Dhru Purohit Show - The Nutrient Most of Us are Under-Eating That Boosts Brain Health and Fights Inflammation and Visceral Fat

Episode Date: March 31, 2025

This episode is brought to you by Birch Living and Levels. When you think of blood sugar regulation, weight loss, or boosting cognition, fiber may not be the first thing that comes to mind. But this essential nutrient does far more than just relieve constipation. It feeds our gut microbes, keeping them happy and thriving—and in return, they produce anti-inflammatory, anti-cancer, immune-supporting metabolites that help us stay healthy, happy, and thriving. Today on The Dhru Purohit Show, we’re bringing you a special compilation episode featuring Dhru’s conversations with top experts on fiber and its powerful benefits for gut and whole-body health. Dr. Will Bulsiewicz breaks down the signs of inadequate fiber in your diet and shares his top four tips for improving bowel movements and incorporating fiber into your daily routine. Dr. Mary Claire Haver explains how optimizing fiber intake can help reduce visceral fat—especially during perimenopause and menopause. Dr. Brad Stanfield highlights psyllium husk as one of the most underrated supplements for boosting fiber intake and supporting overall health. Dr. Will Bulsiewicz is an award-winning gastroenterologist and New York Times bestselling author of Fiber Fueled and The Fiber Fueled Cookbook. Dr. Mary Claire Haver is board-certified in Obstetrics and Gynecology and is a Certified Culinary Medicine Specialist.  Dr. Brad Stanfield is a primary care physician hailing from Auckland, New Zealand who has garnered over 200,000 followers on YouTube for his video segments related to longevity-promoting strategies. In this episode, Dhru and his guests dive into: Signs of inadequate fiber in your diet (02:20) Four tips for improving bowel movements (05:20) How beginners can increase fiber intake and manage gas (17:27) Key behaviors that harm gut health (21:37) How fiber supports gut health and the microbiome (29:15) The benefits of eating a diverse range of plant foods (35:07) How fiber helps combat visceral fat (38:43) The optimal daily dose of fiber (40:38) How to increase fiber intake with psyllium husk (44:50) Recommended water intake when using psyllium husk (48:31) Final thoughts (50:09) Also mentioned: Full episode with Dr. Will Bulsiewicz Full episode with Dr. Mary Claire Haver Full episode with Dr. Brad Stanfield This episode is brought to you by Birch Living and Levels. Get 25% off your Birch Living mattress during their Flash Sale—just head to birchliving.com/dhru today! Right now, Levels is offering my listeners an additional 2 FREE months of the Levels annual Membership when you use my link, levels.link/DHRU. Make moves on your metabolic health with Levels today. Learn more about your ad choices. Visit megaphone.fm/adchoices

Hi, everyone, Drew Prode here. Last year, I made a conscientious effort to up my fiber intake. Why? Well, in addition to wanting to improve my gut microbiome, which I know a lot of you guys want to do, when it comes to cardiovascular health, I'm also a hyper-reabsorber of cholesterol. So fiber is one of the best tools I can incorporate to help improve my diet, but also keep my APOB levels lower from the naturally high place that they like to find themselves. In fact, fiber is so, powerful that it has the ability to regulate blood sugar, lower cholesterol, fight constipation, increase weight loss, promote cognition, and so much more. But unfortunately, most of us are not getting enough. In fact, 95% of Americans do not meet the daily fiber requirements. And for most

people, it's hurting them. And I say most because there are some situations where people's guts are so messed up that they actually would do better by lowering some fiber. and working with a practitioner to get to the root of why there's microbiome imbalance. But we'll save that for another episode. Today's episode is all about how most individuals would benefit greatly by including some more fiber in their diet. So in today's compilation episode, I'm excited to share with you a portion of my conversations with Dr. Will Bolshevich, an award-winning gastroenterologist, internationally recognized

gut health expert, and best-selling author. We discuss all things fiber, how do you? you know if you're getting enough and how to have better and more complete bowel movements, which everybody secretly wants or maybe not so secretly wants, and how to incorporate fiber supplements. And Dr. B, as his patients call him, shares his own journey to heal his own gut. I also talk with Dr. Mary Claire Haver, who's a board-certified OBGYN doctor and a certified culinary medicine specialist about the key role that fiber plays in targeting visceral fat after menopause in particular. And finally, you'll hear from Dr. Brad's Stanford,

field, a primary care physician based in New Zealand, who has garnered over 200,000 followers on YouTube for his video segments related to longevity promoting strategies. And on today's episode, he's going to talk about the fiber supplement that he's most excited about. But first, let's dive into my conversation with Dr. Will Be. What are one, two or three signs that somebody doesn't have that adequate amount of fiber in their diet? Something that they're experiencing, uh, risk factors, daily stuff that they're going through or not going through. What are some signs that they don't have enough of that fiber? I think the most obvious sign that you're not getting enough is if you're not eating enough like real plant food. So, I mean, if you're not really sure where

the plants are in your diet, then you're clearly not getting enough fiber because fiber is found in plants. And the average American, only about 10% of our calories are actually coming from plants. And unfortunately, the number one plant is potato because French, fries are sort of the number one thing that we're consuming, that's vegetable-based. So that's, you know, there's a lot of opportunity for improvement there. But to get into like symptoms, to get into sort of what you're looking for, Drew, I would talk about bowel movements. You know, if I were a cardiologist, I would be here to talk about heart rate and blood pressure.

If I were a pulmonologist, we would talk about pulse oxymetry, respiratory rate. I'm a gastroenterologist. This is my vital sign, bowel movements. I personally think that we're facing an epidemic of disturbed out of balance, out of rhythm bowel movements. There's something to be said for having a good, complete, and dare I say satisfying evacuation on a routine basis. Probably once a day. It doesn't have to necessarily be that, but probably once a day. And when you're consuming more fiber, many people are going two or three times a day and having really good bowel movements.

If it's a struggle, if you feel like you can't completely empty, if you have this sense of like, gosh, I did all that work and only that little thing came out, like those to me are signs that we have an issue. And if you're not adequately evacuating your bowels, then the number one symptom that we're going to see, Drew, is bloating, gas and bloating. And this is widely prevalent. There are a bazillion people, I'm quite sure listening to the podcast right now. who this is something that they've experienced is like the routine presence of gas and bloating. And I'm here to tell you, I'm here to tell you that this is very closely tied to your bowel movements, that if you are backing up, that is the cause of your gas and bloating. And if we could get things moving through, then we can relieve that issue and you'll feel better.

And fiber is one of the ways potentially that we could get that working. Yeah, what I appreciate about your work is that you address it from all sides. So there's people that are out there that might not be having enough fiber. and constipation is something that they really struggle with. And then there's people that start adding in fiber. And if you're that person and you've had challenges with it or you notice a little bit of bloating, you notice a little bit of constipation, even when you start to add in, you have a bunch of tips and a bunch of nuances that are there. We're going to get more into that later on in the interview.

But real quick, we're going to jump around a bit. And because you mentioned it, helping people poop better, you made a fantastic video. This is a few weeks ago. You have four tips that you presented inside of that video. to help people poop better and have better, more complete bowel movements. I have them here in front of me if you want me to tee you up. And if you want to bring up another four or whatever you want to get into, feel free. But could you share some of those tips for improving constipation?

All right. Drew, how about we do this? You lob them my way and I'll try to crush them. So because I don't remember the exact four tips that I did. I got them for you, brother. I did my homework. Don't worry. So the first one was coffee.

And I'd love for you to talk about coffee and what. its benefits are in terms of helping with bowel movements. And also, is it ever a concern that some people need coffee to actually have a full evacuation or full bowel movement in the morning? So let's talk about coffee first. Yeah. So coffee clearly helps people poop. The vast majority of people, when they consume coffee on a routine basis, they're going to notice that they often will have a bowel movement that come shortly after that. And it can be, a part of that really healthy daily routine that you build in the morning that really gets your day started. I mean, I honestly believe that having a good, complete evacuation in the morning is part

of stepping into a great day. So what is it about coffee? There's a couple of things. Coffee is very rich in polyphenols. Polyphenols are antioxidant compounds. An example would be coreogenic acid that the research suggests may help us to move our bowels. Coffee, believe it or not, even without adding fiber to it, actually contains some dietary fiber. And so this is soluble fiber. The soluble fiber is not grit. You would never know that it's there. But it is fiber and it is feeding your gut microbiome.

And so that's one of the other things that potentially helps. Now, we'll say there are some people that coffee just is not a great fit. And so there is about 10% of the population that will drink a cup of coffee. and it will actually trigger urgent bowel movements. With those people, I would consider adding a fiber supplement to your daily coffee, which, by the way, I kind of recommend this for everyone. I do this myself, I did it this morning. Adding a soluble fiber supplement to your coffee on a daily basis is a great way to amp up the microbiome support.

So examples of fiber, acacia powder, partially hydroized guar gum, wheat dextrin. These are examples of ones that will dissolve. You won't even know that they're in. in there. So, and I would try that if you're having some urgency after you drink a cup of coffee. Some people will trigger anxiety. Coffee may not be a good choice for them. It's, I think, the caffeine in that particular setting. And then you have to be careful about this causing insomnia. So for some people, they're very caffeine sensitive. So you want to be careful about coffee in the afternoon. For me, I could drink it at 9 o'clock at 9 and go to Ben at 10 o'clock and I'll be

perfectly fine. That's just the way it is for me, but for others it will be potentially different. So I think from my perspective, coffee is good for the microbiome. We actually have research that indicates that there are specific microbes that thrive when we regular consume coffee. And it's a rich source of prebiotics, both polyphenols and fiber. And I think it's a good part of the morning. I love it. To extrapolate further on my second part of the first question, is it a challenge that some people feel that they can't go to the bathroom first? thing in the morning without having coffee. Or as a gastroenterologist, you're like, look, coffee's

generally good for you. Sure, would we like it a particular way? That might just be a, you know, their body's just used to it. But yeah, is that a challenge at all? No, I don't think so. I don't really, I don't really have concerns if you feel that you're having good, like, better bowel movements because you drink a cup of coffee. Like, I actually experienced that myself. So from my perspective, I don't see that as a red flag. Awesome. All right. Number two. that you went into, which is often underrated, is movement. Tell us how movement actually can help us with not being backed up and relieving constipation. There's this expression that exists called the runners trots. And basically, these are distance runners, people who are training

for marathons and things of that variety, where when they run, they have to poop. And when they're on their legit marathon run, they find interesting ways to do that. So what we're, what we we know is that movement actually stimulates motility within the intestines. When you move, your bowels will move. And our bodies really were designed to move. So this sort of lifestyle, coming back to the lifestyle thing, Drew, this lifestyle where we're, you know, sitting at a desk and working from 9 to 5 or something like that and then going home and popping down on the couch, like, this is not the way that we were designed as humans. So it doesn't have to be a run. It could be a walk, a good, brisk walk, you will notice the difference. This can help you to have a good

regular bowel movement. The second one that you went into, and you kind of covered this a little bit, and we'll be talking more about it, was just high fiber foods, right? The importance of fiber in the first place to make sure that you are, well, actually, I'll let you say it in your own words. High fiber foods, how does pre, like having them in our diet help us not get constipated in the first place. Well, you know, I think there's there is some nuance to this particular topic. Like, I'm not here to say that the solution for every person who is constipated is to crank up their fiber. I think that there's a little bit more to the story than that. But what I will say is this, that when your bowels are moving, like as your bowels are moving through, fiber is your friend.

So for people who are constipated as a gastrologist, my goal, the way I always tackled to this issue is I want to get your bowels moving first. And there's a number of ways that I would do that. And then once I have them moving, then I want to bring the fiber on board because the fiber is going to help us to keep them moving. So I sort of see, I think the key learning here for the audience at home is that it's not so much that I wean into fiber to treat constipation. It's more so that I get your bowels moving and then I bring the fiber on board to keep the bowels moving. I love it. The last one was a supplement recommendation, and this can be helpful for people who kind of feel a little bit stuck and need things to kind of get moving.

And it's magnesium citrate. How do you use it? How do you recommend it to patients? And then you have some dosages that you suggest that people could start off with to help them with relieving constipation. Yeah. And this is actually something worthy of us unpacking beyond what I did in the actual post. Because when I did this post, I was talking about a bottle of magnesium citrate. And many people tried to correct me.

And I think part of it is sort of trying to educate on complex topics through social media. So let's just kind of unpack this together. So magnesium citrate, you can buy at your local drugstore. It's typically about the size of a can of soda and carbonated, lemon lime flavor. It really does not taste good. But when you do an entire bottle of magnesium citrate like that, the intent of this is to jumpstart your bowels. So if you are a person who is constipated, you would not do this on a daily basis because that would basically leave you perpetually in diarrhea. But instead, if you were constipated,

you would do this first. You would drink a bottle of magnesium citrate. This gets things going. You have one or two really good solid bowel movements. And then after that, you want to get into something that's more of a routine that you're going to do on a consistent basis, which could include fiber, but also would potentially include magnesium supplements. So magnesium supplements are more like the routine, daily intervention that you will do to support good healthy bowel movements. And when it comes to magnesium supplements, there's a number of different ones that are good for constipation, magnesium citrate, magnesium sulfate, magnesium oxide. These three particular ones I've had great success. The way that I typically approach it will be depending on which type, starting at

four or 500 milligrams per day. I usually tell people take it before bedtime. It can help in terms of sleep. There's a number of other benefits to magnesium. Magnesium is kind of a cool thing to take. And by the way, I've found that the vast majority of people are actually deficient in magnesium. But if you're concerned about that, you can always get your blood drawn with your doctor before you start doing this. Just get your blood drawn. Make sure you know where it is. Then you start doing this and you take four or 500 milligrams before bedtime once a day. Give it a lot. a week, see how you feel. If you're not where you need to be in terms of having those good regular bowel movements,

then you can start to increase the dose by about 250 milligrams at a time. And until you get yourself to a place where it's like, okay, cool, I'm in a rhythm. This is where I need to be. And you know you're in a rhythm, by the way, Drew, with this particular thing. If you were constipated, you almost surely are going to have gas in bloating. And from my perspective as a GI doctor, when I treat people with this issue, what I'm looking for is that their gas and bloating has improved substantially, if not completely gone. Because I know that once the bloating is gone, I know that I have them in a rhythm where they're

moving their bowels the way that they're supposed to. So magnesium is one of the ways that we can accomplish that. I want to continue on the topic of gas and bloating because so many people suffer from that, right? And we know through books like yours that the data around the data around fiber is so, so strong, at least the data that's available to us right now as we continue to look at what leads to these positive outcomes in society. Are there ways or foods that people can start off with when it comes to fiber? I don't know what the correct term is, but sometimes people completely get excited about fiber. They start adding a ton of stuff and they notice that their gas is, they have a ton of gas, they have a ton of bloating than what is their normal baseline.

For example, does it make a difference if we cook foods versus having them raw? Generally, anecdotally, and just talking to friends, sometimes the same foods or ingredients that somebody would have raw, when they have them cooked, they seem to tolerate that fiber a little bit more. Is there anything like that that you would recommend to the listeners? Well, first of all, that is 100% true. When you cook your food, when you modify your food, you know, these are forms of processing. And there's nothing wrong with processing, meaning like cooking your food or chopping your food or something like that. That's a different thing from my perspective than say an ultra processed food where we're like throwing together chemicals that frankly we don't even know what they are or what they do.

So when we process our food, when we chop it, when we cook it, heat it up, boil it, steam it, whatever it may be, the food structure actually changes. And it's kind of interesting, Drew. there was a study that was done out of the University of California, San Francisco by a gentleman. His name is Professor Peter Turner, and Boll. He's one of the leaders in microbiome research out there. And essentially what he did is he took the exact same food, it was a plant food, the exact same plant food. And he served it both raw and in cooked form. And what he discovered is that you actually get different effects on the microbiome when you cook the food.

So there is no doubt that processing our food, specifically cooking our food or breaking it down, such as you would do with a smoothie, for example, that these are ways that we can make it easier for us to digest because in a way we're sort of predigesting that food through that process that we're doing. So I do think that there's benefits for the person who has gas and bloating. We're focusing on food right now. We could open this conversation up into bigger things too when it comes to gas and bloating. But for the person who has gas and bloating, I do think that it's really important that you ease into your fiber intake.

I always say start low, go slow. And what that means is that we're going to try to get you in a place where the amount of fiber that's on your plate, you're actually capable of processing and digesting it. We want to be at a level that actually is matched to what your gut, microbiome is capable of doing. And then go slow basically means that we're going to start to escalate over time. And as we start to escalate and challenge your gut, your gut will have the ability to keep up with what you're doing as long as you're going slow enough.

And this is how you build. It's the exact same concept of what we do in the gym. When we go to the gym, we start off low in terms of weights that we can handle and then we go slow in terms of ramping it up. So for the person who has gas and bloating, yes, processing your food. This could be done through cooking your food, making, like I'm a big fan of soups, stews, things like that, also making smoothies and predigesting it. Additional things to think about.

You could sprout your food. You could ferment your food in some cases that actually improves it and makes it more easily tolerable. And the other thing is to look at low FODMAP foods. So FODMAPs are the parts of our food that are fermentable that cause gas and bloating. and for the person who has a damaged gut, for example, if you have chronic gas and bloating, you have your old bowel syndrome, then it could be a good place to start with the low FodMap foods and then ramp up over the course of time.

So an example, are raspberries. Raspberries are low in Fodmaps, but they're actually very high in fiber, like extremely high in fiber. And so it can be a great food to start with because it's less likely to cause gas and bloating and make your symptoms worse, but at the same time, like you're getting. given your body exactly what it wants in terms of building up your microbiome and making it stronger. Let's go back to your story a little bit. What were some of the key behaviors for you that you think were leading to the

underlining factors that were causing you to feel sick and your gut being messed up? So I think one of them that you've mentioned is that you were eating a lot of fast food. So fast food would fall in the category of ultra-processed food. give us an idea of your life of like what kind of diet were you eating at that time and then we'll go to other other factors in your life i mean that was a textbook example of the things you should not do and this is despite the fact that i had graduated medical school from georgetown and was a chief medical resident northwestern and you know all these things like i was an accomplished medical doctor and yet my lifestyle was not aligned with what i would recommend at this point in my life being in

my 40s. And I think that, you know, kind of what happens is that the demands of what I was going through professionally from medical school, residency, fellowship, like those three things for me, they were four years each. So this is 12 years of my life from 22 years old to 34 years old, where I'm spending six days a week in the hospital. I'm working like a minimum of 12 hours a day, but most days, 15 or 18 hours, sometimes 30 hours straight. I'm giving everything that I got to getting through this process. And when you're in that sort of place where it's like, look, your sleep is disrupted. You don't have time for exercise.

You don't have time for yourself. You're constantly stressed. When you're in that place, you just, you desperately want some sort of control. over your environment. You want something that you actually have control over. And it needs to be something that makes you feel good. And for me, that thing was food. And so it's not like I sat there and thought that I was eating a healthy diet when I was getting $15 worth of Taco Bell.

But at the same time, I also really wasn't that worried about it because I thought I'm young. My body can handle this. I'm going to be like, you know, I'm strong enough. I'm tough enough. And frankly, I need this. Like, I deserve this. I've earned this because I've worked so hard. This is all I got is this.

And you know, you make those sacrifices. And over the long run, it's just like, I mean, I know this didn't happen overnight. But I felt like I woke up one day and I felt like you look in the mirror and you think of like my self image of myself was an athlete. I played three sports every year when I was in high school. And you look in the mirror and you're just like, dude, who are you? And my gut was sagging over my belt. I had high blood pressure.

I had high cholesterol. Tons of anxiety. And I was just in a bad place. And I knew I needed a way out. And the irony is despite, like nothing against these institutions. I'm very proud of my education. But despite being educated at Georgetown and. Northwestern University of North Carolina.

I really didn't have a great solution to my own problems. I didn't want what I was actually offering to my own patients, which was pills. I didn't want that. But I wasn't really sure how to fix this despite all that education. So there was a period of time where I was trying stuff. And the first thing that I tried was exercise. I thought I can exercise my way out of this. And I was doing about 45 minutes of strength training plus 30 minutes.

of cardio of some variety, six days a week. And I could grow stronger and faster in those kind of things, but the gut didn't go away, the anxiety didn't go away, the low self-esteem didn't get better. And so it was ultimately, frankly, stumbling into a dietary change that allowed me to get myself to a better place. And when it, when it changed my life, I, as a medical doctor, felt like I have no choice now. Like this has to be a part of what I do for my patients.

Because if you find something that powerful, that it doesn't matter whether you learned it in medical school or you learned it on your own. When you find something that's that powerful and that healing, then you have to deliver that to your patients because they deserve that to it. And so that's really sort of the takeoff point for everything that has happened since. It's just like I felt like I needed to do this and do it for my patients. And now here we are. Here we are. Bestsellers later, hundreds of thousands of copies of your book, great mission,

message, social media. And you're really trying to help people understand that a lot of these super amazing hacks that people are looking for we can get with daily basic solutions. And one of those being obviously Fiverr, which we've talked about, we'll talk more about in a second. I want to zoom out a little bit big picture and go from, what does it do? seem to be, as basic as it sounds, just making sure we connect all the dots for everyone. What is it that fiber is doing to the gut that allows us to see that people who are having a certain level of fiber, we'll go into that next, are generally going to be better, more healthier and better off?

Yeah, it's an interesting story because I think we've all known and I think we were all raised hearing from our grandmother that fiber is good for us and we're supposed to be eating more of it. My grandmother used to nag me about that when I was a kid and I was just like, whatever. So it turns out that she was right. And I think that the science that really has changed, that is exciting because there's a new story, there's a new understanding of fiber. And this new story is like enough with us pretending that fiber is boring. It is not. It is so exciting. It is so interesting what we have learned in the last 15 years. which is that when you consume fiber, which by the way, just kind of taking it from the top,

fiber is a carbohydrate. It's a complex carbohydrate. So essentially, if you take a bunch of sugar molecules and you fuse them all together and make a super long chain, that's fiber. And fiber is intensely complicated. So I was a chemistry major in college. And when I look at fiber molecules and I see their chemical structure, I have zero clue how to properly describe. them. And it gives me like a brain cramp to even consider it. So because it's so complicated, we have done some things to try to simplify our understanding of fiber. And we've broken it into

two main categories. Salutable and insoluble fiber. So soluble fiber is the part that you and I were discussing earlier, Drew, when we were talking about coffee. Because basically, if you take soluble fiber and you put it into a beverage and you stir it, it will disappear. You won't even know that it's there. And there are certain properties to soluble fiber, but the main one that people need to know about is that it's food for our gut microbiome. I'm going to come back to that in a moment, but just to take on insoluble fiber real quick, insoluble fiber, insoluble, meaning this does not dissolve no matter what you do. You could heat it up. You could stir it all you want. It doesn't matter. It's still going to be there. And this is the grit. This is the roughage. This is the more

traditional understanding of fiber that we've always kind of learned, which is that you chew it up, you swallow it, it sweeps through your intestines, and then it launches out the other end like a bowel movement. So as a bowel movement. So insoluble fiber is not the part, generally speaking, that really is important to the microbiome. It's the soluble fiber. And this insoluble fiber, what's unique and interesting about it is that as interesting and complicated as we are as humans, our digestive system is actually rather simple. We only have 17 digestive enzymes that are designed to process complex carbohydrates. And this number 17 is inadequate to allow us to break down fiber. We don't have the ability as humans to actually digest it. So if we didn't have microbes,

if we didn't have a microbiome, we would never be able to get the benefits from fiber. But because we have a microbiome, and they're mostly concentrated in our colon, this is the main place, the colon is the large intestine where you will find these microbes. There's about 38 trillion of them there. Because they're there, the fiber will work its way through our small intestine, which is about 15 or 20 feet long, and it will arrive in the colon in your right lower quadrant of your abdomen. And that's where it comes into contact with your gut microbiome. And this is their food.

This is their food because it is one of the only things that we can guarantee that it will not be changed. It will not be altered by digestion. It will be exactly the same that you found it in your stomach. And so those microbes, they have. tons of these enzymes. So again, like we are big and complicated, but our digestive system is simple. We only have 17 enzymes. A single cellular bacteria that we can only see with a microscope could have hundreds of enzymes alone. And collectively, the entire microbiome we've estimated

could have 60,000 unique enzymes. And they use these enzymes. They go to work. They break down the fiber. The fiber stops being fiber. It's now been digested by, digested by your microbiome. And they release, Drew, the sort of key part here, they release the most healing, the most anti-inflammatory molecules that I've ever come across, which are the short chain fatty acids, butyrate, acetate, propionate.

These three molecules, many people have heard of butyrate, they have healing effects in your colon, they have healing effects for the lining of your gut, they have healing effects on your gut microbiome, but they also have healing effects on your gut microbiome, but they also have healing effects. have healing effects throughout your entire body. It will enter into your bloodstream and they will travel down to the tip of your toes

and all the way up to your brain and make a difference everywhere they go. So the reason why fiber is so special, the reason why fiber has overwhelming evidence to support its health benefits is because when we consume fiber, it comes into contact with our gut microbes. They release short chain fatty acids and those short chain fatty acids are what is. activate the healing benefits that we get from fiber. That's great. And do all fibers impact?

Of course, you talked about the differences that are there between insoluble, soluble fibers, but do some of them produce more of these short chain fatty acids than others? Or is that generally related to, you know, diversity and general sense of quantity? So there are, to be honest with you, Drew, we don't even know how many varieties of fiber. exist. And the reason why is because the biochemical complexity of fiber makes it very hard for scientists to even get their, like, wrap their minds around this. But what we do know is that different plants, different plant types have different types of fiber. And those different types of fiber will feed different families of microbes. This is where diversity within the microbiome. This is where diversity with our diet become very important. because ultimately what we want is we want to eat a wide variety of plant foods that allow us to feed a wide variety of different microbes. So all of these different types of fiber, they're all unique.

Now, Drew, to answer your question a little bit more directly, some types of fiber are better at producing buterate, some are better at producing the other short chain fatty acids. There's another thing that I should toss in here while we're talking about fiber and we're talking about buterate. And those are the resistance. Starches. Resistance starches are technically not fiber. There is starch. You will find them in green bananas. You will find them in mashed potatoes when they cool off. You have to cool off the mashed potatoes to form the resistant starch. But this starch is not processed by our digestive system. And as a result, the resistant starch actually behaves exactly like fiber. And what's interesting, Drew, is that. that the resistant starch tends to support and produce a significant amount of butrate,

which is part of the reason why there's an emerging science that is increasingly showing us that there are benefits to us, including these resistant starch-type foods in our diet. So, again, potatoes when they're cooled off, green bananas, you'll also find resistant starches in legumes and beans, things of that variety, whole grains. Fibre is crucial to a healthy gut microbiome. But again, it is key to so many other factors in the body, including weight loss. In my conversation with menopause expert, Dr. Mary Claire Haver, she shares that women going through perimenopause and menopause often see an uptick in visceral fat.

This is a type of fat that surrounds your organs, making it really dangerous for the body. A perimenopausal woman has about 8% visceral fat. but after menopause, that number can triple based on Dr. Haver's research. When left unchecked, visceral fat can lead to cardiovascular disease and increase our risk of heart attacks, strokes, and even diabetes. Let's listen into my conversation with Dr. Mary Claire Haver as she shares the important role that fiber plays in combating visceral fat. You started to peel back the layers of the onion to see that there were many things in your control

that could be supportive and helpful and not leave you in a place where the accumulation of visceral fat year over year in particular, but many other challenges, terrible sleep, pain in different parts of the body, you know, massive changes for the worst in the gut microbiome, that these things didn't have to be completely inevitable. Where did you start to see and what did you start to unpack as you started digging down that rabbit hole? So I started to start to, to realize that your best health in menopause is a kind of synergistic toolkit. And my first focus was visceral fat. I knew that this is a new thing.

It's very specific to the menopause transition. You know, we just see this dramatic increase. And what studies have been done that have shown this is going to work for women or women who have these habits are going to naturally have less visceral fat. So that, the, you know, biggest first foremost is nutrition. and fiber. So, and I was like, fiber, I've never tracked five. I counted calories.

I don't know fiber. Women who consistently get 25 grams or more of fiber in their diet per day have less fissural fat, which leads to less inflammation, which leads to lower blood sugar, which leads to, you know, fiber feeds the microbiome, moves the stool through quicker, decreases the rate of glucose absorption into the bloodstream. I mean, it works in so many different ways. And I was like, huh, okay, let me start talking to my patients about this, talking about it on social media.

Added sugars. I know through the keto movement, good and bad, that a lot of, there's a lot of demonization of sugars. Well, it turns out when you look at the nitty gritty data, it's not sugars as much as added sugars. The sugars added in cooking and processing. And so people who were kind of leaving fruits and vegetables behind are scared of them because they lost weight on keto, you know, we're really worried.

I'm like, listen, those sugars are packaged around fiber and vitamins. and minerals and nutrients. You know, a handful of berries is very different than a handful of candy, you know, even though they may have the same amount of cars. And so, you know, looking at things nutritionally, so women who have less than 25 grams

of added sugars in their diet per day, have less visceral fat, have less inflammation, you know, all that stuff is measurable. Movement. So this goes across the board, but, you know, most women in my generation are pretty good about cardio. I was a cardio person,

I, you know, I worked out to be thin. And I equated my thinness with my health, even as a physician. And that is such a mistake. And that is a conversation I have with my daughters, my patients, anyone who will listen to me is strong over skinny. You know, we move our bodies to be strong. We do cardio for strong hearts. There needs to be a point, you know, but where we're failing, our generation is resistance training. I didn't pick up weight until I was in my 40s, not seriously, you know.

And I'm now doing progressive load weight training. I have a person helping me so I don't hurt myself. But my muscle mass is going to determine my resistance to frailty as I age. It's going to determine my resistance to insulin as I age. And so helping to reframe that for my patients and my followers has been just key. That's incredible. I want to unpack some of the ones that you've shared. And then I have a couple questions on some other categories that are there too.

So fiber, you mentioned that women that have, I believe you said, 25 grams of fiber or more a day, are going to see less visceral fat based on the research that you had come across. Just to contextualize that, depending on the age group, because it's different for different age groups that are there. But in America right now, I think that the average, although there's no average, but there's, you know, different subgroups that are there. but the closest that we could get to the average from what I've seen that's been shared is that many people are having less than 10 grams of fiber. And some people, I think it's the lower 30% of the population. And I'll fact check this and put it inside the show notes afterwards if I misspoke. My apologies.

But it's a lower percentage of the population that's having less than five grams of fiber a day, which is kind of crazy. Like five grams is not a lot of fiber better there. Living in a food desert is tough. and having access to fiber-rich foods, which often have to be fresh or prepared from scratch, is really difficult when you're forced to rely on processed foods due to convenience or whatever. It really, really is difficult to get that amount of fiber in your diet for day. Yeah.

Is there a component of sort of naturally people hear about how protective something like fiber could be? And that's the one thing that they hear and they start running with it. Is there sort of a dose dependency here that you recommend to people that, you know, we just want to make sure we're getting good and adequate amount of fiber that's there? It's not that we're asking people to necessarily get up to like 100 grams of fiber. No, no. So there was a recent study that came out that looked at fiber intake and cognition scores. And this is in patients in their 60s and 70s. And the people who had the highest amount of fiber up to about 32, 35, 35 percent.

women, it kind of tapped out, the benefit tapped out there. So, you know, men started, like, for us it's 25 for females, males, it's 32. You guys are bigger, you need more. I don't read a lot of studies done on men, just because that's not my jam, but I did criminalize that data. So in the cognition studies, it did tap out for females at about 35 grams. They were reaching their maximum benefit for cognition. Fantastic. So as you've heard, there's so many amazing, sources of fiber that we can benefit from, both through our diet and supplementation. In my conversation with Dr. Brad Stanfield, he shares why he's such a huge fan of Cillium Husk as a fiber source. Let's listen it. It's one of the most underrated supplements that's out there. In fact, you just made a video on

this topic about how Cillium Husk is one of the most underrated things, especially for people who are trying to improve their digestion or dealing with constipation. So talk to us about why you're super excited about Cillium Husk and it's part of your routine. Yeah, so Cillium Husk is probably the most boring supplement. And because of that, it's not going to generate headlines, but the evidence is so strong for it. We've got multiple randomized controlled trials looking at what happens if you increase your fiber intake. And overwhelmingly, if you increase your fiber intake, you decrease your cholesterol levels,

you decrease your mortality rates, your heart disease rates, and over and over again, that's been proven in metro analyses where they combine all of the physterilemma. those trials together. And if you have a look specifically at the trials of cillium husk, we can also see the same thing where we lower cholesterol levels, we lower heart disease, and it can be used for irritable bowel syndrome. So, you know, irritable bowel syndrome is incredibly common, and cillium husk can be used to help with those digestive issues. So, you know, it's very, very boring, but I'd probably say that most people should be adding it to an a really healthy diet. Because coming back to the trials looking at fiber, it seems to be a dose

response. As in, the more fiber you have in your diet, the more protective effects seem to be apparent. So if you've already got a high fiber diet and you're not having any gastrointestinal issues, it's not a bad idea to try adding low doses of cillium husk and slowly building up that dose until you reach the perfect point for you because the evidence backs it up. When you're talking about a high fiber diet, I've seen different sorts of ranges. Sometimes you'll hear people talk about, you know, 15 grams of fiber, 15 to 20 grams of fiber for every thousand calories that might be in the, you know, diet. So somebody's having, you know, around 2,000 calories as part of their diet or 2,500.

You know, you're probably targeting around 30 to 45 grams of fiber a day. Is that what you recommend to your patients? How do you help them sort of navigate? what does high fiber diet look like? That's absolutely right. The metroanalysis that I'm referring to suggests that ideally people want to be having at least about 25 grams of protein a day, sorry, of fiber a day. But there is the caveat, though.

So I've mentioned irritable bowel syndrome already. Some people who have irritable bowel syndrome, they can't tolerate a high fiber diet because a lot of the times when you're trying to digest those, that fiber, it causes fermentation. So it worsens bloating it, it worsens their symptoms. So again, just make sure that you speak with your own doctor. But that's, again, where I'm a big fan of Cillium Husk. Because of the type of fiber that Cillium husk is, it's actually used to treat irritable bowel syndrome. So it's a type of fiber that's very, very well tolerated by the body, and it seems that the more you have it, the better off you are, the caveat that if you start to really boost your dosages, they can actually

make the constipation worse. So it's important that if you do choose to use Cillium Husk, you start at a low dose and you slowly work your way up and you make sure that you're having plenty of water on board. Yeah, the water part is key because Cillium, from everything that I've understood about it, it absorbs a lot of water inside the body. So you have people that are chronically dehydrated taking Cillium and they're already dealing with maybe some constipation. And now they feel even more constipated because they haven't had enough water. You know, as a whole. How much water should people be targeting for? Again, there's different activity levels, you know, there's gender differences which typically relate to body size that's there.

You know, is there a general rule of thumb in particular if people are having cillium of like, what is the sort of amount of water they should be targeting in the day? There's no hard and fast rule. What I would say is that if you are having cillium husk, just make sure to have a glass of water with it. And ideally, the best way to assess your hydration levels is the color of your urine. So you want it slightly yellow. And that is a great way to figure out if you're having enough fluid or not. And when people are, I think this is one of the best things that people can do for their health,

just as an aside, you know, so many people are addicted to fizzy drinks. And if you can switch that to water, the benefits that you get are immense. So if you are going to drink any fluids, yeah, make it water. That's fantastic. Just one other question on topic of Cillium Husk. Sometimes I've noticed anecdotally friends that might have a hard time with Cillium Husk might do a little bit better off with things like Acacia fiber, right? Have you seen that some people respond better to some fibers or another?

Or is that just, you know, that's just people needing to test things out, start slowly and then kind of figure out which one works best for them. Yeah, it's a little bit like the diet conversation. So people sometimes ask, what is the best diet? And I think the best diet is the one that you can stick to and that you feel great on. And it's a similar story with fiber. So some people will say Sillium Husk is the way to go.

Other people will use different fibers and that works for them. So it is about individualizing it to what you feel is best for your own body. And obviously in discussion with your doctor as well. Fantastic. I hope you've enjoyed today's episode and are walking away with a new appreciation for fiber and how to get more of it in your diet without driving GI discomfort. That's the key. I also want to say I remain quite open to the fact that some people's gut health has been

so messed up for lack of a better term that any fiber seems to set them over the edge, especially if they're dealing with things like diverticulitis, Crohn's disease, and many of those folks often find themselves in some version of a modified elimination diet or even a carnivore diet where they're strictly removing a lot of fiber. I also want to say I remain very open-minded now. I don't think I was always open-minded, but I remain very open-minded that for some people whose gut health is extremely messed up, extremely messed up, and they might be dealing with diverticulitis or Crohn's disease or IBS or IBD, that some of those individuals seem anecdotally, I've even had some of them on my podcast like Nick Norwitz and Dr. Sean Baker, they found their way to some extreme elimination diet or even the carnivore diet.

And for them, where they feel like they've tried everything, adding fiber in, modifying it, trying different types of fiber, it seems for the first time in their life they've gotten relieved through following some version of the carnivore diet. If you want more information on those episodes, go look up those guests. But I largely believe, and I believe that those doctors that I mentioned would agree with this too, a healthy human gut should benefit from fiber intake and getting the right quality fiber that works well for you. On a personal level, I do well with things like lupini beans and berries and avocado, dried edamame, roasted dried edamame, and obviously most of the vegetables that are out there that

are cooked. But I do really, really bad when I'm having things like raw cauliflower, if I'm having raw mushrooms, even if I'm having too many cooked mushrooms. So this is truly all about personalization and if you want to learn more about some of these topics again you can look up my episodes with dr nick norowitz dr sean baker they're going to give you more of the carnivore perspective but if you want to look into some of the folks that we had on today dr b mary claire haver and dr brad stanfield that have evidence-based approaches that are going to work for the vast majority of the population you can find those links to those episodes in the show notes below until next time thanks for tuning in