Inside Matters

For years, the spotlight in microbiome research has been firmly on the gut. We’ve learned that diversity there is generally a good thing—linked to resilience, health, and better outcomes. But what if one of the most important microbiomes in the body follows completely different rules? In a recent conversation, Dr James McIlroy sat down with Professor David MacIntyre, Director of the Robinson Research Institute, to explore a rapidly emerging field: the female reproductive tract microbiome. What they uncovered challenges many assumptions—and could transform how we think about pregnancy, birth, and early life health. 00:00 Show Returns 01:34 Why Reproductive Microbiome 05:15 Low Diversity Health 09:24 Lactobacillus Protection 12:06 Human Uniqueness 14:17 Population Differences 16:31 Oral Probiotics Myth 19:25 Vaginal Biotherapeutics Trial 22:11 Host Immune Response 27:03 Dysbiosis Triggers 30:42 Microbiome and Preterm Birth 33:06 Labor Inflammation Pathways 38:10 Pregnancy Microbiome Shifts 39:11 Screening and Group B Strep 40:57 Microbiome Screening Potential 42:06 Global Data Predictive Signatures 43:23 Limits of Current Risk Tools 45:30 Point of Care Profiling Vision 46:50 Swab Mass Spec Barcoding 48:27 Composition Versus Host Response 49:58 Metabolic Dark Matter 52:13 Beyond Bacteria, Viruses, and Fungi 55:48 Vaginal Probiotic Trials 57:39 Phase Two Trial Endpoints 01:01:28 Vaginal Microbiome Transplants 01:05:46 Birth Seeding After C Section 01:10:57 Do Vaginal Strains Persist 01:14:05 Ten-Year Personalised Medicine 01:17:45 Wrap Up And Where To Find A Different Kind of Microbiome When we talk about the gut microbiome, diversity is often considered a hallmark of health. The reproductive tract? It’s the opposite. In healthy women, this environment is typically: Low in diversity Dominated by one key group of bacteria: Lactobacillus This might sound counterintuitive—but it’s by design. Why low diversity works here Certain Lactobacillus species—particularly Lactobacillus crispatus—play a protective role by: Producing lactic acid, keeping the environment acidic (around pH 4) Preventing harmful microbes from growing Blocking pathogens from attaching to tissue Producing antimicrobial compounds In short, they create a stable, protective ecosystem. When this balance is disrupted and diversity increases, it’s often linked to: Infection Inflammation Poor reproductive outcomes A Unique Human Feature One of the most surprising insights? Humans are the only species known to have a Lactobacillus-dominated reproductive microbiome. Even our closest primate relatives don’t share this feature. That suggests this system evolved relatively recently—and likely offers a meaningful biological advantage, particularly in pregnancy and childbirth. The Link to Preterm Birth Preterm birth—defined as delivery before 37 weeks—affects around 1 in 10 pregnancies globally and remains a major medical challenge. The microbiome appears to play a key role, particularly in early preterm births. What’s happening biologically? In a healthy pregnancy, labour is triggered by controlled, sterile inflammation This process helps: Break the membranes (waters) Open the cervix Initiate contractions But if inflammation starts too early, it can trigger premature labour. Where the microbiome fits in A Lactobacillus-dominant microbiome helps: Keep inflammation low Maintain a strong mucosal barrier Reduce infection risk When this balance is lost: The environment becomes less acidic Inflammatory molecules increase The barrier weakens Risk of infection—and preterm labour—rises Once inflammation starts, it’s very difficult to switch off. That’s why prevention is so important. What Disrupts the Balance? Several factors can shift the microbiome away from its protective state: Antibiotics (even when used for unrelated infections) Sexual transmission of bacteria Hormonal changes Menstruation Hygiene practices like douching Even small changes in

In this episode, Dr James McIlroy chats with Dr Tanya Mongan, clinical associate professor and gastroenterology consultant at the University of Nottingham. Dr Mongan specialises in gut health, particularly the gut–brain connection and faecal microbiota transplantation (FMT). She talks us through the current state of FMT, why it works so well, and how it’s becoming an increasingly important treatment for conditions like inflammatory bowel disease. We also explore her cutting-edge research into microRNA-based medicines—a new field examining tiny molecules that can help protect the gut and may one day be used to treat conditions linked to an unhealthy microbiome, including cystic fibrosis and neurodegenerative diseases. This episode breaks down the complexities of the microbiome in an easy-to-understand way, covering everything from the limits of current testing to the promise of personalised gut treatments. Dr Mongan also shares insights into exciting new tools such as organ-on-chip models, nano-delivery systems for microRNAs, and even zebrafish models used in gut research. If you want to understand where gut science is heading, what’s real and what’s hype, and how future therapies may become more precise and personalised, this is a must-listen. Chapter Markers 00:00 Introduction to Dr Tanya Mongan and gut health01:51 Has the microbiome “bubble” burst?03:45 The big challenges in microbiome science06:13 What the future of microbiome testing could look like12:45 Understanding faecal microbiota transplantation (FMT)19:22 How FMT works and what current research shows26:29 Why the microbiome is so complex34:57 MicroRNAs: a new frontier in gut health37:41 Where microRNAs come from38:18 How microRNAs help protect the gut39:00 Why delivering microRNAs is difficult39:19 Nano-formulation: new ways to deliver microRNAs40:37 The advantages of organ-on-chip models42:02 Personalised “gut avatars”43:58 Zebrafish and other models used in gut research49:27 Clinical applications and future directions53:17 Microbiome therapy and FMT in clinical practice56:57 The future of microbiome research and treatment01:01:23 Diet, supplements, and the microbiome01:04:34 Weight-loss drugs and how they affect the microbiome01:07:52 Fascinating facts about the microbiome01:09:24 Final thoughts and wrap-up

In this episode, Dr. James McIlroy interviews Dr. Ran Blekhman, an associate professor at the University of Chicago, about the microbiome and its role as 'our second genome.' Dr. Blekhman shares his research findings on the genetic and environmental factors that shape the microbiome, the heritability of microbial genes, and the relationship between the human genome and microbiome. They also discuss Dr. Blekhman's groundbreaking research that analysed over 168,000 samples to understand global microbiome patterns, the influence of early-life microbiome development, and the potential of microbiome-based diagnostics and therapeutics. Tune in for a comprehensive dive into one of the most promising areas of genetic and microbial research. 00:00 Introduction to Dr. R Blackman and the Microbiome01:23 Podcast Growth and Listener Engagement01:56 Starting the Conversation with Dr. Blackman02:04 Exploring the Second Genome02:24 Human Genome vs. Microbiome03:23 Genetic Interactions with the Microbiome04:02 Understanding Microbial Genes and Functions05:40 Heritability and Environmental Factors06:53 Microbiome Diversity and Heritability08:57 Research on Microbiome Heritability17:18 Baboon Model System for Microbiome Studies18:56 Population Scale Microbiome Research25:27 Global Patterns and Data Integration33:36 The Untapped Potential of Microbiome Data35:08 Hypotheses and Discoveries in Microbiome Research36:46 Geographical Variations in Microbiome49:18 Technical Challenges and Methodologies52:20 AI and Machine Learning in Microbiome Studies54:59 Future Directions and Clinical Applications01:00:38 Exploring Early Life Microbiome01:03:30 Conclusion and Further Reading

The Gut-Health Revolution | Dr Chris Damman on Nutrition, Microbiome & the Future of Wellness Dr Chris Damman brings decades of experience from the biotech world and leading global foundations to share his vision for the future of health and nutrition. In this episode, we dive deep into the transformative power of gut health and the emerging science shaping how we eat and live. Gut Health: Ancient Wisdom Meets Modern ScienceDr Damman explains why gut health is central to well-being, describing it as a “full-circle” return to ancient wisdom where food is medicine. Backed by science, he shows how whole foods can prevent disease and support healthier lifestyles, without being restrictive or unrealistic. Next-Generation Nutrition: The 4 FsWe explore the idea of “next-generation nutrition” — simple, practical ways to improve your diet with fibre, polyphenols, healthy fats, and fermented foods (the “4 Fs”). These ingredients, found in traditional diets around the world, play a key role in promoting longevity and gut health. GLP-1 Agonists: A Promising Yet Cautious PathDr Damman discusses the potential of GLP-1 agonists — groundbreaking drugs that help manage appetite, weight, and blood sugar. While powerful, he emphasises the importance of pairing them with real dietary change to avoid over-reliance. Weed, Seed, and Feed: A Gut Health StrategyUsing the analogy of gardening, Dr Damman breaks down how to support your microbiome: weed out the harmful bacteria, seed the good ones, and feed them with the right foods. This holistic model offers a sustainable approach to digestive health. Fermented Foods & ProbioticsWe also cover the role of fermented foods as natural sources of probiotics and why they may be more effective than many commercial supplements. These foods are vital for balancing the gut and reducing inflammation. The Future: Nutrition Tech & Smarter ChoicesDr Damman is now focused on innovation, developing a smartphone app that helps people make smarter food choices by understanding nutritional quality at a glance. His work blends science and technology to make healthy eating both accessible and personalised. ConclusionDr Damman’s insights are a refreshing mix of practical advice and scientific depth. From diet to digital tools, he shows how we can all take charge of our gut health and live longer, healthier lives. Look out for his upcoming book and app, designed to change the way we think about food. Chapters:00:00 – Introduction to Dr Chris Damman01:36 – What is Next-Generation Nutrition?05:01 – How the Microbiome Journey Began10:20 – Malnutrition and the Four Fs17:59 – The Truth About Ultra-Processed Foods23:22 – GLP-1 Agonists: Are They a Game Changer?28:45 – The Future of Nutrition and Health35:49 – Smarter Choices with Nutrient Profiling Tech40:38 – How to Balance 'Red' Foods in Your Diet42:11 – Healthier Baking: Tips That Work43:25 – Personalised Diets for Your Microbiome46:12 – Understanding FODMAPs and Gut Symptoms51:51 – Microbiome Therapeutics and Supplements01:01:38 – What’s Next for FMT (Faecal Microbiota Transplantation)?01:05:00 – Gut Health Technology on the Horizon01:10:55 – Final Thoughts and Takeaways

In this episode of Inside Matters, Dr. James McIlroy sits down with Cory Greenberg, a professional cyclist and founder of Ride4IBD. Cory shares his inspiring journey from his initial diagnosis of inflammatory bowel disease (IBD) while training as a professional cyclist, to overcoming the challenges posed by the disease. The conversation covers his approach to gut health in the context of athletic performance, insights into training and lifestyle adjustments, and his efforts to raise awareness through Ride for IBD. Listeners will gain valuable insights into how Cory manages his condition, optimises his performance, and aims to inspire others facing similar challenges. Through his story, Cory emphasises the importance of creating a sustainable lifestyle and offers practical advice for those living with IBD or looking to improve their gut health. 00:00 Introduction to Cory Greenberg and Ride for IBD01:09 Cory's Early Passion for Cycling03:39 Development Programs and Training11:15 Diagnosis and Struggles with IBD15:46 Managing IBD and Returning to Cycling20:04 Diet and Nutrition for Gut Health37:00 Practical Tips for Gut Health41:16 Debunking Social Media Health Myths41:44 Personal Struggles with IBD43:16 Understanding Inflammatory Bowel Disease44:54 Cycling as a Platform for IBD Awareness45:39 The Genesis of Ride for IBD47:13 Building a Global IBD Awareness Movement50:10 Innovative Approaches to IBD Management55:20 The Future of IBD Advocacy and Support59:42 Practical Health and Fitness Tips01:13:32 Connecting with Ride for IBD

Exploring the Human Microbiome with Dr. Joël Doré: The Future of Gut Health Science In this episode of Inside Matters, Dr James McIlroy engages in an enlightening conversation with Dr. Joël Doré, Research Director at the French National Research Institute for Agriculture, Food and Environment (NRAE). With over 40 years of experience in microbiome research, Dr. Doré shares his extensive knowledge on probiotics, gut health protocols, at-home microbiome testing, and the gut-brain axis. The discussion delves into the intricacies of the human microbiome symbiosis, the evolutionary development of gut microbiota, and its impact on health conditions such as obesity and chronic diseases. Dr. Doré also sheds light on innovative treatments like faecal microbiota transfer and the significance of microbial diversity for a healthy gut. Tune in to discover how the future of medicine and nutrition hinges on understanding and leveraging the microbial human. Takeaways The human body consists of roughly 50 trillion bacteria and 50 trillion human cells. Gut microbiota aids in digestion and protects against harmful bacteria. Microbiota educates the immune system, keeping it ready to react. The microbiome develops from birth, influenced by diet and birth method. C-section births can delay microbiota diversification and increase the risk of chronic conditions. Diversity in the microbiome is crucial for health and chronic disease prevention. At-home microbiome testing lacks standardization and medical utility. Low microbiome richness is linked to higher chronic disease risks. Microbiome diversity can predict responses to obesity treatments. Acrimantium may play a role in health, but microbial ecosystem diversity is crucial. Fecal microbiota transfer can significantly aid cancer treatment. Probiotics may not establish long-term but can still be effective during gut transit. The 100,000 Microbiome Project aims to explore gut health across all ages. Gut permeability issues can lead to neuroinflammation and mental health challenges. Future medicine will focus on the microbial aspects of human health. Chronic conditions are increasingly linked to microbiome health. Dietary choices profoundly impact gut microbiota diversity. Research is ongoing to better understand the gut-brain connection. Preventive nutrition should consider microbial health as a key factor. Timestamps 00:00 Introduction to Dr. Joël Doré and Microbiome Research00:32 Exploring Probiotics and Gut Health Protocols00:49 At-Home Microbiome Testing: Strengths and Limitations01:38 Understanding the Human Microbiome Symbiosis02:48 The Role of Gut Microbiota in Health and Disease08:18 Microbiome Development from Birth11:08 Impact of Birth Methods and Early Life on Microbiome12:00 Antibiotics and Microbiome Diversity17:48 Challenges in Defining a Healthy Microbiome24:38 At-Home Microbiome Testing: Current State and Future Directions32:51 Microbiome and Obesity: Insights from Research34:21 Microbiome and Immunotherapy: Potential and Challenges39:02 Prognostic Model and Microbiota Transfer40:21 Mad Pharma: Pioneering Fecal Microbiota Transfer41:50 Autologous and Allogenic Microbiota Transfer43:53 Challenges and Innovations in Microbiota Transfer51:25 Probiotics: Do They Work?01:01:50 The Best Diet for the Microbiome01:03:00 The 100,000 Microbiome Project01:08:13 The Gut-Brain Connection01:12:58 Vision for the Future of Microbiome Research01:14:35 Conclusion and Final Thoughts

In this episode of Inside Matters, Dr. James McIlroy is joined by Professor Anthony Hobson, founder and CEO of the Functional Gut Clinic.

The following is a conversation with Dr. Momo Vuyisich, co-founder and chief scientific officer at Viome. Viome is a life sciences company that analyses the activities in your oral microbiome, gut microbiome, and blood using RNA, essentially measuring gene expression. This gives the company the ability to be able to assess what the microbiome in these various areas of the body is doing and gives insights into potentially how that links to diseases, which gives you personalised recommendations for how to improve your microbiomes through your environment. So basically your diet. Their vision is that in the future, through the analysis of all of this data, they're able to make predictive bets on who is at higher risk of developing particular diseases and issues due to the composition and function of the microbiome. Momo is an amazing communicator. You'll learn about. the microbiome and its importance in gut health. You'll hear about his own story in terms of how he managed to cure chronic disease through his own diet. You'll hear about his vision for Viome, how the pharma industry works in his opinion, and how things are going to improve over the coming decades. Fascinating discussion, I enjoyed it. I wanted to thank Momo for coming on as such a busy person. Now, with the introduction done, I wanted to say thank you to all of our listeners for supporting the podcast. Some of you are listening to every single episode and sending feedback about the episode, what you liked, what you didn't like, and what you learned. We've been going now for a year and a half. And we're loving every single moment and the feedback from listeners makes it all worthwhile. So if you're enjoying it and you haven't yet liked and subscribed, please hover your finger over that button and give us a five-star review. 00:00:00 Intro 00:05:27 Momo’s vision 00:08:08 Is science improving human health? 00:15:58 Applying science to big health problems 00:18:11 Human genome 00:27:46 Vaccines with probiotics? 00:36:27 Is the microbiome undervalued? 00:45:59 Next gen RNA sequencing 00:52:37 Building Viome 00:58:34 Preventing all disease through diet 01:00:41 Sialic acids 01:11:16 Food industry 01:14:24 Importance of sleep

Learn more about this episode's guest and the topics discussed - https://insidematters.health/ In this conversation, Dr James McIlroy and Mads Friis discuss the fundamentals of health and wellness. They cover topics such as mindset, sleep, diet, alcohol, and the importance of social relationships. Mads emphasizes the importance of eating real food, including fruits, vegetables, and berries. He also highlights the significance of getting enough protein and staying hydrated. While alcohol can be enjoyed in moderation, it is not recommended for optimal sleep quality. The conversation emphasizes the need to focus on the fundamentals of health before diving into more advanced biohacking techniques. In this conversation, Mads discusses the importance of sleep and the limitations of sleep trackers. He emphasizes the need for balance in biohacking and the importance of focusing on the fundamentals of health. He also criticizes the food industry and the misinformation surrounding nutrition. Mads shares his insights on movement, light exposure, and the benefits of cold water immersion, sauna, and breathwork. He concludes by discussing his book on habits and his future plans in the biohacking space. Takeaways Focus on the fundamentals of health, including mindset, sleep, diet, exercise, social relationships, and hydration. Eat real food that your grand grandma would recognise as food. Ensure you are getting enough protein to support your body's needs. Moderate alcohol consumption and be mindful of its impact on sleep quality. Prioritize social connections and relationships for overall well-being. Start with the basics before diving into advanced biohacking techniques. Sleep trackers may not provide accurate information about sleep stages, and focusing too much on sleep data can lead to unnecessary stress. Biohacking should be approached with balance and not become an obsession. It's important to focus on the fundamentals of health, such as movement, light exposure, and proper nutrition. The food industry plays a significant role in the current health crisis, and there is a need for more education and awareness about healthy eating. Cold water immersion, sauna, and breathwork can have various health benefits, but it's important to find the right balance and not overdo it. Mads has written a book on habits and plans to explore other topics in the future, such as sleep, biohacking, and longevity Timecodes: Introduction to Mads Friis and his journey 02:29 The State of Health and Wellness 04:28 The Fundamentals of Health: Mindset, Sleep, Diet, Movement, Social Relationships 07:50 Mads Friis' Journey and Entrepreneurship 09:47 The Importance of Getting the Fundamentals Right 14:16 Cutting-Edge Biohacking and Individual Differences 20:05 The Role of Diet: Eating Real Food and Protein Intake 25:24 The Controversy of Alcohol and the Importance of Hydration 32:05 The Impact of Alcohol on Sleep Quality 36:29 Mindset and Enjoyment of Healthy Choices 39:45 The Limitations of Sleep Trackers 42:04 The Importance of Balance in Biohacking 44:15 The Fundamentals of Health 46:26 Exploring Cold Water Immersion, Sauna, and Breathwork 48:01 The Role of Supplements and the Food Industry 53:42 The Benefits of Movement and Light Exposure 55:53 Finding the Right Balance in Biohacking 58:19 The Influence of the Food Industry 01:08:38 Exploring Hyperbaric Oxygen Chambers and Other Biohacks 01:15:42 Mads's Book on Habits and Future Plans You must not rely on the information in this video as an alternative to medical advice from your doctor or other professional healthcare provider. If you have any specific questions about any medical matter you should consult your doctor or other professional healthcare provider. If you think you may be suffering from any medical condition you should seek immediate medical attention. You should never delay seeking medical advice, disregard medical advice, or discontinue medical treatment because of

The following is a conversation with Dr Saman Maleki, associate professor at Western University with a special focus on oncology, immuno oncology, microbiology, and everything to do with the immune system and the microbiome. Dr Maleki is a pioneer and a world leader in the field of sensitising tumours to immunotherapy through modulating the microbiome. During this conversation, we talked about the state of the art associated with the microbiome and cancer. So if you're interested in how cancer impacts the microbiome and how the microbiome impacts cancer you should listen to this episode. We delved into what the latest evidence is for the use of FMT in making a particular type of cancer therapy called immunotherapy better for treating particular cancers. We talked about the journey from doing the first trials to the area where they are now, which is raising funds to do much larger trials that should definitively prove that changing the microbiome can massively improve response rates to cancer therapies. Even as someone who's got their finger on the pulse of this field, I left the conversation enthusiastic and excited about the potential in the future for developing efficient microbiome treatments to tackle cancer. 00:00:00 Introduction 00:01:38 First interest in the microbiome 00:05:46 FMT for C-Diff patients 00:09:11 Using the immune system to treat cancer 00:19:03 Microbiome research for oncology 00:23:46 Journey from first study 00:27:30 Stimulating immune system with FMT 00:39:09 Chemotherapy, pancreatic cancer and the microbiome 00:48:29 Novel cell therapy and chemotherapy 00:49:02 Future of immunotherapy 00:52:32 Immune therapy response in cancer treatment 00:55:41 Antibiotics and cancer treatment

The following is a conversation with Dr. Petra Louis, Senior Research Fellow at the Rowett Institute for Nutrition and Health at the University of Aberdeen.

The following is a conversation with Mollie Hughes, a British alpinist, world record holder, company director, and entrepreneur. This podcast will appeal to anybody and everybody. It's very easy to listen to Mollie speak and you can kind of get a sense of what it takes to summit Everest and go to the South Pole. She broke the world record for becoming the youngest woman to climb both sides of Mount Everest and the youngest woman to ski solo to the South Pole. And now she's building an amazing adventure business, going around the world talking about her endeavours, and writing a book. We explore how Mollie developed her mindset both before and during her incredible quests, she explains what it’s like to be caught in an 8-day whiteout on the South Pole and how affirmations helped keep her skis moving. Everyone can get something practical from this conversation, especially when it comes to developing a mindset to enable you to achieve your goals and deal with adversity along the way. Timestamps: 00:00:00 Introduction 00:01:33 Mollie’s background 00:05:00 Tackling extreme activities 00:08:59 Controlling fear 00:10:46 Deciding to climb Everest 00:11:34 Fitness to climb Everest 00:15:00 Costs to climb Everest 00:17:47 Kit required to climb Everest 00:20:14 Mollie’s first climb of Everest 00:23:29 Everest’s death zone 00:26:22 Hillary’s Step 00:32:51 Communication and food on Everest 00:35:06 Climbing north face of Everest 00:44:59 Human landmarks on Everest 00:52:31 Skiing to the South Pole 00:58:58 Dealing with isolation 01:07:16 Silence of the South Pole 01:09:20 Joining Ocean Vertical

The following is a conversation with Jordan Haworth, a gut health physiologist working at the Functional Gut Clinic who are based in Manchester and London.