Peter Attia· MD
the problem the the the the push back all of those Technologies get is the ease with which things can get contaminated and so essentially you might be able to get a sample but then in the process of pulling that back out it gets ex it kind of becomes contaminated with the other things that are along the tract and so operatively could potentially be that would be I mean that anyway hopefully someone is doing that right because like it you know if you're if you're in there operating otherwise now the problem is you wouldn't be operating on somebody without a bowel prep and so you've completely destroyed the system yeah that also you're not operating on somebody in an Anor robic chamber those strains might the second they get exposed to oxygen it's sort of different okay so explain how carbohydrate carbohydrate metabolism produces byproducts and what those byproducts are because people who listen to this podcast people like me when I think of carbohydrate metabolism I don't think of any of the things you just said right I think of glucose I think of glucose one phosphate I think of glucose 6 phosphate I think of pyate I think of acetal COA I think of the uh kreb cycle I think of um you know lactate as a byproduct of oxidative phosphorilation so you're thinking of things in a different level because you're obviously looking at a different host so explain the metabolism on that side of the Ledger yeah so in this case when we talk about carbohydrates we're really talking about these fibers and so our microbiome is uniquely positioned to metabolize fibers a wide variety of which we actually can't even metabolize ourselves and um fiber is a one of the primary prebiotics that feeds kind of all of your strains and so you're right when we think about carbohydrate Metabolism from the perspective of the microbiome it's really about these fibers and so they are there are um kind of primary and secondary fermenters in the microbiome that can metabolize these fibers into certain short chain fatty acids which then become precursors for the ultimate short chain fatty acid which is butyrate but butyrate is this incredibly important uh short chain fatty acid that's been studied in a wide variety of conditions and so your microbiome one of the most important molecules it makes is butyrate um and so butyrate has role a role in GI health um the colon cells are the only cells that use butyrate as their source of energy as opposed to glucose which is what used by every other cell and so when you don't have enough butyrate that's been associated with things like colon cancer and you know not having good colon Health um but butyrate is also a small molecule that triggers G protein coupled receptors to then um uh release uh glp1 from these L cells in the microbiome so it also plays a role in sort of this gut metabolism axis um and so berate becomes this really important small molecule that the gut is producing based on the foods that you're eating um and and that's kind of where we've really honed in so if we think about the difference between soluble and insoluble fiber are you referring mostly here to insoluble fiber because you alluded to the fact that it's fiber we aren't able to digest and metabolize that is the food stock for these bacteria yeah that's really where we're focused in on is these insoluble fibers and insoluble fiber I guess is most readily available in vegetables correct exactly are there what vegetables and fruits yeah other fruits as well yep so um by the way I I was asked recently by a patient you know I drink this like green drink every morning and they're like you know why do you drink it do you think it's a substitute for having vegetables and I said I really don't I think I said I think it's a substitute for having vegetables with respect to the vitamins you get and probably even a lot of the polyphenols but it's clearly not a substitute for the fiber just based on the practicality like you wouldn't you can look at the ingredient label like there isn't enough fiber in this to be a substitute so at the end of the day like there doesn't appear to be if if you buy the argument which I think we're going to discuss that fiber is essential for gut health which by extension means essential for human health you have to be eating a ton of fiber insoluble fiber right yeah you you you do although I mean there have been a a um you know m of studies showing that you getting fiber from these external sources these powders now you have to get them in the in the volumes um needed uh but they can be pretty impactful for your microbiome as well how many I mean what what are what are typical recommendations of fiber like how many grams per day 1830 something like that yeah I I think that the I actually don't know what the current kind of standard recommended dose is but I think it's somewhere between 20 and 30 grams a day it's hard to imagine getting that in a supplement yeah and but and I think actually your average Americans consuming like one to two I it's