Dr. Patrick: This algorithm that you were just referring to. So this is a top company that was... Was it started by you or...?

Dr. Elinav: Yes. So basically, the Personalized Nutrition Project was an ambitious project which was headed by me and my colleague, Eran Segal, who's a mathematician from the Weizmann Institute of Science. We started with this project back in 2012, and this was a study that was first published in 2015 and formed the cornerstone of what we call personalized nutrition today. And in this study, we analyzed the data from 1,000 individuals in Israel that kindly gave us the week of their life, and we measured and collected an unprecedented amount of microbiome and host-related data, including a smartphone app that was used in this study, and a continuous glucose measurements that generated very accurate measurements of sugar responses to food in a week of follow-up. And then a very sophisticated machine learning and AI technologies were used to generate predictive algorithms for each individual that are able to accurately predict a person's sugar responses to any given food. And this eureka moment was the basis for personalized nutrition because it allowed us for the first time to formulate diets that are different between individuals but would hopefully lead to normalization of blood sugar levels. And this was tested by us in different contexts including recently in a long-term randomized human trial which compared this data-driven personalized approach to the gold standard American Diabetes Association recommended diet. And we've quite convincingly shown that this personalized science-driven approach was outperforming the current one-size-fits-all diet in a large group of pre-diabetic individuals, which are individuals already predisposed to develop disturbances leading to type 2 diabetes. This set of discoveries has been repeated by other groups across the world and is gaining track and basically tells us that data coming from the host, from the human host and data coming from the microbiome could be combined using advanced technologies in order to predict and maybe to impact dietary interventions at different clinical contexts.

Dr. Patrick: So this company...I know it's called DayTwo. Does a person have to wear a continuous glucose monitor or like, you know, there's a bunch of biomarkers that need to be done to try this out with your...?

Dr. Elinav: That's a great question. And just to make clear to our audience, all the research that I've stated was academically done in an academic setting without any company involved. But following the publication, the Weizmann Institute of Science have licensed the technology to a spin-off company called DayTwo, which further developed it for massive use in app scaling by many more individuals. What the advantage is of DayTwo as a company is that now that they've performed over 100,000 tests on 100,000 people and more, the quality of data that was collected is so great and the resolution is so great that the people that are now engaged no longer need to go through all the procedures that characterized the early studies, and they don't even need to wear our continuous glucose monitor anymore. In other words, a person can now provide a stool sample that can be shipped through the mail plus some commonly available clinical parameters that they can provide through the internet. And then an accurate prediction of that person's glycemic responses or sugar responses to foods and recommendations that are peculiar and specific for that person could be provided because of the background database that was already created.

Now, I'm not part of the company. I'm one of the two scientific founders of the company, but the company is now running on its own mainly in the U.S. and is available in the U.S. The findings that we discovered have been reproduced by others in other human studies in the UK and in the U.S. There are other commercial entities that are developing the same approaches. I can tell you that in the book we published called "The Personalized Diet" in addition to our story, we also describe kind of a do-it-yourself, a non-commercial way to exploit these discoveries. For example, by buying a glucose monitor that, you know, you can purchase in your local pharmacy, and by skin pricking yourself and measuring your blood sugar responses after some of the foods that you usually consume at your daily lives, you can now start to tweak your diet and to change ingredients in your diet in reducing your sugar responses after meals. So you can do it yourself in, you know, of course, much less sophisticated manner, but you can use the same principles that we've discovered in changing elements in your diet and making your sugar responses lower than before.

Dr. Patrick: So it sounds like you're a proponent of people wearing a continuous glucose monitor. I've worn one for the past...oh, almost three years, and I have learned an immense amount of very interesting information from wearing one, probably one of the most surprising ones early on. I started wearing it when I was a new mother and was the effect of lack of sleep on how the way my body responded to the same foods that I've always eaten in terms of my postprandial glucose response, and it was completely out of control when I was...when my sleep was disrupted, you know. There are scientists and researchers out there and physicians that do not like the continuous monitor, you know, glucose-wearing approach because they claim that it, you know, urges people to not eat a healthy fruit or something like that because it may elevate their blood glucose level. What do you think in response to that?

Dr. Elinav: I'm not sure I would like to propose that every person wears a continuous glucose monitor. But I respectfully disagree with those who say that, you know, measuring yourself or using science and technology in order to improve, you know, what you do in your daily lives would, you know, be wrong. I think that, you know, disregarding all the advances that science is proposing to us and not utilizing these advances for our benefit would probably make us miss a lot of the good that science has to offer. You know, by wearing a continuous glucose monitor, you probably experienced many surprises. And maybe, you know, we've done thousands of people, and I can tell you that almost in any person that we've measured, we found counterintuitive surprises. Some people spike their blood sugar to the roof when they eat tomatoes. Now you combine tomatoes with some white bread and the response goes down. So, you know, by not doing the experiment or by not measuring themselves, they would devoid themselves from the benefits of knowing what is good and what is less good for themselves. So I'm all for measurement. I'm all for knowing and for doing this rationally and carefully but doing it.