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[birds chirping]

2
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{\an8}[gentle music playing]

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{\an8}[woman] As humans, we've discovered
so many new things on this planet.

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We've even flown to the moon.

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But hardly anyone has really adventured
into their own gut.

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We feel a lot of shame about our gut.

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But it influences
so much about our health.

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About how we feel,
if we are overweight or not,

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{\an8}what kind of diseases we can get,

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{\an8}how our immune system is being trained,

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{\an8}and, really with that,
the course of our lives.

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["Gut Feeling" by Devo playing]

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The nation got a report card
on obesity today, and the country flunked.

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- [reporter 1] <i>Rates of colorectal cancer...</i>
- [reporter 2] <i>Heart disease...</i>

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- [reporter 3] <i>Irritable bowel syndrome...</i>
- [reporter 4] <i>Increase in autism...</i>

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{\an8}[reporter 5] <i>...depression, anxiety
are skyrocketing.</i>

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{\an8}[woman 1] What is healthy?

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Why is eating painful?

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[man] What changes
do I need to do to get healthy?

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Why's it so hard for me to lose weight?

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[woman 2] How do I still not know
what's right for my body?

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[in Japanese] How do I fix my gut?

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{\an8}[in English] Do I have to spend
$100 a month on supplements?

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{\an8}Mmm!

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[Giulia] There's a lot of noise
thrown at us.

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[blender whirs]

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Is it diet?
Is it carbohydrates? Is it no diet?

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- And if you just look at...
- [all]...the gut...

29
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...all this gets much easier to understand.

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{\an8}[man] We really just think about our gut
as a place where our poop comes from.

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{\an8}But it turns out to be
the center of a biomedical revolution.

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[microbes cheering]

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{\an8}["Gut Feeling" continues]

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[man] Diseases like anxiety,
and depression, cancer,

35
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autism, Parkinson's
are all related to the gut.

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[microbes] Huh?

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This is new science, tip of the iceberg.

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{\an8}There's another 97% left to discover.

39
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<i>♪ I've got a gut feeling ♪</i>

40
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We're getting to the point where
we can make a more precise definition

41
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about what you should eat.

42
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<i>♪ I've got a gut feeling, feeling ♪</i>

43
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The gut is flexible. It really changes
when we change the way we eat.

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And once we've realized that,
everything changes.

45
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{\an8}[music ends]

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[Giulia] Until I was 16 or 17,

47
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I was just as confused by my gut
as everyone else.

48
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[pensive music playing]

49
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[Giulia] I couldn't deal with lactose.

50
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I had a skin disease.

51
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I was suddenly chubby as a child,

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although there was
no apparent reason for it.

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And so I read a lot about the gut,

54
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and I realized that
when you really look at the organ,

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you find so many of those answers.

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One morning, my roommate
came into the kitchen and asked me,

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"Giulia, you love the gut.
You talk about it all the time." [laughs]

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"How does pooping work?"

59
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And I had no idea.

60
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So, I went up to my room,
and I looked in, like, three books,

61
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and when I found out, I was like, "What?"

62
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"Even this part is really cool about it."

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There's nothing to shy away from, really.
All of it is cool.

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[doctor speaking German]

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{\an8}[Giulia] We feel guilty and shame a lot
when it comes to our gut.

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And it's completely crazy
when you think about it,

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'cause this is the organ
that keeps you alive.

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And as soon as you just know a few facts,
you feel a lot of respect for it.

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Science can help us navigate
the questions about our health.

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I remember when I did this the first time
with Professor Krammer, and he just said,

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"See? Everybody looks the same inside."

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We start with the esophagus.

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It'll transport food to the stomach,

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{\an8}which passes it on to the small intestine.

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{\an8}What's left goes to the large intestine,
the colon.

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{\an8}And whatever we really don't need
goes out of the butthole.

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And then we're done.

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{\an8}Gut science has been the hottest area
in all of biomedicine

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{\an8}for the last decade or more.

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{\an8}It is the missing part of the puzzle.

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{\an8}Our gut affects our whole body.

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{\an8}It can even affect
certain conditions in the brain.

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Wow!

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[John] We've known for hundreds of years
that this is so important.

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All we have to do is look to our language.

86
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When we're disappointed, we're gutted.
When we're brave, we make gutsy moves.

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When we have... we're nervous,
we have butterflies in our tummy.

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The gut really is the second brain.

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Wow!

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And from an evolutionary perspective,
our brains have never existed

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without signals coming from the gut.

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I'm being swallowed by my gut.

93
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I mean, you know,
it's the gut fights back.

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This whole field
is disrupting modern medicine.

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{\an8}[serene music playing]

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[Giulia] This is an exhibit
that's based on a book

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that my sister and I did about the gut.

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And the purpose of it
is to just turn the inside out.

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[upbeat ethereal music playing]

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[laughs]

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This is probably better.

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[giggles]

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[laughing] This is much more accurate,
actually, when you look at it like this.

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The intestinal tract,
it's not a straight thing.

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It's a bit, you know,
crooked here, crooked there.

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The stomach, for example,
it goes like this.

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So on top of it, there's an air bubble.

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So when you really have a lot of air
in your stomach,

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and you want to get it out,
lay on your left side

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because then the air bubble
actually can go out quite nicely.

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- [display belches]
- [laughs]

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Whee! [laughs]

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And then if I were a food particle,
and I would arrive at the small intestine,

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then all these folds and villi
would stick out,

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and I would be like, "Ah!"

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And I could be, like, digested
and be taken up into the blood.

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What's interesting is that
we can't digest on our own.

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We need microbes
in order to do that properly.

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The tiniest virus
works with the small bacteria,

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works with a much larger yeast,
works with a super big human,

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and this is what we call the microbiome.

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[microbes chittering]

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{\an8}[Giulia] Most people think
that bacteria are bad,

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but, actually, 99% of them
don't do anything to us,

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and some can even help us.

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[microbes chittering]

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Some bacteria have more important roles
than we could have imagined.

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If we let them live on us,
they'll actually lend us their skills.

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They help with digesting our food.

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[microbe] Yummy!

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{\an8}They help to quiet inflammation
and make the immune system less likely

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{\an8}to cause autoimmune disease.

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[man] Approximately 70%
of our immune system lives in our gut.

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Bacteria train that immune system

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to respond to bad organisms
that might have a consequence on health.

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Ouch!

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{\an8}They help produce chemicals
which we can't.

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[woman] Microbes can shape our hormones,
and they can make us feel hungry or full.

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{\an8}They can be communicating with the brain.
They're communicating with other organs.

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They shape our brain
early in life and as we get older.

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- [beeping]
- [electricity crackling]

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[John] If you looked at the genes
in and on our bodies,

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we would be more than 99% microbial.

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[Giulia] We oftentimes believe that
our human genes determine our health,

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but now we know that the microbiome
is very central to being obese,

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being depressed, having allergies,
or how stressed or relaxed you'll feel.

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We don't know how big is the part
that it plays in these entities.

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For some people,
it might be really relevant,

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and for others, it might be smaller.

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[male producer] Take one.

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[laughs] Thank you.

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[exhales]

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[John] We may not want to admit it,

154
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but we all have problems with our gut
from time to time.

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[Jack] People differ
in their relationship to food,

156
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in their diseases,
in their response to medication,

157
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in their overall life history.

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{\an8}[Maya] If I eat pretty much anything
that's not vegetables,

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I start getting stomach pains,
which makes my job incredibly difficult.

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{\an8}[Daniell] You realize
how much you took for granted.

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{\an8}Like something as simple
as being able to poop.

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I've had to learn
to become grateful for the tiniest things.

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{\an8}[Kimmie] I've tried
to control my weight all kind of ways,

164
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{\an8}but I would lose a lot,

165
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{\an8}and I would gain
a whole lot more. [chuckles]

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[Kobi, in Japanese]
I hear people say they're hungry,

167
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and they look very happy
after they've eaten.

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I'm jealous of those people
because I no longer feel hunger.

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[Jack, in English] We're trying
to understand what's going on

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00:10:03,978 --> 00:10:06,731
with all this variance
that makes people different.

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00:10:07,315 --> 00:10:09,275
We think the microbiome is key to that.

172
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[microbes chittering]

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In order for us
to understand our differences,

174
00:10:15,406 --> 00:10:19,160
we have to first look at
where our microbes come from.

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[microbes chittering]

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[woman] You're born
largely without microbes.

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{\an8}Microbes colonize you
once you enter the world.

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00:10:28,919 --> 00:10:30,671
[baby cooing]

179
00:10:30,755 --> 00:10:34,967
[Giulia] When we're born, this is really
the moment where it tips off everything.

180
00:10:35,926 --> 00:10:37,970
[Erica] When a baby is born vaginally,

181
00:10:38,054 --> 00:10:41,474
they're being exposed
to the bacteria in the mom's vagina.

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00:10:43,934 --> 00:10:45,519
[Giulia] And then, when you come out,

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00:10:45,603 --> 00:10:48,147
the face is going down
in the direction to the butt.

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00:10:49,231 --> 00:10:53,235
You also get some gut bacteria
because you're so close by the butt

185
00:10:53,319 --> 00:10:56,656
that you already get
your first microbial colonists.

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00:10:57,573 --> 00:11:00,785
And they start making this
a habitable place to live

187
00:11:00,868 --> 00:11:02,370
for other microbes.

188
00:11:02,453 --> 00:11:04,163
[uplifting ethereal music playing]

189
00:11:04,246 --> 00:11:06,248
[microbes chittering]

190
00:11:11,712 --> 00:11:15,424
[Giulia] We shape our microbiome
by all the little choices and adventures

191
00:11:15,508 --> 00:11:17,051
we have in our life.

192
00:11:17,843 --> 00:11:20,971
Whoever we kiss, what we put
in our mouth, where we travel.

193
00:11:21,555 --> 00:11:22,682
[Annie] The food you eat,

194
00:11:22,765 --> 00:11:24,892
the relationships you have
with your siblings,

195
00:11:24,975 --> 00:11:29,772
whether you have pets, exercise, stress,

196
00:11:29,855 --> 00:11:33,567
{\an8}your experiences when you were a child,
whether you had adversity or not.

197
00:11:34,151 --> 00:11:37,405
[Jack] Because of this,
everybody has a unique microbiome.

198
00:11:37,488 --> 00:11:40,616
[Giulia] So it's sort of this collection
of microbial memories.

199
00:11:42,201 --> 00:11:46,997
[man] Knowing that the microbiome could be
the key to health is really exciting,

200
00:11:47,081 --> 00:11:49,709
because you can't change your genes,

201
00:11:49,792 --> 00:11:53,671
{\an8}but all of us have the ability
to change our own microbes

202
00:11:53,754 --> 00:11:57,425
{\an8}through simple changes
to our diet and our lifestyle.

203
00:11:57,508 --> 00:11:58,718
[upbeat music playing]

204
00:11:58,801 --> 00:12:00,886
Perfectly greasy. Oh my God.

205
00:12:00,970 --> 00:12:05,558
{\an8}The industrialized microbiome
is probably pretty unhealthy

206
00:12:05,641 --> 00:12:09,687
{\an8}and may be pushing us towards a lot
of our most common and serious diseases.

207
00:12:09,770 --> 00:12:10,813
[stomach gurgling]

208
00:12:10,896 --> 00:12:13,816
{\an8}That could result
in a lot of these chronic diseases

209
00:12:13,899 --> 00:12:15,985
{\an8}that are very, very prevalent,

210
00:12:16,068 --> 00:12:18,946
like obesity, diabetes,

211
00:12:19,029 --> 00:12:22,116
hypertension, food allergies.

212
00:12:23,367 --> 00:12:28,205
{\an8}So, I think the way we think
about disease needs to change.

213
00:12:28,289 --> 00:12:29,790
- [woman gasps]
- [man gulps]

214
00:12:31,751 --> 00:12:34,879
[Justin] Big changes to our environment,
Western diet,

215
00:12:34,962 --> 00:12:37,673
the way babies are born, C-sections,

216
00:12:37,757 --> 00:12:39,133
baby formula,

217
00:12:39,216 --> 00:12:41,969
sanitation, antibiotics

218
00:12:42,052 --> 00:12:44,805
all lead to decreased
microbiome diversity.

219
00:12:45,347 --> 00:12:48,184
Exactly what we see
in the industrialized microbiome.

220
00:12:49,602 --> 00:12:53,439
I was a C-section baby,
who was breastfed for...

221
00:12:53,522 --> 00:12:55,357
I'm not entirely sure for how long.

222
00:12:55,441 --> 00:12:58,277
I'm always running
for my children or my job,

223
00:12:58,360 --> 00:13:00,154
so I'm always super stressed out.

224
00:13:01,071 --> 00:13:05,242
Five-time Nathan's Famous champion,
Takeru Kobayashi!

225
00:13:06,786 --> 00:13:10,915
[Kobi, in Japanese] I don't think
there's anything healthy

226
00:13:10,998 --> 00:13:14,502
about what I do. [laughs]

227
00:13:15,419 --> 00:13:21,091
I wonder what damage I've done to my body.

228
00:13:22,843 --> 00:13:24,011
[Homer gulps]

229
00:13:24,595 --> 00:13:27,014
[Maya, in English]
It does make me kind of wonder

230
00:13:27,097 --> 00:13:30,726
how that affects your health
and what that does to your microbiome.

231
00:13:30,810 --> 00:13:31,644
[microbes chittering]

232
00:13:31,727 --> 00:13:34,230
[Justin] We've lost hundreds of species
in our gut.

233
00:13:34,313 --> 00:13:35,898
They've gone extinct.

234
00:13:35,981 --> 00:13:40,319
And what we're realizing now
is that the most important factors

235
00:13:40,402 --> 00:13:44,323
of determining the health
of this microbial community is your diet.

236
00:13:45,699 --> 00:13:50,412
There are some major deficiencies
in the typical American diet,

237
00:13:50,496 --> 00:13:53,165
even the typical American diet
that's healthy.

238
00:13:57,962 --> 00:13:59,964
[pensive music playing]

239
00:14:00,965 --> 00:14:05,052
Currently in the States,
nearly 60% of all the calories eaten

240
00:14:05,135 --> 00:14:07,596
are ultra-processed food.

241
00:14:09,473 --> 00:14:11,058
The food is ultra-refined.

242
00:14:11,141 --> 00:14:15,479
It's been stripped of all its nutrients
of the original natural ingredients,

243
00:14:15,563 --> 00:14:19,191
and then they add back in
all types of chemicals

244
00:14:19,275 --> 00:14:21,151
and large amounts of sugars.

245
00:14:21,861 --> 00:14:26,198
But people are confused about what to eat
because it's made to look healthy

246
00:14:26,282 --> 00:14:30,160
by adding labels on the packet
that say this is low-cal

247
00:14:30,244 --> 00:14:32,663
and therefore healthy,
or this has extra vitamins.

248
00:14:35,082 --> 00:14:37,751
When you look at
some of these labels in detail,

249
00:14:37,835 --> 00:14:41,463
really hard to work out
what's actually inside them.

250
00:14:42,256 --> 00:14:44,096
That's actually not too bad,
that one. [laughs]

251
00:14:44,174 --> 00:14:46,552
[director] It's not?
I looked at it. It has tons of sugar.

252
00:14:46,635 --> 00:14:48,762
[Tim] Does it? I couldn't see.

253
00:14:49,513 --> 00:14:51,473
It's 30% sugar. Yep.

254
00:14:51,557 --> 00:14:54,018
Just looking at this, it's fiber-packed,

255
00:14:54,101 --> 00:14:57,187
it's got fruit and nuts, it's got
dark chocolate, it's got sea salt.

256
00:14:57,271 --> 00:14:59,899
This to me, first look,
it looks pretty good.

257
00:14:59,982 --> 00:15:01,859
It's only when you
look into the ingredients,

258
00:15:01,942 --> 00:15:04,028
you see, "Oh! That is far too sugary."

259
00:15:04,945 --> 00:15:07,364
[chuckling] You... You see? I was fooled.

260
00:15:09,074 --> 00:15:12,077
[Maya] It's hard to navigate
what you should be eating

261
00:15:12,578 --> 00:15:14,455
because you go to the supermarket,

262
00:15:14,538 --> 00:15:20,961
and the lists of powders and tonics
and things that you need just grows.

263
00:15:21,045 --> 00:15:22,922
[reporter 1] <i>Can chlorophyll
prevent cancer?</i>

264
00:15:23,005 --> 00:15:24,548
{\an8}[reporter 2] <i>Medicinal mushrooms...</i>

265
00:15:24,632 --> 00:15:27,444
- [reporter 3] <i>Red wine's healthy...</i>
- [reporter 4] <i>Probiotics for your vagina.</i>

266
00:15:27,468 --> 00:15:29,261
[reporters overlapping]
<i>Spirulina. Chocolate.</i>

267
00:15:29,345 --> 00:15:30,846
<i>Collagen. Blueberry extract. Coffee!</i>

268
00:15:31,513 --> 00:15:37,227
So, yeah. I find the food world
and wellness culture incredibly confusing.

269
00:15:41,440 --> 00:15:44,860
[young Maya in video]
<i>Today we're gonna make teriyaki chicken.</i>

270
00:15:44,944 --> 00:15:48,530
<i>We have... We have garlic, ginger, sugar,</i>

271
00:15:48,614 --> 00:15:52,576
{\an8}<i>soy sauce, sesame oil, and onions.</i>

272
00:15:53,702 --> 00:15:56,497
{\an8}<i>- First, you...</i>
- You have great confidence, I have to say.

273
00:15:56,580 --> 00:15:59,583
{\an8}- I was a confident cook when I was four.
- [laughing]

274
00:15:59,667 --> 00:16:05,422
<i>Some soy sauce, a lot of ginger because
we can't get enough of that ginger.</i>

275
00:16:05,506 --> 00:16:06,674
<i>All of the garlic,</i>

276
00:16:06,757 --> 00:16:10,427
<i>because we never can get enough
of garlic either.</i>

277
00:16:10,511 --> 00:16:12,846
Cooking and food is truly in my blood,

278
00:16:12,930 --> 00:16:15,391
and it's something
I've been doing since I was really little.

279
00:16:16,725 --> 00:16:19,395
And now it's my passion
and my art and my career.

280
00:16:23,065 --> 00:16:26,944
I received my first Michelin star
when I was 23.

281
00:16:27,987 --> 00:16:32,950
I won Eater's Hottest Chef.
So ridiculous that that was even a thing.

282
00:16:33,659 --> 00:16:36,370
But you do feel the need
to cultivate this image

283
00:16:36,453 --> 00:16:40,124
of the goth, cute pastry chef
with tattoos.

284
00:16:40,207 --> 00:16:43,377
There was just a massive amount
of pressure on me,

285
00:16:43,460 --> 00:16:48,090
and so then I kind of
just let it get out of control.

286
00:16:48,173 --> 00:16:49,383
[gentle music playing]

287
00:16:51,552 --> 00:16:56,390
[Maya] I was really anorexic
for a long time.

288
00:16:57,933 --> 00:17:02,771
But now, my eating disorder
has kind of shifted to orthorexia,

289
00:17:02,855 --> 00:17:08,360
where I'm very obsessed with wellness
and maximizing your nutrition.

290
00:17:09,403 --> 00:17:13,115
So this is, yeah, like,
guarana, suma, reishi, lion's mane,

291
00:17:13,198 --> 00:17:16,535
<i>Cordyceps,</i> the spirulina,
<i>Chlorella,</i> moringa.

292
00:17:18,287 --> 00:17:19,788
Basically, I eat a lot of vegetables

293
00:17:19,872 --> 00:17:22,458
and then supplement it
with potions and powders

294
00:17:22,541 --> 00:17:25,169
and things that the Internet tells me
that I probably need.

295
00:17:28,839 --> 00:17:31,216
I have taken so many things out of my diet

296
00:17:31,300 --> 00:17:34,636
and tried to reintroduce,
you know, "fun foods."

297
00:17:36,221 --> 00:17:39,516
But when I eat sugar,
pork, butter, things like that,

298
00:17:39,600 --> 00:17:42,394
then I feel bloated,
and I feel like I have to throw up

299
00:17:42,478 --> 00:17:44,521
for three, four days afterwards.

300
00:17:46,690 --> 00:17:50,402
Which is really hard because I am trying
to fix my relationship with food.

301
00:17:51,445 --> 00:17:55,074
And then when it feels like
your body is betraying you,

302
00:17:55,991 --> 00:17:57,785
it's, um...

303
00:17:57,868 --> 00:18:01,163
It's hard to... to get past that.

304
00:18:01,246 --> 00:18:02,748
[gentle music continues]

305
00:18:06,335 --> 00:18:09,797
[Maya] I think ultimately
I would really love to know

306
00:18:10,380 --> 00:18:13,008
what I should be eating,
or what I shouldn't be eating,

307
00:18:13,717 --> 00:18:16,887
and what healthy is for me, specifically.

308
00:18:23,310 --> 00:18:27,064
[Giulia] When my patients ask me,
"What makes a microbiome healthy?"

309
00:18:27,147 --> 00:18:28,982
I like to compare it to a forest.

310
00:18:31,443 --> 00:18:35,489
You can't put a few healthy plants in it
and expect everything to change.

311
00:18:36,573 --> 00:18:38,617
A forest needs a healthy balance

312
00:18:38,700 --> 00:18:43,956
where the plants and the life can be okay
with the circumstances,

313
00:18:44,039 --> 00:18:47,000
with the light, with the water,
with the nutrients from the soil

314
00:18:47,084 --> 00:18:48,919
and function together.

315
00:18:51,797 --> 00:18:55,217
Our gut bacteria,
they want just a few grams of fiber

316
00:18:55,300 --> 00:18:58,095
from vegetables and fruits every day,

317
00:18:58,178 --> 00:19:02,432
and it's weird
that it's so hard for us to manage this.

318
00:19:03,392 --> 00:19:06,145
[Justin] Current recommendations
in the United States suggest

319
00:19:06,228 --> 00:19:10,524
{\an8}that we should be eating
28 to 40 grams of dietary fiber per day.

320
00:19:10,607 --> 00:19:14,653
{\an8}And we're only eating
15 grams in the average American diet.

321
00:19:14,736 --> 00:19:17,489
{\an8}The field of microbiome science
is realizing

322
00:19:17,573 --> 00:19:22,202
{\an8}that we probably should be eating
in excess of 50 grams per day.

323
00:19:56,278 --> 00:19:58,906
[in Japanese] How much fiber
is in one hot dog?

324
00:20:00,699 --> 00:20:02,409
[scoffs] What? Zero grams!

325
00:20:02,492 --> 00:20:03,577
[laughs]

326
00:20:05,829 --> 00:20:08,332
[Tim, in English] Whether you have meat
on your plate or not...

327
00:20:08,415 --> 00:20:11,210
You can be vegan, non-vegan.
Doesn't matter.

328
00:20:11,293 --> 00:20:15,964
The key is getting the diversity
of plants in all their forms,

329
00:20:16,048 --> 00:20:19,635
as many as you can
on your plate to feed your microbes.

330
00:20:21,428 --> 00:20:23,555
Why should I eat my veggies? You know?

331
00:20:23,639 --> 00:20:26,934
I'm a big fan of understanding this.
Of course, there are many nutrients in it,

332
00:20:27,017 --> 00:20:29,728
and not so many bad things
that are in processed foods.

333
00:20:32,564 --> 00:20:35,234
But also if the front part
of your body was see-through,

334
00:20:35,317 --> 00:20:39,529
you could actually see digestion,
and you would be able to very easily see

335
00:20:39,613 --> 00:20:42,199
the difference
between processed foods and vegetables.

336
00:20:43,450 --> 00:20:45,160
With processed foods, you could see

337
00:20:45,244 --> 00:20:47,829
that within the first centimeters
of the small intestine,

338
00:20:47,913 --> 00:20:50,123
it's basically all taken up in the blood.

339
00:20:51,541 --> 00:20:54,127
There's a surge of sugar
in the bloodstream,

340
00:20:54,211 --> 00:20:56,380
and we have to pack it
in the cells really fast.

341
00:20:56,463 --> 00:20:59,716
It's, like, almost a stressful event,
actually, for the body,

342
00:20:59,800 --> 00:21:02,844
because, "Where should I put
all this sugar?" You know?

343
00:21:02,928 --> 00:21:04,596
It has to really push it everywhere.

344
00:21:05,764 --> 00:21:08,183
But with the fiber
that we have in vegetables,

345
00:21:08,267 --> 00:21:09,935
it's just more stable.

346
00:21:10,894 --> 00:21:13,981
It would be taken up a little bit,
go further,

347
00:21:14,064 --> 00:21:15,857
be taken up a little bit, go further.

348
00:21:15,941 --> 00:21:17,776
It would even land in the colon

349
00:21:17,859 --> 00:21:21,280
and would be a good source of food
for the microbes there.

350
00:21:21,363 --> 00:21:22,197
[microbe] Delicious!

351
00:21:22,281 --> 00:21:24,825
[Giulia] So it's
a completely different mode of digesting.

352
00:21:24,908 --> 00:21:27,828
You know,
like a long walk instead of sprinting.

353
00:21:32,291 --> 00:21:36,962
If a gut microbiome is very diverse,
has many different kinds of bacteria,

354
00:21:37,045 --> 00:21:39,339
it'll just have
this bouquet of possibilities

355
00:21:39,423 --> 00:21:41,883
to react to what life throws at us.

356
00:21:44,803 --> 00:21:46,179
[tense music playing]

357
00:21:54,688 --> 00:22:00,027
[upbeat, quirky 1960's music playing]

358
00:22:00,110 --> 00:22:03,280
[announcer] <i>Kobayashi continues
to just pound 'em down.</i>

359
00:22:05,365 --> 00:22:09,411
<i>Putting on a clinic.
Look at him go. He's moving his arms and...</i>

360
00:22:09,995 --> 00:22:14,708
[John] So what happens if we don't eat
enough fiber to feed these microbes?

361
00:22:14,791 --> 00:22:17,169
[announcer] <i>Takeru Kobayashi!</i>

362
00:22:17,252 --> 00:22:20,297
If you're not feeding
your gut microbes dietary fiber,

363
00:22:20,380 --> 00:22:22,716
your gut microbes will start eating you.

364
00:22:22,799 --> 00:22:24,926
[microbes chittering]

365
00:22:25,010 --> 00:22:28,221
[Giulia] All these microbes are great.
They help your body a lot.

366
00:22:29,556 --> 00:22:30,974
But they're also microbes.

367
00:22:31,058 --> 00:22:34,895
So there has to be a friendly border
of respect, and this is produced by mucus.

368
00:22:35,979 --> 00:22:39,274
Mucus is a good way of doing that
because it's also a bit permeable,

369
00:22:39,358 --> 00:22:41,902
{\an8}so nutrients and everything
can come through,

370
00:22:41,985 --> 00:22:45,072
{\an8}but the microbes
are being held a little bit distant.

371
00:22:46,156 --> 00:22:48,950
[Justin] Well, it turns out
if you stop eating dietary fiber...

372
00:22:49,034 --> 00:22:49,951
[microbe] No! No! No!

373
00:22:50,035 --> 00:22:52,954
[Justin]...the gut microbes
still need to eat something,

374
00:22:53,038 --> 00:22:57,084
so they will start eating
that mucus lining as a backup food source.

375
00:22:58,335 --> 00:23:01,546
And gradually, over time,
they'll deplete that mucus lining.

376
00:23:02,381 --> 00:23:05,717
Your bacteria are going
to places in the body

377
00:23:05,801 --> 00:23:07,260
where they're not supposed to go.

378
00:23:08,428 --> 00:23:11,765
[Giulia] And when immune cells
that reside there see that,

379
00:23:11,848 --> 00:23:14,017
- they go into a defense mode.
- [horn sounding]

380
00:23:14,101 --> 00:23:15,102
[roaring]

381
00:23:15,185 --> 00:23:17,854
[Giulia] And this can cause
a battle of inflammation,

382
00:23:17,938 --> 00:23:21,983
and it can change
the microbial composition of your gut.

383
00:23:22,692 --> 00:23:26,071
And that is one of the things
that can lead to many diseases

384
00:23:26,154 --> 00:23:28,031
like inflammatory bowel disease,

385
00:23:28,115 --> 00:23:30,826
or some types of irritable bowel syndrome.

386
00:23:30,909 --> 00:23:32,452
[foreboding music playing]

387
00:23:33,537 --> 00:23:34,746
[gurgling]

388
00:23:36,039 --> 00:23:39,584
[Giulia] When we started
to explore chronic inflammatory diseases,

389
00:23:39,668 --> 00:23:42,003
scientists had this thought of,

390
00:23:42,087 --> 00:23:45,173
can we find <i>the</i> microbe
or the microbial community

391
00:23:45,257 --> 00:23:49,177
that makes this disease
or creates that feeling that's bad?

392
00:23:49,845 --> 00:23:53,598
But now when we think about
how this ecosystem interacts,

393
00:23:53,682 --> 00:23:57,436
we have this newer approach
where we also ask ourselves

394
00:23:57,519 --> 00:24:01,356
if we are missing certain bacteria
that are usually there to protect us.

395
00:24:01,440 --> 00:24:02,941
[chainsaw running]

396
00:24:14,411 --> 00:24:16,371
My name is Daniell Koepke,

397
00:24:16,455 --> 00:24:20,750
{\an8}and I am a clinical psychology
doctoral student.

398
00:24:21,751 --> 00:24:25,046
It's really hard for me to remember
what it was like to eat food

399
00:24:25,130 --> 00:24:31,011
before it became associated
with anxiety and pain and discomfort.

400
00:24:32,137 --> 00:24:36,475
When I was in undergrad,
I had a pretty bad diet.

401
00:24:37,017 --> 00:24:40,228
And that diet, the high-sugar foods

402
00:24:40,312 --> 00:24:43,690
and the absence
of more fruits and vegetables,

403
00:24:43,773 --> 00:24:45,650
led to IBS-like symptoms.

404
00:24:46,234 --> 00:24:48,737
So I was experiencing indigestion,

405
00:24:48,820 --> 00:24:51,114
stabbing pains from trapped gas,

406
00:24:51,198 --> 00:24:54,242
constipation, not being able
to go to the bathroom at all.

407
00:24:55,952 --> 00:25:00,624
When you have multiple gut symptoms
that can't be easily put into a box,

408
00:25:00,707 --> 00:25:03,251
a lot of doctors don't know what to do.

409
00:25:03,335 --> 00:25:04,377
[video game sound effects]

410
00:25:04,461 --> 00:25:07,130
[Daniell] Antibiotics are given out
like candy.

411
00:25:07,214 --> 00:25:09,466
"You don't feel good
or think you might have this thing?"

412
00:25:09,549 --> 00:25:10,800
"Here. Take some antibiotics."

413
00:25:12,344 --> 00:25:17,057
In the last five years, I've been on
six rounds of antibiotics in a year.

414
00:25:18,099 --> 00:25:18,934
[explosion]

415
00:25:19,017 --> 00:25:21,937
I lost a lot of weight
when I started getting sick

416
00:25:22,020 --> 00:25:24,481
and had to cut all of these things
out of my diet.

417
00:25:26,274 --> 00:25:28,193
I don't know
how many things I can eat now,

418
00:25:28,276 --> 00:25:32,239
but it's probably
anywhere between 10 and 15.

419
00:25:33,365 --> 00:25:39,496
It feels really limiting,
and I often feel really deprived.

420
00:25:41,623 --> 00:25:47,963
So I have to take these supplements
to maintain my baseline functioning.

421
00:25:49,422 --> 00:25:51,967
These are even more supplements
that... [chuckles wryly]

422
00:25:52,050 --> 00:25:55,929
...I've taken in the past
that no longer work. Um...

423
00:25:56,471 --> 00:25:58,515
I know that pills aren't the answer,

424
00:25:58,598 --> 00:26:04,813
{\an8}but I feel stuck because I don't know
how to grow these new bacteria that I need

425
00:26:04,896 --> 00:26:07,315
{\an8}when I can't eat a lot of these foods, uh,

426
00:26:07,399 --> 00:26:10,860
{\an8}that are required
to, like, have a healthy gut microbiome.

427
00:26:10,944 --> 00:26:12,445
[somber music playing]

428
00:26:13,238 --> 00:26:18,285
[Giulia] If we cut foods out of our diet,
we'll change our microbes drastically,

429
00:26:19,119 --> 00:26:21,746
because who can live there
if you don't feed them?

430
00:26:22,747 --> 00:26:23,790
[sighs sadly]

431
00:26:24,291 --> 00:26:27,002
[Giulia] And if we want
to reintroduce fiber,

432
00:26:27,085 --> 00:26:29,087
we'll have a far more difficult time.

433
00:26:29,170 --> 00:26:30,171
[microbes gagging]

434
00:26:30,255 --> 00:26:34,301
[Giulia] So people who suddenly
eat healthy again will be bloated,

435
00:26:34,384 --> 00:26:36,344
will have some stomach pain.

436
00:26:37,137 --> 00:26:40,473
So it's a process of changing their diet,
but not too drastically,

437
00:26:40,557 --> 00:26:44,519
in a way that all the microbes
in the gut can adjust.

438
00:26:46,730 --> 00:26:49,608
[Maya] Since I've had
such a restrictive diet,

439
00:26:50,567 --> 00:26:56,656
I wonder was I also starving
the microbes in my body at the same time?

440
00:26:58,491 --> 00:27:01,328
And has that changed
how my body can process foods,

441
00:27:01,411 --> 00:27:03,872
and does that mean, like, my future,

442
00:27:03,955 --> 00:27:06,499
I'm always going to have issues
with eating something,

443
00:27:07,751 --> 00:27:10,211
or is it partially a mental block?

444
00:27:10,295 --> 00:27:13,923
I'm not really sure... [chuckles]
...what's going on.

445
00:27:15,342 --> 00:27:18,386
It's something that I would love
to actually learn more about.

446
00:27:27,062 --> 00:27:29,064
Oh. Cool.

447
00:27:29,147 --> 00:27:30,690
[phones dinging, beeping]

448
00:27:30,774 --> 00:27:32,275
- [engine roars]
- [brakes screech]

449
00:27:32,359 --> 00:27:33,860
[doorbell rings]

450
00:27:36,029 --> 00:27:37,447
[upbeat synth music playing]

451
00:27:46,665 --> 00:27:47,957
{\an8}[Maya] It's like Christmas.

452
00:27:48,583 --> 00:27:50,251
{\an8}[in Japanese] I wonder what this is.

453
00:27:50,960 --> 00:27:52,212
[in English] Oh no.

454
00:27:54,923 --> 00:27:55,923
[laughs]

455
00:27:56,341 --> 00:27:59,552
It's weird. All of a sudden,
I don't care about being healthy anymore.

456
00:28:01,137 --> 00:28:03,973
"Collect one scoop of solid stool..."

457
00:28:04,057 --> 00:28:05,058
[laughs]

458
00:28:05,141 --> 00:28:07,102
"...or four scoops of liquid..." Ooh!

459
00:28:07,185 --> 00:28:08,520
"...into tube."

460
00:28:09,229 --> 00:28:10,480
"Mix well."

461
00:28:10,563 --> 00:28:13,066
It's like the world's grossest recipe.

462
00:28:13,692 --> 00:28:17,320
[in Japanese] Ooh! This is like a spoon.

463
00:28:17,987 --> 00:28:19,572
I guess you do this.

464
00:28:21,074 --> 00:28:22,992
[Maya, in English]
I've always found the idea

465
00:28:23,076 --> 00:28:24,994
of gut testing really fascinating.

466
00:28:25,578 --> 00:28:28,081
It would be awesome if I could understand

467
00:28:28,164 --> 00:28:29,916
what's happening in my own body.

468
00:28:31,251 --> 00:28:34,129
[Kimmie] I've tried
so many different things to lose weight.

469
00:28:34,838 --> 00:28:37,090
Hopefully, this might be the thing for me.

470
00:28:37,757 --> 00:28:41,052
[Kobi, in Japanese] I want the test
to tell me why I don't have an appetite.

471
00:28:41,136 --> 00:28:44,764
And about the relationship
between my organs and eating.

472
00:28:45,557 --> 00:28:48,810
[Giulia, in English] I've never had
my gut microbiome tested.

473
00:28:48,893 --> 00:28:52,939
I don't think, at this point of time,
it makes a lot of sense.

474
00:28:53,815 --> 00:28:55,817
All the things you can do
to have a healthy gut,

475
00:28:55,900 --> 00:28:58,903
eating differently,
treating your gut nicer,

476
00:28:58,987 --> 00:29:02,574
you can do them
without having an analysis first.

477
00:29:03,158 --> 00:29:03,992
[toilet flushes]

478
00:29:04,075 --> 00:29:06,578
But if you just want to do
a fun experiment, go ahead.

479
00:29:06,661 --> 00:29:09,164
And for research, it's a great tool.

480
00:29:15,712 --> 00:29:18,173
[Jack] At the beginning
of microbiome science,

481
00:29:18,256 --> 00:29:20,341
we were really our own guinea pigs.

482
00:29:21,259 --> 00:29:24,512
So myself and my colleagues
were collecting our own poop

483
00:29:24,596 --> 00:29:26,264
and sticking it in freezers.

484
00:29:28,057 --> 00:29:31,728
{\an8}So you take a little piece of used
toilet paper, you color the piece you swab

485
00:29:31,811 --> 00:29:33,980
{\an8}with a little bit of poop,
make it a bit brown,

486
00:29:34,063 --> 00:29:35,732
then we extract the DNA from that.

487
00:29:35,815 --> 00:29:39,694
But now we've expanded
to thousands of thousands of samples

488
00:29:39,778 --> 00:29:41,780
from thousands of people
around the United States

489
00:29:41,863 --> 00:29:43,364
and, indeed, around the world now.

490
00:29:47,577 --> 00:29:50,914
If you gave me your microbiome sample,
I wouldn't be able to tell you

491
00:29:50,997 --> 00:29:54,292
a hell of a lot
about how sick or healthy you are.

492
00:29:54,959 --> 00:29:59,464
I can only do that by comparing you
to a really large group of people

493
00:29:59,547 --> 00:30:00,757
and seeing how you fit.

494
00:30:02,342 --> 00:30:05,470
Does your microbiome
look like people who have asthma?

495
00:30:05,553 --> 00:30:06,554
Do you have asthma?

496
00:30:06,638 --> 00:30:08,973
Does your microbiome
look like people who are obese?

497
00:30:09,057 --> 00:30:10,475
Are you obese?

498
00:30:10,558 --> 00:30:12,685
If that's true,
then I can find a signature,

499
00:30:12,769 --> 00:30:14,479
which can help me unpin that.

500
00:30:15,814 --> 00:30:20,193
[man] Each teaspoon of stool contains
terabytes and terabytes of information

501
00:30:20,276 --> 00:30:22,779
encoded in the DNA of the microbes.

502
00:30:22,862 --> 00:30:27,450
{\an8}So each dot on the screen represents
all the complexity of the microbiome

503
00:30:27,534 --> 00:30:30,662
{\an8}of one person distilled
just down to one point.

504
00:30:31,955 --> 00:30:34,374
So what this display shows you

505
00:30:34,457 --> 00:30:37,210
is what kinds of microbes
are shared between samples.

506
00:30:37,293 --> 00:30:39,295
So two samples that are close together

507
00:30:39,379 --> 00:30:42,590
are ones that have
very similar microbial communities,

508
00:30:42,674 --> 00:30:44,259
whereas samples that are far apart

509
00:30:44,342 --> 00:30:46,636
have entirely distinct communities
from one another.

510
00:30:50,181 --> 00:30:52,642
[Justin] When we started
studying the gut microbiome,

511
00:30:52,725 --> 00:30:54,352
the field assumed

512
00:30:54,435 --> 00:30:57,856
that if we looked at the gut microbiome
of healthy Americans,

513
00:30:57,939 --> 00:31:01,860
we would get a good picture
of what a healthy microbiome is.

514
00:31:04,946 --> 00:31:08,157
This visualization shows
the differences between microbes

515
00:31:08,241 --> 00:31:11,077
{\an8}of the industrialized world
down at the bottom,

516
00:31:11,160 --> 00:31:14,664
{\an8}versus the less industrial world
up on the top there.

517
00:31:15,623 --> 00:31:19,669
{\an8}What you can see so clearly is how,
in the non-industrialized microbiome,

518
00:31:19,752 --> 00:31:21,421
{\an8}you have more diversity.

519
00:31:22,881 --> 00:31:26,050
{\an8}[Aashish] So if we only focus
on the Western world,

520
00:31:26,134 --> 00:31:28,136
{\an8}then we are not getting a full picture

521
00:31:28,219 --> 00:31:32,223
{\an8}of what a healthy gut microbiome
composition looks like,

522
00:31:32,307 --> 00:31:33,850
{\an8}or looked like in the past.

523
00:31:46,362 --> 00:31:49,073
[in Nepali] It's difficult to walk here.

524
00:31:52,577 --> 00:31:55,288
[in English] We're going
to traditional communities

525
00:31:55,371 --> 00:31:59,208
and asking people
to donate their... their... their poop.

526
00:31:59,292 --> 00:32:01,169
- Namaste.
- Namaste.

527
00:32:01,252 --> 00:32:03,755
[Aashish and woman speaking Nepali]

528
00:32:03,838 --> 00:32:05,757
[Aashish, in English]
When we go to communities

529
00:32:05,840 --> 00:32:07,383
and say "Can we collect your poop?"

530
00:32:07,467 --> 00:32:11,012
Most of the time people are like,
"Oh no, no, no. Poop? No. Poop, no."

531
00:32:12,055 --> 00:32:17,602
But when I explain to them what I'm doing,
they're like, "Sure. Why not?"

532
00:32:20,146 --> 00:32:22,148
[toilet flushing]

533
00:32:23,149 --> 00:32:27,403
[Justin] It turns out that
the gut microbiome of rural populations

534
00:32:27,487 --> 00:32:29,280
have hundreds of more species

535
00:32:29,364 --> 00:32:32,825
that we just don't see
in the industrialized gut microbiome.

536
00:32:34,911 --> 00:32:40,375
By studying populations that are
still practicing traditional lives,

537
00:32:40,458 --> 00:32:42,460
we will begin to understand

538
00:32:42,543 --> 00:32:46,714
what microbes have been lost
from industrial populations,

539
00:32:47,423 --> 00:32:50,134
and how this is influencing
our overall health.

540
00:32:56,140 --> 00:32:58,518
[video call ringing, connects]

541
00:32:58,601 --> 00:33:00,144
{\an8}We ready? [laughs]

542
00:33:00,228 --> 00:33:01,980
{\an8}Hi, Maya. Nice to meet you.

543
00:33:02,063 --> 00:33:05,316
{\an8}So would you like
to discuss your results now?

544
00:33:05,400 --> 00:33:06,651
Sure. Yeah.

545
00:33:06,734 --> 00:33:10,863
{\an8}What we found in our studies
is that overall, you're pretty healthy.

546
00:33:10,947 --> 00:33:12,740
It's definitely above average.

547
00:33:12,824 --> 00:33:15,660
{\an8}All those vegetables you're eating
every week have not gone to waste.

548
00:33:15,743 --> 00:33:16,577
{\an8}[chuckles] Cool.

549
00:33:16,661 --> 00:33:20,790
{\an8}You know, I've also struggled with having
a disordered relationship with eating.

550
00:33:20,873 --> 00:33:23,710
I've always been very,
kind of, restrictive in my diet.

551
00:33:23,793 --> 00:33:26,087
{\an8}So, Maya, yeah,
many people think like you,

552
00:33:26,170 --> 00:33:30,425
{\an8}that just having
a really healthy kale salad every day

553
00:33:30,508 --> 00:33:32,552
{\an8}is going to keep them healthy.

554
00:33:32,635 --> 00:33:35,179
That's not as healthy as we thought.

555
00:33:35,263 --> 00:33:40,018
The more diversity you consume,
the more rich your microbiome will be,

556
00:33:40,101 --> 00:33:43,062
the more species of bacteria
that will be present inside your gut.

557
00:33:43,146 --> 00:33:48,276
[Tim] And that does allow you to deal with
allergies and intolerances better.

558
00:33:48,359 --> 00:33:50,945
{\an8}- Yeah.
- It's not about restricting things.

559
00:33:51,029 --> 00:33:56,743
{\an8}It's about enlarging your world of foods
that are possible for you to eat.

560
00:33:56,826 --> 00:34:01,539
Well, I think part of the problem is that
I have some kind of, like, mental blocks

561
00:34:01,622 --> 00:34:03,374
for some foods, like pork,

562
00:34:03,458 --> 00:34:07,003
and occasionally my stomach
just reacts really poorly to it.

563
00:34:07,086 --> 00:34:09,130
{\an8}Is that something that I can overcome,

564
00:34:09,213 --> 00:34:12,925
{\an8}or is it just I'm never gonna eat bacon
ever again in my entire life?

565
00:34:13,009 --> 00:34:14,469
{\an8}Oh! Don't say that. Sounds horrible.

566
00:34:14,552 --> 00:34:16,262
[laughing]

567
00:34:16,345 --> 00:34:18,556
- Yeah. It's a struggle, right?
- Yeah.

568
00:34:18,639 --> 00:34:21,684
We do think to alleviate it,

569
00:34:21,768 --> 00:34:24,937
introducing these things
in very small doses, microdosing,

570
00:34:25,021 --> 00:34:29,150
{\an8}and then building it up over time
into large doses can play a role.

571
00:34:29,233 --> 00:34:32,779
Try small amounts,
you know, bring them into your diet.

572
00:34:32,862 --> 00:34:35,364
And if you do that gradually over months,

573
00:34:35,448 --> 00:34:40,703
you might start to regain the ability
to eat a much wider range of foods.

574
00:34:40,787 --> 00:34:44,540
I do really love the idea
of microdosing chips, though.

575
00:34:44,624 --> 00:34:46,000
{\an8}Oh man. So do I now.

576
00:34:46,084 --> 00:34:48,586
{\an8}[laughing] Yeah. Yay, that's so exciting.

577
00:34:48,669 --> 00:34:51,547
[voice breaking] I'm getting emotional
thinking about it. I'm sorry.

578
00:34:51,631 --> 00:34:52,673
[uplifting music playing]

579
00:34:52,757 --> 00:34:57,011
But yeah, it's...
it's been a really long, hard road.

580
00:35:03,017 --> 00:35:06,646
I'm really excited by the idea
of microdosing potato chips.

581
00:35:08,523 --> 00:35:11,984
You know, just changing my diet
a little bit at a time.

582
00:35:13,111 --> 00:35:13,945
And it's been fun.

583
00:35:14,028 --> 00:35:17,240
I mean, I eat, like,
three potato chips a day sometimes,

584
00:35:17,323 --> 00:35:19,158
and I don't feel bad.

585
00:35:20,243 --> 00:35:23,412
It does make me wonder
if I'm eating the right things,

586
00:35:23,496 --> 00:35:28,084
or is it, something's changing chemically
in my brain?

587
00:35:33,131 --> 00:35:35,007
[chips crunching]

588
00:35:35,091 --> 00:35:37,009
- [buzzer sounds]
- [electricity crackles]

589
00:35:45,476 --> 00:35:48,813
{\an8}[Kimmie] According to the world
and all these graphs and charts,

590
00:35:48,896 --> 00:35:53,568
because of my height and my weight,
I'm considered morbidly obese.

591
00:35:55,194 --> 00:35:56,737
I tried to control my weight before.

592
00:35:56,821 --> 00:35:59,240
I went and got
this expensive gym membership.

593
00:36:00,491 --> 00:36:01,826
I've tried diets.

594
00:36:01,909 --> 00:36:05,580
I've tried the weight loss medicine,
and it didn't work for me.

595
00:36:06,497 --> 00:36:12,086
I would lose a lot of weight at first,
and then it just comes right back.

596
00:36:14,005 --> 00:36:15,840
Diabetes runs in my family.

597
00:36:15,923 --> 00:36:17,967
So even though I'm healthy now,

598
00:36:18,050 --> 00:36:22,430
I wanna lose weight before any of that,
you know, onsets in my life.

599
00:36:22,513 --> 00:36:24,640
I wanna be here
as long as I can for my kids.

600
00:36:26,893 --> 00:36:30,229
Society, you know,
makes women feel less than

601
00:36:30,313 --> 00:36:31,522
because they're larger,

602
00:36:32,315 --> 00:36:38,863
and I'm not looking to be skinny
or 120 pounds, just more healthy.

603
00:36:39,906 --> 00:36:42,992
I'm just gonna be this plus-size diva
till the end.

604
00:36:43,075 --> 00:36:46,245
<i>♪ I'm feeling myself ♪</i>

605
00:36:46,329 --> 00:36:51,626
<i>♪ Living it up, straight to the top
I'm flexin', I'm flexin'... ♪</i>

606
00:36:51,709 --> 00:36:53,544
[motorcycle engine revs]

607
00:36:53,628 --> 00:36:55,713
[tire screeching]

608
00:36:56,339 --> 00:36:58,633
[Kimmie] You can be positive
in the body that you're in,

609
00:36:58,716 --> 00:37:02,470
but also be conscious of your health
because you ultimately need that.

610
00:37:02,553 --> 00:37:04,222
[vocalizing]

611
00:37:04,305 --> 00:37:05,640
<i>♪ I'm flexin', flexin'... ♪</i>

612
00:37:05,723 --> 00:37:08,434
[Kimmie] So my question about eating is,

613
00:37:08,517 --> 00:37:10,686
what in the world are y'all eating
that I'm not eating

614
00:37:10,770 --> 00:37:13,481
that cause y'all to lose weight
and not me? [laughing]

615
00:37:13,564 --> 00:37:15,566
[tire screeching]

616
00:37:16,442 --> 00:37:18,277
{\an8}[music fades out]

617
00:37:20,613 --> 00:37:25,326
{\an8}[doctor] As a physician,
when we try to explain to our patients

618
00:37:25,409 --> 00:37:28,788
why they're having
such a hard time losing weight,

619
00:37:28,871 --> 00:37:32,833
{\an8}we have a tendency of blaming
the individuals, blaming the patients.

620
00:37:32,917 --> 00:37:34,418
[comical music playing]

621
00:37:35,169 --> 00:37:38,673
[Eran Elinav] The population
has been doing what we were recommending

622
00:37:38,756 --> 00:37:40,091
for many decades,

623
00:37:40,174 --> 00:37:45,471
yet the obesity epidemic
has not slowed down or reversed.

624
00:37:46,264 --> 00:37:47,264
[all chomp]

625
00:37:47,723 --> 00:37:48,891
[all gobbling]

626
00:37:48,975 --> 00:37:50,851
[man] The word "diet" is really confusing.

627
00:37:50,935 --> 00:37:52,436
Low-fat versus low-carb.

628
00:37:53,187 --> 00:37:56,691
{\an8}Most people understand it
to be really a sprint that I'm gonna do

629
00:37:56,774 --> 00:37:59,318
{\an8}for some period of time to lose weight,

630
00:37:59,402 --> 00:38:02,154
and then I can go back
to my previous patterns

631
00:38:02,238 --> 00:38:04,407
of eating whatever I want to eat.

632
00:38:04,490 --> 00:38:05,491
[comical munching]

633
00:38:05,574 --> 00:38:09,578
[Eran Segal] But a diet, it's really about
changing your lifestyle for life.

634
00:38:12,873 --> 00:38:17,336
Another reason why diets don't work is
that they really focus on the wrong thing.

635
00:38:17,420 --> 00:38:21,632
And in that sense,
they actually could be misdirecting us.

636
00:38:23,843 --> 00:38:26,762
When we put these calorie labels on boxes,

637
00:38:26,846 --> 00:38:28,806
we think, "Okay,
this is the amount of energy

638
00:38:28,889 --> 00:38:31,851
that we will all extract
if we ate that same food."

639
00:38:31,934 --> 00:38:33,644
But of course, that is not true.

640
00:38:33,728 --> 00:38:35,354
[playful music playing]

641
00:38:38,107 --> 00:38:40,693
[Eran Elinav] If you would give
an identical apple

642
00:38:40,776 --> 00:38:42,611
to three different people,

643
00:38:42,695 --> 00:38:47,575
each of these individuals would show
a different response to the same apple.

644
00:38:52,913 --> 00:38:54,790
You know I can't eat this, right? [laughs]

645
00:38:55,624 --> 00:38:58,544
[Eran Segal] They will each process it
in a different way.

646
00:38:58,627 --> 00:39:02,214
They will each extract
different nutrients from it.

647
00:39:04,175 --> 00:39:06,802
They will each extract
different amounts of energies.

648
00:39:07,636 --> 00:39:10,639
[Kimmie] You go your whole life thinking,
"Okay, it's calories."

649
00:39:10,723 --> 00:39:12,600
"Me and you can eat the same thing,

650
00:39:12,683 --> 00:39:15,144
and we should both have
the same results, ultimately,"

651
00:39:15,227 --> 00:39:17,396
and that's just not what it is.

652
00:39:17,480 --> 00:39:18,773
[squeaking]

653
00:39:18,856 --> 00:39:21,609
So, rather than measuring the apple,

654
00:39:21,692 --> 00:39:24,528
one needs to start measuring
the people who eat the apple.

655
00:39:25,821 --> 00:39:27,865
[Eran Segal] Now we focus
on blood glucose levels

656
00:39:27,948 --> 00:39:29,867
in the two hours after you eat a meal

657
00:39:29,950 --> 00:39:33,704
because we understand
that your blood sugar levels after a meal

658
00:39:33,788 --> 00:39:37,458
are directly connected
to weight loss and weight gain,

659
00:39:38,292 --> 00:39:41,253
and also to the development
of multiple diseases.

660
00:39:43,714 --> 00:39:44,924
[woman] Good, good, good.

661
00:39:45,007 --> 00:39:47,134
Some cream cheese.

662
00:39:49,345 --> 00:39:51,555
{\an8}[Tim] I ought to check
my sugar levels this morning.

663
00:39:51,639 --> 00:39:52,999
[Veronique] Especially after that.

664
00:39:53,057 --> 00:39:54,433
Let's see if I beat you.

665
00:39:55,393 --> 00:39:57,186
Oh my God, you're going up really fast.

666
00:39:57,269 --> 00:39:59,581
{\an8}- Definitely beat you this time.
- [Veronique laughs] Yeah.

667
00:39:59,605 --> 00:40:01,232
{\an8}[Tim] Bagels have that effect on me.

668
00:40:01,315 --> 00:40:02,733
{\an8}[Veronique] That's okay for me.

669
00:40:07,822 --> 00:40:10,991
[Eran Segal] One of the seminal works
in the field of microbiome

670
00:40:11,075 --> 00:40:15,079
was a study led by Jeff Gordon
in which he took identical twins,

671
00:40:15,162 --> 00:40:18,374
but one twin was obese,
and the other was lean,

672
00:40:18,457 --> 00:40:23,379
and he transplanted
the gut bacteria from the obese twin

673
00:40:23,462 --> 00:40:25,714
and the lean twin into mice.

674
00:40:26,507 --> 00:40:30,886
The mice that received the bacteria
from the obese twin

675
00:40:30,970 --> 00:40:35,224
gained more weight on the same food
as compared to mice

676
00:40:35,307 --> 00:40:38,394
who received the bacteria
of the lean twin.

677
00:40:41,272 --> 00:40:43,149
[Jack] And that's helping us to understand

678
00:40:43,232 --> 00:40:47,153
why some people experience more difficulty
losing weight.

679
00:40:48,362 --> 00:40:50,698
For some people,
you lose weight, put on weight,

680
00:40:50,781 --> 00:40:53,617
lose weight, put on more weight,
lose weight, put on even more weight,

681
00:40:53,701 --> 00:40:54,701
and it keeps going up.

682
00:40:55,870 --> 00:40:57,913
We think the microbiome is key to that.

683
00:40:59,915 --> 00:41:03,836
You may have to go on a diet
for 9 to 12 months

684
00:41:03,919 --> 00:41:06,297
to reshape the ecosystem,

685
00:41:06,380 --> 00:41:09,633
to prevent the weight
from coming back with a vengeance

686
00:41:09,717 --> 00:41:11,552
when you start eating a hamburger again.

687
00:41:16,348 --> 00:41:17,850
[pensive music playing]

688
00:41:18,392 --> 00:41:22,605
[Eran Segal] Using the microbiome data
that we collected from individuals,

689
00:41:23,481 --> 00:41:28,402
we can start to predict
which foods are the best for each person.

690
00:41:29,028 --> 00:41:31,739
At least as far as blood sugar levels go.

691
00:41:32,990 --> 00:41:34,658
[Maya] Oysters, that's good.

692
00:41:35,326 --> 00:41:37,912
Can't have eggplant sandwiches,
that's bad.

693
00:41:38,746 --> 00:41:43,501
For somebody like me
where obsession is an issue... [laughs]

694
00:41:43,584 --> 00:41:47,796
...having scores
is not necessarily helpful for me.

695
00:41:47,880 --> 00:41:50,341
[in Japanese]
We should put hot dogs in there.

696
00:41:50,424 --> 00:41:53,844
The hot dog and bun
on its own is rated yellow.

697
00:41:53,928 --> 00:41:56,698
- But that's not too bad, right?
- It's not too bad, but also not good.

698
00:41:56,722 --> 00:41:59,183
But it's better
when it's with cheese and avocado.

699
00:41:59,266 --> 00:42:00,809
[Kobi] Oh, I like avocado.

700
00:42:00,893 --> 00:42:01,894
It's amazing.

701
00:42:01,977 --> 00:42:04,355
The more toppings
you add to it, the better.

702
00:42:06,273 --> 00:42:08,776
[Kimmie, in English]
Oh my God. Pork tenderloin.

703
00:42:08,859 --> 00:42:11,695
So you mean to tell me pork is good?

704
00:42:11,779 --> 00:42:13,572
Nobody better not tell me nothing else.

705
00:42:17,535 --> 00:42:19,703
[video call ringing, connects]

706
00:42:19,787 --> 00:42:20,996
Hi, Kimmie!

707
00:42:21,080 --> 00:42:22,581
Hi, Annie!

708
00:42:22,665 --> 00:42:23,999
- Hi, Kimmie.
- [Kimmie] Hi, Eran.

709
00:42:24,792 --> 00:42:26,919
{\an8}You know, you had asked before, like,

710
00:42:27,002 --> 00:42:30,005
{\an8}why is it that
when you try to lose weight, you can't.

711
00:42:30,631 --> 00:42:33,425
So when we looked at your microbiome,

712
00:42:33,509 --> 00:42:37,346
we saw that you had
a less diverse microbiome.

713
00:42:37,429 --> 00:42:40,891
In particular, we noticed
a specific type of bacteria,

714
00:42:40,975 --> 00:42:43,102
it's known as <i>Prevotella,</i> you had zero.

715
00:42:43,185 --> 00:42:44,061
Oh my goodness.

716
00:42:44,144 --> 00:42:47,982
So people who have
that pattern of no <i>Prevotella</i>

717
00:42:48,065 --> 00:42:50,234
have a hard time losing weight.

718
00:42:50,317 --> 00:42:52,194
Then the other thing we found

719
00:42:52,278 --> 00:42:56,282
{\an8}was that there were
three other specific bacteria in your gut

720
00:42:56,365 --> 00:42:58,158
{\an8}that were in low amounts.

721
00:42:58,242 --> 00:43:02,621
{\an8}They're associated with the production
of a specific type of gut hormone

722
00:43:02,705 --> 00:43:04,039
{\an8}that makes you feel full.

723
00:43:04,123 --> 00:43:06,375
{\an8}It could be why you're always hungry.

724
00:43:06,458 --> 00:43:11,880
But it's never as simple as one bacteria,
because no bacteria acts alone.

725
00:43:11,964 --> 00:43:16,051
So you really need to understand
how they act within an ecosystem,

726
00:43:16,135 --> 00:43:19,013
which is why we analyze
the microbiome as a whole.

727
00:43:19,096 --> 00:43:20,681
Does that make sense?

728
00:43:20,764 --> 00:43:24,393
Absolutely. I mean,
I'm kind of amazed, actually.

729
00:43:24,476 --> 00:43:29,565
I mean, just to be able to find out
all those different things about myself,

730
00:43:30,232 --> 00:43:31,775
simply from testing poop.

731
00:43:31,859 --> 00:43:33,027
[laughing]

732
00:43:33,110 --> 00:43:36,947
{\an8}But I don't know.
I guess it just seems so difficult.

733
00:43:37,031 --> 00:43:40,451
{\an8}Why does it seem like... like I'm stuck?

734
00:43:41,076 --> 00:43:43,996
- Am I stuck?
- Yeah. No, you're not... you're not stuck.

735
00:43:44,079 --> 00:43:48,584
So, the good thing is you got here,
but you can also get out.

736
00:43:49,293 --> 00:43:53,088
You really want to do,
I would say, a lifestyle change

737
00:43:53,172 --> 00:43:55,549
where you really change your food,

738
00:43:55,633 --> 00:43:58,344
such that it better matches
your good bacteria.

739
00:43:58,427 --> 00:43:59,303
Oh yeah.

740
00:43:59,386 --> 00:44:02,348
[Eran Segal] And we might be able to find
something that is enjoyable,

741
00:44:02,431 --> 00:44:05,601
something that could be sustained
for a long period of time,

742
00:44:05,684 --> 00:44:07,311
and would also be good for you.

743
00:44:07,394 --> 00:44:11,857
{\an8}You know, we talked about ABCs,
"always be counting,"

744
00:44:11,940 --> 00:44:12,775
{\an8}not calories,

745
00:44:12,858 --> 00:44:17,488
{\an8}but always be counting
the number of fruits and vegetables

746
00:44:17,571 --> 00:44:20,240
{\an8}that you have per week.

747
00:44:20,324 --> 00:44:23,410
Between 20 and 30
is usually considered good.

748
00:44:23,494 --> 00:44:24,494
Okay.

749
00:44:25,621 --> 00:44:27,748
[Kimmie] It definitely clears things up
a little more.

750
00:44:27,831 --> 00:44:32,044
Different bacteria,
you know, different lifestyles,

751
00:44:32,127 --> 00:44:36,465
just different things happening
for different people at different times

752
00:44:36,548 --> 00:44:39,760
just creates different outcomes.

753
00:44:43,806 --> 00:44:45,182
My life is pretty hectic.

754
00:44:46,058 --> 00:44:48,477
I'm responsible for a lot of people.

755
00:44:49,061 --> 00:44:51,980
I have a sick mom
that I'm constantly taking care of.

756
00:44:53,232 --> 00:44:56,485
I'm a single mom
to three beautiful children.

757
00:44:57,486 --> 00:45:02,574
My baby boy, he's autistic,
so I'm always teaching him.

758
00:45:02,658 --> 00:45:05,536
[all chattering indistinctly]

759
00:45:05,619 --> 00:45:09,373
[Kimmie] Eating in a household
with different age groups

760
00:45:10,165 --> 00:45:11,625
that all want different things,

761
00:45:11,709 --> 00:45:15,003
you gotta cook for you,
and then you gotta cook for them, and...

762
00:45:16,255 --> 00:45:18,882
It can be difficult,
and it can be expensive.

763
00:45:20,968 --> 00:45:26,473
So getting my kids on board
with one meal that everybody likes,

764
00:45:26,557 --> 00:45:27,683
that's my project.

765
00:45:28,434 --> 00:45:29,935
[sizzling]

766
00:45:37,401 --> 00:45:39,570
[in Japanese] I'm sure
that I've eaten 10,000 hot dogs

767
00:45:39,653 --> 00:45:41,363
{\an8}since the beginning of my career.

768
00:45:41,447 --> 00:45:43,073
{\an8}[rock music playing]

769
00:45:43,157 --> 00:45:44,199
[whistle blows]

770
00:45:44,283 --> 00:45:46,410
[rock music continues]

771
00:45:53,625 --> 00:45:54,626
[whistle blows]

772
00:45:59,214 --> 00:46:00,090
[rock music ends]

773
00:46:00,174 --> 00:46:05,304
I am Japanese,
but I've eaten like an American.

774
00:46:05,387 --> 00:46:11,310
I think that's what's damaged my body.

775
00:46:12,227 --> 00:46:13,896
{\an8}[pensive music playing]

776
00:46:17,232 --> 00:46:18,734
[man] Wow, this aroma.

777
00:46:19,443 --> 00:46:22,446
[Maggie] This is real Japanese food, huh?

778
00:46:22,529 --> 00:46:24,656
So beautiful.

779
00:46:24,740 --> 00:46:26,033
[in English] So beautiful.

780
00:46:27,326 --> 00:46:29,536
{\an8}- Mmm!
- [man speaking Japanese]

781
00:46:30,120 --> 00:46:33,248
Is competitive eating
damaging your stomach?

782
00:46:33,332 --> 00:46:35,417
When we go out together,

783
00:46:35,501 --> 00:46:38,462
I mean, the rest of us
eat more than you do.

784
00:46:38,545 --> 00:46:39,671
[Maggie] Yeah, it's true.

785
00:46:39,755 --> 00:46:42,090
Kobi thinks he might be broken.

786
00:46:42,174 --> 00:46:44,510
He doesn't feel hungry or full.

787
00:46:44,593 --> 00:46:47,596
- He doesn't feel those things at all.
- [man] Oh really?

788
00:46:47,679 --> 00:46:51,266
There are times when he realizes that
he hasn't eaten anything in three days.

789
00:46:51,350 --> 00:46:53,644
[man] It's that bad, really?

790
00:46:53,727 --> 00:46:57,815
I feel like the more you eat,
especially junk food,

791
00:46:57,898 --> 00:47:00,442
the more you damage your body.

792
00:47:00,526 --> 00:47:01,526
Hmm.

793
00:47:01,568 --> 00:47:03,570
[man 2 speaking indistinctly]

794
00:47:03,654 --> 00:47:09,326
Ever since I started this career,
I've wondered

795
00:47:09,409 --> 00:47:12,955
what damage I've done to my body.

796
00:47:16,834 --> 00:47:22,881
I want to know how it is damaging
my brain and nervous system.

797
00:47:29,179 --> 00:47:31,890
[in English] Earlier, I think
I had this image of myself,

798
00:47:31,974 --> 00:47:34,309
like, I'm this head and brain, and rest,

799
00:47:34,393 --> 00:47:36,103
and this is how I go about life.

800
00:47:36,186 --> 00:47:39,731
My feelings and everything,
my thoughts, are just produced up here.

801
00:47:39,815 --> 00:47:41,441
And this is a bit silly,

802
00:47:41,525 --> 00:47:45,487
and it reminds me even about the way
my little nephew draws people.

803
00:47:45,571 --> 00:47:47,948
[chuckling] It's just this head
with two little feet on it.

804
00:47:48,031 --> 00:47:51,493
And we now know that the gut
is an important adviser to the brain.

805
00:47:51,577 --> 00:47:54,121
It'll collect this information,
send it up to the brain,

806
00:47:54,204 --> 00:47:56,665
and it'll become a part of how we feel.

807
00:47:59,001 --> 00:48:01,712
{\an8}So we all know our first brain up here,

808
00:48:01,795 --> 00:48:05,841
{\an8}but we have a second brain
in here within our tummies.

809
00:48:05,924 --> 00:48:09,052
And there are more nerves
in this second brain

810
00:48:09,136 --> 00:48:10,679
than there is in our spinal cord.

811
00:48:12,389 --> 00:48:17,477
The gut-brain axis is
the two-way street of communication

812
00:48:17,561 --> 00:48:21,565
between what's going on in our bellies
and what's going on in our brains.

813
00:48:22,357 --> 00:48:25,569
[Annie] Think of the brain
and the gut as BFFs.

814
00:48:26,069 --> 00:48:30,490
So if either one is not working,
the other eventually is gonna follow suit.

815
00:48:31,074 --> 00:48:34,578
It may be what allows us
to enjoy the food we eat,

816
00:48:34,661 --> 00:48:37,539
to tell us what to eat, when to eat,

817
00:48:37,623 --> 00:48:40,959
and it's not only
that the microbes could affect your brain,

818
00:48:41,043 --> 00:48:45,797
but it's the food you take that can affect
the microbes that can affect your brain.

819
00:48:45,881 --> 00:48:47,507
[uplifting music playing]

820
00:48:59,853 --> 00:49:04,066
[John] So, today we're
at the English Market here in Ireland,

821
00:49:04,149 --> 00:49:06,568
and this is where I go shopping
on a Saturday.

822
00:49:07,986 --> 00:49:09,488
You come to the market with a list.

823
00:49:09,571 --> 00:49:11,949
[chuckling] But I end up
throwing it out every time.

824
00:49:12,616 --> 00:49:15,327
The smell, the colors,
everything here, you're drawn to,

825
00:49:15,410 --> 00:49:18,830
but your gut is also drawing you
to things maybe it shouldn't.

826
00:49:20,874 --> 00:49:25,170
Our food choices, you know, we think
about it all being driven by our brain,

827
00:49:25,253 --> 00:49:28,507
but what if it's actually
the signals from our gut

828
00:49:28,590 --> 00:49:31,176
that are really pulling the strings?

829
00:49:32,469 --> 00:49:35,180
Now, this is what my microbes really love,

830
00:49:35,263 --> 00:49:37,683
and I have to have this internal struggle

831
00:49:37,766 --> 00:49:41,269
because it's just a recipe
for me to gain weight.

832
00:49:44,189 --> 00:49:47,401
[Giulia] How hungry you feel,
how much you want to eat something,

833
00:49:47,484 --> 00:49:51,989
could come from a tiny bacterial
population in your gut being like,

834
00:49:52,072 --> 00:49:55,325
"I really would like to eat those fries,"
or something, you know?

835
00:49:56,493 --> 00:49:58,912
{\an8}You eat a lot of sugar,
you get sugar-loving bugs.

836
00:49:58,996 --> 00:50:01,123
{\an8}You eat a lot of fat,
you get fat-loving bugs.

837
00:50:01,915 --> 00:50:05,627
So when I go to China,
and I'm not consuming so much sugary food

838
00:50:05,711 --> 00:50:07,921
because there's very little sugar
in the Chinese diet,

839
00:50:08,005 --> 00:50:11,174
I completely lose my desire
to eat chocolate, for example.

840
00:50:11,258 --> 00:50:14,636
Normally, in North America,
I'm craving chocolate every single day.

841
00:50:15,637 --> 00:50:17,097
- [John] Morning.
- [woman] Morning.

842
00:50:17,180 --> 00:50:18,765
- How are you?
- [woman] Good, and you?

843
00:50:18,849 --> 00:50:20,058
Good, good.

844
00:50:20,142 --> 00:50:21,226
Morning.

845
00:50:21,309 --> 00:50:22,853
Ah! [chuckles]

846
00:50:23,562 --> 00:50:26,189
Today, my microbes win,

847
00:50:26,273 --> 00:50:29,276
so it's gonna be the chocolate
that we're gonna go with.

848
00:50:31,611 --> 00:50:33,155
[Maya] I get cravings a lot.

849
00:50:33,238 --> 00:50:36,533
Sometimes, literally,
the only thing that sounds good

850
00:50:36,616 --> 00:50:39,327
is, like, a super rare steak.

851
00:50:40,245 --> 00:50:43,874
I kind of try to just push it
into the back of my mind and ignore it,

852
00:50:43,957 --> 00:50:46,418
but I'm trying to listen to my body more.

853
00:50:46,501 --> 00:50:49,588
My body craves ice cream
or sweets or hamburgers.

854
00:50:50,630 --> 00:50:53,133
[sighs heavily]
I really wish I could eat this.

855
00:50:53,884 --> 00:50:57,596
I love seafood.
I try to eat as much seafood as possible.

856
00:50:57,679 --> 00:51:00,265
[in Japanese] I used to crave

857
00:51:01,308 --> 00:51:04,978
cakes and curry when I was little.

858
00:51:05,062 --> 00:51:09,649
I don't feel that joy
about eating anymore.

859
00:51:13,070 --> 00:51:15,197
[Giulia, in English]
Digestion was very much likely

860
00:51:15,280 --> 00:51:18,909
the first form of thinking
that animals developed.

861
00:51:18,992 --> 00:51:22,537
It was there so that the nerves
could tell the quality of the food,

862
00:51:22,621 --> 00:51:26,500
how the surrounding tissue was doing,
the immune cells that were passing by.

863
00:51:26,583 --> 00:51:28,919
And only after that worked really well,

864
00:51:29,002 --> 00:51:31,880
it was like a nice add-on
to also have this brain up there

865
00:51:31,963 --> 00:51:33,340
that can coordinate senses.

866
00:51:39,221 --> 00:51:41,932
[woman] Hi, Kimmie, we're ready for you
if you wanna come on back.

867
00:51:44,643 --> 00:51:47,854
[Kobi, in Japanese]
I'm going to get my MRI done today.

868
00:51:49,856 --> 00:51:52,359
I'm a little worried.

869
00:51:54,528 --> 00:51:59,950
But I'm looking forward to understanding
what's going on in my body.

870
00:52:03,870 --> 00:52:05,790
[Kimmie, in English]
I'm still a little confused.

871
00:52:05,831 --> 00:52:08,542
I'm just trying
to figure out how my body works,

872
00:52:08,625 --> 00:52:10,669
so moving forward, I can be a better me.

873
00:52:15,090 --> 00:52:17,050
[woman] All right, Kimmie.
How you doing in there?

874
00:52:17,092 --> 00:52:18,218
[Kimmie] Good.

875
00:52:18,301 --> 00:52:20,929
[woman] We're gonna go ahead
and put up a slideshow for you

876
00:52:21,012 --> 00:52:22,848
of a bunch of pictures.

877
00:52:22,931 --> 00:52:27,352
And we're just gonna ask you to watch it
like you would watch TV or a movie, okay?

878
00:52:27,435 --> 00:52:28,520
[Kimmie] Okay.

879
00:52:30,105 --> 00:52:33,733
[Annie] What we're looking at
is activity in the brain.

880
00:52:34,693 --> 00:52:39,906
Seeing how Kimmie and Kobi respond
to a stimulus. In this case, food cues.

881
00:52:41,491 --> 00:52:44,077
We have high-calorie sweet foods,

882
00:52:44,161 --> 00:52:46,454
or high-fat, high-calorie savory foods.

883
00:52:47,372 --> 00:52:51,835
And what we see with Kimmie's brain
is that when Kimmie sees food,

884
00:52:51,918 --> 00:52:55,589
the emotional part
of her brain gets activated,

885
00:52:55,672 --> 00:52:57,465
but more importantly,

886
00:52:57,549 --> 00:53:02,304
the ability to control
these emotional responses are diminished.

887
00:53:03,972 --> 00:53:07,809
With Kobi's situation,
it's definitely more complex.

888
00:53:08,560 --> 00:53:11,021
Hunger is a complicated process.

889
00:53:11,104 --> 00:53:13,315
There are multiple systems involved.

890
00:53:13,398 --> 00:53:17,235
The brain, the gut microbiome,
inflammation,

891
00:53:17,319 --> 00:53:21,990
but also your mood,
your memories, your environment.

892
00:53:23,200 --> 00:53:25,911
There are so many things
that are related to hunger,

893
00:53:25,994 --> 00:53:27,954
and we need to think about the whole body.

894
00:53:29,581 --> 00:53:31,625
[Jack] Doctors are divided up
into specialties

895
00:53:31,708 --> 00:53:34,169
where they just focus on this one organ,

896
00:53:34,252 --> 00:53:37,130
and they ignore
the entire rest of the body, essentially.

897
00:53:37,714 --> 00:53:41,551
It's minimizing our understanding
of how everything is connected.

898
00:53:41,635 --> 00:53:44,346
The beautiful thing about
the microbiome is it's everywhere,

899
00:53:44,429 --> 00:53:46,514
and its effects are felt everywhere.

900
00:53:48,975 --> 00:53:50,894
We have to think more holistically.

901
00:53:50,977 --> 00:53:55,065
And so, one of the things
that I'm really interested in

902
00:53:55,148 --> 00:54:00,362
is when we have co-occurrences
of gut problems with brain problems,

903
00:54:00,445 --> 00:54:02,239
and it's very common.

904
00:54:02,322 --> 00:54:05,951
It's very common
in autism, in Parkinson's disease,

905
00:54:06,034 --> 00:54:09,329
but also in stress-related
psychiatric illnesses

906
00:54:09,412 --> 00:54:11,289
like anxiety and depression.

907
00:54:11,373 --> 00:54:15,710
And so, which came first
is always the question.

908
00:54:19,589 --> 00:54:21,508
[Jack] In the last five or so years,

909
00:54:21,591 --> 00:54:24,302
we found that people
with certain depression-like symptoms

910
00:54:24,386 --> 00:54:25,887
are missing bacteria in their gut

911
00:54:25,971 --> 00:54:28,890
that produce chemicals
which shape brain chemistry.

912
00:54:28,974 --> 00:54:30,850
That changes how you feel.

913
00:54:30,934 --> 00:54:35,563
And it can lead, we believe,
to the onset of depression-like symptoms.

914
00:54:37,816 --> 00:54:41,903
[John] When you give a normal mouse
microbes from a healthy person

915
00:54:41,987 --> 00:54:44,823
and give them the opportunity to explore,

916
00:54:46,241 --> 00:54:51,037
they'll want to see bright areas
and be generally inquisitive.

917
00:54:51,121 --> 00:54:54,916
Whereas if you give them
the microbes from a depressed individual,

918
00:54:55,542 --> 00:54:57,669
they'll huddle into dark areas,

919
00:54:57,752 --> 00:55:02,257
and they will develop
stress, anxiety, and depression.

920
00:55:02,340 --> 00:55:04,843
[whimpering, crying]

921
00:55:06,094 --> 00:55:09,389
[John] There was changes
in the chemicals involved in serotonin,

922
00:55:09,472 --> 00:55:10,515
the mood molecule,

923
00:55:10,598 --> 00:55:13,059
- in their gut and in their brain.
- [electricity crackling]

924
00:55:14,019 --> 00:55:16,396
[Jack] When we added bacteria
into our animals

925
00:55:16,479 --> 00:55:19,441
that's often missing
in people who are depressed,

926
00:55:19,524 --> 00:55:22,861
it actually dampens down
that depression response.

927
00:55:22,944 --> 00:55:27,157
So they may still have depression,
but they don't feel it as severely.

928
00:55:29,909 --> 00:55:30,994
[mouse squeaking]

929
00:55:31,077 --> 00:55:34,914
[Kobi, in Japanese] Yeah, it makes sense.

930
00:55:34,998 --> 00:55:38,626
When I'm training for a competition,

931
00:55:38,710 --> 00:55:41,963
I feel aggressive,

932
00:55:42,547 --> 00:55:47,135
and I don't feel like
talking to other people.

933
00:55:49,471 --> 00:55:55,518
It's scary to think that the brain and gut
are so closely related.

934
00:55:56,728 --> 00:56:00,106
It makes me want to be more careful
with what I eat.

935
00:56:02,942 --> 00:56:05,111
{\an8}[rapid tapping]

936
00:56:05,195 --> 00:56:06,488
[video game character grunts]

937
00:56:07,072 --> 00:56:08,156
[Jack] That's really cool.

938
00:56:09,657 --> 00:56:11,659
Ah, man. You're doing really well.

939
00:56:12,952 --> 00:56:17,499
As a father with a son with autism
and another son with ADHD

940
00:56:17,582 --> 00:56:20,043
and having depression in my family,

941
00:56:20,126 --> 00:56:23,380
I've been very interested in seeing
if there's maybe a link

942
00:56:23,463 --> 00:56:25,673
to disruptions in the microbiome.

943
00:56:25,757 --> 00:56:27,926
And that's shaped my research career.

944
00:56:28,009 --> 00:56:32,013
And I've gone after looking at
which bacteria might be playing a role.

945
00:56:35,642 --> 00:56:38,019
We found that in many cases of autism,

946
00:56:38,103 --> 00:56:42,399
there are children who have diarrhea
or severe constipation.

947
00:56:42,982 --> 00:56:46,027
[Giulia] In other diseases in the brain,
like Parkinson's,

948
00:56:46,111 --> 00:56:48,822
we often see an onset of constipation,

949
00:56:48,905 --> 00:56:53,326
sometimes even decades before
the actual brain disease manifests.

950
00:56:56,663 --> 00:56:58,081
To understand this connection,

951
00:56:58,164 --> 00:57:01,876
we take bacteria from humans
with a certain disease like Parkinson's,

952
00:57:02,669 --> 00:57:04,003
and put them in mice.

953
00:57:08,341 --> 00:57:12,137
[Jack] When we add missing bacteria
into the mice, their symptoms improve.

954
00:57:12,220 --> 00:57:14,222
[upbeat music playing]

955
00:57:14,973 --> 00:57:16,891
[Jack] It's a natural thing.

956
00:57:16,975 --> 00:57:21,354
Just naturally rebalancing that ecosystem
and that chemistry inside the body.

957
00:57:21,438 --> 00:57:22,939
[upbeat music continues]

958
00:57:24,941 --> 00:57:26,151
- [music ends]
- [applause]

959
00:57:26,234 --> 00:57:29,571
And so, we're really starting to see
that the relationship,

960
00:57:29,654 --> 00:57:33,783
our study of the body as a whole unit,
is essential

961
00:57:33,867 --> 00:57:37,370
if we're really gonna get a handle
on some of these chronic conditions.

962
00:57:37,871 --> 00:57:40,498
[video call ringing, connects]

963
00:57:41,249 --> 00:57:43,084
{\an8}Well, very nice to meet you, Kobi.

964
00:57:43,168 --> 00:57:44,210
Hi, doctor.

965
00:57:44,294 --> 00:57:46,588
- Hi, Kobi. Hi, Maggie.
- [Kobi] Nice to meet you.

966
00:57:47,172 --> 00:57:49,007
[Annie] So I have some results.

967
00:57:49,090 --> 00:57:50,341
{\an8}We were excited to see that,

968
00:57:50,425 --> 00:57:54,554
{\an8}that your bacteria
actually looks pretty good.

969
00:57:54,637 --> 00:57:58,224
[in Japanese] Wow.
That really surprises me.

970
00:57:58,308 --> 00:58:01,394
{\an8}[in English] So even though
the competitive eating,

971
00:58:01,478 --> 00:58:03,563
{\an8}you know, may have had an effect,

972
00:58:03,646 --> 00:58:08,193
{\an8}the fact that you eat
a normal healthy diet, Japanese diet,

973
00:58:08,276 --> 00:58:10,528
it influenced your microbiome.

974
00:58:10,612 --> 00:58:13,531
Because the bacteria in your microbiome

975
00:58:13,615 --> 00:58:17,660
responds, like, within 24 hours of eating.

976
00:58:17,744 --> 00:58:18,578
Wow.

977
00:58:18,661 --> 00:58:21,289
But when it comes to the loss of appetite,

978
00:58:21,372 --> 00:58:24,167
it could be a combination of many things,

979
00:58:24,250 --> 00:58:25,877
{\an8}like the actual stomach stretching,

980
00:58:25,960 --> 00:58:29,255
your hormones,
some sort of slight inflammation,

981
00:58:29,339 --> 00:58:31,174
or also the speed of digestion.

982
00:58:31,257 --> 00:58:33,676
- Just to name a few things.
- Okay.

983
00:58:33,760 --> 00:58:36,888
But the other part is the head.

984
00:58:36,971 --> 00:58:39,933
And usually, I am not a fan

985
00:58:40,016 --> 00:58:42,852
of doctors telling people
it's in your head,

986
00:58:42,936 --> 00:58:47,524
but when I looked at your brain scan,
everything was firing.

987
00:58:47,607 --> 00:58:49,984
Basically, every area in the brain

988
00:58:50,068 --> 00:58:52,570
{\an8}that can have something to do
with eating, with food,

989
00:58:52,654 --> 00:58:55,823
{\an8}with feeling nauseous or full,
like, everything is on.

990
00:58:55,907 --> 00:58:57,575
It's almost like it's confused.

991
00:58:57,659 --> 00:59:00,328
[in Japanese] Okay,
I don't like the sound of that.

992
00:59:00,411 --> 00:59:02,914
{\an8}[in English] The only way
this made sense for me was

993
00:59:02,997 --> 00:59:06,084
{\an8}if everything has to work together
to suppress

994
00:59:06,167 --> 00:59:07,627
so that you don't feel full,

995
00:59:07,710 --> 00:59:10,964
so that you don't get disgusted
by more and more food.

996
00:59:11,047 --> 00:59:14,467
You can see how far your body goes
for what you want,

997
00:59:14,551 --> 00:59:16,261
even if it has to harm itself.

998
00:59:16,344 --> 00:59:17,804
[speaking Japanese]

999
00:59:17,887 --> 00:59:20,098
He said, "I know."
He said, "I'm already scared."

1000
00:59:20,181 --> 00:59:22,350
He's like,
"I don't know if my brain is okay."

1001
00:59:22,433 --> 00:59:27,814
Yeah, but it's not that something
is turned off, or gone, or broken.

1002
00:59:28,398 --> 00:59:31,067
It's all there. It's all turned on.

1003
00:59:31,150 --> 00:59:33,903
It's just wired differently maybe now.

1004
00:59:33,987 --> 00:59:37,282
{\an8}Your brain is still trained
to think that you're competing

1005
00:59:37,365 --> 00:59:39,158
{\an8}or eating those highly processed foods.

1006
00:59:39,242 --> 00:59:42,370
[Giulia] Here I think
the situation is very complex.

1007
00:59:42,453 --> 00:59:45,999
Something that would be interesting to try

1008
00:59:46,082 --> 00:59:49,836
- would be to learn to listen to the body.
- Yeah.

1009
00:59:49,919 --> 00:59:54,882
{\an8}If it's just a smell,
or just sensing very basic things,

1010
00:59:54,966 --> 00:59:57,802
and just learning to feel it, sometimes.

1011
00:59:58,845 --> 01:00:00,972
[in Japanese] It's a long journey.
A long one indeed.

1012
01:00:01,055 --> 01:00:04,267
[in English] He said, "This is gonna be
a long journey though, right?"

1013
01:00:05,310 --> 01:00:09,647
[in Japanese] I overeat because
I am a competitive eater.

1014
01:00:10,481 --> 01:00:14,152
But ordinary people overeat too sometimes.

1015
01:00:16,821 --> 01:00:23,494
When you eat too much,
you don't savor the taste

1016
01:00:23,578 --> 01:00:27,165
or fully enjoy the smell of the food.

1017
01:00:28,499 --> 01:00:34,797
You ignore your body's signals,
like fullness.

1018
01:00:37,133 --> 01:00:38,885
[Giulia, in English] It starts early.

1019
01:00:39,385 --> 01:00:41,679
Many kids are raised telling them,

1020
01:00:41,763 --> 01:00:45,391
"Clean your plate. Eat the whole plate
'cause that's what good kids do."

1021
01:00:47,518 --> 01:00:50,229
So we learn to ignore our appetite,

1022
01:00:50,313 --> 01:00:53,066
but get accustomed
to just times where we eat.

1023
01:00:53,733 --> 01:00:55,360
We're on the phone the whole time,

1024
01:00:55,443 --> 01:00:57,820
or on the computer
with the brain and screen.

1025
01:00:59,030 --> 01:01:03,242
Reconnecting, it's really more about
just listening to your body.

1026
01:01:05,703 --> 01:01:11,209
[Kobi, in Japanese]
I hope to live a long and healthy life.

1027
01:01:11,751 --> 01:01:13,044
Good morning.

1028
01:01:14,212 --> 01:01:18,925
I've decided to retire
from competitive eating.

1029
01:01:21,135 --> 01:01:25,098
It's all I have done
for the last 20 years.

1030
01:01:26,057 --> 01:01:28,935
I am worried about
what my next step will bring,

1031
01:01:29,018 --> 01:01:31,229
but I'm also excited about my future.

1032
01:01:31,312 --> 01:01:33,314
I have mixed feelings.

1033
01:01:36,234 --> 01:01:38,027
But first,

1034
01:01:38,111 --> 01:01:44,826
I want to fix my brain and my gut.

1035
01:01:47,537 --> 01:01:50,415
[in English] We're actively working
to enhance the number

1036
01:01:50,498 --> 01:01:53,543
of different microbiome therapies
that are out there.

1037
01:01:57,130 --> 01:02:01,384
If your microbiome's damaged,
can we actually use poop to fix it?

1038
01:02:03,594 --> 01:02:07,974
This is very, very valuable,
more valuable than gold.

1039
01:02:08,975 --> 01:02:13,813
{\an8}What would you say if a doctor told you
someone else's feces could save your life?

1040
01:02:13,896 --> 01:02:17,567
[reporter] <i>A Fecal Microbial Transplant,
simply called FMT,</i>

1041
01:02:17,650 --> 01:02:22,280
<i>puts feces from someone else
into the body of an infected patient.</i>

1042
01:02:22,363 --> 01:02:26,409
<i>He offers a treatment through
colonoscopy, an enema, or pills.</i>

1043
01:02:26,492 --> 01:02:30,455
Fecal microbiome transplant
is the first FDA-approved therapy

1044
01:02:30,538 --> 01:02:33,958
which involves the microbiome
that's available to clinicians today.

1045
01:02:34,041 --> 01:02:38,129
However, it's only allowed to be used
for one particular type of disease.

1046
01:02:38,212 --> 01:02:43,176
{\an8}[reporter] <i>C. diff. When bacteria inflames
the colon and causes extreme diarrhea.</i>

1047
01:02:43,259 --> 01:02:46,304
[Jack] We take the bacterial community
from a healthy person,

1048
01:02:46,387 --> 01:02:49,056
just spray it
up inside the colon, literally,

1049
01:02:49,140 --> 01:02:53,978
in order to re-poop-ulate,
repopulate your gut bacteria inside there.

1050
01:02:54,061 --> 01:02:57,315
[reporter 2] <i>It's a procedure
that has a 90% cure rate.</i>

1051
01:02:57,398 --> 01:02:59,525
[reporter 3] <i>Scientists are now trying
to figure out</i>

1052
01:02:59,609 --> 01:03:03,696
<i>if it can treat hundreds
of other conditions, mental and physical.</i>

1053
01:03:04,989 --> 01:03:09,202
[Jack] With fecal microbiome transplants,
there is really compelling evidence,

1054
01:03:09,285 --> 01:03:11,287
but the science is still developing.

1055
01:03:11,370 --> 01:03:12,789
We're still working on

1056
01:03:12,872 --> 01:03:15,416
if it actually has benefit
in wider populations,

1057
01:03:15,500 --> 01:03:17,293
if the benefit is long-lasting.

1058
01:03:24,217 --> 01:03:27,887
{\an8}[Drew] Here it is,
next to the food we're gonna eat later.

1059
01:03:29,847 --> 01:03:32,892
- [Daniell] Is it in the healthy range?
- [Drew] This is a good one.

1060
01:03:35,436 --> 01:03:36,854
[Daniell] I think for most people,

1061
01:03:36,938 --> 01:03:40,566
it would be scary
to do a fecal transplant,

1062
01:03:40,650 --> 01:03:42,527
especially when it's DIY.

1063
01:03:43,194 --> 01:03:46,656
I also think that most healthy people
don't know what it's like

1064
01:03:46,739 --> 01:03:50,076
to get to a place
where your quality of life is so low.

1065
01:03:50,701 --> 01:03:53,162
I felt like I had no other options.

1066
01:03:58,334 --> 01:03:59,544
[director] Is this love?

1067
01:04:00,127 --> 01:04:01,587
[Drew] Yes, true love.

1068
01:04:02,296 --> 01:04:03,297
[chuckles]

1069
01:04:07,468 --> 01:04:13,266
The first time I did a fecal transplant,
I used my brother as a donor.

1070
01:04:15,017 --> 01:04:20,773
I slowly started gaining weight,
despite not changing my diet at all.

1071
01:04:22,275 --> 01:04:24,193
And I was able to go to the bathroom

1072
01:04:24,277 --> 01:04:27,822
for the first time in, like, three years
on my own.

1073
01:04:29,866 --> 01:04:31,993
But I started getting worse acne,

1074
01:04:32,618 --> 01:04:35,955
and my brother has a history
of hormonal acne.

1075
01:04:37,373 --> 01:04:41,878
And then I decided to use
my boyfriend as a donor.

1076
01:04:41,961 --> 01:04:44,380
He has no physical health conditions,

1077
01:04:44,463 --> 01:04:46,924
but he does have
some mental health issues.

1078
01:04:48,384 --> 01:04:50,887
I took my boyfriend's pills
for several months.

1079
01:04:50,970 --> 01:04:52,513
Stopped getting the acne.

1080
01:04:53,347 --> 01:04:55,141
But over time, I noticed

1081
01:04:55,224 --> 01:04:57,935
that my depression
was worse than it's ever been in my life.

1082
01:04:59,353 --> 01:05:02,231
I got whatever bacteria he normally has,

1083
01:05:02,315 --> 01:05:05,568
and it exacerbated
the depression that I already had.

1084
01:05:08,070 --> 01:05:10,573
I went back to using
my brother as a donor.

1085
01:05:10,656 --> 01:05:14,035
Within a week,
that depression completely went away.

1086
01:05:16,162 --> 01:05:17,622
[Drew] Going right in there...

1087
01:05:18,873 --> 01:05:20,166
with the ice cream.

1088
01:05:23,419 --> 01:05:25,588
There are risks with FMT.

1089
01:05:25,671 --> 01:05:27,173
[microbes chittering]

1090
01:05:27,256 --> 01:05:30,635
[John] When you get an FMT,
you get the good bacteria,

1091
01:05:30,718 --> 01:05:33,971
but the bad bacteria
could also come along for the ride.

1092
01:05:34,055 --> 01:05:35,348
{\an8}- [roars]
- [microbes exclaim]

1093
01:05:35,431 --> 01:05:38,517
{\an8}[Giulia] I would love it
if this was the perfect solution.

1094
01:05:38,601 --> 01:05:40,519
{\an8}[roaring]

1095
01:05:40,603 --> 01:05:44,315
[Giulia] But all the gastroenterologists
I know are extremely cautious.

1096
01:05:44,398 --> 01:05:48,569
We could transplant the susceptibility
to all sorts of diseases.

1097
01:05:49,946 --> 01:05:53,658
So I ask people,
don't try and experiment on yourself

1098
01:05:53,741 --> 01:05:56,535
with some of these
more aggressive therapeutics.

1099
01:05:58,955 --> 01:06:03,876
[interviewer, in Japanese]
If a fecal transplant would give you back

1100
01:06:03,960 --> 01:06:07,922
your feelings of hunger and fullness,
would you do it?

1101
01:06:08,005 --> 01:06:13,052
Yes, if it could help me with my problems,

1102
01:06:13,135 --> 01:06:15,262
I would definitely try it.

1103
01:06:15,346 --> 01:06:18,057
I'll be the guinea pig.

1104
01:06:18,557 --> 01:06:21,352
[reporter 1, in English]
<i>Someone else's feces could save your life.</i>

1105
01:06:21,435 --> 01:06:22,812
[reporter 2] <i>Fecal microbial...</i>

1106
01:06:22,895 --> 01:06:25,106
I thought it was weird as hell,

1107
01:06:25,648 --> 01:06:29,026
but all this talk about poop
just kind of helped me understand

1108
01:06:29,110 --> 01:06:30,987
that pooping is normal.

1109
01:06:31,070 --> 01:06:33,864
It's everyday life.
It's something everybody goes through.

1110
01:06:33,948 --> 01:06:35,116
So why not talk about it?

1111
01:06:35,199 --> 01:06:39,620
I'll bring it up, and it's just
a random poop conversation. [laughs]

1112
01:06:40,746 --> 01:06:43,582
And when I hang up the phone,
I'm like, "Was that weird?"

1113
01:06:43,666 --> 01:06:47,169
Before it was,
but now it's like, "No, it's normal."

1114
01:06:47,878 --> 01:06:49,380
[pensive music playing]

1115
01:06:50,965 --> 01:06:53,884
[Jack] Fecal microbiome transplants
are quite a blunt tool.

1116
01:06:54,510 --> 01:06:56,721
We prefer to use a targeted approach,

1117
01:06:56,804 --> 01:07:02,143
like a precision probiotic
to improve health in a very specific way.

1118
01:07:03,894 --> 01:07:07,815
Most probiotics you can buy in the store
aren't really gastrointestinal bugs.

1119
01:07:07,898 --> 01:07:10,568
They're not designed
to live inside our guts.

1120
01:07:10,651 --> 01:07:14,989
They're normally bugs that you would find
associated with fermented milk or cheeses,

1121
01:07:15,072 --> 01:07:16,991
<i>Lactobacillus</i> organisms.

1122
01:07:17,074 --> 01:07:19,952
So they're not really designed
to take up residence.

1123
01:07:20,036 --> 01:07:23,622
It'd be like taking a houseplant,
and throwing it into the Amazon jungle,

1124
01:07:23,706 --> 01:07:26,125
and hoping beyond hope
that it would suddenly grow.

1125
01:07:27,585 --> 01:07:31,005
Modern medicine is very much
about treating the symptoms of a disease

1126
01:07:31,088 --> 01:07:33,799
rather than the underlying problems
that lead to it.

1127
01:07:34,759 --> 01:07:37,678
[John] Moving forward,
we want to have a smarter approach

1128
01:07:37,762 --> 01:07:42,600
{\an8}to target the microbes in our gut
to actually have positive effects

1129
01:07:42,683 --> 01:07:45,770
and prevent many of the problems
from even starting.

1130
01:07:47,897 --> 01:07:50,858
[Tim] And so, the microbiome
is a game changer for medicine

1131
01:07:50,941 --> 01:07:53,778
because everyone
can be their own pharmacist

1132
01:07:53,861 --> 01:07:56,280
just by picking the right foods to eat.

1133
01:08:00,034 --> 01:08:02,828
[Rob] Inspired by our findings,
one of my colleagues decided

1134
01:08:02,912 --> 01:08:06,415
{\an8}to start drinking smoothies
with 60 different kinds of plants a day.

1135
01:08:06,499 --> 01:08:10,628
And so what you can see is he's over here
in this red region with his regular diet.

1136
01:08:10,711 --> 01:08:12,797
But now,
he's moved over to this orange region

1137
01:08:12,880 --> 01:08:14,048
after eating the smoothies.

1138
01:08:14,131 --> 01:08:15,771
Took a few weeks, but he's really changed

1139
01:08:15,841 --> 01:08:18,260
to this completely different region
of the plot.

1140
01:08:18,344 --> 01:08:21,180
And by the time this ends,
which is a few months later,

1141
01:08:21,263 --> 01:08:24,600
he's now got a much more diverse
microbiome configuration

1142
01:08:24,683 --> 01:08:26,185
than he had at the beginning.

1143
01:08:26,268 --> 01:08:28,228
[director] But you haven't started
drinking these?

1144
01:08:28,270 --> 01:08:30,356
No, I tasted them. [chuckles]

1145
01:08:30,439 --> 01:08:31,839
I think this is one of those things

1146
01:08:31,899 --> 01:08:34,985
where you really need a collaboration
between scientists and, say, chefs

1147
01:08:35,069 --> 01:08:37,488
to not just get all the things
you want in there,

1148
01:08:37,571 --> 01:08:39,198
but to make it taste good as well.

1149
01:08:42,868 --> 01:08:45,663
Well, I have no idea
what that means, but that's cool.

1150
01:08:45,746 --> 01:08:49,208
Um, all right, let's get started.

1151
01:08:49,291 --> 01:08:50,835
[upbeat, whimsical music playing]

1152
01:08:57,007 --> 01:08:59,552
[Maya] Red and green lettuce, check.

1153
01:08:59,635 --> 01:09:02,721
Spinach, check. Purple kale, check.

1154
01:09:02,805 --> 01:09:04,890
Carrot-top greens, check.

1155
01:09:04,974 --> 01:09:11,188
Tomatoes, carrots,
zucchini, some avocados.

1156
01:09:11,272 --> 01:09:16,110
Radishes and dates
is a combination I have yet to try,

1157
01:09:16,193 --> 01:09:19,238
but maybe that'll be
my new macaron flavor, who knows?

1158
01:09:21,323 --> 01:09:24,034
How much smoothie does he eat?

1159
01:09:24,118 --> 01:09:28,956
The produce out here is about
what I eat in produce for, like, a week.

1160
01:09:29,039 --> 01:09:31,250
So one cup of water.

1161
01:09:33,377 --> 01:09:36,881
It does feel a bit like doing
a science fair experiment.

1162
01:09:36,964 --> 01:09:38,966
I'm going to throw in
a whole knob of ginger.

1163
01:09:39,049 --> 01:09:41,510
'Cause you can't get enough
of that ginger.

1164
01:09:43,012 --> 01:09:46,765
I mean, my initial reaction is,
who has time to do this?

1165
01:09:49,143 --> 01:09:51,437
We'll do a whole fig. I like figs.

1166
01:09:51,520 --> 01:09:55,941
I feel like the pink color is probably
extra good for you or something.

1167
01:09:56,025 --> 01:09:57,234
Antioxidants.

1168
01:09:58,027 --> 01:10:00,487
Oh, the potato. I'm also...

1169
01:10:01,572 --> 01:10:03,532
It's going to be so, like... Ugh!

1170
01:10:04,074 --> 01:10:05,284
First time for everything.

1171
01:10:06,952 --> 01:10:07,995
And a teaspoon.

1172
01:10:08,078 --> 01:10:09,830
I think that's it.

1173
01:10:11,332 --> 01:10:12,332
Okay.

1174
01:10:12,958 --> 01:10:16,545
I think this is going to be
an incredibly interesting color.

1175
01:10:17,213 --> 01:10:18,339
[blender whirring]

1176
01:10:25,930 --> 01:10:28,182
Doesn't look bad.
I mean, it doesn't look great.

1177
01:10:28,265 --> 01:10:30,893
But I've drank grosser smoothies.

1178
01:10:32,228 --> 01:10:33,479
Smells real green.

1179
01:10:34,813 --> 01:10:36,899
[laughs] Oh, it's so thick.

1180
01:10:40,611 --> 01:10:42,029
It's got texture to it.

1181
01:10:43,906 --> 01:10:44,907
[laughs]

1182
01:10:48,744 --> 01:10:50,079
It's actually not bad.

1183
01:10:51,914 --> 01:10:54,500
It's fine. It tastes healthy.

1184
01:10:56,043 --> 01:10:57,723
[director] How would you make this better?

1185
01:10:57,753 --> 01:11:01,006
[Maya] Just, I mean, removing things
like the brussels sprouts

1186
01:11:01,090 --> 01:11:03,717
that will kind of, I think, overpower it.

1187
01:11:03,801 --> 01:11:06,971
Or if you're gonna do that,
just turn it into gazpacho.

1188
01:11:07,054 --> 01:11:10,140
I think a lot of the green smoothies
I eat would be so much better

1189
01:11:10,224 --> 01:11:12,393
if they embraced what it is
and added some salt

1190
01:11:12,476 --> 01:11:15,688
and, like, a little bit of vinegar,
and you're just drinking gazpacho.

1191
01:11:15,771 --> 01:11:19,984
It sounds great, but they just need
to season their smoothies, I guess.

1192
01:11:21,777 --> 01:11:23,946
[grunts] Mm-mmm.

1193
01:11:27,283 --> 01:11:30,661
It is kind of spectacular
what food can do to you,

1194
01:11:31,287 --> 01:11:34,123
and how what you eat
really does change your body.

1195
01:11:35,082 --> 01:11:39,461
What you eat today will impact
your microbiome tomorrow, within 24 hours.

1196
01:11:40,045 --> 01:11:43,382
{\an8}My rule is ABC, always be counting.

1197
01:11:43,465 --> 01:11:46,677
{\an8}Always be counting the number
of fruits and vegetables you're eating.

1198
01:11:47,803 --> 01:11:51,849
If you eat about 20 to 30
different fruits and vegetables each week,

1199
01:11:51,932 --> 01:11:53,392
I think you're good.

1200
01:11:57,021 --> 01:11:59,940
[Justin] If you want
some simple rules to follow,

1201
01:12:00,024 --> 01:12:02,943
think about what
the generations before us ate.

1202
01:12:03,569 --> 01:12:07,990
I mean, vegetables, fruits, nuts, beans,

1203
01:12:08,073 --> 01:12:12,077
even fermented foods that are teeming
with different types of microbes.

1204
01:12:12,703 --> 01:12:15,831
Fermented foods
were really the original probiotics.

1205
01:12:17,875 --> 01:12:21,879
You can just take vegetables, add salt,
and let them sit at room temperature,

1206
01:12:21,962 --> 01:12:25,132
and you're gonna have this delicious
fermented food in a couple days.

1207
01:12:29,386 --> 01:12:31,026
- Doing great.
- [Kimmie] You doing great?

1208
01:12:31,096 --> 01:12:32,765
- Uh-huh.
- [Kimmie] That's good, baby.

1209
01:12:32,848 --> 01:12:36,226
[boy] Is this what corn looks like
when it's just not corn?

1210
01:12:36,310 --> 01:12:39,855
[laughs] You mean when it's fresh
and not out of the bag? Yes.

1211
01:12:39,938 --> 01:12:41,774
There's corn in here.

1212
01:12:41,857 --> 01:12:42,858
[Kimmie] Yeah.

1213
01:12:44,151 --> 01:12:46,779
I was definitely confused in the past.

1214
01:12:47,654 --> 01:12:50,491
Learning the science
helped me to know that,

1215
01:12:50,574 --> 01:12:53,577
"Okay, you can't just say I'm on a diet."

1216
01:12:53,660 --> 01:12:56,372
You literally have to change
your lifestyle

1217
01:12:57,539 --> 01:13:00,501
and doing little things every day.

1218
01:13:00,584 --> 01:13:02,753
- [boy] Potatoes cut and rinsed.
- Cut and rinsed.

1219
01:13:02,836 --> 01:13:04,755
[Kimmie] My kids are super competitive.

1220
01:13:05,714 --> 01:13:09,051
I get them to help me.
I've made it like a cooking competition.

1221
01:13:10,219 --> 01:13:12,388
I get them to go
to the grocery store with me.

1222
01:13:12,471 --> 01:13:13,889
Then we get to cook.

1223
01:13:15,391 --> 01:13:18,143
So we've been spending
a lot more time together while doing it.

1224
01:13:18,227 --> 01:13:19,311
What are you doing?

1225
01:13:19,395 --> 01:13:21,855
[boy] I'm helping you.
I wanna be a chef, forever.

1226
01:13:21,939 --> 01:13:22,856
You wanna be a chef?

1227
01:13:22,940 --> 01:13:26,026
Yeah, I wanna cook every single day.
I want to be a chef.

1228
01:13:28,487 --> 01:13:33,075
I've experienced
how people talk about their body,

1229
01:13:33,158 --> 01:13:35,702
and what way of relationship
they have with it.

1230
01:13:36,328 --> 01:13:38,622
[Maya] Two eggs and two egg yolks.

1231
01:13:38,705 --> 01:13:41,708
[Giulia] There's not one super health food
that you can eat,

1232
01:13:41,792 --> 01:13:45,462
or this one advice that you can follow
so everything gets better.

1233
01:13:45,546 --> 01:13:49,133
It's really more about
building up a relationship to the gut.

1234
01:13:49,883 --> 01:13:52,553
[Kimmie] Y'all are doing
such a great job. High five.

1235
01:13:52,636 --> 01:13:56,265
Reconnecting can be done by science,
and can be done by knowledge,

1236
01:13:56,348 --> 01:13:59,560
but only also if you,
you know, get a feeling,

1237
01:13:59,643 --> 01:14:00,894
get a smart feeling for it.

1238
01:14:02,187 --> 01:14:05,149
Carbonara is kind of like
the complete realization

1239
01:14:05,232 --> 01:14:07,401
of the foods that I am most scared of.

1240
01:14:09,403 --> 01:14:11,780
[Giulia] Since I've gotten into
the topic of the gut,

1241
01:14:11,864 --> 01:14:14,741
I have become much more relaxed, actually.

1242
01:14:15,534 --> 01:14:19,621
I feel like I know how resilient
and strong and stable this organ can be

1243
01:14:19,705 --> 01:14:21,582
if I treat it right most of the time.

1244
01:14:22,666 --> 01:14:25,419
It's really more about
just listening to your body

1245
01:14:25,502 --> 01:14:27,504
to create a smarter body feeling.

1246
01:14:27,588 --> 01:14:30,257
[Kobi, in Japanese] Throughout my career,

1247
01:14:30,340 --> 01:14:34,928
what's influenced me
more than competitive eating

1248
01:14:35,012 --> 01:14:36,805
is the hot dog.

1249
01:14:36,889 --> 01:14:42,060
[Maggie] Okay, we're adding avocado,
shiso, shiitake, and garlic.

1250
01:14:42,144 --> 01:14:44,396
[in English] Yeah! It's so good.

1251
01:14:44,480 --> 01:14:49,610
[Kobi, in Japanese] I want
to create a healthier hot dog

1252
01:14:49,693 --> 01:14:52,279
by combining it
with healthy Japanese ingredients.

1253
01:14:53,071 --> 01:14:54,698
Mmm! This is good.

1254
01:14:54,781 --> 01:14:56,033
Very delicious!

1255
01:14:56,116 --> 01:14:59,036
This is something new. Unstoppable.

1256
01:15:00,662 --> 01:15:03,582
[Giulia, in English] You can eat something
and then see, how do I feel,

1257
01:15:03,665 --> 01:15:06,001
one and a half, two,
or two and a half hours later

1258
01:15:06,084 --> 01:15:07,920
when it's being taken up in my blood.

1259
01:15:09,463 --> 01:15:13,258
A piece of cake or fries, chips,
tastes great in the first second.

1260
01:15:13,342 --> 01:15:15,010
You'll be like, "Ah! More of these,"

1261
01:15:15,093 --> 01:15:19,181
but later on, you'll feel really tired,
or foggy, or whatever.

1262
01:15:20,682 --> 01:15:25,229
And a meal of, like, rice and vegetables
might not be as addictive,

1263
01:15:25,312 --> 01:15:27,231
but it'll make you feel more stable.

1264
01:15:27,314 --> 01:15:29,650
Or it might not with you. You can check.

1265
01:15:29,733 --> 01:15:31,360
[Maya laughing]

1266
01:15:31,443 --> 01:15:33,820
[Maya] It feels very validating

1267
01:15:33,904 --> 01:15:36,823
that I can allow myself
to enjoy food more.

1268
01:15:39,743 --> 01:15:43,997
The idea that I could have
a bowl with my husband

1269
01:15:44,081 --> 01:15:50,587
and not punish myself
by not eating the day after,

1270
01:15:51,547 --> 01:15:53,423
it would be nice. [laughs]

1271
01:15:55,300 --> 01:15:57,427
Mom, good job on the corn.

1272
01:15:58,095 --> 01:16:01,390
We're gonna do a cheers
towards Mom's good cooking.

1273
01:16:01,473 --> 01:16:02,808
- [Kimmie] All right.
- Yes!

1274
01:16:02,891 --> 01:16:03,891
[upbeat music playing]

1275
01:16:03,934 --> 01:16:05,185
<i>♪ I'm feeling myself ♪</i>

1276
01:16:05,269 --> 01:16:06,603
<i>♪ Never give up ♪</i>

1277
01:16:07,229 --> 01:16:08,272
<i>♪ Straight to the top... ♪</i>

1278
01:16:08,355 --> 01:16:10,357
[engine revving]

1279
01:16:13,819 --> 01:16:15,696
[Kimmie] The only thing that matters

1280
01:16:15,779 --> 01:16:18,657
is how you feel,
what you think, what you do.

1281
01:16:18,740 --> 01:16:20,242
Nobody else matters.

1282
01:16:20,867 --> 01:16:24,496
And maybe my body being different
is the best thing for me.

1283
01:16:25,163 --> 01:16:26,283
<i>♪ I'm flexin', I'm flexin' ♪</i>

1284
01:16:27,416 --> 01:16:31,378
[Giulia] Your body is really the expert,
and you should listen to it.

1285
01:16:32,337 --> 01:16:35,841
Knowing more about the gut
made me feel more proud of it.

1286
01:16:35,924 --> 01:16:37,676
[laughing] I guess I could even say

1287
01:16:37,759 --> 01:16:40,387
I have a feeling of loyalty
towards my gut,

1288
01:16:40,470 --> 01:16:43,974
and even my butthole. [laughing]

1289
01:16:46,852 --> 01:16:48,854
[pensive music playing]

1290
01:16:53,483 --> 01:16:56,043
[Giulia] Not everybody should talk
about their poop all the time,

1291
01:16:56,111 --> 01:16:57,904
especially if they don't feel like it.

1292
01:16:59,364 --> 01:17:01,450
But I think you should know
something about it.

1293
01:17:01,533 --> 01:17:02,868
[poop chittering]

1294
01:17:02,951 --> 01:17:06,955
[Giulia] There are, for example,
seven different consistencies of poop,

1295
01:17:07,039 --> 01:17:10,334
neatly described
in the Bristol Stool Scale.

1296
01:17:11,084 --> 01:17:13,837
Seven and six are a rather liquidy stool.

1297
01:17:13,920 --> 01:17:17,966
This can happen if digestion was disturbed
by something like an infection.

1298
01:17:18,967 --> 01:17:22,971
Four and three is what
you want to find in the toilet,

1299
01:17:23,055 --> 01:17:28,018
and is described as a sausage or snake,
smooth and soft.

1300
01:17:28,644 --> 01:17:30,145
[poop chittering]

1301
01:17:30,854 --> 01:17:33,774
[Giulia] And then we get
to the droppings of a goat,

1302
01:17:34,566 --> 01:17:36,735
and these are the areas of constipation.

1303
01:17:37,944 --> 01:17:42,824
So the consistency or shape
can be a very helpful solid information.

1304
01:17:42,908 --> 01:17:45,118
Like a little text message from your gut.

1305
01:17:45,202 --> 01:17:47,996
So you might as well sometimes
just turn around, check it out,

1306
01:17:48,080 --> 01:17:50,582
and then, you know, take the hint.

1307
01:17:50,666 --> 01:17:51,958
[music continues]