Dr Rupy: Is 5 grams of fibre from chickpeas the same as 5 grams of fibre from a granola bar?
Dr Amrita Vijay: No.
Dr Rupy: Are all fermented foods good for your gut?
Dr Amrita Vijay: Yes.
Dr Rupy: Oh. Could oily fish support the gut like fibre does?
Dr Amrita Vijay: No.
Dr Rupy: What are three foods you eat every day for your gut personally?
Dr Amrita Vijay: Lentils, spinach, chickpeas.
Dr Rupy: Sounds like mine. And does a more diverse microbiota always mean better health?
Dr Amrita Vijay: No.
Dr Rupy: Right. Okay, we've got a lot of things to unpack here. Let's start with the oily fish research that you did. What what was the study looking at and what did you find that was surprising?
Dr Amrita Vijay: So the study that I did was comparing omega-3 supplements of 500 milligrams of omega-3 supplements to inulin fibre, which is a known prebiotic. So just dialling back to what the definition of a prebiotic is, it's a compound that's commonly present in foods that elicits a health benefit via modulating the composition and the functionality of the gut microbiome.
Dr Rupy: That's a prebiotic definition.
Dr Amrita Vijay: That's a that's the definition of a prebiotic. So we wanted to compare to see if taking 500 milligrams of omega-3 had similar effects of taking 20 grams of inulin, for example, in terms of modulating the composition and functionality of the gut microbiome.
Dr Rupy: And what what led you to even hypothesise that there might be an improvement?
Dr Amrita Vijay: So there have been some previous studies that have shown that omega-3 supplements do modulate the composition and functionality of the gut microbiome. These were initially done in animal studies, but there were some small to large-scaled human studies as well that showed that omega-3 does have an impact on modulating the composition of the microbiome.
Dr Rupy: That's fascinating. I don't think I've come across that before. That's awesome. So what did you find?
Dr Amrita Vijay: So what we found was the 500 milligrams of omega-3, so specifically breaking that down to the composition of EPA and DHA. So EPA, which is the eicosapentaenoic acid and DHA, which is docosahexaenoic acid, the two main types of omega-3 fatty acids. We did see modest improvements in the composition of the microbiome, but also increases in the beneficial compounds that the microbes produce, typically short-chain fatty acids. So this was all across a period of six weeks. Although the effects weren't as comparable to what we saw with the 20 grams of inulin fibre, we did see that it did did have an effect on positively modulating the gut microbiome. And when we actually also measured cardiovascular markers, so for example, we did a whole lipid profile, we measured things like total cholesterol, different fractions of triglycerides, for example. We did see that the supplementation of 500 milligrams of omega-3 did decrease these levels, which is again known in previous literature as well. But the decrease in these specific levels of these lipids were actually mediated by the changes that we saw in in the microbiome.
Dr Rupy: Okay.
Dr Amrita Vijay: We concluded to say that omega-3 supplementation does have prebiotic-like effects similar to taking 20 grams of inulin fibre.
Dr Rupy: Okay. So was there, I mean, there was just one arm of the study in terms of the intervention of looking at 500 milligrams. And that was that like 250 EPA and 250 DHA?
Dr Amrita Vijay: So it was 160 milligrams of EPA and 110 milligrams of DHA.
Dr Rupy: Okay. All right. Okay. So 500 milligrams was like with all the other omega-3s that are short-chain.
Dr Amrita Vijay: Yeah.
Dr Rupy: Okay. So that's quite a modest dose, right? I take 1.5 grams every single day.
Dr Amrita Vijay: Absolutely. So what we've seen as well is in terms of the effect that it's got on the microbiome is very much dose-dependent.
Dr Rupy: Okay.
Dr Amrita Vijay: So some of the studies that have actually shown significant improvements in the composition as well as levels of short-chain fatty acids, for example, even butyrate, which we didn't find in our study. They were quite high doses of omega-3. So for example, they looked at four grams, three to four grams per day of omega-3. So the the effect that it can elicit on the gut gut microbiome is definitely dose-dependent.
Dr Rupy: Okay. Do you now, do you take fish oil yourself?
Dr Amrita Vijay: I do.
Dr Rupy: You do? What kind of dose do you take?
Dr Amrita Vijay: I do take 1.25 grams.
Dr Rupy: Okay, fine. Yeah, yeah. Because it would be interesting to see again, if you were to repeat that study, whether you'd you'd have a larger magnitude effect that could be equivalent to the the inulin as well, right?
Dr Amrita Vijay: Absolutely. I think, I think, yeah, going for a higher dose, that's, you know, equivalent to probably having, you know, more than two portions of fish, oily fish per week. I think looking at that would be an interesting study.
Dr Rupy: Yeah, yeah. I've always wanted to believe that I can get the same dose of omega-3, specifically EPA and DHA from from fish, but I've struggled because you'd have to eat quite a bit of sardine from what I've what I know about the omega-3 density in different fish. And it's near impossible to get in a plant-based diet unless you're supplementing with algae oil as well. Are there some people do you think that you think would be able to just get it from fish or do you think we all should be supplementing?
Dr Amrita Vijay: I don't necessarily think that we all should be supplementing. I mean, if your if your diet is predominantly fish-based, I mean, if you do eat a lot of oily fish, probably even, you know, more than two portions a week, you should be able to get the required amount of omega-3s that's been shown to elicit the anti-inflammatory effects and the protective effects on cardiovascular disease and things. So I think the supplementation would come in if you if you're not able to meet those requirements or like you said, if you're predominantly on a plant-based diet, then yes, you would you would look to supplement.
Dr Rupy: Are there any other supplements or foods that we wouldn't typically think of as beneficial for our gut having a prebiotic effect that you've come across in the literature or your own research?
Dr Amrita Vijay: I mean, polyphenols, they've been talked about as a prebiotic. And it's predominantly because, you know, they do get fermented or broken down by the gut microbes and they produce all the beneficial molecules that and also elicit anti-inflammatory effects. So polyphenols have been considered as a prebiotic as well. I think we're we're still exploring other types. And I I would say this though, I mean, although we did say that omega-3 does elicit prebiotic-like effects, it's not really a prebiotic because again, a prebiotic needs to be broken down by your gut microbes.
Dr Rupy: Okay.
Dr Amrita Vijay: So I think the the word there is a prebiotic effect.
Dr Rupy: Effect. Ah, okay. Uh-huh.
Dr Amrita Vijay: So it's not it's not really a prebiotic because I think a prebiotic again needs to needs to get to your gut and needs to be broken down. So it acts as a substrate for your microbes. And then when it does that, it breaks down, so for example, the fibre or the polyphenols to then release these beneficial compounds that then has health benefits. So although we do see changes that the omega-3 does confer on the composition and functionality of the microbiome, it doesn't actually necessarily mean that the microbes are breaking down or fermenting the omega-3s because obviously omega-3s are just they're fats basically.
Dr Rupy: They're just fats. Yeah, this is why I was quite, yeah, because that's why it's quite stark in my mind anyway. I just think of, you know, as good as they are and as beneficial as they are, I don't think I've ever considered them to have a beneficial effect on the gut because they're not like a typical prebiotic that you've heard of before. But I guess the, to clarify what you said, they're having a prebiotic-like effect rather than being a true prebiotic. And what what are some true prebiotics that are like bonafide, they've got the Dr. Amrita stamp of approval that they are prebiotics in the truest sense?
Dr Amrita Vijay: Dietary fibres. I mean, the the research I've done, inulin, for example. Um, you know, inulin's typically found in things like chicory root, leeks, onions, garlic. Um, so, I mean, inulin's been extensively studied for its prebiotic effects, mainly because it produces butyrate and butyrate is obviously a type of short-chain fatty acid that helps to maintain the the lining of the gut and have anti-inflammatory effects and also been implicated in a range of other metabolic disorders as well. So it's been protective against a whole range of metabolic disorders.
Dr Rupy: Do you think it's necessary for us to supplement with inulin on top of having a high fibre diet? Because I personally don't take inulin in a supplemental form. I just try and get my, you saw my lunch earlier, it was like white beans and had radish and all the rest of it. Do you think there's an added benefit of adding a little bit more inulin if you can tolerate it or can you get enough from your diet?
Dr Amrita Vijay: I mean, so obviously being a researcher or being a scientist, the studies that I do look at isolated forms of isolated components of foods. So for example, inulin fibre. But this is just for for us to understand the mechanism because we obviously like isolate it from specific foods. It's more easier to understand how that specific component has an effect on the body. But if you ask me, I mean, I always root for whole foods over supplements. And if you are actually getting enough fibre as part of your diet, I wouldn't recommend supplementing it with with additional fibre, for example. You're doing yourself enough good in just having a diverse diet with different types of fibre. So this is the other thing about about fibres. It's not one size fits all. It's, you know, it's not looking at just one type or one specific fibre. It's about looking at a whole broad range of different types of fibres because all these different types of fibres have different effects in your body. So it's always better to incorporate a whole range of different foods because you then get different types of fibres incorporated as part of your diet, which then has, you know, a whole range of different health benefits. So it's it's benefiting you overall rather than looking at just one specific type of fibre and one specific health benefit that's associated with it.
Dr Rupy: Yeah. Um, this is going to sound like a silly question. Is there just one type of inulin? Is inulin just one thing that we find in multiple different whole food ingredients like chicory, garlic and artichoke or there are different forms of inulin?
Dr Amrita Vijay: I'm not 100% sure of this, but I think, I think they they might slightly vary in structure. Um, I'll probably have to double check.
Dr Rupy: We'll have to double check that. I'm genuinely interested in that because I, you know, it's almost like the deeper you go, the more you find like the analogy I use is saturated fat. You know, when I was at med school, um, and even after med school, I just thought saturated fat was one thing. And and you know, you dig a little bit deeper, you're like, there are multiple different types of saturated fat. And there are different types of concentrations of saturated fat. Olive oil's got saturated fat, chocolate's got saturated fat, red meat's got saturated fat, but they're all different types of saturated fat. So the deeper you go into this hole, the more confusing it gets. And that's why I ask silly questions like, is there just like one type of inulin?
Dr Amrita Vijay: It's not a silly question, but I think there there could be slight differences in the structure. And the reason I say that is because resistant starch, for example, there was a study that looked at um, resistant starch that was extracted from tapioca and resistant starch that was extracted from maize. And they did differ in structure. And they had completely different effects on the composition and the functionality of the microbiome.
Dr Rupy: Wow.
Dr Amrita Vijay: So there could be differences in the structure of inulin, for example, um, you know, when you're comparing it between different types of foods.
Dr Rupy: Okay. And another question, maybe this is one for after the pod, but we really struggle to find a robust and reliable database of foods and their corresponding inulin content. We've really tried to introduce this into our nutrition calculator. We can just give general fibre amounts, but I haven't found the robust one to to say, okay, this type of onion has got X number of inulin or this type of onion, you know, has got a different amount. Do you have access to anything?
Dr Amrita Vijay: Because it doesn't exist.
Dr Rupy: It doesn't exist.
Dr Amrita Vijay: It doesn't exist.
Dr Rupy: That's crazy.
Dr Amrita Vijay: And we do really need that information because no one's actually gone down to actually measure these really important things. And it it really doesn't exist. And I'm not surprised why you haven't found it because it doesn't not exist.
Dr Rupy: Oh my gosh. Can you work on that in your next research project, please?
Dr Amrita Vijay: Absolutely. Absolutely.
Dr Rupy: I think it's really important to find a database or like or create a database of this stuff because, you know, the the the more the higher in terms of accuracy we can define high fibre foods and the types of fibres they have in their food, the better and the more prescriptive we can be with individuals and patients as we move towards like food prescriptions and we move to towards and we'll talk about this a little bit later, modulating the gut microbiota with high fidelity. Um, so yeah, I it's really frustrating that we don't have that because we get asked about that a lot as well. And I think it would help people who are perhaps sensitive to certain foods and they can't figure out why. Um, so yeah.
Dr Amrita Vijay: Definitely.
Dr Rupy: Okay. I I I I I'm assuming you're going to do a research grant on that.
Dr Amrita Vijay: Put that's a great idea. Put that through.
Dr Rupy: Um, great. Okay. Another thing that we need to talk about is this idea of diversity. Um, so a general theme, I think within the gut health world is to get uh, aim for a more diverse microbiota. You said in the quick fire questions that a diverse microbiota isn't necessarily indicative of better health. Can we unpack that a bit?
Dr Amrita Vijay: Sure. Um, I think the question is what encompasses that diversity that you're talking about. Um, so someone could have a high diversity, but what's actually encompassing or what's what are the the microbes that's um, that's forming up that diversity. So you could have, you know, someone with um, slightly higher diversity compared to, you know, someone else, but it could be that that person's got um, more number or more abundance of pathogenic bacteria that's sort of driving their diversity to be slightly higher than the other person. So I think diversity is, you know, is it's basically just an overall picture, but I think it's really important to get into the nitty-gritties of it and just to see what are the what's actually um, what are the drivers of this specific diversity index? So, you know, whether you've got um, you've got pathogenic bacteria that's actually driving this diversity or you've got a good mix of bad good and um, and bad bacteria that's that's um, that's present within the sample. So, um, I wouldn't just take that, I would take diversity as face value, um, but I wouldn't sort of pin my hopes on it saying this is definitely your health index or your health matrix to um, to see how healthy your gut microbiome is.
Dr Rupy: Okay. So if I do a gut microbiota test and it says that I have a really diverse microbiota, in my head, a green light goes off and I'm like, that's great. But that's not what you're saying is that that's not necessarily indicative of better health. It just shows that there's more diversity, but we don't really know what microbes you're diverse in unless we go deeper into the um, into the test, which these current tests that are commercially available don't do.
Dr Amrita Vijay: Correct. I mean, some of the test that you get available at the moment, they do delve into the specifics in terms of the composition. So they do they do look at the types of different types of bacteria that you've got in your sample. And um, typically they would give you, you know, percentage of abundance of these specific bacteria that's that's present in your in your sample. So it's, you know, I wouldn't I wouldn't just um, open up your report and I would I wouldn't just look at your diversity score and be like, right, this is this is great or it's it's in green, so that's that's it and just close the report. I think I would delve deeper to try and understand what is actually driving this whole diversity um, score to be high or low depending on what your what your sample report says.
Dr Rupy: Okay. Um, you mentioned the words uh, good and bad bugs. Uh, is that always necessarily the case? Are there always uh, good bad good bugs and bad bugs or does the sort of situation, the environment, the context matter?
Dr Amrita Vijay: Absolutely. So I think we need to think about the gut microbiome as an ecosystem. So where you've got um, you've got your so-called good bugs living in harmony with your so-called bad bugs. Um, but I think I think we need to begin to move away from trying to just group, you know, certain bugs as good and certain bugs as bad. Okay. Um, a really good example of that would be Prevotella copri, for example.
Dr Rupy: Prevotella copri.
Dr Amrita Vijay: Prevotella copri. Um, so in some contexts, Prevotella copri has been um, called a good bug. So, initially when Prevotella copri was was studied, it was more prevalent in rural populations where they had a really high plant um, plant diet and, you know, high fibre diet. And it was mostly associated with being protective against metabolic diseases and things. But then more recently, Prevotella copri has also been associated with rheumatoid arthritis, for example. And this has mainly been seen in the western sort of population where they've got predominantly a high fat, low fibre diet. Yeah. Um, so, I mean, it's the same, it's the same microbe that belongs to the same species, but why, why this, why this difference then? Why is it good in one context and bad in the other context? And I think that makes us realise that maybe we need to dig deeper and it could be down to the difference in strains. So from species, the next level down would be the specific strains. So it's it's the getting into the finer details of what a specific bacteria could actually do. So different strains actually have different functions as well. So again, going back to probiotics, for example, um, and this whole, you know, uh, concept of um, probiotics not being as effective. It's mainly because a lot of the studies that have looked at the effectiveness of probiotics actually haven't gone into strain level um, characteristics of specific bacteria because when you go down to strain level, um, different strains have different functions. So they carry different machinery with them. So they they elicit different responses. And um, so it's really important to go down to strain level because that's when you realise that, oh, actually, you know, you've got the same species, but two different strains belonging to that same species, but having completely different functionalities within the microbiome.
Dr Rupy: So to use an analogy that might be imperfect here, so when we're talking about species and strains, I'm thinking about cars around the world. So, so like at the different kingdom, like right at the top, you've got different cars from different parts of the world, American-made cars, German-made cars, Japanese-made cars. And then the more uh, narrow you get in terms of the types of cars, then you've got, you know, let's focus on Germany, let's say, uh, Porsche, VW, Audi, some of those might be around Europe. Um, and then you've got different uh, types of cars. You've got saloon, you've got 4x4, etc, etc. Let's say the the type of car is the species and then the strain level is like the model of a particular 4x4. Is that that's the way we should be thinking about it?
Dr Amrita Vijay: I think I think that's a really good analogy just to break it down.
Dr Rupy: Okay. Do you actually think that's a good analogy? You can use it if you want.
Dr Amrita Vijay: I think it's good. Yeah, why not? I mean, the, yeah, the the saloon and the SUVs. Yeah. Um, could be the the the strain level. Yeah.
Dr Rupy: Okay.
Dr Amrita Vijay: I think I think that's a good analogy.
Dr Rupy: Okay. So, so the at the strain level, it's giving you a like a model number of the car and this gives you a better idea of what probiotic is actually going to be having a beneficial effect. So you were saying that some of the probiotic studies, they haven't shown a beneficial effect because they haven't gone down to this this strain level. When we look at strain level, what uh, do we find in some of these probiotic studies? a beneficial effect, something that's measurable in terms of um, positive um, health benefits?
Dr Amrita Vijay: Yeah. So for example, um, Lactobacillus is a known probiotic, right? So but Lactobacillus is your um, your genus. And then you go down to Lactobacillus plantarum, which is your species level. And then you go to Lactobacillus plantarum DS011.
Dr Rupy: Okay.
Dr Amrita Vijay: So don't take my word on on that specific number, but normally your strains are it normally ends with an alphanumeric number. So you've got, you know, a a an alphabet and then a number that's associated with it. And that's that's when you know that's a strain.
Dr Rupy: It's a strain level. So when you get to the numbers on the end.
Dr Amrita Vijay: When you get to the numbers on the end. So it's normally alphanumeric. So when you when you see that, then that's information that's that's a specific strain.
Dr Rupy: Okay.
Dr Amrita Vijay: So those specific strains, um, they've actually done studies to show that those specific strains for Lactobacillus, for example, have, you know, positive effects on um, symptoms like IBS. Um, so when you go to the supermarket, for example, and you've got all these products that are on the shelf, um, they don't actually tell you what the strain is. So people are just like, oh yeah, it's got Lactobacillus and it's got Bifidobacterium, for example. And they're like, oh yeah, this is all I need and this is going to be really good for me. But then, and if they are suffering from IBS, you it might not be really good for them because it's not that specific strain that's been clinically proven to show to have a positive effect on symptoms in on elevating symptoms of IBS.
Dr Rupy: Okay.
Dr Amrita Vijay: So it is really important for people to be aware of the specific strains that have been clinically tested and proven to have beneficial effects on specific symptoms associated with specific disease. So for example, I've just talked about IBS. Um, but you've got a whole range of other, you know, studies that have looked at specific strains on um, diarrhoea, for example, people who have been on antibiotics. Yeah. Um, things like that. And um, more recently, um, there's been the UK Probiotics um, reference list that's just been published.
Dr Rupy: Oh, I didn't I haven't seen that.
Dr Amrita Vijay: Um, it was I think it was published earlier on in March. And it's I think it's going to be a public database where people can actually just go on there and just look at different um, you know, ailments or whatever they want to get a probiotic for. And then they can find specific product that's available in the UK that has the specific strains that have been clinically proven to to um, to show a positive effect.
Dr Rupy: Wow. And do we have enough of that clinical research data to demonstrate that a specific strain is going to help someone with IBS as an example or like recurrent UTIs or whatever it might be?
Dr Amrita Vijay: Yeah, so I think IBS has been extensively studied. Yeah, I think IBS has been really has been extensively studied. There's quite a lot of um, evidence out there and studies out there that have actually looked at probiotics in IBS.
Dr Rupy: Because when I think of IBS, I just think of so many different reasons as to why people might be suffering the symptoms of irritable bowel syndrome. And I'm just trying to get in in my head like why a specific strain might be universally beneficial to someone or give, you know, have a high probability of being beneficial when there are so many other factors that could be implicated in someone's um, tolerance of of foods or or symptoms when they eat.
Dr Amrita Vijay: Yeah, and I think it again goes back to the specific symptoms that people are having. So I like you said, IBS is just an umbrella term, right? I mean, there's so many symptoms that are associated with IBS. So for example, you've got IBS, you know, you've got constipation, you've got diarrhoea. Um, so but they have there are specific studies that have looked at these specific symptoms. So bloating and cramps and all of that stuff as well. Um, but again, you've got this whole gut brain connection with IBS and that's I think a whole new topic. Um, I don't think there's anything that's been done there or maybe it's it's quite new at the moment. Um, but yeah, I think that's again a whole new sort of um, area of research that people need to factor in because I mean, IBS has been, I'm sure you know, has been sort of renamed as, you know, um, disorder of the gut and the brain and not just a gastrointestinal disorder anymore. Yeah. So you're right, you're absolutely right. There's so many factors, um, or nuances that are associated with this whole umbrella term of IBS. But um, yeah, but in terms of sort of studies that have been out there, I think there have been quite a lot of um, studies that have looked at the effects of of probiotic intakes on elevating symptoms associated with IBS.
Dr Rupy: What are your, what's your hot take on probiotic um, supplements at a strain level or higher for general health benefits? Is there any evidence for that?
Dr Amrita Vijay: There are there's there's I don't think there's any evidence out there for if you're healthy and you take probiotic supplements, there's no evidence to show that it's going to make you healthier.
Dr Rupy: Okay.
Dr Amrita Vijay: Um, it's mainly, it's mainly for people who who suffer from specific disorders or diseases. The same question with the fibre, right? I mean, if you if you're already taking enough fibre, there's I mean, there's there's no evidence to show that if you increase your fibre intake to, I don't know, like 50 grams a day, it's actually going to be more beneficial for you.
Dr Rupy: Right.
Dr Amrita Vijay: Um, it's probably something that we need to look at. I mean, you should be taking notes of all these different research studies you're going to have to do after this pod.
Dr Amrita Vijay: I mean, it's it's again going back to the omega-3s, for example. Um, so vegans and vegetarians tend to have lower levels of specifically EPA and DHA in their blood.
Dr Rupy: Ah. Oh, okay. Yeah, that makes sense if they're not.
Dr Amrita Vijay: That makes sense because they don't eat eat fish. And obviously, you know, getting your um, your omega-3s from flax seeds is not the same as getting your omega-3s from from oily fish. Um, but vegans and vegetarians, um, they they have very low risk for cardiovascular diseases and they're generally considered healthier than people who eat meat, for example. But does that actually mean if they do start taking omega-3 supplements, so the EPA and DHA, they start incorporating that, does that lower their risk even more? Yeah, yeah. Um, so, yeah.
Dr Rupy: So we don't know.
Dr Amrita Vijay: We don't know. We don't know.
Dr Rupy: Um, okay. And in terms of probiotic rich foods, so I'm talking about fermented foods in particular, kimchi, sauerkraut, and other probiotic foods, you know, kefir, natural yoghurts, take your pick. How do we understand those to have a beneficial impact on our general health?
Dr Amrita Vijay: So I think I did say yes to your question when you asked me whether all fermented foods um, have the same beneficial effect on the microbiome. Um, the general answer for me is yes, because just thinking about the concept of fermented foods, you've obviously got a whole range of diverse live probiotic bacteria that's present in these foods. Um, and it's not like talking about a specific supplement, you're talking about a food that's naturally fermented.
Dr Rupy: Okay.
Dr Amrita Vijay: So it's not talking about a food that's pasteurised and then you add in the probiotic bacteria in it. So I'm not talking about those foods, but I'm talking about foods that are naturally fermented. So for example, kefir.
Dr Rupy: Okay.
Dr Amrita Vijay: That's been naturally fermented using the traditional grains, um, fermented for about, you know, um, 17 to 18 hours. And you've got this whole range of different um, probiotic bacteria that's that's present in this in this specific product.
Dr Rupy: I have a silly question about uh, um, dairy-based uh, foods. So because of the laws within the UK for good reason, not using raw milks, which is very popular on TikTok and Instagram at the moment. Um, does that mean that the pasteurised dairy that is pasteurised first and then has probiotics added to it afterwards, is not the same in terms of the health potential benefits of naturally fermented foods?
Dr Amrita Vijay: Um, I would say that the probiotics that are added into products, I think I would I would say that they they don't necessarily um, withstand the the acidic environment in in the stomach and they don't necessarily always pass through that and embed embed themselves within the gut.
Dr Rupy: Okay.
Dr Amrita Vijay: Compared to a product that's been naturally fermented and where you've got um, microbes that are used to being in an acidic environment because of the natural fermentation process.
Dr Rupy: Ah, okay.
Dr Amrita Vijay: Um, and those those microbes, because they're used to that sort of environment in the first place, they do have more of a tendency to withstand the acidic environment in the of the of the stomach and then and then go through and embed itself within within the gut.
Dr Rupy: Gotcha.
Dr Amrita Vijay: So it's just, you know, thinking of it from an ecological point of view, it's, you know, what what are these microbes used to? What sort of environment are they used to?
Dr Rupy: Okay, that makes sense. So sorry, I was I cut you off there. You were about to talk about foods that are naturally fermented like kefir and some others.
Dr Amrita Vijay: Yes. So, um, yeah, so things like kefir, um, sauerkraut, kimchi, that's all been naturally fermented, they tend to have a more diverse range of of bacteria in them. So you've got more chance, like I said, the acidic environment also helps these bacteria to withstand the acidic environment in the stomach and then go through and make it into the gut. Um, but also you've you've um, basically got a much more diverse range of these these beneficial bacteria. So there's more chances of of not all of them, probably a more chances of most of them sort of getting through and embedding embedding themselves within the gut. So, um, in terms of of that, when you look at the um, the odds of, you know, having eating or consuming a fermented food compared to taking a probiotic supplement, for example, you've got more chances of benefiting from having a fermented food rather than rather than taking a supplement.
Dr Rupy: Okay. So the way I see it in the way I understand that in my simple brain is uh, an almost like a synthetic addition of a probiotic that has been grown specifically to be injected into a food is less resilient than one that has been naturally fermented in a kimchi or sauerkraut or something that you've made on, you know, either bought from the supermarket and is in the refrigerated section or one that you've made using a mother culture because that's more likely to withstand the acidic environment in your gut because it mirrors the process that it's had to go through when you've created said product in the first place. Is that?
Dr Amrita Vijay: Correct.
Dr Rupy: Okay, great. All right.
Dr Amrita Vijay: And I just like to quickly add on that as well. So it's not just the um, the microbes, the diversity of the microbes that's actually in the product, you know, that that that occurs in the product because of the the natural fermentation process, but it's also the metabolites that these microbes produce.
Dr Rupy: Okay.
Dr Amrita Vijay: So you've got the added benefit of not just having the, you know, having the microbes, but also the the beneficial metabolites that these microbes produce. Um, so again, that also sort of increases the chances of making through, making it through the the acidic environment and embedding it embedding itself within within the gut. So it's it's an added benefit there.
Dr Rupy: Even if the microbe that we've consumed is not live in the digestive tract by the time it's been, you know, it's made its way through the stomach and the small intestines, can it still have a beneficial effect on your gut health?
Dr Amrita Vijay: I think the metabolites that they produce, um, if they are not, if they're if the metabolites are still there, so if they haven't been processed or they haven't been sort of like wiped out, um, they would still have a beneficial effect for sure. Um, there are products that that you might find in the supermarket where they've sort of pasteurised the product. Um, those basically, they would still argue that it might still have some of the metabolites in them, but it's got none of the beneficial bacteria because all of them are dead basically. So as soon as you heat, you know, heat pasteurise anything, you you basically killing off all the live bacteria that are essentially good for you. But I think what from from a microbiome perspective, you would ideally want to have the live microbes in addition to the metabolites that they're producing taken together rather than, you know, just looking at the the metabolites or as they call it now, the postbiotics.
Dr Rupy: The postbiotics. Yeah, yeah. Yeah.
Dr Amrita Vijay: Um, so, um, again, postbiotics is, you know, something that we don't know much about. We're not really 100% sure whether it actually has a beneficial effect or not because it's it's lots of people are talking about it, you know, isolating specific short-chain fatty acids, butyrate, for example, in these pills. And you, you know, yeah, there you go. Just take some butyrate. You don't need the microbes, just take the, you don't need the microbes. And again, it's um, the answer is I don't know. I mean, I'm not sure how much of an effect that's whether it's got the same effect of having the live microbes actually producing these these molecules within the gut, um, or whether, you know, just taking a pill which I'm a bit sceptical about. Sure, yeah. Um, yeah, I don't I don't I'm not too sure about that.
Dr Rupy: Sure, yeah. Um, I appreciate that because I think it's important to emphasise how little we know about this subject. And you know, you're you're a domain expert and this is what you spend your uh, career studying and the fact that you can't tell us with confidence means that whoever is telling you confidently online that you should be taking this supplement, you know, is clearly not not um, uh, being true to the science. Um, on the subject of fermented products that are no longer have live microbes, um, if I take the example of one of my favourite products, tempeh, uh, you know, that's undergone a fermentation process. It's packaged and we we buy it and then we cook with it, etc. Is it fair to say that that's not got any live microbes in? So you're lacking that the the same benefits that you would have if you consumed a fermented pickle or a fermented kimchi or sauerkraut?
Dr Amrita Vijay: I mean, I wouldn't I wouldn't isolate specific foods. I think I would, I mean, tempeh is great, right? But, you know, even though, although you say that it might not contain the live microbes, it still does have other other nutrients that could be beneficial for you. So it's not about saying, oh, this is this has been fermented, but so for example, sourdough bread, right? So if you think of sourdough, the sourdough fermentation, you know, it's it undergoes um, you know, it's the dough is basically fermented over, you know, a period of time. And um, it does make the nutrients bioavailable to you. Although, you know, the the end product that you consume is is bread and obviously all the live microbes have been killed off in that process. But that doesn't mean to say that that bread's not nutritious for you. It is, of course it is nutritious for you because it does the whole fermentation process actually does do other things as well. So it breaks down the nutrients and makes it more bioavailable for you. Um, and there obviously have been studies that looked at sourdough bread and in improving blood sugar levels and um, does it can have positive impacts on the gut microbiome as well. So I wouldn't I wouldn't specifically isolate or just just look at a specific food product and be like, right, okay, so this has been fermented, but it's been cooked or it's been heat treated. So that's because it hasn't got the live microbes in it, it's not going to be um, beneficial for me. Of course, when you're comparing that to something that's got live bacteria, um, you would, you know, you'd probably have more benefits when you consume, you know, a fermented food that's got the live bacteria in it. But it's about a balance. And it's about incorporating a whole, that's that's why it's about incorporating a whole range of different foods in your diet because, you know, you you might you might get something out of one specific food, which you might not get from the other. So it's it's about balancing it out that way.
Dr Rupy: Absolutely. Yeah, yeah. And you know, it's like top trumps of food. If we were going to compare the microbe availability across tempeh and kimchi, the difference is obvious, but you know, tempeh's got like a ton of protein in and kimchi will have relatively little. So to your point, it's all about balance and ensuring that you're getting a diversity of these foods. And on the subject of fermented foods, what would you say is a meaningful dose of of fermented foods that we should be looking to try and get in in our diets as regularly? Is it something that we should be having daily or a couple of times a week in your mind?
Dr Amrita Vijay: Yeah, absolutely. I think if you can get um, one to two portions of fermented foods a day, that's that's brilliant. I mean, there've been there's there's there was a recent study that was that looked at uh, consuming six portions of fermented foods in a day. Obviously, that was, you know, what's a portion? Is that like a tablespoon or like a?
Dr Amrita Vijay: I mean, yeah, I mean, I I don't I'm not sure whether they had specific recommendations on on I'm sure they did. I mean, I don't think, you know, they were asked to eat bowls of kimchi and sauerkraut. But no, they were they were asked to incorporate six um, servings of fermented foods in a day. And what they found was like, you know, they had tremendous impacts on reducing inflammatory markers and um, obviously having an effect, positive effect on microbiome as well. And this was over a period of six weeks. So I mean, I'm not saying aim for six. I mean, if you can aim for six portions a day of fermented foods, that's brilliant. But I think one to two portions, you know, a day, just just adding in a ferment as part of your um, daily diet, I think it's not going to it's going to do you more good than harm. So.
Dr Rupy: And I know this is a difficult question to answer, but um, I'm a big fan of incorporating some of these probiotic uh, foods. Am I saying that right? Is that am I right in saying that a kimchi is a probiotic food or is it uh, am I am I butchering the terminology there?
Dr Amrita Vijay: So there's this whole thing about not all fermented foods are probiotics. Because again, if you go back to the definition of a probiotic, they're basically live microbes that elicit a health benefit when consumed in certain amounts. Okay. So, but I mean, I would say that kimchi could have probiotic bacteria in them because it's it's the whole process of the natural fermentation basically allows a whole diverse range of live bacteria in them. So you might have that Lactobacillus plantarum, you know, which is considered a probiotic in kimchi. Uh-huh. Um, so I would just look at fermented foods as, you know, most likely to have at least one or two probiotic bacteria in them because it's it's a natural fermentation process. Obviously, it also depends on, you know, Lactobacillus, for example, it's mainly, you know, you probably would find it in things like dairy and all of that. But not to say that, you know, you you might have it in kimchi or um, definitely sourdough, uh, when you look at sourdough bread, the profile of it before it's been cooked, it does have um, Lactobacillus in that in it as well. So, um, yeah, so Lactobacillus is like it's really diverse. Um, and it's um, I think it's a super bug that you probably find in almost all kinds of foods.
Dr Rupy: Yeah, yeah. Yeah. You've probably you've likely answered this question already, but I'm a big fan of using products like kimchi or sauerkraut as a flavour base and cooking with them. So instead of just serving it on the side of a diversity bowl or a protein bowl or whatever, as sort of like part of the salad, I'll throw it into a stew with um, onions as the base, uh, some olives and then like I'll throw in like either a sauerkraut or something like that with some white beans and then top it with either leftover chicken or crispy tofu or whatever it might be. Um, am I damaging to to if I can use that terminology, the probiotic benefits? Am I sort of reducing the the microbial benefits to me by cooking it slightly or does it not really matter as much?
Dr Amrita Vijay: I think by cooking it, it depends on how aggressive you are.
Dr Rupy: Aggressive you are. Low to medium heat.
Dr Amrita Vijay: If you're cooking it, if you're if you're like sort of like stewing it for about half an hour, that's that's all your your live bugs gone.
Dr Rupy: Okay, yeah, yeah, okay.
Dr Amrita Vijay: Um, but I think if you add it towards the end of your cooking process, okay, um, that's probably you you're probably um, preserving it a bit more, I would say.
Dr Rupy: Yeah, yeah. So I I guess like within this, a diversity is the best uh, strategy. So cooking it a bit, cooking it lightly, having it somewhat raw. It's the same sort of approach I take with vegetables in general. Like sometimes I will have spinach just washed and finely chopped and I put that into the end of a meal or I serve it as part of a salad. That way you get more vitamin C. Sometimes I will use it and I'll throw it into the stew and it'll cook down for, you know, 10, 15 minutes. So I've I've lost a lot of the heat sensitive vitamin C, but I'm still getting some benefits from the other polyphenols that you find in spinach. So diversity is a great strategy.
Dr Amrita Vijay: Yes.
Dr Rupy: Okay. Um, on the subject of 30 plants a week, uh, so this is something that is uh, very common. Um, I've written about it in my books, we've talked about it on the podcast before. Should we all be aiming for 30 plants a week? Is this something that you think is bonafide science or is there again, is it a complicated sticky situation?
Dr Amrita Vijay: I think the the 30 plants a week is um, it's just a guide.
Dr Rupy: Okay.
Dr Amrita Vijay: Um, I wouldn't say that it's um, written in stone that you have to achieve the 30 plants a week for you to gain maximum benefit in terms of, you know, improving your your microbiome. I think it's a guide for you to reach up to 30 plants a week. Um, and if you can reach 30 plants a week or more, that's that's brilliant. But I think I would see that as a guide for to encourage people to incorporate more um, more plant-based foods as part of their their daily diet.
Dr Rupy: Okay, fine. So if you can't hit 30 plants a week, you're not failing. If you're incorporating fermented foods and high fibre foods every single day, that's probably the most important thing. I don't want to put words in your mouth, but is that the most important thing in your mind?
Dr Amrita Vijay: I don't think I would say that's the most important thing. For me, what is the most important? For me, I I don't think I've got one most important thing as part of it. I think for me, it's like it's just just incorporate things into your diet. So for example, fermented foods are great. So just add that in. Um, you know, you people say 30 plants a week, use that as a guide. So just add as much as things as you can. Um, I wouldn't try and single out a specific food or a specific ingredient and say you have to incorporate that, you know, that's the the most important thing that you have to incorporate as part of part of your every meal. I think having, you know, a balanced whole food diet and having that approach is is going to get you far anyway. Yeah. Um, and just just looking at it from, you know, someone who's got um, who probably hasn't got a very, you know, diverse diet. I think all of these things just make just gives them um, sort of maybe motivates and encourages them to at least add in one thing in a day and and then build that up a bit further as they go. Um, because it's really it's overwhelming for someone who's, you know, who's not used to eating, I don't know, 30 plants a week, you know, it's it's probably really overwhelming. That number can actually put someone off. Um, but I think also you don't realise that, you know, including things like herbs, spices and all to add up to that number. Yeah. Um, so it's it's gradually building your your diversity plate up one step at a time and not not getting overwhelmed and not thinking that I really have to include or exclude the specific um, food out of my out of my diet. I think it's it's finding that balance and taking it from there.
Dr Rupy: Yeah. Honestly, people should just hang around the Doctor's Kitchen studio for a day because we probably get 30 plants a a day.
Dr Amrita Vijay: That's amazing. That's amazing. That's that's um, yeah, that's really good. I mean, um, so I grew up in India basically and um, and obviously like you you probably agree. Yeah. Um, we've got the best diet. We've got the best diet. Not to brag here, but um, but yeah, I mean, if you just think about it, like what you have for breakfast, what you have for lunch and what you have for dinner, you've you actually cover quite a broad range of of different of different foods. Um, and obviously, while I was growing up, I never appreciated that. I mean, I was, you know, I was given, you know, a really quite, I was probably like, I had a really diverse diet growing up. Um, and I wasn't appreciative of that at all. Um, but just thinking back and even till today, I I do follow um, Indian cooking practices. We eat a lot of Indian food at home. And, you know, I open up my spice box and you've just got, you know, a whole range of of different spices and you just add a little bit of that into your into your dish and there you go. That's like 15, you know, you've hit 15 different plant-based foods already in just in in just one dish. Yeah. Um, so I think it's it's easier than people than what people think it is to achieve um, or increase their their diversity as part of their diet. It's it's it's about adding stuff in rather than, you know, taking things out and restricting yourself from um, from specific foods.
Dr Rupy: Where did you grow up in India?
Dr Amrita Vijay: Bangalore.
Dr Rupy: Bangalore. And what would be like a typical breakfast, let's say, uh, when you were growing up or amongst your family?
Dr Amrita Vijay: So, um, I grew up in Bangalore, but I'm actually from Kerala.
Dr Rupy: Oh, okay.
Dr Amrita Vijay: So, South Indian for for folks who don't know.
Dr Amrita Vijay: South Indian um, folks. Yes. So the typical breakfast for me, um, was um, idli and dosa.
Dr Rupy: Idli and dosa. Oh gosh, I love dosa. I love idli. So good. So exotic.
Dr Amrita Vijay: Yeah. Again, which are fermented.
Dr Rupy: Yeah. So how talk through people through how you make idli?
Dr Amrita Vijay: Yeah, so idli is um, it's basically like a steamed rice, what do you call it? It's not a pancake, is it? It's more of a.
Dr Rupy: Yeah, it's like a it's puffy, isn't it? So it's kind of like it's kind of like a pancake, but like I I mean, I find it's a bit more bready than a pancake.
Dr Amrita Vijay: Yeah, like a bready thing. I would I would call the dosa as a pancake more than than the idli.
Dr Rupy: Yeah, it's like a fine crepe.
Dr Amrita Vijay: Yeah, like a fine crepe basically. Um, so the whole process of of making that, what mum would soak um, some dal, um, some rice, um, fenugreek seeds, um, she would soak that overnight with some water. And then the next day morning, she would grind it into a fine paste. And then again, she would leave that that whole day.
Dr Rupy: Another day.
Dr Amrita Vijay: Another day for it to ferment. And obviously in India, you're you're blessed with, you know, warm weather. So, you know, you've got a a a dough that's risen to double its size, you know, the the following day, the following morning. And um, and for idlis, we've got a specific moulds that we use. Um, so they're they're like um, muffin moulds.
Dr Rupy: And when you say mould, we're not talking about a microbe mould. We're talking about an actual like cooking mould.
Dr Amrita Vijay: Yeah, cooking mould basically. Um, and yeah, she would so for idlis, you just put it into that and then you steam it for about 10, 15 minutes and you've got these fluffy pancake top things. And we normally we normally have that with um, sambar, which is a lentil-based um, gravy as such. Um, predominantly made of um, um, toor dal, um, some onions and tomatoes and spiced up with some turmeric, um, chilli powder. Yeah. And, you know, she would throw in some vegetables in there as well. So things like drumstick, carrots. Um, so we would have that uh, along with the idlis. Um, or she would make a coconut-based chutney.
Dr Rupy: I love that. So good.
Dr Amrita Vijay: Coconut chutney with the with the idli or the or the dosa, which is the.
Dr Rupy: And with the with the idli, um, you haven't introduced a starter or anything like that. It's just the natural microbes that live on the surface of the rice and the lentils that you've blended up the day before.
Dr Amrita Vijay: Exactly. Exactly. Yeah. So there's no there's no starter culture. There are no like grains that help in the fermentation process. It's it's the natural microbes that's present in the grains and the lentils and also on your hands.
Dr Rupy: Mum's hands. Yeah, yeah, yeah.
Dr Amrita Vijay: Because she would she would go in and she would mix it with her with her hands.
Dr Rupy: This is the thing. This is why mum's cooking always tastes better. Yeah. It's because they're introducing their microbes and it's coming from love.
Dr Amrita Vijay: Absolutely.
Dr Rupy: You know, there is actually science behind this, right?
Dr Amrita Vijay: Definitely. Definitely. The extra love from from mum's microbes.
Dr Rupy: And so when you look at that breakfast through the lens of your academic work and your career, you know, I'm looking at that and thinking, that's got 30 plant points pretty much in already. You've got the rice, the lentils, the other type of lentil, the drumstick, the carrots, the spices, the coconut chutney on the side, you probably got some extra vegetables thrown in there. Like your breakfast is like 15 plant points or something. It's absolutely it's incredible.
Dr Amrita Vijay: It is. It is. And I'm obviously now being being in the field, I'm like, oh gosh, yeah, wasn't wasn't appreciative of that at all while I was growing up and eating all of that healthy food. But um, yeah, there you go. You just you just, you know, hit those 30 plants a week or, you know, not even a week in a day, just by having, you know, a nutrient dense breakfast and then followed by lunch and and dinner. So, um, yeah.
Dr Rupy: When you um, you did your talk at where we connected the first time, you were talking about describing a Mediterranean diet to Indian either Indian patients in the UK or Indian patients in India. I can't remember exactly where now. How do you approach this? Because Mediterranean diet, I think is touted as, you know, the best microbiota supporting diet out there. But how do we translate that into more of the principles rather than a cuisine choice?
Dr Amrita Vijay: So when you when you sort of peel back the principles behind the Mediterranean diet, it's basically a diet that's high in fibre. It's basically a diet that's high in polyphenols. Um, it's a nutrient dense diet. So I think if we if we look at it from from that principle, it's quite easy to translate that to different cultures. Um, so for example, I did go to India where I where I did a dietary intervention study in the south of India again, not in Kerala, but in a place called Pondicherry. Um, so the whole point of that dietary intervention study was to um, so this specific group of patients that had um, non-alcoholic fatty liver disease. Okay. And um, the aim of that study was to provide them with a low GI diet because a low GI diet, so basically increasing the amount of fibre in their diet, um, would automatically lower their um, their liver fat and help improve their um, their symptoms of non-alcoholic fatty liver disease.
Dr Rupy: And we call it something different now, don't we?
Dr Amrita Vijay: We call it MASLD.
Dr Rupy: Yeah, MASLD. Yeah. Metabolic associated steatotic hepatitis or liver disease. Yeah, MASLD. Yeah.
Dr Amrita Vijay: I think it's because the um, there was a there was a stereotype or some sort of politically incorrect nature of saying non-alcoholic uh, fatty liver disease and they wanted to take the alcohol out of it. Yeah. But anyway, yeah, MASLD. Yeah.
Dr Amrita Vijay: Yeah, MASLD. So, um, so the concept was to um, prescribe them a diet that was that was going to be high in fibre and uh, with the aim of of them having um, specific outcomes that were associated with NAFLD. So lower um, liver fat, which was one of the main outcomes. And um, when we went out there, obviously went with a group of my colleagues uh, from the University of Nottingham. And um, obviously except for me, all my other colleagues had no idea about what the typical diet is um, back there. So, you know, we kept talking about, oh yeah, the Mediterranean diet, the Mediterranean diet. But I kept saying to them, I don't think they're actually going to understand what a Mediterranean diet is. Yeah. So we really need to like just stay stay clear from using that term, but just just think about the principles behind the Mediterranean diet. So increasing fibre, increasing specific um, you know, nutrients in the diet that's actually going to have beneficial effects on reducing their liver fat. Um, so when we when we did when we when we went out there, um, and we had a chat with the the group of participants and these were all men, by the way. And in India, there's this whole culture of the women actually cook the food, not the men. So we again hit another roadblock because it was not just, you know, it was not just educating the men about the benefits of going on this specific diet because, you know, they'd be like, oh yeah, okay, yeah, I'm happy to take part. But then that wasn't translating into anything because, you know, they're not the ones going back home and cooking. Yeah. And when they would go back home and then sort of explain to their wives or their partners that this is the study I'm taking part in and you need to start cooking in a different way. That was it, you know, the the women were like, but why? You know, tell me why. So we then realised that we needed to actually educate the women in the household who are actually cooking the food and try and explain to them the benefits of making that shift in their cooking practices and in the food that they were eating. And again, the next question was that, oh, would I have to then cook two separate meals, one for my husband and then one for the rest of the family? And then again, we had to, you know, say to them that, well, it's not just going to benefit your husband. Actually, this specific diet, you know, increasing fibre is not just meant for your husband to to feel better, but actually it's going to benefit you and your kids and the whole family in the long run. So I think it was a really interesting um, exercise and I think an eye opener for a lot of my colleagues as well to to realise that, you know, dietary interventions probably done in the UK don't translate directly to dietary interventions that are done in a different part of the world. Yeah. So it's really important to take on board um, the cultural specifics, um, the difference in diet, the different traditions, you know, and also sort of educating them in in a manner that actually is going to make sustainable differences um, you know, in being able to incorporate that that specific diet as well. So, I mean, the intervention was quite simple. It was uh, replacing white rice with red rice, which is a again, a common type of rice that's um, that's commonly found in Kerala.
Dr Rupy: Oh, is it commonly found in Kerala? Because I've heard of Camargue rice, but I think that's French. That's a that's a rice that's found in found in France.
Dr Amrita Vijay: Okay. No, this is called Matta rice.
Dr Rupy: Oh, okay.
Dr Amrita Vijay: Uh, so it's sort of parboiled red rice. So it's basically rice that's still got the bran.
Dr Rupy: Okay.
Dr Amrita Vijay: Bran on it. So.
Dr Rupy: Sounds delicious.
Dr Amrita Vijay: It is. It is really tasty. Uh-huh. Um, so it was just getting them to swap white rice with the red rice and um, also lowering their portions as well because again, you know, we're we're very much carb heavy. Yeah. Um, so it's so cutting down portions of of their rice, but then um, compensating that with more vegetables and and more of the lentils and dals and things. So it wasn't it wasn't a big massive ask, but then that whole process was such an eye opener because, you know, yeah, we we also gave them the rice. It wasn't that they needed to go purchase their rice on their own. We gave them the rice to actually cook with. But again, there was still resistance from, you know, from the person cooking the meal saying, oh, what's this now? Because I've been used to cooking white rice, which probably takes five minutes to cook compared to red rice, which probably takes a bit longer because of the bran that's in it. So, um, yeah, so that was a that was that was a fun and interesting study.
Dr Rupy: I think there's some interesting um, crossover there as well in terms of um, how to get more people, particularly in urbanized environments in the UK on board with dietary changes because a lot of those practices and social norms have been or have migrated across from different parts of the world, one of which is India. Um, and so yeah, actually that being reflected in practice. I mean, I'm I'm privy to that and that's why and working in, you know, central London where you see people from Korean background, Jamaican background, Sri Lankan background, you you sort of grow accustomed to what might be more applicable and relatable and resonate with the person in front of you. And whether the person in front of you is actually going to have any impact on their diet at all, you know, whether that is the um, the the husband or the wife in in the family. So I think there's a lot to learn from those kind of practices and that experience abroad. It's probably eye opening for your colleagues as well.
Dr Amrita Vijay: Definitely. Yeah, definitely.
Dr Rupy: Functional activity in microbiota tests. Um, we talked a little bit about this before that so the tests that we currently have are 16S RNA technology. Perhaps we should define what that is and how specific we can get in terms of what we can see using those investigations and where you feel we should be moving toward when it comes to accurately representing what our microbiota is doing for our health and well-being.
Dr Amrita Vijay: Yeah, so, um, I think the past 15 years or so, um, things 16S sequencing has been on the forefront wherein, you know, 16S was um, the 16S test basically gives you an indication of the different types of bacteria, but goes down to species level. So we talked about the genus and then we talked about the species, like the car analogy that you that you brought up, which I absolutely loved. Um, so I think, but now with um, there's been advancements in the technology of being able to to actually measure um, in terms of microbiome analysis, there's been there's been advancements there. Um, wherein we are actually able to go down to strain level, but also look at the functionality of different microbes. So it's not just looking at who's there, but actually what they do. So, um, in terms of the um, the tests or the analysis in in the research field, um, metagenomics, as they call it, where you've got the strain level clarity on strain level as well as the functionality is is gaining a lot of momentum at the moment. Um, and I think that's really important because it actually gives us a broader picture and it gives us a deeper meaning into what these microbes do and what they're there for.
Dr Rupy: So the metagenomics, why does this have uh, wider benefits um, to consumers if they were to get their hands on those kind of tests?
Dr Amrita Vijay: So metagenomics gives you um, an indication of the strain level profile of the um, of the bacteria that are present in in your gut. So it's not just the the species that you get with 16S, but it's going um, one step deeper into the strain level as well. But also gives you um, the functionality of these different microbes. So it's not just telling you who's there, but also what they do.
Dr Rupy: And so, um, you've mentioned before that these microbes are picky eaters. Um, how does this type of investigation help us determine what they like eating and and and how would that like, how would you infer from that information um, some extra stuff that you could do in terms of your diet and lifestyle to improve your your overall health?
Dr Amrita Vijay: So, again, just just going back to picky eaters, right? So the reason I said that was because um, specific microbes like munching on specific types of dietary fibres, for example. So you you've got a specific group of microbes that prefer munching on inulin fibre, for example, and maybe another group of microbes that prefer munching on resistant starch, for example. And then these both these groups of microbes um, they result in the production of specific types of um, short-chain fatty acids. So the ones that feed on um, inulin result in the production of butyrate, for example. And then the ones that feed on resistant starch might result in the production of propionic acid, for example, which both have specific health benefits. So with the metagenomics, we're able to actually identify which are those microbes that have um, the ability to produce butyrate. So, and also specific microbes that um, have the ability to break down carbohydrates. So have the machinery to actually break down dietary fibres. So when you do a dietary fibre intervention, for example, if you actually, if you've got a group of people who actually haven't got the machinery to break down dietary fibres, you might not even see or you might not even find differences in their end points that you're looking for. So specific people or specific interventions or having incorporating fibre, for example, um, it might sort of increase the the abundance of that machinery if you've already got it, which is a good thing, which means to say that you're more well-equipped to um, break down dietary fibres and then therefore release the short-chain fatty acids that are beneficial for you. Um, or it actually might incorporate the machinery within you if you actually haven't if you haven't already got it. So metagenomics actually would give you that sort of information about, so it's called carbohydrate-active enzymes. So it's basically enzymes that help break down carbohydrates. So it's it's the machinery that helps ferment and break down dietary fibre and therefore release short-chain fatty acids. But the other thing about metagenomics, which I'm really interested in at the moment is also looking at um, trying to elucidate um, the links between the gut brain axis, for example. So you've also got um, functional pathways that are associated with the production of neurotransmitters or the precursors to the neuro to the production of neurotransmitters. So for example, you've got specific microbes that are um, that are responsible for the production of tryptophan, the biosynthesis of tryptophan, which is again a precursor for um, for serotonin. Um, so it actually gives you that deeper meaning as to what's actually going on within, you know, within the gut and how to actually elucidate um, mechanisms between what's happening in the gut to your to your final functional outcome.
Dr Rupy: Wow. Okay. So what I'm reading from this is um, there are certain people that might be better positioned to maximize the impact of a high fibre diet in converting that fibre via the machinery or the microbes into short-chain fatty acids that are then absorbed and then forming precursors for things like tryptophan that is the precursor to serotonin. So these folks could have like a real incredible impact on their brain or their mental well-being, their mood, etc, versus some other people. And so your response is dependent on your microbial profile.
Dr Amrita Vijay: Yeah, your response will be dependent on your your baseline microbial profile. Okay. But also depending on the intervention. So for example, you're doing a probiotic intervention, you know, you you sort of embed these beneficial microbes within your gut for for you actually to then um, be able to have and incorporate that machinery that you need to to break down or um, digest specific specific foods better and then to for you to maximize the benefits out of it.
Dr Rupy: Okay. That's fascinating. And are there blood tests that we should be looking at in conjunction with some of these microbial tests to determine, you know, a beneficial effect?
Dr Amrita Vijay: Yeah, so I mean, not talking about clinical blood tests that that measure sort of like inflammatory markers or anything, but there are you if if there's a way to measure the levels of short-chain fatty acids. So short-chain fatty acids can actually be measured in serum. And I think that would be a great way to to give an indication of how well your machinery is working in terms of breaking down fibre because obviously the byproduct of fibre being broken down is short-chain fatty acids. So you if you've got, you know, if you haven't got uh, a high fibre diet, you've probably got low levels of short-chain fatty acids circulating in your bloodstream. Um, but then if you decide to do a test and you you've seen low levels of short-chain fatty acids in addition to your microbiome test and you see low levels of specific microbes that are associated with the production of short-chain fatty acids and then you decide to go on a high fibre diet or increase your fibre intake, you can do a follow-up test um, to see how your short-chain fatty acid levels have actually gone up and how that then reflects back into your um, changes in their microbiome as well.
Dr Rupy: Yeah. That's fascinating. To bring this conversation to to a close, I'd love to learn a little bit about some of the things that you've changed in your own lifestyle or advise to perhaps loved ones or colleagues about changes to improve their health. I know one of them, which is fish oil from the sounds of things and your research. Um, are there any others in that vein that you've introduced as a result of your work?
Dr Amrita Vijay: I think for me, I think it goes back to um, just keeping it really simple, just going back to, you know, if you're going grocery shopping, for example, um, I would just pick foods that are in its natural state and natural form. Um, not to say that beans in a can are going to be bad for you, absolutely not. But then I wouldn't go for baked beans in tomato sauce. I would just go for cannellini beans that are in, you know, that's in water basically. And and and and do my own thing with it. Um, and I think cooking your own meals, cooking from scratch, um, it doesn't have to be elaborate meals, it doesn't have to be, you know, the idli and the dosa that I grew up eating, but it can be really simple, simple things that you can do at home that's going to give you that nutritionally dense um, meal without having to rely on convenience food. Um, and like we've, I think we we all keep talking about there's no such thing as a silver bullet. Um, it's about just going back to your roots and it's about just questioning or asking yourself, um, how's this going to actually benefit me? You know, just looking at the the ingredients, for example, you know, if it's got 10 ingredients on it, question it.
Dr Rupy: Okay.
Dr Amrita Vijay: Um, compared to to or three ingredients, you know, so it's just simple things like that. And I think for me, a whole food approach, um, is something that I personally um, stick to and and that's that's something that I advise to people, friends and family as well. And it's it's really not that hard. It's really, really not that hard. I think it's, you know, we're just everything's just really confused and colluded at the moment with with so many options. Yeah. But I think don't let them, don't let those things uh, take you away from thinking about raw food, um, and just asking yourself, you know, was this something that my granddad or my grandma ate, you know, back in those days? And if it's a no, then I would stay clear from it.
Dr Rupy: Okay. Those are good heuristics. I think, you know, for me, um, trying to get in incorporate a whole food diet as much uh, variety of fibres as possible, um, prioritizing whole food sources of protein for me as well, it's it's it's definitely a focus. Um, and also, I I getting probiotic rich foods in, fermented foods is something that I've definitely prioritized over the last few years, given the research that I've been privy to. If we were talking again in like five years or 10 years time, I'm sure we'll talk before then, but uh, if we were talking uh, let's say in a in a time horizon of uh, the next decade, what do you what do you think is the most exciting avenue of gut health research or maybe even consumer available products that we should be looking out for?
Dr Amrita Vijay: I think the whole gut brain axis. Ah. Um, the whole um, the diet first approach towards mental health. I think that's definitely an area that's um, that's gaining traction at the moment. And again, um, focusing on the diet based approach rather than, you know, here's a pill and this is going to get your anxiety away. I mean, there's there's been trials already that's looked at, you know, the Mediterranean diet, for example, and that's, you know, shown promising impacts on elevating um, anxiety and depression, for example. So, um, there's already evidence there that a whole food approach does have impacts and positive impacts on mental health. Um, but I think we've also we've just also been focusing on diet, but I think lifestyle is also equally important. Yeah. Um, so it's about, you know, getting that good balance of both a healthy diet as well as um, physical exercise um, is really important, especially in in the whole, you know, mental health um, area, which, yeah.
Dr Rupy: Which I think is gaining a lot of momentum and traction at the moment. Yeah. I think it's underutilized right now, diet and mental well-being and given the crisis and the devastating increase in diagnosis of uh, anxiety and depression, particularly in younger people, diet really needs to be assessed. Um, Amrita, this is great. Thank you so much. I really appreciate your work and I I'm sorry I've given you so many extra research questions to go and find funding for, but uh, I I look forward to reading some more of your papers and connecting with you.
Dr Amrita Vijay: Sure. Thank you so much for having me. It was great.
Dr Rupy: It was great. It was really fun.
