Feel Better, Live More with Dr Rangan Chatterjee - #40 Healing IBS and Gut Health with Jeannette Hyde

Episode Date: December 12, 2018

Are you struggling with IBS or some aspect of your gut health? Right now, IBS affects almost 20% of the UK population at some point in their lives and it can be a major cause of distress and disability for the people who suffer from it. This week, I talk to nutritional therapist and author, Jeannette Hyde, about some of the common problems that she sees in her practice. She shares simple tips for treating these, improving symptoms of IBS and manipulating our microbiome - from time restricted eating to the foods that can help (and hinder) our gut health. Jeannette explains why she steers clear of the FODMAP diet for her clients and how personalisation is key when it comes to finding a diet and lifestyle that works for us. Jeannette and I also discuss alcohol consumption, something that is often overlooked or underestimated when we take a look at our lifestyles. But gut health isn’t all about what we eat. We discuss how stress and other factors can also play a huge role. This conversation is full of great tips and I hope you find that it helps you! Show notes available at drchatterjee.com/gutmakeover Follow me on instagram.com/drchatterjee/ Follow me on facebook.com/DrChatterjee/ Follow me on twitter.com/drchatterjeeuk Hosted on Acast. See acast.com/privacy for more information.

Because the more diversity of fruit and vegetables you have with all the fibre, the textures, the colour, the plant chemicals and everything in there, that that promotes lots of diversity of different bacteria in the gut. And when you have diversity of bacteria, then that correlates with good health, everything from, you know, good weight to a strong immune system to good gut health. Hi, my name is Dr. Rangan Chatterjee, medical doctor, author of The Four Pillar Plan and television presenter. I believe that all of us have the ability to feel better than we currently do. But getting healthy has become far too complicated. With this podcast, I aim to simplify it. become far too complicated. With this podcast, I aim to simplify it. I'm going to be having conversations with some of the most interesting and exciting people both within as well as outside the health space to hopefully inspire you as well as empower you with simple tips that you can put

into practice immediately to transform the way that you feel. I believe that when we are healthier, we are happier because when we feel better, we live more. Hello and welcome to episode 40 of my Feel Better Live More podcast. My name is Rangan Chastji and I am your host. Before we get started today, just a quick word to let you know that I'm going to be doing multiple talks around the UK and Dublin in January 2019 to celebrate the launch of my new book, The Stress Solution. You can see all the live dates at drchastity.com forward slash events. Also on my website, you can access a free six-part video series that I have created to help you get more energy. You can get hold of

all six videos at drchatterjee.com forward slash energy. Now today's guest is Jeanette Hyde, nutritional therapist, gut health expert and author of The Gut Makeover. My conversation with Jeanette was actually recorded a few months ago, but I think the content is as relevant now as ever, especially at this time of year, when many of us are feeling the pressures of the festive season. We discuss the best foods that we can consume to improve our gut health, the various stages of behavior change, how alcohol affects us. And throughout the conversation, Jeanette fills us in with fascinating stories from her clinic. This episode is full of tips on the simple things that we can all do to improve our own gut health. Now, before we get started, I do need to give a very quick shout out to our sponsors who are essential in order for me to be able to put out weekly podcast episodes like this

one. Athletic Greens continue their support of my podcast. I prefer that people get all of their nutrition from food but for some of us this is not always possible. Athletic Greens is one of the most nutrient-dense whole food supplements that I've come across and contains vitamins, minerals, prebiotics and digestive enzymes. If you are looking to take something each morning as an insurance policy to make sure that you are meeting your nutritional needs, I can highly recommend it. For listeners of this podcast, if you go to athleticgreens.com forward slash live more, you will be able to access a special offer where you get a free travel pack box containing 20 servings of Athletic Greens,

which is worth around £70 with your first order. You can check it out at athleticgreens.com forward slash live more. Now, on to today's conversation. forward slash live more. Now, on to today's conversation. Jeanette, welcome to the podcast. Hello, nice to see you again. Yeah, Jeanette, it's fantastic to have you on. One of the reasons I really wanted to have a conversation with you is that not only have you written a fantastic book on the guts called The Gut Makeover, but you're working day in, day out with what I would call patients, I guess you call clients, real life people who are, they've got busy lives and they're trying to improve their health.

And I really want to do a podcast with some real practical tips from someone at The Coalface. So I wonder what are those common problems that you're seeing in your clinic? And what are some of those things that people are actually doing? They think they're being healthy with, but actually when they see you, they're not being quite as healthy as you might want them to be. Yes, exactly. So a lot of people come and see me. The various things will drive them to make that appointment. But one of the big ones is IBS. So a lot of people have sort of been around the block a lot of times and they're not making progress. They've tried the FODMAP diet, which a lot of people listening to this might know, which is where you take out all these foods with particular types of fibre in them for about a

month, don't you? And that's quite often what GPs might recommend somebody with IBS. Or they may have tried things on their own. They've been down the health food store, they've bought a probiotic, but that doesn't seem to do anything or it bloats them even worse. So they're looking for kind of expert one-on-one help with the journey and also using, you know, quite very up-to-date, innovative approaches. You had the wonderful Sachin Panda on the last two podcasts that I've just listened to. And, you know, he is, you know, one of the main guys behind the time-restricted feeding research from, you know, the Salk Institute in San Diego.

And I remember in 2015 when I was writing The Gut Makeover, looking at his mouse studies that were coming out at that time, and I literally thought I was reading them wrong because he had these three groups of mice, and they would be, you know, shall I just go right into detail straight away here? Do it, yeah, yeah, yeah. So the one in 2015, he'd done several before then,

was this particular study where there were three groups of mice. They were all given exactly the same calorie count of food over four months. You had one group that could eat the food, the chow, any time they felt like it. You had one group that could eat in a 12-hour window and one group that could eat in an 8-hour window. And at the end of it, the mice that were eating all day long, you know, the kind of Western 24-7, you know, snacking all day long kind of pattern, they were all obese. And the ones in the 12-hour window and the 8-hour window lost weight.

You know, the ones in the 8-hour window lost most. They also dissected their guts and looked at their microbiomes and the microbiomes of the 12 and the eight hour ones were much, much, you know, they were healthy, the bacteria was thriving and all this kind of thing. So what it was, so I started using time restricted feeding in my practice and I've also used that in my book and I've even sort of recently tweaked it a bit more how I'm using it one-on-one but I'm just to come back to there are all kinds of very interesting pieces of research out there for dealing with gut issues and and manipulating your microbiome and improving symptoms of IBS that often people haven't you know it hasn't come on their radar yet. So I work with lots of things like that.

I also do lots of stool testing with the IBS and find out if there's any root causes, no parasites, yeast infections, not producing enough of the right enzymes to break food down. And I also talk to people and I look at their lifestyles very closely. You know, some people never even imagined that the fact that they're wolfing down their desk while they're answering 20 emails is part of the problem as well. And then on top of the IBS, you normally have people often quite low mood or their anxiety is really bad or they're not sleeping very well. Or they can't lose any weight, even though they might say to me, I'm eating 1500 calories a day. I've been doing this for two years. You know, nothing's happened. You know, the weight has got stuck as well. So what are you finding? And so let's say someone comes to see you and they're struggling to lose weight. And I appreciate there are so many

different factors that play a role in someone's weights. But, you know, what are some of the common themes that you see when people are saying, hey, Jeanette, you know, I've been trying to lose weight for the last three years. I've tried this diet and this diet and this diet and I've not managed to. Help me. You know, are there some common themes that you see that people are either not telling you about or that they're doing wrong? Well, usually they have got digestive symptoms. It'll be bloating, you know, either loose stools or constipation or chronic acid reflux. I mean, sometimes when people talk to me about bloating, they say I look six months pregnant before I go to bed. And I used to think they were that was a sort of term, a phrase, and they were exaggerating.

And then they started sending me photos on my phone in their pyjamas, you know, and they really did, you know, thin people with these big. But lots of them. And then I see the food diaries and often it's like wonderful they really did, you know, thin people with these big, but lots of them. And then I see the food diaries and often it's like wonderful food diaries, you know, very, very sort of all round diets, eating a good quality breakfast, lunch, dinner, you know, you know, good protein in there, lots of variety. You know, they're doing lots and lots of good things. You know, do you want to know what the butt is the butt is it's a massive blind spot for a lot of people is um the the alcohol and binge drinking at the weekend and these are you know it's not always but all walks of life you know um people who are retired some people have you know the high-flying jobs and they're drinking a lot of alcohol and they haven't put two and two together, that their IBS is terrible all the time.

You know, like not even knowing if they're going to make it to the loo on time. You know, the IBS is so bad. So bad. But they've got this kind of big thing, elephant in the room, that's not being acknowledged. Yeah, that's really interesting, Jeannette. I mean, first of all, just to clarify for those listening, IBS is something we call Irritable Bowel Syndrome. And we think it might affect up to 20% of the UK population at some point in their lives, which is just a remarkable statistic. And it's something that I think medical doctors

traditionally, many medical doctors haven't really taken that seriously. I think that is changing now. But I can tell you that, as I'm sure you've seen, Jeanette, that these patients are really struggling, you know, that their symptoms are having a real negative impact on their quality of life. You know, I know people who've left their jobs before because they're too nervous. They're nervous, they have to walk past their boss to go to the toilet 10 times a day. So they'd rather leave their job, you know, really huge impacts. Yeah, that's massive. And the embarrassment as well of having terrible wind and working in an open plan office, things like that. Yeah, I think it's a real problem that we need to take more seriously.

And, you know, we call this condition IBS, as if it's one condition, as we both well know. There are so many different causes, and in different people there'll be different things causing those symptoms. We're also talking about weight loss here with genetics. And I'd love to delve into alcohol because I also see that where people are not putting the two and two together. It's as if the alcohol is, that's a part of my lifestyle. That's static. I'll change my diets. I'll read all these wonderful blogs or

buy these books and I'll make these changes but that is an unchangeable so I'm interested to know what impact is alcohol having and how do you go about having that conversation with them well it's it's interesting I mean you probably know about the five stages of change if people don't there's you know you're in denial and then the of change. If people don't, there's, you know, you're in denial. And then the second change is you might sort of start to contemplate making a change. And then the third one might be you start researching into the change. And the fourth would be action where you implement the change.

And the fifth will be maintaining the change. So I also think people shouldn't be too hard on themselves. You have to realise you don't just wake up one morning and you're alcohol free. It is a real journey. So number one is, you know, you have to get right back to the beginning with the denial stage. And many, many people are in complete denial. So maybe hopefully even just doing a podcast like this might move somebody from denial onto research. But that's the goal really, is just to give, you know, this is what I want. Yeah, so moving people on. So that's what I do.

So, and also, you know, work with people for them to maybe start to realise that they are drinking a lot more than they think. Because, of course, they all say on the Food Diary, I drink a couple of glasses of red wine a night. are drinking a lot more than they think because of course they all say on the food diary i drink a couple of glasses of red wine a night and you get into detail and in the most unjudgmental way by the way but because you just need the facts you can't help people until you've got the information you can't so hiding it from the nutritional therapist doesn't help because you can't so but but you kind of got to have trust rapport so people will open up and they will then sort of talk about it in more detail and when we get into more detail i they

open up they hear themselves talking about actually what's going on they'll be go oh yes well i'm not as bad as my friends because when i go to the rugby i only have six pints or you know they talk about well yes i only drink at the weekend because, you know, my husband, he wants me to keep him company when he drinks and he'll be really annoyed if I don't join in too. And then you sort of say, oh, so what's a Saturday look like? And, you know, they'll start going, well, at lunchtime we might go and have a couple of drinks down the local pub and then they'll tell you about the rest of the day. And actually they sit there talking and as they're talking, they realise and you realise that actually they're drinking all weekend long. Yeah, and I think that's, you know, it's really important, isn't it, to deal with the people we're trying to help in a very compassionate, very kind way and have those sort of frank conversations. And I often find that as well, when a patient starts, you know, when they feel that their space has been created in a very non-judgmental way, they start opening up.

And as they're saying it, they often, you know, the penny almost drops in the consultation room. Oh, wait a minute, that is, you can almost, in many ways, I think it's that in the context of their own life, in their own environment, they can get very used to certain habits. And that can appear to be normal in the context of their life. But it's only when they're having to tell someone, you know, a third party that has no, you know, personal or emotional relationship with them, that it can start to, I think, you know, the penny starts to drop and they think, wait a minute, actually, I'm drinking a bit too much, aren't I? And I think that's so important because, know i always say that patients or clients are not going to make a change long term just because we've asked them to i really don't think they are

i think it's only going to be when they start to feel the difference and they start to be part of that process and i know that's something you take very seriously with with your patients i know you use um you know, you talk about, I've heard you talk about this before, about this whole concept of motivational interviewing. And you talked to me about how information isn't necessarily the problem. Behavioural changes. I wonder if you could just elaborate on that.

Yeah, well, that it's exactly what you just said is people won't do something because you've told them to do it. They have to have intrinsic motivation. So when we meet, what I really try hard to do is to jump on, find out lots about you and what you love doing and what things are important to you. and what things are important to you and then try to work with you to ask you the questions so that you can suggest the solutions. And what happens is, so I'll give you an example. So I might be, you know, when I get to know you, you might say, oh, I love history, I'm learning Spanish. You know, this might all, oh, I love history.

I'm learning Spanish. You know, this might all sound irrelevant, but it's not. It might be, I really, really love seeing my girlfriends. But do you see those three things? And then you can even, like history. Oh, so what kind of things? You get into it. Historical building. Have you got a National Trust card?

I used to a long time ago. Have you thought about getting one now? And then it's like, oh, yeah, I used to a long time ago why have you thought about getting one now and then it's like oh yeah i used to love national trust at the weekend i could go walk it i could meet my friends you know and suddenly that's like rather than way in right yeah yeah and rather than it being oh yeah we always meet up and we always go to the pub and we always drink when we meet this particular group of friends i mean well we're gonna have a picnic at the national trust i know that might sound a bit silly, but what I find is people, they kind of start imagining lovely scenarios, lovely things to do. And then they walk out of the consultation going, oh, I'm so excited. I can't wait to do this.

It doesn't sound silly at all, Jeanette. I mean, this is what I found in almost 20 years of seeing patients now. You've got to find something that you can resonate with, with that patient. Yeah, exactly. Something that means something to them. It's got to be personalised. If you're got to find something that you can resonate with with that patient. Yeah, exactly. It's something that means something to them. It's got to be personalised if you're going to get, if you're really going to help our patients. So it's got to be personalised.

So that makes a lot of sense. And then that National Trust membership that they re-engaged with gets them out in nature, which improves our psychological wellbeing anyway, gets them more physically active. Potentially if that's the same person who's drinking a lot at the weekend actually they're out so they're probably drinking a bit less you know all those kind of knock-on effects right exactly yeah and you're finding out what motivates each person so you know it might be somebody who's a real high flyer for

instance and they're overweight and uh and they've come but you want them to actually make put the changes into practice but you've got to actually make, put the changes into practice. But you've got to find out what is the absolutely, almost like the killer question or the absolute biggest thing that will motivate them. And I found recently with somebody, a high powered person, that it was actually that their job, that basically they have a high powered job and their earning potential totally rests on them being brain sharp. Right. And you imagine they're eating lots of rubbish and they're drinking heavily and they've noticed they're not so brain sharp. So actually, they're really interested in making those changes because they want to stay at the top of their game and be brain sharp. They've noticed they're becoming brain foggy.

So the interest isn't necessarily, I want to reduce my risk of heart disease. I want to lose weight. Their interest might be, for example, I want to stay at the top of my game so I can stay in this job. Yeah, earning potential. Yeah, exactly. And that's this whole concept of personalisation.

And for people who are listening to this right now and are looking for those practical tips that we're going to get into i'd encourage you to have a little think about you know why is it that you want to be healthier what is it about that you know is it the way you look the way you feel is it because of your job is it because you want to be you know a more active parent and have more energy what is it and really try and tap into that is that what you're finding in your practice as well yeah totally but people have to know that they're going to go out and really enjoy it so one thing I found with that time restricted feeding is I just found that people would could imagine instantly that that was something attainable easy they're not going to have to

go hungry they don't have to sort of forfeit any foods that they love and they enjoy do they so they literally go oh okay rather than eating at 10 p.m when my husband comes in and going to bed with heartburn every night and I've noticed I've put on a lot of weight over the last year I'll eat with the kids at six and I'll have a cup of cup of herbal tea with my husband while he's eating his dinner when he comes in at 10 do you see what I mean yeah and then and then so that scenario I'm telling you there is actually my sister because she said do you know how people who are in your extended family won't listen to anything that you say do I ever do they put their hands over their ears oh god it's Jeanette talking again not that nutrition C-R-A-P, as one person put it.

So do you see what I mean? Absolutely. So I don't now tend to, you know, make suggestions for people around me at all. That's something you have to learn, don't you, as a health practitioner, to hold back, and only if people ask for help, you know, help. Yeah, people don't want to be lectured to when they're not ready for it no one does no so i completely hold back anyway the time restricted feeding came out i went out for lunch with my brother and my sister for my birthday in february and i think it just came organically into the conversation about time restricted feeding my sister was saying that she was doing slim fast and all these other things and she put on a lot of weight over the last you

know year or so she was eating late she was having the acid reflux. And I was talking about time-restricted feeding. Anyway, I saw her very recently. She walked back into the room and I said, oh, you're looking really well. How are you? She said, oh, I've lost a stone. That's about, what, seven kilos or 14 pounds, something like that. She said, I did that thing you told me to i'm having dinner with the kids at six now instead of waiting for the husband and i've lost that amount of weight and i mean she looks fantastic and she said that is the only difference i made it took her three months she did that in three months but coming back to sachin panda um don't you think that's sort of like incredible there's all these people out there and i'm seeing amazing transformations in my practice.

I want to go into that, to what other changes you're seeing. For people who've not heard those two podcasts, I'd encourage you to just go back, whatever podcast platform you're listening to this on, just go into this podcast, the Feel Better Live More podcast. And a few episodes back was part one and part two of my conversation with Professor Sachin Andhapanda, where he talks about

a lot of his research that was initially done in animals. He's now moving into human trials about how we focus for so long on changing what we eat, maybe we need to put as much focus on when we eat. And I think the reason why his podcasts with me have proved so popular is because it's a very practical intervention for people. It makes intuitive sense. And this is about, you know, this whole idea that we're not designed to eat, you know, 24 hours a day or certainly from 6 a.m. all the way to 11 p.m. You know, our bodies are just not designed for that. And I'm also seeing, Jeanette, that if people just restrict the hours in which they eat.

And you know what? We can delve into this a little bit because I, in my book, The Four-Pillar Plan, I talk about a 12-hour window. And the reason I talk about that is because I think that's pretty much practical and achievable for everyone, for pretty much everyone. And I do, in clinic, I do go a bit deeper with some people.

And I cover that in the book. I say, guys, some people will benefit from going low and short, but just start there, right? See if you can get that dialed in and I know I try my very best to do that and I manage to on most days but I know you've been using this in your clinic with patients since 2015 so about three years now yeah can you tell me about some of the benefits you've seen because I think it's a whole variety of different conditions right yeah yeah totally. So often people are coming, the number one thing on their list of goals that they want to sort of quickly sort out is the IBS symptoms. You know, I was talking about people who like dashing to the bathroom and hardly making it in time and the embarrassment factor. And often

that's the number one thing. There may be the weight, there may be mood, sleep, other things as well, but that's the one they want to focus on first. So what I've done quite often is get them doing a 16 hour fast. So not for everybody, by the way, because it is quite tough, I think, around lifestyle and all the rest of it. But for the big cases like, you know, inflammatory bowel disorder and stuff like that and also diverticulitis and some of the really bad IBS cases, I start by saying do a 16-hour fast with an eight-hour window. So that's eight hours in the daytime where they would eat food within. Yeah, and do that for the first month. So it's not like an 8 a.m. till a 4 p.m.?

It can be, but do you know what? Just to get them started, they choose what they do. So for instance, let's say somebody tells me they hate breakfast. I leap on that. I leap on that fact. That's one of my key entry points. I'm like, oh, you don't like breakfast. Well, you don't have to eat breakfast.

And they're like, really? I've always been told i've had to eat breakfast so they don't so suddenly instantly they're those kind of people might be very happy to start you know eating at 12 to late yeah yeah yeah so what you've you've seen that with you've you've found that useful in patients suffering with iris Syndrome. Yes, and also things like ulcerative colitis and diverticulitis. Wow. So with those people, quite often, you know, they're running to the bathroom with all those three conditions I've mentioned there. That's what we're trying to improve.

And if you go back to the mice research, it's the microbiome will flourish and have more diversity just being by not having food sort of charging through it you know all day long yeah so what happens it's like i say to people it's like think of it like a lawn you need to not walk over it for a few hours let it have time to flourish and thrive that's a a great analogy. And I think, you know, and we'll get into some real practical tips for gut health. I mean, often a lot of the things we're talking about

to improve people's gut health, we're talking about the foods that they can put in through their mouth, you know, that are going to help, you know, feed and nourish their gut bugs and their microbiome. But we don't give as much attention to saying, hey, guys,

we need a period of time where we're not putting those foods down, even if they are healthy, gut-friendly foods. We're saying we don't, hey guys, we need a period of time where we're not putting those foods down, even if they are healthy, gut-friendly foods. We're saying we don't, you know, you want a period of time in each 24-hour period where you're not shoving them down your throats because your body, like your lawn, as the analogy you just used,

needs a bit of time just to sort of reset. And that's something that Tim Spector talks about a lot. You know, Professor Tim Spector, he was actually on my very first podcast. You know, one of the UK's leading microbiome researchers. And he often will talk about periods of time where we don't eat and not snacking and having that period of time without food being good for our microbiome, which is incredible. So I'm interested that you use a very safe approach. I might add, you know.

Yeah, no, they've got nothing to lose by doing that. Yeah, because I'm guessing- And there's no pills, you know, nothing. I think that's important to really emphasise. People are coming to see you, almost certainly, I guess, they've already been under different doctors and may have tried some pharmaceutical approaches.

Either they're frustrated with that and they want to come off those drugs or I'm guessing that they actually go, I don't want them, they don't make me feel good or they're not working. They're not working anymore sometimes. Jeanette, help me do something. Well, it's not me helping, it's I'm going to help you help you. Yeah, so that's really key, isn't it? So you're not the one helping them, you're just helping facilitate them helping themselves. So when you talk about restricting their eating when there's eight hours do you get any pushback when people

are quite um their whole life is being affected by something like not getting to the bathroom on time they're they're very open on you know on the five stages of change they're not they've gone past research they're straight into action um people who um haven't got such severe things going on as that, whereas maybe they want to just lose weight or this or that, there can be more pushback. I do have people who go, oh, but my girlfriend will sort of go mad if I don't eat with her in the evening when she comes home from work. Do you see what I mean? Yeah, absolutely. So no, these people, the ones who are very motivated,

especially they've tried all the drugs and they're still taking the drugs and the drugs are just not working. You know, things like, you know, IBD, you know, people can be bleeding for, you know, nonstop and it can go on for months and months and months and some people become housebound even. So, at that point, if somebody says, listen, don't have breakfast, if you don't like breakfast anymore, try to eat between 12 and eight, would you do that? Yeah.

Okay. So the people I'm working with have been doing these things quite, you know, and they go home and they just get straight on with it. And I've had several of these cases and I thought I was just doing it you know to regularize the microbiome and put that in better shape so that is going to have a knock-on impact I wasn't expecting the results as fast as they're coming I mean the 16-hour fast with those two conditions you know within within a month formed stools no bleeding and you, you know, suddenly being able to go out the house again. That's incredible. And, you know, if I think back to that conversation I had with Professor Panda, you know, he talks about, and I've read all his research papers about how restricting

our eating window can have multiple downstream consequences it can reduce inflammation levels in your body it can improve the functioning of our immune system and you know you're talking about ulcerative colitis which is an autoimmune disorder it's when the immune system is misfiring to a certain degree so you know this is a this is a recommendation that is having an effect on the immune system it's helping us with our blood sugar control, which is why I tend to use it a lot with type 2 diabetic patients. But I'm going to add there that it's very important that if you are on some medications from your doctor for type 2 diabetes, some of them can actually drop your blood sugar or, you know, increase the tendency for you to drop your blood sugar. And, you know, it's always

important to discuss this with a healthcare professional, whether you need to modify those modifications before you go for long periods of time without eating. Just something, just as a safety note, it's worth checking. But generally time-restricted eating and time-restricted feeding is a very safe recommendation that can impact, as I said, weight know, weight, blood sugar, immune system, inflammation levels, all kinds of things in the body. So it makes sense that when you make that recommendation with a patient, Jeanette, all kinds of different diseases or conditions may start to improve. It may not always, but it's always worth a try. I find that incredible. Well, the gut starts healing itself.

It goes into healing and repair mode. It's the autophagy, isn't it? Absolutely. Yeah. So incredible that you've been using this research for a few years. And I think it's also important to say that, you know, we don't have human trials yet saying in ulcerative colitis, time-restricted eating or time-restricted feeding helps to put ulcerative colitis into remission. We don't have a trial of that. What we do have is very well-conducted animal research.

Sachin Panda talks about his app where they're collecting human data from all over the world, and early human trials are underway. But I feel like you, Jeanette. way but I feel like you Jeanette I feel very happy making this recommendation with my patients particularly those who are suffering from a condition because I can't really see any downside and intuitively it makes a lot of sense so yeah thank you for sharing that and I hope people who are listening to this if you weren't convinced by Professor Panda's podcast which I presume you possibly were you know Jeanette is actually there seeing patients in real life and seeing incredible benefits. So I'd highly encourage you guys to give it a try.

And diverticulitis as well. Wow. That was the other one within a month. So tell me about that patient. That was, again, 16 hours, exactly the same thing and completely resolved after a month. Well, that's incredible. Has it taken you about a trial and error to figure out that you're, that you're recommending an eight-hour eating right now and a 16-hour fast? Or is there a degree, for people listening, is there a degree of flexibility there?

With those sort of big cases where people are really, you know, they're in a bad way, they need to get their lives back. I've just been getting on with the 16- hour thing and the people involved were just ready to do it, you know. But what is interesting is after that first four or six weeks is, I mean, no one's going to do that forever and ever and ever. We're then transitioning on to 14 hours. 14 hours. So that would be, you know, you're eating in a 10 hour window. So that would be, let's say, 8am to 6pm. So you're using that as a short term intervention, but know you're eating in a 10 hour window so that would be let's say 8am to 6pm so you're using that as a short-term yes intervention but then you're expanding it out yeah that's

you know yeah I think that's a great idea and I would also say that I do genuinely believe that for most of us we can start to implement a 12-hour eating window for the majority of our days so I tell you what when I was a kid we always had a 12-hour fast window for the majority of our days. Shall I tell you what? When I was a kid, we always had a 12-hour fast. There were no snacks in my house, you know, my parents. And the kitchen door was shut. We'd eat dinner at 6 o'clock. That was it. My mum and dad would do the washing up by hand and shut the door.

We didn't have a biscuit tin in the house. It was like, I mean, obviously I'm showing my age here, but it was like as i've got older and older that our kind of sort of eating culture has just changed so radically yeah and there's the irony there that actually we probably didn't need research on time restricted eating 100 years ago because everyone was probably doing it yeah anyway yeah it's only now because of this culture where we have access to food all the time. You know, I see it in my kids that go to school, this whole snack culture now.

You know, there's a snack mid-morning, a snack mid-afternoon. What's the snack when you go and pick them up? You know, it's just snack, snack, snack everywhere. And again, you know, I appreciate some of you feel that they need them, but I would always say that there's probably an underlying issue, which is change your metabolism so that you do need or you think you need those snacks and while snacking in the short term may you know feed that energy crisis or that blood sugar drop in the long term we need to understand what was the root cause

of that um you know i just want to go into ibs a little bit irritable bowel syndrome and you know your book has had phenomenal reviews youette's The Gut's Makeover and it's a it's a very practical simple guide to helping people revolutionize their health by improving their gut health since you wrote the book in 2015 has anything changed have you come up with have you found things that you think actually you know if I was writing it now I'd write it in a different way or I'd add some things in okay well I'll tell you found things that you think, actually, if I was writing it now, I'd write it in a different way or I'd add some things in? Okay, well, I'll tell you the things that are just for the long term in there are just eat a massive diversity of different fruit and vegetables. And why is that? diversity of fruit and vegetables you have with all the fibre, the textures, the colour, the plant chemicals and everything in there, that that promotes lots of diversity of different bacteria in the gut. And when you have diversity of bacteria, then that correlates with good health,

everything from good weight, a strong immune system to good gut health to brain health. Because that's one of the things we do know about gut health. I mean, a lot of people say, oh, it's too early. You know, we need more research. And yes, you know, everyone in microbiome research. I recently spoke to Professor John Cryan. He's one of the world's leading researchers in gut health.

And, you know, he's very keen not to, you you know overstate some of the benefits you know he's a scientific researcher he wants to make sure we've got robust studies before they start making recommendations but i think what everything is what everyone is agreed on is that a diverse microbiome so one where there's lots of different species interacting in harmony with each other is considered to be a strong and healthy microbiome and you're saying that actually if people can focus on increasing the diversity of their diets yes lots of different colours fruit and vegetables all these kind of things you know that's going to help promote diversity absolutely and you go into that in your book and I do what I do there is I've

basically designed a diet for one month where I'm trying to sort of, you know, tick as many boxes as possible, sort of boost your whole microbiome and sort of help, you know, reduce inflammation in the body as well. So in there, you've got the diversity. You've also, I took out all the grains, mainly because there's more space on the plate for all these lovely vegetables that you get in every meal. This is a short term recommendation, right? It get a short term recommendation right four weeks four weeks what and then in the second half you start to put some fermented foods in there as well for the probiotic bacteria to populate the gut um and uh that you don't drink any alcohol for a month um so what would i do what would i do differently now and also i have a 12 hour overnight fast in there i'll tell you what I would do different now is I would put more emphasis on the, and especially having heard Sachin just last week with the 14 hours

and what I'm seeing with 16 hours, I think I would put more emphasis on the time-restricted feeding because I do meet people who've done the plan and some of them haven't taken the 12-hour thing very seriously. And I think now I would just write more pages on it and give more examples about why that is so important. Give more emphasis to it. So actually, you know, I was lecturing with Sachin last year in Iceland

and we went out for dinner and we had a chat and, you know, still trying to figure out what is that ideal recommendation for public health. But I think Sachin often recommends a 10-hour window because he thinks well you know i may be slightly i'm just trying to remember this correctly but it's actually said look you know if you say 10 hours and it might end up being 11 hours it might end up being 12 hours because you know if you make a recommendation not everyone's going to stick to it and they may

try but just go a little bit over um which i think is a good tip and i think clinicians like me and people like yourself who see patients we've come up with our own strategies our own little tips to help our patients actually do what we would love them to do to help improve their health so that's interesting

so you give a bit more emphasis onto time-restricted eating one thing that comes up quite a lot is a lot of the foods that we recommend to improve people's gut health some people with irritable bowel syndrome symptoms yeah can't tolerate them very well i know this is such a massive topic yes and again i think if i was you know writing that again i would put some emphasis on on this as well because so many of the people that I see in my clinical practice have at some stage

done this FODMAP diet. It's basically, you know, a diet that has been designed to help alleviate the symptoms of IBS. But it involves cutting out of the diet loads and loads of vegetables. So things like leeks and mushrooms, and there's a big long list of them if you look online. So people often have done that for a short spell. My understanding from people who work, you know, with their GPs or whatever or done it is that they're only supposed to do it for a month or so, but they often find a bit of relief during that month

and are holding on tight to it. And I might meet them two three four five years later when they're still on it and they're still on it wow and they're still and they're horrendous gut problems but they're too scared to go back to any of those foods so the benefits from it by that stage gone and they but they they're very scared of those foods it's almost do you know what i mean it becomes a bit of a there's fear attached around it and i think that's something we've all got to be careful of when we talk about food is that yes there are foods that are more healthy than others but i think some of our patients and some of your clients probably you know if we don't do our job

as well as we could do in the way we talk about these things you know people can sometimes have a really unhealthy relationship with certain foods and really start to be very very scared of them and i i think you know for me the whole fodmap diet really makes me think of something you said right at the start which is you know if people have been struggling with symptoms for so long that it's really impacted what they can do in their life. You know, they're willing to try anything. And if a low FODMAP diet gives them symptom relief, they're like, you know what, I can take this because I'm not getting my bloating. I'm not getting that urge to go to the toilet. But, you know, I spoke to Megan Rossi, who is a dietitian who talks a lot about the low FODMAP diet in the podcast a few episodes ago.

And again, Megan's also the opinion, like you, like myself, that the low FODMAP diet is just a short-term intervention. It can take the sting out of things. It can help calm things down. It can help make life a lot more tolerable. But ultimately, you want to try and fix the situation that the root cause is so that you can start to reintroduce some of those foods that ultimately the long term are going to be very very healthy for your microbiome so do you use the low FODMAP diets with your patients no never so that's not something you do so you no no I actively avoid it because my goal is to get you to having as big a diversity of different fruit and vegetables in your diet as possible. And what happens is when people have gone on the FODMAP for too long is that the microbiome becomes very depleted.

I mean, I do stool testing with people and it comes back and, you know, on the diversity score, they're sort of right at the bottom. And so right there, you can see why their gut problems are getting worse, because, you know, because something you were trying to do for the good is actually in the long term, making the situation even worse. Yeah, you're stopping, I guess you're stopping putting in foods that are going to fan the flames, but you're not trying to figure out how to put that fire out in the first place. And so what you're trying to do is help them you know personalize personalization is absolutely the key to this and what you find is when those people start saying right and we agree between us so which of those which of those foods that you've been avoiding for quite a

long time should we start by reintroducing and they might say oh i used to love mushroom soup i used to love it right so it's like well look make mushroom soup and you know you do um you know I give them a handout and they sort of monitor their symptoms for three days so I say okay try mushroom soup make a bit literally start with one tablespoonful the first day and monitor your symptoms if you're bloating if it's having a terrible impact and they build up over three days but what I'm finding is that with a lot of people, there's a lot of FODMAP foods they can eat before we find which ones are actually in their particular case, the triggers for their particular gut. And when you find those triggers, do you avoid those with them? Yes, yes, we do. So like somebody might, you know, it might be the one thing they can't tolerate are leaks.

Yeah. And you know, all it is is leaks. Yeah. You can live your life without leaks, can't you? I don't know, I have a lot of leaks, but yeah, I probably could if I had to. But you know what I mean? Yeah. You could choose to have shallots instead, you know.

And sometimes you just find it's actually a very small handful of foods that are the real problem. And people and things like mushrooms, you know, they've got beta glucans in them, you know, very good for the immune system. And also they are prebiotic, which means they feed lots of good bacteria in the gut. So to have a healthy gut long term, if that's one of the foods you actually can tolerate, it's such a shame that you're not having it in there so we i'm we're trying to find which ones in your particular case you can tolerate and start to build them back in and as you're building in back in these foods people are getting better yeah and they're sort of nourishing their guts and ironically often it makes them you know it makes it easy for them to tolerate those foods that right at the start they couldn't have that's right because they've got you've got a more robust microbiome and it helps your digestion of everything better.

Yeah, so I think that's great tips for people there. And if you are one of those people who have tried a low FODMAP diet and you are still on one because you find that it actually helps you with your symptoms, well done for doing that, well done for actually trying to sort of you know take control of your health and do something but it may be worth talking to someone like either your gp or getting referred to someone or talking to a nutritional therapist like jeanette to actually try and figure out actually what can you start to reintroduce how can we start to help you you know diversify your diet so that you can build a strong healthy gut microbiome i mean we're not going into this area today but one thing i always do with my ibs patients you know stress is a huge trigger and

it's something i always tackle with them because i find even when i can give them some good stress management techniques that can also help to start improving gut function so of course the other thing i've noticed a lot with ibs as well there's often um you know things that have happened in people's childhoods as well that you know if they trust you and these things start to come out you find that there can be some quite big things you know sexual abuse things like that that have happened in the past and so getting them or directing them towards talking therapy talking therapy at the same time that can be really helpful too. Yeah, I think you raise a great point there, which is that Irritable Bowel Syndrome, like so many of the other chronic complaints that we're seeing today

in practice, have got multiple factors that are driving them. Diet is one component. Even when you talk about IBS, we think, oh, it's a's a diet thing right because it's to do with our guts no you know diet is one part of that but stress and trauma are very very important parts and I also see that Jeanette I see that there is in many cases not all of them it may be that I've not I've not managed to uncover it in some people that certainly I can only go from my clinical practice I see many cases, there are some underlying emotional issues that need resolving. And, you know, often I feel my role is just to, you know, just to sort of open that door a little bit and then either continue that with them or pass them on and refer them on to a trained counsellor or therapist to help them. So I, you know, thanks for raising that. I think

it's a very important point. And often, you know, I find until those issues are properly dealt with we hit a plateau i can only go so far with diet i don't know if you find that as well well the other thing and i love this in your book about the movement um you know people can be just sort of focusing really hard on the diet and i'd have a conversation with somebody and you know they're actually seated 12 hours of the day, these IBS patients, you know, driving to work, then being in very sort of demanding jobs and driving home. And, you know, and it's only as we're talking, you know,

and they're explaining it to me, I might feed it back and go, do you realise you're seated for 12 hours a day? And they go, really? I've not really thought about it like that. Do you know what I mean? And I said, you're not having a lunch break either are you and they're like um no i haven't got time for lunch you know they're eating at the desk and all that stuff as well yeah but but but um physical activity is important right for our guts yes totally because you know when when when you're you're you know moving and um so on your your your gut bacteria improves and you produce short-chain

fatty acids which help with the gut lining and to keep that repaired and in good shape so again moving around if you have IBS is really important and I have directed many people to your book on the movement because you know the movement snacking because you know um I'm talking to them about that and just you know to tell you about this so some of them have really sort of like realized oh my god you know i am sat seated 12 hours a day oh my god yeah no of course that they all say to me god that makes sense it's a bit with the time restricted meetings people always like my god that just makes logical sense right it's just we've gone you know what i say to people is that the rules of good health have not changed

you know in the last 5 10 10, 50, 100 years. What has changed is the modern environment in which we live. So therefore, we almost have to go back to some of these basic things that actually, until recently, were just part of everyday lifestyles and everyday culture. But we're almost having to relearn them and re-imprint them into our modern, busy, stressful daily lives. Yeah, and rather than our environment, you know, dictating to us how we are, us, you know, dictating the environment. So these people, for instance, you know, I find out, well, what could you do? You know, there's some of them, they go up and down the stairs in these high rise buildings once an hour. And their colleagues think they're going for a coffee.

I love it, man. I'm so happy hearing these things. These are, you know, this is what I did. You know, we're sitting here in the basement of Penguin in central London. And I think I've told the story in the podcast before, but I really, you know, I gave them a wellbeing talk and I encouraged them. I said, guys, you're on the eighth floor, right? What if from tomorrow morning,

not next week and not next January, what if from tomorrow morning, you all helped to encourage each other, those of you that can, go up and down the stairs at least once a day. And it's incredible, you know, that pretty much all were doing it the following morning. And I think it was about 80, 85% of them were still doing it four times a week, four to six months on. Just incredible when something a lot of them weren't doing,

but just by opening up their eyes to that possibility and having their friends and their colleagues helping them, they're still doing that. And that's going to help people's IBS symptoms as well. It's one piece of the puzzle. So, Janette, I really appreciate you sharing some of those real-life stories from your clinic. I wonder if we could just finish off with four,

sort of four big tips that I can leave and that we can leave my listeners with that they can start putting into practice hopefully immediately to start improving their health. Okay so the first one I would say is maybe keep a diary about your drinking because I think that a lot of us we don't realise till we actually see it in black and white how much we are drinking. Alcohol. Yes and I think that you know especially in IBS or if you've got a weight issue, it's a big factor. So, you know, it's just worth seeing it in black and white. And sometimes that can, you know, you start to have a conversation with yourself about, well, actually, maybe my partner and I will try and do this, that or the other.

It's much easier to drink less if you've got support and you're supporting each other, not alone. That really, really helps. So document it so you actually know. I think it's a great tip. I would. I would. The other thing is I would do the eat in a 10-hour window. If you've got a weight issue or a digestive issue, start trying to eat in this 10 hour and be really really anal about it by the way um you know uh i as well i have like a template i give people and sort of on one column they write you know what time they um ate the breakfast they started eating the breakfast at what time they finished the last mouthful of food in the evening there's no sort of like you know and i say nothing but herbal tea or uh water out with that in the fast um

in the fast period okay great so that's what i'm saying i know you spoke with such in the other day and talked about whether you have black coffee or not i'm finding that herbal tea and water is how it's working that's great because it's very clear that people can hear it and go okay fine i'm going to try that and that's what I'm finding works. Third tip? Third tip would, and we haven't actually even touched on this much, have we, is fermented food. There's a lot on that in your book, right? Yes, yes.

Well, you did mention what more would you do with the book if you were writing. Now I'd have a bigger section on the fermented food. Is that because you're seeing a, you know, that really helped people in your clinic? Yes, and also it's much more accessible than it was even three years ago. So when I wrote the book and I first gave it to my agent, his immediate reaction was, oh my God, this has to be food in this book that's accessible and people get in regular supermarkets.

And I really appreciate that guidance from him and the publisher at the time because I think that's one of the things that made this a very practical doable book but in there I had kefir and kefir if you don't know about it is a fermented drinking is a fermented milk that is like drinking yogurt and it's got it should have billions of bacteria in it if it's been produced you know authentically and at the time I had been using kefir based on very small studies to do with sleep and there were a few other things around from about 2012. But I had been sending my clients down to a local Eastern European shop that was selling kefir because at that time, you could only get it in like the Polish, the Hungarian shops. And now it's everywhere, right? Yeah,

yeah, yeah. But so I had to kind of beg them and I was like, please can I keep the kefir in there because it makes a big difference, you know, especially with the sleep and the mood. But that's a great thing, isn't it? As awareness grows about these things, then the demand grows and it becomes more accessible for people. So you're big on fermented foods, kefir being one of those. And the other thing that I'm really into myself now is, you know, making kombucha and I'm making sauerkraut because they're easy to make as well.

But coming back to just fermented foods. Yes. If you're not at the moment having fermented foods, yeah, look out for things like kefir. They are in all the supermarkets now and they taste delicious. You just put them in the blender with a handful of, you know, berries in the morning, spoonful of flax seeds. And you've got a very gut friendly breakfast there. And it's very filling with of flax seeds. And you've got a very gut-friendly breakfast there. And it's very filling with the flax seeds. Those are prebiotic, feed the good bacteria in the gut.

Do you see what I mean? Tick off loads of stuff and out you go. Fantastic, I love it. That's a great tip three. Yes, yes. And guys, for those of you listening, before we get into Jeanette's final tip, there's going to be a show notes page,

which is drchatterjee.com forward slash gut makeover. So if you go there, everything me and Jeanette have spoken about and links to various articles, Jeanette's book, you know, Jeanette's social media channels are all going to be there if you want to connect with her afterwards. Or you just want to follow up on some of the things that we've discussed. So Jeanette, what's that final tip, would you say? OK, it's diversity. If you're having the same breakfast every day, stop immediately. Just go to a supermarket, go to the frozen section and make sure you get, just fill a drawer of your freezer if you've got all the top bit at the moment is, you know, you just go to Tesco or something like that. And they've got, you know, mangoes, coconuts, you know, berries, mixed fruits, everything. All in frozen form. And frozen, by the way, if you do look at the research, it's fine.

It still keeps its color, the polyphenols and the plant chemicals in it. And it's still got all the fibre. Those are the two bits of it you need for your gut health. And it's much cheaper and it's convenient. And often I work with people, they live alone. You know, you're not going to buy all this fruit and then there's only one of you eating it. It's always on hand, right? And it's cheaper and it's cheaper.

Jeanette, that's a great tip. Diversity. So just keep the diversity. And if you're going out, you know, at lunchtime, just, you know, wherever you are, you know, getting your, just try, order something different. If you're in the restaurant, right, look at the side dishes. Oh, when did I last have aubergine? I will order the aubergine. Or it might be something that you don't like favour cooking at home, like, you know, Jerusalem artichokes or something. Have it when you're out.

Have it when you're out. And then when you're out and about, just be very conscious about, oh, I had the nicoise salad yesterday. Oh, I'll have the Middle East and falafels with the blah-de-blah today. Just keep life interesting for yourself. I love it. So four very, very practical tips for people that they can start implementing in their life immediately. For those listeners who want to stay in touch with you,

where can they find you on social media? Well, I'm on Instagram, Jeanette Hyde Nutrition, two N's and two T's. I'm on Twitter, Jeanette Hyde. And I have a really, actually quite a lively Facebook group called The Gut Makeover. And I post stuff regularly on there

that I think will be helpful. And also people interact with each other on that one as well. Well, okay, guys, I'm going to link to all of those channels in the show notes drchastity.com forward slash gut makeover so please if this podcast has inspired you if you're interested in hearing more from jeanette please do go to those show notes and check out those links that i put in there jeanette thank you so much it's been a real pleasure talking to you and I hope we get the chance to do it again at some point in the future thank you that concludes today's episode of the feel better live more

podcast I hope it has left you feeling inspired to make some changes in your own lifestyle if you have not yet heard episodes 21 and 22 with Professor Sachin Panda, I highly recommend that you give them a listen. They have proved to be two of my most popular podcasts to date. And we discussed the incredible benefits of time-restricted eating. This is a super accessible strategy to help you improve your overall health. Obviously, Jeanette is a huge fan and so am I. If you want to continue your learning experience now that the conversation is over, do take a look at the show notes page at drchastji.com forward slash gut makeover, where you can see everything that was discussed today, as well as links to further blogs on gut health. As always, please do let us know what you thought of today's show

by tagging us both on social media. In fact, why not take a screenshot of this episode right now and post on your social media channels. If you regularly enjoy my weekly podcasts, one of the best ways to support it is to leave a review on Apple Podcasts or whichever platform you listen to podcasts on. These reviews help to raise visibility of the podcast, which in turn helps me to attract better guests. Of course, feel free to support this podcast in the good old-fashioned way of spreading the word by telling your friends and family about the show. Stress is a big contributing factor to all gut problems and I cover this in detail in my book The Stress Solution which is full of simple and accessible tools to help you de-stress so that you can live a happier and calmer life. It is

available to order right now in paperback or in the, which I am narrating. For those of you new to the podcast, my very first book, The Four Pillar Plan, is all about helping people to make simple and accessible lifestyle changes. If you don't have a copy yet, please do consider picking one up. And for those of you listening in the US and Canada, The Four Pillar Plan is available to buy over there with a different title, which is how to make disease disappear. That's it for today. I hope you have a fabulous week. Make sure you have pressed subscribe and I'll be back next week with my latest conversation. Remember, you are the architects of your own health. Making lifestyle change is always worth it because when you feel better, you live more.

I'll see you next time. Thank you.