Mayim Bialik's Breakdown - Dr. Will Bulsiewicz: Help & Heal Your Gut

Episode Date: April 19, 2022

Dr. Will Bulsiewicz (gastroenterologist, nutritionist, New York Times-bestselling author of Fiber Fueled and The Fiber Fueled Cookbook) stops by to break down gut health and practical steps we can take to heal our guts. He unpacks gluten, food sensitivities, and fiber’s role in gut health. He explains the significance of microbiomes, challenges highly restrictive diets, and discusses why bowel movements directly inform gut health. Mayim and Dr. B consider the gut’s effect on mood, why digestive issues can still manifest even with proper nutrition, and the evidence-based benefits of a plant-based diet. They discuss the ways food intolerances can lead to disordered eating and how to fix those intolerances, the mental health impact of dietary challenges, and empowering oneself with information about one’s specific dietary needs. Dr. Will Bulsiewicz' book: https://theplantfedgut.com/cookbook/ BialikBreakdown.com YouTube.com/mayimbialik Learn more about your ad choices. Visit megaphone.fm/adchoices

There's a systematic review and meta-analysis done that showed that dietary fiber reduces our likelihood of having a heart attack, reduces the likelihood of dying from heart disease, reduces our likelihood of getting esophageal cancer, colon cancer, cancer, breast cancer, less likely to die of cancer, less likely to have a stroke, less likely to have diabetes, less likely to have kidney disease. How is this not on the news? Why do I have to talk about it on my YouTube channel? Right.

Like, what the fuck is wrong with our system? Hi, I'm I'm Biolic, and welcome to my breakdown. This is the place where we break things down so you don't have to. It's my and be all this breakdown. She's going to break it down for you. Because you know she knows a thing or two. And now she's going to break down. Today we are truly going to break something down so you don't have to do it.

We're going to be talking to Dr. B. Why do we call him Dr. B? Because his last name is Boleswitz. It's spelled with W's and Cellsons. C's and Z's. Dr. Will Bulsowitz is a gastroenterologist, and he is going to fix our poop and our mental health at the same time. But first, I'd like to introduce you to the person who really fixes our poop and mental health, and that's Jonathan Cohen. Hello, my name. Jonathan, how are you? I'm doing pretty well. I'm wearing your jewelry today. I just found it lying around the studio. I

collected it and it's, you know, it's now mine for the episode. Is it helping your mental health? It's not hurting it. I think we should also acknowledge that you stole one of my socks. And so now I just have a one socked foot. I removed from your body a sock that I don't feel reflected the glory of who you are. It was a little ratty. It had some problems.

It had two enormous holes. It wasn't my best sock. Did you feel your best in that sock? I mean, my foot was less cold than it is now. Jonathan, we're talking to someone who is really at the intersection of mind and body, mind and body, you and me, this show and our listeners. I'm very excited.

I would like to just point out that I always say mental health has huge components of the body. I thought pain is mental health, physical movement has mental health, and what you're about to say ties that together. Five years ago, if you would have told me this has anything to do with mental health, I'd be like, that's crazy. That's for people like Jonathan who want to believe there's connections between everything.

Well, folks, Jonathan and all those hippies were right. I'm not saying the scientists are wrong. This is an example of a scientist who is right, but you're absolutely right. Our culture was not having this kind of conversation. and what the conversation is revolves around the fact that you are what you eat is like the simplest way to say it. There are actually ways that we can eat if we would like to take into our own hands many physiological problems that we have, many diseases that we are told are unethical.

unavoidable, such as diabetes, heart disease, high cholesterol, right? We can literally, if you want to, your mood, your irritability, your restlessness, your anxiety, we now know, for real, yo, that what goes in your gut absolutely impacts all of those things and more. And Dr. B, yes, he is the New York Times bestselling author of a book called Fiber Fueled because one of the things that he has sort of used as an approach to gut health is a strong concentration on fiber and in particular not having foods in your body that stay there for an excessive period of time. And one of the first things that makes people uncomfortable about these conversations is, I don't want to eat every two hours. That's what

newborns do, right? So in our modern diet, our sad diet, our standard American diet, as our pediatrician calls it, we eat a lot of foods that just stay in your body for like a long time and also leave residue in your body. And what that means is you don't get hungry every two hours or every three hours or four hours, but you often are not literally emptying your body of things that are hurting it. A lot of people hear things like plant-based, and they get very, very upset. Because they want to go to the barbecue.

Because they want to go to the barbecue. And here's the thing. I don't think me or Dr. B is saying, you know, don't go to the barbecue. Like one of his... Fiber can help you pass the barbecue through. One of the things he talks about is this notion in American culture in particular,

and Western culture, but American culture, that like the main thing on your plate is a hunk of protein. I mean, even if it's... Right, like a big steak, and that's how I grew up, a big chicken, like that, like, what are you eating? Well, I'm going to eat meat and then a couple things on the side. And what we've learned and what the China study and, you know, many vegan physicians have been talking about for decades and decades, indeed, is that countries that place plant-based protein at the foundation of their diet, even if they eat meat, have meat, those people don't. get the same diseases that we get. And I mean cancer, diabetes, type 2. This is not an episode

you should turn off because this is not a scolding episode. This is not a judging episode. This is basically me needing to ask Dr. V why I can only have successful poops if I eat gluten. Slightly off course, but we're also going to cover how serotonin is made in the gut. We're going to talk about the actual mental health connection between what we eat and sort of how we behave. Another thing I want to talk to Dr. B about is this notion of food sensitivities. Everyone has food sensitivity. Everyone. Well, the word that people use is allergies.

And I'm very particular about that because I come from a highly allergic family, like proper clinical allergies. And when people talk about food sensitivities, I'm not. I'm just being honest, I don't always understand what's going on. Meaning, is it your tummy? Are you grumpy? Maybe you just need a nap. Like, what? And then you in particular have a lot of food sensitivities that you, like, if you eat something you're not supposed to, it's not just like, oh shit, I shouldn't have eaten that thing. It's like, I'm feeling unstable in my soul. And I need to regroup in an environment that supports the regrouping process. Because that piece of egg snuck in and I don't think I should eat eggs.

I am filing an objection. Sustained. I've been mischaracterized. This reenactment is slanderous. So Dr. Will Bolsoitz is a gastroenterologist. He is a gut health expert and the New York Times bestselling author of fiber-fueled. And there's a cookbook. That's right, folks.

He's authored more than 20 articles in peer-reviewed scientific journals, which is a very big deal, especially if you're not like a tenure track professor type in a laboratory. He's given tens and tens and tens of presentations at nationally recognized meetings. He's presented to Congress, to the USDA, and he is committed to a really active and really helpful social media presence with very simple things that Jonathan would like us to try. But before we talk about why that doesn't make sense, let's get Dr. Will Bulsowitz over here. Dr. B. Break it down. We're very excited to have you. Excited to be here.

So first of all, I bring regards from a friend of mine whose name is Lisa Shurga. And the reason that I'm so excited to talk to you is that Lisa was this friend of mine who was gluten-free. And she was like, oh, she's gluten-free. Like years ago, she was gluten-free. Before it was like a thing. That's the sound you make anytime anyone says they're gluten-free. So what I know is that Lisa has lived the Dr. B life, and Lisa is no longer gluten-free. And for me, this is so phenomenal, not just because she can eat more things, but because I have become more and more curious about the foods that I put in my body.

Yes, largely since this gentleman. and I started spending more time together. I was vegetarian since I'm 19, and I've been vegan, I don't know, 15, almost 15 years. Wow. I'm incredibly impressed as a sciencey person by just your studies and your credentials

and the life that you have built because also I was a pre-med student and it's very difficult to get an MD and then come out like thriving and positive with color in your face. Like you seem to be thinking, thriving in your career as an MD, which is already very exciting. But your specialization is very interesting to us because Jonathan's been talking about things

that you talk about for a long time. And I was like, he's nuts. He's crazy. He's thinking too much about it. I don't believe this. And he's right about many, many things. And finally, our culture has come around to talking about the things that we're going to talk you about. And you wrote this book. And I think, is this the first guest I've made this kind of

list for it? Like, I have a list of the things that I need to talk to you about. But the first thing I want to ask, why can I only have a satisfying poop if I eat gluten? So first of all, I am so glad that right off the bat we're talking about a poop. We're not wasting any time cutting to the chase of what we actually care about and what we want to talk about. Why beat around the bush? Let's just get to it. Yes. Well, first of all, I think gluten, and we could unpack gluten if you want to. Your friend, obviously, read my book. And, you know, there are some people who are like, Dr. B, you're cutting it against the conventional messaging, like what everyone's talking about with gluten. And I'm like, well, I don't know what to tell you other than I'm just reading the science

and explaining what I see in these papers. And so it's not about like echo chambers or what you hear on YouTube and repeating it again. It's about ultimately going to the source of truth. There is truth that exists, or at least it's the closest that we can get to the truth. And this is what science is about. So I go to that place and I take a look and what is it telling me?

Let me interpret that and then bring it to you. And the answer is that there are many forms of gluten-containing foods, buy them. Some of them are super unhealthy, ultra-processed foods. They're not really good for us. But the flip side, like, are you really telling me that a whole grain, delicious sourdough bread is actually bad for me? I'm not. I know you're not. I know you're not. I know there's people out there that are. You're talking about if you were to compare that to a fast food restaurant bun. Exactly. Right. And eating healthy food, right, empowers our gut microbiome, these 38 trillion living microorganisms that are inside of us that, like, outnumber our human cells.

We are less than 50% human. And they make up 99.5% of our genetic code. And when we eat delicious sourdough bread, we are feeding them. We are fueling them. They grow stronger. and then they give us delicious. Like, perhaps I shouldn't use the word delicious, but they give us great bowel movements

that are deeply satisfying and make us walk out of the bathroom in slow motion as dubs fly. My Ambialx breakdown is supported by Superpower. We all know the feeling of leaving a doctor's office and kind of feeling like we didn't get anything out of the experience that was useful. Maybe they're like, you're fine, drink more water.

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Superpower used to cost $499.99. Right now, it's $199 for the full experience, which is much more affordable than anything else out there. Make this the year you stop guessing about your health with superpower. Superpower. Not only did Superpower reduce their price to just $199, but for a limited time, our listeners get an additional $20 off with the code break. Head to superpower.com. Use the code break at checkout for $20 off your membership. And after you sign up, they'll ask how you heard about them. Make sure to mention my ambiolics breakdown to help support the show. For my body, what I've picked up on is that it seems that there's certain things that I eat that are glutinous, which make me really uncomfortable. Like it hurts my tum-tum. And I get like really gassy, like literally bloated, like really physically bloated.

And if I eat other things that have gluten, I sometimes don't have that reaction. So then I'm like, well, maybe there's variability because of all the things that I know about, let's say, stress. Like, stress is increasing your immune response to anything. And if I'm eating other things that are inflammatory, but I really, I tried being gluten free. And I was not having satisfying bowel movements. Is it because I wasn't eating enough fiber? Let's unpack this a little bit and talk about gluten. Because first of all, gluten is a protein. Gluten is typically found in foods that are made from wheat, barley, and rye. Those are the grains that involve gluten. And this is a newsflash. This might shock people, but there are other things in wheat barley and rye. It's not just gluten.

Like, wheat is not just gluten. There are other things. And they did this interesting study, Ma'am. So, like, again, let's go back to the research and let's see what the research shows us. They did this interesting study with people who, first of all, they proved that they do not have celiac disease. Celiacs don't like to hear that. They don't want to hear that from you. Yeah, exactly. Well, because if you have celiac disease, I'm telling you right now, you need to be gluten-free. There is no, like there's no negotiation here. You are gluten-free. If you're my patient, and you tell me that you're not going to be gluten-free, then you're not going to be my patient anymore. So, because this is the treatment for celiac disease, and it's actually

quite dangerous if you don't stay gluten-free. But once we get that out of the, out of the equation, and we're talking about a group of people who they don't have celiac, but when they eat gluten-containing foods, like you described, they have symptoms, gas, bloating, discomfort, cramping, maybe diarrhea or constipation. What's the deal? So they sent them home with three weeks' worth of breakfast bars. And there's three types of bars. One was a placebo.

Okay, cool. That's our baseline. We're going to compare it to that. It was just a sugar bar. One was a breakfast bar that had gluten in it. And the third was a breakfast bar that contained what are called fructans. F-R-U-C-T-A-N-S. Now, fruit tans are almost like fiber, and you find them in gluten-containing foods.

It's part of wheat. So people ate these three bars, and they marked down what they're doing in terms of their GI scores. And it was quite shocking because when they analyzed the data, they discovered that when people were eating the high-glutin-containing bars, they had less symptoms than with the placebo. the placebo was causing more symptoms than the gluten. Flipside, which I love, I was like, yes, that's awesome. Flipside, when they consumed the fructan containing bars, they got triggered. It's not even a reaction to gluten. It's a reaction to the fructans.

Fruit tans are almost like fiber. They're actually really, really good and healthy for us. We want them. They feed our gut microbiome. The proper term for fructans would be prebiotic. People have heard of probiotics. I'm talking about prebiotics, which basically means food for your gut microbiome. Fruit tans are that.

We want them. But the problem is that when you have a damaged gut and you consume too much of them all at once, you may find that it causes symptoms. And that's not gluten. That's fructans. I jumped in with like the poop and the gluten just because I had to. But let's take it back a step. Why are most people's guts damaged?

I think it's a large part of it is this society that we live in. It's our diet, but it's also, it goes beyond our diet. Let's look at the diet first. All right, what is the average American eating? If you break it down, 60% of our calories come from ultra-processed foods. These foods did not exist 100 years ago. We don't have microbiome studies to know what most of them do to our microbiome. And there are literally 10,000 food additives that the FDA has approved and allowed into our food supply.

And by microbiome, just for people who don't know, you're talking about literally like the environment of your insides, of your kishkas, as we call them. I'm thinking like when you, God forbid, get a yeast infection, like the pH is off. Is this kind of the equivalent for your gut? Like things can be out of whack? A yeast infection would be like an imbalance of the vaginal microbiome. Right. So it's interesting, Ma'am. We are covered from the top of our head to the tip of our toes in these invisible microbes. Right. And it's quite hard for us to imagine that they're there, but they are there. They're as alive as you and I are. And it's kind of like, look, if we zoomed out from Earth, if we're up in an airplane and you look down at Earth, you don't see anyone there. But when the plane lands, you get off the plane and here's all these people. There's eight billion of us. And if you took a microscope and you took a look at what's happening inside your body right now, what you would discover.

is that concentrated inside your large intestine, which is your colon, there are 38 trillion microbes. Tell people what a microbe is. So with mostly bacteria, these are mostly bacteria. Now, we have to like kind of evolve in our understanding of bacteria because we spent the last hundred years saying how horrible they are and they need to be destroyed. And yet here we are. And in the last 15 years, we're starting to understand that actually most of these bacteria are good for us.

And they want us to thrive and do well. So we have bacteria. we have these fungi, which are almost like yeast. That's what you're referring to with the vaginal yeast infection. Thank you for taking us there. Always. And we have the archaea. These archaea are quite interesting because we think that they are the oldest life on the planet.

They've been around for four billion years. We've only been around for about three million. And actually, we've only had oxygen on this planet for two and a half billion years. So basically they're like on a scorched earth. I don't know what they were doing. but they're there for 1.5 billion years and there was nothing here. So anyway, this community, they live inside of us. They live in harmony.

They live in balance. They are in ecosystem, just like the Amazon rainforest, just like the Great Barrier Reef. And when they are healthy, then basically what you get is there's this functionality where they all work together as a team in support of human health. it's quite, I mean, I'm just speaking as a doctor that it is very clear to me how much we grew to trust and rely on these microbes. Because they have taken up residence in a way where our physiology actually is completely dependent on them. So we need them, just to run through this, we need them for proper digestion. Like we can't process and break down our food without them. they support our metabolism, our immune system, our hormones, our mood, our brain health.

They can actually manipulate our genetic code. If you take a moment and you think about everything I just described, basically what I'm saying to you is, I think that we found a new organ. It's called the gut microbiome. It probably is the most important organ for human health. and it's not even human. So definitionally, an organ is a group of specialized cells that have the same function. And so it's a little bit different, but it's almost like a, it's almost like a satellite organ.

I mean, I think we have to look at it as such because it's so central to human physiology that we can't get by without it. And so if we care about our heart beating properly or our liver or, you know, you go down the line, then we have to care about this too. And the problem is that we couldn't see it on a cat scan, right? It's invisible to the naked eye. Yet, if you take it and pull it together, it actually weighs more than your brain. And these 38 trillion microbes, like, it's hard to define. What is 38 trillion? I don't know.

If we open up to the sky and we take all the stars in our galaxy, there are 100 billion stars. And we take Jonathan's colon, hello, Jonathan. And we're going to start putting microbes into your colon one galaxy at a time. We would put... This is the weirdest audio porn ever. Not to be too visual with Jonathan's colon, but I'm going to put 380 galaxies full of stars into your large intestine. And that represents the number of microbes that not only you, but I have and that Miami has and the listeners at home have, that's how many we have. that's how many we have. It's crazy.

Is it that people who have, you know, serious problems have less microbiome or just not a high functioning microbiome that's like supportive of each other? And so you have like, you know, some of those trillion going in one direction and some of them going in the other, they're not communicating properly. And if you ask any biologist, what is the measure of health within an ecosystem? They will say biodiversity. Yep. It means as many different varieties of species as possible.

Now, what's interesting is if you look at the microbiome, when biodiversity erodes, when we are less diverse in terms of the number of microbes, this is when we see the manifestation of disease. And the microbiome, like, when it is damaged, the word that I would use is dysbiosis. The word that exists on the internet is leaky gut. Be careful what you read about leaky gut on the internet. Well, that's the next thing I need to talk to him about. Just before you go where you're going, we're quick list of it. everyone's so messed up. So they're out of balance. They're eating things. Horrible diet. Horrible diet. 60% processed foods, 30% animal products, eating more than your body weight and meat on a yearly

basis, more than any country in the world. And we get upset that China eats meat and they're eating like literally one sixth of what we eat in the United States. We don't sleep. We don't exercise. We are on our tablet or our phone or a television at 10 o'clock at night, which is completely disrupting our circadian rhythms. We're putting weird stuff on our body when we shower. We clean our home to the point of making it like ultra squeaky clean. And then we're just killing everything in the process of doing that. And then we never actually go outside to spend time in nature. Well, I do want to say that, you know, and this comes up, you know, as a person who's, who is a vegan as well as a lifestyle vegan and, you know, has been vegetarian, you know, I was vegetarian when like literally

you didn't even tell people because it was so embarrassing what people would say to you and like my parents were like mortified and, you know, like, so I've, you know, I've been through a lot of years. I'm 46 and I've been like on this journey, you know, for a very long time. And many of the things that people say about this category of things that we're talking about are absolutely things that we can talk about now because 100 years ago we were worried about other things like wars and learning about vitamin C. Like, you know, we're at a developmental stage in our culture where we can talk at this level and we no longer get to say, oh, well, poor people are going to eat fast food and tough, right?

We're now having these conversations that are not just for wealthy people. They are not just for people who can afford to think about these things. What Dr. B is talking about is things that impact everyone. And these are things that we all should be thinking about, meaning even good sleep, even reducing stress, not being on technology. These are things that are for everyone. This is not some Hollywood trend. It's not a thing that celebrities are doing. And actually, Dr. B specifically talks a lot about challenging some of the highly restrictive eating.

practices that many people, especially in the city that I grew up in and live in, that's just like, that's just normal. Like it is normal to meet someone who basically can't eat anything in Los Angeles. But what I did want to talk about, I like sharing things from my personal life. And I mean, we've already shared about poop. I had a situation, I'm not going to be specific, I will deliberately be vague. I had a situation when my kids were young. It was just a very stressful time, you know, I had two young kids and I, you know, had gotten my doctorate, but I was like teaching and like, it was a hard time. And I found out some information that was deeply, deeply troubling. But where I was at in my life, I did not share that information with anyone. And I could go into a lot of

depth about why I held this. But what started happening is something that had never, happened to me before, I started not being able to eat, meaning I started not being able to process food. And what would happen is things that had never happened to me, bathroom-wise, like I was constipated or I had to, like, very strange, because for me, I had never had those symptoms. I never connected it to this thing that happened until, like, almost a year later of like doctor after doctor, what is wrong with me? Like, God forbid, you think, do I have stomach cancer? Like, what is going on?

And I was diagnosed with SIBO, small intestinal bacterial overgrowth. I was tested for leaky gut. They thought I might have a worm or, you know, like all the things. I then started becoming, I don't want to say allergic, but so highly sensitive. to the main staples of my diet, which as a vegan were beans, nuts, tofu. My diet shrunk.

And when I was also actively breastfeeding, exclusively breastfeeding a child for part of this, and he relied mostly on breast milk. His stomach would go bananas when I ate these things. So I had me and a child having these severe reactions. So what I did is I went holistic because Western doctors were like, well, just put you on antibiotics for 62 years. Or you constitutionively need to be on antibiotics.

Sorry, this is your life. And I'm thinking, nothing runs in my family like this, like all the other things run in my family. So I ended up going to a very, a lot of people would consider this an out-there healer. And she talked a lot about food sensitivity and things like that. And long story short, I did end up being able to add those things back to my diet, as did my child. But no one except this holistic person said, is there anything going on? Is there anything emotional going on in your life?

And, you know, you think about some people have a nervous stomach. That's my favorite example when people are like, what's mine body syndrome? It's like people who lose their stomach before a date, before a job. interview, that's mind-body connection, right? But what was fascinating to me is I didn't, I mean, they thought I might have atypical IBS. Like, they did not know what was wrong with me. And so as given all these diagnoses, it would have been so easy for me to be put on antibiotics that I did not need. Many people said, well, you just need to eat meat and dairy, right? I mean, like, people suggested everything. And what it was was that I was dealing with an incredibly stressful

thing that was not being dealt with. What you eat and what happens in your gut, I mean, it's kind of chicken and eggy, right? But it is directly linked to stress, to mood, to a wide variety of mental health maladies. So can you kind of talk about that? I am like shot out of a canon right now because I have so much that I want to say. It's so important for us to understand that we are a complete human being, that we are not organs functioning in isolation. We are not just like proteins, fats, and carbs coming into contact with digestive enzymes or gut microbes, and that equals your digestive apparatus. We have a soul.

We have a spirit. Our body is intertwined and connected. One organ is talking to another. Will they revoke your medical license for saying that? Absolutely not. Are you sure? Absolutely not. Yeah.

Well, so look, our health care system, just to comment real quickly on that, our health care system, I feel about health care the way I feel kind of about my parents, which is that when you're a kid, you think that they're God. Like, they're perfect. They're infallible. When I was a medical student, I looked at these doctors and they are a god. They walk on water. And then, like 14 years later, I finally emerged from my training and came out the other side.

I was 34 years old. And I realized that this is flawed. And part of the reason why I realized this is because it affected me personally. So this was actually like one of these moments in my life. I'm sure you guys have had these where you feel like you're being cursed. and then you discover five years later that actually you were being blessed because you're getting exactly what you need in that moment to transform you into something better. But 10 years ago, so I'm in my 40s now, 10 years ago, I'm like looking in the mirror at this man

who's 50 pounds overweight and there's the blood pressure pills on the sink and high cholesterol and I just wanted to curl up under a blanket in a dark room and be left alone. I mean, I was clinically depressed. And I knew that something was wrong. I knew that something had to change. I tried to exercise my way out of it and it did not work. And ultimately, it was changing my diet, transforming my diet in the way that you're describing mym that changed my life.

And honestly, I feel like it also set back at the clock where I'm feeling younger in my 40s than I did in my 30s. But to move back into talking about what you're describing Miami, this is so important. because you can do everything right. You can eat the right food, exercise, sleep, meditate, do yoga, drink juices, and not be well. And that's because we are a complete human. We are far more complicated than that. And we have to treat the whole human, not just the digestive system.

And we have to recognize that our mood affects our gut. and vice versa. So I'm going to focus on how our mood affects our gut, and then if you want me to expand beyond this, I will. We have evolved defense mechanisms that protect us in moments where we need a surge of energy, where we activate our sympathetic nervous system. If the dog is trying to attack us, then like, I need that. That's going to save my life and stop me from being bald. And what happens in that moment is your brain, the pituitary gland, will release a hormone called corticotropin releasing hormone, CRH. The CRH, basically what happens is this initiates your stress response.

And there's a cascade of events that take place. And if you're trying to survive that dog coming at you, the cascade of events are to your advantage. We want this. But we pay a price. Because down at the bottom, if you follow that waterfall down, you will discover that you have disrupted and damaged your gut microbiome. And this is why in moments of stress, 85% of us will suffer digestive symptoms of some variety.

And 15% of us will get headaches. Very common for people to like hit like, boom, acute stress and then boom, you know, you're in the bathroom with diarrhea or you get constipated or you get bloated. Now, that's an acute issue. But what you're talking about is something different. You're talking about something that is unsettled in your life. something that is disturbing you. And it may not even be a part of your conscious mind.

This may be a part of your non-conscious mind. And it may be something that you're thinking, I dealt with that. That's not an issue. It's out of the picture. But it's not. It's still there. The memory exists. It's a part of who we are.

It's imprinted in our brain. And unfortunately, because we have not adequately dealt with it and it remains unsettled, I'm talking about in the non-conscious mind. Because it's unsettled. It is activating your stress response. So then what happens when this pathway that was supposed to protect us in an acute moment of stress where we need an extra little surge? What happens when we're activating this 24 hours a day, seven days a week? This is how you can be perfect on every level, doing everything right.

You're still not getting better. And that's because you're being held back by what's happening with something that's completely unrelated to nutrition, frankly. Well, this ties back to so many people have gut issues. in our society. And, you know, Maim and I talk about somatic release, somatic works, connecting the emotions with the body

and there are sort of multiple paths to understanding what you're holding. Consciously or not consciously. You can work through the mind or you can work through the body and connect the mind. And if you're working through the mind, then you want to connect it to what's happening

in the body or the other way around. And in the work that I've done, every single person out of thousands and thousands of people that I've worked with, I've only met one who didn't have some pretty significant thing that they were carrying around, either childhood or recent stress or stuff that's just like totally unprocessed, that, you know, there's a reason why we're sitting in our tablets at 10 o'clock at night because we don't want to feel anything. Right. That's so interesting. We have no, as a society, we don't have any tools to process or not it's not that we don't have any but for most people we do not have the right tools

the active practice of clearing the mental inbox of understanding what's happening emotionally and so it just all accumulates and then we realize oh we have this massive health issues and so we we you know either have an emotional problem or some massive health issue and that's the only way we start to deal with this stuff that is otherwise you know tucked underneath the rug Jonathan Do you think that it's actually that we don't have the tools and that we require the tools for us to do this? Or do you think that it's that the modern lifestyle has disconnected us from what it means to be authentically human? I think it's... I think that's a trick question.

Well, I think it's this ecosystem. And when you talk about the balance and harmony of our gut microbiome, like our life has evolved in a way that it's very easy for us to prevent, you know, the slowing down practice. We don't have community. We don't have a lexicon or a dictionary or, you know, any of the language. We talk a lot about therapy and self-understanding. And if you speak to someone who's been in active therapy, no matter what it is. It could be a meditation practice. It could be with talk-based therapy.

It could be with hands-on body work of some kind to do somatic work. Any sort of self-reflection. If you talk to anyone who's had extensive practice, they have a different lexicon of like, if you ask them how they are and they know that you want to. hear how they are and you know you have the time and space to have that conversation their ability to express what's actually going on for them and and communicate their overall stress levels and you know what's being dealt with what's triggering them in the current moment is completely different than someone who has never had any of that experience and it to me it's a

learned behavior a practice of identifying stress understanding its impact its origin your role in it making yourself not the victim of circumstance and understanding what you can choose to change what you can't. And yeah, I would say that most people are illiterate when it comes to beginning to understand how their lives are impacting them from an overall stress standpoint. I appreciate this. And I think, first of all, I think this is a great and important conversation that we're having on this particular topic because it's important for people.

I tend to go on podcasts and I write these nutrition books. And I myself know that there is so much more to this than just nutrition. And we fixate on it and we really need to broaden out the conversation and talk about stuff like this. Now, here's what I would add. This is just from my perspective. I think we all have our context, right? So we all are sort of contributing based upon what we've seen, what we've experienced. And I feel that the modern lifestyle is antisocial.

And we are social creatures. You want to bring out the best in a human being. Tell them that you love them. Support them. Make them feel safe. surround them with other people. It's impossible to be the best version of yourself by yourself. But you're right.

I mean, if you want to torture a person, you isolate them. Right? I mean, you literally can torture a person by doing that. And in my life, the things that I'm doing, the things that I'm doing now are only, frankly, made possible because my wife and my family support me. I would like you to talk a little bit about your wife because I know she is a significant part, not obviously because she's your wife and you had babies together. But she also was an important part of kind of your personal transformation.

Is that correct? Yeah. Yeah, yeah. So if you go back to 10 years ago, I sort of described this vision of a guy who's in his early 30s. I'm actually in my medical training. I'm in Chapel Hill in North Carolina. I had completed medical school many years earlier. I was a board certified internal medicine doctor.

I could have been a primary care doctor. but I was training to become a specialist. And again, like, I was not in a good place. And I didn't love the man that I was in that moment. And I was on a date with this person who is now my wife. And we have two children. We're about to have three very soon. She's pregnant.

Thank you. And so, but like, I would have never known that this was where we were going to be 10 years later. In this moment, we're just on. a date. And we're in Carborough, North Carolina, and like Smithfield, which is like the sausage capital of the entire planet outside of Germany, Smithfield is like 30 minutes away. I mean, this is pork country in North Carolina. We're out at dinner and I'm getting the pork shop. And here's this person, you know, this is like 2012. And she says, I'm not even going to order from the menu. She says to the waiter, can you bring me the collards, black eyed,

peas, the green beans, and some mashed potatoes, and just make it look nice on a plate. And so I'm just like, yo, who is this person? Like, I've never even been around someone who's vegetarian, let alone vegan. But what I noticed is that this is just my observation, that she enjoyed her food just as much as I did. She cleaned her plate. She did not restrict. she ate until she was full. She looked amazing.

She was completely in control of her health. And I'm over here, and I got the meat sweats. And seriously, you know, they've actually proven that the meat sweats is real. Well, the microbes can metabolize, and our microbes create our pheromones. Oh, that's why people smell meaty. You actually are smelling the product of these microbes. And it comes to other sort of, conversation is like, why do we kiss? And they've shown that we actually share a hundred million

microbes when we kiss. It's like a compatibility thing with our microbiome. So yeah, pharomones, like pharomones come from microbes. Like when you, when you're on a date, you're like, oh, this person smells good. It's microbiome compatibility. It can even be unconscious as well. Totally. I don't even realize that you're thinking that. So, well, so anyway, so I witnessed this and we finished the date and I'm like hungover. I haven't even had any alcohol. I'm hungover from this meet. And she is like energized and ready for round two of the day. And it just opened my mind to being forced to look in the mirror because you have to understand that the training program that I had put myself through was intensely rigorous where I'm working basically six days a

week, you know, 15 or 18 hours a day, sometimes 30 hours in a row without even eating. Because that's how we make good doctors is to do that to them. It's, I mean, it is complicated because we also do need to get enough experience taking care of patients to be independent. So that's part of the challenge is like how do we strike the proper balance? Because there is a balance. It's not such a thing as like, let's make it easy for people. But anyway, you know, it's like I'm getting smashed. I'm getting slammed constantly.

And convenience emerges as the most important thing in my life. And food like, heck, it needs to taste good. I won't lie. I loved the food that I was eating. It was like Philly cheese steak. and cold cut subs. I loved it. It tasted great. It was convenient. It was quick. And I was paying the price with my health. And I didn't realize it. And I was forced ultimately to take a look in the mirror at the food that I had been raised on, the food that I had prioritized in my own life and accept that maybe the

stuff that I really enjoy eating is actually causing harm to my body. Can you say that again? Maybe the stuff that I love to eat is actually causing harm to my body. I did not make a radical change. I did not become vegan. I made one small change. I still needed convenience. And I felt like, you know what? Blenders are convenient. You don't need to be good at cooking for that. So let me go home. And instead of going to Hardee's and getting like 2,500 calories for four bucks, let me go home and take out this blender. And I'm just going to throw in some bananas, some blueberries, some greens, maybe some walnuts, and then like, you know, some soy milk. Buzz, blend it up, drink that for dinner.

And like, I just have to say that I instantly was energized. So the point, the important point from this point forward, what I want people to know about my personal health journey is that because I had suffered with my own health issues, this has inspired me as a doctor. And I made small, smart, sensible choices, but I just kept doing them consistently. And then they became habits. And then I stopped thinking about them. And then I started craving those foods, which I'm pretty sure is because my microbiome adapted to them.

And then next thing you know, like you find yourself on a predominantly plant-based diet with some fish. And you're feeling way better and you've lost 35 pounds. And you say, well, what if? What if I could just try going without it? And that's what I did. and I got back to my high school weight, but I was in my late 30s. It was the first time I got back to it in like 20 years. I think it's super important to this notion of like the steps towards training your body to,

like lots of people think that, oh, I'm just going to switch and now I'm only going to do this other thing. And it's like they have massive shock and their body isn't ready for that transition. Your body in general is adapted to whatever the life it is that you've been leading for the last three months. and adaptation is required anytime you're going to change in any capacity. So I used to play soccer in high school. I thought I was in great shape. And then we would switch to basketball season and I would be completely out of breath. It's a different sport.

When you change your diet, your gut microbes, like here's the beautiful and empowering thing that we haven't had a chance to say yet. They are adaptable. They can be shaped. They can be made what you want them to be. they can actually be like you can restore functionality you can heal them they will forgive you so anyway to that point jonathan like when you make a change if you like cannonball into the pool you're like not adapted to this diet at all and you should expect pushback in the form of a

pissed off upset digestive system flip side you make small incremental changes in the same way that like if you go to the gym you make small incremental gains these small incremental changes over the course of time, allow you to shift and move things wherever you want to take them. So if you want more plants in your diet, you are 100% capable of doing that. You just have to slowly introduce them and allow your body to adapt over time. This is something when people ask me about like veganism. Like this is something people ask me about a lot. And, you know, I'm, I'm sure Dr. B gets this. You know, it's a lot of like, I could never do that. You're so amazing. And it's like, no, that it's a, it's a, it's a,

does not take a superhero. Take steps. Well, one of the things in particular is like, I love my cheese. People love to say that. And here's the thing about any change that you're going to make. There is an adjustment period. And part of what I say, and I literally think that there's an emotional correlate for this. When you try something new, if you directly compare it to what you had been doing,

it's going to be very painful, shocking, and you're not going to keep it up. So if you say today I eat cow cream cheese and tomorrow I'm going to start eating vegan cream cheese. It's not going to work because your brain, biome, whatever it, like all the things are going to only compare. It's the same way if you try and break an emotional bad habit. It's like it's going to feel shocking to, for example, stop micromanaging everyone's life around you. It has taken me, you know, a lot of years just to start chipping away at that. You cannot try and do it all at once. And this is part of what you just said is a problem in our culture because people don't want to take time.

Well, because people want shortcuts. The idea of a health hack is a flawed idea. You know what a health hack is, honestly? A health hack is you doing something consistently, sustainably for a long enough period of time that you stop thinking about it because it's a habit. And then that's actually a health hack because now this habit that you created is actually paying dividends in perpetuity as you move forward and it's helping you to heal. And you're not even thinking about it.

Like, I don't even think about it anymore in terms of my diet. But, ma'am, you're exactly right. This is you need to allow your body to be educated in this new approach. You wouldn't wake up one day. Like, I don't care how smart you are. you don't go on Jeopardy without studying. You don't run a marathon without training. Totally.

Right? You have to train. So I totally agree. And just to give people, I'm giving people a little bit of the benefit of the doubt, which is not always my strong suit. Because, look, I've read a lot about different diets. I've had experimented with different diets. It was never really explained to me this level of adaptation that's required.

And it's pretty easy to think that, like, oh, if eating plants is good for me, then I should be eating a lot of plants and just switch over. And the fact that we're climatized, a custom, we have to sort of transition and have our body adapt to something, to a new routine, I think is new information for a lot of people. Even though, Jonathan, I don't know exactly what you eat, but even though Miami and I are eating a vegan tire. He eats three things all day. Nice. We need to work on that. Even though we may be eating this way. I do think it's very important for people to understand that there are many forms of a healthful diet. When you go to look at it, when you go to look at it, though, like if we look at

the science, if we're being sincere about evidence-based nutrition, what you're going to discover is that in populations across the globe, all of these different forms of healthful diets are at least predominantly plant-based diets. Period. Period. There's no caveat to that. Okay, I'm going to play the devil's advocate just to give voice to some of the people out there who have heard other information? Sure. Do blood types impact it? They've studied this. They've studied the blood type

diet. And here's what they found. It's interesting. The type A diet was the diet that actually did best for people regardless of whether you were a type A or not a type A. And when you look at the type A diet, guess what it is? It's a plant-based diet. It's a plant-based diet. So all those Cs who are like, all I need to eat is meat, you're like, eh, not so much.

Well, so look, you're not actually fixing your gut. If you eat these foods and you get gas and bloating and you run away, you are scared of your food. You are running away from a food monster. You are not finding joy in your food. And you're not actually addressing the underlying problem, which is that you have a damaged gut. Right.

So instead, you're avoiding. That's effectively the equivalent of the person with the injured knee who says, I'm not going to walk anymore. And the problem is that when you go down this path and let's pretend you eat a completely meat-based diet, okay? So you're not actually healing your gut. Your gut is growing weaker because you're no longer exposing it to any food other than literally just meat.

And simultaneously, I can assure you that with 100% certainty, if you actually are following this diet and only eating meat, your LDL quest. is absurdly high, absurdly high. And LDoclastrol is a known risk factor for coronary artery disease. I have never heard, if you want to, Jonathan, you mentioned, like, am I going to be, you know, lose my medical license for this conversation? I'm pretty sure if a cardiologist recommended that diet, they would lose their medical license for it.

And part of the reason why is because just to, I mean, I can't help like, like, share this as a medical doctor because it concerns me that people. doing this. Not only is LDL cholesterol a known risk factor for coronary artery disease, we have different drugs that lower LDL cholesterol, and the drugs actually work through different mechanisms, but they all work to the same end point of lowering LDL cholesterol, and when we study people with heart disease, they are less likely to have a heart attack and less likely to die of heart disease. Our number one killer is coronary artery disease. We should not be running towards a diet that enhances our risk of the number one threat to our life. That makes no sense to me.

I'm just going to say that's an amazing response. He's an amazing person. I wanted to get a little bit back to some of the kind of, you know, regulatory mechanisms, let's say, of the gut. This is not a facetious question, but, okay, I'll start like this. So I grew up in a home with four people, and we had one bathroom until I was 15 and my brother was 19. And that's, four humans with one very small bathroom. I rarely, if ever, thought about, like, how my bowel movements were. Like, I just didn't think about it as a teenager. I just, like, whatever.

I just, you went, like, you just be as efficient as possible because there's four people who need the same bathroom, right? And once I got to college and, like, I became a vegetarian and you start, like, meeting other people. And, like, you know, it was like my first boyfriend in college. and like he had a whole thing about like his diet. And I was like, what? And I'm like, he's from Northern California.

They must think about all that stuff in Northern California. But what I discovered is that there is a whole world of people who are connected to their bodies in ways that I just wasn't raised to be. And I'm sure there's a lot of reasons. But one of them was that we didn't have time to like talk about that. It was just like getting, get out, fine. What I noticed as an adult, I only learned this as an adult. sometimes I feel nauseous and I get a headache.

And it's often because I have to poop. And then I had children. I have a, they're now 13 and 16. And we're the variety of people that were part of the diaper-free movement. I don't know if you know about this. There are those of us who pick up on a child's cues, which they do give when they go to the restroom when they're infants. And if you reinforce those cues, they will give them stronger.

and basically my children could sign for potty before they could walk, eat solid foods, or talk. And I learned a lot about the digestive system with, also with breastfed babies, it's a little more predictable. But what I learned is that babies and toddlers often have a very bad mood before they have to poop or when they have to poop. And if they are constipated, they are very, very ornery. and I realized I know adults with this same kind of pattern. And I thought, my gosh, like, this is just a consciousness that I didn't even know about. And when we talk about, you know, we're kind of like poking fun at like, oh, it feels so good to have a healthy bowel movement. But can you speak a little bit about not kind of, I'm not asking you to be funny, although you are funny.

why does it feel good to have a particular kind of emptying of that part of your body? Well, we're supposed to be having this. I mean, honestly, having a good, healthy, complete evacuation is supposed to be one of the highlights of our day. I'm being serious. I mean, so this is a very, very important bodily function. So easy for us to be taboo about it because it's poop. but like I just talked about how powerful this microbiome is.

Digestion, metabolism, immune system, hormones, mood, brain health, genetic expression. And guess what makes up poop? It's not the excrement of your food. 60% of the weight of your bowel movement comes from your microbes. So when you poop, you are actually, this is a window. The health of your bowel movement is a window. into the health of your gut microbiome. And when it's working the way that it's supposed to,

much like the heart, it is in rhythm. Your body thrives on rhythm. So it should almost be effortless where you get those cues, you know it's time to go, you head to the restroom. It's a nice, relaxed, complete evacuation.

It's not traumatic. You feel satisfied? Yes. It's not effort-based, right? You're not grunting. you're not bearing doubt. You don't feel like an incomplete bowel movement, which by the way is like one of the things that I always ask my patients is like,

do you feel like you completely empty? Because there are many people, there are going to be people who are listening right now. They don't think that they're constipated. They say, Dr. B, I poop every day. You're crazy. But if you poop every day but you don't completely empty or you poop and then you have to poop again 30 minutes later, that basically means you didn't completely empty in the first place. you are backing up and you are constipated.

And constipation can manifest with really funny, interesting symptoms with people. Like the number one symptom is gas and bloating. But you can get nausea. Yeah. You can lose your appetite. You can get fatigue. Some people get hangary or get headaches. You can definitely get pain.

The pain can be so intense. People think they need surgery. Yeah. You're just full of it. In the book, you also give a bit of a glossary to looking at our movements as a sign of health. It's like it is a window into how our body is doing.

And lots of people, again, just in terms of like not knowing, most people don't look at their movements. And if they do look, they have no idea what they're looking for. Could you give us a little bit of info on sort of like a shorthand of what we should be paying attention and what that might mean? I'm so glad we're talking about poop. This is like, this is literally, I'm like the only guy in America that you can bring into an interview and I'm like, yes, let's get into this.

So, all right, there's this thing, someone, I don't know who this Bristol person is, but their name has been forever attached to bowel movements. Because whoever Professor Bristol is, we have the Bristol stool scale. And there are seven pictures of bowel movements. And if you look at your, like, some people are like, I don't look. I just flush. I'm like, come on. Give it a look.

What's going on down there? and you can look and there's actually like images or cartoons that illustrate what the bowel movement might look like. So now there's seven types. Type four is right in the middle. That is your glorious, like, you know, strutting out of the bathroom with a little bit of a weird grin. That's the type of bowel movement that you want. This is the type of bowel movement that we vegans brag about because I have two vegan children. And this is that they never have trouble in the bathroom.

bathroom. It doesn't take a long time. We are efficient and you feel great. This is the vegan poop. Yeah, and you're dropping bombs at least twice a day, sometimes three. And every single time, you're like, that was great. Feeling good. I enjoyed that. Right. I have a t-shirt that I've been wearing for years. It says, eat plants. Take epic dumps. I've seen it on your Instagram account. Well, and the problem is now my daughter can read. So I'm like, oh, no, what kind of an example of my setting for my kids here. A healthy one. But anyway, type four, the way that a normal bowel movement should look is like a sausage.

It's soft. It's formed. It's tubular. Okay. This is a type four healthy bowel movement. This is where we want to be. This is glorious. Now, if you move all the way to type one, type one is constipation.

These are like hard balls. Pellets. Hard balls of stool. Yeah, pellets. And it hurts. It actually hurts to get them out because they're not, they actually can't easily. passed through the anal canal. So it's like birthing a child. I mean, hold on a second. Oh, you got in hot water now. Yeah. And well, and I'm also getting myself into trouble because if my

wife hears this podcast before the baby is born, I probably would slap. You can tell her. I know exactly how you feel. I had a number one 15 years ago. Exactly. Flip side, the type seven is liquid. It has no form. It has no shape. It comes out urgently. And this. diarrhea. Now, if you are on one of these extremes, type one, type seven, it's actually empowering to understand that this is indicative of injury to your gut microbiome. You are a person who deserves to be healed, and we shouldn't wait until like the bomb drops and some major medical diagnosis comes along. Your body is already telling you the warning shot across the bow is there. Let's go ahead and take the steps necessary to get this fixed. I wanted to tell you,

ask about the issue of food sensitivity because this is like the most often spoken phrase, at least in Los Angeles, that I have heard in the last two years of my life. Can you talk about what is food sensitivity versus an allergy? Yeah, so let's separate these two. I'm going to call it a food intolerance versus a food allergy. We'll start with food allergy. This is very important. An allergy, by definition, before we even get into the food, is your immune system activating in response to something from outside your body, like some sort of foreign thing. So like it could be pet dander, it could be pollen, you know, the flowers are in bloom. Okay, now you got seasonal allergies. It could be asthma, hyperreactive airway diseases. When it comes to food and food allergies,

it's that your immune system is responding to something in your diet. And there's a specific group of foods that we know account for the vast majority of food allergies. What are they, Dr. B? So these include dairy and eggs and fish and shellfish and nuts and peanuts and and soy and corn and wheat. Now here's the thing. When you have a food allergy, your immune system gets activated. It can be scary.

If your throat is closing, you need an epipen and you need to be in an emergency room now. So in that setting, literally any exposure, even the most trivial amount where you don't even realize it's there could activate the immune system. This is why like a person with a severe anaphylactic reaction to peanuts, we can't have peanuts on the airplane now as a result of this. This is very different from a food intolerance. Food intolerances, by the way, are far more common.

They affect we believe about 20% of people. and it is manifest with discomfort of some variety. GI symptoms, gas, bloating, cramping, pain, diarrhea, constipation. Like, these are the manifestations of a food intolerance. It is symptomatic. Can they manifest other places? Because what I'm hearing a lot is like, when I eat this, I get a pain in my lower left back and I know that that's because I ate the cantaloupe.

Like, can it manifest other places? All right. So it's a little bit, there is some complexity to this where. Right. If you have histamine intolerance, which is a specific food intolerance that does not involve the immune system, but because histamine has receptors throughout the body, we can manifest a headache or runny nose, sinus issues, or skin issues. You could get hives.

You could get flushing. You can get a rash. and that's not actually an allergic reaction, that's histamine. And it would actually require a trained health professional to help you to disentangle those possibilities to understand what's what. You don't want to figure this out on your own when there's the possibility of a food allergy because food allergies are dangerous. But with food intolerances, you know, a person has an allergy, you put one drop of milk

on their tongue, you might initiate this problem. You take a person with a food intolerance, I can assure you one drop of milk is not going to activate their food intolerance. There is an amount of each of these foods, but here's the key. So two things I want to say. Allergy, immune system. Intolerance, not immune system. It's very simple. Not inflammation. Not inflammation. It is not inflammation. It is sloppy digestion. And the second thing is that the intolerance can be fixed. You don't have to live with it. But when you run away from it, when you say that food causes problems, I'm going this way and that food's going that way. Okay.

You are creating disordered eating. So, okay. I want to respond. I want to respond because what you just touched on is also this like this tremendous intersection of mind and body where, you know, a physician, a gastroenterologist can have this conversation with us because the mental health impact. of both dietary challenges, right? Meaning it's upsetting to constantly feel afraid of food. It's upsetting to constantly be damaged by food. But the mental health impact of both that fear,

which is completely legitimate, and then also the compounding of the things that we do to try and fix it is what creates to me, this like cadre of people who are like, oh, I don't eat that. I don't eat that. You cannot engage in the world with, and to me, it's like, I wonder what comes first. Are these people who kind of want to be removed, you know, from a normal eating environment?

Are there things that they could be doing? But also, the fear that you'll have that reaction is enormous. We are creating a negative feedback loop. First of all, before I go any further, I want to say that what I'm describing, I have seen thousands of times and thousands of patients and it's very human and you are not a flawed human for having this happen to you. It is actually just indicative of the fact that you are a human being and we are all doing our best, myself included. But what we do is we create a vicious cycle. And the vicious cycle basically is it occurs in a person who has chronic health related issues

specifically any sort of symptomatic thing because you start to become neurotic about it. You wake up in the morning, and you have no control over this. This is like, you're not making this choice. Trust me, you wish that you were feeling better. But you wake up in the morning and you say, I hope that today is a good day. I hope that we're going to have a good one. And then something happens, triggers your symptoms. Immediately, your brain goes there.

You fixate on it. You focus on it. You can't think about anything else. It activates your sympathetic nervous system. Your sympathetic nervous system then actually heightens your acuity in terms of how closely you're paying attention to these nerves that are sensing and feeling. And so you actually feel an intensification of the symptoms. It actually starts to get worse. This is mind-body syndrome. That's literally, I mean, that's...

It's a male adaptation to chronic health-related issues where we wake up in the morning and hope that we're going to have a good day. In the minute that we don't, it destroys our day. This is also true of people, and I'm speaking because I'm one of them, with significant psychiatric history. Meaning my level of hyper awareness to my emotional state can this can happen emotionally. I don't know what N you would need, you know, to have a significant correlation here. But for people like me, you know, who have chronic pain that will move around, right? It is so intertwined. It can happen in your gut just like it happens in your mind. This is why when you're having gut related issues, one of the things that I teach in my new book is that you can do belly breathing, right?

Which has nothing to do with nutritional choices. But yet by belly breathing and just practicing that and becoming good at that, you can actually take control of how you feel. And so this is the type of empowerment that we need. If someone is having a food reaction and as we described, lots of people are like, okay, I'm not going to eat. that and you move away from it. How do you reintroduce that food or if you know you're having a reaction or if you're having a reaction, what are you doing outside of like if you take a break from that food? How are you sort of building yourself back up to rehab and then reintroduce that so that you're not having this elimination diet? Give me an example, Jonathan, and with the type of food

that you would use here. Okay, someone says, for example, apples. They have this bad reaction to apples. So they remove it. And maybe it's like they are a little cramping. They have a little bit of gas, whatever it might be. And then, okay, so I remove it. And maybe it's not an actual allergy because they're not like, you know, freaking out or having hives. But, you know, they want to sort of like get back into it. Is it like take a break and diversify your food so that your body reacclamates and then slowly reintroduce. Like, what's the approach? So the approach. So actually in my new book, I described what's called the growth strategy, GRWW. G-R-O-W-T-H, and it's actually a step-by-step process that you follow to address exactly what you're talking about.

So the first letter is G-genesis. You have to know the root of the problem if you actually are going to create a treatment strategy. If you don't know what you're treating, then you're just throwing stuff against the wall and hoping something sticks and hoping you get lucky. That's not really a way to approach health care. Poor life. Right? So we have to start there because if a person, Jonathan, if a person is constipated, they will manifest symptoms with the fiber content that's in an apple. Yeah. And they will think the apple is the problem when, in fact, if I made you poop, you would have no problems with apples.

Okay, wait. So G is genesis. Yep. Then we go into, I'm going to pair R-O-W together, restrict, observe, work it back in. And basically, this is the method that you take in terms of using these foods and isolating them, where you create counter currents. You stop it. You see how you feel. You restart it. You see how you feel. And in creating these countercurrents, you actually are empowering yourself with information. about how your personal body, because we're all different, how your body responds to this individual food. So once you know what the food is that you're intolerant of, then T stands for you train your gut. And then the last thing, H stands for holistic healing. And really, this is just my way of reminding everyone that, you know, like we talked about before, you can eat, you can sleep, you can exercise, and yet you are a complete human being. And there can be these parts of who you are that may be affecting your digestive function, and they may have absolutely nothing to do with nutrition,

and you may not even feel that they're connected to your gut microbiome. Real quick, I had a patient recently who has all sort of colitis. I tried everything to get her better. She was not getting better. We were both frustrated. And then one day she comes in. She's in remission, meaning that she's not having diarrhea around the clock anymore.

She feels like herself again. And I was thrilled, but I wanted to know, what did you do? because I couldn't fix you, and I'm the freaking New York Times best-selling GI doctor. She realized that her job was holding her back. She dreaded going to work every single day. Her boss would demean her in front of her peers publicly. And she finally got the courage to walk out.

She found a new job. She was happy to treat her with respect. And now her ulcerative colitis, this complex, inflammatory, chronic, functionally autoimmune disorder is actually in remission. It's like she doesn't even have it. She didn't change her diet. Growth. People love talking about how like 95% of serotonin's in your gut. Yeah.

Now, one of the things that is dangerous about the popularization of science, which I appreciate and I think mostly it's amazing and it's great. But when people hear things like that, it often, you know, kind of skews and can become very sensationalized. So the notion of kind of like what serotonin does, obviously we think of it for SSRIs and we think of it as, you know, maintaining more serotonin and the synaptic cleft and like all those things and antidepressants and great, fantastic. But serotonin also, it's part of motility function, correct? Totally. It's not so much that like your gut is the center of happiness, which I think is the way a lot of people interpret that.

it's that serotonin is it's a neuro it has a neuroendocrine function which means that it innervates parts of your body and the gut has a vast representation of binding for serotonin but not necessarily like to make you happy it has other functions that it does yes actually i'm glad that we're sneaking this in at the very end because we talked earlier about how the brain affects the gut now we're talking about how the gut affects the brain so So, yes, 90 to 95% of serotonin is in fact produced in the gut. Serotonin is the happy hormone, lifts our mood, makes us feel energized. And as you mentioned, we treat with selective serotonin, reuptake inhibitors to boost

serotonin levels. The serotonin that's produced in the gut does not cross the blood-brain barrier. That is not directly affecting your mood. Thank you. It is involved in bowel motility. Actually, Maim, many times, in people that are suffering with complex, functional digestive of disorders, we will actually treat people with medications like serotonin reuptych at baby doses, at baby doses, like the lowest dose that you can take and then you cut it in half

because if you can restore those nerves and basically like take away the visceral hypersensitivity because you actually have five times more nerves in your gut than you do in your spinal cord. It's the second most populated place of nerves in the entire body outside of the brain. Because evolutionarily, this is a very, very important, like next to genitals and face, if you're a primate, there's a very important part of your body because it is life or death. This is where we're interacting with the outside world, right? Like our skin is a wall. Our skin is a barrier.

Whereas our place of vulnerability is where we is our gut. This is where we're interacting with the outside world. This is why 70% of the immune system is right there in the gut. Now, does our diet and our gut microbes have the ability to affect our mood? I love that we get to end on this because it's such a fascinating topic. Science is emerging to say that the answer is yes. We have dietary studies, interventional studies, where they have demonstrated the ability to improve, for example, major depression.

One is called the Smiles trial. Professor Felice Jacka, who is in Australia, she randomized people to either a Mediterranean diet or control. And what they found is that in the control group, this is moderate to severe depression, so like not mild. In the control group, only 8% were better. And in the diet group, 32% were better.

So if you take four people who have moderate to severe depression and you give them this diet, one of them, this is going to change their life. That's pretty amazing. I always say to Jonathan, how many people were in the study? Where was it published? Meaning, has it been peer-reviewed? And what are the other factors that have been controlled for statistically?

Because what you can't do is say, and this is kind of like the notion when I was a teenager, I remember, like when your parents would be like, don't smoke cigarettes. And it's like, but everyone in France smokes cigarettes and they don't get cancer. that's not a proper study because what you have to look at is not just the diet, where are they eating this diet? What's the rest of their lifestyle like? So the reason that I'm so anal retentive about studies is that you have people hearing things, especially in popular media, about things that diet can do without fully understanding the kind of studies that you are working from and that you are trying to show people. we don't just say something for fun and build a diet around it and sell a book. We look at the science.

We look at the science. We make sure things are controlled for like where do they live? What's their socioeconomic background? What is the rest of their mental health like so that we can identify and say the diet is working because the science of the body is predictable? And no one's study proves anything either. That's the other thing is we need patterns. We need verification.

We need to see this when different populations. This is just the start of this. But the point, though, is that we do believe that the gut microbiome is involved in affecting our mood. And if you take a look under the hood at people that have, for example, major depression, what you're going to see is a reduction of the short chain fatty acid producing microbes that produce anti-inflammatory compounds. You're going to see this in anxiety disorders as well. So where we are today is we have data that suggests, like with complete clarity, we need more data. We have data that suggests that food affects mood.

We have data that suggests that microbes affect mood, probably not through the direct serotonin, but it could be 5HT, which is a serotonin precursor for all the nerds who are out there at home. This is what we're talking about. And also, I think more than likely the short chain fatty acids, which are what we get from consuming dietary fiber. And so it's an interesting place that we're in. Now, here's what I'm doing. I'm involved with a personalized nutrition company called Zoe because I don't believe that there is one size fits all. And also because I believe that we can do better than randomized control trials. Randomized control trials are great.

But the problem is that they are population averages. And they are not necessarily you. How do we create information that we can apply to the individual user? But the answer is that what we're starting to, this is what I'm actively involved in, is like, what if you have 10,000 people, and all 10,000 people gave you a microbiome specimen, were a continuous glucose monitor, did blood lipid testing,

had an app, and entered into the app exactly what they're eating. and every single day they told you how anxious they are. But we have 20,000 people and someday will be 100,000 people. And I'm actively involved. I was actually just looking at some of the data today. You know, the question is, can we fully connect this story? Food, microbes, mood, right? Like we have it in separate compartments right now.

And we have it with small studies. The study that the randomized trial that I just cited was like literally 65 people. All right. But I have a data. base of 20,000 people. They've all given me their microbiome. They've all told me what they're eating. And they've all told me what their anxiety level is.

That's going to be incredible. I want to give you my microbiome. There's interesting data now where we traditionally have just kind of described the microbiome. And now we're starting to move into a place where actually we're manipulating it. And so in melanoma research at MD Anderson, they are actually, so first, check this out. They treat melanoma with immunotherapy. All right. So they're like shaping the immune system to fight the skin cancer. First, they notice that when you give antibiotics prior to immunotherapy, people do way worse. They did a randomized trial because they thought, oh, this is just

like, oh, they're just sicker. So that's, you know, if they're sicker, they're getting antibiotics. They did a randomized trial. People did way worse when they received antibiotics. Then they did a fecal transplant trial. People did way better and they got a fecal transplant prior to immunotherapy. Take home message of bacteria is very important. Yeah. They did a fiber trial. And in the fiber trial, think about this. This is insane. For every five grams of fiber that you consume, you increased your likelihood of survival by 30%. Wow. And 19 out of 20 people out there on the street right now in the United States are inadequately consuming fiber. Can you supplement with like a cilium husk or does that fiber have to come from

vegetables that you're sort of breaking down yourself and consuming? You can't take a C minus diet and gut and take cilium husk and turn it into an A minus. That's not possible. You can take a C minus and turn it into a C. Yeah. But ultimately the three to five pounds of food that you consume on a daily basis needs to be the dominant driving factor. Eat the food.

But like, the data on fiber is ridiculous. There's a systematic review and meta analysis done that showed that dietary fiber reduces our likelihood of having a heart attack, reduces the likelihood of dying from heart disease, reduces our likelihood of getting esophageal cancer, colon cancer, breast cancer, less likely to die of cancer, less likely to have a stroke, less likely to have diabetes, less likely to have kidney disease. How is this not on the news? Why do I have to talk about it on my YouTube channel?

Right. Like what the fuck is wrong with our system that we don't want people to know this? Because there are ways, you know, I lobbied Congress, but only 2% of subsidies go to like real produce. And you're never going to get these people to buy this food when it's unaffordable. There you go. You're never going to get people to buy this food if it's unaffordable. Also, our society doesn't give anyone time to cook. You know, the whole rise of most packaged food is that, you know, they,

set out to be like, oh, it's so convenient, you never have to cook again. And people have bought into that. Well, but look, this is also post-World War II. It was like the first time that women were like going into labor force. People freaked out because like you took my woman out of the kitchen. This is when we started having an emphasis on convenience efficiency. So it wasn't, it wasn't a horrible thing. You know, polyester fabric, you never had to iron it. Like, because the lady didn't have to you're the woman of the house didn't have time to iron your freaking shirt so all these things start from an attempt at efficiency but now that we know this should not be the way we live such an interesting conversation because the other thing that happened in world war two was the discovery of

penicillin which is the greatest medical discovery in the history of humanity but unfortunately it's been it's so um you can see where a doctor this these are the top three causes of death and all of a sudden we have a way to get rid of them that is so sexy and it's attractive, we got seduced by it and we went way too far with it. But I think the other thing, too, is that I don't know how you guys feel about this. We're fairly similar in age. I feel like there's a quality of life standard that has become problematic for the United States because I think that wealth was growing in the 50s, the 60s, and the 70s. And wealth is no longer growing in the United States. And so our generation is working harder because none of us want to take a step

backwards relative to our parents. Yep. But education is way more expensive and houses are way more expensive and food is more expensive and gas and you just keep going. And the problem is so we are forced into this like most of my friends, everyone in the house works. Yeah. They work constantly. Someone else is helping raise the kids. And it's just, right? So we've like lost track. of who we were because we're trying to maintain our wealth standards. But what we haven't done is taken that next giant leap back, which is, oh, we actually need to be living more communally because there are people at different phases of their life who can cook and who may want to participate in child rearing, but we've maintained a shrinking

income pool against a higher cost of living while also trying to do it ourselves and not having any family, not having any community, and we can't do it all. It's a major black eye, I think. It's a major black eye for our culture that we don't take care of our elders and integrate them into our households. Dr. Bolshewitz, I think you're an incredible person. I think you're an unbelievable physician, and I think it's incredible what you are doing that so many, so many people have not done in your field. And you are really a hero of ours. And thank you so much. That is like very surreal to hear from you And my wife is going to freak out when I tell her this later

So I'll be back on track with this one His books check them out if you haven't already Fiber-fueled and fiber-fueled cookbook Check out his Instagram It has to happen. He's such a cool he's such a cool dog I mean I've met a lot of doctors in my life Like I just I like the way he talks I like the way he explains things

He is very calm and unfazed I feel like, because he, yeah, I feel like everyone, everyone deserves a doctor with that level of, like, expertise, knowledge. Like, he seems reasonable. Like, I just, I think he's a very good doctor. And now I'm just, like, super fascinated about, like, everything I eat and what's going to happen to my body? And I just, he cleared up a lot of things for me. And just, wow, I'm very, very wowed by him. This is a man who has, you know, he left the sector of.

medical care as we know it to pursue a life of literally I mean of course people are going to be like he just wants to make money like that's I'm not going to go there what I'm going to say is that this is a person who innately felt something was wrong both with his body his the way he

was functioning and the way people practice medicine and he this is a very different life that he has now you know he's a spokesperson for an entire aspect of care that Chinese medicine and Ayurvedic Indian medicine has been talking about for thousands of thousands of years. I wondered about gut stress and isolation. We talked

about that, how being isolated increases gut stress. I wonder, and I'm sure there's no data on it yet, if there have been more stomach and digestive issues since COVID, given how isolated people have been. Oh, yeah, why do you think people are drinking and smoking weed all the time? No, but not. When to be... It's because they're bummed out. But when is, this is kind of like a fascinating exercise. We've never been so isolated from one another and to track that. But there's not a scientific study. Of course not. It's too many variables. I understand. Good. But just think about the impact if there had been like, you know, whatever measures could be. Yes. He made me feel very like knowledgeable about things that like I was always like, I don't get like, I, I've never had this many

questions for someone specifically. That's really great. Well, Jonathan, thank you for letting me talk about your food. I'm still going on the record to say that. Slightly mischaracterized in my food stuff. Just saying... Are you in denial? No. From our breakdown to the one we hope you never have. We'll see you next time.

It's My and Beallix Breakdown. She's going to break it down for you. She's got a neuroscience PhD or two. One fiction. And now she's going to break...