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Josh Dech - CHN (04:23.735)
Dr. Will Bolswitz, welcome to Reversible.

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Dr. Will Bulsiewicz (04:29.003)
No, that's... I think we're good.

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Dr. Will Bulsiewicz (04:37.866)
Josh, thank you for having me. It's a pleasure to be here.

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Josh Dech - CHN (04:40.566)
Pleasure to have you here. I know we were talking off air. I've been following your stuff for a very long time It's actually been a long time getting certain professionals like yourself in here and you with your background specifically in gut I'm so excited to dive into the things we're diving into Mostly because I think we do a lot of the same stuff but differently in so many different ways I'm just jazzed to hear your opinion about this But before we get started well just to kind of frame our audience who might be not familiar with you at this stage just yet

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How did you get into gut health? Like what drew you to all the work you're doing now with these world -renowned companies?

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Dr. Will Bulsiewicz (05:15.819)
Yeah, I mean, I think in some ways I stumbled into these things. I mean, maybe, maybe this is the path that was intended for me. but basically I decided in medical school, roughly like 2004 that I wanted to be a gastroenterologist. And this was like nothing to do with gut health or nutrition or gut microbiome. I mean, to be honest with you in 2004, we basically didn't know anything about these things anyway.

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It was more so that I just saw that I would have the opportunity to interact with patients one -on -one in the clinic. Take a person who has a chronic and complex health issue. It could be inflammatory bowel disease, Crohn's disease, ulcerative colitis, but it could also be irritable bowel syndrome or acid reflux or celiac disease.

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And to sit down with them and to be able to guide them through a process that leads them to a better life. And, you know, the beauty of gastroenterology is that these issues that affect people are really ridiculously affecting their quality of life. And it's hard for them to be happy and have good days. And so the impact that you make on a person's life is felt quite tangibly when you can improve and lift those symptoms that are holding them back.

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So to me, that's sort of the vision of what I wanted to be. It's been my dream since I was a teenager to be a medical doctor. I never had any intent to being an author or being on podcasts or any of the other things that have happened in my life. But I think that the other thing that's worth bringing up for those who haven't heard of me before, don't know about my work is that there was a really substantial shift in my mindset when I was in my early thirties and I became sick myself.

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And it wasn't specifically inflammatory bowel disease, although I did have my own gut issues, but it was more truly like metabolically unhealthy. I was 50 pounds, 20 kilos overweight. I had high blood pressure, high cholesterol. I had, I was depressed. I was anxious. I had extremely low self -esteem. Even like, if you saw me on paper, you would think that my life was completely perfect. And if you saw me.

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Dr. Will Bulsiewicz (07:26.828)
Like at home by myself under a blanket in a dark room, you would understand I was not in a good place. And so, and in that moment, Josh, where I became the person who needed the help. I was a board certified internal medicine doctor. I could have easily treated blood pressure and cholesterol and these things with pills. And in that moment, that's not what I actually wanted for myself.

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And so that was a bit of an eyeopening experience because I spent 16 years pursuing my education to become a board certified gastroenterologist. Yeah. I felt that there was something that was missing and what I ultimately discovered was the power of nutrition. And in discovering the power of nutrition, I discovered the power of the gut microbiome because it's a quite natural fit in my fields of gastroenterology, which is that number one, everyone who comes in, they have problems with food.

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Josh Dech - CHN (08:20.43)
Mm -hmm.

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Dr. Will Bulsiewicz (08:20.938)
So I don't know how it's possible to like have a good interaction with a patient without being able to talk to them about food. And number two, I am convinced knowing what I now know that literally every single one of these people also have problems with their microbiome. And it's most profound and pronounced among those with inflammatory bowel.

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And so to me, like this is the root of the issue. This is where the healing opportunity exists. Is there a role for medicine? Yes, there's a role for medicine. Medicine can be something that we use in our path towards healing, but it should not be the principal thing that we use in our path to healing. It should be an adjunct, something that we have in addition to addressing the root of the issue.

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Josh Dech - CHN (09:01.709)
So I've got to ask you, so being a GI, having gone through this, spent 16 years in this career, why is it the number one thing I hear from the clients I see dealing with Crohn's or colitis is that my doctor said, diet doesn't matter, eat whatever you want. It has no bearing on this disease. And I'm like, man, that is third grade biology. What is happening, Will?

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Dr. Will Bulsiewicz (09:22.859)
I think that people get stuck. So first of all, I've been there in terms of my mindset. Granted, it was 15 years ago, but I've been there in terms of my mindset. And I also, I also am very sad that this is the case, to be honest with you. So, and I've seen people who are highly intelligent, highly intelligent people who can't for whatever reason, see this bigger picture.

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So, I think part of the problem, Josh, not to get too detailed into this, but the

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Josh Dech - CHN (09:57.419)
You get as detailed as you want, Will. I'm here for the ride.

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Dr. Will Bulsiewicz (10:00.043)
Well, thank you. I don't think we want to dig into the details of why healthcare is a broken mess, but it is. It's a broken mess. It's a broken mess in my country. It's a broken mess in your country in Canada. It's a broken mess in the UK. We all have complaints. Most of the complaints are quite similar. The systems may be different, but the problems are quite similar. Part of the issue is that medical doctors are trained in a hospital. There's a reason for this, which is that...

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If you can deal with a person who's like literally in the process of dying and get them back, then it helps you to be prepared for dealing with people that are not that sick. But the problem is that the vast majority of care does not occur in the hospital. There's a transition that takes place. Like in the hospital, it's acute care. I still think that it's a travesty, the food that we feed people in the hospital. I think it's a travesty.

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Josh Dech - CHN (10:53.416)
It should be criminal. It's wild. Yeah.

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Dr. Will Bulsiewicz (10:55.946)
It's a disgrace, but yet at the same time, like it is still this acute moment where hopefully this is just a matter of days that they're in the hospital. Then we transition them to the outpatient world and the outpatient world we're working towards long -term goals. This is not like, can I get this person out of the hospital in the next three days? This is, can I make this person healthy for the next 10, 20, 30 years?

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And so the problem is like all of our training happened in the hospital. So there's no actual training in the space where we're actually taking care of people, which is outside the hospital. So this is a big part of the issue. The other part is that we're not trained in nutrition. So in 16 years of training, I had 14 days of nutrition.

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And that 14 days was not complete days, nor was it my ability to have a conversation with you. If you were my patient, this was like, Hey, here's this weird trilogy of symptoms, like, you know, congestive heart failure and skin changes and delirium named the vitamin deficiency. Okay. That's like completely irrelevant to actual practice. so, and.

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Josh Dech - CHN (12:00.23)
Hmm.

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Dr. Will Bulsiewicz (12:07.656)
And I think that like at the end of the day, the other problem is that there's pressures within the system.

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that are requiring doctors to produce in a very, very efficient fashion. By efficient, I mean minutes.

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And it's quick and easy to write a prescription. But if we want to talk nutrition, it's going to take us some time.

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Josh Dech - CHN (12:31.716)
Yeah, I think that's the biggest danger of an insurance -based model. I mean, if you're running a medical clinic and you want to be reimbursed and you're making, say, $20 for a patient, you get them in and out in seven minutes, you want to pay your nurses, your overhead, you want to pay your staff, you have a lot of expense to cover, you spend more than 10, 12 minutes, you might be breaking even. And we're getting a lot of these people coming in and out.

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who exactly what you're saying. I mean, it's a bizarre system where people are sort of stuck sick. Now, I'm definitely, I like to joke my hairlines back here because my tinfoil hat rubs it all off. But the idea is that we have a system where really the money is made, not the beginning of life or the end of life. It's made in the middle where people are sick and they're medicated for a lifetime of these medications. Like talk about a subscription based model. I mean, that's the best business revenue there is. And you have people who start to finish.

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I got clients coming in, I'm sure you've seen in your practice, as young as three, four years old, dealing with bowel disease of some kind, all the way up to geriatric patients. And so, I mean, it's a pretty bizarre stretch we're starting to see in the growth of bowel disease, but people aren't getting the treatment that they need. So I'd love to ask, well, in your opinion, what is driving this epidemic? I've talked about it in previous podcasts that back in 1990, anywhere from 1 .3 to or 1 .5 to 3 million global cases of IBD as per

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for the CDC estimates in 2020, I think the last point of data was like seven and a half million. So we've gone up arguably up to five times in the last 30 years, exponential growth, 50 % of those diseases are in North America, which is just 5 % of the global population. What is going on in North America in general, that's leading people to have this epidemic of gut disease.

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Dr. Will Bulsiewicz (14:15.525)
Yeah. Well, Josh, we also see the, we see a similar and even in some cases, more aggressive emergence of inflammatory bowel disease in third world countries as they industrialize, which I think gives us some of the clues as to what's going on. and I think that in order to properly understand this, you have to start with the fact that like, what is inflammatory bowel disease? And many people describe it as autoimmune.

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And I actually think we need to refine that, believe it or not. It's not exactly that.

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Josh Dech - CHN (14:48.383)
I believe you so much. Keep going, please.

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Dr. Will Bulsiewicz (14:52.486)
So we all have a microbiome. You do, I do. A person with inflammatory bowel disease does, we all do. And this microbiome is an important part of our body, the way that our body functions, yet it's not actually our body. It's foreign to our body. It's made up of 38 trillion microbes. And we have sort of,

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signed an agreement with them that, you know, you help us, we'll help you. And this is how we're going to go through our life. And as long as we all commit to that agreement, then this should yield good results for all of us. And unfortunately, I feel like we've broken that agreement in the last 50 to 100 years.

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And a lot of that has to do with the lifestyle changes that have taken place during this period of time. So pinning it down to one thing is a bit unfair because I feel like that would be ignoring the broader context of everything that's happening here. But at the end of the day, coming back to inflammatory bowel disease and this question, like, is this autoimmune? I actually think that, so autoimmune is the rejection of our own body.

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But inflammatory bowel disease, our immune system is not rejecting our own body. In inflammatory bowel disease, our immune system is rejecting our microbiome. And so it's an attack. Our body has made the decision that our microbiome is the enemy and therefore our microbiome needs to be eliminated in the same way that our immune system would eliminate a virus or a bacteria or a pathogen of some variety.

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And this is what creates that inflammation that we see the inflammation that you see, whether it be in the colon and in ulcerative colitis, or whether it be throughout the intestines, classically the terminal ilium in the colon. In Crohn's disease, this is the result of our immune system being activated in response to something that it believes to be a threat, inappropriately believes to be a threat. And specifically in response to our microbiome.

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Josh Dech - CHN (16:54.011)
Hmm.

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Dr. Will Bulsiewicz (16:54.404)
So the actions in the microbiome, the problem is in the microbiome. When these conditions emerge, it has to do with the microbiome. I'm not saying there's no genetic element. There is a genetic element, but it's not a change in our genetics that happened in the last 50 or a hundred years. It's a change in our microbiome that's happened. And this is the consequence of, you know, our microbiome is the product of our environment. And when people say environment, to most of us, we would think of, well, do you mean like the world that we live in?

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Yes, in some ways, but actually if you think about these microbes living in your colon in a almost God -like way, we control that environment. We control it with our food choices. We control it with our sleep patterns. We control it on some level. I'm not saying this is totally controllable. We control it on some level with stress and our ability to sort of create harmony within our life. We control with exercise or how much we're physically active.

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There's all of these different factors that feed into this area. And the problem is that the shift that's taken place in the last 50 to a hundred years is all in the wrong direction. So it's this multifactorial thing that the life that you and I lead in 2024 is very different than the life that my grandfather led in 1924. Very different.

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Josh Dech - CHN (18:17.911)
You know, it's interesting over my entire career here. I mean, we're going to do probably see 200 cases of Crohn's colitis this year alone. And I have yet to have one GI specialist actually sit down and have a conversation about what it is we're doing. and remarkably successfully. I mean, we did over the last two years, about 300, we'll do 200 this year. So it'll bring us to probably just north of 500 cases. And what's really unfortunate is I'd say the state.

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of the medical system.

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And I will openly admit I've got a bit of a chip on my shoulder against conventional medicine for a lot of reasons. And sometimes a lot of GIs, because, you know, they go in after 15 years of trying to treat the patient with all the steroids, all the biologics, every drug under the sun. They've been on Stelara and Humira and Intivio and Remica. They've given them everything. And here they are 15 years later. And in three weeks, they go from 50 bowel movements down to three. And they go, well, your medication must have finally started working.

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Dr. Will Bulsiewicz (19:18.37)
huh huh... huh...

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Josh Dech - CHN (19:18.805)
The math doesn't add up and so I have yet to have any GIs really sit down and what you guys are doing and you're obviously affiliated with Zoe and what you guys are doing down there.

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is really changing the game on gut health and how people are seeing it. Are you working with the medical system directly? Are you sort of barred out from the traditional Western medical system, be it for profit or whatever else is going on that's maybe keeping you out? What does that look like to integrate this information, this clearly very, what's what I'm looking for, very tangible, very fixable stuff to integrate it into the Western world? What is that looking like right now?

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Dr. Will Bulsiewicz (19:59.589)
Yeah. so I've loved talking about this because I feel like this addresses many of the concerns that you have and that I have too, right? Like we're sharing a lot of the same concerns here. And I feel like Zoe, we're a bit of like, we're disrupting and we're a bit maverick in a way. not in the, in the way of like being out of control, but more so let's think about it like this.

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We have healthcare systems, your country, my country, the UK, that say that diet and nutrition is not worth investing into. Right? They're not going to pay to help you with this. Yet every single person, particularly people who with inflammatory bowel disease, when they go to their doctor, they want to know what do I eat? And they're smart. They're smart enough to know that diet impacts their disease, whether their doctor acknowledges that or not. They know that.

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So with Zoe, what we're trying to do is expand our understanding of the ways in which food meets microbes meets health. Right. And that's a connection that like to me is firmly established, but we are working to make it even more clear. And we're also working to make it more individualized to understand it on an individual level.

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Now, in order to accomplish this, in order for me to basically say like, Josh, for you personally based upon your microbiome and by the way, we, so I guess I should zoom out for a quick moment. People who do Zoey, and this is available in the U S and the UK. It's not yet available in Canada, although we would love to be there one day soon. people who do Zoey, they receive a kit in the mail.

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And using that kit, they provide a microbiome specimen. They wear a continuous glucose monitor for two weeks. They enter into an app what they're eating. They eat cookies and then they measure their blood fat through a finger prick onto a card. All right. So, and taking that information, we can put it into a database where we now have well north of a hundred thousand people closing in on 200 ,000 people. Again, we have their microbiome. That's a tremendous amount of data by itself.

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Dr. Will Bulsiewicz (22:15.268)
We know their blood sugar response to what they were eating for every single meal during those two weeks. We know how they responded to the same meal so that I can compare my results to your results or to any one of these other 100 ,000 people, their results. You put it into a computer system and basically running the equivalent to artificial intelligence. You run machine learning algorithms.

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And now instead of saying in general, this is what we recommend. Now we can say, no, no, hold up for a person who's exactly like you, your age, your gender, similar microbiome characteristics, similar response to blood sugar. Here's, here's what we would recommend. All right. Now the thing I want to really get into that I think is really cool and exciting about this is that this is community driven. All right. So this is not authorized by the government. Frankly, the government would never do this.

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Josh Dech - CHN (23:08.621)
Mm -hmm.

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Dr. Will Bulsiewicz (23:08.772)
If we wait for the government to do this, it'll never happen. This is when people band together and they say, I know that there's not one size fits all when it comes to diet. And I want the science to explain that to me in a way that's like not just me kind of trying to figure it out. Nothing wrong with that. But in a way where the science actually can back up my understanding of my body and how my body works.

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And in order to accomplish that, you need tons and tons of data, tons and tons of people. And that's what this basically is where every single person who participates in Zoey, they get that information themselves. They also are contributing that information of themselves so that we can apply it to other people. And as we grow, it allows us to get more granular and detailed.

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The future is having more than a million people. The future is having people with inflammatory bowel disease, Crohn's disease, ulcerative colitis and other health conditions, Uroval syndrome, and getting granular with those conditions, not just on a general basis. So to me, like this is, we are, I think, like doing really cool things. We just published our first randomized control trial in Nature Medicine, which is one of the top medical journals on the planet. We're doing really cool things already.

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But I think we're just getting started. I think it's going to be amazing what we do in the future.

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Josh Dech - CHN (24:24.297)
I think the entire science of the microbiome is just scratching the surface. You know, there's so much more that's out there and for everything we know, it's like the more we learn, the less we know. And we know nothing, which I think is really amazing. You know, we've got trillions of microbes. I mean, tens of millions of different strains and species and how they interact. It's really a grain of sand on a beach.

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for how much we actually really fully understand of the microbiome, which each individual strain and species do and how they interact and how they signal. And it's a really bizarre system. But you had mentioned that.

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the IBD is really a microbiome issue, which I find obviously, you know, interesting as someone who works in Crohn's colitis. But I'd be curious your take onto what you believe is it, it isn't a microbiome that's driving the changes. And here's why I ask, you know, we've distilled it down really to what we tend to see as three different things as being the primary. Now the gut microbiome being as complex as it is, we might be 10, 20 or 50 years away from really hammering this down to the...

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the individualization of the gut microbiome and really being able to fine tune and tailor through FMT or whatever kind of intervention and treatment. But we look at this and say, okay, well, we've got hundreds of cases that we've seen, 95 % of them, it comes down to three things, parasites, clostridia and fungal issues. And then whatever else is underlying that may have changed or altered that terrain. So maybe there is, like you said, the industrialization. I mean, we know...

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Dr. Will Bulsiewicz (25:29.378)
Mm -hmm.

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Josh Dech - CHN (25:53.094)
as a fun sidebar will, the EPA, when they actually approve pesticides, it's on their website, the quote, it says, EPA only registers a pesticide when it determines it will not cause unreasonable adverse effects on humans or the environment while considering the economic, social and environmental costs and benefits of the use of the pesticide. So the people being paid to approve the thing get to determine if there's a reasonable amount of damage to human life or the environment, whatever it is, before they say, yep, go ahead, the finances make sense then.

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we're good with this and that's sort of what we're dealing with. So it's going to be many other layers looking at some of those. Maybe it's heavy metals that set the stage for a fungal overgrowth and immunosuppression and whatever it is. So in our practice, we've got this distillation. What is it you guys are seeing specifically in the microbiome? Is it the good? Is it the bad? Are there specific external microbes like more easily detected things like you can do an organic acid test and see the fungal issues. What is it you guys are figuring are the root causes of these diseases?

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Dr. Will Bulsiewicz (26:53.667)
Well, I think it's hard to pin it down to like some specific thing at least in the landscape that I'm looking at. So I appreciate that there's different ways to approach similar issues. And, you know, again, what I get back to is that if you're guiding a person to a place where their inflammatory bowel disease is under better control, then that is a win.

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And that's what we're looking for. So I'm an, I'm an outcomes driven person and I, celebrate those outcomes regardless of how we got to that place. So, yeah. So to me, it's, this is a dysbiosis driven thing. I mean, we do have examples of specific bacteria, you know, such as an inflammatory invasive E. coli that's been associated with the development of Crohn's disease.

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Josh Dech - CHN (27:23.363)
show.

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Dr. Will Bulsiewicz (27:38.467)
So, or there are other microbes that have been associated with these things. Now, like whether or not you can draw microbiome specimen from an individual person who does not yet have inflammatory bowel disease and then predict that they will develop inflammatory bowel disease in the future, we're not yet at that place. But at the same time, as you have seen throughout your experience in dealing with these people, the development of inflammatory bowel disease does not happen like that. It takes time.

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And it is a process that ramps up until it becomes fulminant. So I do think that there's an evolving process that takes place. And certainly we could learn more by collecting microbiome specimens along the way. It would require us to have basically a massive cohort study of people that were monitoring their microbiome prior to developing inflammatory bowel.

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Josh Dech - CHN (28:28.321)
So you've got to get real lucky or specialize in like wizardry or something to figure out, you know, who's going to have it, where it's coming from, or you're looking at genetic models and predicting factors.

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Dr. Will Bulsiewicz (28:38.308)
Yeah, I think so. I mean, there are aspects that are predictive of developing inflammatory bowel disease. That being said, like predictive in a way where you can say with confidence that a person is likely or unlikely to develop the condition. No, that's not the case. But I think what we come back to though, Josh, is that like...

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You know, we, you and I, we may be talking about inflammatory bowel disease right now, but obviously there's a world that exists. Like you, you take care of people with other digestive health issues outside of inflammatory bowel disease. And I have throughout my career as well. there's a world that exists where there's all these other health conditions that are digestive in nature related to our microbiome. And then like, I want to expand that view much, much wider than that.

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Where in, you know, in my view, I'm seeing that there are these metabolic issues and that's a lot of the work that we do at Zoey. There are these cognitive issues or mood related disorders. There are hormonal related problems that again, like the connection, it's not to say that the microbiome is the only factor in our health that would be ignoring many other aspects of our body and how we work.

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But I think that it's worth acknowledging that the microbiome is a factor in the health and the manifestation of these issues. And if, when we expand the scope, like if it's just digestive issues, it's already a lot of people. But if you expand that scope to include these other health related issues, which include metabolic, frankly, it's the majority of Americans. And to me,

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This is where this conversation becomes really important because this is an opportunity, which is that don't wait until you have inflammatory bowel disease and don't ask. Like I'm not saying it's wrong, but don't ask for a test to tell you whether or not you could or could not develop inflammatory bowel disease, knowing that it's not going to be, it's not likely to be accurate.

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Josh Dech - CHN (30:36.956)
Mm -hmm.

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Dr. Will Bulsiewicz (30:39.298)
Let's focus on what we can do to elevate our health, all of us, whether we are healthy or unhealthy. Let's focus on that. That's what the opportunity is.

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Josh Dech - CHN (30:46.684)
It's a really unfortunate position. I think a lot of people are put in. I was literally on the phone with a friend of mine today and his wife's having some bowel issues. You know, she'll go two weeks without a bowel movement and then she's on for a week on the toilet 10 times a day and it's back and forth and she can't figure it out. And she went to her doctor and they said, well, we can't refer you until you're bleeding or until we have ABC. It's like, it's not broke. Don't fix it to the nth degree where it imagine the insanity of going to your doctor with a hairline fraction. Like, yep, keep walking on your leg when it turns

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into a compound, the bone breaks through the skin, then we'll treat you. And by treat you, we'll just put numbing cream on it for the pain and your leg will kind of manage itself because we're not treating the root cause of the problem. And we see this time and time again. And so we're not getting to these roots and these people. I mean, I know we can go around the same mountain a hundred times in a row, but they're stuck here. And so I'd love to figure out, you know, your lens, you mentioned metabolic, you mentioned E. coli, there's lots of different factors. Are you finding this? I mean, obviously you got 16 years.

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Dr. Will Bulsiewicz (31:19.746)
Mm. Mm.

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Dr. Will Bulsiewicz (31:36.994)
Yeah.

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Josh Dech - CHN (31:46.491)
professionally trained working in this beyond what I've got a handful of years through one specific lens and I like to say if you give me a hammer for long enough eventually everything looks like a nail where I'll go yeah well I see I see claustridia I see parasites I see fungus I see ABCD therefore

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Dr. Will Bulsiewicz (31:56.354)
Mm -hmm.

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Josh Dech - CHN (32:02.169)
And so as clinicians, we're responsible to do our due diligence to not repeat the same thing and put people in a box because, you look like these last hundred clients. Therefore, you must be the same thing. And so I'd love to get an idea of your scope and what you guys are doing right now. How are you finding there are common threads across the board where it's environmental? Is it toxins people are getting? You mentioned industrialization of third world countries where bowel disease is more prominent. There's a lot of different factors here, but at least in North America and we'll even say UK where the majority of these cases

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might be housed right now. Are you seeing common threads where you can go 80 % of people have this as a layer to their bowel disease?

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Dr. Will Bulsiewicz (32:41.281)
Well, what I can tell you is this, that, we have a substantial amount of information about the microbiome of Americans versus British people. So, I mean, we have, you know, a large microbiome study would be a thousand people. That would be a large one. We have, you know, again, like well over a hundred thousand, over 10 ,000 in the United States. Right. So, so with that many people,

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You can start to look and see things. And one of the things that we've discovered is that people in the United States generally have a less healthy microbiome than people in the UK. So we assign a score for a person's gut health. And if you were to give a score to most Americans using the British standard, most Americans would have an unhealthy gut. So it's kind of interesting to think.

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Josh Dech - CHN (33:38.006)
No.

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Dr. Will Bulsiewicz (33:38.4)
You know, we're not the same country, but things are worse here in the US. They're worse.

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Josh Dech - CHN (33:40.502)
Yeah.

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Josh Dech - CHN (33:45.364)
Here's what I like to ask. So I mean, obviously the health outcomes are different, but if we look at there was a study in cell reports or something back in like 2018 -2019, I've talked about this a few times on a couple episodes sporadically where they compared rural and urban Nigerian microbiomes to that of urbanized American centers. Then they found the difference between, you know, childhood, infant, children and adults was actually less of a gap in these rural Nigerian communities versus say North America.

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interpretation of the data was like, okay, well, maybe we are over time really destroying a lot of our microbes that we get innately from birth from coming through the birth canal through breastfeeding all these different bits, and we're destroying them. And maybe this is why I mean, looking at the microbiome samples from some of these countries, it looks that they have a lot more.

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ability through their microbes to actually break down, digest and utilize fibrous tissue. Whereas over here, you have millions of people going to carnivore and doing better. Is that because we've lost the microbes and our ability to digest fibrous foods? Is that because the junk we're spraying on is actually causing a lot of upset? Looking at the pesticides and the billion plus pounds that they utilize on these foods.

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Is this what's really causing some of these disease and these differences between the microbiomes or is it that geographically and genetically you're born here, you adapt with these microbes? What do you think is going on? I know it's kind of a not well articulated, but if you could interpret that one, I'd love to hear your thoughts.

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Dr. Will Bulsiewicz (35:14.977)
Yeah. Yeah, no, totally. So, we've seen this repeatedly that if you look at the microbiome of people that are native to Africa, that they have great greater diversity within their gut microbiome, that diversity within the microbiome, it's not the only measure of health within the microbiome. I feel like in some ways it's a little bit too simple, but at the same time, it is a measurable way in which you can look at, general gut microbiome health and understand capability and function.

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Right? Because when we have a more diverse microbiome, it's more like basically we have a more variety of microbes that have these different functions and enzymes that we need in order to help us to process and break down our food. So now in the United States, we have a long standing history going back multiple generations at this point of fiber deficiency. So people simply haven't been eating this food.

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The reason why is because we have replaced it mostly with ultra -processed foods. Ultra -processed foods now make up 60 % of the American diet, 70 % of a child's diet. And these ultra -processed foods, many of the things that are in there, we don't really know what they do.

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the majority of things that are approved by our FDA under a loophole called generally generally recognized as safe or GRAS. This is what I call it. I call it GRAS. I'm sure there's other ways to sort of initiate that. Yeah. the majority of things that have been approved using this loophole have never actually had feeding studies.

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Josh Dech - CHN (36:44.497)
It's a cool slang, yeah.

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Dr. Will Bulsiewicz (36:56.034)
Now, when I say that, I don't just mean human feeding studies, which by the way, to me should be the standard. Like you should be required to do a human feeding stand study in order to introduce something into the complete American diet.

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Josh Dech - CHN (37:07.341)
The irony is, don't they consider human studies like that in a lot of these cases unethical?

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Dr. Will Bulsiewicz (37:13.601)
that's an interesting question. You know, I, I think, well, I think that you have to go back to the history of this law, which is that it was passed immediately after world war two. And the intent was that they were going to start to the food and drug administration was going to start to regulate food. Right. And they were just starting to develop these sort of new foods that didn't previously exist. And the government said, look, we don't want to stand in the way of stuff that we know is safe.

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Right? So we're not going to require you to do like feeding studies for salt because humans have been consuming salt for hundreds of years. So let's just approve this and move on. And the problem is by creating this loophole, they started to then apply this to everything. And now here we are and we have 10 ,000 food additives in our food system. We don't know what they do. They haven't had feeding studies in animal models or humans.

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Very few have had human studies of any variety. We certainly don't have long -term studies at all. And when you try to disentangle or decipher what's doing what, when a person's 60 % of their calories is ultra -processed and they're consuming all these different additives, good luck. It's impossible to peel apart, this one thing is doing this thing. It's impossible. There's way too many things in there to make any sort of understanding of that.

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So now the problem is that your gut microbiome is adapted to whatever it is that you've been eating. So, and that adaptation is, manifested in function. So if you eliminate fiber rich foods and you replace it with ultra processed foods, you are, you are making the choice to basically sacrifice the capacity and ability of your microbiome to process and digest fiber. And fiber is a complex thing.

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Because we as humans have the ability to process and digest many different things. But the one thing or like one of just a couple things that we clearly cannot process and digest ourselves is dietary fiber. That's where our microbiome comes in. Our microbiome is the workforce that allows us to basically break down the fiber into its essential components.

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Dr. Will Bulsiewicz (39:38.88)
and ultimately to release the short chain fatty acids that we can potentially get.

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If you take a person who has eliminated fiber and then you apply inflammatory bowel disease to this, we are in a very, very deep hole in terms of our capacity and ability to process and digest fiber at that point. So it's a legitimate challenge. The other aspect that I would add to this, it starts, like I hate talking about this in some ways, Josh, because it feels very dark, but I'm going to bring it back to like optimistic view.

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Josh Dech - CHN (40:11.303)
I appreciate that. I know as practitioners we can often, you know, raise the red flags and not bring it back to like, look, there's a solution and everyone, you know, wants to jump off a cliff after. Yeah, good.

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Dr. Will Bulsiewicz (40:19.232)
There is a solution. Yeah. I want, and I want to talk about this because I think it's quite important, but it's also nuanced. It's also nuanced and then we have to keep it real. But the, so the other aspect to this is that there is a professor at Stanford who is a friend of mine, Justin Sonnenberg.

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And he's been studying this sort of question, like he's gone and immersed himself in Africa and done many of these microbiome studies. and one of the things that he's done is shown generational passing of the microbiome through fiber deficiency. So in other words, basically what he does is he says, I'm going to start with mouse number one. All right. And I'm going to give mouse number one and low fiber diet. Okay.

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Grandma, let's pretend that grandma started with a thousand microbes, but now by the time grandma has her daughter, grandma is down to 600 microbes. Okay. Now the daughter inherits 600 microbes and the daughter's on a low fiber diet. So the daughter goes from 600 microbes down to 300 microbes. Now she has the granddaughter and the granddaughter inherits 300 microbes. This daughter has already inherited dysbiosis.

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in this research now, of course you can't recreate this in humans because that would take us a hundred years. But in this research, when he reintroduces fiber, you're able to bring many, many of these things back, but not all of it. So is it possible that we have through generations that started with our grandparents of transitioning in the post -World War II period to a.

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more ultra -processed diet, a more fiber deficient diet, is it possible that we have created an issue that has been transferred from our grandparents to our parents to us? Yes. Now the key though, from my perspective is that, and this is like most applicable more than any other type of patient that I've ever worked with to inflammatory bowel disease, because these are the people.

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Dr. Will Bulsiewicz (42:32.03)
where to me the dysbiosis is the deepest because you don't just have dysbiosis under the hood. You have an inflammatory, a chronic inflammatory condition where your immune system is actually digging you deeper. The dysbiosis in the state of a flare is worse.

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These people would benefit from the short chain fatty acids that come from fiber. The challenge is that their gut microbiome is not designed to process and digest fiber, particularly during a flare.

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And the amount that they can tolerate is very limited. So how do we address this? Number one, we should work to get them out of a flare. When we get them out of a flare, that in itself is going to enhance their capacity and ability to process and digest food substantially. Number two, we need to introduce fiber, but we need to do it in a very gentle, slow way. So, and this to me is a low FODMAP approach initially.

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So FODMAPs are fermentable carbohydrates that can be quite, can cause a lot of gas and bloating and be hard for people who have got issues to process and digest. So to me, you would start with a low FODMAP approach. And I'm not sitting here and saying that you need to just inflict pain on yourself and go a hundred percent plant -based. This is not the argument. The argument is that fiber is to your benefit. Fiber can help you to heal your gut and make it stronger.

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Josh Dech - CHN (44:02.368)
Mm -hmm.

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Dr. Will Bulsiewicz (44:07.901)
It is in your best interest to reintroduce fiber, but it is a process and it's not necessarily easy.

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Josh Dech - CHN (44:12.672)
Mm -hmm.

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So on that note, you know, fiber is something that I'm always very cautious with, obviously, in the IBD space. People dealing with these types of things don't have the capacity, like you said, to break down and utilize it. Their microbes can't turn them into short chain fatty acids. They don't get all these benefits from it, et cetera, et cetera. And so a lot of people, of course, the doctors will classically go, we'll follow the white diet.

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white breads and white rice and white potatoes and things that require really little to no mechanical breakdown in the GI. Like your mouth could do it all if it really tried hard enough. You could just chew on it till it turns to sugar. And so there's really little work to be done.

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On the other hand, a lot of these people have responded extraordinarily well to say a carnivore diet. And on that same note, we've seen people go carnivore with microbiome testing at say 30 or, you know, at three months and a nine month period who have actually shown an increase in their gut microbes. Now, is this simply through hermesis? Is this through something else? Are there microbes being introduced to these heavy proteins when they're carnivore based? What are we seeing here in the splits? Because obviously you're an advocate for fiber when appropriate. I'm not against fiber.

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in my practice, I've definitely seen obviously in the limited scope that I've got here, I've seen a reduction in fiber at least temporarily beneficial than reintroducing it later. What is your take on that and what is doing to the biome and why some of these diets might be beneficial on the animal based before transitioning to fiber if at all?

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Dr. Will Bulsiewicz (45:28.892)
Mm -hmm.

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Dr. Will Bulsiewicz (45:37.244)
Sure. So, I guess what I would, what I would say in response to this, and this is, this is trying to focus on, cause at the end of the day, what I care about again is outcomes and people being better. Like that's what I care about. This is, I'm not here to promote a dietary pattern above all else, ignoring the health. Yeah. Right. So, now when it comes to carnivore, like, as you know, we don't really have much data that doesn't dismiss the fact that there are clearly people.

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Josh Dech - CHN (45:48.228)
Sure.

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Josh Dech - CHN (45:53.852)
I respect that for sure, yeah.

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Dr. Will Bulsiewicz (46:07.228)
who have come forward to say that this has helped them substantially. So let's acknowledge that first. What may be going on there? How would I explain that knowing everything that I now know? Okay. Number one, they are eliminating ultra -processed foods. There are additives that exist within ultra -processed foods that I'm very concerned are disruptive to the gut microbiome, disruptive to the gut barrier. And as a result of that,

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are basically promoting the ongoing inflammation that results in inflammatory bowel disease. So that's number one. Number two, I do think that there's something to the idea that the simplicity of it, it's a little bit easier than, for example, what I'm proposing, which is to reduce your fiber intake, go low FODMAP, reintroduce over time, right? Like there's a lot more complexity to my proposition than there is to say, eliminate all plant -based foods entirely.

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Josh Dech - CHN (47:01.272)
Mm -hmm.

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Dr. Will Bulsiewicz (47:02.363)
Right. That's like pretty straightforward. number three, I do think that by doing this, you are going to enhance the production of beta hydroxybutyrate and other ketone bodies. And so what is beta hydroxybutyrate? one of the ketones is a cousin of butyrate. It's actually conceptually similar. It's not the same.

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They have looked at like activity of beta hydroxybutyrate versus butyrate and it's less active than butyrate is. So if you had a choice, you would choose butyrate. Yet at the same time for a person who's not getting either, right, because they're on a fiber deprived Western diet and they're clearly not in ketosis, to shift towards getting beta hydroxybutyrate is clearly a step in the right direction.

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So that to me can be part of this process. Number four, the fourth thing that I would mention is that it's a journey. It's a journey of healing. And what's right for you in one moment may not be exactly what's right for you in six weeks. Right. And in some ways, I think that there's a healing process that let's pretend for a moment, Josh, that this person who's struggling with inflammatory bowel disease, they do this, they get better.

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Right. And it's six weeks later and the microbiome is in a better place. I would make the argument that in the, in this is, this would be my argument that in the long term, not the short term, I'm not worried about six weeks, but in the long term, in terms of suppressing their inflammatory bowel disease, in terms of reducing their health risks, I would want to reintroduce fiber. I would want to transition them back to including this in their diet.

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So that's the way that I feel about it. And I think that that would be more possible if there was a healing that took place during those six weeks, as opposed to, like I don't, I don't know that people are trying to permanently restrict fiber for the rest of their life, but that to me is a quite scary idea because we don't know, we don't know what that means.

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Josh Dech - CHN (49:11.132)
It's interesting. Have you had much of a chance to study some of these like populations, these tribes who are literally like raw meat carnivores, like they kill a reindeer living up north and somewhere and none of it and they eat the organs raw and drink the blood raw. Have you guys studied much of that through Zoe and the work that you guys are doing?

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Dr. Will Bulsiewicz (49:30.011)
No, we haven't studied that at all. Now part of that is I think that what you're describing are the indigenous people to Canada, right? So like we're not available in Canada. But I do think that like independent of Zoe.

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Josh Dech - CHN (49:40.052)
Right.

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Dr. Will Bulsiewicz (49:48.315)
There, there's something about the adaptability of the body that is undeniable. And so to me, like, I think that part of what the message is here and trying to find the common ground, even though I, like, as you can tell, this is not the diet that I advocate for, but.

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Trying to find that common ground. I think that there is a message to be said for the adaptability of the body and the microbiome. And we see this through indigenous tribal people throughout human history. And the fact that like the reason why we developed this relationship with our microbes, if we want to get back to why do they exist? Why are they here? Why are they a part of us? How did we get here? The answer to that question is that humans started in Africa and radiated out.

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And we found ourselves in different ecosystems and different environments across the planet. And because humans are not readily or easy to evolve, we needed something that was easy to evolve that could adapt to a changing environment. And that's where the microbes come in because they can change real fast. So yeah.

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Josh Dech - CHN (50:59.952)
Very interesting.

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It's really interesting that we do live in a world you talk about this adaptation I just talked to Eric Edmeats the other day He wrote the evolution gap if you're familiar with the book and the whole idea is that humans have created this world that is no longer biocompatible with our world today and It's the adaptability or I should say the lack of adaptation right because technology Evolves so much faster than the human capacity than human genetics or our biomes even though our biome can adapt quite quickly our technology our way of life

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in our living is adapting or changing so much faster than we can adapt. And this has sort of left us in this gap, really an evolutionary gap where we find ourselves full of disease. And so the question is, can we adapt? Is the human body available or able in the next hundred years or a hundred thousand years to adapt to eating all the seed oils, all the sugars, all the junk, or we die out long before all that happens?

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Dr. Will Bulsiewicz (51:57.518)
so we adapt, we are adapting. we adapt in the sense that you can introduce 10 ,000 food additives into a food system and people are still alive. Right. But yeah, like that by itself, like think about that, right? These are things that like the majority of them didn't exist a hundred years ago. There was never a human in history that had ever consumed this. And now we're doing that times 10 ,000.

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Josh Dech - CHN (52:10.028)
Which is amazing.

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Dr. Will Bulsiewicz (52:27.195)
All right. so yeah, we clearly adapt. I think that the, I think that the, the issue is more so that, through our healthcare system and advances in nutrition that have taken place that basically I can make nutrition more readily available, right? Like nutrition is very easily accessible in our countries. because of that, people are living longer and by living longer,

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I mean, like in general relative to the fact that the life expectancy, not that long ago, you know, 150 years ago, life expectancy was like 50. Right. and that's because like, if you had a heart attack, you clearly were going to die. If there was a pandemic, most people were going to die. Right. And we have this ability to like using our healthcare system, do things to keep people alive and propped up artificially.

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So now what we have is you may be living longer, but actually the quality of that living, the level of health that you have during that time is becoming progressively diminished. And actually we've started to recently turn the corner just in the last few years where life expectancy is now actually going down. The thing about evolution, Josh, is that, and this is something I think about, is that like, if we think about it in a purely Darwinian way,

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So the concept is survival of the fittest, right? And the idea throughout like human history or the evolution of all life on this planet was that basically if you could survive long enough to procreate and put children out into the world, then you would pass on your genetics and therefore your genetics would ultimately like become more and more dominant, right? And the traits that weren't able to survive to the point of procreation, they would stop existing.

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we clearly live long enough to procreate now. Right? Like, so that sort of concept, like to me, evolution has gone out the window. But in recent years, I'm getting increasingly like sort of disturbed by what I see in terms of birth rate and fertility. It's dropping off substantially. And many countries are below the birth rate in order to sustain their country.

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Josh Dech - CHN (54:45.095)
It's very scary.

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Dr. Will Bulsiewicz (54:55.678)
and believe it or not, even India has like dropped substantially in recent years. Now I'm not claiming that this is all health related. There are also sociocultural aspects to what's happening. But, but I do think though that like, it's just part of this sort of broader picture of like trying to understand where we fit as humans within this planet and how to make it work.

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where we are going to coexist with modern technology, yet we have a body that was not designed for it.

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Josh Dech - CHN (55:27.847)
Hmm.

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Josh Dech - CHN (55:33.344)
Well, you're a very interesting guy and I realize.

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This has been almost an hour and it's flown by and regrettably we haven't even quite gotten to the breakdown of what it looks like to reverse IBD and all that. So I'd hate to put you put the pressure on you to do this. Can you sort of give us an idea here bullet points in the next few minutes sort of a one two three four five or whatever that looks like for you to say look we talked about all these different factors and all the things that are not biocompatible where it's coming from what's happening dietary principles things we can apply when and how we sort of.

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Obviously this you could do a weekend symposium and hardly scratch the surface So an hour is just enough to kind of give a taste, but I'd love to give the listeners dealing with IBD some kind of Something to look forward to or to look through and say hey if I explore these options This might give me a new lens to sort of help reverse the IBD What are those steps look like if someone comes to see you?

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Dr. Will Bulsiewicz (56:29.883)
All right. So, the way that I like to approach inflammatory bowel disease is I think about it like it's a forest fire and it's burning out of control. Right? So now that forest is their microbiome. We want to restore the forest, but it doesn't make sense to start planting trees while the fire is burning. So from my perspective, step one is we have to get these people into remission. So now.

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Once they're in remission and the fire has actually been put out, now we have the ability to regrow the forests, but we must acknowledge that will take time. So, this is not a quick fix type of thing from my perspective. And there are different tools that we can apply and use within the setting to try to rebuild this forest and plant these seeds. One of them is nutrition.

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you and I may have different views on how to approach that and that's okay. Like again, I, I've done my best to try to find that common ground. Cause I think it's important for people to have opposing views and be able to find common ground these days.

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Josh Dech - CHN (57:33.443)
Especially nowadays.

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Dr. Will Bulsiewicz (57:36.701)
Yeah, exactly. So, and we can respect one another and have that conversation. So one of them is nutrition. And from my perspective, that includes the, the implementation of, of fiber and plant -based foods. And that's not to me, I don't like, I do get a little bit frustrated at times because I think that that comes across as being a vegan thing and it's not. It's more so to me, frustration in the inadequacy of our intake of these foods.

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And my feeling that we would be much more healthy if we would increase these foods in our diet, ideally prior to having inflammatory bowel. So to me, part of this process is wanting to introduce those foods, but doing it gently through a low FODMAP approach. The second thing would be the addition of fermented foods. We have data that show, and by the way, there's many options for fermented foods, not just plant -based, but in addition to that. And we have data from Stanford.

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where they did an eight week fermented food intervention and were actually able to increase the diversity within the microbiome and reduce measures of inflammation. So this is to me an exciting thing. I have to acknowledge with that, there may be people who have histamine intolerance with inflammatory bowel disease. And so the fermented foods may not be like that may not be early, early sort of process for you.

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That may be later process for you, but histamine intolerance. My second book, the fiber fueled cookbook is all about this topic. And if I were to summarize real quick to me, if we repair the gut barrier, that's how we repair histamine intolerance. so there's a nutritional approach. Secondarily, I think it's quite important to acknowledge there are aspects to healing that have nothing to do with lifting a fork. So, and that is building a daytime routine.

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that where we are no longer flogging our microbiome. It is about building a daytime routine that's in line with our circadian biology. And basically we're getting out of the way. We're going to stop like doing things that disturb the microbes. And instead we're going to start doing things that allow them to grow and thrive. So, and we do that through orienting towards the rise of the sun and the fall of the sun in the evening. The rise of the sun includes things like getting daytime early daytime.

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Dr. Will Bulsiewicz (01:00:00.699)
exposure to sunlight. So that basically teaches our body anchors our body to that time, right? Actually makes it a lot easier to go to sleep at night. I believe in spending time outdoors on a daily basis that includes exercise. So to me, a morning walk, I like to actually rock. So I have a rock vest that I'll do use when I do this is one of the ways in which we can help to accomplish this. I also think on the flip side, we need a nighttime routine.

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Way too much bright light, devices, staying up late, alcohol, late night snacks, and all of these things are disrupting us. So to me, like trying not to consume any alcohol or food after 8pm, winding down in the evening, trying to maintain consistency of our bedtime, consistency is important. These are all strategies that I use in terms of.

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wanting to align my body. And so, and then beyond this, I guess the last thing that I would add is many people with the most severe dysbiosis, they can do everything right. They can eat the right food. They can sleep and exercise and all these different things. And there may be something in their pasts from a trauma perspective that is, whether they are conscious or not conscious of.

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the harm that it's causing, it can be the engine that drives dysbiosis. It's basically chronic activation of the inflammatory pathways. And so I think it's important to acknowledge that for many people, the greatest healing that can take place is actually when they heal the wounds of trauma that are holding them back. And so, and I do think that's an important part of understanding digestive health, including

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including inflammatory bowel.

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Josh Dech - CHN (01:01:57.589)
What's really interesting, well...

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coming in here because having seen your stuff, having followed you for a long time and I know we're just getting to the end here. So I'll make her quick. I was very much under the impression it's plants, plants, plants, plants, almost vegan. And so even I as a longtime follower misunderstood some of that messaging. And there's a lot that I disagree with out there as I'm sure you do a lot. I agree with some parts and pieces of people I follow where I go, you know what? I like this what they're saying. I don't like this so much. I have yet to have a single thing in this conversation where I actually did disagree and go, that doesn't make any sense to me. All of it's very founded.

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All of it is very middle ground. It's solution based and results oriented ultimately with always like a hey, you know what? I don't know, but I'd love to learn. And this has just been super eye opening and I really had a very interesting time just hearing from you. I know again, we just scratched the surface.

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Dr. Will Bulsiewicz (01:02:42.875)
What? I appreciate you saying that. And I think that like, if I were to unpack this, because this is a point of frustration for me in my private life away from what you see on a screen. Okay. If I were to unpack this for a quick moment, there's a very different, there's a very big difference between the way that I would treat a person who had Crohn's disease or ulcerative colitis compared to the advice that I would basically put.

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Josh Dech - CHN (01:02:53.045)
Sure.

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Dr. Will Bulsiewicz (01:03:12.443)
on the table for the average American who does not have inflammatory bowel disease. And, and I think that that's part of what it is, is that like many of these things that I'm trying to do, I sincerely believe Josh, and people are entitled to their opinion on this, but I sincerely believe that as we sit here in the United States, we're getting more sick. And the solution to this issue is, like to me, this is me.

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Josh Dech - CHN (01:03:16.277)
100%.

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Dr. Will Bulsiewicz (01:03:41.756)
If we could correct our fiber deficiency in the United States, this is for the general person. We would address a lot of these health issues and I'm completely convinced of this. Now, to me, this is not a vegan thing. If we simply got rid of our ultra processed foods, which you and I would clearly agree on, this would be a massive step in the right direction. So, but again, I think that the important point though is that when I sort of give that general advice, I'm looking at the big scope.

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of people out there and the way in which I think that like, what is the general approach? But there should be an individualized approach. And this is why I say my messaging changes when I'm talking to someone who has Crohn's or ulcerative colitis, but this is also why things like Zoe need to exist because Zoe is not trying to give one size fits all advice. Zoe, what we're trying to do is crack the code on personalized nutrition.

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So that we can show you how to eat for your like what works best for you personally. So that's like, I think it comes back to these same general concepts.

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Josh Dech - CHN (01:04:44.4)
Yeah, I think it'd be very interesting one day to see almost like a standardized version of personalized healthcare where we have this data and all this information based on blood and microbiomes. We can do all these tests and here's what we can do for you and here's what we know is going to work based on a thousand years of data. I think we can get there. I think it's a really interesting conversation to broach.

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Dr. Will Bulsiewicz (01:05:04.699)
Yeah. And when, and, and wouldn't it be a great day too, if the left -hand was talking to the right hand in healthcare and we didn't have these silos of there's the Western medicine and doctors, and then there's the, you know, alternative medicine or however we want to describe this, right? Like,

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Josh Dech - CHN (01:05:18.349)
All right. Well, four point four trillion dollars speaks pretty loudly. And that's sort of what the system is worth right now financially. And, you know, we have to go back and I recognize that they have considered the EPA and the FDA have considered the economic and social environmental costs and benefits of the use of these protocols and decided that it's financially worth it. And so here we are. At least my tinfoil hat theory on it. I think I don't think there's one big evil plot.

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to keep everybody suppressed and everybody ill. But I think there are special interest groups that have unfortunately lobbied and pushed certain things in a certain way where it's ended up where people are sort of milked like cattle for profit.

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Dr. Will Bulsiewicz (01:05:55.612)
It's the, well, what it is is it's that there are certain industries that are empowered with money and they can flex that money on an individual person to get the vote that they're looking for. And it's an unfortunate thing because I don't think that should exist in any way.

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But it does exist. And so it's not so much that the system that there's some broader conspiracy to try to inflict harm on people. I think it's more so that the system has a weakness, which is that lobbying can be used to empower specific industries that have an agenda and that agenda may have nothing to do with human health. It may be a hundred percent making more money. And unfortunately, that's what we see.

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Josh Dech - CHN (01:06:40.044)
Yeah, I totally agree. Well, I know we could go for hours and hours. I've really enjoyed this and maybe we get to have you back one day. But for right now, if you could just let our listeners know, what are you up to? Where can they find you? What do you want them to dig into as the next piece of information here?

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Dr. Will Bulsiewicz (01:06:56.892)
well, you can find me. So I guess a few things for those who are interested in learning more about Zoe, go to joinzoe .com slash will be, if you decide that you want to do it then, and by the way, like a great place to start is we have a Zoe science and nutrition podcast. So you can definitely start with that and check it out. But if you said you want to do it, the value is that using that, website joinszoe .com slash will be.

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There's a code that you can use to save some money. So that's a beautiful thing. My, my social media is the gut health MD. You can find me on Instagram and Facebook there. I would encourage people to come check it out. You can just join my email list, which I'm quite proud of. This is where I like to have good conversations. And then I have my books. My books are fiber fueled in the fiber fields cookbook. Quite proud of them. So thank you, Josh.

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Josh Dech - CHN (01:07:47.975)
It's been brilliant. I'll make sure all that's in the show notes. If you guys are listening right now, just hit pause. There's 30 seconds left. Just go down, click those links, grab those things, and we'll make sure you have access to all this fantastic info from Dr. Will B, the Gut Health MD. Will, thanks so much for being here.

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Dr. Will Bulsiewicz (01:08:03.931)
Thanks Josh, thank you everyone.

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Josh Dech - CHN (01:08:06.311)
Well, that was brilliant. Thank you. That was that was quite a delight. Man, hats off to you. And Shadeen, hi, good to see you here. Yeah, thank you. I think so. This is another one of the reasons I don't like planning. I know you guys kind of wanted some questions ahead of time, but I think it can make interviews quite rigid and I try not to do too much of that. So, yeah, just more inquisitive.

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Dr. Will Bulsiewicz (01:08:13.947)
That was fun, I enjoyed it, thank you.