So one of the trials that we're running at the moment
is using fecal transplants bycapsules in patients that get a
lot of side effects from theimmunotherapy.
So some patients will developthis bowel inflammation that
looks a lot like Crohn's disease, and we've got a randomized
trial using these capsules totreat their cellulose.
But what's even more exciting,even that'll answer one question

(44:32):
about preventative.
So you can suddenly say at thestart of their cancer journey
can you do something to improvetheir microbiome?
And there's simple, like evensome research showing that the
amount of fiber in your diet,every five gram increase I think
it's five gram will improveyour success rates from cancer
therapy by a certain percentage.

(44:55):
That's not controlled data,that's just questionnaires, but
it's such a simple thing thatthe person can take control of,
rather than the doctor takingcontrol of.
Say, well, what can I do toimprove my diet?
What things can I do to have ameasurable and beneficial impact
?
And that's probably theexciting bit is how can you do
it to empower the patient totake control and to actually

(45:19):
improve your outcomes?

Speaker 1 (45:20):
Yeah, I think the empowering a patient that's
amazing.
Yeah, what are the biggestmisconceptions you hear about
gut health that drive you crazy?

Speaker 2 (45:30):
Okay, slightly polarizing, kind of yeah, I've
got to bite my tongue a littlebit.
Don't, don't bite your tongue.
I'm a big advocate of nolong-term restrictive diets, so
gluten and dairy, for example,has been demonized by everyone.
I'm not saying everyone shouldgo for gold with all these kind

(45:51):
of things.
Everyone's circumstances aredifferent.
But there's very few peoplethat need to be on a no gluten
or no dairy diet.
You can do low gluten, lowdairy, yeah, yeah, yeah.
But as soon as there's thatthink of I actually I'm going to
pose this a little bit quicklySay you have high blood pressure
, yes.
Or talk about cholesterol.
Yeah, yeah, you go on acholesterol drug.

Speaker 1 (46:11):
Yes.

Speaker 2 (46:12):
If it's causing you trouble.

Speaker 1 (46:14):
Yes.

Speaker 2 (46:14):
Or if it's not dropping your cholesterol.
Yes, you're not going tocontinue taking the drug.
No, yes, you're not going tocontinue taking the drug.
No, yes, people get put onto agluten-free diet or dairy-free
diet as a way of treatingsomething, whether it be their
skin, their bloating.
There's something else, but ifit doesn't improve their
bloating or it doesn't improvetheir skin, they're on it

(46:35):
seemingly forever.

Speaker 1 (46:36):
Yeah, okay.

Speaker 2 (46:36):
They don't stop that diet.
Then, more importantly thanthat, then suddenly it starts to
impact when they go out fordinner.
Yeah, okay, they don't stopthat diet.
Then, more importantly thanthat, then suddenly it starts to
impact when they go out fordinner.
They're worrying about whatthey put in their mouth, even
though it probably has nodifference to anything else.

Speaker 1 (46:49):
Yeah, yeah.

Speaker 2 (46:50):
But that psychological impact has a
bigger impact on their life thananything it was trying to treat
.

Speaker 1 (46:55):
Yeah right.
And it's really I talk topeople.

Speaker 2 (46:58):
That's such an interesting way of thinking,
yeah.
And so I talk to people and sayI actually really want to
liberalize your diet and I wantwe can talk to a dietician and
help you do it slowly.

Speaker 1 (47:06):
Yes, being on this road, yeah, yeah, yeah, not
something going.
No, no, you can.

Speaker 2 (47:09):
And people burst into tears when they say it because
it's actually people, yeah,people.
We all know this.
We're all really good atputting on facades and
everything else but it has ahuge impact on someone's life.

Speaker 1 (47:20):
Yeah.

Speaker 2 (47:20):
And just that food choices.
So if something causes moregrief than benefit, then there's
no point of continuing.
We have to think of it anotherway of doing it.
So and again, a lot of the timeit's not the gluten, it's the
preserve we talked about thepreserve in the packets, yeah.

(47:43):
Most people all the as much beerand beer as you like and
they're perfectly fine.
So the same amount of glutencontent.
It's often just a differentform of yeast or a different
something else with lesspreservatives, and always have
to be clear what are you tryingto achieve?
with any intervention, whetherit be diet, medication,
supplement If it doesn't, ifit'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.
So I think that's probably thebiggest thing that I find is

(48:04):
that, yeah, for every.
It's not a one size fits all.

Speaker 1 (48:06):
Yeah, and you're, I mean, as you've kept saying, the
never, never like never, never,never, never, never.

Speaker 2 (48:12):
Say never, yeah, yeah .

Speaker 1 (48:15):
Is there anything you've changed about your own
health approach as you'velearned more about your gut
health?

Speaker 2 (48:25):
Yeah, also a good question.
I guess more recently in thelast few years, as my kids are
slowly getting a little bitbigger, I looked at my kind of
own life and health and when Ifinished my PhD and trying to
find again what I want to wantin life and that balance.
I took on a few things andagain I like to research a lot

(48:47):
of these things too and otherfactors.

Speaker 1 (48:48):
So we can learn Exactly.

Speaker 2 (48:51):
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.
And so I've shifted starting myconsulting sessions at 8.30
instead of to 9.
And so I know I can have timein the morning to do some
exercise.

Speaker 1 (49:05):
Yes.

Speaker 2 (49:05):
And that way it gets me off on a great day.

Speaker 1 (49:07):
Yeah, yeah.

Speaker 2 (49:08):
And that's kind of one of those.
Really, it's nice to get you upfor the best day.
I use Pruzilium on my breakfastevery morning, oh really, and I
try to sneak it into my kids.
This if I can.

Speaker 1 (49:16):
Yeah, okay, and it always in the morning rather
than and it's not morning, ornight I think about it and say,
well, what is your biggestsource of whole?

Speaker 2 (49:23):
So not all five is equal.
So come back to that question.
There's a lot of subtypes of it, but if it's simplest way,
you've got your fruit and vegfiber and you've got your whole
grain type fiber.

Speaker 1 (49:31):
Yeah.

Speaker 2 (49:31):
When do most people have their whole grains?
It's usually cere, that's all.
You don't need very much.
Yeah, a teaspoon of psylliumevery morning, with the whole
lot of other stuff like berriesand a few things, and that's,
that's one of the things I'vedone.

Speaker 1 (49:46):
Okay.

Speaker 2 (49:46):
We get the cheap and cheerful.

Speaker 1 (49:47):
Yeah, yeah.

Speaker 2 (49:48):
From Woolies yeah, bag will cost you $6 or last you
six months and that's, that'sall we get, and is it organic of
a?
Husk.
It's a, it's a tub of husk.
There's not, there's not much,not much organic things about it
, right?
So again, you can't, you can'tchange everything.

Speaker 1 (50:03):
Yeah, yeah, okay.

Speaker 2 (50:08):
As long as you're having it, I'm doing it, Sorry.
So that's one of the thingsthat I have done, and and but
it's also and that and again.
Yeah, starting late and thenthinking, listening more to my
own body.
So on the way that I was goingto grab a cup, I picked up a cup
of coffee.
Instead, I'll sat down and I'lljust sit down and enjoy the cup
of coffee and just just winddown, put it down the phone,
yeah.
So those kinds of things justswitching off a little bit, yeah
, and winding back, listen to myown self.

Speaker 1 (50:28):
I think, yeah, it is because we're always on.

Speaker 2 (50:30):
Yeah, like always on, always on.

Speaker 1 (50:31):
Always on, yeah.

Speaker 2 (50:36):
And it's never solid.
No, no, no I know, Outsides,outsides, yeah, and that's why
it's I I've we've talked a bitabout before I speak at.
Gwingana and run a retreat, butI actually really I use that as
my own also, the retreat ofmyself.
So it's just switching off.
It's switching off from reality.
I can actually tell work.

Speaker 1 (50:58):
call me if there's an emergency, otherwise I'll be
back next week and your Gwinganaretreat you do with a
cardiologist, yeah, Like can youjust talk about that.

Speaker 2 (51:06):
So I was on, I'd never heard of Gwingana before I
was asked to go down, and I wasasked to go down by yeah, up,
sorry up.
Yeah, I was asked by thecardiologist to go and talk.
He's been going there for eightplus years talking about heart
health, and he used to do itwith a neurologist at one stage
and there was obviously now withgut health.

Speaker 1 (51:26):
And.

Speaker 2 (51:28):
I went down there once and it was really
interesting talking to everyonethere.
There was a few people therethat were there for the first
time.
You'll never see someone saythis is my last time I'm going
to be here there's alwayssomething to look at.

Speaker 1 (51:41):
Oh, what about that?

Speaker 2 (51:42):
Yeah, and what I loved about it was the phone
there's no, reception no.
There's no laptops.
It's a structured kind ofsemi-structured kind of yes.
Work show.
So you don't do dairy andgluten-free, it's whole foods.
I have meat and a few thingsthere too, and so I felt

(52:07):
refreshed.
So I remember calling him up afew days later.
I was like I'm coming back, Idon't care if you want me or not
, I'm coming back.
And I said that same thing tothe owner and I'm like I'm
coming back, I don't really carewhat happens, and I love it for
me.
And so we go down there andit's now my wife goes down there
regularly.
It's such a lovely.

Speaker 1 (52:27):
It's just a reset.
It's a reset, it is a reset,and you do need a reset, just to
go.
Ah, take breath, deep breath.

Speaker 2 (52:34):
And what I actually found.
Every time I come back, I'vegot 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 nextlittle while.
Yeah, okay, good, that is good.

Speaker 1 (52:47):
If you could only do one thing in your career from
now on private practice,research, education what would
you choose?

Speaker 2 (52:59):
That's the hardest question of the lot.
I still don't know.
That's my biggest thing.
So there's all this saying inmedicine is that whenever you
ask someone how do you find thatbalance between public work at
the public, hospital, privatepractice and academia, they say
one of four things will fail thepublic work, the private work,
the academia or your family.

(53:20):
Right, and that's the saying.

Speaker 1 (53:22):
Yeah, yeah.

Speaker 2 (53:23):
And so I know inevitably at least not the
family bit at least one of thoseother three other three will
fall away, and I don't knowwhich ones they are.
Yeah, and actually I use thingslike Wingana or something as a
way of saying well, what do Iwant?
What balance do I want?
Take that break, take a switchoff from everything.
And so I use those kind of daysto kind of figure that out.

(53:44):
But if I, I think it would endup being being a clinician.
I love working with patients andyou kind of.
I don't get over-involved, butI'm invested in them.
I want to see them succeed, Iwant to see them feeling better,
and that's that's uh.
Yeah, I've been.
I'm a doctor at foremost.

Speaker 1 (54:01):
I think out of one of those things.
Yeah, I think you'd miss theresearch, though I would, I
think you would.

Speaker 2 (54:06):
I would.
Um, yeah, I would, yeah, Iwould.
What, what, what?
What?
What's really nice about thepublic system is that we were
linked at some instance with theGarvin Institute, unsw.
So there's a lot of, a lotsmarter people than I am that
sit in the lab that do all thesethings, that they need access
to patients, and so there's.
We do a lot of collaborativeresearch where they we have

(54:27):
questions that need to be asked.
So all the my inquisitive mindthey can say, oh great, we can
do X, y and Z to try and figurethis out, tease this out, and
then so there's a lot of it'scollaborative work.
So it's no longer me on theground doing lots of things.
I don't spend any time in thelab, but we've got lots of
students and lots ofcollaborators that do it, and so
you can still stay in academiawithout being too heavily

(54:50):
invested in academia.

Speaker 1 (54:52):
Which is probably where your four things you know.
Yeah, yeah, okay.
Good, if you could put onemessage about gut health on a
billboard, what would?

Speaker 2 (55:04):
it say I reckon poo at work Don't be afraid to poo
when you need to poo.
Yeah, don't be afraid to poowhen you need to poo, okay.

Speaker 1 (55:15):
I think that it's so interesting because there's so
many people that do holidaymeetings about it.

Speaker 2 (55:20):
And no one talks about poo.
No one talks about poo.
But I guarantee you next timeyou're at a dinner party you
bring up poo.
Everyone else at the dinnerparty will tell you all about
their kind of gut troubles.
You're all in the same boat.

Speaker 1 (55:31):
Yeah, but everyone poos, exactly Everyone poos.

Speaker 2 (55:36):
Exactly, yeah.
And if you don't talk about it,then you miss other things.
Like we haven't talked a lotabout screening, and that's
actually really, really, reallyimportant to remember.
But if something's not rightand you don't talk about it, you
don't know what's normal versusabnormal or what things change.
So don't be afraid.
And if you don't want to talkto friends and family, talk to
your doctor.

Speaker 1 (55:55):
Yes, talk to your doctor.

Speaker 2 (55:59):
Don't sit on something, literally no.
But don't sit on something ifsomething's not right.

Speaker 1 (56:03):
Yeah, okay, let's talk about the screening thing
then, because I think that isreally important.

Speaker 2 (56:08):
Yes.

Speaker 1 (56:09):
So you know, I think you can now, because even I did.
I requested you can request ascreening kit from the
government from 45.
Yes, yes, you can.

Speaker 2 (56:17):
So there's two.
So bowel cancer is a reallyfortunately it's actually
there's a lot in the news aboutit, which is really important
because people need to be awareof these things.
Bowel cancer is one of thosecancers that is preventable,
which is a really exciting thing, because cancers don't just
appear.
They grow from little polyps.
So polyps if you think aboutyour bowel, think about little

(56:40):
moles on your arm.
It's the same kind of thing thatcomes up.
You can get these little polyps, these little growths in your
bowel that aren't a problem intheir own right, but if left
alone they will grow and whenthey get to a certain stage
they'll start to turn into acancer.
So cancers most cancers appearfrom these polyps.
That process takes 10 years togo from nothing to a cancer.
So you've got this window ofopportunity to intervene Right

(57:04):
and so the bowel.
There's two ways you can screenfor bowel cancer.
There is those poo kits that,when they turn 50, will start
getting every two years in themail, where you poke your poo
and it looks for tiny traces ofblood.
So if you see blood then youneed to go see your doctor, but
if it will see, it's for someonewho doesn't have any problems

(57:24):
with their bowels.
You poke it and it starts tolook for any polyps that are
starting to change and turn intoa cancer.
That has to be done regularlybecause they're not designed to
look for polyps.
It's designed to look forpolyps that are changing.

Speaker 1 (57:36):
And they've also changed it now.
So it's you do do two threedays apart.

Speaker 2 (57:40):
Yes, you actually do three, there's three little
pokes and it doesn't matterwhether one's positive or three
positives, it's considered thesame Okay.
They're very sensitive, so theyare designed to pick up more
things that are there.
So if you take a positive testwith no other history, 60% will
have a normal colonoscopy, 38%will have polyps and just under

(58:03):
2% will have an early cancer.
And the key bit is early.
A lot of cancer we can treat atthe time of colonoscopy or it's
a minor surgery and you move onwith life as opposed to more
later.
By the time it presents, it'soften too late, and so there's a
big push, because young peopleare now getting bowel cancer.

Speaker 1 (58:18):
Well, one of my friends she was 35 and she had
bowel cancer.

Speaker 2 (58:23):
We see it every week, unfortunately.
We see young people gettingbowel cancer.

Speaker 1 (58:27):
And what like.

Speaker 2 (58:29):
Yeah, there's a lot of questions about why is that
happening?
It's part of it.
Each generation gets thatlittle bit younger.

Speaker 1 (58:34):
Yeah.

Speaker 2 (58:34):
But there is.
We talked about environment andeverything.
There's something in yourmicrobiome that is changing.
There's a lot of work trying tounderstand it, so the
government's now pushed thatscreening program to 45, but you
have to request it from yourdoctor.

Speaker 1 (58:49):
I requested it online .

Speaker 2 (58:51):
Online, yes it won't come to you automatically.

Speaker 1 (58:53):
No, no, no yes.

Speaker 2 (58:53):
And you can even get it done younger with your GP.
So it's a different type oftest, but it's.
You can get it.
And who should do it younger?
No, yeah, that's a big question, I think.
When it comes down to it, ifthere's ever concern about
family history, your ownsymptoms, a conversation is the
first step.
So sitting down with your GPand saying what is my risk, my

(59:15):
individual risk, what can I doto kind of change it?
And am I going to startscreening now?
And if not now, when am I goingto start screening?
And that's a very appropriatefirst step.
Not everyone needs to have ascreening test or a colonoscopy,
but it's saying let's have agame plan in place, and so if
you're 30,.
A lot of people come to see meand say should I be screening at
30?

(59:35):
And I say, well, what's yourhistory?
If this is the risk of doing aprocedure, or this is the risk
of doing those screening testsversus the positives, and it
depends on how much sleep you'relosing over.
This is the downsides.
And if we're not going to do itnow.
Come back at 40 and we'll talkabout it yeah, yeah, but it's
interesting.

Speaker 1 (59:51):
So my friend, no family history like none.
And she's actually in Germanynow because there was another
thing where she's actuallygetting.
They've taken like a tumor andthey're creating a vaccine for
that to treat it.
I've told her she needs to comeback and talk to you when she

(01:00:11):
gets back.
Yeah, there's some reallyfascinating things about it,
exactly.

Speaker 2 (01:00:14):
And there's so much.
If found early enough, it'svery treatable.
And I think that's the reallykind of key bit.
So if there's any changes toyour bowel habits, any bleeding,
anything that doesn't feelright, don't just say, oh, it's
nothing.
If it's just go talk to your GPand it could all just be, all
it may need to be is aconversation and then you walk

(01:00:36):
away.
But have a talk better talkYou're going to.
Yeah, there's no point lookingback saying I wish I did speak
about it six months and itliterally can just be a
conversation.
It doesn't necessarily mean youneed to have a colonoscopy.
Those kits are really good.
As soon as there's symptoms,the kits are kind of a mute
point.
So if they're designed for ahealthy population with no

(01:00:57):
symptoms.
So as soon as there's symptoms,everyone talks about a
risk-first benefits approach.
But we talk about a colonoscopyto kind of find these things
and if there are polyps therethey get snipped off at the time
.

Speaker 1 (01:01:08):
Yeah, okay.

Speaker 2 (01:01:09):
And you move on and you say come back in five years,
ten years yeah okay, good.

Speaker 1 (01:01:14):
What's the biggest thing?
People don't realise abouttheir gut health.

Speaker 2 (01:01:21):
I think that everything you do will change
something about your gut health.

Speaker 1 (01:01:26):
Yeah, I think the fascinating of the three things
what you put in your mouth, yourenvironment and the movement,
yeah, Everything you do have animpact on your gut health.
Yeah.

Speaker 2 (01:01:35):
And again, you fix the things you can't fix.

Speaker 1 (01:01:38):
Yes.

Speaker 2 (01:01:39):
You pick one thing to change, see how it goes before
trying to change everything.
If you try to change everythingand it doesn't fit within your
lifestyle it doesn't work.

Speaker 1 (01:01:46):
It was actually really interesting.
So Amelia said that one of thethings she does is she focuses
on one thing for a term.

Speaker 2 (01:01:51):
Yeah.

Speaker 1 (01:01:52):
Because like.

Speaker 2 (01:01:53):
I love that One little thing, just one thing.

Speaker 1 (01:01:54):
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.

Speaker 2 (01:02:00):
I like to.
I talk to people.
I say, well, okay, what is?
Everyone can improve somethingin their diet.
And so, classically, you havethe question saying I struggle
to lose weight.
And you get that question allthe time.
And again, I'm not a dietitian.
I send people to the dietitian.
You say, well, write downeverything that you put in your
mouth for 48 hours and you'llactually start to see trends.
And if you're going, the primeexample you don't have people

(01:02:23):
get hungry, tired and bored inthe afternoon, don't need to get
home.
Your kids are eating dinner.
You end up eating half of theirdinner too, without even
realising it, and then you haveyour dinner, where a lot of it
can actually be if you know it'shappening.
You have a snack before goinghome, and so you don't get to
that stage.
So A lot of it can actually beif you know it's happening.
You have a snack before goinghome, and so you don't get to
that stage.

(01:02:43):
So find the one or two thingsthat you can change.
There's no point in changingeverything else, or if you can
substitute something forsomething else.
So I like to think if you reachfor a bag of chips, you reach
for something else.
Grab for a banana instead, orgrab somebody.
So pick the one or two thingsthat you're not going to notice
if you don't have it.

Speaker 1 (01:03:02):
Yeah, yeah.

Speaker 2 (01:03:03):
But it will have added benefits over time.

Speaker 1 (01:03:05):
Okay, all right, craig.

Speaker 2 (01:03:08):
Yeah.

Speaker 1 (01:03:08):
This is always fascinating to talk to you.
I've learnt a lot and I stillcontinue to question you going
what, what, huh, tell me.
And it does make me think andrethink about what is happening
in my gut and how so many thingsimpact it, and it's not just
what you put in.
Before we wrap up, I've got onequestion for you.

(01:03:29):
Uh, before I turn 50, what isone thing yeah, you think I
should do?

Speaker 2 (01:03:36):
oh, oh, good question , I get no.
Can I suggest that there's twothings?
Yeah no, it's the first thingI'll say get yourself screened,
which yeah?
Yeah, which you've done yourspeak to you to say that's the
number one thing before you turn50, think about bowel cancer
screening something simple, lazyand thing to do.

(01:03:58):
the second thing is I'd almostyeah, no, it's my second thing
to do.
The second thing is I'd almostyeah, no, it's my second thing
to do is stop and listen to whatyour body wants.
So if you're rushing out thedoor with a coffee cup, a
takeaway coffee cup, I don'tdrink coffee, Okay Well let's
say there's an.
If you're running out the doorwith a banana in your hand,
ready to go somewhere, just takea seat down for a few minutes

(01:04:19):
on your own and kind of listento your body's cues.
If it needs to go to the toilet, you go to the toilet.
If it needs to just chill outand relax that five minutes,
you're not going to notice itlater in the day.

Speaker 1 (01:04:28):
No, that's a good point.
And you know what?
Even before picking the kids up, sitting in the car for five
minutes and just breathing.

Speaker 2 (01:04:36):
I tell people with the gut chemotherapy yeah, it's
a great time, Get to school 15minutes earlier to end on
pickups, Because as soon as youget home it's over.

Speaker 1 (01:04:43):
You can't, yeah, you can't Like.
Yeah, as soon as you've gotanother human Sit in the car put
your headphones in.
Oh, you've got radio good radioin the car, put it through on
there, put your seat back andjust that there early and just
put on an eight-minute body scanbecause I knew it was going to

(01:05:04):
be a stressful day and I waslike I'm just going to let it be
.
And it was amazing.

Speaker 2 (01:05:08):
It's a changed mindset.
You're never going to notice iteight minutes later in the day
and it just sets you up for sucha great kind of afternoon
evening, whenever it may be.

Speaker 1 (01:05:16):
Yeah it does yeah.
Whenever it may be, it doesyeah, it helps Just calm, calm.

Speaker 2 (01:05:19):
Calm.

Speaker 1 (01:05:20):
Okay, good, I like those two things and I do like
the.
If you're grabbing a banana toeat in the car like even eating
in the car or drinking in thecar.
Just stop and just don't do itExactly.

Speaker 2 (01:05:32):
Sit down at the coffee shop, sit down somewhere,
just even for two minutes, justsit down and have something to
do it out.
Yeah, yeah, okay, good, okayAll right, craig, thank you.

Speaker 1 (01:05:40):
Thank you very much for sharing your expertise, your
research and your passion forgut health.
Um, I know it was when I satdown with you first.
I was just fascinated and Ineeded to know more and more.
Um, and I do feel like we haveonly just scratched the surface,
like I think there's so muchmore that we need to understand.
But by thinking about what youput in your mouth, your

(01:06:04):
environment and the movement, Ithink the holistic approach is
such a great way to make sureyour gut is actually okay.
So thank you for that.
If you want to learn more aboutCraig's work, I'll link
everything in the show notes andif you've enjoyed this episode,
hit, subscribe, share with afriend and continue to chat

(01:06:27):
about poo, because we all needto talk about poo.
It can't be a taboo topic.
And before you go, try craig's,try this before you're 50.
Have a poo scan or the bowelscan, and also take the time to
listen to your body.
Give it a go, see how itchanges what you're doing and
let me know, because, fuck,we're nearly 50, and isn't it

(01:06:51):
amazing?

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