Hello everybody and welcome to the vP Life podcast brought to you by vitalityPRO.

My name's Rob and I'll be your host on today's episode.

Today we're joined by Dr.

Rui Lopes, a medical doctor and clinical researcher who leverages his expertise

as the medical advisor for Owlstone Medical, a biomedical company that

is aiming to revolutionize the way we test GI disorders including SIBO.

During today's episode we take a deep dive into what Owlstone

are trying to accomplish and how their breathalyzers work.

We then take a step back and explore the world of SIBO, what it is and the various

treatment options that are available.

As usual we get through a lot in today's episode so be sure to

check out the show notes and the transcript should you need them.

And I'd like to ask you a little favor.

Our podcast is slowly gaining traction and we'd love it if you could leave us a

review wherever you listen to podcasts.

This will help us grow, reach more people and allow us to host future guests.

And with that, on with the show.

Hi, Rui.

Thank you for joining us on today's episode of the podcast.

Would you just quickly like to sort of introduce yourself, who

you are and what it is you do?

And then we can just sort of take a deeper dive into OMED health as well.

Yeah, perfect.

Yeah.

Thanks, Rob.

Uh, it's a pleasure to be here.

So, um, The journey where I am today until, um, getting to

Owlstone has been nothing but typical for a doctor usually does.

Somewhere along the way I kind of drifted away from the NHS, but I started

as every doctor starts, completed my studies, um, started working in the

NHS as a physician, and I've been there for the past six, seven years.

And I've always had this very traditional path for my clinical

training and my specialization.

But the interest for research was always there for me.

And around two years ago, motivated a great deal by the fact that

I have two young children, I transitioned onto the industry.

And for that, I've leveraged my research knowledge and my clinical experience

across a variety of therapeutic areas, including gastroenterology, where I'm now.

And this became extremely useful for my role as a medical advisor

at Owlstone um, it's a great role.

It's a great place to work, uh, particularly when you see the cutting

edge research that we produce in breath analysis and, and biomarker analysis.

And this grants us the status of, uh, world leaders in breath research, really.

And OMED is, is just a brand of Owlstone where.

We're pioneering these new breath technologies, such as the OMED

breathalyzer, this portable, precise piece of engineering for the monitoring

of GI disease, such as SIBO and IMO.

Before we sort of dig a bit deeper into OMED, let's just sort of Discuss a

bit more about your sort of foray into gastroenterology, what sort of made you

choose that as a speciality or what sort of do you to that field specifically as

opposed to, I suppose, endocrinology or?

Yeah, so I've done throughout my, my clinical training.

I've, I've had exposure to lots of, um, uh, therapeutic areas.

Gastroenterology was one of them and I've done a lot of research, uh, particularly

in, in biomarker analysis in IBD and IBS.

And that was really the one of the most interesting pieces of

research that I've conducted in the past, in the past few years.

And that was a big selling point for me when, when, um, the

Owlstone role came, uh, to play.

Because it, it landed perfectly with, uh, my experience in biomarker,

um, analysis and discovery.

Uh, because it's, it's the mainstay of, of, of Owlstone.

This, uh, breath biomarker identification and research to try and, and create these

new expedited pathways for non invasive diagnostics of very complex diseases.

Okay, fair enough.

Well, let's dig into the nuts and bolts of it then.

Um, I think a lot of people have heard of SIBO, but maybe not a lot of people

actually know what it really is.

I mean, there are a lot of acronyms out there.

You have SIBO, you have SIFO.

There are various different types of SIBO.

Um, you, there are very different, various different ways of obviously testing it.

But just sort of add from a sort of a 50, 000 foot overview, what

is SIBO and who does it affect and how is it affecting them?

What is this sort of this condition actually doing to people?

Yeah.

So, so if we look at our, our gut, um, and particularly if we break it down into

different parts, small intestine, large intestine, when there's a change in the

composition, the density and the function of the organisms that are in the small,

present in the small intestine, um, This leads to an imbalance of our microbiota.

And the microbiota is this agglomerate of organisms that we have in our GI

tract and other places in our body.

And SIBO, which stands for small intestinal bacterial overgrowth, is a

type of, uh, this imbalance, uh, that we often mention as dysbiosis, which

is characterized by an overabundance of bacteria that are usually in the large

intestine or in the mouth and throat.

And they relocate to a place where they really shouldn't be,

which is the small intestine.

And when these bacteria are present in the colon, they are usually not harmful.

They are part of the normal digestion, so they help breaking

down fiber, for example.

But, however, when, when the stomach and the small intestine usually, have very few

bacteria, and the composition of this, the organisms present here, is very different

from the ones from the large intestine.

And things like, for example, stomach acid and the movement of the food along the

GI tract tends to limit this overgrowth of bacteria in the small intestine.

But any impairment to these protective mechanisms can cause SIBO, and SIBO

can affect a wide range of individuals.

So we believe, according to published literature, it's about one in seven of us,

but it's particularly prevalent in those that have underlying conditions such as

IBS, diabetes, or they've had abdominal surgery in the past, for example.

And the different types of SIBO, as you mentioned, we often categorize

it based on the gas that is produced.

Uh, predominantly by, uh, the organism, uh, in, involved.

So, uh, it could be hydrogen, which is mostly produced in, in SIBO.

Methane, which is mostly produced by, uh, these organisms called Archaea,

in a condition called IMO, which is often branded together with SIBO.

Hydrogen sulfide, for example.

And, and there's different, different gases that are produced

in, in different situations.

And we tend to break it down into different categories of SIBO,

but if you look around in the literature, everything is under the

conglomerate of, of, of SIBO, really.

And, and this, and the development of SIBO can, can occur due to several factors.

Yeah, like I said, an impairment of those protective mechanisms will lead to the

bacteria accumulating in the wrong place.

So things such as impaired gut motility will lead the bacteria to start, start

accumulating in the small intestine.

abnormalities in the structure of the, of the GI tract, disruptions of the

microbiome because of antibiotic use.

There's really a wide range of factors that are crucial for

understanding how SIBO happens and how we can diagnose it and treat it.

Okay.

So it's going to predominantly sort of affect people who are already in a, I

suppose you would say, a diseased state.

But when sort of, I suppose, treating it In a traditional sense, what you

would normally do is you would go to your, uh, your physician and you would

do a traditional breath test there.

Try and sort of analyze which of the forms of SIBO is present.

And I suppose this is where OMED comes in and specifically the

technology you've helped to develop.

How is this different to how you would normally, uh, work with your

physician and treat this condition?

Um, how does the technology work and what is it that You're providing

that it's perhaps different from the status quo, the norm, right?

So, if you consider, for example, um, the case of the UK, we have a system

that is heavily burdened by a lot of complexity in terms of, um, dictated

by, The investment of government budgets and things that, like, for example,

the COVID 19 pandemic that have caused further burdens onto the system.

And you have this amount of people that suffer from GI conditions and GI

symptoms, millions of them, every day.

They struggle to find access to even diagnostic tests for conditions

that could be SIBO, could be IMO, could be something else.

And, and that's where OMED comes, um, into play.

We provide this device that is a point of care portable device, which is precise

and, um, overlaps very nicely in terms of preciseness with, with in clinic

devices that cost millions of pounds.

Um, and this, a, a fraction of the price can allow you to, to measure

accurately, um, gases like hydrogen and methane that we know are involved,

um, in conditions like SIBO and IMO.

Okay.

And, uh, the, the goal of OMED is to provide this platform that

aims to transform how we normally manage gastrointestinal disorders.

And, and the focus is, is being accessible, quick.

Non invasive, allowing the patient and their medical practitioner to

monitor their clinical status almost in real time, which is something that

doesn't really happen at the moment.

And behind this technology is the technology of breath testing that

Owlstone has developed over the years and led us to become the

leaders in breath analysis worldwide.

And for example, if you look at SIBO, at the moment, There's a, a big long

wait for you to access a specialized care for even the diagnostic of, um, uh,

functional, uh, gastrointestinal disorder.

If there's the availability of a device or a test that can provide a diagnosis or

the monitoring component almost in real time, that leads the physician in care to

understand how their interventions have an effect on the levels of the gases, on

the symptoms and on the patient's general

clinical status.

This is a technology that is fundamental for streamlining care for individuals

that suffer from GI symptoms every day.

Okay.

And is this a sort of a direct to consumer device or is this something

that people are having to sort of work with their physicians to sort of acquire?

Is it, um, are you able to just pick one up or, again, is it something

that you would, uh, Maybe go and see your, your PCP and then work with

them utilizing this piece of kit.

Yeah, so at the moment, we're working together with, uh, industry leaders, with,

with gastroenterologists and other, other, um, healthcare practitioners to help them

with the monitoring of their patients.

So.

As things stand now, to acquire the device, uh, to acquire the

OMED breathalyzer, you would have to go through your practitioner.

But the future allows us to, uh, provide this directly to consumer, um, if we want.

This is a, uh, like I mentioned, it's a precise device that allows you to,

comparatively to an in clinic piece of machinery that costs millions of pounds.

measure accurately your levels, allows you to record your symptoms, allows

you to record your lifestyle, your levels of stress, your sleep, uh, your

exercise, um, and, and even your diet.

And, and this almost real time monitoring component is essential for you to

understand how any intervention that you take, any modification that you do.

on yourself and your diet, for example, uh, if it has any impact, uh, in, in

the levels of your gases and ultimately on the underlying cause, which is SIBO.

I'd like to backtrack quickly and just sort of, uh, maybe discuss in

a bit more in, in depth what the difference between your various types

of gases is and how they would present, present differently in terms of

symptoms or what that actually means.

I think we've, uh, talked about a few times You get a methane, you get

hydrogen, and if I'm correct, you also get a hydrogen sulfide form of SIBO.

But when it comes to the nuts and bolts, but maybe how does that

sort of alter either treatment or how does that alter the diagnosis?

So when you look at the gases, the gases are ultimately produced

predominantly by the organism that is underlying the cause of your symptoms.

So if you look at SIBO, SIBO is, like I've mentioned, an overabundance of bacteria.

And there's specific bacteria that tend to produce hydrogen when they

get into contact with substrates.

So anything that comes in your food that doesn't get absorbed goes on

to that, to those bacteria, become essentially their own food and lead

them to produce hydrogen, which in large amounts can lead to symptoms such as

bloating, flatulence, abdominal pain.

And this is for SIBO alone, but if you look at gasses like methane, methane is

traditionally produced by an organism called archaea, which is not a bacteria.

It tends to exist across your whole GI tract.

Um, some people more than others have, uh, lateral preponderance of archaea in their

body, so they become producers of methane.

Uh, so when exposed to certain types of substrate from your food,

essentially, it will lead to the production, the production of, of

methane via the metabolism of hydrogen.

So there's these complex biochemical pathways in the microbiome where

different gases are produced, uh, ones directly from a metabolism of food,

others from metabolism of other gases.

But essentially, what all these gases have in common, and regardless of the organism

that produces them, is that their quantity and the way that they act on the, on the

intestinal wall will drive the symptoms that are, that affect millions of people.

One of the most, uh, known differences, if you, when you talk about hydrogen

and methane, for example, is that people traditionally associate

methane with, uh, IBS, uh, with constipation, which is something

that's been shown in the literature.

Higher levels of methane are associated with a slower GI

tract that leads to constipation.

So it's something that's been observed in IBS, for example.

Um, and higher levels of hydrogen have been, uh, observed.

But for example, in cases of patients that have a faster

GI tract leading to diarrhoea.

But there, there is a large overlap in the symptoms of these conditions and

probably explains why they tend to be agglomerated under the name of SIBO alone.

So, would you then say that, uh, SIBO sort of almost forms the, the base

of a lot of these other GI disorders like, uh, IBD, IBS, Crohn's, Ulcerative

Colitis, is there always going to be an element of SIBO in these individuals

or are they too sort of, can they be very distinct from one another?

I would err on the side of caution is saying always, always will be

SIBO or IMO in those individuals.

We know that a large frequency of, um, of SIBO exists in IBS.

So we know that people that have IBS very frequently have, uh,

SIBO underlying undiagnosed.

And until they're diagnosed and treated, their symptoms are not

appropriately managed, uh, regardless of the intervention that they take.

And we know that SIBO is related to, um, other, uh, medical conditions, other

functional and motility disorders, immune disorders, and, and endocrine disorders.

I wouldn't say that, particularly when you try to associate with other

GI conditions that, um, are very hard to diagnose, like IBS, uh, I wouldn't

say that this is the sole cause, but it is, it is a large contributor, yes.

Okay, then I suppose the next step is to discuss how you are sort of suggesting

physicians go about treating SIBO.

What is, I mean, again, a lot of physicians will sort of utilize

antibiotics as their sort of first port of call, something like Rifampicin.

Um, Rifaximin, I think it's called, but are you sort of advocating

for a more natural approach?

Are you sort of very much looking into drugs as a treatment opportunity

or how are you at OMED going about, uh, yeah, with the supportive side

of it, treating it specifically?

So at OMED and at Owlstone um, as a whole, we tend to base our approach

always backed by, uh, scientific evidence.

And, um, the problem sometimes with the evidence surrounding conditions of, uh,

gut gut brain disorders, for example, Is that, uh, the quality, um, is not

always the best, the quality of the evidence, and, and the studies that are

conducted are relatively underpowered.

However, there is, there is a mainstay of therapy for SIBO and, and IMO,

where we tend to treat, try to treat the underlying cause where applicable.

Antibiotics is, uh, a large contributor to eradicating, uh, the condition.

And then, um, treating nutritional deficiencies, identifying trigger

foods is a big component as well of the treatment of SIBO.

So things like antibiotics, as you mentioned, Rifaximin is, um, the, the

main antibiotic we use to treat SIBO.

Um, and IMO as shown as the best quality of evidence in terms of treatment for

eradicating, eradicating this condition.

But things like, for example, diet interventions.

Uh, obviously, uh, a big, uh, contributor to identifying trigger

foods, identifying tolerances, and try to create personalized, uh, diets long

term that are balanced and allow for, um, um, someone that ha that suffers

from GI symptoms to manage their condition without recurrently having to,

go to antibiotics to get rid of SIBO.

Diet alone has been shown, for example, to starve the bacteria that cause SIBO.

So if we, if you take a targeted approach to identify and restrict the trigger,

the trigger ingredients, then you can successfully manage long term disease.

In terms of when you look at how we, we manage it at Owlstone, we tend to focus

our component on the low FODMAP diet.

We, we see the benefit in the literature of the low FODMAP in the treatment

of IBS and the treatment of SIBO.

Um, and low FODMAP involves Reducing certain, uh, amounts of fermentable,

uh, fermentable carbohydrates.

They tend to be associated with symptoms, uh, such as bloating, and,

and flatulence and abdominal pain.

And in, again, in numerous studies this has been shown to help alleviate

symptoms by, by starving the bacteria and the organisms that produce

the, these, uh, gases in excess.

And in your experience, when somebody's following one of these diets, whether

it be a sort of a low FODMAP diet, or potentially something like a ketogenic

paleo diet, or some form of elimination diet, Are they at some point then

able to reintroduce a lot of the foods that they were previously eating?

Or does this become their quote unquote new normal?

Are they then sort of stuck with this way of eating to sort of remain in a state of,

uh, in a SIBO free state going forwards?

Or is the idea to then sort of allow an in an individual to reintroduce

foods, uh, that they were, that they were otherwise partial to or just form

a, generally a large part of their day?

Diet on a day-to-day basis.

Yeah, that's a great question.

So, uh, one of the problems with these restrictive diets is that when they are

continued for a long time, they tend to lead to nutritional deficiencies because

they are quite restrictive in the way, in the approach that we take for, for

trying to identify these trigger foods.

I think the goal of low FODMAP and other similar diets is The restrictive

part has to be long enough to allow us, uh, to take away, uh, a big group of

foods, but short enough that doesn't cause a tremendous impact on the, on

the clinical status of the patient.

So we don't want to cause, uh, nutritional deficiencies.

But there is a component for reintroduction and the reintroduction

part is very important.

It's not just to identify What gives you symptoms, but also to identify the

tolerance levels of certain certain foods So you might have you might be

okay to consume certain Carbohydrates, for example when you talk about the

low FODMAP diet You might consume a certain carbohydrates with minimal to

no symptoms, but then when you go to increased servings, there might be quite,

uh, quite a lot of symptoms for you.

And you might be okay with that, with constructing your diet around

that, to have limited amounts of those particular trigger foods.

Uh, always present in your diet but at a limit that allows you to,

to go about with your day with no impact in terms of, uh, of symptoms.

But there's, the, the goal is to always test this reintroduction, this tolerance

level occasionally because we know from, for example, allergy studies that

things tend to change along the way across, across the span of several years.

Your tolerance levels to certain foods in things like IBS and and SIBO will vary.

So your diet has to become, has to be modulated around that.

It has become relatively flexible for you to test these, these foods along the way,

trying to make sure that your tolerances increase in the way that your diet remains

balanced and you're not going to a very restrictive pattern that it'll eventually

might get rid of SIBO, but will give you other problems.

Yeah, create nutritional deficiencies along the way.

If, if carbohydrates are essentially what are sort of, well in part, um, driving,

uh, a number of these conditions, then why not just sort of take a sort of a shotgun

approach potentially, and then just use something like a ketogenic diet, which

will sort of remove well all simple sugars and all complex sugars from the equation.

What are your thoughts on sort of a ketogenic approach, and

why, how does it differ from a low, the low FODMAP approach?

So if you look at a low FODMAP, it's not, it's not just carbohydrates

that are involved, and they have been shown to cause symptoms

in people with IBS and SIBO.

I'm not very experienced with, uh, the ketogenic diet as a whole, but I know

that the evidence for things like IBS and SIBO is relatively, there's a relatively

unclear role for, for using it long term.

Now, we know that, for example, with FODMAPs, which are the, uh, low

fermentation, uh, low fermentable oligod and monosaccharides and

polyols uh, we know that these, are things that are poorly absorbed and

are osmotically active, and they go along the intestinal tract, and they

get fermented by these bacteria.

So, if you have a microbiota that is not imbalanced and is dysbiotic,

we know that this will drive those bacteria that predominate and dominate

over others to increasing numbers and increasing places where they shouldn't be.

So we know that a low FODMAP is something that has shown to improve

bloating and gas in patients with IBS, with SIBO, and there's evidence

to support this in the prevention and management of patients long term.

But again, there has to be a lot of caution in terms

of these restrictive diets.

It has to always be done under the auspice of a dietician

or a healthcare practitioner.

to prevent it from, from treating one thing but causing further problems.

Of course, and I think it's always, it should always be noted as you just said

that any sort of intervention should be done under the guidance of a physician.

When sort of treating these conditions, what are your thoughts on compounds

like antimicrobials, like berberine, like colloidal silver to sort of

further support the eradication of some of these underlying issues?

Do you think these sort of more natural, um, remedies have their place,

or would you just sort of prefer to stick to something like an antibiotic?

I think there's a place for, for antimicrobials.

There's definitely evidence for specific, uh, antimicrobials in general.

They're proving their, their antimicrobial activity and,

and other functions in the gut.

Now, I'm, I'm, again, weary in terms of a blanket statement

of using them across, uh, as a replacement, strictly a replacement

for antibiotics, without discussing the benefits and the risks of both.

The antimicrobials, the evidence that exists related to SIBO,

is, uh, of poor quality.

It is there, but it is relatively underpowered studies.

So, there needs to be more research in these natural treatments for

SIBO and IMO and IBS to allow us to confidently say this is something

that we can offer alongside antibiotics or instead of antibiotics.

But again, I'm not completely putting them away.

I think there's a place for them, but it has to be on a case by case situation.

And there are a number of other, uh, therapies and modalities currently

being explored in this space.

I know there's a lot to be said about limbic system retraining

and looking at the vagus nerve and stimulating the vagal nerve.

Is this something you've explored, uh, at all?

Or is this a body of evidence you are in any way familiar with?

And do you think that these approaches that maybe look at,

from a gut brain perspective, it's more a brain gut take on it.

So sort of reversing the order of operations as it were, do you think these

modalities hold any promise or unless you're actually treating the underlying

is pathogenesis, the right word, um, pathology of these other modalities,

perhaps maybe a bit sort of weak in their, um, approach or just underpowered.

Well, there's definitely a, a growing interest around this topic of gut

brain s as being, uh, bidirectional.

Not like you said, not just, uh, brain gut, but gut brain as well.

And what we've seen in terms of research is we know that the mental, the mental

health and anxiety and depression affect the way you perceive your symptoms and,

and affect the existence of symptoms and the frequency in which they occur,

uh, in, in specific populations.

I think they hold promise, uh, for future integration within treatment protocols.

Uh, things like, for example, retraining, uh, limbic system, vagal

nerve stimulation, to address this neural regulation of gut function,

uh, and this interaction between the microbiota and the gut brain axis.

But again, the evidence is still very, very new, very scarce.

There has to be more quality evidence, more, um, more studies done, conducted

to, to see how this, this, this, uh, relationship is bidirectional and can be

modulated both ways with effect on, on, on symptoms and eradication of disease.

But again, I, I don't think this is a, a treatment of its own.

It will always be something.

As, um, used in conjunction with an eradication method.

So it will be something to more manage symptoms long term.

Or, uh, or manage symptoms when eradication is not possible, for example.

Fair enough.

Yeah, I suppose it's going to be always going to be more as an adjunct

therapy and not just a monotherapy.

Exactly.

You mentioned, yeah, you mentioned the future a couple of minutes ago.

Where do you sort of see the future of, of breath testing going?

And, and maybe this is just purely speculation and, Uh, just something

that's of interest to me, but do you sort of see breath testing maybe being

used in the next five to 10 years and sort of a, in a metabolic sense, maybe

as a tool to help navigate and determine certain cancers or at this point, do you

think it's purely going to be kept in the realm of a sort of functional GI care?

Oh no, no.

I think, I think the future of breath testing is incredible.

incredibly promising.

Not just in in GI disease, but just across all areas of medicine.

I think over the next 5, 10 years there's going to be significant advancements.

Not, not just about the accuracy and make them completely translating onto

in clinic methods, but also in the By making it accessible, like we do

with the OMED Breathalyzer device, making it accessible for the masses to

streamline care and reduce waiting lists.

I think that there's, there's, that for instance, there's a great potential to

use breath testing in, in early detection of metabolic diseases, as you said,

um, in identifiying specific biomarkers related to metabolic dysfunction.

Um, there's already ongoing research in the use of breath testing

for, for, for cancer diagnostics.

And this will revolutionize the way we, we screen and diagnose a range of diseases

from, from cancer to liver disease.

The, I think, The world is our oyster in terms of how we can apply these

volatile organic compounds, VOCs and breath, to link with specific

diseases and, and create these non invasive methods to diagnose and treat.

I would be remiss if I didn't ask about probiotics, something that

I probably should have touched on earlier and asked about.

Do you think probiotics have any specific sort of Place in, again, in functional

GI care and, and disease, or are they more or less sort of preventative?

Uh, are they something that you would take prophylactically, do you think?

And sort of, are your strain, are these sort of multi, multi

formula sort of approaches or maybe a single strain approach?

Do you think, do you have any thoughts on probiotics specifically?

Yeah, so I think there's, there's, um, there's a role for both, for

preventive and targeted care.

Okay.

Again, there's data on certain diseases like IBS.

There's limits of data on, on, on probiotics and SIBO.

Um, with, I think, there's recent meta analysis where they show, kind of, both

ways, there's no significant difference with, um, the incidence of SIBO, uh, with

probiotics compared to a control group.

But I think there's a component that we've seen with, uh, with, uh, recent

studies on probiotics in IBS and IBD.

There's a component to use them as targeted therapy, but it will always

be on, on a very bespoke situation with a particular patient and not, not

like a mainstream approach to eradicate or even, or even prevent the disease.

I think there's always There's always a component for prevention in terms of multi

strain, of improving your gut microbiome.

Particularly if you feel better taking it.

And there's no side effects and it doesn't interact with anything that

you take in terms of medication.

Sure, I'm more than happy to advise people to take that approach and trying

to get this balance between health and well being and control of disease.

There's not enough studies out there yet for the targeted approach of probiotics.

For to be able to standardize this treatment formulations to use in patients.

I suppose that sort of naturally leads on to a quick discussion about prebiotics.

Do you think prebiotics again have their place?

Or is that very much sort of a case of adding fuel to the fire?

Especially if there's sort of an underlying pathology again in

the case of something like SIBO.

Are these products helpful?

Are they damaging?

My view of the literature says oftentimes, um, I suppose this also

falls into the FODMAP side of things that if you're adding in a prebiotic

to somebody who's already in a diseased state, that it's probably

just going to make the issue worse.

But do you have a sort of an opinion on that or counter or yeah, what are

your views on prebiotics as a whole?

I think, I think there's a, there's again a benefit for prebiotics in terms

of promoting gut health in general by stimulating the growth of beneficial

bacteria, but again, as I said, It could be adding fuel to the fire, if we promote

it in the diseased state, uh, where we have these specific organisms that feed

on specific foods that are non digested.

And if you're introducing several strains or a particular strain, you might tip

the balance of the scale to another type of dysbiosis, and not necessarily to,

to make it a eubiosis environment where everything works perfectly in your gut.

I would be more wary in using it in the diseased state, in someone

who has active SIBO, versus using it in someone that is looking to

just improve their general health.

Uh, because they, they occasionally have symptoms, they, they feel that

their digestive function is not as good as it could be, and their metabolism

is not as good as it could be.

So I, I think there's, there's um, incorporating it in, in the diet

can be a good and effective way to improve the gut health, but very

wary of using it in diseased states.

I suppose like everything, it is ultimately about just finding balance

and utilizing the right tool and the right individual at the right time.

Exactly right.

I think before we close, I'd just like to, and again, a selfish question.

I'd just like to pick up your brain a little bit about how you, knowing what

you know and uh, and what you've studied and, uh, the clinic and yeah, how you

incorporate these practices in your life.

Do you sort of follow any specific dieting exercise regime?

I hate the word biohacking.

It's sort of almost become cult like.

But do you sort of including any of those sorts of practices in

your life to optimize your life?

Yeah, it's just always interesting to hear it from the horse's mouth, so to speak.

So I would love to say I practice what I preach about, but I'd be lying.

Um, I, I, I tend to maintain, try and maintain a balanced lifestyle.

So in terms of diet, uh, for years I followed the Mediterranean style diet

because I'm Portuguese, but recently that, that, that has become very hard to

achieve, but I tried to, it's all, again, like you said, it's all about balance.

I try to include a bit of everything in my diet.

I try to not restrict myself too much.

'cause fortunately, I, I, I don't suffer from GI problems.

So, uh, but I try to maintain my diet relatively balanced by

including a bit of everything and, uh, not letting it tip to excess in

a particular, in a particular part.

Um, in terms of, uh, in terms of exercise, could do more, I, I, I enjoy hiking

and climbing and, and occasionally, uh, I, I do that and, uh, it helps me to

stay active and, uh, cardiovascular, um, cardiovascular exercise does me to,

to, to feel a bit better about myself.

I've, I've, I've attempted diets in the past, so something like periodic

fasting, intermittent fasting.

Which, which helps, but it's very difficult to maintain, um, long term.

But, but there's, there's a lot of things that, that, that you could do, alongside

of things like, for example, uh, specific diets, uh, specific treatment regimens,

uh, uh, sorry, exercise regimens, and, and things like cold exposure, for example.

But I think it's all about balance.

As long, as long as you can find balance for you, cause, uh, it's not a one size

fits all kind of thing, as long as you find balance for you and what works for

you, and try and maintain that, don't let it tip towards one end of the scale, just

try and, and, Allow a bit of everything.

Don't restrict yourself too much because long term it's very hard

to maintain and will probably, um, have worse consequences.

But yeah, I think, I think I'm managing so far.

But I, um, I'm definitely not, not, uh, practicing what I preach.

So, uh, I'm not not the best example.

No, well, I mean you are otherwise healthy.

So if not, why not?

But yeah, no, I couldn't agree more.

Um, and just to sort of reinforce what you just said, this sort of

concept of biochemical individuality is, uh, is very important.

And I do find it fascinating that a lot of people in the influencer space Who sort of

promote these very extreme diets, whether it be carnivore or vegan or ketogenic.

They all, over time, you watch them, Paul Saladino, the individual who really

pushed the carnivore diet for a long time, being a prime example of this,

they always seem to come back to center, whether it's sort of reintroducing

carbohydrates, reintroducing vegetables.

Uh, practicing less fasting, uh, fasting is a stressor obviously in

a, in a, in a therapeutic sense.

Um, it's amazing, but only in the short term, uh, obviously with long term

use, you're going to potentially create dysfunction in your HPA axis and creates

all sorts of hormonal dysregulation there.

So yeah, no, I couldn't agree more.

It's, it's, it's ultimately about maintaining that sort

of healthy middle ground.

Where's the best place to find you and your company.

Rui?

I know you've mentioned both Owlstone and OMED for the consumer who's looking

to potentially particularly purchase one of the, these breath analyzing, uh,

products, where would you point them to?

Yeah, so if, if you're interested in, in learning more, um, you can find

regular updates and, and our latest research and developing in our websites.

So generally about breath research at Owlstone Medical and, uh, more

specifically about g the GI space, uh, OMED Health, so omedhealth.com.

And owlstonemedical.com for detailed information about what we do and how

we are advancing the field of breath based diagnostics and research.

Um, I intend to, to publish some of those updates as well in latest research

and developments in my LinkedIn.

So if you feel free to contact me there.

Okay, perfect.

And we'll publish links to all of those socials and websites in the show notes

as well as any other studies that we sort of either mentioned or discussed.

or that I would think that the listener would otherwise find interesting in

the, yeah, again, in the show notes.

Thank you so much for your time.

We really appreciate it.

This has been enlightening.

Definitely learned a lot and we'll have to get some points soon.

Yeah, thank you.

It's been great to be here.

Thanks Rob.