Naveen Jain: There is no such thing as universal healthy food or universal healthy supplement. and it goes back to thousands of years ago we knew one man's food is another man's poison. So there's nothing here, there's no rocket science here. for me when I did the first test, it told me not to eat broccoli, not to eat cabbage or brussels sprouts. It told me exactly why I shouldn't do it. and I have a choice. I'm going to still smoke knowing I'm going to have a cancer, right? That's a choice you can make. But now it's very clear. You can eat it knowing that it's going to cause inflammation.
Dr Rupy: Welcome to the Doctor's Kitchen podcast. The show about food, lifestyle, medicine and how to improve your health today. I'm Dr Rupy, your host. I'm a medical doctor, I study nutrition and I'm a firm believer in the power of food and lifestyle as medicine. Join me and my expert guests where we discuss the multiple determinants of what allows you to lead your best life. Making illness optional. I want to address the provocative title of today's podcast head on because it is not just clickbait. It is the genuine ambition of my next two guests on the show. Momo Vujisic is co-founder and chief science officer at Viome, and he provides scientific leadership with his vision to revolutionise healthcare from symptom management to a true preventative medical system. He leads product development, clinical test and implementation and their comprehensive clinical research portfolio. Momo is an adjunct professor at the University of New Mexico and New Mexico Tech. Before co-founding Viome in 2016, Momo spent 12 years at Los Alamos National Laboratory where he led the applied genomics team and developed the core technology used by Viome today. Naveen is quite frankly one of the most energising and inspiring billionaire entrepreneurs of our time. An intensely curious personality who believes that the energy of an obsessed entrepreneur if used with innovative technologies can create crazy ideas that push humanity forward. He's also the author of the award-winning book Moonshots: Creating a World of Abundance and his current moonshot adventures are Moon Express and Viome. Now Moon Express is something that Naveen mentions right at the start of the show and it is the only company globally with the permission to harvest resources from the moon, developing the infrastructure needed to push humanity forward towards a true multi-planetary society. It's super, super exciting. He's vice chairman of the board at Singularity University and Naveen focuses on educating and inspiring leaders to address humanity's greatest challenges by using and developing innovative technologies. He also has many accolades including the humanitarian innovation award from the United Nations and I do like his perspective which is quite unique in that the planet will always thrive. It is humanity that we really need to be looking after and if you think about it through that lens, it really does make sense. Viome has a mission to make illness optional by building an AI driven platform that analyses the interaction between food and our microbiome and our human cells. Viome is able to develop precision nutrition to prevent and reverse chronic diseases rather than another gut health or nutrigenomics testing company. Viome is described as a data driven precision nutrition company. Today we talk about Momo's personal health journey with idiopathic arthritis, Naveen's moonshots, the limitations of DNA reviews, the Viome Research Institute making the tech available for more people and other scientists around the world, different types of omics, the gut as a series of chemical reactions and how food is an addition to these reactions, predictive as well as preventative medicine which is super exciting for me, why Viome is not just a microbial testing company, systems biology and Viome's microbial holistic supplement and food-centric approach and just why we need to get on with it. And I really do like the urgency as well because we are looking down the barrel of a very, very complex healthcare system over the next 10 to 15 years with the rise of chronic disease. So innovative technologies like this need to be scaled and need to be tested as well. So before we start, I also want to make very clear that in no way have I received any benefit in kind or financial from Viome in the decision to make this podcast. In some ways my views are not wholly aligned with the company, but I do respect their drive and vigour, which is why I wanted to showcase their story and work. And I think this blend of scientific knowledge, personal experience, entrepreneurial drive and unashamed ambition to even dare pose the question of making illness optional is why I was so excited to have this conversation with both Naveen and Momo today. Please do enjoy. Momo, Naveen, it's a pleasure to chat to you. Momo, we've chatted before on one of your legendary walks that I've just found out that you do with Naveen regularly. a thousand miles last year, brilliant. I would love to start off this pod by by going into a bit about your back story. So Momo, if you wouldn't mind, we'll start off with you and and how you've come to the position where you are now.
Momo: Yeah, so really the the where I am now was led by two different pieces. One was scientific and one was personal. two different stories that sort of melded together. The personal story was that I developed idiopathic arthritis at a young age in my 20s and idiopathic just means that medicine doesn't know what causes it. And so they wanted to pour, you know, anti-inflammatories on my system and I was a heavy heavy user of NSAIDs for many years because I didn't want to take the biologics. And so that was sort of a deteriorating over time, slow sort of low-grade inflammation, joint pain, soft tissue pain, a whole bunch of other symptoms. And while I was in grad school and postdocs and being a scientist and so on, and the second part was that I as a scientist and with a PhD in chemistry, I I think I understand the human body the way it's supposed to be understood, which is that we are basically a sack of chemicals and chemical reactions and they're very, very well controlled and they're the being controlled and being in some kind of a nice balance maintains our health. And if out of these thousands or tens of thousands of chemical reactions that are occurring in our body today, this moment, every moment, if some of those reactions go either too low or too high and they multiply, then that can lead to disease and then eventually that can lead to symptoms. And so as a scientist and as a sort of a primary part of my science career was analytical biochemistry, being able to measure things, I wanted to digitise the human body, digitise it when it's healthy, digitise it when it starts to fall apart and then and then understand how we can reverse that and prevent that. So through my journey, my personal journey of of this sort of weird rheumatoid arthritis/ankylosing spondylitis kind of a mystery disease, I rejected the idea that this is a bad luck or a mystery or some some extraterrestrial force. I I just was convinced that there was something that was irritating my immune system and that it was thinking that it was it was not self when it was in fact self. So that's why it was called autoimmune disease. That's what the doctor told me at least. So it turns out, to make the long story short, that there is a specific kind of a molecule that all mammals produce. So mammals are a group of animals that we belong to. And all mammals produce this molecule, it's called Neu5Gc, NEU5GC, except humans. Humans do not produce this molecule, but we have the ability to absorb it and we have the ability to transport it in our bodies and actually integrate it into our own cells. These are epithelial cells in the joints and in the arteries and veins and soft tissues and so on. And so once I found out about this molecule after reading the world's literature on low-grade inflammation and anything that could trigger the immune system and autoimmune diseases and nutrition and I tried every single diet on the planet and nothing worked. Nothing absolutely worked. In fact, the ketogenic diet really messed me up badly. It was kind of a big hit at that time and I tried it for three months and it was just a a terrible, terrible thing. Anywho, so once I found out about this molecule and and dug into the literature, I realised this could be it. And so I basically withdrew all mammalian products from my diet, completely 100%, no cheat meals, nothing. And I knew about the chemistry about this of this molecule that it's a very stable molecule. It's integrated into our cells and it stays there for at least a month before it's recycled. So I was extremely good at staying with my diet for two months. I had tried vegan diet before, but I had only tried it for two weeks and it didn't do anything. So I thought, okay, that's not for me. And so this time, I completely removed mammalian products and my disease started to regress. And after two months, I kind of knew this was it. And because I was in a pretty bad shape, it took over a year to heal, but my body actually healed. And so now for many years since that diet switch, I have not had any symptoms. I have zero symptoms and I have completely cured myself. You know, my right hip was starting to lock up at that time. It was simply not wanting to move and now there there's not even pain, there's nothing for many, many, many years. So this was a real powerful personal story that says, you know, what appears to be true is not actually true that I had this, you know, variety of symptoms that were that could have been classified as multiple diseases, but it was just labelled as an autoimmune disease and the modern medicine's response is, let's just pour, you know, anti- anti-inflammatory onto you and that's the best we can do. When in fact, there was a root cause, I removed it and the disease completely went away and I haven't taken an ibuprofen in many, many, many years, right? So that was really powerful and that made me completely switch my scientific career from everything else I was doing. I was involved in, you know, I was leading 50 projects in seven countries, a really busy scientist and and it just dawned on me that, you know what, I went to a retirement party and this one person was retired and retiring and he had a very, very, you know, successful scientific career by all standards. And they announced how, you know, he went to this many conferences, he published this many papers, this many patents. And my simple question was, has any of that work impacted a single human being on this planet? And the answer was no. It was those papers are sitting on a cloud server somewhere and someone may or may not read them for the rest of the human history and that's it. That was his scientific career of 40 years. And I thought, oh my God, I am absolutely wasting my precious time on earth. And so that was just a jolt. It was like a heart attack. It was like an amazing feeling, hey, I can actually use my passion, my my energy and my knowledge to actually help humanity live better lives, right? And that's basically when when this whole cascade of cascade of events happened that led to Naveen and I co-founding Viome and now spending many years with Naveen and it's been just an incredible journey. I mean, I I hope I have time to write a book at some point in time about this because it's it's just been an incredible thing matching my scientific background with Naveen's amazing business background and creating something that doesn't exist today.
Dr Rupy: Yeah, absolutely. I mean, the the power of a story like that is just so impactful. I mean, my own personal story with overcoming illness using a diet and lifestyle approach is something that jolted my own career along as well, which is why I'm so passionate about nutrition and lifestyle and all the other clinical tools that we have at our disposal as medics that we unfortunately put to the sideline because we're not taught about it from a medical school. Naveen, I'd love to to bring you in here and talk a bit about your your journey and and and what has led you down this path of of health and wellness.
Naveen Jain: You know, in life, you rarely, you know, you're born and say you're born to do this. And people always say when you were young, did you really always wanted to do healthcare? Did you always want to go to the moon? And the answer is, yes, most of the time we rewrite the history and go back and say how all my life this is all I wanted. But I think the truth really is, it just happens to, you know, things happen and things build on each other. So it's really never the last straw that breaks the camel back. It is all the other straws that have accumulated until then and last straw just happened to be it, right? And so to me, you know, I have never been, you know, say that, hey, I want to go disrupt healthcare. You know, to me, when I look at an industry, it's never about the industry. I focus from a very different perspective. As you know, my previous company, I was, you know, looking at space exploration and people say, what is what's common between the space exploration, the internet work that you did and now you're doing healthcare? And the answer is there is one big common thing in all of them. So when I was doing the internet, we really believed this was the medium that will change the trajectory of how humanity lives. You know, the fact today we talk about connecting people as a birthright. And and I remember, you know, way back, you know, 30 years ago, people say like, connection is, why would you want that? Why would you want your phone to be with you? Why do you want people to be able to contact you all the time? I mean, my point is the thing that just seems so crazy and now we take them for granted. You know, going to, you know, space exploration is not about exploring space, even though we humans are explorers by nature, right? But it is about saving humanity from potential extinction, right? So imagine 7.4 billion, every species we call human lives in a single lives on a single spacecraft. If our spacecraft gets damaged, we it's not that our planet won't survive. Our planet would do just fine. The human species may not survive, right? And people have a very hard time grabbing and you know, especially in Europe, oh, I'm really worried about the planet. Really? Are you that great? Planet, you don't need to worry about. worry about yourself and the species that you belong to, right? Go back 65 million years ago when our spacecraft got hit by a large asteroid. In fact, all the dinosaur species which were substantially larger in size than us, they all disappeared. The planet in fact thrived. It thrived so much, it created the human species, right? Now imagine if human species get wiped out, it may create a superhuman species for all we know, right? But the fact is if we love this our human species, wouldn't it be nice to actually back it up onto multiple places? And I think, you know, whatever that, you know, means, we can say why moon, why not Mars? And the answer is really simple. Yes, you want to be actually on Mars. In fact, you want to be beyond our solar system because, you know, moon is still in the, you know, cis-lunar earth cycle and something happens to earth, it's very likely the who knows what will happen to the our, you know, orbital cycles of the moon at that point. But moon is a great place to learn to live outside the planet Earth and it's still three days away. You don't want to be on Mars six months away. As I said, it's better to be a lunatic three days away than to be a Martian six months away. If should ever happen, right? Having said that, ultimately you want to go beyond your solar system in case our sun is going to blow up, whether it is now or a billion years from now, the sun is going to implode. It's just a cycle of universe, right? And when that happens, you want to be in a different solar system. In fact, you want to be beyond our galaxy into a different galaxy. And if I were to really venture out, I would say you want to be beyond our universe into another multiverse. And you may argue that many of us are already living in a multiverse anyway, right? But coming back to it, right? You know, you start to look at the stuff that I was doing that what do I do next? And every time I start a venture, I actually ask myself three questions. And the reason I mentioned is everyone who's listening to it, if this is one takeaway they take from this podcast, this is going to change actually entrepreneurship and how we move the society forward. So the three questions I ask myself, why this, why now, why me? And why this is really simple. God forbid, I'm actually successful in solving the problem that I set out to do, would it help a billion people live a better life, right? And I'm going to apply this to our healthcare company, Viome, how we actually why Viome fit into that. The second part of it is why now. And why now is what has happened in the last couple of years, but more importantly, what do you expect to happen in the next three to five years that will allow you to solve this problem now than it was possible a decade ago or half a decade ago. And the reason is, if you can take advantage of the technologies of tomorrow, that actually you can intercept when they are going to be ready, then you are actually riding the wave of the exponentiality. And I'm going to tell you why exponential concepts are so hard to understand. And the last part really is, why me? Why me is what questions that you are asking which are different from what everyone else in the industry is asking. And the questions you ask are the problems you solve. And I think this is the key part of the message is that most entrepreneurs either have the technology and trying to figure out what problem to apply to or worse yet, they are going out and actually doing what everyone else in the industry is doing because they're asking the same questions, right? Now, let me give you an example of how I applied that to Viome. And, you know, to me, this is again, goes back to in life, there is always the trigger. And the trigger is just the trigger, but not the event itself, right? And I started to look at and saying, you know, my dad had pancreatic cancer. And of course, I lost my dad to pancreatic cancer. And to me, that was a trigger event. Like, why do people die from these diseases? Is it something that built into our human cells that once we get 40, we have to get a chronic disease, that we're going to get obese, we're going to have diabetes, we're going to have heart disease, we're going to have cancer, we're going to have dementia, we're going to have Alzheimer, we're going to have depression. The answer was, there's absolutely nothing in our DNA that says you have to have these things, right? And these are the matter of choices we make, even though we as humans like to say, oh, it's a bad luck. Oh, Rupy, it's really, I'm so sorry, it's a bad luck that you got this. The answer really is not a bad luck. It's a matter of bad choices we have made, sometime knowingly, but more often unknowingly, the choices we make are the things that happen. The first part was, we say, what if we can prevent and reverse chronic diseases? And that was the fundamental mission. So if you say, why, imagine living in a world where illness is optional. I mean, that was literally our tagline. Imagine living in a world where illness is optional. And we say, okay, number one question, why this? If it is successful, would it help a billion people live a better life? Answer was 7.4 billion people. Check mark. Why now? And as Momo mentioned, why now was simple. To do to solve this problem, the three things needed to happen. We have to be able to digitise the human body and the cost of sequencing had to come down significantly. At when we started the company, the cost of sequencing was going to be about $1,000 plus. And we were absolutely convinced in the next couple of years, the cost will come down to $100. Little that we know, the cost actually came down to $10. So this is the beauty of exponentiality is when we were 10 times optimistic, turned out we were 10 times pessimistic of where things were, right? Same thing, we said, even if you were to digitise the human body, it's not going to solve the problem. You have to be able to process this massive amount of data. And we realised we're not going to have access to supercomputers to be able to do that. And the cloud computing was actually starting to come along. The first time when we actually analysed the samples of people, it cost us over $40 on Amazon Web Services just to process one person's data. And we knew in the next couple of years, the, you know, this cost will come down to about $10. Little that we knew that it came down to around buck 50, right? I mean, that's really the power of the things that how fast things were moving. And last part was, even if you could process the data, what would we do this massive data unless AI is powerful enough and self-learning that we are able to in fact make a sense of this massive trove of data. And we realised that AI is going to be so powerful, self-learning, we could get there. And that was the reason we said time is now. The last part is where how Momo came into the picture. My thinking was, you're when it comes to chronic diseases, people were all asking the same questions. They were two questions being asked. What does my DNA looks like? Because somehow DNA they thought was magical. If we could figure out the human DNA, we will know the software of the human body. And the second thing was people were starting to realise the microbiome is something important. And they could if they could just figure out which microbes are in my gut, I'm going to magically solve this problem. And now, me having no background in science, no background in biology, to me, it was very interesting how I looked at this problem. I said, look, your genes don't change when you gain 200 pounds. So I can do your DNA test today and when you gain 200 pounds, your DNA will be the same. Now, you become depressed, your DNA still hasn't changed. Now you get autoimmune disease, your DNA hasn't changed. You get, you get my point, autoimmune disease, you can have every known disease known to man, your DNA doesn't change. And if DNA doesn't change, what does change? It turned out, even if your genes are not changing, your gene expressions are always changing. And we say, oh, that is the key. We really, really need to understand the gene expression. And little that I knew, I have no idea what gene expression is, but we knew that was the thing. Now, interestingly was, same thing in microbe. Now, I don't know what these microbes are. In my world, they are like little human beings. That's how I honestly thought when I was starting the company. I say, these microbes are like little human beings. If what if they are like just human beings? The hundreds of different microbes can do exactly the same thing. So you take two people with diabetes, they can have completely different organism, still be diabetic because they're producing the same chemical that makes you diabetic, right? Or the same organism could produce completely different thing based on the environment, just like a human being. A person can do a bad behavior when they are in the bad environment and do a good behavior when they're in the good environment. What if these little organisms are doing the same thing? And it that was literally the key that we are going to focus not trying to understand which microbes are there, we're going to focus on what they are actually doing. And that was the fundamental belief. And we say, our questions I'm asking is, what genes are being expressed, what microbes are doing, not which microbes are there or what's the DNA. And that is really was the how Viome was born. And anytime, by the way, you ask these three set of questions, you can apply this to a company you start or the girl you meet or the boy you meet. You can ask, why her, right? Right? Why this, why now, why me? And you can literally apply this to everything you want in life, right? And I mean, so my point I'm trying to make is, so Viome was born out of a simple belief that chronic disease can be prevented and reversed. And in my journey to find this, you know, finding gene expression, I went to NASA JPL. I was my understanding was if they can go to Mars and look for a life, they must have some technology, right? And it turns out they couldn't figure out how to do the things, right? So I went there, talked to all the scientists and they told me they have delta-doped UV sensor that can tell me what microbes are there and if there is a microbiome, any organism, living organism there, but they couldn't tell me what they are actually producing. So I went to NASA Houston, then I went to NASA Kennedy Space Center, I went to Lawrence Berkeley, Lawrence Livermore, and I was now on my journey to Los Alamos National Lab. That's where I met Momo. So Momo says, well, not only I can tell you if it is bacteria, virus, fungi, I can even tell you exactly what they are doing. And he was working on a project and to date, I have asked my in our my private walks, so Momo, what were you working on that applied this technology? And he tells me my security clearance is not high enough for me to learn that. So there you have it. However, my security clearance was just good enough for me to say, I will take this technology and get people to stay healthier.
Dr Rupy: Gotcha. I love that entrepreneurial approach to this question and the question itself, I think, that as medics and even perhaps in in scientists, we don't dare ask, you know, making disease optional. It just sounds so completely left field. And I I actually want to bring Momo in here again because what what Naveen was just touching on there was the different types of techniques that we had and what we were looking at, the diagnosis of, you know, what types of microbes there are, what language are they speaking, what populations they are. And and the and the word omics gets used quite a lot and I think it's quite confusing for a lot of people. So maybe we could define exactly what those different methods are and the different types of omics.
Momo: Yeah, so omics, omics just means it's a it's a method, it's a laboratory method that measures many things at once. And so when we talk about gene omics, we're measuring or understanding many genes at once. There used to be a field called genetics that people used to spend their entire careers studying one gene, literally, but that was limited by the technology. It was not their fault. And so I want to I want to bring up these omics technologies because it's it's very important. You know, genomics is now a hot field. It's been for the last 15 years. And I just want to bring up a metaphor that I like to to explain. So if if if someone told you today, hey, you can jump in your car today and drive 100 miles an hour on the freeway, yeah, people would say, sure, I can, right? But what if I told you that in 10 years, you can jump in that car, in your car, and drive 100 billion miles a year, which is faster than the speed of light? What do you think if you did a poll on the street of a thousand people, what do you think they would say?
Dr Rupy: Pretty impossible.
Momo: Impossible, right? They would literally say that that cannot happen. Like it's literally impossible. But that is exactly the scale of the technology improvement in 10 years from 2004 to 2014. In other words, in 10 years, we were able to obtain a billion times more data than we than we were in 2004 with the next generation sequencing. And so until 2004 or just a few years later, for the entire human history, we were always limited by the technology, meaning that bright people had bright ideas and and bright bright, you know, concepts about companies or projects, but they just couldn't couldn't execute on those. And today, we are no longer limited by the technology. So for example, I say to people, you know, we have 100%, 100% of all science and technology needed today to understand the root cause of every single chronic disease, every single cancer and aging. We just need to do it, right? We don't need to talk about it, we don't need to write papers about it, we just need to do it, you know, and I I follow the principles of Elon Musk, which is on a Sunday, he doesn't sit around with his friends speculating what's the world going to look like five years from now. He says, this is what the world's going to look like five years from now and I know that because I'm going to build that world, right? And he strategizes how he's going to arrive at that world. And that's really the mindset that I would like all scientists and physicians to think about is that the future is determined by us. We can build it. It's not a random chaos cascade that someone else imposes on us. So I would like to empower everyone who can help with this that let's build that better world where it's no longer a matter of bad luck that you get multiple sclerosis and you're in a wheelchair and you're suffering every single day. It's no longer a bad luck that you have an IBD flare and your life just turned to misery and you can't have a life professional or personal, right? It's not a matter of bad luck that you get pancreatic cancer and you're just told, you're going to live for two years or ALS or pick any disease you want, any cancer you want. It's just we now have all the technology to solve these problems. And so, um, what I would just on this topic, I would like really people to think of Viome as a technology platform. What people see on viome.com is one application of our technology, but we are now going to be rolling out many, many applications. I'd like for people to think about what we've created, Naveen and I and obviously a huge team of brilliant scientists, is we've created a a world's leading systems biology platform that allows us to digitise the human body and then understand the root causes of chronic diseases, cancers and aging. And we've opened this platform up to the whole world. We in fact have a website called the Viome Research Institute. People can go on there and find out what it is that we do, but all of this technology that we've developed is now available to any any scientist, any physician in the whole world to access it fully and and build something, build an app. So think of it as the App Store for health applications where, you know, one additional dramatic, you know, example that I would like to give is that before the smartphones, if there was some guy, some super smart guy with a PhD in computer science in a small town in let's say Ukraine, right? There was no possible way with any amount of work or any amount of skill for him to impact the humanity. Today, the smartphone and the App Store has enabled that one guy to write an app in just a few weeks and to automatically impact the entire humanity if that app is useful. And that's exactly the way people should think of Viome. We have built a health App Store where we are building apps on our own, we are building apps with our partners, but we welcome anyone else to to come on it and to develop their own apps that we simply don't have the time or resources to devote to because the opportunity is massive. How many apps are there today on the App Store? Apple couldn't have possibly built them. They just they're just not that's not possible. So we're really democratising access to this absolutely cutting edge science and technology and making it available to everyone.
Dr Rupy: Maybe we should talk about exactly what Viome does at the moment as well as the applications of what Viome has in its research capacity that would enable scientists from around the world to to capitalise on the technology that you've already created.
Momo: Yeah, perfect. So let's talk about this concept of of, you know, omics and omics testing and I I want to give a a few really important examples that I think are are going to be very dramatic for the audience. So, um, let's let's start from the beginning. If if we were to sequence the DNA of your liver, brain and heart, the DNA in those tissues is identical. And the reason is because that DNA has the potential to be any one of those organs, right? But it doesn't tell you which one it is and it doesn't tell you what it does. But if you sequence the RNA, the expression of those genes, which genes are actually active in which tissue, now you can distinguish kidneys from liver, from heart, from brain with absolute certainty because those organs perform dramatically different functions based on the same same DNA, right? So that's one layer that's really important about RNA that we study. The second layer is, if you have a kidney that is healthy and a kidney that's diseased or you have, let's say, visually it's more dramatic, if you have an inflamed intestines of a person with Crohn's disease, right, versus healthy intestine when they're in their remission. So remission versus relapse or flare, right? If you sequence the DNA, you will get exactly the same answer. It hasn't changed. So a person can have a normal, healthy life with the same DNA as when they're sick as a dog in bed 24 hours a day, right? It's because the DNA doesn't change, but the expression of the genes is vastly different in those two health conditions. So not only can genes tell us what a tissue or what a microorganism is doing, but what is the difference between a healthy state and a sick state? So that's one core concept at Viome that we we approach is we're looking at the functions, not the potential. And we apply that to human genes and to microbial genes in the gut microbiome and the oral microbiome, vaginal microbiome, skin microbiome, any kind of a microbiome. Um, and then the second concept that's extremely important is that while there are people who tell you, hey, look, when you're flaring in IBD, your gene expression profile looks very different. Your immune system has activated all these other genes versus healthy. If a common person reads that, it's going to be complete gibberish to them. That doesn't make any difference to look at the heat map of the of the differential gene expression analysis of of a person in flare versus versus in remission, right? What we need is a platform that can now say, aha, we know what caused that expression pattern to change. It's the combination of nutrition and the microbiome that stimulated that change in the human gene expression. And we now know how to change it and modulate it so that that person never experiences the flare. Now we're talking about translating science into something that's not just a paper sitting on a cloud server, right? So that's really important. And that's the concept at Viome. Does that make sense, Rupy?
Dr Rupy: It does, yeah. The one thing I would say is, how do you uniquely recognise the pattern that would allow you to intervene in various ways? And and the the two examples you used were were nutritional tools and and lifestyle tools and and some might argue that those are are limited in their capacity to to to make drastic changes regardless of how well defined they are in terms of the intervention.
Momo: Yeah, so so that's a that's a I I think probably the most important question of this of this podcast and and what people want to know. So here's the concept. The concept is, let's forget about let's forget about the names of the microbes. The names don't matter, meaning Rupy, Naveen and Momo doesn't mean anything. If I need a dentist, if I have a bad tooth, right? I'm not looking for a Joe or a Naveen or a Rupy. I'm looking for a dentist. I want to know what the function of that person is. By meeting someone and saying, hey, my name is Momo, what's your name? Oh, it's Joe. That doesn't help me at all. That doesn't mean anything. I want to know what it is that you can do for me. And so that's the fundamental difference between all of our all of other microbiome tests and all of the genetic tests is that they only tell you the potential, right? They don't tell you what's actually happening. And so this is Joe, he could be a dentist, he could be a medic, he could be a an accountant. I have no idea because the only thing I can measure is his name. That doesn't mean anything, right? Okay, so that's the fundamental difference. So, um, I want to everyone to think, I want your audience to think about the gut microbiome not as a collection of names, which is what everyone else is presenting it at, but as a collection of chemical reactions. So a microbe is literally a sack of enzymes and chemical reactions where the microbe says, hey, there's glucose in my environment. If I take it in and I process it into some other molecules, I can actually make energy and I can multiply and my species will will maintain its integrity on on planet Earth, right? That's evolution, that's evolution, I mean, that's basically life, right? And so, um, so it's all about chemical messaging and and sensing and so it's chemicals and chemical reactions. I just mentioned a chemical, which is glucose, just a simple sugar, and a chemical reaction that converts that sugar into water and carbon dioxide to extract energy. So when we eat a meal and we're saying we're eating meat, potatoes and broccoli, to our brain, that means something, we can go to the grocery store and procure those things. But when those when those foods are chewed up and pushed into our intestines, those the that all that entire concept that we think of as food goes away. The concept that now becomes is, oh, potatoes have starches, they have indigestible fibers, they have some other micronutrients. Broccoli has hundreds of different kinds of polysaccharides, fats, and phytocyanins and all kinds of antioxidants, minerals, vitamins and so on. So you have basically a flood of molecules that's hitting our intestines. And there are two customers for these molecules. One is our own body starts to absorb things as quickly as it can. Second, the remaining parts of that of that food go into our colon where the microbiome lives and we feed it basically. And why are we feeding this mass of one and a half kilograms of bugs? You know, people call microbes bugs or germs and ew and let's kill 99.9% of the germs, right? Yet, we have evolved with one and a half kilograms or 40 trillion bacteria or and other microorganisms in our in our colon. Why is that? It's because they can actually process a lot of this food and convert it into something useful that we cannot convert it to. And that's because our genes are very limited. We only have 20 to 22,000 genes, so we can only do so much processing of food. Your microbiome at this moment in time has more than a million genes. In fact, an average human microbiome codes for about two million genes in our in our data. And so the microbiome has the ability to digest food in a much more profound way than we do. And remember that yeast when they make beer, right? We use yeast to make beer. If you ate unfermented beer, meaning just barley, people would say, ew, that's nasty and I can't do anything with it, right? But you drink beer and you're like, wow, this Guinness is amazing. And that's basically a byproduct of the yeast consuming the ingredients that you gave it and produces something that you love. And that's basically the concept of the colon. There are hundreds of different microbial species living in the colon. They're consuming the food you ingested and producing something that is useful for our health and our physiology. So that's that. And so the concept at Viome is not about listing the bacterial species because that doesn't help anyone including us. Like, you know, people say I have an elevated ruminococcus something. How do I, you know, that's not normal, what do I do? Don't do anything. There's nothing to worry about that your ruminococcus is out of range, right? It's a made-up number that doesn't make any sense, right? What what we are doing at Viome is we are converting nutrition into molecules. So we have a food ontology that says for anyone's diet, there is 15,000, let's say roughly molecules that that person is ingesting into their body. Then we measure the functions of their microbiome and we say, okay, how's your microbiome going to process these molecules and is it going to produce beneficial or harmful byproducts, right? And that's really the key of what we are doing. And now, if you if you do a lot of clinical research and we do an enormous amount of clinical research and understand what is a healthy microbiome function, what microbiome functions are associated with IBS, with depression, with anxiety, with type two diabetes, with sugar control, and you build these machine learned models because we use machine learning for everything, the amount of data is vast. If you build these machine learned models, so now you understand what microbial functions are healthy and which ones are harmful. Now we can ask a very simple question. Let's reduce it to literally two microbes, right? So let's say we um we do a microbiome test of someone's someone's stool and we find only two microbes and instead of instead of like typical 400 microbes, and let's say that those two microbes instead of normally having 4,000 genes, they only have one gene each. And so microbe A can process a polysaccharide from quinoa and make lipopolysaccharide. And lipopolysaccharide tells my my immune system, whoa, you have some kind of an infection, mount an attack, like all all soldiers, like, you know, fire fire at at will, right? At the whole body, something's wrong here, right? The other microorganism takes a polysaccharide from apples and makes butyrate. It ferments it just like you would make apple cider, right? It makes, sorry, but this is into butyrate. It does not go all the way to alcohol. So it makes it into butyrate. The butyrate production in the colon feeds our intestine and makes it elastic and and able to absorb food, but it tells my immune system, calm down, everything's cool, chill out, shut down all your inflammatory pathways, there's nothing here to see, right? So let's say we find such a person and we understand now their two microbes, which food do you think we're going to our computers are going to recommend? They're going to tell them, eat apple and avoid quinoa because that's how we're going to rebalance your microbial functions and those signals that are created by the by your microbiome will keep your immune system in a in a very nice, healthy state. That's sort of a tiny, tiny, tiny example because in reality, we have about 10,000, let's say to 15,000 molecules coming into a person's intestines. We have about 3,000 different chemical reactions performed by a typical microbiome. And then we have a flood of several thousand different molecules that are produced by that microbiome, right? And some of those are harmful and some are not. And so what our computers are doing with mathematics and machine learning is, okay, you have these particular microbes that are performing these functions. Some are good, some are bad. The good ones we want to stimulate. So any food that contains substrates or molecular ingredients for those functions, we're going to tell you to consume. And these other functions of the microbes are bad for you. So any food that contains ingredients that can feed those functions, we're going to tell you to avoid them. And once you stop feeding a microbe, for example, if you have the yeast that produces beer and you don't give them barley, don't give it barley, can the yeast produce beer? It absolutely cannot. You deny it the substrate that is used to make ethanol and it absolutely cannot make beer. It can't make ethanol out of thin air, right? It can't. It has to have a specific substrate. And that's exactly the principle here that we're modulating microbial functions to produce more of the beneficial molecules and to produce less of the harmful molecules. That's the concept. And so one takeaway from this podcast is that while traditional nutritional sciences have attempted to understand is coffee good for all humans or is it bad for all humans? Is dairy good for all humans or bad humans? Pick any food you want. What we are asking is for any food, what are the ingredients, molecular ingredients in that list? What are the functions of your gut microbiome and how are those ingredients going to affect the function of your gut microbiome, therefore affect your physiology? So we're looking we're using chemistry and mathematics to answer the question instead of, oh, broccoli is good for you, go ahead and eat more broccoli. So today, today, when a customer submits their blood and stool sample to our laboratories, from that moment until that from the moment the laboratory receives those samples until the Viome application shows which foods that person should consume or not consume and which supplements that person should take and what amounts, this is a 100% objective process that includes measuring the chemistry and overlaying mathematical formulas on top of that. There is literally zero humans involved in any part of any of that process. The laboratory is automated, the bioinformatics is automated and the results and recommendations are automated. And the algorithms that overlay on top of the chemistry are all developed from either domain knowledge, meaning published literature, or from our own machine learned algorithms that we're starting to publish.
Dr Rupy: Yeah. That that's made it very clear for me in terms of the process and the thinking behind the the testing and and actually creating that data set that can give us the answers without human interface. Um and I also appreciate the fact that, you know, current nutritional science, as I'm doing my master's at the moment, nutrition aims to answer the uniform question, which is just not applicable in a in a day-to-day environment. Naveen, I want to bring you back here actually because as someone who's coming at it from the entrepreneurial side and the business side as well as obviously the the altruistic side as well, um when when you get this data set, when you get sort of the answers as to what you should be eating, I guess one of the the issues is how do you enact that behavior change? So you can tell me I should be eating this list of foods and stuff and that's my option to eat those foods, but how do you make that the easiest thing to do given the constraints of our food environments?
Naveen Jain: Right. So first of all, a great question, Rupy. So the first thing is, let me just summarise what Momo said. There is no such thing as universal healthy food or universal healthy supplement. And that was a fundamental mission. So if you say, why, imagine living in a world where illness is optional. I mean, that was literally our tagline. Imagine living in a world where illness is optional. And we say, okay, number one question, why this? If it is successful, would it help a billion people live a better life? Answer was 7.4 billion people. Check mark. Why now? And as Momo mentioned, why now was simple. To do to solve this problem, the three things needed to happen. We have to be able to digitise the human body and the cost of sequencing had to come down significantly. At when we started the company, the cost of sequencing was going to be about $1,000 plus. And we were absolutely convinced in the next couple of years, the cost will come down to $100. Little that we know, the cost actually came down to $10. So this is the beauty of exponentiality is when we were 10 times optimistic, turned out we were 10 times pessimistic of where things were, right? Same thing, we said, even if you were to digitise the human body, it's not going to solve the problem. You have to be able to process this massive amount of data. And we realised we're not going to have access to supercomputers to be able to do that. And the cloud computing was actually starting to come along. The first time when we actually analysed the samples of people, it cost us over $40 on Amazon Web Services just to process one person's data. And we knew in the next couple of years, the, you know, this cost will come down to about $10. Little that we knew that it came down to around buck 50, right? I mean, that's really the power of the things that how fast things were moving. And last part was, even if you could process the data, what would we do this massive data unless AI is powerful enough and self-learning that we are able to in fact make a sense of this massive trove of data. And we realised that AI is going to be so powerful, self-learning, we could get there. And that was the reason we said time is now. The last part is where how Momo came into the picture. My thinking was, you're when it comes to chronic diseases, people were all asking the same questions. They were two questions being asked. What does my DNA looks like? Because somehow DNA they thought was magical. If we could figure out the human DNA, we will know the software of the human body. And the second thing was people were starting to realise the microbiome is something important. And they could if they could just figure out which microbes are in my gut, I'm going to magically solve this problem. And now, me having no background in science, no background in biology, to me, it was very interesting how I looked at this problem. I said, look, your genes don't change when you gain 200 pounds. So I can do your DNA test today and when you gain 200 pounds, your DNA will be the same. Now, you become depressed, your DNA still hasn't changed. Now you get autoimmune disease, your DNA hasn't changed. You get, you get my point, autoimmune disease, you can have every known disease known to man, your DNA doesn't change. And if DNA doesn't change, what does change? It turned out, even if your genes are not changing, your gene expressions are always changing. And we say, oh, that is the key. We really, really need to understand the gene expression. And little that I knew, I have no idea what gene expression is, but we knew that was the thing. Now, interestingly was, same thing in microbe. Now, I don't know what these microbes are. In my world, they are like little human beings. That's how I honestly thought when I was starting the company. I say, these microbes are like little human beings. If what if they are like just human beings? The hundreds of different microbes can do exactly the same thing. So you take two people with diabetes, they can have completely different organism, still be diabetic because they're producing the same chemical that makes you diabetic, right? Or the same organism could produce completely different thing based on the environment, just like a human being. A person can do a bad behavior when they are in the bad environment and do a good behavior when they're in the good environment. What if these little organisms are doing the same thing? And it that was literally the key that we are going to focus not trying to understand which microbes are there, we're going to focus on what they are actually doing. And that was the fundamental belief. And we say, our questions I'm asking is, what genes are being expressed, what microbes are doing, not which microbes are there or what's the DNA. And that is really was the how Viome was born. And anytime, by the way, you ask these three set of questions, you can apply this to a company you start or the girl you meet or the boy you meet. You can ask, why her, right? Right? Why this, why now, why me? And you can literally apply this to everything you want in life, right? And I mean, so my point I'm trying to make is, so Viome was born out of a simple belief that chronic disease can be prevented and reversed. And in my journey to find this, you know, finding gene expression, I went to NASA JPL. I was my understanding was if they can go to Mars and look for a life, they must have some technology, right? And it turns out they couldn't figure out how to do the things, right? So I went there, talked to all the scientists and they told me they have delta-doped UV sensor that can tell me what microbes are there and if there is a microbiome, any organism, living organism there, but they couldn't tell me what they are actually producing. So I went to NASA Houston, then I went to NASA Kennedy Space Center, I went to Lawrence Berkeley, Lawrence Livermore, and I was now on my journey to Los Alamos National Lab. That's where I met Momo. So Momo says, well, not only I can tell you if it is bacteria, virus, fungi, I can even tell you exactly what they are doing. And he was working on a project and to date, I have asked my in our my private walks, so Momo, what were you working on that applied this technology? And he tells me my security clearance is not high enough for me to learn that. So there you have it. However, my security clearance was just good enough for me to say, I will take this technology and get people to stay healthier.
Dr Rupy: Gotcha. I love that entrepreneurial approach to this question and the question itself, I think, that as medics and even perhaps in in scientists, we don't dare ask, you know, making disease optional. It just sounds so completely left field. And I I actually want to bring Momo in here again because what what Naveen was just touching on there was the different types of techniques that we had and what we were looking at, the diagnosis of, you know, what types of microbes there are, what language are they speaking, what populations they are. And and the and the word omics gets used quite a lot and I think it's quite confusing for a lot of people. So maybe we could define exactly what those different methods are and the different types of omics.
Momo: Yeah, so omics, omics just means it's a it's a method, it's a laboratory method that measures many things at once. And so when we talk about gene omics, we're measuring or understanding many genes at once. There used to be a field called genetics that people used to spend their entire careers studying one gene, literally, but that was limited by the technology. It was not their fault. And so I want to I want to bring up these omics technologies because it's it's very important. You know, genomics is now a hot field. It's been for the last 15 years. And I just want to bring up a metaphor that I like to to explain. So if if if someone told you today, hey, you can jump in your car today and drive 100 miles an hour on the freeway, yeah, people would say, sure, I can, right? But what if I told you that in 10 years, you can jump in that car, in your car, and drive 100 billion miles a year, which is faster than the speed of light? What do you think if you did a poll on the street of a thousand people, what do you think they would say?
Dr Rupy: Pretty impossible.
Momo: Impossible, right? They would literally say that that cannot happen. Like it's literally impossible. But that is exactly the scale of the technology improvement in 10 years from 2004 to 2014. In other words, in 10 years, we were able to obtain a billion times more data than we than we were in 2004 with the next generation sequencing. And so until 2004 or just a few years later, for the entire human history, we were always limited by the technology, meaning that bright people had bright ideas and and bright bright, you know, concepts about companies or projects, but they just couldn't couldn't execute on those. And today, we are no longer limited by the technology. So for example, I say to people, you know, we have 100%, 100% of all science and technology needed today to understand the root cause of every single chronic disease, every single cancer and aging. We just need to do it, right? We don't need to talk about it, we don't need to write papers about it, we just need to do it, you know, and I I follow the principles of Elon Musk, which is on a Sunday, he doesn't sit around with his friends speculating what's the world going to look like five years from now. He says, this is what the world's going to look like five years from now and I know that because I'm going to build that world, right? And he strategizes how he's going to arrive at that world. And that's really the mindset that I would like all scientists and physicians to think about is that the future is determined by us. We can build it. It's not a random chaos cascade that someone else imposes on us. So I would like to empower everyone who can help with this that let's build that better world where it's no longer a matter of bad luck that you get multiple sclerosis and you're in a wheelchair and you're suffering every single day. It's no longer a bad luck that you have an IBD flare and your life just turned to misery and you can't have a life professional or personal, right? It's not a matter of bad luck that you get pancreatic cancer and you're just told, you're going to live for two years or ALS or pick any disease you want, any cancer you want. It's just we now have all the technology to solve these problems. And so, um, what I would just on this topic, I would like really people to think of Viome as a technology platform. What people see on viome.com is one application of our technology, but we are now going to be rolling out many, many applications. I'd like for people to think about what we've created, Naveen and I and obviously a huge team of brilliant scientists, is we've created a a world's leading systems biology platform that allows us to digitise the human body and then understand the root causes of chronic diseases, cancers and aging. And we've opened this platform up to the whole world. We in fact have a website called the Viome Research Institute. People can go on there and find out what it is that we do, but all of this technology that we've developed is now available to any any scientist, any physician in the whole world to access it fully and and build something, build an app. So think of it as the App Store for health applications where, you know, one additional dramatic, you know, example that I would like to give is that before the smartphones, if there was some guy, some super smart guy with a PhD in computer science in a small town in let's say Ukraine, right? There was no possible way with any amount of work or any amount of skill for him to impact the humanity. Today, the smartphone and the App Store has enabled that one guy to write an app in just a few weeks and to automatically impact the entire humanity if that app is useful. And that's exactly the way people should think of Viome. We have built a health App Store where we are building apps on our own, we are building apps with our partners, but we welcome anyone else to to come on it and to develop their own apps that we simply don't have the time or resources to devote to because the opportunity is massive. How many apps are there today on the App Store? Apple couldn't have possibly built them. They just they're just not that's not possible. So we're really democratising access to this absolutely cutting edge science and technology and making it available to everyone.
Dr Rupy: Maybe we should talk about exactly what Viome does at the moment as well as the applications of what Viome has in its research capacity that would enable scientists from around the world to to capitalise on the technology that you've already created.
Momo: Yeah, perfect. So let's talk about this concept of of, you know, omics and omics testing and I I want to give a a few really important examples that I think are are going to be very dramatic for the audience. So, um, let's let's start from the beginning. If if we were to sequence the DNA of your liver, brain and heart, the DNA in those tissues is identical. And the reason is because that DNA has the potential to be any one of those organs, right? But it doesn't tell you which one it is and it doesn't tell you what it does. But if you sequence the RNA, the expression of those genes, which genes are actually active in which tissue, now you can distinguish kidneys from liver, from heart, from brain with absolute certainty because those organs perform dramatically different functions based on the same same DNA, right? So that's one layer that's really important about RNA that we study. The second layer is, if you have a kidney that is healthy and a kidney that's diseased or you have, let's say, visually it's more dramatic, if you have an inflamed intestines of a person with Crohn's disease, right, versus healthy intestine when they're in their remission. So remission versus relapse or flare, right? If you sequence the DNA, you will get exactly the same answer. It hasn't changed. So a person can have a normal, healthy life with the same DNA as when they're sick as a dog in bed 24 hours a day, right? It's because the DNA doesn't change, but the expression of the genes is vastly different in those two health conditions. So not only can genes tell us what a tissue or what a microorganism is doing, but what is the difference between a healthy state and a sick state? So that's one core concept at Viome that we we approach is we're looking at the functions, not the potential. And we apply that to human genes and to microbial genes in the gut microbiome and the oral microbiome, vaginal microbiome, skin microbiome, any kind of a microbiome. Um, and then the second concept that's extremely important is that while there are people who tell you, hey, look, when you're flaring in IBD, your gene expression profile looks very different. Your immune system has activated all these other genes versus healthy. If a common person reads that, it's going to be complete gibberish to them. That doesn't make any difference to look at the heat map of the of the differential gene expression analysis of of a person in flare versus versus in remission, right? What we need is a platform that can now say, aha, we know what caused that expression pattern to change. It's the combination of nutrition and the microbiome that stimulated that change in the human gene expression. And we now know how to change it and modulate it so that that person never experiences the flare. Now we're talking about translating science into something that's not just a paper sitting on a cloud server, right? So that's really important. And that's the concept at Viome. Does that make sense, Rupy?
Dr Rupy: It does, yeah. The one thing I would say is, how do you uniquely recognise the pattern that would allow you to intervene in various ways? And and the the two examples you used were were nutritional tools and and lifestyle tools and and some might argue that those are are limited in their capacity to to to make drastic changes regardless of how well defined they are in terms of the intervention.
Momo: Yeah, so so that's a that's a I I think probably the most important question of this of this podcast and and what people want to know. So here's the concept. The concept is, let's forget about let's forget about the names of the microbes. The names don't matter, meaning Rupy, Naveen and Momo doesn't mean anything. If I need a dentist, if I have a bad tooth, right? I'm not looking for a Joe or a Naveen or a Rupy. I'm looking for a dentist. I want to know what the function of that person is. By meeting someone and saying, hey, my name is Momo, what's your name? Oh, it's Joe. That doesn't help me at all. That doesn't mean anything. I want to know what it is that you can do for me. And so that's the fundamental difference between all of our all of other microbiome tests and all of the genetic tests is that they only tell you the potential, right? They don't tell you what's actually happening. And so this is Joe, he could be a dentist, he could be a medic, he could be a an accountant. I have no idea because the only thing I can measure is his name. That doesn't mean anything, right? Okay, so that's the fundamental difference. So, um, I want to everyone to think, I want your audience to think about the gut microbiome not as a collection of names, which is what everyone else is presenting it at, but as a collection of chemical reactions. So a microbe is literally a sack of enzymes and chemical reactions where the microbe says, hey, there's glucose in my environment. If I take it in and I process it into some other molecules, I can actually make energy and I can multiply and my species will will maintain its integrity on on planet Earth, right? That's evolution, that's evolution, I mean, that's basically life, right? And so, um, so it's all about chemical messaging and and sensing and so it's chemicals and chemical reactions. I just mentioned a chemical, which is glucose, just a simple sugar, and a chemical reaction that converts that sugar into water and carbon dioxide to extract energy. So when we eat a meal and we're saying we're eating meat, potatoes and broccoli, to our brain, that means something, we can go to the grocery store and procure those things. But when those when those foods are chewed up and pushed into our intestines, those the that all that entire concept that we think of as food goes away. The concept that now becomes is, oh, potatoes have starches, they have indigestible fibers, they have some other micronutrients. Broccoli has hundreds of different kinds of polysaccharides, fats, and phytocyanins and all kinds of antioxidants, minerals, vitamins and so on. So you have basically a flood of molecules that's hitting our intestines. And there are two customers for these molecules. One is our own body starts to absorb things as quickly as it can. Second, the remaining parts of that of that food go into our colon where the microbiome lives and we feed it basically. And why are we feeding this mass of one and a half kilograms of bugs? You know, people call microbes bugs or germs and ew and let's kill 99.9% of the germs, right? Yet, we have evolved with one and a half kilograms or 40 trillion bacteria or and other microorganisms in our in our colon. Why is that? It's because they can actually process a lot of this food and convert it into something useful that we cannot convert it to. And that's because our genes are very limited. We only have 20 to 22,000 genes, so we can only do so much processing of food. Your microbiome at this moment in time has more than a million genes. In fact, an average human microbiome codes for about two million genes in our in our data. And so the microbiome has the ability to digest food in a much more profound way than we do. And remember that yeast when they make beer, right? We use yeast to make beer. If you ate unfermented beer, meaning just barley, people would say, ew, that's nasty and I can't do anything with it, right? But you drink beer and you're like, wow, this Guinness is amazing. And that's basically a byproduct of the yeast consuming the ingredients that you gave it and produces something that you love. And that's basically the concept of the colon. There are hundreds of different microbial species living in the colon. They're consuming the food you ingested and producing something that is useful for our health and our physiology. So that's that. And so the concept at Viome is not about listing the bacterial species because that doesn't help anyone including us. Like, you know, people say I have an elevated ruminococcus something. How do I, you know, that's not normal, what do I do? Don't do anything. There's nothing to worry about that your ruminococcus is out of range, right? It's a made-up number that doesn't make any sense, right? What what we are doing at Viome is we are converting nutrition into molecules. So we have a food ontology that says for anyone's diet, there is 15,000, let's say roughly molecules that that person is ingesting into their body. Then we measure the functions of their microbiome and we say, okay, how's your microbiome going to process these molecules and is it going to produce beneficial or harmful byproducts, right? And that's really the key of what we are doing. And now, if you if you do a lot of clinical research and we do an enormous amount of clinical research and understand what is a healthy microbiome function, what microbiome functions are associated with IBS, with depression, with anxiety, with type two diabetes, with sugar control, and you build these machine learned models because we use machine learning for everything, the amount of data is vast. If you build these machine learned models, so now you understand what microbial functions are healthy and which ones are harmful. Now we can ask a very simple question. Let's reduce it to literally two microbes, right? So let's say we um we do a microbiome test of someone's someone's stool and we find only two microbes and instead of instead of like typical 400 microbes, and let's say that those two microbes instead of normally having 4,000 genes, they only have one gene each. And so microbe A can process a polysaccharide from quinoa and make lipopolysaccharide. And lipopolysaccharide tells my my immune system, whoa, you have some kind of an infection, mount an attack, like all all soldiers, like, you know, fire fire at at will, right? At the whole body, something's wrong here, right? The other microorganism takes a polysaccharide from apples and makes butyrate. It ferments it just like you would make apple cider, right? It makes, sorry, but this is into butyrate. It does not go all the way to alcohol. So it makes it into butyrate. The butyrate production in the colon feeds our intestine and makes it elastic and and able to absorb food, but it tells my immune system, calm down, everything's cool, chill out, shut down all your inflammatory pathways, there's nothing here to see, right? So let's say we find such a person and we understand now their two microbes, which food do you think we're going to our computers are going to recommend? They're going to tell them, eat apple and avoid quinoa because that's how we're going to rebalance your microbial functions and those signals that are created by the by your microbiome will keep your immune system in a in a very nice, healthy state. That's sort of a tiny, tiny, tiny example because in reality, we have about 10,000, let's say to 15,000 molecules coming into a person's intestines. We have about 3,000 different chemical reactions performed by a typical microbiome. And then we have a flood of several thousand different molecules that are produced by that microbiome, right? And some of those are harmful and some are not. And so what our computers are doing with mathematics and machine learning is, okay, you have these particular microbes that are performing these functions. Some are good, some are bad. The good ones we want to stimulate. So any food that contains substrates or molecular ingredients for those functions, we're going to tell you to consume. And these other functions of the microbes are bad for you. So any food that contains ingredients that can feed those functions, we're going to tell you to avoid them. And once you stop feeding a microbe, for example, if you have the yeast that produces beer and you don't give them barley, don't give it barley, can the yeast produce beer? It absolutely cannot. You deny it the substrate that is used to make ethanol and it absolutely cannot make beer. It can't make ethanol out of thin air, right? It can't. It has to have a specific substrate. And that's exactly the principle here that we're modulating microbial functions to produce more of the beneficial molecules and to produce less of the harmful molecules. That's the concept. And so one takeaway from this podcast is that while traditional nutritional sciences have attempted to understand is coffee good for all humans or is it bad for all humans? Is dairy good for all humans or bad humans? Pick any food you want. What we are asking is for any food, what are the ingredients, molecular ingredients in that list? What are the functions of your gut microbiome and how are those ingredients going to affect the function of your gut microbiome, therefore affect your physiology? So we're looking we're using chemistry and mathematics to answer the question instead of, oh, broccoli is good for you, go ahead and eat more broccoli. So today, today, when a customer submits their blood and stool sample to our laboratories, from that moment until that from the moment the laboratory receives those samples until the Viome application shows which foods that person should consume or not consume and which supplements that person should take and what amounts, this is a 100% objective process that includes measuring the chemistry and overlaying mathematical formulas on top of that. There is literally zero humans involved in any part of any of that process. The laboratory is automated, the bioinformatics is automated and the results and recommendations are automated. And the algorithms that overlay on top of the chemistry are all developed from either domain knowledge, meaning published literature, or from our own machine learned algorithms that we're starting to publish.
Dr Rupy: Yeah. That that's made it very clear for me in terms of the process and the thinking behind the the testing and and actually creating that data set that can give us the answers without human interface. Um and I also appreciate the fact that, you know, current nutritional science, as I'm doing my master's at the moment, nutrition aims to answer the uniform question, which is just not applicable in a in a day-to-day environment. Naveen, I want to bring you back here actually because as someone who's coming at it from the entrepreneurial side and the business side as well as obviously the the altruistic side as well, um when when you get this data set, when you get sort of the answers as to what you should be eating, I guess one of the the issues is how do you enact that behavior change? So you can tell me I should be eating this list of foods and stuff and that's my option to eat those foods, but how do you make that the easiest thing to do given the constraints of our food environments?
Naveen Jain: Right. So first of all, a great question, Rupy. So the first thing is, let me just summarise what Momo said. There is no such thing as universal healthy food or universal healthy supplement. And here is the answer to your question. It doesn't say don't eat it. And it says, here is why. And that is what actually for me was the key. It says your your microbes are producing very high amount of sulfide. Sulfide is causing inflammation in your gut. Broccoli, cabbage and brussels sprouts contains high amount of sulfate. It's going to get converted into sulfide, increasing increasing your inflammation. Now, it told me exactly why I shouldn't do it. And I have a choice. I'm going to still smoke knowing I'm going to have a cancer, right? That's a choice you can make. But now it's very clear. You can eat it knowing that it's going to cause inflammation. It said, don't eat spinach. Now, to me, that was like, how can you possibly tell me that when Popeye told me that spinach was good for everyone. You take a, you know, can of spinach and you get healthy. So how can you actually tell me that spinach is not healthy for me? Well, it turns out Popeye was not the scientist, right? So that's a good thing. And what we learned was the Popeye didn't know about the oxalate in spinach. So if my gut microbes are not able to digest oxalate or oxalic acid, it's going to end up in a kidney stone. And by the way, I did not follow and I end up with a kidney stone. Very good feedback loop. It tells you, don't do that again. Very painful, yeah. Very painful, right? And I think as I said, any man who has ever had a kidney stone will tell you that it is same as a woman having birthing a baby. So now I can. Yeah, yeah, I've heard that from many a patient. Yeah, definitely. So point I'm trying to make was by the same thing happens on supplement side. You know, people take these nutritional supplements and it is based on faith. So I say, Rupy, are you taking supplements? And you know, during COVID, he said, oh, yeah, yeah. Why are you doing that? Well, I want to boost my immune immunity. Well, how well is it working for you, Rupy? And and now you look at me like puzzled, I think it is working. How do you know that? Well, I hope it is working, but you have no idea. Right? And that is really where where Viome shines. When you do the test, we tell you, here is your immune health, here is your cellular health, here is your biological age, here is your gut health. And by the way, under immune health, this is your inflammatory activity. This is your gut microbial induced stress in your body. This is your histamine introduced inflammation. This is your viral inflammation. This is your bacterial inflammation, right? Now, you have all the knowledge. When we say go do this and when you do the retest, it closes the loop. It tells you, hey, look, this changed. And let's assume some things don't get better. We don't get discouraged by it. Now we go and say, we learned that based on all the knowledge of 200,000 people, we saw this inflammation and we thought we're going to give you curcumin. It did not work for you. Hmm, maybe we're going to try elderberry now. And we gave you elderberry and it worked. Now we are looking for a pattern who are just like people who have Rupy, where the curcumin doesn't work and the elderberry work. And that becomes part of our AI to say when we see this pattern, don't ever recommend curcumin, always recommend this, right? And that constant learning is creates that flywheel effect that my 200,000 customer will always be better than someone else's first customer because all the learnings that we have had creating this flywheel effect, right? So the key to me was and this is where most businesses fail, they don't understand the power of flywheel. If I am selling the water bottle, my first customer gets exactly the same product that my millionth customer. But when you're using the AI that is self-correcting and self-learning, guess what? A millionth customer is substantially better off with in our ecosystem than someone's first customer because all the things that have been happening, right? So our side from a business perspective was very simple. How can we continue to reduce the cost of getting people to be understanding the health insight? And by the way, we sell our services almost at cost. And the reason for that is so that we can get more and more people to get the benefit of our service. Partly it is altruistic because we do want to help a billion people. And partly it is a good business, which is every customer who joins allows us to understand why people have chronic diseases. So I have now 20,000 people who have depression. That allows me to say, wait a sec, everybody who has depression always seem to have low butyrate production, very high LPS production, very high sulfide production. Very interesting. Now we know how to modulate it using the substrate that Momo talked about. And if we could do that, could we actually reverse symptoms of depression? And that's literally what we did. We took a time one and we saw here are the people who have IBS, here are the people who have depression, here are the people who have diabetes, here are the people who have anxiety. And now we're going to give them these recommendations. Four months later, we measured their clinical scores at the beginning and at the end. And here was the most interesting point. Even though it was not a clinical trial, we could show that your clinical score of IBS SSS came down by 36% people who have high IBS severity. Depressive symptoms, the score PHQ-9 came down by 32%. The score anxiety, clinical score called GAD-7 came down by 29%. And our risk for diabetes that we measured by measured a validated against HBA1C came down by 30%. Now, imagine that. That is just one part of how the people think of this voodoo thing, food and supplements. This is like non-science. And now we are showing the clinical outcomes and we are going to be publishing the evidence, scientific evidence-based paper that is going to be actually submitted to the peer-reviewed journal next week. And that tells you the power of having the large set of data. And then we realised from here, Rupy, that now we are able to understand the diseases, can we build the predictive biomarkers? Remember, I didn't say diagnosis of the diseases. Even before you get a disease, can I tell you, hey, Rupy, keep going down this path, you're moving towards becoming a diabetic person. You don't have a diabetes yet, or you're moving towards a person who normally would have depression, or you're moving towards a person who is likely to start to move towards a autoimmune disease. And or when you follow recommendation, you can see, oh my God, I'm moving away. You would have never seen that from DNA that are you progressing towards a disease or you're moving away. So we saw the same thing in cancer that microbes are very tightly interacting with our human tissues forming cancer. And there were three research papers that came out very recently that really to me were complete breakthrough. And let me describe you what these three papers were. To me, that was how I believe, why I believe that cancer could be eliminated in the next decade. So if I am a betting man, I would say humanity would have solved the problem of cancer within a decade of now we're starting to understand that we were going about it the wrong way. So number one research showed that they looked at 18 different types of tumors and they saw the unique microbes inside the tumor. That's interesting that why would the microbes be sitting inside the tumor? Second thing was, the tumor was displaying the microbial peptide on the surface of the tumor. Now, wait a sec, why would the tumor being an organism want to invite the immune system to attack it by displaying the foreign substance unless microbes are somehow releasing the peptide that is declaring itself as self, so immune system says, oh, this is just part of us, leave it alone. And immune and tumor is taking advantage of the fact these microbes are commensal and they're going to tell the immune system, leave us alone. And they're feeding the microbes and microbes are protecting the tumor. Now, imagine that. And that's the third research was really interesting. They did the immunotherapy for melanoma patient. And for many of these patients, the immunotherapy just did not work. Simply changing their gut microbiome. Now, listen, simply changing the gut microbiome, the therapy started working. The immunotherapy turned non the are changing the gut microbiome turned the non-responders into responders. And that is the thing that most people don't understand. When we take a drug, where the effectiveness of that drug or the toxicity of that drug could be changed by a gut microbiome. As Momo pointed out, it's a chemical factory. You pop in a levodopa and if your gut microbes are taking the levodopa and they're producing tyrosin, the tyrosin metabolises that levodopa and the humans get nothing out of it. You take digoxin and digoxin is really interesting. If you take digoxin and if you have the microbes that are in fact are deactivating the active component in digoxin, you're done. There is nothing is going to happen. And I think one of the point that Momo made that I think I want to just reiterate that many of the diseases, it seems like are somehow related to the human host. And of course, we are the host, we are the human, the disease do appear in the human host, but what is the trigger? The trigger may actually be something microbial. And this is the one example I can give you. There is an organism, certain people have these organism, Agathalenta. In some people, it does nothing and it's totally commensal. In other people, it releases a protease and the protease is called gel E. And the gel E tightly binds to the human peptide named GLP-1. And GLP, only reason I'm mentioning is that everyone knows the GLP-1 maintains your glucose homeostasis and it maintains your appetite. Now, if this peptide, this protease binds to this peptide, guess what's happening? Now you have in fact gotten rid of the your appetite regulation and your glucose regulation. Guess what's going to happen? You're going to get diabetes, you're going to get obesity. Now, now you can say, well, it is GLP-1 is not working. Well, GLP-1 would have been working just fine if you didn't have this microbe binding to it, right? So point is then we start developing drugs trying to reactivate. And rather than get to the root cause.
Dr Rupy: What you've eloquently described there is the typical pattern of reactive healthcare rather than preventative. And there's there's two things I want to pick up. What one, we talked about immunotherapy with cancer and I I I know the the paper you're talking about where they improved the host microbial system and they improved response to immunotherapy. L-dopa is something that we give to Parkinson's patients and it can be changed by by microbial populations and digoxin is a medication that we use for cardiac patients. So we've jumped around a little bit there, but one of the things that I think is really, really exciting and you mentioned right at the start is predictive medicine. So predictive methods of trying to anticipate ill health before it happens. Now, for me, as someone who works in A&E and in general practice, that is the most exciting area because if I can give a test or some suite of investigations to every patient at cost at a very, very low cost every single year and we can say, look, if you continue down this route, whether it be smoking, whether it be this, we can accurately predict to the month, maybe even the day that you are finally diagnosed with the disease, that would be completely game-changing, completely game-changing.
Momo: Yeah, that's exactly what we want to build. Remember, going back to human body is a is a container with tens of thousands of chemicals and chemical reactions that all need to work in synchrony in order to to maintain health. And so if you look at any disease, let's say someone has a heart attack, that heart attack didn't start last night because someone ate a steak. That heart attack started 30 years ago with chronic inflammation, right? Same with diabetes, same with every chronic disease. None of the chronic diseases come about by doing one bad thing. And there were molecular symptoms of that disease years or decades ago, Parkinson's, Alzheimer's, any any disease. And we have now the science and technology tools to actually identify those molecular symptoms that are completely invisible to us. No one can no one can measure those using traditional clinical tests or walking into an office and saying, hey, something's wrong with me, right? They're just absolutely minute gene expression level changes basically in someone's gut microbiome or someone's human genome. And and so let's use that science and technology to actually understand that molecular disease. I call it the molecular disease because it's a it's asymptomatic and let's use it to revert it back to healthy so that no one will be diagnosed with that disease. You you don't need to tell someone, hey, you're going to get a heart attack in three years, five months. We we can tell them if you follow this these recommendations, you're never going to have a heart attack.
Dr Rupy: Yeah, exactly. And one of the things I wanted to ask you about, Momo, is um in in terms of the research institute that you you mentioned, the Viome Research Institute. I mean, that sounds phenomenal. Is it is it sort of like providing your technology in an open source such that other scientists around the world can can can use the data sets that you've collected?
Momo: Yeah. Um, no, we don't do that. So, so yeah, so there's an asterisk with, you know, when I said that that the technology is open for free, unlimited use to the whole world. There is an asterisk and that is that if someone applies for a grant and this has happened already, we go into a contractual agreement with them where we say, hey, we're going to work together, we're going to generate some kind of IP. We want to exclusively license that IP if it comes out of our technology and we want you to license to to commercialise that IP if it comes out of your technology. So, in other words, the absolute number one primary purpose of that grants program and and giving people the whole world access to our technology is to convert their science and our technology or their clinical expertise and our science and technology into a clinically useful product that's going to impact human health. If that's not the purpose, then we're not interested, right? So that has to be the guiding principle for every discussion. It can't be, oh, I need papers for my tenure. It can't be, you know, I'm curious about this. It can't be, but this is going to be fascinating. None of that matters. It, you know, and in fact, right in the first submission of the application is, how is this going to be translated into what product? We want to know up front, are you thinking like, hey, I want to convert science and technology into something that's useful or are you interested in publishing papers? Because unfortunately, many people are driven by publishing papers.
Naveen Jain: I was going to add a couple of things on the other subject and then I think one thing that Momo did not say, the main thing we are doing is providing free access, that means we don't charge them for any of our kits. That means we can allow them to use our saliva technology, blood transcriptomics, our stool meta transcriptomics to be able to see everything that's happening in the human body and to see can we understand what causes people to have ALS? What is causing people to have Alzheimer? What is causing people to have dementia or Parkinson? And we want to understand that and translate that into a commercial product that in fact helps people. The two other things that we have not quite gotten to yet and I think as we're running out of time, I just want to make sure we bring it up. One is, we in fact, and I want you to be the first to know, we just last night received the FDA approval for the early diagnosis, earliest diagnosis of oral cancer and throat cancer. Right? And that is a breakthrough device, breakthrough device designation and that came out simply around a partnership that Momo just mentioned, a university professor wanted to know, can we actually just look at the saliva and not just the microbes in the saliva, but the human genes that are expressed in saliva and the microbial activities that are changing the human gene expression and can we use that to detect the cancer in the mouth and in the throat? And it turns out when we did the machine learning on the people who had stage one, stage two, stage three, stage four cancer with 97% specificity and 90% plus sensitivity, we were able to diagnose the earliest stage cancer. And what we saw was very interesting. There were about 250 or so features. Many of them were microbial that microbes were producing enzymes and peptides, but here was the most important part. We saw them changing the gene expression, human gene expression, and they were turning up the known oncogenes and turning down the tumor suppression gene. So microbes were doing exactly to protect themselves to from the immune system. And that was the key to getting the breakthrough device designation from FDA. And that so that's one thing that happened. As we were going around learning about autoimmune disease and cancers, we saw some very interesting phenomena that what was causing people to develop these colorectal cancer or IBD and IBS. And then we went to a we went to GSK and we showed them that this is what we see when people have autoimmune disease like ankylosing spondylitis. This is what we see when people have IBD or IBS. They say, you know what, we can develop a vaccine against these targets now. Imagine that. Now, vaccines to prevent a cancer from happening or even to reverse in the early stage when the cancer has happened to be able to actually attack the target so the cancer can actually be completely neutralized by our own immune system. Those are the kind of things I would have never imagined even in my wildest dream, a company that we are going to set out to improve people health in one day be able to, you know, predict the diseases before they happen, diagnose the disease when they do happen. And when we people come to us farther along, we are able to reverse them using vaccines, phages, drugs, nutritional nutrition, and that to me is the key that multimodality is when people are late and then but focus on prevention of the diseases.
Dr Rupy: Yeah, I mean, it's just music to my ears, all of this stuff is brilliant. I mean, it's exactly what I've been thinking about and obviously wanting but it's just out out out of this world. Um, Momo, I wanted to ask you, I know we're we're running out of time here, but um, you know, some people would describe Viome as a as a microbial testing company. It's clear that that's not. How would you describe what you're doing at Viome now and and the approach that you take?
Momo: Yeah, so we we I I we, you know, we haven't come up with a layman's term, but it's a systems biology company and a systems biology means that our biology is not determined by the human genes alone. It's in fact, it's turning out to be mostly determined by the microbial genes in our oral cavity, in our gut, in our intestines and so on. So it's a systems biology approach where we look at the human body holistically so that we don't make the same mistake we've been making where people, um, when someone has Parkinson's disease, um, modern medicine says something's wrong with your brain. When someone has a bipolar disease, right? For decades, for for forever, basically, people have been told there's something wrong with your brain and all the drugs are targeting the brain. Now, there's a clinical report in a peer-reviewed article showing that a person who had very, very difficult bipolar disorder, meaning she was not functional properly, um, fecal microbiota transplants from her husband completely cured her of bipolar disorder, meaning that she no longer takes any medications and she no longer has any symptoms of bipolar disorder. She has a normal life. This was achieved in six months with nothing but fecal microbiota transplant, meaning they took her poop, the doctor took her poop and and put it inside of her intestines and her bipolar disorder went away. Now, we have all the science and technology tools to understand why this happened, but we just need to study bipolar disorder, but the fact that it happened so dramatically after years of using medications without any success, that's that's that's a pretty compelling story. So yes, so we are not a gut microbiome testing company at all. We do have a great microbiome test in that our test is a comprehensive functional test. We don't we don't just enumerate, we just don't just list the names of the microorganisms because they don't mean much. Um, but we also have a blood test and currently we're productizing a saliva test and after that, there will be a vaginal swab test for women's health and urine test is already actually implemented in a hospital system as a test bed to to look for whether we can implement it in infectious disease diagnostic situation. So we are truly looking at the human body from all aspects including the nutrition, the microbiome, the immune system, our own gene expression. Soon we're going to bring on other tests that measure specific proteins and small molecules in the human body that can tell us, for example, Hashimoto's. I don't know if Hashimoto's is is prevalent in the UK, but in the US, it was essentially unknown a generation ago. And today we have an epidemic of Hashimoto's and no one knows what causes it. Medical system basically reacts to a person that's symptomatic that comes to the hospital and they tell them, you already have the autoimmune disease, we're going to try to manage it, but it's managed. What we want to do at Viome is we want to is we want to collect longitudinal data on millions of people and for those that develop Hashimoto's, we want to go back in time and ask the question, okay, what molecular events took place in people who developed Hashimoto's that are different from those from people that did not develop Hashimoto's? And it will likely have to do with the microbiome and the immune system. And then we can say, okay, now that we know these determinants, how can we prevent them from ever happening? And that's true preventative medicine. And I want to highlight one more time that everything that I'm talking about, whether it's been done or it's being done or we will do it, we have already 100% of science and technology at our hands. There is no technological wonder that needs to take place. We just need to do it. And so I urge all scientists, all physicians to basically exploit this technological development and solve problems instead of speculating about the future and instead of focusing on being focused on publishing papers. Let's do it.
Dr Rupy: Yeah. No, I hear that. I hear that call to action and I'm sure the physicians listening to this, it's going to certainly spark their interest, particularly with the moonshot ideas. Um, Naveen, just to to close, I guess, you know, we've already talked about the aspirations for Viome and all the other things that you're doing. If you could crystallise what that looks like over the next 10 years, what what do you what do you envisage?
Naveen Jain: Well, you know, to us, the ultimate use will be that our hospital system and our current healthcare system just disappears and we create a true, so if you were to ask me how we want how we define Viome, Viome is a true healthcare company where you're supposed to be taking care of your health, not taking care of the disease, right? So point is, today we don't have a healthcare companies, we have really the symptom management companies, right? And we want to become a true healthcare company that takes care of your health. And one day when there is no emergency rooms, one day when there are really no hospitals and one day when there is no one who is living with a chronic disease. So to me, the our mission, our goal is and hopefully in 10 years, we can create a world where being sick is truly a matter of choice, not a matter of bad luck. So make just because people say being healthy is a choice, we say being sick is a choice as well.
Dr Rupy: Fab. I love it. I'm feeling super inspired and motivated now. That's great. Thank you so much both of you for your time. I know you're super busy. Honestly, it's my pleasure. My pleasure to meet you both.
Momo: Thank you, Rupy, for doing everything that you do and and let's spread the message. Let's do it. Let's not talk about it.
Dr Rupy: Definitely. No, I appreciate that. And I can't wait for our next walk and hopefully that will be with Naveen one day.
Naveen Jain: Look forward to it, Rupy. You take care of yourself, okay?
