Ubiome: Tests & Tools for a Healthy Microbiome Guest: Jessica Richman The purpose of this presentation is to convey information. It is not intended to diagnose, treat, or cure your condition or to be a substitute for advice from your physician or other healthcare professional. Dr. Kellman: Hello, everyone. I'm Dr. Raphael Kellman from KellmanCenter.com. I am excited to welcome you to this amazing segment of The Microbiome Medicine Summit. The microbiome and its role in maintaining health and healing disease is one of the greatest medical discoveries in modern medicine. We are so excited to share key insights that will help you uncover the unseen root causes of your health issues. According to research, we are made up primarily of bacterial cells that control virtually every aspect of our physiology. And in this segment as well as throughout the summit, we will shatter the myth that bacteria are the enemy, and you will see that, in fact, these bacteria of the microbiome are actually your greatest allies when it comes to improving health and will enable you to activate your highest potential. With that said, let me introduce our special guest, Jessica Richman of ubiome. And we're going to address the importance of testing and seeing your unique microbiome, seeing what it's all about and learning really from people, from an organization, that was there from the get go when all the microbiome research began to flourish. But before we speak before we discuss and have this conversation, a little bit about Jessica. So Jessica Richman is the co-founder and CEO of ubiome, a startup that uses big data and citizen science to understand the human microbiome. Jessica 2016 The Kellman Center for Integrative and Functional Medicine. All rights reserved. 1
attended Stanford University where she studied economics and computer science and at Oxford University where she studied as a Clarendon Scholar also receiving a Fullbright Scholarship for further studies. Along the way, she worked for Google, McKinsey, Lehman Brothers, the Grameen Bank, and top-tier Silicon Valley venture firms as well as other entrepreneurial projects and adventures. Her work has been published in the New York Times and other national publications and has been featured in dozens of media outlets. She has spoken at many conferences including TEDMED. So Jessica, thank you so much for being part of The Microbiome Medicine Summit. Jessica: Absolutely. I'm excited to be here. Thanks for having me. Dr. Kellman: Great. And I know you're going to contribute so much. So tell us how did ubiome come to be and why people should be taking a ubiome stool analysis. Jessica: So that's a great question so about how ubiome came to be, we actually started with a crowd funding campaign right after the NIH funded Human Microbiome Project ended which was in late 2012. At that point only the NIH had started this and finished this $173 million huge project to better understand the human microbiome. And they'd only looked at 242 people. And we thought in the age of the Internet, that's not even the number of friends on your Facebook friends list and we could definitely do more and crowd sourced this collection of data to get a big data sets and learn more about the human microbiome. So we did a crowd funding campaign on Indiegogo. And then in ten weeks we had over 2,500 people which we then and over $350,000, which funded us for the first year of operation. And we gathered and then we continued to go from there to a much bigger data set. But we gathered this big data set, better understand the microbiome, and then make useful and interesting products and services for people. So 2016 The Kellman Center for Integrative and Functional Medicine. All rights reserved. 2
what we currently have is a consumer product that helps you better understand your microbiome so a lot of people use it to test before and after a specific intervention. Some people will say change their diet. For example, go on the microbiome diet. And they will say let's test before you go on the diet and then after so you can see how the composition of the overall microbiome changes. So the diversity of your microbiome, the types of microbes that are there. People also use it when they take probiotics or prebiotics. [Inaudible] or they're just trying them out. And people can say, Okay, I've taken my probiotic for thirty days. Does it actually change something in my gut or not? You can see the difference. So we've also set up a clinical So the current test that you get it s not a clinical test it's a research personal citizen science research only to do experiments on yourself. It's not so, just to answer health and wellness questions. We do have a clinical test that we re developing. I'd love to tell you more about that once we get down into some details. But that will be a test ordered by a doctor, processed in a clinical lab that will enable you to have some medical level information about your microbiome. Dr. Kellman: So, Jessica, what are the types of microbiomes that you're finding and how are you defining healthy microbiomes versus unhealthy microbiomes? Jessica: That's a very good question. So there isn't a medical consensus on what a healthy microbiome is. Dr. Kellman: Yeah, that's why, Jessica, I said healthy microbiomes, that there are many, but is there some pattern? Jessica: That's a great question. Yeah, it's a really good question. So it's wellknown scientifically that a diverse microbiome is a healthy microbiome, for the gut microbiome, that is. And there are certain bacteria that are generally rare, but in the diverse the microbiome, you'll definitely have them. So we have a diversity score that people can look at, and we have for the tracking the 2016 The Kellman Center for Integrative and Functional Medicine. All rights reserved. 3
changes in the microbiome, for example, if you're taking a specific probiotic, we can look for that specific bacteria in your gut. So I think at this point scientifically certainly saying you are healthy and you are not the same way that you can for levels of thyroid hormone or something like that where it's very clearly well understood what is the normal range. But that's something that our research helps us lead in that direction. And I think in the meantime what people can do is see what's healthy for them on an individual level. So people can say, okay, here's when I have these symptoms. Here's when I may need intervention. And then here's how my microbiome looks after those interventions. You can identify a personalized healthy baseline. Dr. Kellman: So what are you seeing? Let's say someone comes back to you and says, "You know, I put in these new probiotics. I followed a certain type of diet, a microbiome-oriented diet. I'm feeling better." What may you see when you actually look into the bacteria of the microbiome? Jessica: Oh, so you might see in certain instances, we've had people have some very interesting effects. So you might see an increase in the diversity of the microbiome. That's a pretty clear one. You might see a change in the function of the microbiome, as well. So one of the things that we also track in addition to you have this specific bacteria are the functions of those bacteria. So we have, for example, you might see a switch to more fat-metabolizing bacteria as opposed to carbohydrate-metabolizing bacteria when people are on a lower carb diet. And we can see those changes there. So people can see how their microbiome's responding, and they can also see how they compare to other groups. For example, to a group of healthy omnivores which we use as, there's no scientific definition of those, but we use that as a good baseline of what your cohorts of other people have in their microbiome. So I would say there are two ways of using it. One is to compare yourself over time after an intervention, to 2016 The Kellman Center for Integrative and Functional Medicine. All rights reserved. 4
see the differences. And the other is to compare to that group that can then say, Wow, why am I so out of whack on this one bacteria? Why am I so out of whack in terms of my diversity? Let me try some interventions. Dr. Kellman: It's a great mirror to really reflect back to us how we're doing, what kind of progress are we really making. Wonderful. Jessica: That's actually just to sort of add on to that point, it's kind of a shame that the most sophisticated technology we have at this point for better understanding our diet, our health, and the complex interactions in our gut is a scale. How old is that? 400 years? So this is really just like you said like a mirror, like a scale. Dr. Kellman: It's phenomenal. So in other words, you're seeing changes in the percentages of different bacteria in the microbiome when someone makes a dietary or a supplement change? Jessica: Exactly. That's right. Dr. Kellman: So let me ask you, Jessica, what's some of the most fascinating things that you guys discovered through testing so many microbiomes out there? You guys are really at the frontier. Jessica: That's a really good questions. Yeah so individual scientists are doing important studies on their microbiome. And we also work with a lot of researchers who are finding have interesting hypotheses, which also take a bit longer because there's a study cohort and there's you can't really release information until you've published it. But in terms of what we've found in individuals, we've got some fantastic blog posts of people who found some really interesting things. So we have a power user Richard Sprague who's done a really interesting experiment with prebiotics and sleep. So there's this idea that if you eat potato starch, you will increase the levels of bifidobacterium and then have better sleep. 2016 The Kellman Center for Integrative and Functional Medicine. All rights reserved. 5
So he took potato starch and tested his microbiome and sure enough you could see the change in his microbiome and also correspondingly you could notice the change in good as sleep tracked by a sleep tracker. So it's one of the things where you hear that it might work. Oh, it's supposed to increase certain levels of bacteria, but then you actually see it. Dr. Kellman: Now, what type of bacteria do you start to see when someone was supplementing with potato starch, which is a resistant starch that can help? Jessica: Exactly. Dr. Kellman: So what did you see? What kind of new bacteria did you see flourish? Jessica: So I remember it was a type of bifidobacteria. Dr. Kellman: Bifido, yeah. Jessica: Yeah, it was type of bifidobacteria. But it's in a blog post on our site, and people should take a look at it and check it out. Just Google "Richard Sprague and ubiome. And I'm sure it will come up. Yeah, so there's that one. There's also another really interesting study that intrigued me a lot is a study that we did with a researcher at University of North Carolina, Chapel Hill. And she has this hypothesis that eating disorders are actually caused by the microbiome. Dr. Kellman: Eating what? Jessica: Eating disorders. Dr. Kellman: Oh, eating disorders! Jessica: Yeah. So there's this really interesting idea that a lot about the gut- 2016 The Kellman Center for Integrative and Functional Medicine. All rights reserved. 6
brain connection and how some things we think of as mental health issues may actually be gut health issues. And it's one of those crazy hypotheses. When I first heard it, I was like, eating disorders? How could that be possible? But she's had some really interesting research around suggesting that that might be the case, and we were able to help her by helping her as her cohort and bring in the Google people to test their microbiomes, also do an extensive survey and see if we could find something. And really, for me, that's the kind of research that I started ubiome to do. It's like someone has a really interesting idea. And we can test it easily for them and just start to figure out what's true and fill in the Typically in science it's very hard to get things like this done because you have to be a very well-respected researcher and a very fancy institution, and you have to apply for your grant. And you have to get it. And the rate of NIH grants given is like 8%. So just the chances that you'll get your questions answered that's interesting and promising is perhaps a little bit maverick, are really low. But in the case of citizen science, you can do things like answer those kinds of questions very easily. And then it can point to further research, which then leads to a much more heavy duty type of investigation. But that's one of the things I love is that not only can you do your individual research about your crazy hypothesis, not you personally, but all of us out there, but also researchers. Dr. Kellman: Sure. Now Jessica, let's tell our listeners the difference between getting a stool test and getting a ubiome test. Jessica: Absolutely. So one thing I want to clarify is that current consumer product that you can get at ubiome.com is a personal research tool. It's kind of a Fitbit for your gut, if you will. It's a quantified health factor. It's not a clinical stool test so that's one major difference there. 2016 The Kellman Center for Integrative and Functional Medicine. All rights reserved. 7
The other is that we use a very simple collection technique, which is not gross as poop. Let's put it that way. You just take a swab of your toilet paper. You don't have to spread Saran wrap on your toilet and do all these gross things that people used to have to do. And then in terms of results, we have a much more of a select technical method that we use that allows us to understand to give data back on thousands of bacteria, as opposed to having a culture-specific ones and then pretty much report them one by one. Because the current tool is a quantified self-test where we tell you about health and wellness, we're developing some clinical test that we haven't announced to the public what they're going to be and how they're going to be structured, but we have a clinical lab set up. And that will allow us to use the same sorts of techniques that we're using to do the consumer test but on a clinical level so that they be ordered by a doctor, and the results would be medical results as opposed to a personal quantified self tool. Dr. Kellman: And how would it be different? Because you're still reporting on all the bacterial genes in the microbiome. Jessica: So without giving too much away, the goal of the test would be to give results that have more known clinical implications Dr. Kellman: I see. Sure. Jessica: And that doctors can use in their practices as opposed to more of a quantified self tool. So on the consumer side we stick very much to health and wellness questions like I would say earlier how did you diet affect your microbiome, resistant starch, how does that affect your microbiome, things like that, as opposed to clinical results where we tie them back to specific research about the microbiome. And they're intended to be used by a doctor with their patient. I shouldn't say much more. 2016 The Kellman Center for Integrative and Functional Medicine. All rights reserved. 8
Dr. Kellman: No, I know. I didn't mean to pry, but I just wanted to get a general idea. Now, Jessica, is there something (or many things) that you guys from ubiome have learned by actually seeing the microbiome face-to-face that may contradict some of the advice that people are receiving because of perhaps some of the studies or perhaps because is just became common knowledge without really having great studies behind it? Anything that surprised you? Jessica: So I think this will come as no surprise to some people, but it will come as a great surprise to other people about probiotics, for example. So probiotics is a huge industry ($30 billion industry just in the U.S. alone every year, $30 billion), and most probiotics it's sort of unclear if they work or not and who they work for and did you get a good bottle or a bad bottle. It doesn't have the kind of quality control that you would have for a pharmaceutical product, for example. So I think maybe of the open secret of the probiotic industry is I don't know it's going to work or not. So I think there's a lot of testing and that's one of the things that we hope to do going forward is looking at specific probiotics, who they work for, who they don't work for, why, which ones work most often, things like that. I think that will be really valuable not only to the probiotics industry to make better products but also to the public to be able to say okay, this is 67% of people who use this probiotic had better results than the people who didn't use this or whatever. And that way we can really start to say how can we help people heal their guts and give people much more specific advice than, Oh, go to Whole Foods and buy something. Dr. Kellman: Right. Right. And then Jessica, it's not uncommon that people actually take the wrong probiotic, when you're trying to reduce inflammation. Oh, I got a probiotic in the health food store. What are they getting? They're getting something that is likely to provoke inflammation. So this is incredible that the ubiome organization/company is going to not only evaluate who 2016 The Kellman Center for Integrative and Functional Medicine. All rights reserved. 9
probiotics may work for, in other words what condition your gut is in if it will work for you or not but also what types of probiotics will work for what types of health issues that you have, right? Jessica: Exactly. Dr. Kellman: In other words, one size does not fit all. Jessica: Exactly. That's an area that has just suffered from lack of data. It's not really their fault of the probiotics industry that these types of studies haven't been possible to do until a few years ago, and they haven't been cheap to do, right? So it's the kind of thing everyone can just do and learn about until we started offering these kinds of tests and gathered that kind of data. But I think you're absolutely right. This is field that's just crying out for more data. Dr. Kellman: Incredible. Jessica: We just need to know what works and what doesn't. Dr. Kellman: It must be so exciting to work for ubiome. Jessica: It really is! No, it's so funny. I was talking to a friend of mine a few weeks ago and the guy goes, "I've never heard anyone so excited about the microbiome." Yeah, that's so true. It's not like a normal dinner party conversation. Dr. Kellman: Well, it is, if people would know why. I always say, "Why am I so excited?" Because it's a revolution. It's an incredible revolution, changing the bottom line which is a whole other discussion. Jessica, if I was working for ubiome, tell me how I apply by the way at the end, I'll tell you it's great. I love it. I want to tell you something. I want to tell you something. If I was working for ubiome, this is a study that I would propose, okay? I like to look for the 2016 The Kellman Center for Integrative and Functional Medicine. All rights reserved. 10
footprints of the microbiome, and I'll explain what that means. In other words, you said this. I said this. Many other people are saying it. There's no such thing as a healthy microbiome. There are likely many healthy microbiomes, just like there's no such thing as one unhealthy microbiome. There's probably loads of unhealthy microbiome. But one way that I look to see if someone's unique microbiome is healthy or not is let's look at its footprints. In other words, let's look at the effects it's having on us its partner, the human being. And are we seeing high markers of inflammation like CRP, interleukin-6, TNF-alpha? Are there autoantibodies to various disorders? And then some other markers, which I'm not going to get into now. And then based on that I make certain assumptions irrespective sometimes of what I see on the stool test whether their microbiome is healthy. What I would like to do, a study that I would like to do to see is this true, is there real consistency between abnormal/unhealthy blood markers let's say of inflammation in the person's blood test and some fundamental problem in the actual microbiome that you test at ubiome. Any thoughts on that? Jessica: My thought is that that's brilliant, and we should do it. Dr. Kellman: Yeah? Jessica: One of the reasons I created this company is that citizen science, no, I'm not just saying that. We definitely do that. One of the reasons we started this company is exactly that. Okay, so I may have to look in the literature to see what kind of research has been done. Dr. Kellman: Oh, I could tell you that. I could tell you. That's what we do all day. Jessica: But what we could do is we could just say, okay, great, get your blood tested with the service using these parameters for this type of patient. 2016 The Kellman Center for Integrative and Functional Medicine. All rights reserved. 11
Also get ubiome tested. We'll take a look at those types of data and see what correlations there are. The advantage of being able to involve the public in this kind of science and do it on a large scale is exactly that. So when this is over, I ll put you in touch with some great people. And let's do this. Dr. Kellman: That's great. Jessica: And then we'll somewhat actually have some good data and that we can hopefully publish and will also help us better understand those kinds of questions. Dr. Kellman: Oh, this is going to change everything. This is so incredible. Jessica: Yeah. Dr. Kellman: So now, Jessica, now look you guys are at the frontier so you're in a great position to tell us a little bit about how the microbiome will revolutionize health and medicine and life. Jessica: Yeah, so that is a great question. So I think that a lot of our understanding in medicine necessarily is based on the data that we have. So we look at specific culture pathogens and we say Oh, that must be the cause of everything. Or when genomics could first when the human genome was first sequenced, people said, Everything s caused by genes. Or when people look at dark sections of DNA, they say, Oh, those sections of DNA don't do anything because we don't know what they do. So there's not necessarily this histological confusion where you thing the tool and measurement is the object that you're measuring. And I think that what these new types of tools like sequencing the microbiome will allow us to do is we'll probably still have that bias but we'll be able to have totally new sets of data to look at that will help us figure out what the landscape is. So I think very that the larger consequence of that is that, I hope, that medicine will move much more to a paradigm around prevention 2016 The Kellman Center for Integrative and Functional Medicine. All rights reserved. 12
and around complexity and gardening versus war is the metaphor instead of trying to kill things in your microbiome. Dr. Kellman: Right. I use the analogy pruning. Pruning the vineyard. Jessica: That's great. That's exactly. Pruning the vineyard. That's right. And I think that's a much more accurate representation of what's been going on in our bodies. We really are creatures of homeostasis, and we're creatures of a complex system that's part of my background. And my studies at Stanford and Oxford are complex systems. And we really are this complex system. So if you go with an intervention like an antibiotic and we slash and burn parts of the complex system, then there are unintended consequences in other parts of the system. So I hope that I get to some of it. I hope that medicine becomes more complexity- and prevention-oriented and that it becomes much more cognizant of ramifications of interventions that look like they're doing something good over here but when you look at the whole system, these are causing a lot of problems over here. And then specifically in terms of the microbiome, I think that we'll just discover that a lot of things that we thought were something else are actually microbiome problems. So whether those are autoimmune disorders. There's some research that came out on autism. And it might be at least a gut-related implication. Things that we don't think are infectious diseases may turn out to be infectious diseases. So I think there are a lot of overturned hypotheses that we think we're looking at one kind problem. We're actually looking at another one. Kind of the same way with cancer, for example, we used to think there was cancer. Now, we know there's a thousand different cancers, and they're all totally different. And that's because we can now see there's a tumor and see what it is. And I think this is very similar where things that we thought were one thing actually turn out to be a hundred different things that we have to think 2016 The Kellman Center for Integrative and Functional Medicine. All rights reserved. 13
about and categorize those hundred different things. Dr. Kellman: So when you say that something that we thought was not an infection or its origins was not due to an infection and maybe it is an infection, are you saying that there's an overgrowth of a certain bacteria in the microbiome? Is that what you mean? Jessica: I think that's one example of that. Absolutely. I think another example would be like in the instance of H. pylori where people didn't think that that was an infectious disease, and it is. So ulcers were thought to be caused by stress and all this and now it's clear that there's a very strong agent that's part of that's causing problem. And I think that that's true, not to characterize it too simply, but there's definitely a component that people didn't understand before. And I would say the same thing may lead to other health conditions where it was thought that it was an autoimmune problem, for example, but actually it's an infectious agent problem. Or it was thought that it was just a syndrome that nobody understood and maybe it's all in people's heads, but it turns out it's actually a virus. I think there's some really interesting candidates for that, and I can't say yes, that is true at this point. Dr. Kellman: But, Jessica, in the end, if the bacteria that started to significantly overgrow and became an infection, its origins was in the microbiome likely, as well, right? Jessica: Yeah, absolutely! So that's a really interesting point. So this is some research that we're starting to do with the CDC that I'm really excited about. Their research questions are asked was are there some people who are more susceptible to getting hospital-acquired infections? That was their interest. But for that matter, it could be any other type of health condition. Are there some people that are more susceptible due to the analysis of their microbiome to start with? To identify who the high-risk people are before they even get infected because you know their microbiome is disrupted, you're much likely 2016 The Kellman Center for Integrative and Functional Medicine. All rights reserved. 14
to get an infection. And I think the answer to that is, we haven't done that piece of research yet, but I think the answer to that can that happen, absolutely, yes. The question is how and who, and how do we measure it and all those kinds of things are the more in-depth, careful questions you have answer. But from the perspective of can an imbalance lead to an overgrowth, which then leads to symptoms that we than call something totally different [inaudible], yes. So I think that happens a lot. Dr. Kellman: Jessica, so it's possible that even in so-called infectious diseases is really at the core really a microbiome problem. Jessica: Yeah, that's exactly right. So we've been looking so much at the weeds in the garden if we can extend that metaphor. We're looking so much at the weeds; we don't look at the soil. We don't at what else is growing in the garden. We don't think about could we have avoided the whole situation of an infectious disease then, and started taking the antibiotics, which then further damages the whole garden and so forth by looking at what's going in the soil and repairing the soil with diet and probiotics and prebiotics. Dr. Kellman: Sure. Jessica, one of the take home messages that I want people to learn about and appreciate from the Microbiome Medicine Summit is that when you're dealing with complex systems like an ecology of trillions of bacteria that are working as a whole and interacting with other complex systems, scientists understand how these systems interact. And they called this study dynamical systems theory. And one of the important messages is that even small changes in those systems can have powerful, powerful effects on the whole system. Jessica: Absolutely. Dr. Kellman: And I know you alluded to this before, and this is exactly the story of the microbiome that small changes, in other words small dietary changes, perhaps the right prebiotic with the right probiotic or introducing the 2016 The Kellman Center for Integrative and Functional Medicine. All rights reserved. 15
right bacteria that will then cause other bacteria to proliferate can have profound effects on the whole microbiome, causing numerous healthy bacteria to begin to proliferate, have numerous effects on the brain, the gut, etc because in dynamical systems, a small, little change can have powerful effects. Jessica: Yeah, that is a really an important point. And actually it's interesting. That's such an interesting conversation because there s a lot of places where it doesn t usually come up which is yeah [inaudible] complex systems is the part of the work that I did in the social sciences, actually. Dr. Kellman: I know. I know that. That's why I'm bringing up. Jessica: Yeah, exactly. It's sort of a mathematical explanation for all kinds of phenomena from everything from weather to the historical development of cities to the microbiome. There's this huge range of different things that all look entirely different but behave in similar, predictable or it may similar, unpredictable. So yeah, I think that's really true. And part of the research that we want to do is figuring two things. First of all, what are the things that we can say will absolutely help people, will absolutely help? And then the second thing is will absolutely help an individual. That's the most important thing. I think this is a way into personalized medicine, or precision medicine, whatever you're calling, and it has all these different names. People have been trying articulate long time. But I think this convergence of the contract health, citizen science, patient empowerment- they're all kind of the same thing- leads us to a personalized approach. Dr. Kellman: Ah! I was thinking of that word. Yes, I was thinking of empowerment exactly because small changes that were in the past kind of poo pooed. Ah, come on! What does diet have to do with your cancer? What does a change in a prebiotic or taking a probiotic, come on, how is it going to affect this autoimmune disease? You ve got to use big technology and fancy drugs. So these things were poo pooed. 2016 The Kellman Center for Integrative and Functional Medicine. All rights reserved. 16
But in the pharmacological model, in the old model of the human being, it's not based on this concept of dynamical systems where you make one change in the old model, and if you're lucky you'll get one effect. But when you make even smaller changes in this way of understanding the body in terms of dynamical systems, you could have powerful, powerful widespread effects. Jessica: It's so true. It's non-linear as you would expect in a system like the human body. You wouldn't expect you would add one and one and to get two. Actually you're not adding. What you're doing is you're taking some unknown function, and then all kinds of step functions and non-linear equations. And then you add one to it. And you don't get two. Dr. Kellman: Three or maybe five. Jessica: 5,000 Dr. Kellman: 5,000. Exactly. So here's really a great topic. One plus one, when it comes to the microbiome, does not equal two. It may equal 3 or 3,000 or 3,000,000. Jessica: Exactly. We re thinking we re adding. When we say one plus one, we're thinking the arithmetic operation of adding which is very clear. There is one, and then you move the other next to it, and then you have two. But we're not adding. But it's not adding. It's multiply, dividing partial differential equationing. It's doing a lot of stuff. And then you come out with a totally different number, and we think we're adding, but we're not adding. It's a way more complicated operation going on there. Dr. Kellman: It's incredible, but it's awe-inspiring, seeing a whole new view of the power in reality and the power in life. By the way, this is another reason why I wanted to create the Microbiome Summit is for people to really tap into an awe-inspiring view of life of reality of something that's happening within us and to make use of that incredible power. 2016 The Kellman Center for Integrative and Functional Medicine. All rights reserved. 17
Jessica: Yeah, I totally agree. And one of the things that I appreciate about what we're doing because people are trying to figure out, What do I do? is that increased awareness of diet. And so as we're figuring out what is the answer that we can tell each individual or what is the actual equation you should absolutely do this. There's a component of just, like you said, being awe-inspiring, helping people think about their health in a new way and change habits even a little bit can have a big impact. Dr. Kellman: So my last question is this. So how is the Jessica Richman of today different than the Jessica Richman before you started/helped to create ubiome? How are you different in terms of who you are as a person? Jessica: Wow! Dr. Kellman: I know, that's a tough question. You can answer whatever you want. Jessica, how is it different also in terms of what you're personally doing in regards to your health? Jessica: Oh, that's a really good question. So in terms of my life, wow, it's changed a tremendous amount. I think that one of the things that I wanted to do personally and why I started this, because this is not my field and it wasn't like a natural extension of what I was doing, was that I really wanted to do something that world-changing impact. When I was at Stanford, I did this scholars program around how technology changes society. And we studied all sorts of studies like how the bicycle came in widespread use and how the Internet changed various things. And I did some similar work at Oxford actually afterwards. And it's just exciting being a part of something that was really a huge technological change that going to happen probably one way or the other, but I could really help shape it and make it into the kind of change I wanted to see in the world to use a cliché. So personally having had the opportunity to do that has just made me more 2016 The Kellman Center for Integrative and Functional Medicine. All rights reserved. 18
confident and happy, frankly, just contented feeling like what I m doing is important. And now I feel like I'm doing something important so it's made me a much happier person. It's made me a more confident person. And there's a lot of things you only learn by doing them. You only learn by walking the talk. I've had some bad press. And I've had some twenty-four hours a day. And I've had systems go down at just the wrong time and those entrepreneurial stories you always hear about. And it's seasons you go through. I've learned a lot. And then personally in terms of health care, so it's very actually ironic that I started this company because I have an iron gut. Nothing goes wrong with my gut. But totally opposite of my co-founder who has all sorts of issues. But I can basically eat anything. And I'd probably be an interesting objective study for the opposite reason because I just don't think I have gut-related problems hopefully. I always have this nightmare that studying this will somehow jinx me, and I'll start getting the gut problems that I see so many people have. But I think what's it's helped me do is eat a more diverse diet and also focus on different prebiotics which is something that I didn't do before because I didn't really pay attention to it. And I started seeing how the logic of it and how you can create a more diverse microbiome based on feeding your microbes the right thing. So I've been certainly started eating more prebiotic foods than I had before. And I have a pretty healthy diet, but I definitely started eating a much more diverse diet. Dr. Kellman: Are you taking prebiotics as a supplement? Or are you getting in the food? Jessica: Pills, actually. Yeah. So Quest bars and things like that have prebiotics in them, s ometimes drink direct prebiotic supplement. And I feel like for me it's a good preventative. But with the gut that I have so yeah that's definitely been a change that I've made because I just didn't have an awareness of these things and how important they are. 2016 The Kellman Center for Integrative and Functional Medicine. All rights reserved. 19
Dr. Kellman: Are you taking a probiotic? Jessica: I'm not actually taking a probiotic. Dr. Kellman: Ah, good. It's funny because in my book I say that if there's really one supplement you should take, assuming you don't have excessive bloating and pain, is more than anything, more than vitamin C, more than vitamin D, is a good prebiotic. And I think you agree. Jessica: Yeah. No, I completely agree with you. I totally agree. Yeah. I have a citizen science company I have to have the paper published to prove that, but I would absolutely that from my perspective, especially since I'm not trying to solve this problem, I'm just trying to maintain what I have and make sure that it stays that way. I think prebiotic is just feeding your bacteria. Dr. Kellman: Wonderful. Jessica: If you feed yourself, why shouldn't you be feeding your bacteria? Dr. Kellman: Exactly. Take care of those little guys. And one piece of advice that you can leave us with? Anything that comes to mind? Jessica: So I think that overall I think I love this trend of the quantified cells, the empowered patient, whatever you want to call it, people being empowered to understand their own bodies. And I think that the final tip I would give is not take X brand of probiotic because it's the craze or whatever. It's really a matter of shifting your perspective that your health is not something that is managed by these outside people who are your attendants who tend to you once a year and give you health or something. Dr. Kellman: Beautiful. Take notes of that, folks. Great. Jessica: Yeah, it blows my mind because how many hours a year do you see your doctor? Twenty-five or something. 2016 The Kellman Center for Integrative and Functional Medicine. All rights reserved. 20
Dr. Kellman: Thank you for that. Right. Jessica: How many hours do you see yourself? So I think there's definitely that taking that very proactive approach to your health and tracking things for yourself, learning for yourself, is really, really important from a having better health level. I think that's clearly been shown people who pay more attention to their health have better health. Dr. Kellman: Yes, yes, yes. Jessica: But another take is just from a confidence perspective, you don't feel like you're this object people are operating on. You feel like you are the steward of your own health, and you can learn and be empowered to try different things out and figure out what the answer is for yourself. Dr. Kellman: Right and together with others, with like-minded. Jessica: Yeah, exactly. That's right. Dr. Kellman: Synergy and working together as a wonderful community, especially when it revolves around the microbiome because it's all about giving. It's all about a grand flow of giving and receiving. It's so awe-inspiring. And the work that you're doing is incredible, so frontier, so exciting. Jessica: Thank you. Yeah, I'm real excited to be doing it. Dr. Kellman: Yeah, and again, I'm going to apply for job. Jessica: Well, awesome! We'll consider it. Bring me your application. Oh, this is great. Well, we're going to be connecting on many, many levels. So, Jessica, thank you so much for participating. Jessica: Yes. Dr. Kellman: For all of you listening, thank you again for joining the 2016 The Kellman Center for Integrative and Functional Medicine. All rights reserved. 21
Microbiome Medicine Summit. According to research, we are mostly bacterial cells that govern our health. These bacteria actually outnumber our human cells ten to one so we must learn to take care of our microbiome. So with this information, we can tap into their power to heal us. Please, please, please take this groundbreaking, revolutionary information home with you by clicking on the banner beside or below and be sure to share with your family and friends. This is Dr. Raphael Kellman, and I wish all of you an abundant and healthy life. Thank you for being part of this microbiome revolution. 2016 The Kellman Center for Integrative and Functional Medicine. All rights reserved. 22