Entrepreneur Ravi Shroff, Managing Director, Excel Industries Ltd, demystifies the Gut Microbiome and talks about how it impacts your health and well-being

Entrepreneur Ravi Shroff, Managing Director, Excel Industries Ltd, demystifies the Gut Microbiome and
talks about how it impacts your health and well-being

 

It’s really a privilege to be here, thank you for inviting me. I’m going to talk about the gut microbiome, as you all know. I’ll start by talking about my personal journey, and what led me to this field. In 2009, I had an episode where I suddenly experienced intense joint pain following a course of antibiotics. I consulted many medical professionals and underwent so many tests; I was repeatedly told that there was nothing wrong with me.

However, I knew that something was clearly wrong with me. Through a process of elimination, I identified milk as the culprit, and a doctor suggested dietary changes. I made many more changes over the next two years and that transformed not just what I was eating but also how I was feeling. I changed from being someone who was done by 5 pm and even had mood swings. I had not realised that my digestive system was under a little bit of stress prior to this episode. But with all the changes I made, I became a transformed person; my energy levels went up, my mental clarity improved and there were many other positive changes. I also used to be much bigger than I am right now.

So, I wanted to understand what was happening inside me and that led me to study it, do a lot of research on it, and go deeper. At the same time, the word microbiome was starting to emerge around the world and more and more importance was being given to it. I put two and two together and realised that something had changed in my microbiome. As a scientist, I am always curious to get to the root cause and in that process, I figured that what was working for me. I realised there were more correlations to be made and if I could do it for myself and feel better, I was sure I could help many other people too. People started approaching me, saying, we know you made changes, and something worked for you. So, then, I decided to go found this venture.

I’ll just talk a little bit about what we do. We are a lab based right here in Mumbai. Dr. Upasna, who’s here in the audience, is heading the science of whatever we’re developing. We have a state-of-the-art lab, probably one of the best in India, to understand what’s going on in your gut. The idea of the gut microbiome is how do you understand it because not much work has been done on this in the past, except in traditional medicine.

Ayurveda, for example, recognised that most diseases originated from the gut.

But Ayurveda had empirical evidence whereas modern medicine focussed more on understanding the cause of things but not necessarily always going to the root cause. So, this is the first time, through understanding the gut, that we can probably merge many fields of science and traditional medicine together.

That’s what we do in our lab – understand the microbiome. What is the microbiome? Essentially, the microbiome is a collection of microbes. And microbes have been around on this planet for about a billion years. Humans have existed for 10,000 years; so, imagine the amount of information that a creature even as tiny as the microbe carries from evolving over a billion years versus humans having just about 10 ,000 years of information.

You can see them on your body, outside of you and inside of you. Everywhere you go on this planet, any environment, there’s going to be a collection of microbes that have been surviving there, existing there, for a long time. And these microbes are very connected with all the systems they are a part of including on your body, and specifically in your gut. So, most of your microbiome resides in your gut. You’d be surprised to know that approximately 1 kilogram worth of microbiomes, microbes, reside in our gut so you can imagine the number is about 10 trillion and the human body has only about a trillion cells. So, 10 to 1 is the ratio of microbes.

Oftentimes in a lab and with our science team we joke that are we more microbe than human because of the number of microb It’s sort of hard to differentiate between the two though. The interesting thing about the microbiome is that it interacts with almost every part of our body. And particularly from the gut and the gut perspective, as I was sharing with you, approximately 90% of diseases have some correlation going back to the gut. So, it’s really important to understand what’s happening in your gut and make as many correlations as possible so that you can sort-of improve your quality of life. What does the gut do basically? You know, the gut performs some very core functions in our body. The entire metabolic balance and harvesting nutrients, energy from our environment, is done by the gut. Production of vitamins, hormones, and metabolites, controlling different organs in your body and your brain…

A lot of this is done through the guts. Also, 95% of the happy hormone called serotonin gets produced in the gut. So, you can understand how the gut relates to your mood as well as your immune function. Again, by evolution, your immune system is very correlated to your gut, and gut microbiome, because most of their foods that we eat – our interaction with the environment – a lot of it goes through our gut. So, 70% of the immune system is connected to the gut. If you work with your gut microbiome, you can work on all of these aspects: immunity, mental health, digestion, hormonal balance, weight and weight management, sleep, skin and hair, And, of course, for women particularly, preparing your body for pregnancy, things like that, even the other aspects related to hormones, all of this can be managed through a healthy gut microbiome.

Now, how do you know if your microbiome is healthy or not? So there’s eubiosis and dysbiosis. Eubiosis is where you have more of the good bacteria compared to the bad bacteria. And dysbiosis is when the bad bacteria outnumber your good bacteria. Typically, dysbiosis starts affecting your body and you start getting things like acidity. You feel lethargic. These are the initial symptoms. You have mood fluctuations, skin issues, acne, stuff like that. You won’t be sleeping well or, headache, migraine, bloating, gas, a whole bunch of things. These are all linked to a dysbiotic gut. These could be early symptoms and, if you don’t take care of it, it could progress, get worse, and start to affect other parts of your body as well. It’s becoming very evident from the science that the gut is connected to almost all other vital organs of our body. So, nourishing all of these organs, signalling all of these organs – all of this is controlled and managed through the gut. And that is why it becomes all the more important to take care of your gut and gut microbiome, so that you can have a healthy heart and a healthy liver. A lot of metabolic disorders like diabetes and obesity are controlled in the gut-liver axis as well. If you don’t take care of your dysbiosis, it progresses and starts affecting these organs. The interesting question is, what happens if you have dysbiosis, right? And we can talk a little bit about this later, but you know, like it’s possible to reverse your dysbiosis as well.

Yeah, so if you are diagnosed with dysbiosis, if you are diagnosed more bad bacteria and less good bacteria, how would you go about reversing it? And the answer is fairly simple, you know, it’s in our day-to-day habits. It’s in what we eat. We need to nourish our body with good bacteria and there are many ways to introduce good bacteria. My personal preference is to introduce it through food. I’m not a big fan of taking too many medications and these are natural foods one can consume in small amounts regularly and which can help you introduce some of these good bacteria in your system. People often ask me how much they should have and stuff like that. I would say, don’t take a giant bowl of it and eat it every day thinking it’s going to help you. You need to have a good healthy habit of eating enough. Maybe half a bowl or something like that but have it daily and have it regularly and keep mixing so that you keep your gut nourished with more and more varieties of good bacteria as well. With good bacteria, they also need to survive in your gut. And to help them survive, there is something called prebiotics – these are foods that support bacteria and nourish them. So, along with those probiotic foods which contain natural bacteria, also to have prebiotics.

The best way to introduce pre-biotics, again, is to have a variety of foods in your meal, try and eat as much diverse food as you can and, a lot of vegetables, fruits, and grains of different kinds – they all contain prebiotics, so keep mixing your foods. If you find that something does not suit you, try and make a note so you can eliminate those. There are also other ways to find out which foods are not suiting you. Just to keep this very very simple, people often ask me what foods to avoid, what to add to your meals, things like that. So, I’ve just made an easy list here. A lot of it has come from my own experience, and of course, there’s enough written about it out there.

A big revelation for me was that foods contain preservatives, right? A lot of times we want the convenience of eating a meal out of a packet. We open something, either heat it up or directly consume packed food. So, the thing that they are preserving the food from is to prevent it from going bad with bacteria. And the moment you add a preservative that kills bacteria, imagine consuming that and that same preservative going inside your system. What’s it going to do to the bacteria in your gut? It’s going to kill it. And if you’re eating this every day, you are basically harming your gut daily. It’s the same with processed foods and alcohol and diet drinks. A lot of people think they can keep consuming diet drinks because there are no calories but they cause slow damage to your system and it’s the same with artificial sweeteners.

More and more research is coming in about the inflammatory properties of red meats and again it is known to damage your gut, so I don’t say that you cut it out completely but like try and limit as much as you can. On the right hand side, we have foods that actually help your gut. So, foods with polyphenols are all different coloured foods like purple, green, yellow. Foods that have resistant starches – starches also nourish your microbiome. Fermented foods, as I shared a little while earlier, contain probiotics. Food with good fats and a lot of times people think fat is the enemy so let’s cut out all fat, but your body does need good fat. So, try and incorporate things like nuts in your diet, ginger, garlic, turmeric. These are also foods that heal, these are known antioxidants and turmeric has been talked about a lot. It’s not just about the food that you eat, right? There’re certain other habits as well that you need to practice. So, the number one thing I spoke about is eating fibre-rich and prebiotic food but hydrating adequately.

Then, getting enough sleep, avoiding antibiotics as much as you can; I mean, I do understand their role and antibiotics are definitely life -saving, but if your illness is not that critical and if you can talk to your doctor and do without antibiotics, try it. Just to give you an example, in the last 15 years, I have had only one course of antibiotics. And the only time I took it was when I had to take dental treatment for tooth extraction. So I’ve not taken antibiotics in 14 years and I’m perfectly healthy. I have not missed anything because of bad health. So, getting enough sleep also is very important for your gut and a lot of times I am sure, through your experience, you have realised if you had a stretch of less sleep it starts affecting your digestion, you start feeling queasy, your anxiety level goes up. So, it is important to get adequate sleep as well. Surprisingly, exercise is also good for the gut because it helps with motility, blood circulation, and your mental well-being.

A little bit of yoga or meditation, if you can do, also has a very positive and calming effect on your gut. Going forward, just to understand a bit more about the gut. While whatever we have spoken so far are general recommendations, one thing is coming out very clear which is that no two people are the same. The foods that work for one person or the habits that work for one person are not necessarily going to work for another person. And it’s very, very important to do simple things like keep a journal or a diary, keep some kind of note, especially if you’re embarking on the journey, trying to improve your well -being and health. There’s also tools available now where you can understand specifically what’s going on. There are inflammatory markers available. There are other tests available which help you understand what’s happening in your body, your gut and the use of these tests, also being self-aware and understanding what works for you and definitely reaching out to maybe a practitioner who is also understanding gut and gut microbiome.

Everybody has a unique fingerprint in their gut microbiome. You also have your own unique circadian rhythm that works for you in terms of your sleep cycle, body cycle and you have your own DNA which makes you unique. So, the combination of these three and if you want to manage your gut, you need lifestyle habits and other habits which are unique to you. You also need food preferences and how to modify your diet and how much you eat, what you eat, things like that. And, of course, health goals, right? Everybody’s able to have different endurance levels, different ability to deal with things. Some people get anxious and stressed easily. Some are able to endure things much better. So, how do you use all of this and manage to reach your health goal in a better way? And, of course, to lead a much better life. So, it’s important to use the tools available.

How can one use this information to benefit you to achieve your health goals, and your other goals faster. So, for example, how to manage obesity, how to manage other things like IBS, bloating gas, a lot of these things, it’s possible now to have a peep inside your gut. So, while you may love to follow someone’s advice, you may love to do what somebody else did but it is also very important to understand what works for you and how you work with your body to achieve your goals in a better way and a smoother way. Essentially, that’s what our lab does and it’s a very sort of easy and convenient way. I mean, these tools did not exist earlier, but now it is possible to get your gut tested right from your home and like us, there are many other companies that are offering this test as well, where it is just a simple stool sample; the kit comes home. You send the kit back to the lab and basically you get a personalised report which helps you understand. It tells you what the inflammatory bacteria in your gut are, what other gas-producing bacteria does.

Helping you understand what are the foods that are going to break down easily in your gut and are going this through a process which is easy to measure and follow and then you can come back later and check again as well whether there is improvement because the only way to make an improvement is if you measure something. So, this is kind of like the tool that’s available now, to be able to understand and measure what’s going on in your gut. The road to health is paved with good intestines. That’s the motto we follow.

 

ROTARIANS ASK

The University of San Diego has done a lot of research on the microbiome, and they believe you can change your microbiome in 21 to 30 days, and you could lose a little bit of weight. What are your thoughts on that?

Basically, that’s what we do and that’s what we understand. How to transform your gut, how to align your gut with your goals. That’s essentially what comes out of the test. I was a little alarmed when I saw the presentation that alcohol is bad for the gut, so I just wanted to clarify. I mean, beer is fermented, wine is fermented, I hope they are fine. In moderation, as I said, you know, it’s good, and in good spirit, I’m giving you a good response, so… We see a lot of advertisements these days of the good bug and lots of external Ayurvedic medicines and everything to improve gut health, and a lot of awareness.

Should we go for those or more personalised ones? How does it work?

There’s always the easy way of just picking something and trying, right? And there is the longer route where you’re wanting to actually make improvements over a period of time. I would say that products that are already available on the shelf, yes, these are going to work for some people, and they are not going to work for some people. It’s a trial and error process and definitely because of the convenience, you should try something like this if you’re experiencing issues. But in a lot of cases, we find that if the issue is chronic or long-term or something that needs more attention, it is always better to find out what’s deficient and use that. For example, in our test we are able to pick up which are the exact probiotic strains that are missing in your body and, in fact, Dr. Upasana’s PhD is on probiotics. In the diagnostic space, as well as among clinicians, there is very little awareness and adoption of gut microbiome testing.

What do you think is inhibiting this from being adapted into mainstream practice in India?

Mainstream medicine relies a lot on standardised tests. And unfortunately, because of the number of microbes present in our system, which is in excess of thousand species, it is not possible to standardise a test like this unless you have millions of people’s data and what’s really missing today is a lot of data from India, which is not yet generated or published. So, one of our aims is to generate as much data as we can. So hopefully, at some point in the future, we also can say with a little more confidence, particularly for the clinicians and the medical fraternity, that yes, we are very sure of what we’re seeing from our report.

Upasana, with a hectic lifestyle, how much probiotic should we have?

I think all of us carry these probiotics tablets along with us. Dr. Upasana: When we talk about probiotics, there are two aspects to it. One, which product to take, which probiotics are actually required for your body. And secondly, even if you’re taking a certain probiotic, the dosage will be dependent on the probiotic bacteria that you already have. So, if the probiotic composition in your gut is really low, then we have a certain dosage that we stick to. But if you do not need so much probiotics, then the dosage changes accordingly. The problem with probiotics is that they are the most pricey guests that come in. So, they’re going to enter your system, they are going be there as long as you are pampering them with the right food, with right amount of attention in any and every form. The moment that goes off, the probiotics also go off. So that is why usually, when people say that you’re supposed to have probiotics, it’s usually for a longer period of time. So once your gut is all right and you have the next test, you are probably going to hear that now you might not need it on a very daily basis.

How do you relate to naturopathy in India which also heals the person and this whole gut aspect?

In my view, naturopathy is a field of medicine that works first on lightening the load on your system. You may be carrying some load knowingly or unknowingly and then preparing you to take more load through the 10, 15, 20, whatever 3-week kind of course that you do. Because sometimes, when your body is under stress, your capacity to deal with your environment just drops dramatically. So, I would say, naturopathy is very, very good at capacity building and working with the right diet, working with the right sort of approach, which I think is always recommended in any form of naturopathy and perhaps that may get enhanced with knowing actually what suits you in that list as well. So, in my view, it can work very well concurrently. Ravi, in India, we do not get tested for food allergies frequently. What’s your take on that because lots of people are probably ignorant of it actually. I completely agree with you and I feel that everybody has some extent of reaction to some food. Sometimes it’s very minor, maybe not noticed, sometimes, you know, it’s on the edge where you start noticing and sometimes it gets worse, that’s where people really pay attention. But it is important to use the diagnostic tools that are available and so many more tools are now available, such as food allergy, intolerance, testing your gut microbiome, inflammation, and so many other things. It’s important particularly for a person who wants to improve their quality of life to know what is my starting point and where are my challenges going to lie and an allergy kind of test is one of those that one must take if they want to, particularly through improve their quality of life. If I had to choose between a Yakult or a Danon, which would you advise? I am sure her answer will be different than mine but I’m a very big no for sugar and anything that contains sugar is basically just to make it more attractive for you to eat. I would question the probiotic value of that if they add so much sugar in it. So, I’d say try and find natural forms of sugar, nothing against the companies. They have done a great amount of research, contributed a lot, but my personal choice would be anything that doesn’t contain this much amount. You mentioned the Illumina machine that you’re using. I’ve heard something about that… can you mention that and is it the one you are using for examining the gut? So, Illumina is the global world standard for sequencing and basically what we have in our lab is a technology which uses a sequencer. What the sequencer does is it reads any DNA, RNA, end-to-end and basically knowing what the DNA RNA is, you can characterise what that thing is going to do, whether it is bacteria, plant, animal, human, whatever. So, our lab’s capability is to study DNA and RNA and using that and the algorithms that we have built in our labs, including the algorithm that Dr. Upasna has built, we are able to understand each microbe and the role it is playing in your gut. That’s basically the underlying technology and Illumina is a company that makes these machines. They have approximately 90% of the world’s market in this and it is a state of art technology on understanding.

Basic questions. For a lot of us, our gut movement in the morning starts with tea or coffee; what is your take on that? My take on this is very simple, and I’m giving you a general answer that goes just beyond this. Like, I ask myself a question every day, how am I feeling today?

And I try to recall what I did yesterday, what I ate, and I’ve been doing this for a long time to be able to tune in and for me, now, I know that one cup of coffee in the morning works best and I don’t need any more than that and so I’ll have only that 1 cup of coffee, preferably before 11 in the morning and then I’m done. Anything more than that makes my system queasy, I get a little jittery and things like that, which is a natural effect of caffeine and other things.

I would say, trial and error, ask yourself questions about how you feel post certain things and question your habits for sure. And then if that cup of coffee I need early morning is that, that should be fine. I mean, then I feel that my dependency on the gut movement is on that, it’s actually very natural. So, even coffee contains prebiotics that nourish the gut. But again, whether it is nourishing your gut or not or whether it is having the opposite effect is important to understand. I was in Bangalore, and I tried this saliva test which helps you give DNA markers. And I had the option of going for a gut test. So, there was a big difference between which to go for.

I tried my saliva tests. I’ve got some reports for DNA markers which will help you throughout your life. So, when the gut is not consistent, and the analysis may be not consistent over a period of time, how do you think this is a better option compared to the other tests like the saliva test or something else? Saliva tests will pick up your own DNA and this picks up the DNA of the microbes in your gut, so there’s a basic difference between the two. And, well, I can’t change your DNA yet. You know, there’s technologies out there like CRISPR, which some day doctors will be able to change your body constitution. But at least the microbes in your gut, you can control by your diet. And understanding what changes are required are far simpler through dietary. And that’s the difference between a gut microbiome test and a general DNA test.