Revolutionising Liver Health: The Link Between Gut Health, Genetics, and Lifestyle

In this episode, we dive deep into the intricate connections between liver health, gut health, genetic predispositions, and lifestyle factors. Our guest, Gary, a seasoned physician and entrepreneur, shares his extensive experience from pioneering liver disease research in the 90s to running a successful metabolic clinic focused on functional medicine today. Learn about the evolution of understanding fatty liver diseases like NASH and MASH, the impact of processed foods, and the groundbreaking treatments emerging, including the promising effects of GLP-1 therapies. Gary also discusses the pivotal role of a clean diet, exercise, and quality sleep in managing liver health, and the challenges of implementing these changes in a clinical setting. Don't miss this insightful conversation packed with practical advice and forward-thinking approaches to improving liver and overall metabolic health.

00:00 The State of Food Quality in America vs Scotland 02:39 Understanding Fatty Liver Disease: Past and Present 05:29 Genetic and Environmental Factors in Fatty Liver Disease 08:13 The Evolution of MASH: From NASH to Metabolic Health 10:46 Emerging Treatments and Medications for Liver Disease 13:35 The Role of GLP-1s in Managing Liver Health 16:18 The Gut–Liver Connection: A Historical Perspective 19:07 Building a Successful Liver Clinic: Insights and Challenges 33:52 Understanding Metabolic Health and Genetic Testing 35:13 The Importance of Gut Health 37:39 Transforming Workplace Wellness Initiatives 45:48 The Future of Functional Medicine 51:30 Addressing Liver Health and Alcohol Consumption

Takeaways

• The quality of food in America is declining, impacting health.
• Fatty liver disease is increasingly common, especially among those with higher body mass indexes.
• Genetic predisposition plays a significant role in liver disease.
• MASH is a critical condition that combines fatty liver with inflammation.
• Advancements in GLP-1 medications show promise for treating liver disease.
• Gut health is essential for overall wellness and liver health.
• Guy Neff's journey reflects a blend of medicine and business acumen.
• Building a successful liver clinic requires navigating numerous challenges.
• Functional medicine is gaining traction as a holistic approach to health.
• Routine testing for liver health is crucial for early detection and intervention.

You must not rely on the information in this video as an alternative to medical advice from your doctor or other professional healthcare provider. If you have any specific questions about any medical matter you should consult your doctor or other professional healthcare provider. If you think you may be suffering from any medical condition you should seek immediate medical attention. You should never delay seeking medical advice, disregard medical advice, or discontinue medical treatment because of the information in this podcast.

In this episode, Dr. James McIlroy interviews Dr. Ran Blekhman, an associate professor at the University of Chicago, about the microbiome and its role as 'our second genome.'

Dr. Blekhman shares his research findings on the genetic and environmental factors that shape the microbiome, the heritability of microbial genes, and the relationship between the human genome and microbiome. They also discuss Dr. Blekhman's groundbreaking research that analysed over 168,000 samples to understand global microbiome patterns, the influence of early-life microbiome development, and the potential of microbiome-based diagnostics and therapeutics. Tune in for a comprehensive dive into one of the most promising areas of genetic and microbial research.

00:00 Introduction to Dr. R Blackman and the Microbiome 01:23 Podcast Growth and Listener Engagement 01:56 Starting the Conversation with Dr. Blackman 02:04 Exploring the Second Genome 02:24 Human Genome vs. Microbiome 03:23 Genetic Interactions with the Microbiome 04:02 Understanding Microbial Genes and Functions 05:40 Heritability and Environmental Factors 06:53 Microbiome Diversity and Heritability 08:57 Research on Microbiome Heritability 17:18 Baboon Model System for Microbiome Studies 18:56 Population Scale Microbiome Research 25:27 Global Patterns and Data Integration 33:36 The Untapped Potential of Microbiome Data 35:08 Hypotheses and Discoveries in Microbiome Research 36:46 Geographical Variations in Microbiome 49:18 Technical Challenges and Methodologies 52:20 AI and Machine Learning in Microbiome Studies 54:59 Future Directions and Clinical Applications 01:00:38 Exploring Early Life Microbiome 01:03:30 Conclusion and Further Reading

In this episode of Inside Matters, I'm joined by Dr Johan van Hylckama Vlieg, Chief Scientific Officer at Freya Biosciences. As a global leader in microbiome research, Freya is pioneering innovative approaches to women’s health through biotherapeutics that are rooted in groundbreaking microbiome science.

00:00 Introduction to Dr. Johan van Hylckama Vlieg and Freya Biosciences 01:39 The Potential of the Microbiome 03:08 Challenges in Translating Microbiome Science to Treatments 05:29 The Rise and Fall of Microbiome Hype 08:58 Immunotherapy and the Microbiome 20:37 Women's Health and the Microbiome 35:01 Tools for Measuring Vaginal Dysbiosis 35:31 Intervention Studies and Donor Programs 36:23 Engraftment and Immune Response 37:39 Strain-Level Analysis and Engraftome 39:08 Vaginal Microbial Transplantation 44:13 Single Strain vs. Consortia 47:15 Freya's Development and Future Vision 50:04 Lessons from Kaleido 01:00:47 The Gates Foundation and Global Health 01:03:45 Predictions for the Microbiome Field

Dr van Hylckama Vlieg has spent more than 20 years exploring the vast and complex world of the microbiome — the trillions of microbes that live in and on our bodies. These tiny organisms play a huge role in our health. Over time, science has moved from simply identifying these microbes to understanding how they influence our immune system, metabolism and overall wellbeing.

Yet despite this progress, turning those discoveries into real treatments remains a challenge. Dr van Hylckama Vlieg explained that while the science is compelling, the industry needs solid clinical data to bring investors and pharmaceutical companies on board. He sees microbiome-based immunotherapy as a particularly exciting area where transformative breakthroughs could lie ahead.

Freya Biosciences has chosen to focus on the female reproductive tract — a part of the body where the microbiome is less complex than in the gut but just as important. Dr van Hylckama Vlieg spoke about the key role of lactobacilli in maintaining vaginal health. When these helpful bacteria are dominant, they protect against infections and support fertility. When the balance is lost, a state known as dysbiosis, the risks rise significantly.

He also highlighted a wider issue — the historical lack of funding and focus on women’s health. This is something Freya and others in the field are determined to change, and their research is already moving things in the right direction.

One of Freya’s most innovative developments is vaginal microbiota transplantation or VMT. Inspired by the success of faecal microbiota transplants for gut health, this approach involves transferring a healthy vaginal microbiome into someone with dysbiosis. Early results are promising. Many women show a successful shift to a healthier microbial state.

Looking ahead, the goal is to leverage the successes of these natural transfers and develop targeted microbial treatments that can be scaled up. This could lead to safe and widely available therapies that restore balance and improve reproductive health.

Reflecting on his previous experience at Kaleido, another microbiome venture, Dr van Hylckama Vlieg spoke about the need for strong links between science, clinical design and commercial strategy. Though Kaleido faced setbacks, the underlying science remains solid and is being explored by others in the field.

His outlook remains positive. With more trials underway and deeper understanding of how microbiomes influence disease, there is hope that these therapies will move from the lab into everyday medicine. Particularly in areas like immunotherapy, the potential to address root causes rather than just symptoms could be a game-changer.

Dr van Hylckama Vlieg’s insights offer a compelling look into a rapidly evolving area of science. As researchers and companies like Freya push forward, the possibilities for transforming healthcare through the microbiome are growing fast. From improving fertility to preventing infections, these tiny organisms may hold the key to better outcomes for millions — especially in areas of health that have long been underserved.

The Gut-Health Revolution | Dr Chris Damman on Nutrition, Microbiome & the Future of Wellness

Dr Chris Damman brings decades of experience from the biotech world and leading global foundations to share his vision for the future of health and nutrition. In this episode, we dive deep into the transformative power of gut health and the emerging science shaping how we eat and live.

Gut Health: Ancient Wisdom Meets Modern Science Dr Damman explains why gut health is central to well-being, describing it as a “full-circle” return to ancient wisdom where food is medicine. Backed by science, he shows how whole foods can prevent disease and support healthier lifestyles, without being restrictive or unrealistic.

Next-Generation Nutrition: The 4 Fs We explore the idea of “next-generation nutrition” — simple, practical ways to improve your diet with fibre, polyphenols, healthy fats, and fermented foods (the “4 Fs”). These ingredients, found in traditional diets around the world, play a key role in promoting longevity and gut health.

GLP-1 Agonists: A Promising Yet Cautious Path Dr Damman discusses the potential of GLP-1 agonists — groundbreaking drugs that help manage appetite, weight, and blood sugar. While powerful, he emphasises the importance of pairing them with real dietary change to avoid over-reliance.

Weed, Seed, and Feed: A Gut Health Strategy Using the analogy of gardening, Dr Damman breaks down how to support your microbiome: weed out the harmful bacteria, seed the good ones, and feed them with the right foods. This holistic model offers a sustainable approach to digestive health.

Fermented Foods & Probiotics We also cover the role of fermented foods as natural sources of probiotics and why they may be more effective than many commercial supplements. These foods are vital for balancing the gut and reducing inflammation.

The Future: Nutrition Tech & Smarter Choices Dr Damman is now focused on innovation, developing a smartphone app that helps people make smarter food choices by understanding nutritional quality at a glance. His work blends science and technology to make healthy eating both accessible and personalised.

Conclusion Dr Damman’s insights are a refreshing mix of practical advice and scientific depth. From diet to digital tools, he shows how we can all take charge of our gut health and live longer, healthier lives. Look out for his upcoming book and app, designed to change the way we think about food.

Chapters: 00:00 – Introduction to Dr Chris Damman 01:36 – What is Next-Generation Nutrition? 05:01 – How the Microbiome Journey Began 10:20 – Malnutrition and the Four Fs 17:59 – The Truth About Ultra-Processed Foods 23:22 – GLP-1 Agonists: Are They a Game Changer? 28:45 – The Future of Nutrition and Health 35:49 – Smarter Choices with Nutrient Profiling Tech 40:38 – How to Balance 'Red' Foods in Your Diet 42:11 – Healthier Baking: Tips That Work 43:25 – Personalised Diets for Your Microbiome 46:12 – Understanding FODMAPs and Gut Symptoms 51:51 – Microbiome Therapeutics and Supplements 01:01:38 – What’s Next for FMT (Faecal Microbiota Transplantation)? 01:05:00 – Gut Health Technology on the Horizon 01:10:55 – Final Thoughts and Takeaways

Irritable bowel syndrome (IBS) is often brushed off as little more than an inconvenience. But in a recent conversation between Dr James McIlroy and Professor Yan Yiannakou, a consultant gastroenterologist with decades of experience, it’s clear that IBS is far more serious than many realise. Their discussion sheds light on the true impact of IBS and the exciting developments in its treatment.

IBS: A Closer Look

Affecting around 10–15% of the population, IBS can be life-altering for some. Beyond the discomfort, it can seriously disrupt work, relationships, self-confidence, and mental health. Historically, because there was little visible evidence of physical disease, IBS was wrongly considered a psychological condition. Thankfully, this outdated view is changing. New research highlights real physiological changes in the gut, such as immune activation and heightened sensitivity, helping to validate patients’ experiences.

Recognising the Symptoms

Professor Yiannakou explains that IBS typically involves abdominal pain, changes in bowel habits, bloating, and excess wind. Previously labelled a “syndrome” because its causes weren’t well understood, IBS is now recognised as a real disease linked to changes in the gut microbiome and immune system. Symptoms can vary from mild discomfort to severe, debilitating pain that significantly affects daily life.

Breaking Down Misconceptions

A key part of the conversation tackles the myth that IBS is “all in the mind.” While stress can worsen symptoms, it is not the root cause. Dismissing IBS as purely psychological can deepen patients’ distress and delay proper care. Professor Yiannakou stresses the importance of treating IBS as the genuine, physical condition it is.

What Causes IBS?

Although the exact causes are still being explored, IBS often develops after a major gut infection, which can disrupt the gut’s immune system. Treatments are now moving beyond simply managing symptoms like constipation or diarrhoea, with more focus on addressing underlying causes, particularly gut microbiome imbalances.

Hope for the Future

Research into the microbiome’s role in IBS is opening up new treatment options. Early trials of microbiome-based therapies show promising results, but more work is needed to bring these breakthroughs into everyday clinical practice.

Final Thoughts

Professor Yiannakou’s insights highlight the urgent need for better recognition and treatment of IBS. Dispelling outdated myths and focusing on the true physiological causes of the condition offers real hope for those living with IBS. As research continues, the future looks brighter for more effective, lasting treatments.

The conversation touches on everything from genetic influences on obesity and the challenges of sustained weight loss, to the exciting potential of GLP-1 drugs and next-generation probiotics. There’s also a fascinating look at how the microbiome might act as both a diagnostic and therapeutic tool in future medicine.

Finally, Max shares highlights from his book The Power of Hormones, which brings together history, science, and practical advice for anyone curious about how hormones and the microbiome shape our lives.

This episode offers an insightful look at where cutting-edge science meets real-world potential—and why the microbiome could be the key to a healthier future.

Timestamps:

00:00 Introduction to Professor Yan Yau and IBS 01:02 Understanding the Impact of IBS 02:19 Symptoms and Diagnosis of IBS 04:41 Physiological Causes of IBS 06:29 Severity and Psychological Impact of IBS 09:31 Potential Causes and Triggers of IBS 14:22 Current Treatments and Challenges 16:30 Future of IBS Treatments and Research 40:39 Clinical Trials and Patient Involvement 42:32 Conclusion and Final Thoughts

In this episode of Inside Matters, Dr. James McIlroy sits down with Cory Greenberg, a professional cyclist and founder of Ride4IBD.

Cory shares his inspiring journey from his initial diagnosis of inflammatory bowel disease (IBD) while training as a professional cyclist, to overcoming the challenges posed by the disease. The conversation covers his approach to gut health in the context of athletic performance, insights into training and lifestyle adjustments, and his efforts to raise awareness through Ride for IBD. Listeners will gain valuable insights into how Cory manages his condition, optimises his performance, and aims to inspire others facing similar challenges.

Through his story, Cory emphasises the importance of creating a sustainable lifestyle and offers practical advice for those living with IBD or looking to improve their gut health.

00:00 Introduction to Cory Greenberg and Ride for IBD 01:09 Cory's Early Passion for Cycling 03:39 Development Programs and Training 11:15 Diagnosis and Struggles with IBD 15:46 Managing IBD and Returning to Cycling 20:04 Diet and Nutrition for Gut Health 37:00 Practical Tips for Gut Health 41:16 Debunking Social Media Health Myths 41:44 Personal Struggles with IBD 43:16 Understanding Inflammatory Bowel Disease 44:54 Cycling as a Platform for IBD Awareness 45:39 The Genesis of Ride for IBD 47:13 Building a Global IBD Awareness Movement 50:10 Innovative Approaches to IBD Management 55:20 The Future of IBD Advocacy and Support 59:42 Practical Health and Fitness Tips 01:13:32 Connecting with Ride for IBD

In this episode of Inside Matters, Dr James McIlroy explores the remarkable evolution of Faecal Microbiota Transplantation (FMT), from its unlikely beginnings to its promising future—and shares exciting new data from his company, EnteroBiotix.

We begin with the pioneering efforts of Mr Ben Eisman in 1958, whose early use of FMT saved lives in cases of severe diarrhoea. From there, Dr McIlroy takes us through decades of progress, culminating in today's pharmaceutical-grade approaches that are changing the face of gut health treatment.

The conversation spotlights the dramatic effectiveness of FMT in tackling recurrent Clostridioides difficile (C. diff) infections and dives into the expanding potential of microbiome therapies for a range of conditions.

James also shares exclusive insights from EnteroBiotix’s recent phase 2 trial, which delivered encouraging results for a next-generation, FMT-based therapy targeting Irritable Bowel Syndrome (IBS). Designed to be scalable, consistent, and patient-friendly, this new approach marks a significant step forward in microbiome medicine.

This episode is a deep dive into one of the most fascinating areas of modern healthcare—and a look at where we're headed next.

Timestamps:

00:00 – The pioneering work of Mr Ben Eisman 01:55 – Understanding C. difficile and FMT 03:03 – Modern breakthroughs in FMT 05:06 – Challenges and innovations 07:25 – EnteroBiotix’s next-generation solution 11:12 – Clinical trials and promising data 14:04 – What the future holds for FMT 17:05 – Final thoughts

In a fascinating conversation with Professor Max Nieuwdorp of the Amsterdam Medical Centre, Dr James McIlroy explores groundbreaking ideas and research surrounding the microbiome, hormones, and their profound impact on metabolic diseases. This insightful dialogue uncovers the remarkable potential of faecal microbiota transplant (FMT) and emerging pharmaceutical strategies in tackling obesity, diabetes, and even cancer.

Timestamps:

The Journey into Microbiome Research

Professor Nieuwdorp's interest in the microbiome began serendipitously during his postdoctoral studies at UCSD. There, he encountered revolutionary ideas, particularly through the work of Jeffrey Gordon, which highlighted the significance of the microbiome long before it became widely acknowledged. An unforgettable early success with FMT on a patient with Clostridium difficile infection set the foundation for his enduring commitment to this field. Over the years, Nieuwdorp has been involved in pivotal studies, evolving his understanding of how microbiome therapies could be used in metabolic diseases and beyond.

Understanding FMT and Its Role

FMT has shown remarkable efficacy, especially in treating infections like Clostridium difficile. The discussion highlights an astounding 90% cure rate demonstrated in early trials, a feat Nieuwdorp describes as "seminal". Nonetheless, expanding this success to metabolic conditions such as obesity and autoimmune diseases remains a promising, yet ongoing, challenge.

The Nexus Between Microbiome and Obesity

While the connection between the microbiome and obesity remains a complex issue, Nieuwdorp emphasises how the microbiome's role in weight control is likely more significant over the long term—akin to directing an oil tanker—than as a quick fix. The conversation delves into why the body finds it easier to gain weight than to lose it, considering genetic predispositions and evolutionary pressures. This adaptability of the microbiome, combined with dietary habits, may significantly influence how our bodies metabolise and store energy.

Revolutionary Treatments on the Horizon

Emerging pharmacological treatments such as GLP-1 agonists are causing waves in medicine. These drugs, alongside the potential of next-generation probiotics, promise to reshape how obesity and associated conditions are treated. Intriguingly, research continues to suggest the microbiome might itself produce GLP-1, hinting at a future where therapies target these microbial mechanisms directly.

The Path Forward: Microbiome as a Predictive Tool

Professor Nieuwdorp envisions a future where microbiome profiling becomes a standard diagnostic and preventative tool. It has the potential to predict disease susceptibility, allowing for earlier and more personalised interventions. In parallel, the continued development of FMT and its derivatives may revolutionise treatments for a range of conditions, from cancer to metabolic disorders.

The Educational Perspective: "The Power of Hormones"

In addition to his pioneering research, Nieuwdorp shares insights in his book, The Power of Hormones, presenting a layperson’s guide to understanding hormones across a lifespan. This book interweaves historical narratives with scientific discussion to elucidate how hormones and the microbiome intersect in influencing daily life.

This extensive dialogue with Professor Nieuwdorp is a testament to the potential of microbiome science and the exciting horizon that awaits both researchers and patients. As innovations continue, integrating microbiome knowledge with traditional medical interventions could profoundly change how we understand and treat human health.