Microbiomes. In simplest terms, they are the entire collection of various tiny organisms such as bacteria and fungi that live in and on our body. Scientists is have found that upsetting the balance can lead to illness and, conversely, understanding microbiomes better can help improve our health. We have trillions of organisms in our body that make up our microbii dont mean mat, so researchers are using big data to learn more about them and how they work. So how can we take advantage of what microbiomes tell us . Well, here to talk to me now about this Promising New Research is the founder and chief science officer of viome which uses technology and microbiome biology to improve health. Momo, thank you very much for joining us. Lets start, if we may, by understanding what the problem is here. Whats the Health Challenge that youre trying to address . We have a massive, massive epidemic of chronic diseases. Youve heard about parkinsons and alzheimers ask and diabetes and obesity and so on. More than 50 of the population suffers from one of these diseases, and the rate is actually increasing. So the more money we put into health care, the more diseases we get back. And the reason for that is that we are treating symptoms. Were not really understanding the root cause of these diseases and putting money into prevention. Gerry so what does any of that got to do with the gut . Yeah. So the gut microbiome is the key to all these diseases. If you ask any doctor, for example, what causes health and disease. Gerry a technical term a lot of people wont understand, but what is a microbiome, and what in particular is a gut microbiome. Gut mean our intestines, micro means its very small. There are about 40 trillion of them in each one of us gerry bacteria, viruses. Thats right. Fungi, yeast, theres some plant viruses, bacterial viruses, so there is a mixture of a vast number of work nhlingss, and they organisms, and they get to process the food we consume first as nutrients for themselves, and thats what they use to survive. And then they process that food and make a lot of other different chemicals, thousands of different chemicals that we have evolved to depend on. And so the chemical output of the gut microbiome is like a chemical vessel. It determines the health and disease. Gerry way beyond we think of things we eat, put in our system act and we get an upset stomach, and we understand that part. Youre saying whats going on in our gut has implications for our whole body health, essentially. Absolutely. So we are, for the first time, redefining chronic diseases in terms of there is no magic about it. Its not some unknown factor. Its really if you pick, lets say, ibs, its gerry irritable bowel syndrome. Weve identified it as common among people who suffer from ibs is their gut microbiomes produce chemicals that are associated with a disease, and theyre missing chemicals associated with health. So two people can have completely different gut microbiomes, and yet people who have ibs, even though they have competition, the chemical output of those two gut microbiomes are very, very similar. Gerry but, again, we all have just like dna, we all have our own gut microbiome, and we may have the way we treat diseases may be dependent on what kind of microbiome we have. Thats right. So, first of all, we have to understand whos there. So which microbes are present, and then we need to understand what theyre doing functionally. And its this function that turns our health into disease. And this function can actually be regulated very easily with diet. And so we can make any gut microbiome produce the chemicals we want to by restricting the foods that it uses to produce harmful chemicals and by providing it foods that the gut microbiome uses to produce healthy chemicals. So for every person we can fine tune the diet using the chemistry in their gut and mathematical equations that weve developed with Machine Learning to actually compute everyones personalized diet. Gerry so you and i may have the same condition, the same disease, but the treatment of that disease, the response or the prevention, if you like actually, as you were talking about earlier, getting to the prevention of that may be completely different for others. I might need certain foods and certain chemicals, and you might need a completely different set. Thats exactly right. We just need to have our own personalized diet such that your gut microbiome will produce beneficial chemicals for you. Gerry how does it again, you talked about all kinds of diseases and, again, i think people understand things like ibs or problems in the bowel, problems in the digestive system can be addressed this way. How does the gut microbiome, or what is the potential of this type of approach for treating other conditions . What kind of conditions are you particularly looking at do you think theres real promise there . We are prioritizing the big four, ibs, depression, obesity and diabetes. However, were also work very hard on autism. Theyre all directly related to the gut micro biome and their activities. So a majority of neurotransmitters are actually produced in the gut. And recently a study showed that autism can be actually treated very effectively with just food transplant, and thats really the best treatment there is currently available. Its not fda gerry youre talking about taking fecal matter from one child to another. I dont want to get too detailed here, its not so dinner time viewing, but is that right . Thats as simple as that. You take poop from a healthy child, and you install it into the child with autism, and their symptoms get better both neurological and gastrointestinal. Gerry and what about depression . Depression is directly controlled by the gut microbiome. We have extremely good models that were going to publish soon showing that its we can test someones poop and know whether theyre depressed or not with very high acts are city accuracy without knowing who that person is at all. The most exciting thing is we can actually knowledge late those funks just using personalized diet. So soon were going to enter Clinical Trials to demonstrate that. Gerry what about the real big challenges that really continue to, i mean, at least the serious challenges that you talked about, cancers, heart disease, things like that. Is there evidence in the gut microbiome that we can address those issues too . Absolutely. So heart disease, for example, is caused by infrom inflammatiot sor so many of these other chronic diseases. Its actually caused by biochemical activities of the gut microbiome. So it produces proinflammatory chemicals that actually increase the activity of our immune system unnecessarily. So it regulates the inflammation. And so by feeding each person personalized diet, we can actually reduce that inflammation. And cancers, i want to mention that cancers are not only known to be maintained by gut microbiome activities, they have been shown to be caused by gut microbiomes. Pan carrottic cancer was pancreatic cancer was shown to be caused by gut bacteria that traveled from the gut, through the bile duct and they turn off our em moon system in the pancreas, and that causes cancer because cancer cells are always produced. But the immune system kills them, basically. Gerry this sounds like very exciting research, and youre doing a lot, youre raising a large amount of money for your company. But on one level part of me says people have been talking about diet for centuries. Doctors, right back to physicians back to ancient times basically saying our health is all about diet. In what sense is this a dramatic change from that solid advice that, you know, an apple a day keeps the doctor away . Yeah. Current state of the art for diets is truly a guess. You go online, you read some forms, you present your conditions, and then you try different diets. I had an early onset rheumatoid arthritis, and i tried millions of diets, none of them worked. Youre just guessing what we are bringing to the game is math and chemistry. So were converting this sort of magic of diet to a chemical reactions that go on in your microbiome, and the math is converting this chemical activity into mathematical equations so that we can now, for example today, when a customer signs up for viome service, the personal diagnosis that is made has nothing to do with a human being. It doesnt depend on someones experience or anecdotal evidence. It is purely mat call equations. Gerry how can we discover what is the makeup of our gut microbiome, and what can be done about it . Right. The commercial side of our company has a product that someone can purchase on the web site, and they receive a kit for stool collection. They collect their stool, ship it back to our labs, and once the sample is analyzed, we can make very personalized recommendations. And i want to highlight one aspect of that while weve been tuning inflation for a long time, what we recently developed is a machinelearn model which can tell you exactly which cashes to eat and which not carbs to eat and not to eat in order to lower the blood sugar. Theres this phenomenon where if you eat carbrich foods, it can cause diabetes and other diseases. Every person responds differently to different carbs, so we have found that anyone can eat carbs, it just depends on the person which carbs. Is so our app guides every customer through this. Gerry thank you very much. It sounds fascinating. Were going to take a break now, but well be back with more right after this. Thank you very much. If your adventure. Keeps turning into unexpected bathroom trips. You may have overactive bladder, or oab. Not again were seeing a doctor when we get home. Myrbetriq treats oab symptoms of urgency, frequency, and leakage. Its the first and only oab treatment in its class. Myrbetriq may increase Blood Pressure. Tell your doctor right away if you have trouble emptying your bladder or have a weak urine stream. Myrbetriq may cause serious allergic reactions, like swelling of the face, lips, throat or tongue, or trouble breathing. If experienced, stop taking and tell your doctor right away. Myrbetriq may interact with other medicines. Tell your doctor if you have liver or kidney problems. Common side effects include increased Blood Pressure, common cold or flu symptoms, sinus irritation, dry mouth, urinary tract infection, bladder inflammation, back or joint pain, constipation, dizziness, and headache. Looking for a destination that isnt always the bathroom . Ask your doctor if myrbetriq is right for you. And visit myrbetriq. Com. I want some more whats he doin . But, he cant look at him its just not done please sir. I want some more more . More . More . More . Please sir he has asked for. Thank you what . Well he did say please sir yes he did and, thank you yeah. And thank you hes a wonderful boy laugh a delightful boy all boys thank you, thank you, thank you. Gerry while technologys being used for Big Health Care projects such an analyze aring microbiomes, its also being employed on a very personal scale. Now dr. Schaumberg is chairman and ceo of american wealth, a company that uses telecommunications to deliver athome health care. He joins me now from boston. Thank you very much, indeed, for joining me. Thank you, its a pleasure. Gerry start by telling us what exactly your company, what American Well is and how your product works. Well, American Well is a Technology Company that helps doctors connect with their patients taking into account large degree of considerations that at the end of the day allow me, the patient, to connect to people that i trust from the comfort of my home with a fraction of the price without compromising on the quality of care that they receive. Gerry and how does that work . You literally have an app or something on your exciter, and you can computer, and you can consult doctors that way . Yes. You have an app or web site or even a television device, and you can reach out and talk to same doctors in your community that you know and trust that have full access to your records. Those visits are like any other visit, usually fully reimbursed by your employer and your Health Insurance company. So its really an extension of the care that we know for many, many years. Its not a replacement. Gerry and, again, these are doctors that youre familiar with, these are not random higenerated doctors who happen to be available at that particular time. Yes, its interesting. Telehealth started as a call center in many ways. Its a solution that replaces my relationship with my doctor with someone that knows very little about me that ive never met. We always felt that that type of solution has lots of limitations. And our mission is not to do that, but rather to help the doctors that we know in our community to interact with their patients having full access to their full set of information through a hybrid model that allows me to see the people that i need to see in person when i need to and otherwise go online when its convenient for me and to my health care team. Gerry but doesnt a doctor really need to see, be present with a patient in order to really see whats going on . You know, look at the color of my skin or something, the way in which im moving or speaking, whatever . Isnt that direct personal contact really important in medicine . I think that the direct personal contact is very, very important. But you can do a lot today online. I mean, you have devices like the apple watch or many other much more sophisticated clinical devices that connect data back into the doctors office. And then you have very High Resolution cameras that can pretty much do fairly good videoconferencing in the same way that im sitting in boston and youre sitting down there in new york and still have a fairly good conversation. You can tell a lot about me by looking at the camera. But that does not always replace physical relationship. In American Well we dont believe telehealth should be the only way to interact with your doctor but, rather, sometimes a very effective way. So give an example. When i am considering to go to the emergency room and not really sure that i need to, it may be a good idea for me to interact with nurses or doctors in the e. R. In my community online, let me know whether i need to show up now or maybe i should show up later. And its very, very helpful. Gerry weve got to take a quick break. I do want to hear more about that example and im a little concerned that you can maybe diagnose me down the line there from boston. That made me nervous. 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Go to 5hourtea. Com. Gerry doctor, just before the break we were explaining how telehealth works. Give us some specific examples, if you would, of the benefits of this system over some of the other more conventional forms of medicine that were used to. Sure. So telehealth alone is just one component of a huge revolution thats happened in health care. The good and bad news is that everything we know is about to change, and heres what i mean by that. We are used to the fact that when we are not feeling well, were going to a physical location somewhere, and we do some lab tests and other tests, and we get fixed, and then we go home and continue about our lives. This was the normal way health care happened for hundreds, maybe thousands of years. Whats changing now is that very much like our car alerts us when somethings wrong, we are going to continuous hi be connected countously be connected to the health care system. So our body is going to emit continuous data into the cloud. This data will be analyzed, and when something is wrong with us, the system will reach out and allow people that we trust to go back and provide us with what we need much faster and much cheaper in a very high quality. Gerry sorry to interrupt, but that literally means you could get an alert saying your Blood Pressure is dangerously high, or your cholesterol level . Are you talking like that . Youre being constantly monitored, is and doctors would be able to intervene and respond like that . Exactly. And when we think about intervening, we may have the benefit regardless if we live in a big up to like boston or a small village to get access to the best minds in america and maybe the world in order to put in algorithms and work flows that are normally not accessible to everybody to make that intervention unbelievably impactful. Gerry everybodys really worried about privacy, were putting all of our medical information out there even more than we have, how do you address that concern . Its a very valid concern. And the best thing we can say is that that we should do the best we can. Cybersecurity is a very big part of our life in every field, including health care. And we spend enormous amount of effort, we and our partners are spending an enormous amount of effort to make sure that whatever is available today is incorporated in everything that we do. Its a big part of our life. But unfortunately, you can never be sure, and we should always understand that when we get the benefits of connectivity, there are serious risks associated with it, and there is no way to sugar coat that. Gerry doctor, it sounds like fascinating information. Im sure many, many people will be taking advantage of it. My thanks to dr. Schoenberg. Just ahead, how technology will have an even greater role in our lives in the future. Ms does suck. Ms mucks with your Central Nervous system, almost everything about your body, your muscles, your organs, your ability to speak, your ability to understand, your ability to move. Ms took everything from me, everything i thought was important, everything i valued. I used to jump on a trampoline and swim with the kids. Ms has effected me being a mom because, im sorry. Despite ms, i will keep riding my bike. I will continue to be the strongest mom that i possibly can. I will still dance with my husband. I will continue to live the life that my daughter expects me to live. Multiple sclerosis may be a part of who you are, but it doesnt define you. I will never stop, i will never quit. Im gonna keep being me. Gerry advances in technology are trang all aspects of our lives while our increasing on to session with some would even call it addiction to digital devices is not necessarily good for our health, thankfully innovation is helping to dramatically improve our physical wellbeing. Weve heard about a couple of those innovations this week, but there are many billions of dollars being invested in all kinds of new technology that will save millions of lives and improve our quality of life enormously, some of the most exciting coming in the area of disease prevention. The old saying that stitch in time saves nine is never more true than when applying to cancer, heart disease, dementia is incredibly expensive. The opportunity to adopt behaviors or treatments that will head off those diseases will not only help us live longer, it will save trillions of our hardearned dollars. Thats it for us this week. I wish you a healthy and active week. Be sure to follow me on twitter, facebook and instagram, and well be back next week with more indepth interviews right here on the wall street journal at large. Thank you for joining me. Gregg good evening, im Gregg Jarrett sitting in for the vacationing lou dobbs. An agreement with el salvador allowing the u. S. To send illegal immigrants. The latest attempt to stymie the president beginning to
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