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REPLAY: The Microbiome: Understanding Impacts of Soil Quality, Polyphenols, and Fasting with Dr. Adrian Lopresti and Dr. Emeran Mayer

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REPLAY: The Microbiome: Understanding Impacts of Soil Quality, Polyphenols, and Fasting

In this week's podcast replay, Dr. Emeran Mayer, gastroenterologist and brain-gut expert and our ambassador Dr. Adrian Lopresti discuss the various factors from childhood development, every day life and our environment can all impact our gut microbial balance. Emeran brings insights into the impacts of maternal stress, diet, environment, and birth experience on a child’s overall gut health. He also shares how the Earth’s microbial balance influences soil quality which then has a follow on effect of the amount of polyphenols in our fresh fruits and vegetables.

They also discuss how that polyphenol content in food not only provides various health benefits but can also modulate the microbial abundance in o9ur guts. Finally, the episode wraps up with an interesting discussion on time restricted eating (TRE) and how it can provide vast health benefits, not only on a macro level but also on gut function and at the microbiome level as well.  

This podcast is supported by excellent resources such as books, infographics, and articles which should not be missed! 

Covered in this episode

[00:32] Welcoming Dr. Emeran Mayer
[01:29] Main factors that influence gut microbiome
[05:19] Prenatal health and maternal stress and its affects on the microbiome
[09:47] The impact of industrial agriculture on the soil microbiome
[12:41] How those changes in the soil affect our microbiome and overall health
[16:27] Polyphenols and gut health
[18:11] How gardening changes our microbial diversity 
[19:53] The impacts of time restricted eating on the microbiome
[27:05] Final tips from Emeran
[30:31] Thanking Emeran and final remarks

Key takeaways 

  • The brain-gut microbiome axis can be understood as the central system for balance in our bodies, and various inputs alter this system.
    • Food is a major input at the gut which can affect brain function and stress signals (acute or chronic) is the major input at the brain end that can modulate general gut behaviour and receptors on gut microbes that alter their behaviour.
    • Lifestyle factors also correlate to altered gut health. Moderate exercise intensity positively impacts gut microbial health while high intensity, prolonged exercise can have negative impacts.
    • A healthy night’s sleep can counter pro-inflammatory mediators derived from the gut.
    • Medications that directly affect microbes are also impactful. 
  • The foetal microbiome’s development starts prior to birth and can be affected by the mother’s stress levels, medications and diet which can result in long term impacts on the baby. If the mother has metabolic issues during pregnancy, this low-grade inflammation will inhibit the beneficial microflora proliferation that the newborn child is exposed to during birth. 
  • Modern faming industries have reduced the diversity and abundance of microbes in our soil which has a follow on effect on food quality. Microbes have a unique interaction at the root level to assist with mineral uptake and plant development which has now been replaced with chemical fertilisers which boost quick growth but compromises plant quality and resilience. 
  • Soil microbes contribute to the nutrient density and polyphenol content of plant foods. Polyphenols are too large a molecule to be absorbed through our gastrointestinal tract, but it’s the interaction or metabolism of polyphenols within the gut microbiome which provides us with health benefits. Less than 5% of polyphenols can be ascribed to the antioxidant effect. 
  • Curcumin is a great example of a compound which poorly absorbed in the small intestine (like polyphenols) but has known local health benefits.  
  • Fasting or restricting our food intake to a specific number of hours in the day (also known as time restricted eating) affects the microbiome. Fasting for 16 hours alters gut contractility, secretions, blood flow, immune function and microbial geography for a health benefit. During this fasted state a switch in rhythmic contractions has a cleansing mechanism to shift excessive amounts of bacteria in the small intestine to the colon for excretion. Time restricted eating also affects gut geography where microbes can localise to the gut wall to better interact with receptors.  

Resources discussed and further reading

Dr. Emeran Mayer

Dr. Emeran Mayer's website
Book: The Mind Gut Connection
Book: The Gut-Immune Connection
'Role of the gut microbiome in the pathophysiology of brain disorders.' 
Neurobiology of Brain Disorders (Second Edition), 2023, Pages 913-928
Complete list of Dr. Mayer's publications

Regenerative Agriculture

Article: What is the difference between organic and regenerative agriculture?

Intermittent Fasting and Time Restricted Eating

Podcast: Intermittent Fasting: Fad or Metabolically Beneficial?


Research: 'Multiple antidepressant potential modes of action of curcumin: a review of its anti-inflammatory, monoaminergic, antioxidant, immune-modulating and neuroprotective effects.' J Psychopharmacol, 2012

Polyphenols and the Microbiome

Article: The microbiota - polyphenol interplay in neurodegenerative disease
Research: 'Targeting neuroinflammation by polyphenols: A promising therapeutic approach against inflammation-associated depression.' Biomedicine & Pharmacotherapy, 2022
Research: 'Effects of Polyphenol Supplementations on Improving Depression, Anxiety, and Quality of Life in Patients with Depression.' Front. Psychiatry, 2021



Adrian: Hi, and welcome to FX Medicine, where we bring you the latest in evidence based integrative, functional, and complementary medicine. 

FX Medicine acknowledges the traditional custodians of country throughout Australia, where we live and work and their connections to the land, sea and community. We pay respect to their elders, past and present, and extend that respect to all Aboriginal and Torres Strait Islander people today. 

With us today is Professor Emeran Mayer, a world-renowned gastroenterologist and neuroscientist with over 35 years of experience in the study of clinical and neurobiological aspects of how the digestive system and the nervous system interact in health and disease. He's published over 350 peer reviewed scientific articles and has published two great books that I highly recommend: The Mind-Gut Connection, and The Gut-Immune Connection. 

So, welcome to FX Medicine, Emeran. Thanks for being with us today.

Emeran: Thanks for inviting me to be on the show. It's a pleasure.

Adrian: It's definitely a pleasure to have you here. 

So, over the last decade or so, we have begun to finally appreciate the critical role that the gut has on health and disease, and in particular, the bi-directional relationship between the gut and the brain. And I know there's an increasing body of research that confirms that the gut and the diversity of a microbiome could influence how we think and feel and is linked to mental health conditions, and even neurodegenerative diseases such as Alzheimer's disease and cognitive decline. 

So, I know that there are several lifestyle and dietary, environmental, and biological factors that can influence the health of our gut and the diversity of our gut microbiome. Can you briefly just summarise what these factors may be that might be influencing our gut microbiome?

Emeran: Yeah. So, I like to start out saying that the brain-gut microbiome axis, in my opinion, is a central homeostatic regulator in our bodies, almost everything is transmitted through this system. So, the food that we ingest is obviously a major factor, but there's also other molecules that the body produces, like bile acids or oestrogen, for example, or androchanular which is secreted with the bile into the gut, which influences the microbes and the microbes break it down. So, food and certain chemicals that we ingest, toxins are the main influences from the gut side. 

So, the brain-gut microbiome, as I refer to it as the brain-gut microbiome axis. I like to call it a ‘system’ because it communicates in both ways. But at the lower end, at the gut end of this brain-gut microbiome axis, food is the main influence that changes. 

But then you look at the brain, and the brain sends signals. Every emotional state in the brain or acute and chronic stress sends signals down to the gut, including, the habitat, which modulates the gut, which is the home for the microbes and changes their behaviour. But it also, these stress mediators like norepinephrine, they can also directly affect receptors on the microbes and change their behaviour.

So, now you have two major influences. You have food on the one side. You have the brain and emotional states and stress on the other end of the axis. And then, there's other factors like physical exercise, for example. It's been shown that moderate exercise has a beneficial effect on the diversity and the health of the microbiome. Severe exercise, like ultra-marathons actually have the opposite effect, are not good for the gut or the microbiome. And athletes have many such problems related to these negative effects.

Then there's also sleep. Sleep is another major thing, obviously goes through the brain. But sleep has a major anti-inflammatory effect. So, healthy, regenerative sleep plays a major role in inactivating inflammatory mediators that might come from the gut. So, it has a regulatory effect on the system as well. So, I would say, lifestyle factors such as food and exercise and sleep are probably the main determinants of the health of the microbiome.

Adrian: Okay. So, you've got your diet that's going to influence our microbiome and obviously, the type of diet that we eat. And then you've mentioned sleep being a positive thing. And then exercise being a positive thing up until a certain point and then potentially having an adverse effect on our gut if we do too much exercise, like marathon running.

Emeran: Yeah. And you may want to add to these three factors, medications. So, medications, in particular, the ones that directly affect the microbes, like antibiotics, obviously, have a major negative effect on the microbial ecosystem.

Adrian: What does the research say about our mother's prenatal health and stress levels? What impact does that have on a growing newborn?

Emeran: That's an interesting thing. So, a lot of research has shown the early life factors when an infant is born, going through the birth canal of the mother, and basically, for the first time, the sterile gut of the newborn is colonised by these microbes, which are usually a mixture between the vaginal and the faecal microbiome of the mother. 

But then the interest moved further upstream, and it was found that the vaginal microbiome of the mother is influenced by, for example, stress that the mother experiences and also by if the mother had, even in animal models, one dose of an antibiotic that would affect the vaginal microbiome and then downstream would affect the infant's colonisation its microbiome.

So, then, also diet of the mother has a big influence. So, for example, if the mother is on the unhealthy Western or it's called the “standard American diet,” it creates this low-grade inflammatory state called metabolic endotoxemia. So, women that are obese and have Type 2 Diabetes or have this metabolic endotoxemia, when they deliver a child, this child already is exposed en utero, the brain of this child, to this low-grade inflammation. But then also when it comes to the birth canal, it gets a compromised dose of microbes from the mother. So, there's really two ways that this negatively affects, the inter-microbiomics. It's probably the most important programming phase in the human's life, the first… both the prenatal, then the perinatal, and the postnatal three years, probably the most important phase for long lasting, sometimes permanent, changes or damage can happen.

Adrian: As a psychologist, we often talk about the health of the mother during the en utero, the impact it has on the growing baby. And we would often think about it in terms of its impact on stress hormones, on all those factors, which is certainly happening, but it sounds like potentially, it's impacting on the child's gut microbiome when they get born. And so, that could potentially have an impact on their health, including the mental health.

Emeran: Yeah, and you have sort of these dual factors, one is mediated by the microbiome, as we just talked about. And the other one is this stress model. So, we've worked a lot with this maternal separation models where either a pregnant mother is being stressed, and you look at the effect on the nervous system, on the stress system of the offspring. Or you do that stress on the mother of newborn animals, and that will have a major effect. 

So, there's multiple avenues, one of them being mediated by the microbes, an important one, that has a long-lasting effect not just on diseases like allergies that are sort of starting early in life, but also programming the microbiome in a way that it's more susceptible, for example, for cognitive decline later in life, for Parkinson's and depression and anxiety. So, I think if you had to focus on one thing to improve population gut microbial health, you would probably want to invest your efforts and your money early on in life from pregnancy to the first three years of life.

Adrian: So, there’s obviously then, critical periods in life where exposure to certain factors such as stressors can have a profound impact and permanent effect on the gut microbiome, is that correct? Is there a point where once you're exposed to it there's going to be long-standing effects on the microbiome?

Emeran: I'm always impressed about the resilience of biology and biological systems. So, it's not that if you had negative exposures as a child, or if your mother was stressed during pregnancy, that your fate is sealed for the rest of your life. There's always things that you can do in terms of counteracting these negative influences. So, for example then, a healthy lifestyle and healthy diet, not taking an antibiotic for the respiratory infection. The big question is, does it return the microbiome then to an optimal state or just it improves it within a certain bandwidth, but the upper limit of that bandwidth is still compromised compared to somebody who grows up in a perfect world?

Adrian: Yeah. I was interested… I was reading your book on, The Gut-Immune Connection book that you recently published and you talk about how even the soil and its microbiome have changed over time. Can you tell us how soil is different now and reasons why?

Emeran: Yeah, the changes in the soil mainly has to do with industrial agriculture, with just mass production of corn and soybean and miles and miles of these monocultures with tractors going through and plowing, turning the soil upside down, without regenerating the soil with cover crops or rotating different crops over the year, where you basically replenish the soil with the kind of nutrients and bacteria that the soil under natural conditions would have. 

So, the diversity and the abundance of soil microbes has gone down significantly, in particular in these areas for industrial agriculture, both with the tilling and with the use of chemical fertiliser, which basically replaces the microbes. So, typically, the microbes would interact with the root system of plants, and in a very elaborate symbiosis, would stimulate the plants to produce phytonutrients, and help to absorb minerals and many things. 
So, with chemical agriculture, the plants grow big and fast, without the help of the microbes. So all these elaborate mechanisms that are built into nature, into these interactions of soil microbes with the plant roots, and then enhancing the nutrient content of these plants, all this is sort of being eliminated through chemical agriculture. 

So, we don't see it. The plants look great. They get bigger and bigger, and many of them lose their flavour, if it's fruits and vegetables. But also, the plants no longer produce these molecules by which they defend themselves against pests and diseases. So, that requires another input of chemicals.

And so, essentially, we have replaced the normal lifecycle of plants and soil microbes with a system where we suppress these natural systems and rely totally on the chemicals. So, there's a growing movement of what's called “regenerative organic agriculture,” where using cover crops and not using extensive tilling, and sort of giving back to the soil the things that that we take out by growing millions of tons of produce. So, we're giving this back and people have shown that it's actually more cost effective. You need a lot less chemicals to grow your plants and the plants are better, healthier than if you grow them in the modern, traditional way.

Adrian: And so, does that change in the soil, does that then also influence our microbiome?

Emeran: Yeah, so this is the interesting thing. So, in a natural environment, the soil is abundant with microbes, not as dense and not as concentrated as in our gut, but pretty close to it. And these microbes constantly interact with the ribosome, which are the little rootlets and the roots of the plant. And there's interaction, the plant secretes sugar like molecules which attract the microbes and then the microbes stimulate the plant to produce what's called polyphenols, or often the misnomer of antioxidants, which are then transported by the plant into the leaves, the fruits, the vegetables. And when we eat these plant-based products, then we consume these polyphenols that originated from the interaction of soil microbes with the plant rootlets.

And these polyphenols are not absorbed in our small intestine because they're such big molecules. So, they travel down the intestine where they are met by the microbes and the microbes in the gut now break them down into small molecules that are both beneficial for the microbes, for our gut microbes, and beneficial for many functions of our bodies and our brain. 

So, you have this complex system, it starts in the soil, goes through the plants, the plant's product goes through our digestive tract, and ends up with microbes in our gut. And the gut transforms it into health promoting molecules.

Adrian: Okay, okay. So, it's the polyphenols in the plants that then potentially kind of impact on the gut microbiome. So, it's not necessarily the polyphenols and the antioxidant effects, it’s more around what potentially it could do on the gut microbiome.

Emeran: Yeah. So, in the literature, many of these polyphenols if you test them in a test tube, they act on cells, they act like antioxidants. But when you eat those polyphenols with your fruits and vegetables, they cannot be absorbed. They don't show up in your bloodstream. It's only the breakdown products created by the microbes in your gut that become absorbable. And less than 5% of the beneficial effects of polyphenols can be ascribed to the antioxidant effects. It's a growing science to find out what all these metabolites, these polyphenol metabolites do to our various organs.

A very interesting finding is that it improves the inner lining of our blood vessels, so the endothelium. It improves that function and prevents inflammatory changes that are caused when that inner lining is disturbed. So, that's been shown in the heart. It's been shown in the brain, that many of our most common chronic diseases are related to this low-grade inflammation. And so, what these polyphenols do, these metabolites of polyphenols, they improve the endothelial function of these blood vessels, get rid of the inflammation and prevent the downstream effects that we have chronic ongoing inflammation in our blood vessels in the heart or in the brain or in the liver. 

So, the impact of this on our health overall, of these systems that we've been talking about, is tremendous. We just have not scientifically understood it. We know that eating lots of fruits and vegetables is good for your cardiovascular health, and your brain health, and health in general. But we don't know exactly all the molecular mechanisms that underlie this, but these vascular anti-inflammatory benefits, I think, are a big part of the story.

Adrian: I know that there's a good body of research demonstrating that polyphenols can have a really positive effect on mental health and cognitive health. Me personally, I've done lots of research on curcumin and saffron in terms of its impact on depression and anxiety and I wrote a paper several years ago, where there was obviously a lot of work interested in trying to increase the bioavailability of curcumin. And so, in this paper I wrote, well, maybe it's not bioavailability, but its impact on the gut that curcumin has many of its potential effects. And that kind of fits with what you're saying.

Emeran: Yeah, exactly. So, I think curcumin is another molecule, it's one of those big molecules that cannot be absorbed by our small intestine. So, it just behaves like these other polyphenols that I mentioned to you. It requires the microbial metabolism to be turned into these anti-inflammatory components, which have been shown, curcumin, turmeric. It's been shown in randomised controlled studies, for example, that it has benefits on inflammatory bowel disease, the significant inflammation of the large intestine. And most likely, regular high consumption of turmeric will probably reduce this chronic inflammatory state that seems to be the common denominator now of our chronic diseases. You can almost find in the literature, like all roads lead to Rome, to now say, all roads lead to chronic low-grade inflammation, and it does start in the gut. Because 70% of our immune system is located in the gut.

Adrian: And it's just amazing that we've neglected it, and really haven't considered the importance of it, but certainly we're becoming more and more aware of it. 

So, we've got then the changes in the soil, then that affects the polyphenol abundance, or even the diversity that's potentially occurring. Also, I saw a paper. I just briefly read the abstract of the paper, actually. But there was also some research showing that gardeners or people who engaged in regular gardening versus people who didn't engage in regular gardening, their microbiome was also different. So, it's even potentially exposure, actually, to the soil? Is that possible?

Emeran: Yeah. There's different possibilities how this could happen. So certainly, if you don't constantly disinfect your hands when you work in the garden, plants and fruits have millions of microbes living on them. It's really mind boggling how many microbes are on the surface of an apple, or in the core of an apple. And so, if you expose yourself by handling this, and not necessarily constantly washing your hands, you will incorporate many of these microbes into your digestive system, and they will be in your household.

It's also been shown that with farm animals, if you grew up on a farm with farm animals, you will have a different gut microbiome with greater diversity. And that's with gardening probably, as well. Then there's also the psychological aspect, clearly the relaxing effect and the mindfulness effect of gardening through these mechanisms that I mentioned earlier, that the brain sends the signals down to the guts all the time will have an effect on the microbes as well.

Adrian: Yeah, unless you're a gardener like me, where you kill everything, and it just stresses you out. But potentially.

Emeran: Yeah.

Adrian: Now, the other thing I wanted to briefly just talk about was, obviously the foods we eat now have changed, as has the quality which can affect our gut, but in your books, you also talk about how we eat and the timing of the food intake can affect our gut microbiome. And obviously, there's increasing interest in meal timing, and fasting, and intermittent eating, and time restricted eating, and all those different options. Can the timing and doing fasts and intermittent eating, can that affect our microbiome, positively or negatively?

Emeran: Yeah. There's obviously different fasting techniques. I think most of them, unless you do it for spiritual reasons and go to meditation retreats on a regular basis, I don't think they necessarily apply to the average person. But time restricted eating is something that has a lot of theoretical and practical benefits both in animal models and in humans. And it is something practical, it's feasible with a little bit of discipline, you compress your eating time into eight hours. It's not certain when this has to be, you know, it's in the morning, or it's towards the evening, but that for 16 hours, you keep your GI tract empty from entering food into it. 

So, let's say you have your last meal. Takes about an hour or an hour and a half, before this meal has emptied your stomach and your small intestine. And then your gut is basically empty of nutrients coming in. And it will switch to a different pattern of contraction and secretion and blood flow and immune function.

So, it essentially switches into a different operating mode. It's a rhythmic pattern. Every 90 minutes there's a wave of forceful contractions, going from the oesophagus, all the way down to the end of your intestine and it moves things. So, any bacteria that haveovergrown or have an increased abundance in the first part of the small intestine, every 24 hours, will move everything down towards the large intestine. And excessive amounts of bacteria that may have ended up in the small intestine will be moved back to where they belong, which is the colon or the large intestine. And so, that's one effect of this time restricted eating, a very important one.

The other one, you automatically eat less, like in the evening if you have your meal at, say, seven o’clock, you don't sit in front of the TV and eat snacks or go to the fridge and drink a beer. So, you essentially consume less, because you want to keep the 16 hours free of any exposure to nutrients. And so, that's another factor. 

A third factor is that it actually has been shown to change what's been called the “gut microbial geography.” So, how close the microbes get to the layer of your gut. So, normally it gets separated by a mucous layer. When you fasted, they move closer to the actual wall of the gut and interact more with the receptors on the side. So, there's multiple things happening from changing the habitat, decrease in caloric intake, and then direct changes in microbial function. And so, we noticed the gradual decrease in weight and which was easy to maintain as long as you stick with that kind of diet. It is a little bit difficult to maintain with social activities or when you travel. But it's a regular pattern, eating pattern. I think it's something that I would highly recommend.

Adrian: So, you're eating in an eight hour window? Is there a particular time when that should start? Or you mentioned kind of after 7pm? So, do you generally go from 11 till 7, 11am to 7pm? Is that your eating window?

Emeran: Yeah, yeah. And for some people, depending on their work schedule,  it varies. It's interesting. So, in animal studies, it's clearly been shown to be of major metabolic benefits, decrease inflammation, better metabolic health. So these animals didn't gain weight, even though they had free access to unlimited amounts of calories. In humans, it's even more difficult to show this. So, there's studies that have shown same benefit in humans and others have not. But there's a lot of factors obviously. And anytime you try to replicate something in a human population which is heterogeneous weight wise, and dietary habits wise, it's always difficult to prove it. I mean, for us personally — as a scientist, I shouldn't say this — but having experienced this myself, I would say, it does work if you stick to it in a vigorous fashion.

Adrian: And it is achievable. It's eating in that eight hour window, if you kind of get used to it, it is certainly achievable. So, whereas some different diets and your fasting diets and things like that can be a lot more difficult to do.

Emeran: Yeah. It's not realistic. Also, this 8-16, this time restricted eating, it's more like the normal eating rhythm that our bodies have evolved to. What we're doing today, everybody always needs energy bars and snacks the whole day. Then in the evening, on the TV, it's a constant influx of calories into our gut, which was not the case even 75 years ago. So, I think it's kind of returning, like many other things, returning to traditional patterns of lifestyle including food intake.

Adrian: I feel like last week I did the fasting mimicking diets, which I'd never done before. So, five days where you're on that fasting mimicking diet. And I did it. It was...I didn't feel bad. Energy wise, I was okay. It was just, it was so repetitive and boring.

Emeran: Yeah.

Adrian: Not sure whether I will do it again. But I don't know how people can do the fasting ongoing, that's for sure. There's just a pleasure of food that sometimes and the social connections and the social engagements and things that, just the lifestyle stuff, you can't do with the fasting. That's for sure.

Emeran: Yeah. And this is a really big thing. I'm glad that you mentioned it. The early studies on the Mediterranean and the health benefits of the Mediterranean diet, which have been criticised, but one thing that the authors noted at the time in the '60s, was this remarkable social interaction of people in the Mediterranean countries around food. And you could almost say food is the one element that holds people together, on festivities and celebrations and funerals. It's almost like the glue of social interactions. And if you break that, or if you make food intake a non-enjoyable activity, that's always with anxieties and worries in your brain that you're eating the wrong thing, I personally think that that's a big part of the negative effects of what's called the standard American diet, that you have almost eliminated that portion of lifestyle around foods. The positive reinforcers.

Adrian: Definitely. Okay, so I could keep going forever. There's so much content. In your books, there's so much information. And I certainly highly recommend it for people who haven't read your books in the past. So, we'll certainly have links to it in the show notes. 

Just finally, are there any tips or recommendations for holistic practitioners who are working in this area that you can give to help them work with their patients?

Emeran: Just one comment about this. It's interesting, I've always been kind of critical of functional medicine in the US. But then I've gotten invited to quite a few of their meetings. And I have to say that, from a general perspective, this holistic view of the body and the importance of lifestyles, paying attention to lifestyles, is something I really like about any of these holistic health care approaches. 

And I think, when it gets to the specifics, I'm more critical. I like to pay attention to evidence, because I think if we stop paying attention to evidence, then we just have to say, “Yeah, we're all selling placebos or prescribing placebos.” Which is not a bad thing, either because I think we have underestimated the power of the placebo response.

But I would recommend, in general, if you can afford and have access to a healthy, varied diet, and you do the things that we talked about, you pay attention to what you eat, predominantly plant-based, where the food comes from, how is it grown. Is it grown in a return to the organic way, or at least an organic way without all the chemicals on it? When do you eat? Can you change your lifestyle to restricted to certain time of the day, eliminate or greatly reduce sugar consumption? And have your moderate daily exercise. 

There's also a recent study on one of the polyphenols, on one of the flavonols, a study done in thousands of people, a three-year intervention with SIBO or with the supplement in a capsule form. And it showed the benefit on mortality and morbidity from cardiovascular diseases. And there will be another study coming out from the same population, that there's also a decrease in the prevalence of cognitive decline. 

I mean, those studies are rare because they're obviously very expensive, costing millions of dollars. It was also interesting, these flavonol supplements worked best in the people that did not have a high natural flavonol intake. So, they were the ones that were actually probably not on a healthy plant-based diet, largely plant-based diet.

Adrian: Yeah, absolutely. So, we really need to concentrate on our diet and our sleep and our exercise and our social connections, and our stress levels are absolutely the integral part of one's overall health. 
Out of curiosity, what was the supplement that you're referring to, in that study?

Emeran: That supplement? It's a flavonol. It's one of the flavonoids and you have to take the same dosage that was used in the study. It's not inexpensive. But I think if you are concerned about your cardiovascular and your brain health, it's pretty worth the investment to use that.

Adrian: Terrific. Well, thank you very much, Emeran, for joining us today. And thank you very much for the research that you've done in the area and you've just published an immense amount of articles and scientific papers in the area. And the two books, The Mind-Gut Connection and The Gut-Immune Connection, they are great. And I certainly recommend anybody interested in the gut and the brain and the microbiome to read those books. They're terrific. So, thank you very much for the work that you're doing.

Emeran: Yeah, thanks a lot for having me on the show. It was a pleasure talking to you. And I hope your audience will get some benefit out of this as well.

Adrian: So thanks, everyone for listening today. Don't forget that you can find all the show notes, transcripts and other resources from today's episode on the FX Medicine website. I'm Dr. Adrian Lopresti and thanks for joining us. We'll see you next time.

About Dr. Emeran Mayer

Emeran A Mayer is a Gastroenterologist, Neuroscientist and Distinguished Research Professor in the Department of Medicine at the David Geffen School of Medicine at UCLA, the Executive Director of the G. Oppenheimer Center for Neurobiology of Stress & Resilience at UCLA and Founding Director of the Goodman Luskin Microbiome Center at UCLA.

He is one of the pioneers and leading researchers in the bidirectional communication within the brain gut microbiome system with wide-ranging applications in intestinal and brain disorders. He has published 410 scientific papers, co edited 3 books, published the best selling The Mind Gut Connectin book in 2016 and the Gut Immune Connection book in June 2021, and is currently working on a PBS documentary about the mind gut connection.

He is the recipient of numerous awards, including the 2016 David McLean award from the American Psychosomatic Society and the 2017 Ismar Boas Medal from the German Society of Gastroenterology and Metabolic Disease.



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