 Well, I thought today we do a deep dive into our gut, because in my next book, The Longevity Paradox, you're going to learn that almost everything that happens to you in a good or bad way actually happens in your gut. And I think I've entitled this a gut sense because what most people don't realize is that the gut is actually the sixth sense that we have. And just like we feel things from touch in our skin or we smell things in our nose or we see things with our eyes, in fact, your entire gut surface is actually a giant sense of touch, sense of smell. It actually sees things. And so we now know that really our biggest sense organ is actually our gut. And the more we're learning about that, the more we realize how much our gut actually has to do with most of us. This is just a quick schematic from your mouth and nose all the way down through your stomach, your small intestines, your ileum, and your colon out your rear end is the same surface area as a tennis court. And those of you who just watched Wimbledon, that's a lot of surface area. And you kind of look at us and go, well, how'd that get in there? Well, the surface area is actually formed, if you remember high school biology. There are all these structures within the small intestines called microvilli. And it's actually the microvilli that have all the absorptive area that accounts for the 20 or the huge surface area that's actually in there. And it's actually what happens at the microvilli that determines so much of our fate. So a few kind of starting points. Everything, another way to think of all of this system is actually your skin turned inside out. And in fact, that's basically what it is. So if you can imagine that your skin has just turned inside out. And if you think about what the skin on the outside of us is designed to do, well, it's obviously supposed to protect us from the elements, if you will. And it's, believe it or not, the home for a large number of bacteria, part of our microbiome. And we now know that this microbiome is there to actually protect the skin. And so it's actually a mutual admiration society. Well, it shouldn't surprise us that if the skin, the lining of our gut, is basically the skin turned inside out. That it's actually designed to do many of the exact same functions the skin does. And that is to protect us from the outside world and be a home for the microbiome in your gut. But it has one other important feature that the skin really doesn't have much interested in, too. And that is it's got to get everything that you swallow into you, if you want it into you, and keep the things that you don't want into you out. So it's got to have incredible abilities far beyond the skin to do all that. Now, to do all that, one of the things I always want people to envision is that everything you swallow is outside of you, always. From here to here, anything that is inside of you actually remains outside of you. And my patients always wrinkle up their nose, and I just swallowed it. It's in here. I know it's in here. Well, if you watch a car go through a tunnel under a river that you would see that car go into the tunnel and you noticed it went into the river and you would expect the car would be wet on the other side. But of course, it wasn't. It wasn't in the river. It was in a tunnel. And so even though everything you swallow is inside of you, it's actually every bit is outside of you all the way down as anything that's in contact with your skin. And so there's an entire outside world within us. And the more we understand what goes on in that outside world, the better are we to let the outside world knows what we're about. So the outside world is composed of the food you swallow and then the bugs, the microbiome, I call them bugs. They're bacteria. They're fungi. They're worms. They're definitely worms in there. There's protozoans. And there's tons of viruses. And there's about, at any one time, four to five pounds of bugs. Now, when people go on cleanses or if you fast, one of the first things that happens is you lose a lot of weight. And part of that is that you've lost that four to five pounds of bugs. They actually eat most of what you swallow. And they like what you swallow or not. And we'll talk about that. But if you stop swallowing, one of the first things that happens is they don't make babies. They don't make reproduction of themselves. And so one of the things as much as it's fun to think about it, most of what winds up in your toilet is actually living bugs and pieces of living bugs. Terry Walls, my friend, a physician from Iowa who cured herself of MS by eating nine cups of vegetables a day, she coined the phrase that every time you look into the toilet after your bowel movement, you should see a large coiled snake looking back at you. And if there isn't a large coiled snake looking back at you, then you're not eating properly for these guys. And she's absolutely right. So these bugs were introduced into most of us when we exited our mother's birth canal or vagina when we were born. And as I told Maria Shriver, she took a crap on her children as my mother took a crap on me. And your mother hopefully did too. And she inoculated us with our first set of bacteria. And she did that on purpose. Some of you suspect she did that on purpose for another reason, but she did that because it turns out that the bugs initially in us educate the immune system. And for the purposes of fun and the fact that we live in California, I call them our border patrol. And interestingly enough, about 65% of all the white blood cells, the lymphocytes, the immune system, lines up along our gut. So they're all there, 65% of them. Why? Because this is the major interface between us and the outside world. Most of us think it's our skin. But our skin is just a few square yards. And this is a tennis court of information exchange between the outside world. So it's no wonder that our border patrol is on our longest border. Because that's where we interact with the outside world and the things we swallow in the microbiome that's living in there. And so that's where the rubber meets the road. Now, so why swallow these guys in the first place? Well, we know that germ-free animals who are born without allowing any contact with bacteria can live. You don't need these bacteria. But they don't live as long as if they had their own set of bacteria. And germ-free animals have now been used extensively in trying to figure out what information the bugs in your gut exchange with your immune system. And this information is exchanged constantly. So getting back to mom and why she did this, mother's breast milk is designed to feed the baby. But the baby is actually two babies. One, us, the human baby. But it's also, if you will, the baby bugs. And that she just gave to you. About 5% of mother's breast milk has, you all guys know it, is oligosaccharides. And these are long chain sugar molecules that the baby and we absolutely can't digest. We have no mechanism to absorb these particular sugars and use them for ourselves. And yet mom puts 5%, 10% of the calories in her breast milk for something that her baby can't use. How stupid a design is that? Well, it's because these guys have to have this to start growing. That's their fertilizer. And without this, these guys don't grow properly. And one of the things we've learned recently in infant formulas in babies who are bottle fed is no one was smart enough to realize that these complex sugars, and not just plain old sugar, is what these guys need to grow. And so many bottle fed children, up until we began realizing, never get the nourishment to implant their bugs properly. The other thing that's important to realize is cesarean babies never have mom take a crap on them. And so they never get inoculated with their original set of bugs from the mother. So we know that cesarean babies, it actually takes about six months for them to begin to have a competent immune system, whereas almost immediately these bugs begin to tell the immune system all about the outside world. Welcome to the outside world. We're your guide. We've actually been in your mother, and we've actually been in your mother's mother. And in fact, interestingly enough, for the sisterhood, all bacteria come from your mother in the original time. Now, we can get really nerdy and deep diving because the energy producing organelles in all of ourselves are mitochondria. And we now know that mitochondria are actually engulfed bacteria that billions of years ago, a deal was made where these bacteria hopped inside of cells and said, tell you what, this is a nice place to live in exchange for living in this lovely cell. I'll provide you with energy if you'll give me something deep. And that stuck. So it turns out that mitochondria are bacteria in us there. And they have their own DNA. In fact, one of the striking things is when all of our cells divide, normally we think of all our genes are in our nucleus and that they divide and separate. Well, bacteria, DNA in the mitochondria, divide separately. And when you do all your ancestry.com and things like that, when you look for your ancestors, what we're actually doing is tracking maternal mitochondrial DNA. Because all of your mitochondria, you inherited from your mother. And we don't get any mitochondria from our father. They're in the egg. The sperm is a low life, as all of us know. And just doing its work but doesn't contribute anything. My mother reminds me all the time, and my wife, and my kids, both daughters. So here's the really cool thing, the nerdy part. Your bacteria come from your mother. Your bacteria that we now call mitochondria that live in all of our cells come from your mother. And there is now pretty doggone good evidence that your mother's bacteria talk to your mother's mitochondria in just kind of the ultimate sisterhood. And we now know that bacteria in us actually constantly send text messages up to their sisters, the mitochondria, to tell them how things are going in the outside world. Now, why do they bother to do that? Well, if we did a body count of all the cells in us, 90% of all the cells that make up you and me are non-human. Sorry about that. So we're basically a condominium for bugs. The really weird thing is, if we did a gene count, humans actually have not a very big genome. We actually have a very small genome, but we're by far the most complex animal. So how's that work? Well, if we did a gene count, all the DNA material in us, 99% would be non-human. 1% is human. So next time you're feeling very proud of yourself, you're just basically a bug carrier. And we're beginning to suspect that the bugs are using us for their purposes and not the other way around. They're not just crap that goes into your toilet every day. OK, so back to mom and her bugs. So these bugs immediately start talking to the immune system, to your young white cells. And they start telling your immune system, OK. Now, we've been around a long time. We've been around for millennium. And there are certain proteins, primarily in food, that we've learned over the eons of time are bad actors. They're not your friends. And we want to teach you about them. And so whenever you see them, you ought to go on alert, because they're not your buddies. On the other hand, we've known a lot of the foods that mom's going to give you and you're going to find that are perfectly acceptable. And we want to teach you about that from day one. And so we now know, not only do these bugs actually live inside our gut, but exciting new information is that these bugs actually make direct contact with the cells lining our gut. And I've been trying to get my editor at Harper Collins to have a picture of a bug with a direct connection with the cells in our gut. That's kind of do, do, do, do. But they really are a part of us. We now know, for instance, since we have a lovely pregnant woman in the audience, that bacteria actually are in your placenta. And her bacteria in her placenta are already, before her baby's born, communicating to the immune system of her baby about how things are in the outside world. And some of the exciting information in autism spectrum shows that the mother's bacterial population at the time of her pregnancy may in fact be one of the big factors in the formation of the autistic brain, because we know the gut in autism kids is screwed up to say it nicely. OK, so far so good? That's pretty bizarre stuff. So these bugs talk to our immune system. What's interesting is we know that cesarean babies have far higher instances of allergies and food intolerances than babies who are born vaguely. And again, that's because they've lost a critical window of time to educate the immune system about who they should be worried about. And so the immune system never really gets the proper training about who to trust and who not to trust. And so the immune system is far more active in babies who are born with cesarean. As many of you know, there's a movement to take cotton swabs and swab the birth canal and the vagina and the perineum and rub them onto the baby's nose, in the mouth, in a cesarean section. I had, a couple years ago, a doctor in Santa Monica refused to do that for his patient, who's my patient. And I actually had to write a prescription for him to do that so that she could have her baby swab. No, you need these guys. OK. All right, so we got a tennis court. We've been educated about the food. And quite frankly, if you've read the Plant Paradox, you know that the longer that we've been exposed to proteins and foods, which include lectins, which are the plant defense system against being eaten, and we'll come back to those, then the longer our immune system has been educated by our microbiome, that we know this particular plant. Your mother's mother, mother, mother, mother has been eating this plant for the last 2 million years. And yeah, there are some lectins in this plant, but it's OK because we got your back. We know how to handle these guys. And just don't pay them any attention. On the other hand, as you know from the Plant Paradox, that there are foods that are quite new to us and to our bacteria. And it's my contention and many others' contention that the newer that food is, then the less chance we've had, the less time we've had, to have bacteria in us that have evolved to handle those. But more importantly, the less chance we've had to educate our immune system, that these are proteins that we've known forever and we really don't have to get upset about them. So this whole system starts not only from day one. We now know it starts in the womb. But the more we're learning about how critical this part in the whole shebang is, the more we're looking at baby health and more importantly, mom's health during the pregnancy. OK, so this huge absorptive area, the horrible design, is that what I've drawn here is actually what this looks like microscopically in one of these little villi. And the cells that line our intestines are only one cell thick. And they're held together. Anybody play Red Rover, Red Rover when you were a kid? So we all locked arms and two lanes. And the big kid usually came around with his knee up like this and the girls squealed and it broke. And apparently, kids don't play that anymore. I guess you can't play it with a cell phone. So anyhow, all these cells are lined up end to end. And they're all held together with what are called tight junctions. And these tight junctions are the locked arms of all the kids. Now they have to be there because there's only one cell separating all the foreign proteins you eat, all the bacteria that are living there, all the worms, all the fungi from you. One cell, that's it. Now why is it just one cell? Well, because when we swallow food, food consists of proteins. It consists of sugars. And it consists of fats. That's all there is. Now that was basically the lecture in medical school. OK, nutrition class. There are protein, sugars, and fats class dismissed. And that's about all we ever learn. Now the problem in digestion is that most proteins are much too big to pass through the wall in a way that's a good thing. Sugar molecules in the old days used to be chains of sugar molecules, complex carbohydrates. And fats are also much too big to be carried across this wall. So digestion is actually designed to break proteins into small particles amino acids. And sugars into simple sugars and fats into lipids. Why? Because it turns out these cells are pretty cool. Let's suppose we have an amino acid here. What happens with this little amino acid is the cell bites off a bite of the amino acid. And then the amino acid wanders its way through the back of the cell. And then the amino acid is popped out the other end of the cell. And waiting on this side is our venous system of the belly called the portal vein. And it carries almost everything you absorb to the liver. And in the liver, you reconstruct things back into whatever you want to build it out of. But one of the rather humorous things is I'll just use an example of collagen. Collagen is a very hot topic right now. Well, collagen is a very large protein. And collagen cannot be absorbed intact. Instead, it's broken down into its original amino acids. And then you absorb all the amino acids that make up collagen. On the other side, your liver has to decide how much collagen it wants to make. And if it says, oh, here's some nice amino acids. I think I'm going to make the cell membrane. Instead, thank you so much for those collagen amino acids. I'm going to use them for something else. But wait a minute, I gave you that for this. So it's OK to take collagen, but it's a bit naive to think that all of the collagen you ate is immediately going to become collagen on the other side. Our bodies aren't that smart that we can be told, here's some collagen, make sure you use it properly. OK, so one other kind of fun fact. And some of Gundry MD products use compounds that are primarily in cruciferous vegetables to stimulate some receptors called the R receptor. And whenever you eat cruciferous vegetables like broccoli or cauliflower or kale or arugula, there are compounds in cruciferous vegetables that actually hit these listening devices. It's like I'm sure there were some listening devices with President Trump and Vladimir Putin in the private room. And they actually are listening for and tasting these compounds. And what these compounds do is actually tell your immune system that some food is on the way and it's food that you recognize and don't get all upset. OK, I'm going to erase some of this. Now, this all sounds wonderful and very smooth, pretty easy. The problem becomes when these guys, this is their side of the border. And we can call them our guest worker program because they are incredibly important, actually to back up for a second. I and others believe because 99% of our genes are nonhuman and that most of them live inside of our gut that we've actually uploaded most of our information processing to the cloud. And the cloud is our bacterial cloud. Why would we do that? Because only 1% of our genes are actually inside of us and we're actually not exposed to the outside world. On contrast, about 99% of all the genes we have are living inside of what we've swallowed. And so many of us think that for efficiency purposes, this cloud, which contains most of the genes in us, is far more efficient at telling us what's going on in the outside world. It's really, it's like, again, it's like, holy cow, we've uploaded almost all of our decision-making processes, interpretation of information, not to this brain, but to this brain. And we'll talk about that in the next lecture. OK, so back to here. So normally, this is intact, but along come our friends lectins. And lectins are big, foreign proteins. But some fantastic work a few years ago by Dr. Fasano from Johns Hopkins finally broke the code of originally what was gluten intolerance, celiac disease. And everybody knew that lectins were, in general, very large proteins. And they couldn't get through the wall of the gut. They couldn't get absorbed. And yet, people, for instance, with celiac disease, which is true gluten intolerance, it was clear that gluten was causing an immune problem at the gut. So what Dr. Fasano found was that lectins could bind to the sugar molecules on the lining of the gut. Lectins are sugar-seeking proteins. And they love particular sugar molecules, one of which sits on the wall of each of your cells in your gut. So they actually flip a switch that makes a compound called zonulin. And zonulin hits another receptor and breaks the tight junction. Now, imagine that that's happening cell, after cell, after cell. And these tight junctions are now apart. So now, rather than this wall, we've got gaps between the cells. Now, what can happen is not only can lectins go through the gap, but bacteria can go through the gap. And pieces of bacteria called LPSs, lipopolysaccharides. As you know in the book, I don't swear, but I can't resist calling them little pieces of shit, because that's what they are. They're bacterial cell walls. And big proteins go through. Now, when all this happens, here's your immune system, you're border patrol on the other side going, oh my gosh. The hordes have broken through the outer defenses. We're under attack. We're being overrun by invaders. And we should call back to high command. We should hit the air raid sirens. We should go to threat level five. And we should prepare for war, because clearly we're under attack. And they send troops to the front lines. And they signal, among other things, that holy cow, there's some bad guys in here. We've got to get them out. And the next time you have an interesting case of diarrhea, you know, guaranteed that somebody got into you that shouldn't have gotten into you, and you're going to get rid of them as quickly as possible. But this now sets up the immune system calls to all of you that wherever you guys see any foreign protein that happens to look like a lectin, that happens to look like a piece of bacteria, I want you to shoot, kill, and ask questions later. And give you an example. Kelly Clarkson was a perfect example. Kelly Clarkson had Hashimoto's thyroiditis, which is a autoimmune attack on her thyroid. It turns out that the proteins in the thyroid gland look remarkably similar to the barcode of a lectin protein. Our immune system determines whose friends and foe by literally reading a molecular barcode on every protein, saying, eh, is this guy in the no fly zone? Is this guy's passport invalid? And if it is invalid, then it says, I'm sorry, you're in the clinker. And we're going to kill you. So lectins use proteins that mimic other proteins in our body. And so when pork Kelly Clarkson, who had a leaky gut, I can guarantee you, when her immune system, fighter jets see her thyroid, goes, oh my gosh, her poor thyroid is full of lectins. We should shoot to kill. We'll ask questions later. Now, what happened to Kelly is she got the plant paradox. And lo and behold, she got lectins out of her diet. She started eating food that actually fed friendly bacteria. And she sealed her gut. And since lectins were no longer getting into her, her war stopped. The immune system, you know, OK guys, the war is over. We can go have a donut. And she no longer attacked her thyroid. And that's how she got off of her thyroid medication. So autoimmune disease happens at the gut. Apocrates told us this 2,500 years ago. He said, all disease begins in the gut. Pretty smart guy. So our gut is not just the crap we eat or the crap that comes out of the rare end. It's our largest sensing organ. And it's really the home to our computing cloud of everything that's going to happen to us. So I think I'll quit there because we've got another lecture on what happens with the gut in the brain. Questions? You mentioned that these also guess good bugs. What kinds of things are we doing wrong to enable the bad bugs and what can we do to help the good bugs? Great question. Yeah, there's always, just like kind of there's a war here, there's a war for space in your gut. There's only so much real estate. And location, location, location is one of the keys. I think just I'll briefly touch on that because we're going to talk a lot about that in the next lecture. But the bad bugs love simple sugars and saturated fats. They love them. They demand them. Unfortunately, most of our good bugs can't use saturated fats. And they can't use simple sugars. They like complex sugars, polysaccharides. The bad bugs can't use polysaccharides. They have no digestive mechanism to use them. So one of the things we've done in a typical Western diet is heavy on sugars and fats and almost non-existent for complex carbohydrates, for resistant starches, and long-chain sugars. So for the most part, the good bugs are basically starving to death, hiding in corners. And the gang members are saying, man, it's the best thing that ever happened to us. The problem with these gang members is by far most of the LPSs that we recognize as dangerous come from the bad bugs. Very few of the good bugs produce the LPSs that we worry about. And it's probably because up until really the last couple of generations, most of our gut bugs were friendly. And we know that people in the very long-lived societies have a very distinct friendly gut bug population that actually, believe it or not, nourishes this wall of the gut. And one thing I'll leave you with, as we get older, most people, when they see their parents or their grandparents, their skin gets very thin and becomes very fragile. And you can just kind of glance at it, and it'll tear or their bruise. You see all the old folks with bruises. What we now know is this is your second skin. It's actually your largest skin. So what you see happening on this wall is reflected on your outer skin. And the really exciting research that's going to be coming out in the longevity paradox is that this thin skin that we see on old folks is actually the thinning of this wall. And as this wall thins, the hordes at the gate, as I call them, constantly now break through. And this is actually what actually brings out our death. And this has been proven in very elegant animal studies. So one of the things that's been exciting is whenever I meet new patients and they know how old I am, first thing they say is, let me see your hands. Let me see your skin. You don't have the hands and skin of an old man. Because I spend all my time taking care of my gut buddies. And they, in turn, actually reinforce the wall. It's actually really exciting. And that's reflected out here. If you put stuff on your skin. Yes. Yeah, the microbiome, we know a lot about what the microbiome on the skin likes and what it doesn't like. The microbiome will actually defend their home to the death. You can introduce actually bad bacteria. And they will actually fight to the death to keep those bacteria from hurting us. The other thing we know is that the microbiome, just like there are bugs that plump this wall, we now know there are bugs that plump the skin just as well. Because that's their home. And one of the exciting things with one of the ingredients in my skin, Caroline, called bonacel, which is produced by a bug called BC30, is that the byproducts, the poop, if you will, of BC30 bugs, actually plump skin. It actually gives skin cells what they want. And that's the really cool thing is the science is here now that we know exactly what we need to do to keep our inner skin healthy. And we know exactly what we have to do to keep our outer skin healthy. Is there anything else the mother can do to maybe take down that six-month immune system? Like can she take probiotics or prebiotics or give it to the baby? Well, it turns out there's recent research that you are, with your breast milk, inoculating there are bacteria in your breast milk that are actually designed to supplement the bacteria that you pooped on your kid. So that's actually fairly recent. People have always believed that breast milk was sterile because, oh my gosh, you can't have bacteria in breast milk. That would be crazy. But there are now bacteria in breast milk that will colonize the baby. But it's not enough as that just initial big old whack on the kid's face and nose. Do you recommend mom taking extra prebiotics or probiotics? Well, again, I think the big thing, particularly for mothers, is the more prebiotics, which are the fibers, the soluble fibers that good bugs like. The better off you are for the baby, particularly when you're breastfeeding. All right, well, thank you all for your attention. Appreciate it. All right. Thanks for watching. Don't forget to visit my website, linked in the description box below, for more of my best tips. If you haven't already, click the circular channel icon to subscribe and make sure you never miss another video. Because I'm Dr. Gundry and I'm always looking out for you.