How The Gut Microbiome Affects Your Blood Sugar Levels

This week on the 20 Minute Fitness podcast we welcomed the Co-Founder & CEO of Pendulum Therapeutics, Colleen Cutcliffe, Ph.D. Colleen has a Ph.D. in Biochemistry & Molecular Biology from Johns Hopkins University, worked in a pharmaceutical company and an early-stage biotech DNA sequencing company prior to Pendulum. Colleen and her co-founders thought that the microbiome was an emerging and fascinating new space of health and they wanted to use their technical backgrounds to create a whole new family of products targeting the microbiome.

 Don’t miss today’s episode to learn what you should pay attention to when looking at your blood glucose levels and how your microbiome affects your metabolism!

Three Things You’ll Learn

1) What You Should Know About Blood Glucose Levels

Historically we used to focus only on two numbers when it came to blood glucose levels. Our fasting glucose levels, which normally should be below 100 mg/dL for people without pre-diabetes or diabetes. And our blood glucose level spikes after eating, which should be below 140mg/dL for people without pre-diabetes or diabetes. However, we are starting to realize now that there is more to the story.

It’s also important to know how you respond to glucose over time and over different things that you eat. Because your traditional metrics might be great, but you might still respond to certain foods with an out-of-range spike.

Press play to hear Colleen explain why continuous glucose monitoring is important and what plays a role in your glucose spikes!

2) The Microbiome’s Role In Metabolism

There are many factors that can influence your blood glucose responses and of course, genetics is one of them. But the microbiome also plays an important role in how you metabolize glucose. If you’re missing certain bacteria that can lead to out-of-range blood glucose spikes. The reason behind this is that you might not have the right bacteria to metabolize certain foods.

These sugar spikes are followed by sugar crashes and can lead to things like brain fog or fatigue on a daily basis. These spikes can get more frequent as you age and in the long-run can lead to pre-diabetes and diabetes, they can negatively impact your cardio and metabolic health, and damage your immune system and inflammatory response.

Listen to this week’s episode to learn more about how your microbiome impacts the way you metabolize glucose!

3) Improving Your Microbiome For Better Blood Glucose Response

After experimenting and figuring out which foods cause a spike, you’ll want to find a solution. One solution can be cutting certain foods out of your diet, but this may be hard for some people. Less drastic options include changing the sequencing of eating certain foods, playing around with the timing of when you eat certain foods, and experimenting with intermittent fasting.

Healthy nutrition is always going to be at the core of a healthy microbiome. You should have high fiber foods in your diet to provide the prebiotic foundation for cultures to grow. Combined with a healthy nutritional foundation, Pendulum probiotics will further help to lower your blood glucose spikes.

Tune in to hear more about Pendulum and how it can help to improve your metabolism!

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Martin Kessler: In response, new scientific developments have brought us microbiome-targeted interventions such as live symbiotics, post-biotics, biotherapeutic products, and even genetically modified organisms. One of these new products is Pendulum Glucose Control or PGC, which is a symbiotic that is delivering targeted bacteria strains that help our metabolism. A randomized double-blind placebo-controlled trial has demonstrated that PGC lowered blood glucose spikes by about a third on average among type 2 diabetics. With me today is Pendulum Co-Founder and CEO, Colleen Cutcliffe to talk more about how our microbiome affects our metabolic health and why this isn’t just important for diabetics. Before I welcome Colleen, though, a quick shoutout to our sponsor, ShapeScale, your personal 3D body scanner that keeps your physical health in check. More on shapescale.com.

Hi, Colleen. Welcome to 20 Minute Fitness.

Colleen Cutcliffe: Thank you! Thanks so much for having me.

MK: Yeah, it’s great to have you. Well, could you please start off by introducing yourself and your background to our listeners?

CC: Sure. Well, my name is Colleen Cutcliffe. I am the Co-Founder and CEO of Pendulum Therapeutics, and my background is pretty hardcore science. So I have a PhD in Biochemistry and Molecular Biology from Johns Hopkins. I did a traditional postdoc, worked in a pharmaceutical company, and then a early stage biotech company that was doing DNA sequencing that went public. And on the other side of that, I started Pendulum with two co-founders, also very technical. And really, the idea was that the microbiome was this emerging new fascinating space of health, and we thought we can use our technical backgrounds to create a whole new family of products that targeted the microbiome.

MK: Awesome! And from what I understand, you’re targeting the microbiome to influence blood glucose levels. Maybe we can start off there. What are we considering normal blood glucose levels for healthy adults that are not diabetic or even pre-diabetic?

CC: Well, it’s interesting to think about blood glucose levels. Traditionally, people measure either your fasting blood glucose, so that means you haven’t eaten anything for about eight hours, and you typically wanna be below 100 mg/dL for that, or you’ve just eaten something and about two hours later, you wanna know, “How high did my blood glucose spike?” And you usually wanna be about below 140 mg/dL for that. But what people are starting to realize is it’s not just about those two points, your fasting, and then two hours after you eat, but it’s actually about how your body responds to glucose over time and over different things that you eat. And your nutrition plays a really important role in how your body responds to sugar.

CC: And so it’s really actually more about the area under that glucose spike curve. And these new technologies around continuous glucose monitors are enabling people to get a lot of data around how their body responds to specific foods. And what we’re understanding is that you may have great fasting glucose numbers, and you may have great two-hour postprandial glucose numbers, but there might be certain foods that when you eat them, they cause you to spike out of range. And so you might be walking around feeling like, “Oh, I’m healthy and I’m great,” but actually, there’s certain things you’re doing to your body that are causing your blood glucose to spike out of range, and that’s really what causes all sorts of other things for us people who are otherwise healthy with our fasting blood glucose levels.

MK: Yeah, I think it’s definitely fair to say that continuous glucose monitoring has really become a thing, and it’s gotten a fair amount of attention as we’re now having not just one, but multiple start-ups, actually, work in that personalized nutrition space. And I find it interesting what you’re mentioning. And we also had Josh Clemente, Founder of Levels, on the podcast, and he was talking about, I think it was a study in Israel of how one can completely correspond differently to eating just a single cookie or even a banana. For some, it might spike it like crazy like over 140, even though you’re not diabetic or pre-diabetic. And for some, maybe relatively level at 100. But yeah, what factors do you think play there that due to that kind of behavior? Is it genetic, or is it a microbiome? Or what is really influencing that kinda response?

CC: The way our bodies respond to glucose, of course, it’s multi-factorial, so genetics certainly play a role. But what we’re starting to learn is that the microbiome actually plays a huge role. So when you think about it, everything you eat, at first, goes to your gut. And it gets metabolized by your microbiome, which are all these bacteria and viruses and fungi that live inside our gut. And they help us metabolize our food in order to create small molecules, some of which are helpful, some of which are harmful. But one of the things that has started to emerge is that your microbiome plays a really important role in your metabolism, and actually, if you are low or missing certain strains of bacteria in your microbiome, you can be more susceptible to having these blood glucose spikes out of range.

CC: And so if you have diabetes or pre-diabetes, you’re having a global problem with how your body processes sugar. But if you don’t have either of those, there are certain foods that when you eat them, if you don’t have the right gut bacteria there to metabolize them, you can spike out of range also. And this is something that many people have experienced when they really look at these continuous glucose monitors, is that certain foods that maybe they’ve been eating and not thinking about very much are causing them to spike out of range. And what we feel when we go through a day where we’re going through these sugar spikes and sugar crashes is things like brain fog or fatigue or the post-lunch down. And so we try to compensate by having caffeine and things like that, but really, it is our blood sugar levels that are at the core of why we have all these other symptoms that we experience.

CC: And I think all of us can imagine, “Yeah, there are certain foods that when I eat them, I feel a little bit groggy afterwards,” or, “I feel a little bit worse the next day when I have certain meals.” And really, what we’re realizing is that it is how your body is metabolizing those foods, and that your microbiome is very core to that. And unlike your genetics, which you kind of you get what you get; with your microbiome, you can actually change it. And so you can change the way your body metabolizes food if you give your body the right microbes.

MK: Got it. And do you see also some long-term issues if you have those spikes that are a little bit out of range? In a way, it’s normal to have an insulin response, and you may not be insulin-resistant at all, we just have a higher spike, and like you said, it can sometimes lead to those sugar crashes and sugar spikes that lead to brain fog. But are there long-term consequences?

CC: Well, ultimately, as we age, what we realize is that all of us get worse at metabolizing. So everybody probably remembers a time in their life where they could eat and drink whatever they wanted to, and they didn’t have to worry about anything. And as you get older, you have to really worry about that, and that’s because one of the things that happens to your body as you age is you start to have more and more of these spiking-out-of-range, more and more of these inability to metabolize food and metabolize sugar properly. And so it leads to a lot of other problems besides just the obvious things like diabetes and pre-diabetes. And so we now know that the way your body responds to blood glucose can affect some of these soft things like brain fog and sleep and energy levels, but in the long term, it can also play a role in things like your cardiometabolic health and other susceptibility to other chronic diseases, especially around your immune system and your inflammatory response. And so it turns out that the way your body responds to glucose and your ability to metabolize it properly is intimately tied to a lot of different health issues that you’ll experience as you age.

MK: And how do you make best sense, really, of what is really the root cause of certain response? Let’s say I sign up to one of those programs, I get a CGM, maybe I go through months two or three, and really learn a bit more about my continuous glucose response throughout the day. And I notice a spike and of course, it may be related to something I’ve been eating, but from what I understand, there are also other factors at play here like your cortisol levels, your sleep, and how much you’ve been exercising before or right after you had a meal. How do you really narrow it down and find the root cause of those spikes?

CC: Well, I think if you really wanna understand what’s causing spikes for you, it does require some degree of self-experimentation. So it could be that there are certain foods that are problematic, as you said, depending on the time of day, depending on how your sleep was previously for women, depending on what part of your cycle you’re in, or if you’re post-menopausal. These hormones can all play a role in how your body responds to glucose. And the microbiome is now emerging as another thing where that you can start to experiment with where you can give your body certain microbial functions and see whether that changes your blood glucose response. And that’s one of the key things that we’ve really honed in on at our company at Pendulum. We are giving people microbes and then we are looking at their response with continuous glucose monitors to help people understand, “Is this product actually helping them to metabolize their sugars better, especially for some of those problem foods?”

MK: Right. And how do you best go about it, then, once you have narrowed it down, maybe it is a food, maybe it’s a combination of food and your microbiome. How do you go actually about influencing it? Is the solution to cut out certain foods? Or what would you recommend?

CC: Well, I think the maybe one of the most straightforward things is to cut out certain foods, but for many of us, that’s a tricky thing to do. And so we more wanna figure out, “Okay, how can I actually enable my body to eat these foods?” And so you can start to, like any experiment, you wanna make sure you’re doing it in a controlled way. You can start to do things like change the sequencing in which you eat certain types of foods. You can start to play around with the timing of when you eat foods. Of course, many people are realizing that if they fast, it matters very much what the first food is that they put into their bodies after that. And then again, if you’re changing your nutrition, oftentimes, that is also altering your microbiome. And so trying to make deliberate changes to your microbiome and measuring those changes is another way to know what’s correlated to better blood glucose spikes.

MK: And how do we know our microbiome is maybe not processing certain foods well and contributing to a spike in blood glucose levels?

CC: It’s very hard to know a priori if that’s really happening. There are a variety of microbiome testing companies out there and certainly, many people take those tests. It’s hard to know at this point in the science whether those tests are guiding you in terms of what you can do differently. However, the most direct way to know whether changing your microbiome can change your blood glucose spikes is to try a product that is changing your microbiome, and then measure whether you’re making those changes. And so for example, one of the microbes that is emerging as pretty fundamental and core to our microbiome is called Akkermansia muciniphila. This is a strain that is involved in your gut lining and regulating how thick that gut lining is. And so when you hear about things like leaky gut or you have irritable bowel syndrome, oftentimes, people are low or depleted in this particular strain. And it’s also been found to be low or depleted in people with a variety of diseases, including obesity, diabetes and even certain traditionally neurological diseases, things like Parkinson’s and Alzheimer’s.

CC: And so we are starting to realize there are some of these particular strains that play fundamental roles in our microbiome. And so for us at Pendulum, we are very interested in this Akkermansia strain, and we worked with Harvard to try to understand what is Akkermansia doing. And actually, what we found is that when we include it in our formulation, it does result in helping people respond to blood glucose, respond to their glucose levels better as measured by blood glucose. And so we are actually the only probiotic out there that has Akkermansia in it, but there are a variety of tests you can take to know whether you have low Akkermansia levels, and then you can take them again after taking the product to know if you increase those levels.

MK: And outside of pharmaceuticals, are there any ways to, well, foster some of those bacterial cultures like Akkermansia? I think there was a study that said that cranberry extract could help in enriching Akkermansia cultures. Is there any truth to that? So maybe you can shed some light on that.

CC: Well, the microbiome is sort of a complicated ecosystem. You think about it like your garden. Just because you plant something there, it doesn’t mean it’s gonna grow; it depends on what else is hanging out in your garden. And so the microbiome is the same way. So you could eat foods that try to help increase Akkermansia, and these are typically high-fiber foods. But it’s not necessarily true that that will mean they will grow. And so that’s why we decided that we would develop a product that has Akkermansia in it because if you’re eating the high-fiber foods that will… Or the food for Akkermansia, plus you’re giving yourself the strain itself, it gives you a much better chance to increase the levels. And just to be clear, our product is not a pharmaceutical drug. It is something that you can buy online, and so everybody has ready access to it. But there are… High-fiber foods are really the best way to bolster Akkermansia.

MK: Got it, because those really provide the prebiotic foundation for cultures to grow. So let’s talk a bit more about Pendulum, then. What is in Pendulum? How does it work? How does it influence my microbiome?

CC: When we first started exploring the microbiome, there was a pretty important study that came out of the Netherlands where they showed that if you did a fecal microbiome transplant, which is as terrible as it sounds. Basically, you take feces from one person and put it into another person, what that does is it completely changes that person’s microbiome. So when they do these fecal microbiome transplants from healthy people into people with diabetes, what they found was they could resolve their symptoms. And that tells you, “Okay, there’s something in the microbiome that is actually helping these people metabolize their sugars better.” And so we really set out to understand: What is the difference between people who are healthy and people who have a hard time metabolizing sugars? And what are the microbes that are responsible for performing those activities that metabolize your food?

CC: And what we found was there’s two specific pathways that are really important, that are very high in healthy people and low or entirely missing in people with pre-diabetes and diabetes. And it is, first of all, the ability to metabolize fiber into butyrate. And fiber, of course, it’s quite well-known to be healthy for us. We all know we should be eating a high-fiber diet. And then butyrate is a small molecule, which is also quite well-known to the upstream of insulin and glucose response. But what’s never been known is: What are the microbes that do that metabolism of fiber into butyrate? And actually, we don’t have anything in us that allows us to that metabolism. It’s entirely done by your microbiome. So if you don’t have those microbes, the fiber you’re eating is literally going right through you. And so we discovered is that this is a multi-step biochemical reaction. There are strains that metabolize fiber into butyrate, and we created a formulation that has those strains in it.

CC: And the second pathway is around this gut lining and the way that your body regulates that gut lining. And so we added then, of course, this Akkermansia strain to really go after that mucin regulation, along with butyrate production. And we found that when you have the two of these together in a clinical trial, that you can significantly reduce A1C, as well as blood glucose. And this was a placebo-controlled double-blinded randomized trial that was just published in BMJ Open Diabetes, and shows that essentially, we had this vision that the microbiome allows you to create products that have the efficacy of a drug, but the safety of a probiotic. And that’s really what this has, it’s lowering A1C and lowering blood glucose, compared to placebo, very substantially, both clinically and statistically significant. But it’s, at the end of the day, it’s a probiotic that is helping you create butyrate and helping you, too, with your gut lining regulation.

MK: Right, so you’re basically saying without the body’s ability to create enough butyrate, you can eat as many fiber as you want, it’s still not gonna help you much to handle some of the blood glucose levels.

CC: Yes, well, over… There have been a multitude of studies showing that over time, if you really modify your diet to a higher-fiber diet, that over time, you can give enough food for certain strains to start to appear. But when you wanna talk about optimizing your microbiome and when you wanna talk about accelerating to getting to the optimal microbiome, it really can’t be done through nutrition alone; you have to really be fueling with the right microbes.

MK: Now, I’m curious because you mentioned that in your study of those diabetic groups, they didn’t even have enough of those cultures, and they didn’t have enough butyrate. What is the reason for that? Has there been any research done on that?

CC: Yeah, it’s very interesting to try to understand what causes people to have this depletion because most people don’t start out that way. We start out with very diverse microbiomes. There are factors that are under our control that change our microbiome, such as our diet and how much we exercise. These things can alter our microbiome. And if you’re not eating a very high-fiber diet, then you’re not giving the food for these microbes. And so that can be one big reason of why people are depleted in those strains. But what we’re discovering is that there are a lot of things that are outside of our control that also cause us to be depleted. So things like aging, stress, menopause, even circadian rhythm, every time we travel, we’re actually changing our microbiome, it’s not even just from the food we eat, but simply by going from day to night, that can change your microbiome. So there are all these factors that are ultimately resulting in a depletion in our microbiome. We tend to, as we get older, have less and less diversity in our microbiome. And that less diversity is problematic because we’re losing these key functions. And so there are ongoing many studies coming up showing all the things that impact our microbiome, but the important thing is that we can do something about it, we can give those microbes back to ourselves.

MK: Yeah, I’m curious, with some of that loss and diversity, it’s almost permanent unless you forcefully reintroduce some of those bacterial cultures.

CC: Yes, and I think this is important because many people experience things and they don’t really understand, “Hey, if I eat the same thing that that person eats, how come I’m having all these additional problems? Why do I have inflammatory issues? Why am I having metabolism issues?” And at the core of it really is this microbiome depletion. So if you can give that back to people, you can get them to be able to have the same effect from the foods they eat as other people. And it’s true, many of these microbes, we don’t even know where in the environment they reside. They haven’t been found on any foods, they haven’t been found in certain climates. And so it’s almost impossible to know another way to get them back without actually just directly ingesting them.

MK: Yeah, so yeah, my point, really, is that even if somebody has been diabetic and maybe they have been leading a really unhealthy life, eating a lot of processed foods, and not exercising, not sleeping long enough, and being maybe stressed, and that has all altered their microbiome in a way that makes it really hard to change, even if within a week or two, they become a completely different person, become super healthy; that wouldn’t really change, dramatically, their microbiome in that short period of time, right?

CC: Yeah, usually, it takes a while to change your microbiome. And your point is exactly right; there are certain things you may never be able to get back just by having a healthy lifestyle. But of course, I have to say that eating well and having good fitness is of course very important. It’s not just about altering your microbiome. So it’s the combination of all those things that can lead to a healthy life.

MK: For sure. And now, if you use Pendulum, is it like something that you have to keep using for your entire life because you never have enough of that culture? Or is it like something that you go through like a three-months course and then you have enough of a foundation of Akkermansia, for example.

CC: Well, to be totally honest, we’re still at the beginnings of really understanding the microbiome in this science. And so it’s unclear what allows something to now culture in your microbiome versus not. One of the interesting observations we have, though, is that in our study, we… After people took the probiotic for 12 weeks, we then had a washout period. So they didn’t take the probiotics for four weeks after that, and then we measured their microbiome again. And what we found was that for most people, the microbes are gone when you’re not taking them anymore. But there was a percentage, about 15% of people, they still had the microbes in their microbiome, even though they weren’t taking the pills anymore. And the idea is perhaps if you now have those microbes seeded, and you do change your diet to be a higher-fiber diet and you’re now giving them the food, you might be creating an environment where now, they can thrive.

CC: And so, what, when we run these trials, of course, we always tell people, “Don’t change your diet, don’t change anything, just take these pills.” And you don’t really know, and sometimes, people do it subconsciously, you don’t really know what changes they’re making. But this is fascinating because if you can actually, long-term, alter your microbiome by simply seeding it and then changing your nutrition in some way, that could be mean that you just have to seed them for a short period of time, as opposed to having to take them forever. And perhaps, as a business model, that’s not a great thing to say, we don’t want this to work, but really, because it’s a complicated ecosystem, I think all those things matter. And I think it, one of the studies that we’ve been doing is in fact to understand: If you had a higher-fiber diet, will you not only have a longer sustaining of these strains, but could you, in a short amount of time, actually get them to the level they need to be at? So you could actually take the pills for a shorter period if you had the right fibers.

MK: Because outside of studies, what would you actually recommend to your customers in terms of their diet? I’m sure it’s not a silver bullet for an unhealthy diet.

CC: It is definitely not intended to be a replacement for having a healthy diet, so we definitely don’t tell people, “Keep eating your McDonald’s, you could just take these pills and be fine.” I think nutrition is a very important part when you think about the microbiome. And so in fact, actually, when people purchase our product, they also get nutrition consultations. And what we’re trying to help them understand is a lot of people don’t even really know: What is a healthy diet? What constitutes a healthy diet? What foods have high fibers in them? How do I even cook these foods? I think many people, or maybe I shouldn’t say many; some people know sunchokes, these Jerusalem artichokes are a very great source of fiber, but: How do you even prepare them? Do you just eat them them whole? How can you incorporate them into your foods? So these are all the sorts of things that we try to help people with so that they can have the right nutrition paired with the right microbiome.

MK: And right now, most of your customers are diabetic, or do you also have non-diabetic customers? I understand it’s not a prescription medicine, anybody can order them, but is it mostly for those that have diabetes, or is it for anyone, really useful?

CC: Well, when we set out to develop the product, we were really looking for things that can help you metabolize your glucose better. And of course, when you’re looking for something, you start with the sickest population, so we really started with the trials looking at people with type 2 diabetes. But I can tell you, for example, I don’t have diabetes or pre-diabetes, and I tried the product. And for me, I felt that I had more energy throughout the day. So rather than hitting the 1:00 lull, I found that I had really good energy and my workouts were actually stronger when I was on the pill.

CC: So of course, as a scientist, I said, “Okay, this is probably a placebo effect. I helped make the product, so I know what’s happening.” So I had to run a trial on myself where I wore a continuous glucose monitor. I told the team, “Give me placebo or give me intervention. Don’t tell me which one is which.” And I really ran the study on myself, and what I found was that when I take the pills, actually, all my sugar spikes and sugar crashes are all diminished throughout the day. And that’s why for me, that shows up as a more sustained energy throughout the day, a better workout. And we have customers saying the same things. We have marathon runners sharing with me data on their 26-mile run and how they’re running faster now that they can metabolize their glucose better.

CC: And so even though we developed this product initially looking at people with type 2 diabetes, actually half of our customers, they don’t have diabetes or pre-diabetes. And so it’s really a product that people are feeling benefit from, especially if they know the importance of blood glucose, and especially if they’re measuring their blood glucose response, they’re really seeing a difference with the product. And so and they’re feeling these soft benefits that we were talking about earlier like improved energy, improved sleep, less brain fog, and even better GI. When your body is metabolizing food better, oftentimes, you have better digestion and better GI symptoms. So we’re really seeing that people are getting so many more benefits from the product than we initially intended, mainly because blood glucose is so important to your health.

MK: Right. And how much is it actually lowering those glucose spikes? Is there a percentage across the people that went through the study? How did that look like?

CC: Yeah, so it lowered, compared to placebo, lowered A1C by 0.6 points, and it lowered blood glucose spikes by 33%. So quite a large amount for those blood glucose spikes.

MK: And for those of our listeners that might be already monitoring their glucose levels, at what point do you really see the greatest benefit? How high would have your glucose levels to be for it to become a substantial effect?

CC: Well, it really, it varies from person to person. So to be honest, I personally, when I wore a continuous glucose monitor, I don’t have any particular foods that spike me out of range, so getting above that 140. But we definitely have customers where for certain foods, they’re getting into 150, 190 up to 200 with certain foods, and they can start to see those decrease. So it really varies from person to person. I would say that also the amount of time it takes before you see that impact seems to vary. So when we did our study, we did it over a 12-week period because actually, it takes 12 weeks to see an A1C change. You can oftentimes see blood glucose changes sooner than that. But the other thing to keep in mind is that all these microbiome studies that have been done showed it takes about two months to fully change your microbiome. So if today, you decide to become a vegetarian or vegan or whatever, totally change your diet, it takes about two months for your microbiome to change. So typically, we’re seeing people, with their measuring over time, they will see results around 12 weeks, but there are definitely people who see them sooner. And again, if you change your diet at the same time you’re introducing these microbes, you can alter that timeline, too.

MK: Yeah, that’s fascinating. Outside of Pendulum, I’m sure you’ve learned quite a bit through the advice component that Pendulum also provides. What are some common do’s or maybe don’ts that you would recommend to our listeners when it comes to their nutrition or maybe exercise or lifestyle that can have a positive influence on their glucose levels?

CC: Well, I think it’s really important when you’re thinking about your nutrition, your glucose levels, to try to keep fiber as high as possible in your diet. And many of us may feel like we’re eating a high-fiber diet, but it really can always be more. And so getting to these fruits and vegetables that have high fiber, certain beans have high fiber content in them, that’s really good for you. Another thing that we often do, sometimes, is that we’re trying to be healthy by being more so-called hygienic. So we use these antibacterial soaps, we have antiseptic wipes, we…

MK: Yeah, especially now, during COVID.

CC: Yes, exactly, exactly. And I think one of the downsides to all of that is that you are killing off the good microbes, as well as the bad ones. And so it’s okay to hug the dog when they’ve come in from being outside. We should use regular soap instead of needing antibacterial soaps. It really is a balance between making sure you don’t have those bad microbes come into your life, but also not killing all the good ones because the downstream repercussions of killing the good microbes is that you’re not gonna be able to metabolize glucose as well, you’re gonna have these inflammatory issues, you’re gonna have potentially respiratory issues. And so we have to figure out what that balance is and not become very extreme in wanting to think all bacteria are bad.

MK: Yeah, how bad is it, for example, to take an antibiotic?

CC: Well, an antibiotic is like setting off a nuclear bomb in your gut. It really kills everything, everything in sight. And interestingly, there have been a few studies that have shown that kids who are on antibiotics, systematically, before they’re two years old or before they’re six months old are also more systematically prone to some of these diseases. So there was a study that just came out of the Mayo Clinic showing that if you’re under two years of age, kids who are under two years of age that were systematically on antibiotics also, as they became teenagers, were more likely to be obese, to have diabetes, to have celiac disease, to have attention deficit disorder. So there’s all these things that the antibiotics are really killing that you need to have around. And children are, of course, the most susceptible because they’re just starting their journey of health. But I should give the disclaimer, in no way am I an anti-antibiotic. Antibiotics save lives, so if you have a bacterial infection, you should definitely take it. But don’t go to your doctor and try to self-prescribe an antibiotic, it’s not all good.

MK: Yeah. This should be almost a last resort, right? This should not be something to use for a common cold.

CC: Yes, we have immune systems in place to battle many of these things and oftentimes, we don’t give our body a chance to fight it off itself. And that’s actually really bad for our immune system. We need those exposures in order to be able to fight the big battles when they come along.

MK: Now, the microbiome, I think, it’s a usually fascinating topic, and it feels like, like you just mentioned, almost every week, there’s a new interesting study that comes out. Where do you see the potential in the next coming years for the microbiome, how it can help us improving our health, or maybe curing certain chronic illnesses, as well?

CC: I think where the microbiome has started is really addressing GI disorders and certain infections like Clostridioides difficile infection. And I think there’s still a lot of room to improve on those fronts. There’s a lot of research being done around Crohn’s disease, IBD, as well as the C diff infections, and I think we’re only gonna get better at those. But then as we start to look forward, I think things like our product, which we’re going after metabolism, there will be more work that’s done, certainly by us on that front and others, that will really help people with these chronic metabolism issues. And as we look forward beyond that, I think there is another big opportunity when we think about things that we typically have thought of as neurological disorders.

CC: So in my first job, I worked at a pharmaceutical company going after Parkinson’s disease, and we were always looking at the brain, and all the things that are happening in the brain around Parkinson’s disease. But what’s, we started to learn is that actually, your gut microbiome produces neurotransmitters like dopamine, like GABA, and there is literally a vagus nerve where those neurotransmitters can go from your gut to your brain, and they are actually in much higher concentrations than the neurotransmitters that get created by your brain. And then probably the most fascinating thing is that Parkinson’s and Alzheimer’s, one of the diagnostics is that you get these plaques in your brain. And what they found is that you have neurons in your gut and actually, those plaques show up in your gut before they show up in your brain. So I think there’s also this huge opportunity to help the neurological diseases by going after the gut microbiome, and that can expand to things like Parkinson’s, Alzheimer’s, autism, attention deficit disorder. There’s a huge opportunity in the gut-brain arena.

MK: Wow, that’s fascinating! How many years do you think we’re away from that?

CC: Oh, man! You know, I can’t answer that question. [chuckle] I hope we’re around the corner, but it takes, and…

MK: Yeah, you never know.

There’s a personalized component, so it’ll take a while, it’ll take a while.

MK: Yeah, it’s exciting to watch from the sidelines, that’s for sure. And where do you see Pendulum fit in all of that? Do you see any other future products on the horizon that are gonna have an influence on your microbiome?

CC: Yeah, we are really one of a small handful of companies that started at the same time that we did, and we’ve been really trying to address these in a very scientific and clinical way, so developing these products the way you would a pharmaceutical drug, but then wanting to bring them to consumers. And so at the core of our discovery platform is high-resolution DNA sequencing paired with all of these biochemical assays. And so we’re starting with metabolism. I think there’s still more for us to do on that front to get even better and to try to understand the answer to your question: Does somebody have to take this forever? Or are there ways we can help them establish those microbes so that they have longer-term health, or they’ll have to continue to take the pills? So I think there’s a lot for us to do on that front. We actually have a second product that we are working with, we’ve primarily been working with Johns Hopkins on that, really addressing pain. And many people experience GI pain, but this is also a gut-brain question because pain actually comes from your brain. And so this is why I think that gut-brain is very interesting. And of course, we have a bunch of other things we’re working on that I can’t tell you about, but I will say that we’re really… There’s a big opportunity to go after a bunch of chronic illnesses through the microbiome.

MK: Yeah, it’s really interesting that you mentioned that because we also had a guest on hypnotherapy on the podcast a while ago. And like you said, the brain is also a huge influence on the GI pain. It’s fascinating how everything in our body really interacts together, and how we should really look at all kinds of different angles to heal and nourish our body. Yeah, I think that’s a really good note to finish off today’s show. If our listeners wanna learn more about Pendulum, maybe try out the product, where can they find you?

CC: If anybody’s interested in the product or learning more about the microbiome and the key role it can play in a variety of health issues, they can visit us at pendulumlife.com. And we’re also very happy to answer any questions about anything around the microbiome, not just around the product we have.

MK: Awesome. Colleen Cutcliffe, thank you so much for coming on the show.

CC: Thank you for having me.

MK: However, to be frank, at its current price level of $165 for a monthly supply, I find PGC a little bit out of my own price range and beyond what I, as a metabolically-healthy person on a low-carb diet would really need. However, if you are overweight, diabetic, or suffer from non-diabetic hypoglycemia, then I can start to see it as a sound investment. Before you do any of that, however, you should definitely work on your lifestyle, first. My advice is to eat a diet high in fiber, protein, and low in carbohydrates and especially sugars. Fermented foods can provide a great probiotic boost, and sticking to smaller, more frequent meals can also help lower your blood glucose response. And eating all the matters, too. Eat first your proteins, then fats, and then eat your carbohydrates. Exercise frequently to keep metabolically flexible. Take a walk after your meal. Get a sufficient amount of sleep. Anyways, thank you so much for listening to 20 Minute Fitness. I am Martin Kessler. Our show is mixed by Lilla Laczo and produced by Shape in San Francisco. See you next week.

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Lilla Laczo

Lilla is a content writer and community manager at Shape.
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