Ep. 526 Build Muscle, Burn Fat, Fix Your Microbiome – The Ultimate Blueprint for Healthy Body Composition with Dr. William Davis

Today, I am delighted to welcome Dr. William Davis, a cardiologist and New York Times bestselling author of the Wheat Belly series. He is also the author of Undoctored, Super Gut, and his latest book, Super Body.

In our conversation, we dive into the toxic diet industry and how it profits from repeatedly delivering wrong messages. We explore physiological changes in body composition that contribute to poor metabolic health and inflammation, the dangers of ectopic fat, and the influence of our environment. Dr. Davis explains the weight loss Ponzi scheme and how muscle loss drives changes in body composition. We also unpack the gut-muscle axis, the role of the microbiome in muscle building, SIBO and treatment options, and examine the broader effects of oxytocin on body composition, touching on the benefits of replacing lost biological compounds, like collagen and hyaluronic acid, the impact of Max, the microbiota, and accessible carbs, along with practical takeaways to support healthier living and better body composition.

This conversation with Dr. Will Davis is incredibly insightful, and I look forward to having him back to discuss the female and vaginal microbiomes.

IN THIS EPISODE, YOU WILL LEARN:

• The specific probiotic strain that influenced body composition in a clinical trial

• The benefits of fiber for your metabolism and fat distribution

• The role of collagen and hyaluronic acid in joint, skin, and vascular health

• How animal-based fibers affect the microbiome differently from plant fibers

• The value of fermented foods for cultivating beneficial gut microbes

• The long-term risks of restrictive diets 

• How declining estrogen alters immune function in women

• The lasting impact of antibiotics and past treatments on gut microbiota

• How to prepare your gut for a thriving microbial ecosystem

• The surprising effects of foundational probiotic interventions on mood and social behavior

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“There are safe and very effective ways to lose weight and preserve or increase muscle.”

– Dr. William Davis

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Connect with Cynthia Thurlow  

• Follow on⁠ X⁠,⁠ Instagram⁠ &⁠ LinkedIn⁠

• Check out Cynthia’s⁠ website⁠

• Submit your questions to ⁠support@cynthiathurlow.com⁠

Connect with Dr. William Davis

• On his website 

• On YouTube

• Blog

• Defiant Health (Podcast)

• Books

Transcript:

Cynthia Thurlow: [00:00:02] Welcome to Everyday Wellness Podcast. I'm your host, Nurse Practitioner Cynthia Thurlow. This podcast is designed to educate, empower, and inspire you to achieve your health and wellness goals. My goal and intent is to provide you with the best content and conversations from leaders in the health and wellness industry each week and impact over a million lives.

[00:00:34] Today I had the honor of connecting with Dr. William Davis, who is a cardiologist and New York Times best-selling author of the Wheat Belly series of books, as well as Undoctored, Super Gut and most recently, Super Body.

[00:00:43] Today, we spoke at length about the toxic diet industry and how a lot of money is made delivering the wrong message over and over again, the impact of physiologic changes in body composition that contribute to poor metabolic health and inflammation, why visceral fat is so problematic, the impact of ectopic fat and the influence of our environment, what the Ponzi scheme of weight loss is and how the loss of muscle drives changes in body composition, the gut muscle axis and how the microbiome determines how much muscle we can actually build, SIBO and specific treatment options, why oxytocin is so much more than a bonding hormone and directly impacts body composition, how replacing what our bodies have lost, specifically things like collagen and hyaluronic acid, can be very helpful for shifting body composition, the impact of MACs, the microbiota-accessible carbs and last but not least, tangible takeaway messages that can help set you off on a path to healthy living that will positively impact body composition. This is a truly invaluable conversation, one you will probably listen to more than once. And I can't wait to have Dr. Davis back to talk more about the female microbiome, vaginal microbiome and more.

[00:02:09] Dr. Davis, such a pleasure to have you on the podcast. I've been a huge fan of your work for a long time. Welcome to Everyday Wellness.

Dr. William Davis: [00:02:17] Thank you, Cynthia. Delighted to be here.

Cynthia Thurlow: [00:02:20] In the book, you have many, many quotes that really resonated with me. And when we're talking about the diet industry, it's $150 billion a year industry. You mentioned a lot of money is made delivering the wrong message over and over again. What does that mean to you as a clinician, as a physician, as a researcher? What are we getting so wrong about weight loss?

Dr. William Davis: [00:02:48] Cynthia, as you and I talked before you started recording, you and I have deep scars from all the criticism-

[laughter]

[00:02:53] -all the nonsense we've had to endure. But the real tragedy, as you know, was I think you and I have an understanding we're sharing with your listeners on how to really address disease, how not to have heart disease, how not to be a type 2 diabetic, how to minimize your risk of an autoimmune or neurological condition. This-- the crazy thing is of course that science is there already. We didn't have-- we don't have to invent it. We don't have to do thousands of human clinical trials to validate. They've been done for the most part. There's still more to learn, of course, but so much is already known, but it's not being passed down.

[00:03:29] You and I know that it's going to be two generations before our colleagues catch on that coronary disease is dirt simple to get rid of, type 2 diabetes, you can get rid of it in just weeks to months. Fatty liver, three weeks, it's gone. But this is not being passed on because the world is driven by revenue generation, the pharmaceutical industry and of course the medical device industry.

Cynthia Thurlow: [00:03:54] Yeah, it's interesting to me how I can see these things differently being out of that traditional model over the last nine years. And I think for many listeners it's harder to see that-- we see it from a 30,000-foot grasp. But the complex interrelationship of special interests, lobbying groups, and the pharmaceutical industry, we talk about the Flexner Report and how this evidence-based care is driving, focusing on pharmaceutical interventions for every single symptom that we address. And so, I think for many patients, they get confused because they've been told for many years, "Exercise more, eat less, count your calories, avoid fat, and focus on heart healthy grains," and I'll put that in air quotes, we know that's not correct. What are some of the physiological changes that we're seeing now that maybe we didn't see 40, 50, 60 years ago because our food industry has shifted so enormously?

Dr. William Davis: [00:04:56] One of the big changes that you and I can just see by going to Walmart or Target, [chuckles] the grocery store, is the explosion of abdominal visceral fat. Of course, that is fat that encircles the abdominal organs. And we all know it's well established that fat is unique. It's different. It's different than the fat below the skin, so called subcutaneous fat. That's the stuff that accumulates in your buttocks and your thighs, neck. And that's, it may be an aesthetic issue, but it's not really a metabolic issue. It's the abdominal visceral fat. Even more concerningly, as you expand abdominal visceral fat, other things happen. You become more insulin resistant and thereby of course, prone to such things as coronary disease, type 2 diabetes, dementia, breast cancer, hypertension, other conditions. It's inflammatory and of course, inflammation drives numerous diseases.

[00:05:49] It exports fat to other parts of the body. So, the so-called ectopic fat issue. So, because you and I come from a cardiac background, it's now clear that fat that encircles the heart, so called epicardial fat, is a major driver of cardiovascular events like sudden cardiac death and heart attack, myocardial infarction. It also get-- ectopic fat also accumulates in the pancreas, where it damages beta cells, in the kidneys where it can damage kidneys and lead to kidney disease, in the joints like hips and knees, where it accelerates breakdown of your cartilage and thereby arthritis. And it also gets deposited in muscle, so called myosteatosis. And once a person develops myosteatosis, which by the way becomes almost universal into your later years, especially in females, oddly, we know that you're likely to die younger.

[00:06:41] So, these are very very important issues they have at their root though, awful diet and all the other things we're exposed to, glyphosate, herbicides, pesticides, ridiculous dietary guidelines tell us, cut fat, eat more healthy whole grains. All those factors have conspired to, among many things, cause an explosion of abdominal visceral fat, ectopic fat, myosteatosis and loss of muscle. This has come to light lately because of the absurd world of GLP-1 agonists. So, what they've done with these drugs is they've essentially accelerated the adverse effects of losing weight. So, losing weight is good. You lose weight, your triglycerides come down, small LDL particles, the real cause for heart disease comes down. Your HDL goes up, your blood glucose comes down, your blood pressure comes down, your waist shrinks, your C-reactive protein drops [laughs] upfront.

[00:07:41] Then, of course, let's say your friend paid $12,000 for a year's worth of Wegovy or Mounjaro or one of those GLP-1 agonists. She endures the nausea and vomiting, all the other side effects, she loses 40 pounds. She looks great, right? Though she does look 10 to 20 years older because she lost facial fat and facial muscle, but she lost 40 pounds. Metabolically, she looks better. She stops the drug because most people can't afford that, as you know, forever. She regains 32 to 34 pounds of fat, mostly in the abdomen, not so much in the skin, in the subcutaneous compartment, the muscle does not come back. She lost 10 pounds of muscle. Of the 40 pounds she lost, 10 pounds or so was muscle that does not come back, maybe a little bit comes back.

[00:08:27] She now is off the drug, metabolically less healthy. Her blood glucose is now higher, triglycerides higher, more likely to have fatty liver, C-reactive protein, other inflammatory measures worse, she's less healthy than she was before she took the drug. And even worse, because of the loss of muscle, she has essentially sealed her fate. Earlier falls, fractures, frailty, loss of independence. And we now know with good evidence from numerous long-term databases of tens of thousands of people, she's going to die several years younger. The NHANES database, the EPIC-Norfolk database, the Asprey database, numerous others. I've tracked people for as long as 20 years after weight loss, people who lose 10% of their weight or more.

[00:09:20] So a woman who loses, let's say 18 pounds starting at 180 pounds, or a guy who loses 24 pounds starting at 240 pounds, they're going to die several years younger. So, they have approved a class of drugs. As you know, our colleagues are saying these are miracles, they're breakthroughs, not recognizing that they have essentially sealed these people's fates for disability and earlier death. The tragic truth of course, is that there are safe ways to do this. There are safe ways to lose weight, very effective ways. There are safe ways to preserve or increase muscle. This is not being passed on though, to the public because there's no money in it. And that's the key. If you and I can dispense something that makes us a ton of money, physicians make money by dispensing drugs. A lot of them have found tricks like having their own pharmacy. And so, if they prescribe drug for a thousand dollars a month, they get a big bite out of that.

Cynthia Thurlow: [00:10:21] Yeah, I think that a lot of people don't realize that when they lose body fat, they're also losing muscle mass. And that acceleration of sarcopenia after the age of 40, and especially in women, women are a little more susceptible. We generally have less muscle mass than men. I was part of a generation that was conditioned to believe that thin was in, do all that cardiovascular exercise. I was 30 years old before I started lifting weights and it was because I was getting ready for my wedding. And I recall I never had a conversation with any of my coaches in high school playing sports that women should lift weights.

[00:10:58] And so I think about the fact that this generation, my generation, I'm sure most generations have not been conditioned to or have not been instructed to maintain muscle mass throughout their lifetime to eat enough protein. And I know that you mentioned in the book, 25% of all weight loss is muscle. So, just to be thinking if someone loses 18 pounds, understand that 25% of that is muscle. And it's much harder to put that muscle mass back on as we get older. It's not easier, it gets challenging. I look at my teenage boys, they breathe and they have 10 g of protein and they build muscle effortlessly and easily. You mentioned in the book the Ponzi scheme of weight loss, which I thought was clever. Can we talk about this?

[00:11:43] Because I think that this reaffirms what the point that you're already making. But I think it reaffirms some of these themes that we have conditioned our patients to believe that ultimately end up again leading to the same end result is that whether it's yo-yo dieting, sarcopenia, they all end up leading to this acceleration of aging and frailty.

Dr. William Davis: [00:12:06] Yeah, it's tragic, isn't it, that almost conventional methods to lose weight. It could be a calorie reducing program that you pay a lot of money for or maybe a meal replacement program where you're paying for your meals. It could be a bariatric procedure, lap band, gastric bypass. It could be a pharmaceutical, most popularly coursed GLP-1 agonists. But they're all variations, of course, on the same theme. They all reduce calorie intake. So, if you get lap band, you have a band put around your stomach and it reduces stomach volume. You take in less food to feel satiated. A GLP-1 agonist reduces your interest in food. It slows gastric emptying. So, they're all variations on reducing calories. And we know with clear cut evidence when you cut calories, as you point out, you will lose muscle. It's inevitable using those methods.

[00:13:01] And when you lose muscle, your basal metabolic rate, of course, there's elegant work. Thank you to the National Institutes of Health, the NIH, has done several studies to show us when you lose weight, you'll lose muscle and your basal metabolic rate drops and it guarantees weight regain. So, for instance, the NIH is Biggest Loser study, they took the graduates of the eighth season, including-- I'm not going to say anyway, they took the graduates of the eighth season, the winner lost 239 pounds in seven months, 239 pounds. Which by the way, goes against this idea that people are overweight because they're lazy and indulgent. So here, he's working out four to six hours a day. He's cut his calorie intake. Danny Cahill was the winner of that eighth season.

[00:13:55] He cut his calorie intake to 800 calories per day, which is essentially starvation, misery. But he did it. He won. He looked great. He and the other graduates, of course, look great in clothes. Underneath, they're wearing Spanx to conceal all the skin flaps- loose skin flaps, when you lose that much weight. Anyway, he wins, he looks terrific. He leaves, he continues. I talked to him. He continued his exercise program, two hours a day, resistance exercise, aerobic work, six days a week, which is a huge commitment. And he maintained a low-calorie diet. He regained all the weight and he'd go back every year to the reunion that the producers of the TV show would host.

[00:14:40] And he saw all the other graduates regain all the weight and becoming increasingly demoralized, beaten down after a heroic effort to lose weight, looking great, enjoying that for a few months, couple years, they regain all the weight. Now, the NIH formally studied these people, and of course, their basal metabolic rate in this study was 27% lower. And it's an effect that persisted for six years. That's as long as the study went six years. So, for all practical purposes, you lose muscle, your basal metabolic rate drops permanently, and you regain weight even with extreme exercise and a very severe calorie restriction. So, this is what those GLP-1 agonists, bariatric procedures, low calorie-- [chuckles] So, of course, there are better ways to do things, but it's not being passed on. As you know, our colleagues still say things like, “Move more, eat less, smaller portion sizes, cut the fat, calories,” all that nonsense. We now have a century's worth of evidence to show us this does not work.

Cynthia Thurlow: [00:15:51] Yeah, it's so interesting. And I did watch the-- I'm like a documentary nerd. And there was a documentary about the Biggest Loser on Netflix. And I watched it and I saw his story. And you start to feel incredibly empathetic for what these patients have gone through. And it's not just the Biggest Loser patients. It's so many of our other patients. I recall poignantly how many of my cardiology patients wanted bariatric surgery, and they literally had to gain weight to qualify for insurance coverage of their bariatric surgery. Maybe their BMI was 38, they needed to be at 40, and they would band together with a family member to gain additional 20, 30 pounds to qualify for bariatric surgery and have it covered.

[00:16:37] And, you mentioned in the book, and it was certainly my clinical experience, the dumping syndromes, the nutritional deficiencies, there was never a perfect situation after gastric bypass, gastric banding, some of my patients beat the band is what, when they would actually beat the gastric band that they had in place. And so not to mention higher rates of suicide. There's a lot that goes into this. And so, I'm glad that you're bringing greater attention to this. So, let's talk about the gut muscle axis, which for a gut microbiome nerd like myself, I really appreciated your very comprehensive coverage and explanation of the role of the gut microbes and muscle, how important this is to be able to create sustainable long term weight loss.

Dr. William Davis: [00:17:22] As time has gone on, Cynthia, I'm coming to the conclusion that the major driver of a lot of the things we're seeing, whether it's abdominal fat expansion, ectopic fat, loss of muscle, myosteatosis, all those things. A major driver, I believe is small intestinal bacterial overgrowth, SIBO of course, S-I-B-O we say and endotoxemia. This is a tough thing for people to understand because they say, well, how can gut microbes affect the brain or muscle or the uterus or the prostate or the skin? Well, so what I believe has happened to modern people is our wild overexposure to antibiotics that's taken place over the past century since the discovery of penicillin. 650,000 prescriptions written per day, by the way, for antibiotics. 650,000 per day. So, there's wild overexposure. Antibiotics are indiscriminate.

[00:18:16] They don't just kill bad things like the E. coli in your bladder or the pneumococcus in your lungs. They kill lots of things. They kill all the beneficial microbes, the lactobacilli, the bifidobacteria, the Faecalibacterium, the Akkermansia, the beneficial microbes. It's common to take one course of antibiotics, one course, and you lose literally hundreds of species. And a lot of those species were there to suppress the over proliferation of fecal microbes. So, as you know, fecal microbes are supposed to stay in the colon, and the colon's happy with that.

[00:18:52] They can still go off and do bad things and cause colon cancer and diverticular disease and ulcerative colitis, of course, also, but for the most part, the colon is well suited to deal with fecal microbes like E. coli, but when we lose all those beneficial microbes, the fecal microbes are allowed to overpopulate unrestrained, and then, remarkably, they ascend into the 24 feet of small intestine. I didn't believe this at first. I thought, no way. Years ago, I thought that's got to be rare. Until this thing came along. The AIRE device, A-I-R-E. It's just a device. Blow into it, talks to your smartphone. 0 to 10 measures hydrogen gas. That's the original one, invented by a PhD engineer in Dublin, Ireland. Here's a more recent device. It measures hydrogen gas and methane. It tells you they're mapping devices.

[00:19:43] They map where microbes are living in your gastrointestinal tract. It wasn't intended to do that, by the way. I had to call the inventor to say, “Hey, the Angus, you invented a mapping device,” [laughs] because he thought it was something else. Anyway, it's become clear when people start to test themselves, it's everywhere. And it correlated with what was going on clinically. That is, somebody had tested positive, thereby had fecal microbes living in their small intestine, and they had a hemoglobin A1c of 11.1%. They had coronary disease. They had recurrence-- frequent recurrence of atrial fibrillation. They had fibromyalgia. They had food intolerances. “Oh, I can't eat. I can only eat seven foods. [Cynthia laughs] I can't eat nightshades and FODMAPs and histamine containing food, all this stuff.” And they all tested positive. Now you might say, well, is it a valid test?

[00:20:40] So we would address the SIBO and all these phenomena would go away. Now, the way I got rid of it for the majority of people. So, if antibiotics got us here, I'm reluctant to say antibiotics are the solution because that's what it's done in the conventional world. If your doctor even knows what this is, they'll say, well, here's a prescription for Xifaxan. And it does work with about 60% efficacy. It's not great. It's okay. It's temporary. The SIBO tends to come back over, over and over again. So, I asked this question, Cynthia. I said, well, if you took a commercial probiotic off the shelf, what's the likelihood that your SIBO, 24 feet of fecal microbes will go away? And low? Not very likely. You might get rid of some bloating, diarrhea, but it's not going to get rid of these 24 feet of trillions of fecal microbes.

[00:21:34] So I asked this question. What if we chose microbes known to colonize the small intestine, which is very unusual, and choose microbes known to produce bacteriocins, natural antibiotics that kill fecal microbes. So, I chose three. I chose a strain of Lactobacillus reuteri, a strain of Lactobacillus gasseri. I originally chose Bacillus coagulans. I've since replaced it with Bacillus subtilis. There's nothing wrong with coagulans. It just wasn't very reliable in fermentation in your kitchen. So, I replaced it with Bacillus subtilis. And so far, that has been miraculously effective in normalizing breath hydrogen gas and reversing whatever phenomenon could be blamed on the SIBO. But the thing that people have a hard time understanding is how can microbes be experienced in all of the parts of the body? Well, it's because the small intestine, of course, is very permeable by design.

[00:22:33] That's where we absorb nutrients, vitamins, minerals, amino acids, et cetera. But when it's infested with fecal microbes, these fecal microbes are very inflammatory, and they increase the already permeable small intestine. When those fecal microbes die, they release their toxic compounds, but specifically, compounds in their cell walls call it endotoxin, and that enters the bloodstream. And so, people who have this have a several fold higher blood level of endotoxin. And that's how microbes in the GI tract can be experienced, say, as depression or dementia in the brain or as higher blood glucose or as recurrences of atrial fibrillation or worsening congestive heart failure, rupture of the lipid component of your coronary disease or muscle aches of fibromyalgia, on and on and on. So, it became clear that what we have is this massive epidemic. And by the way, by my calculation, about half the population has this situation. And I wouldn't-- if you would have said that to me 10 years ago. I said, Cynthia, you're crazy, no way.

Dr. William Davis: [00:23:42] But I did some simple math. There are several dozen studies that ask this question in condition blank, what proportion of people test positive for SIBO, usually using breath hydrogen gas, sometimes endoscopic aspirate. There's some other ways, but let's put in irritable bowel syndrome. Well, there's 60 to 70 million Americans, remarkably, with irritable bowel syndrome. It varies from study to study, but roughly about 31% will test positive. Well, that's 18 million or more right there. How about obesity? Well, there's 110 million obese Americans. 50% test positive. That's 55 million right there. Add up all the numbers that have come from studies of type 2 diabetes, fatty liver, neurodegenerative conditions like Parkinson's disease, autoimmune conditions, fibromyalgia, sleep apnea, add it all up, easily, easily exceed 100 or 150 million people. And so, we're talking about something that is exceptionally common.

[00:24:47] And of course, if you're obese and you take a GLP-1 agonist, it does nothing for the SIBO. And so, when you stop the drug, of course the weight comes back. And of course, that SIBO and endotoxemia drives loss of muscle, expansion of abdominal visceral fat, myosteatosis, it distorts the behavior of so called myokines, muscle-derived cytokines that help maintain muscle. And so, it's kind of a perfect storm when you have this, that disrupts health in so many ways. So, taking a stomach acid blocking drug for stomach acid, taking drugs to inhibit recurrences of atrial fibrillation, taking a statin, of course, the most absurd of all statin cholesterol drugs to reduce risk of cardiovascular events. In other words, these are woefully inadequate solutions.

Cynthia Thurlow: [00:25:38] It's so interesting to me because SIBO is something that I've been talking about for probably 10 years, and kind of the conventional way that you diagnose it is with lactulose. So, patient will take lactulose and then they're giving breath samples over the course of two or three hours. And on every patient, I suspected that had SIBO, they had SIBO and oftentimes they had mixed both methane and hydrogen. And so, to me, they would have unrelenting digestive symptoms. They would tell me, “Oh, I've been feeling badly for years,” and then I would have just as many patients. We would-- if I was looking at stool studies and looking at symptoms, I would say, let's at least test. And I would tell them, SIBO doesn't happen overnight.

[00:26:23] This is not something that you just catch like a cold. This is something that's a kind of long-standing probably, maybe it was the last dose of antibiotics you received, maybe it was the death of a loved one, there was some type of insult that made you much more likely to finally declare yourself. And to your point, I think there are a lot of people who are unknowingly suffering. And because they're in that kind of traditional allopathic medical model, it's not even being considered. And I think for anyone that's listening, the reassurance is what your symptoms are that you're experiencing are real. And there are ways to combat these symptoms that don't necessarily involve more toxic drug therapy or having to see 15 specialists. I know we're talking before we started recording, and we're talking about, you can have 10 or 15 specialists and still not be getting good quality care.

Dr. William Davis: [00:27:17] I should mention that the way I got those microbes to work in normalizing SIBO and breath hydrogen gas was to ferment them, that is to grow them. And that is, we grow it in something that looks and smells like yogurt. Of course, it's not yogurt. You can't buy this at a supermarket. [chuckles] That's something different. That's mostly garbage. We're going to ferment them, but we're going to ferment them using prolonged fermentation. So, for instance, Lactobacillus reuteri, my favorite microbe in the world, [chuckles] doubles. They don't have sex, they just double themselves. Reuteri doubles every three hours at human body temperature. So, if you ferment the reuteri by itself, we let it ferment for 36 hours. Not the few hours of yogurt, conventional yogurt making. We're going to do it 36 hours, 12 doublings.

[00:28:04] We do flow cytometry on these yogurts, and we get about 300 billion per half cup serving, or 120 mL. Now, sometimes we co-ferment all three. People with really bad SIBO do a little better by individual fermentation, because when you co-ferment all three together, it works. But you may get lower numbers of microbes because they're competing with each other. So, the best way is the individual-- It's a bit of a hassle. You have to source the microbes. You got to get your-- I use organic half and half. Because, as you know, we reject this nonsense of cut your fat, etc. That's nonsense. You don't have to cut your fat. So, we use organic half and half. It's higher fats, 18% fat. It's delicious. Fermented for extended periods. And so far, Cynthia, has worked incredibly well.

[00:28:49] I do have two clinical trials ready to go. As you know, we're not pharma. We don't rip people off for billions of dollars. So, we have to go long and slow in our clinical trials as we gather some funding, but we will do validation studies. But Cynthia, if the solution is something you make in your kitchen that looks and smells like yogurt and has no-- essentially no downside, just--and all kinds of benefits, well, why-- why wait? We're not telling you to take your small intestine out surgically. We're saying make this thing that goes great with blueberries.

Cynthia Thurlow: [00:29:24] I love this. And when I was reading the book, I just kept thinking of how many patients had come to me and they would say “You're the third practitioner I've seen for my SIBO, and I'm feeling hopeless, and I'm not sure what direction to go in.” And so, there are a lot of people, as I stated before, that I think are suffering for years before they get to a point where they come to a solution that is naturally focused and something that they feel like they can do themselves. In the book, you talk about this connection between a very important hormone called oxytocin and L. reuteri. Let's talk about how this microbe can actually trigger the release of oxytocin and how this-- I think we have this association with oxytocin as the bonding hormone. And yes, that's what it's about. But there's so much more to it that I think is really fascinating.

Dr. William Davis: [00:30:15] Exactly right. So, for many years since its discovery, everyone thought oxytocin was this thing that causes uterine contraction, and that's why it's given to ladies at term pregnancy. Your daughter says, “Hey, I want to deliver my child on Wednesday, 8:00 AM on August 23rd,” [chuckles] she comes in, they put an IV in, they give her a continuous infusion of oxytocin, Pitocin, and she delivers her child. Well, end of story. It's turning out that oxytocin is so much more than that. It's responsible, of course, for intensification of feelings of love, empathy and generosity. It's also proven to be a major player in what I call shape and body composition. So, if you believe the original MIT studies, very elegant work from a few years back in mice a cancer group was exploring because reuteri been shown to kill cancer cells.

[00:31:09] And they are looking at an intestinal cancer model. But they saw that the mice who received the reuteri grew very rapidly, what they called rich, luxuriant fur [chuckles]. Their skin thickened because of dramatic deposition of dermal collagen, and they maintain youthful musculature and a youthful immune system until death, in other words. So, if a mouse doesn't get-- it gets old, loses its hair, stops mating, gets old and dies. The mice that got reuteri stayed slender, thick hair, stayed young, played with each other, mated. They stayed young until death. Now, they didn't look at this in a longevity way to see if it extended life, but it kept them young until death. And so that's what inspired me at first. I got the microbe. It was actually available commercially as a tablet for babies. And so, the dose was really small.

[00:32:07] And that's why I thought, well, you could take the entire bottle every day, which is stupid, of course. So, I said, let's ferment it. That's what got me started in this yogurt. It's not yogurt, of course, where we ferment it, increase it, and that's how we get about 300 billion. That may be part of the reason, one of the problems we have in the whole microbiome world, we don't have the benefit of dose response data most of the time. So, for instance, there's a very elegant study from South Korea with Lactobacillus gasseri. I believe it's the BNR17 strain. There's like two strains that work for this purpose. The BNR17, the 2055 strain.

Cynthia Thurlow: [00:32:45] We like technical information.

Dr. William Davis: [00:32:47] Well, they compared placebo, no microbe to 1 billion to 10 billion. And the endpoint was waist circumference, placebo 1 billion, no reduction in waist circumference, no change in diet, no change in action, just take this microbe. 10 billion, about three and a half centimeters reduction in waist circumference. And they did cross sectional. It was either MRI or CT, and it showed over 20 cm2 reduction in abdominal visceral fat. Really cool, right? Well, if 10 billion worked, what would 50 billion do? What would 100 billion? What would 5-- Well, we don't know. They like us, we don't have-- let's say your study costs $150,000 to do and you add on different doses. Well, now it's 300 to $450,000. And so, we're limited by budget, so we often don't have dose response.

[00:33:40] I do believe, though, [chuckles] gut sense is that with reuteri, the effective intake is probably around 40, 50 billion or more per day. So, I think that's why we're getting all these wonderful effects that mimic a lot of the mouse experience with the 300 billion. And we'll see if that holds true in clinical trials when funding gets-- becomes available.

Cynthia Thurlow: [00:34:04] Well, and I appreciate your transparency because I think that the general public probably doesn't realize the complexity of having clinical trials and funding for clinical trials, especially if you're outside of a major research institution or doing it privately, there are challenges to this. And so, I appreciate and value that you feel a strong sense of responsibility to do research in these areas so that you'll be able to help more people long term.

Dr. William Davis: [00:34:30] You know, Cynthia, it's really important that we experience all these effects mimic the increased muscle, the amplification of immune response. But I think the biggest thing we accomplished is, and they're going to sound goofy, making people nicer [Cynthia laughs] because what we're seeing is a lot of those effects from oxytocin increase love, the intensity of love, affection for the people around you, generosity, acceptance of other people's opinions. So, in our clinical trials we have, we always include questionnaires on well-being questions. Things like, I am happy with where I am in my life. I am happy with the relationships I have because I think that's the biggest effect I see. At least anecdotally. People say things like “I do the yogurt and my relationship is better. My relationship with my co-workers, I'm more tolerant of their quirks and foibles.”

[00:35:29] “I introduced myself to strangers in line for coffee at Starbucks. I'm less anxious when I have an event to go to. And I used to get social anxiety and now I welcome it. I embrace people, I meet them, I introduce myself.” So, I think that's probably going to be the biggest. Yeah, all those wonderful physiological effects, that's great. But I think one of the biggest things we accomplish is to make us better human beings.

Cynthia Thurlow: [00:35:55] Well, gosh, I say all the time we're still five years out of the pandemic. I think anything that's improving our kindness, our approachability, just being a good social citizen is a huge win. In the book, you talk a lot about how there have been a lot of evolution of dietary recommendations and why it's so important to consider things like organ meats into our diet. What is it about the combination of constituents in organ meats that are so beneficial for our health? Beyond the obvious, like, I think my listeners are knowledgeable, but there were some components to or some constituents that you discuss in the book that I think really caused me to pause and think differently and a little bit more thoughtfully about collagen and hyaluronic acid in particular.

Dr. William Davis: [00:36:44] Cynthia, so much what you and I are talking about is doing nothing more than replacing things that we've lost. So, because of our exposure to antibiotics, we've lost reuteri. I know you're interested in women's health. menopause. Many ladies have lost Lactobacillus crispatus, the dominant microbe in the vaginal microbiome. We abandoned consumption of organ meats like heart, pancreas, brain and skin, and thereby lead a diet, a lifestyle lacking collagen and hyaluronic acid. And those two things play a role. They're important. The FDA says they're not essential, by the way, but I would say-- you would say, oh, yes, they are essential, because if someone gets collagen, it rebuilds the cartilage, because cartilage in your joints is 70% collagen. It reduces wrinkles. Ladies love that because it increases dermal collagen, it reduces abdominal visceral fat and increases muscle mass.

[00:37:40] Hyaluronic acid-- ladies always say to me, “Oh, don't tell me about hyaluronic acid. I know all about it because I put it right here.”

[laughter]

[00:37:45] For $150 a month for an ounce of hyaluronic acid serum. I thought, okay, well, you put it there. What did it do for the skin on your neck or chest or-- nothing of course. The real power of hyaluronic acid is consumed orally, where it goes the dermal layer of skin and adds further to dermal collagen. It adds to moisture retention in the dermal layer. So, you get that plumping effect ladies like. It increases collagen in joints. It also increases the synovial fluid, the lubricant in joints. And so back to our world, a major signaling phenomenon in arteries is the glycocalyx.

[00:38:27] Little hair like projections that line arteries that signal and tell the artery whether they should be constricted or relaxed or develop atherosclerosis. Well, what-- what's that glycocalyx made of? Hyaluronic acid. And how about the uterus, cervix and vagina? What's it made of? Hyaluronic acid. So, here we've been leading a lifestyle, depleted of these very important nutrients. So, all we're doing, Cynthia, right, we're replacing things. That's why we do these things so safely, so effectively, so harmlessly, because we're just restoring things you should have been getting all along.

Cynthia Thurlow: [00:39:01] It's kind of like the way that I view hormonal replacement therapy as we're replacing what our bodies were making naturally. And this is brand new to me. You mentioned that hyaluronic acid is digested by microbes. It blooms into beneficial species and this then increases a very important short chain fatty acid butyrate, that in and of itself is beneficial in insulin sensitivity and reducing inflammation and visceral fat. And that was fascinating to me. I was like with all that I know, I was like, I love learning. And that was completely new to me.

Dr. William Davis: [00:39:36] Isn't that something, Cynthia? Of all the fibers we're told to eat, of course, most people say eat more bran fiber, which is cellulose fiber that's inert. You just poop it out. We're talking about fibers that microbes can digest. Hyaluronic acid is one of the very few fibers that comes from animals. Most fibers come from plants, asparagus, grains, all hyaluronic acid, one of the very few fibers that comes from animal sources. And so, this ridiculous cut your saturated fat, cut your cholesterol nonsense that destroyed the health worldwide, or it was one of the factors, at least. There's other factors, of course, caused everyone to abandon consumption of those two things. And relevant to what I've been talking about lately, very crucial for what I call shape and body composition.

[00:40:26] Where fat is located, how much muscle you have, whether or not it has fat in the muscle, all these things. And so, what we're trying to-- what I'm trying to advocate, of course, is a way to reclaim control over shape and body composition. What I think is probably a far smarter way to think about weight loss, because weight loss is disabling and dangerous.

Cynthia Thurlow: [00:40:49] Absolutely. And I think, you know, certainly in the book, you have made a fruitful argument for being conscientious about the things that we're choosing to do in terms of lifestyle that impact how we-- or how our body composition starts to evolve and shift. Talk to me about microbiota accessible carbohydrates, I think this is fascinating. I think that patients are probably very familiarized with fruits, vegetables and fibrous vegetables. But what specifically do they do in the microbiome that are-- that's so beneficial?

Dr. William Davis: [00:41:29] So I tell people, imagine you tied your dog up in your backyard and you forgot. You come back five days later. How's your dog doing? It's dead. Because you didn't allow it to eat, didn't feed it, or didn't allow it to run wild or whatever. It dies. Well, you got to do the same thing with the microbes in your gastrointestinal tract. You got to feed them. And if you don't, weird stuff happens, such as if you don't have the nutrients for microbes, microbes adapt. And one of the adaptations is an excessive proliferation of species like Akkermansia mucinophila. Mucinophila, mucus lover. And so, you deprive your microbes of fibers. Many species disappear or are reduced in number, become quiescent. Akkermansia loves fibers when you deprive it.

[00:42:22] So in a normal situation, Akkermansia big player in your microbiome, 3%, 4%, 5% of all microbes in your GI tract in the colon. Well, when you deprive it of fiber, it has the added capacity, it's unusual, to consume human mucus, mucinophila and it'll start to digest mucus in your colon and in your small intestine that causes colon-- it takes a while, may take a year and a half, causes colonic inflammation, ulcerative colitis risk goes up, risk for colon cancer goes up. Diverticular disease, endotoxemia is increased. Thereby other effects like rise in triglycerides, expansion of abdominal visceral fat, reduction in HDL, rise in small LDL, brain effects, skin effects, in other words. And that's why people get mad at me. They say, well, I'm a carnivore or I'm ketogenic, I'm keto. Not recognizing that you must get fibers for-- it may take a while.

[00:43:21] People are tantalized by the upfront benefits where I lost 8 inches off my waist, my triglycerides dropped. Yeah, yeah, sure, sure, that's right for now. But long-term bad things happen. And as you know, Cynthia, a fiber free diet, a keto diet is the best studied diet there is because it's been studied for a century. Because children have a reduction in the frequency of grand mal seizures when they go on a ketogenic diet. And it reduces seizure frequency by about 50%. These kids are, you know, they get brain damage from these things. So, what happens to those kids when they go keto? They stop growing. They develop calcium oxalate kidney stones, about 8%. These are kids, kids aren't supposed to get kidney stones. And by the way, calcium oxalate is a disease of the microbiome, sometimes uric acid kidney stones, they sometimes have cardiomyopathies.

[00:44:13] And you know how bad that can be. Occasional sudden cardiac death. They get constipated and they have those undesirable changes in their microbiome. So, we know that-- that's the irony here, despite-- because everybody's so enticed by the weight loss up front and the metabolic benefits, but it's a long-term disaster and I have spent a lot of my days counseling people. So, I did keto for a year and a half and something went wrong. And people say, “Well, you're not doing it right.” Well, yeah, because you're not getting the fibers to nourish microbes. And I do fear it may take 20 years that there's going to be a big uptake in colon cancer because of that consumption of human mucus, the shift in bowel flora composition towards that of biophilia and desulfovibrio. These are colon cancer causing microbes because they produce hydrogen sulfide gas. And so, I hope that's not true, but I think it is true that there's going to be a big rise in colon cancer from these people who if they do these diets too long.

Cynthia Thurlow: [00:45:11] It's interesting to me that I feel like fiber has now become a very polarizing topic of conversation. I was talking to a gut microbiome researcher at an event I was just at and we're joking and I said it's the big F word. And I actually in preparation for promoting my new book, I've had a couple wonderful podcasts that were like, I'd love to bring you back, but we can't talk about fiber because they have a carnivore-ish or carnivore-focused community, or they have a very ketogenic-focused community. And I think that elimination diets in specific circumstances I think can be very beneficial. Transparently, my community knows this, but I had a ruptured appendix in 2019, spent 13 days in the hospital, almost died. And when I say I had-- this is what happens to healthcare providers.

[00:45:59] You end up having every complication known to man. Pan colitis, small bowel obstruction, retroperitoneal abscesses. [Dr. Davis laughs] When I say I had a fistula, I was a hot mess. Thankfully, I was as healthy as I was. But for about 18 months, nine months, definitively, I couldn't eat any fiber. It took me about 18 months to start reintegrating fiber into my diet. And I'm the first person to say now that when a patient tells me they cannot tolerate fiber, sometimes its portion related or it could be the particular item they're trying to integrate. But more often than not it speaks to me now about the health of their microbiome, or lack thereof.

[00:46:38] And when we're thinking about the unique challenges that women experience as they are navigating the loss of estrogen, in particular, how that impacts immune function, the loss of diversity, inflammation, reduction in short chain fatty acid production. I mean, it's this domino effect. When patients tell me they can't tolerate fiber, it's oftentimes a red flag for the health of their microbiome.

Dr. William Davis: [00:47:00] Absolutely. I've seen this go away. [laughs] Or FODMAPs intolerance or histamine intolerance. All these things, I think about-- imagine we talk to our great grandmothers and say, “Hey great grandma, I can only eat seven foods.”

Cynthia Thurlow: [00:47:15] Yeah.

Dr. William Davis: [00:47:15] She says, “What's wrong with you? [Cynthia laughs] There's nothing wrong with the food. There's something wrong with our microbiomes.

Cynthia Thurlow: [00:47:23] Absolutely. So, if someone is listening and they're tipped off by the conversation, they're realizing what Dr. Davis is saying is really resonating. What's the first step for them? Obviously purchase your book because I think it's an incredible resource and it's one that I'm sure I will reference frequently. What would be the first steps when you're working with a new patient, what's the first step? It's probably not-- I think back to my traditional allopathic model in cardiology where, flying by the seat of your pants in a hospital with very acutely sick patients or even in the outpatient environment, there wasn't a lot of focus on lifestyle. We're changing that. But if someone's listening and they're just thinking about baby steps, what's the first couple things they should be thinking about?

Dr. William Davis: [00:48:08] I do Cynthia, I liken it cultivation of the gastrointestinal microbiome to having a nice backyard garden in springtime. So, if I want to have a garden in my backyard, let's say I lay out a 10 by 10 plot, I pick out the rocks and the twigs and the weeds, I plant seeds and then I water and fertilize the growing. And I've got tomatoes and cucumbers and eggplant at the end of the season. Microbiome is the same exact way we're going to prepare the soil, filter your drinking water so you don't get chlorine and fluoride and pharmaceuticals, get rid of pharmaceuticals like the stomach acid blocking drugs, nonsteroidal anti-inflammatory. And there are ways to do this, of course. Avoid processed foods that contain preservatives, antimicrobial preservatives. Avoid emulsifying agents because they emulsify your mucus lining.

[00:48:55] So ice cream, salad dressing, you can still get ice cream and salad dressing, but you're going to either buy safe products or make them yourself. So, we clean up our life, we prepare the soil, and that also means avoiding sugar. That's mostly a fungal overgrowth issue. Then we plant the seeds. Now, people think that commercial probiotics are the seeds. They're not. At least not in their current state. Most commercial probiotics are nothing more than haphazard collections of random microbes. In other words, there's not a lot of rhyme or reason to it. Usually true, there are some products that do have rhyme and reason built into them. But for the most part, a manufacturer, because I help formulate probiotics, I can tell you most will say, well, we think Lactobacillus acidophilus is good. Throw that in. We think Bifidobacteria longum is good, throw that in too.

[laughter]

[00:49:47] And they-- so, that means the current commercial probiotics are not all that helpful. They don't-- they're not harmful, but they're not that helpful. So, what I do is I restore these keystone species, foundational species, but specifically those species we mentioned earlier in this SIBO yogurt. And Cynthia, I'm sorry, I call it SIBO yogurt. Makes it sound like it's only useful for SIBO. It's not. It could have been called restoration of foundational keystone microbe yogurt, [Cynthia laughs] but they colonize the small intestine and colon and produce bacteriocins, so it pushes back all those unwanted species. And we also further cultivate diversity and other microbes by consuming fermented foods like kimchi, kombucha, yogurt you make yourself, not the garbage in the store, kefirs, very easy to do. You can do it on your own kitchen counter. It's almost no cost.

[00:50:43] The crazy thing, the wonderful thing about fermented foods, because the Sonnenberg’s at Stanford have done extensive work in this very helpful stuff, it's clear that the microbes of fermented foods, Leuconostoc mesenteroides, Pediococcus species, they don't take up residence in the human GI tract. Now, what good are they? Well, they somehow cultivate beneficial species. No one knows exactly how or why, but it's probably by cultivating species that were present in very low numbers but hiding in the mucus barrier. And so, you get a bloom in Faecalibacterium, Akkermansia, good levels of Akkermansia, [chuckles] Lactobacillus, Ruminococcus, Lachnospiraceae, all the beneficial species. By consuming that fermented food and then long term we have to just keep the fibers coming and other things like polyphenols that so just eating vegetables and fruits and just real foods, not processed food. That is your-- that's your water and fertilizer.

[00:51:46] And so that's all it takes for the majority of people, though, as you know, there are some people who are hurting so bad. These are the people who say things like, well, I took antibiotics for three years for Lyme disease or I took doxycycline for four years for my acne [chuckles]. And they have massively disrupted gastrointestinal microbiomes and huge amounts of inflammation. Those people may have to go further, but I use the SIBO yogurt as kind of the starting place because of that bactericidal effect. And that seems to work incredibly well. We will validate, I hope, in our clinical trial.

Cynthia Thurlow: [00:52:21] It's really exciting and I've so enjoyed this conversation. Please let listeners know how to connect with you outside of the podcast. How to get access to your new book, Super Body, which I really enjoyed and like I said, given my interest, was completely up my alley. And I love that we both have a cardiology background. Reformed, reformed.

Dr. William Davis: [00:52:43] So my blog is williamdavismd.com, has thousands of articles. I have a YouTube channel. I have a podcast called Defiant Health. The books, of course, Super Body. The Super Body, the focus is this idea of reclaiming control over shape and body composition as a superior way to manage weight, rather than this ridiculous, dangerous idea of just losing weight. The Super Gut book is based mostly on of course, taking control of your microbiome, mostly gastrointestinal, with things like SIBO yogurt and other microbes. That's one of the great things, as you know about microbes is you can get microbes to achieve specific things. If you want to be protected from urinary tract infections, let's get some Lactobacillus crispatus. If you want a better newborn child, let's make sure it gets Bifidobacterium infantis, especially if mom's going to breastfeed.

[00:53:36] If you're an athlete or you engage in heavy physical exercise and you want faster recovery with a reduction in creatine kinase, which you know very well from muscle damage, let's get Bacillus coagulans. In other words, you can use microbes to achieve. It's becoming clear so many conditions are really nothing more than reflections of disrupted microbiome. Calcium oxalate kidney stones, that's a microbiome issue. Gout, uric acid, hyperuricemia, that's a microbiome issue. Depression, suicide, anxiety, these are microbiome issues to a great degree. And so, if I was a pharmaceutical executive, I'd be quaking in my shoes when you see the power of what we can accomplish with managing the microbiome.

Cynthia Thurlow: [00:54:23] Well, thank you for the work that you do. It's been such a pleasure connecting with you and looking look forward to future conversations.

Dr. William Davis: [00:54:30] Thank you, Cynthia. I give you great credit for doing what you're doing, having the courage to do so despite the criticisms of our colleagues.

Cynthia Thurlow: [00:54:37] Absolutely. Isn't that the truth? Oh, but they're coming around, right? They're coming around.

Dr. William Davis: [00:54:42] Yeah. Give it a couple more generations. [Cynthia laughs]

Cynthia Thurlow: [00:54:47] If you love this podcast episode, please leave a rating and review. Subscribe and tell a friend.

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