The Knowledge Project with Shane Parrish - How to Repair and Nourish Your Gut | Dr. Giulia Enders

Starting point is 00:00:00 What can unlocking a healthy gut do for your life? It can re-centre one of the most important organs we have. And really with that have all these second and third-hand effects that you wouldn't even maybe have thought of. All these influences on your mental health, on just your sleep quality, on your metabolism, on your weight, on how you just feel emotionally during a day. It's sometimes more potent than genetics.

Starting point is 00:00:24 And why would you not want to get into something that is so easy to influence and change and then has such a wide reach on every aspect of your health. What's the biggest myth about the gut that you wish would disappear? I think a lot of people are afraid that it's like too fragile, too sensitive, to stupid, to handle things. And the gut is a very robust organ. If you treat it right and understand it most of the time, it can take a lot, actually. And so sometimes when people think they have all kinds of sensitivities, some people do.

Starting point is 00:01:00 and then for other people it's more something that damage the gut. So now when all these foods come into contact, fructose, gluten, dairy, and so on and so on, the gut always has an issue, but that's more because it has an underlying general issue that you have to first take care of. And then when it's all healed up and doing well again, you probably are able to eat all these foods again.

Starting point is 00:01:23 But people then stop entirely, especially with IBS, for example, and they say, I can't have all of these things. And I would say, you're right, you're not. imagining this, you really can't at the moment, but it's not because, you know, your stupid gut can take it, because there's something underlying that we need to fix first, and then slowly and surely you'll be able to have all these things again. Sometimes people have a little bit of a wrong view of what their body's actually still capable of and what medicine and, like, things from the outside can do to it. What are the most common signs that the gut is not healthy?

Starting point is 00:01:55 Very simple things are just the basics. Do you have a belly egg? How is digestion? Your body basically sends you a text every morning when you go to the bathroom. Might check it out. It's free. Just turn around and look. And then also some other things are also a bit more subtle when you look at the effect of an unhealthy gut on symptoms like anxiety, risk of depression, just an immune system that's out of check. Maybe influenced by some disturbances in the gut has an impact. If someone wanted to improve their gut health, what should they eat more of? I would say, eat more of things that you really, like, but that are luckily also healthy. That's always the first step. Because what I see oftentimes

Starting point is 00:02:37 in clinic was that people would eat these things because they hurt, they were healthy, but they hated them, and then they just stuffed their face with the stupid kale that, ugh, you know. And then always I said, oh, no, that's not good. Let look at like all these vegetables and fruit there are, which ones of those do you like? Because there'll be one or two that you like. And it's often way easier to go from there and then starting having just a bit more of that healthy stuff. Some people really like asparagus. Others will not mind having an onion more, you know, putting it in your sauce when you have like some ready-made sauce.

Starting point is 00:03:10 Like just things you don't mind or that you really like the taste of and then have a little bit more of them. And I think that's always the starting point because drastically changing the diet, also putting way more fiber in all of a sudden, will just make you gassy or bloated because your guts is not used to that. and your microbes suddenly get all these foods.

Starting point is 00:03:30 It's like a forest and then you just dump some fertilizer on it. What's that going to do? You know, slowly change your diet but with the things you like and the microbes like. That's a good compromise. Are the better foods for gut health? Like, what would those be? Like, what are the best foods for gut health? It is individual for some people because gut microbes are individual.

Starting point is 00:03:51 Some people might have gut microbes that when they eat beans, it's wonderful. They got all their fiber. They do all the nice things. some other people have gut microbes where they are horribly bloated when they eat beans. And this relies on your gut microbes. So I would say, look at the different vegetables and fruit. If you want to, then go ahead and look for their fiber content. You will always have two types of fiber.

Starting point is 00:04:14 One is water soluble. The other is water non-soluble. What does that mean? That means, for example, cereal or the skin of an apple, for example. It has fiber that are not able to fully dilute into something gel-like, when they're mixed with water, they'll just stay a bit like sturdy, fibery stuff. And those can mostly not be digested by the microbes because they're tough to really crack up. And they will just form bulk.

Starting point is 00:04:40 And this bulk is good because it will knock on the walls of the gut and be like, and the gut is very clear, so it bounces back and this propulsed digestion. This is really what gets your regular bowel movement, so it's good to have. But this other type of fiber, the water-soluble one, is usually what makes up the fruit. flesh of the apple, for example, and in asparagus, or when you just have carbs like rice and noodles and so on, if you cook them once, let them cool down, suddenly their content of, like, the resistant starch. And so with that soluble, water soluble fiber rises. So just having your carbs cooked, cool them down, and then you can even reheat them, makes them more prebiotic.

Starting point is 00:05:19 So prebiotic meaning food for good microbes in the gut. There are things that are good for the microbiome like, let's say, beans, onions, you know, green leafy vegetables. But if you don't crave them at all, start with ones that you crave, because then that might mean you actually have the microbes that are eating them that make you want to eat it. How did you get interested in the body? I think it all started in my teen age years when I suddenly got a skin disease, and I realized that I know nothing about my body. I'll be hanging around in this body, you know, for it.

Starting point is 00:05:54 another 70 years or so. And I just don't know how to, like, understand all these processes where this suddenly coming from. And I have to go to a doctor who tells me then, I just put this on it, helps a little bit, then comes back. And I realized, oh, I just have to, like, do what he says, because I have no idea. And then I started reading. And I started, like, being surprised, understanding so much more. Also realizing that it gives you quite a friendly kind of power when you know more about the body. What was the skin condition? Well, I had, like, these open wounds coming up. Then he said, oh, it's like X-M-R-M- or something, and I put steroids on it and went away, but then it just came back. And I thought, well, this can't be it for the rest of my life, you know, so what else is there?

Starting point is 00:06:34 And I found all these things about the gut, about after probiotics, sometimes things like this can pop up or how food can even show up on the skin. So that was just a topic I got into. And then I tried all these things, very unscientifically at the same time, this and this and a little bit of that. But after a while, I realized, oh, it was getting better. I could visibly see how it was getting better. how I could help myself just by trying things out and by having more knowledge. You were experimenting on yourself. Yes, definitely.

Starting point is 00:07:01 Some of the things I wouldn't recommend today with the knowledge I have now, but, you know, I was young and just did it. What was one of the crazier things you tried? I overdosed on zinc, and then I really, back then, I just got a really sensitive smell. Like, I could smell things from further away. At least that was my impressioning experience. Wait, so if you overdose on zinc, you can get like a superpowers. I read later on that this may be possible, and I just had this happening to me, so I thought, oh, wow, okay.

Starting point is 00:07:31 And is that when you decided you wanted to be a doctor? Yeah, before that, I wanted to go into, like, energy engineering. I'd already done, like, internships, and I was really into that. But then I realized, oh, I can read these medical texts and even, like, papers or books for hours on, and even if I'm really tired. And so something within this topic is, like grabbing my attention, and it's really easy for me to get into it, especially when I discovered the gut, that was it. From there on, you know. What's the link between the gut and the immune system? Well, there's lots of immune cells

Starting point is 00:08:03 residing in the walls of our gut, and they're checking out, what's going on. At least, you know, the gut is one of the- Is that like the heart of our immune system? I mean, the immune system has different locations where it's being trained, but the gut is a very large and a very center one, because especially there's all these exchange happening with the outside world. When you look at us from the outside, you would almost think the skin is the biggest surface to the outside world, but the gut is a huge one where you have all these substance skins coming and crossing the wall into the blood of our. So that's a quite intense process. And of course, the immune cells will be there to just see what's going on and really be sure that there's

Starting point is 00:08:39 nothing, you know, wrong happening. And there they'll also learn tolerance. Usually in an unhealthy gut, that's the training boot camp of tolerance. They'll be like, some peanut came, but it was all right, our cells are still doing fine, and then all these immune cells are gathering and saying, oh, this is peanut, it seems to be quite okay because we're still doing fine. And it sounds like a really funny process, but it's happening every day all the time. They're just training this tolerance. And of course, then when your gut cells aren't doing so well, there's maybe little wounds,

Starting point is 00:09:09 or it's been stressed so the protective mucus layer is down, then the immune cells might be wondering, maybe the peanut is not so good for us because the cells aren't looking so good. So should I be watching out for peanut next time? So these are some of the processes that can lead, for example, to sensitivities or allergies or just a gut that's not feeling well. There's a lot of supplements that are pre and probiotics. Are there foods that we could take for the prebiotics? Definitely. It's all the same stuff. It's have your veggies, have your fruit. So they have prebiotics in them? Absolutely. And as I said, usually in a fruit, you see that the, The skin of the apple, for example, has the water non-soluble fiber, and then the flesh has the water

Starting point is 00:09:49 soluble fiber. And those are prebiotic. And you can basically pick any vegetable. Then you have some like banana that have a little less. But if you pick a green banana, for example, the starches are not yet unpacked. So it's not so sweet because unpacking the starches, making some sugar out of them makes a banana sweet. But if it's really green, then this hasn't happened so much. So there's more prebiotic in them.

Starting point is 00:10:11 So that's why in some countries, green bananas are also used when you have some diarrhea, because they might help with feeding good microbes, which then fight off the diarrhea-causing microbes. Is fiber like the most important thing that most people don't think about very much? Fiber is maybe an overlooked thing because we have managed to produce foods that just have less and less fiber, because the caloric density is again higher. That makes the dopamine cells go, yay. then we will rather pick those. But I think the effects of fiber are just so nice.

Starting point is 00:10:45 When you look at metabolic health, for example, we've seen one study that I like to quote is when you looked at Pacific Islands where the rice cooker was introduced. People put on a lot of weight. And that one aspect, the hypothesis of this paper mentioned and explained, was that the rice was suddenly now not cooked and then cooled down and then reheated, but it was cooked and just stayed warm. So all the starches and the carbohydrates in the rice were so superly fast accessible

Starting point is 00:11:15 that the glucose in the blood spikes goes down, you get hungry, you need another snack. But if you have the rice cooled down, the starches again. And then when you eat it, it takes more time and more enzymes to unpack this crystallite starch. So then it slowly gets your blood sugar up and then down again. So you don't have this. And this also is good for your, you know, weight. because when they then had people cool down the rice after cooking again, but people would also lose weight again.

Starting point is 00:11:44 So you see that it's sometimes not only about the number of calories that's on the package, but really also how you prepare these foods that then will make a metabolic impact. Are there any other foods like rice like that? Well, all the starches, when you have noodles, when you have potato, when you have rice, these typical starches, when you cook them and you cool them down, they get more prebiotic. So potato salad, for example, wonderful, or just have a lot. having cooked potatoes in the fridge and then making them fry them up again with a little bit of olive oil or something, you know, that's already better for the microbes than just having them all.

Starting point is 00:12:19 And do we need a wide variety of fiber or is it something where we can just consume one or two foods and get all the fiber we need? No, the thing, there's this rule, I think, by Tim Spectre, who made this prominently, and it's very good and you made all the wonderful research for that, that if you have about 30 different types of fruit and vegetable a week, then you're really in a good window where there's so much variety of different foods that there can be a variety of different microbes eating them in your gut, which then contributes to your health. Does eating fiber reduce your risk of cancer?

Starting point is 00:12:52 Yes. Why? When you look at cancer, there's different types of cancer. We have a hereditary kind of colon cancer, for example, but we have also colon cancers where we now have the leading indicators that the microbiome play a part in it. And also when you look at fiber, what it does is also propel digestion. So, for example, all this metabolized stuff that really is ready to just get out of your body doesn't sit there for very long, releasing also possible toxins, for example,

Starting point is 00:13:19 and they then come in contact with your gut cells. So there is a type of pro-inflammatory or then even pro-cancerous processes that are being influenced positively by fiber. And that is once by influencing the gut microbiome, two, by influencing just the problem, process of digestion itself. And then three, also effects that have to do with metabolic risks of cancer. So fiber and the way it slows down the intake of blood sugary things, for example. When you have spikes of blood sugar all the time, this can be pro-cancerous by multiple roots, by making the immune cells a bit more aggressive by then, you know, promoting pro-inflammatory causes. So it's a very

Starting point is 00:14:01 complex building. But the simple answer is, yes, fiber can protect. you of colon cancer, for example. And then other cancers that are related to those metabolic processes that I mentioned. What causes the inflammation inside of us that you mentioned? For example, a very simple link is sugar. When you look at sugar, it is high energy and immune cells will realize that they have now this budget of energy to spend. And of course they are pro-safety. And of course they say, oh, I'd rather have some more safety guards and some unnecessary inflammation than too little. This is a little bit the tendency they're leaning towards. Well, because when you look at our history, thousands of years, it's always better to have

Starting point is 00:14:42 this additional safety, but we rarely ever had enough energy for that. Our energy budget was always limited, cut off at the very, you know, necessary things. And suddenly we have all this energy to spend. And then the immune system, as we see, is a bit switched on by sugar. It goes a bit more into the aggressive direction because it can, you know. And this is one process that sugar will tip off. And we see, for example, people drinking soft drinks, high in sugar for 10, 20 years, they have a significant elevated risk of inflammatory diseases.

Starting point is 00:15:13 And this isn't always the one cause why someone has an inflammatory disease. It's different other possibilities, pollution in our environment, making the immune cells irritated and aggressive genetic predisposition where there's less calming signals, you know, in an immune system, for example, all these other things. But for example, sugar is one of them, and it can tip off these processes, and this then can have a range of effect. And there's different types of sugar, too, right? Like there's naturally occurring sugar and fruits, but then there's, like, white sugar that's refined.

Starting point is 00:15:48 And then high fructose corn syrup. That is true. And you can definitely say that this, like, concentrated high fructose corn syrup is like one of the ones where we see these ungood effects, if it's administered in a too high dose, the clearest. But I'm not convinced by these things saying have a date instead because there's just the same molecule in it. The fiber of the date might slow it down the take up a little bit. But if you have like, you know, dates that have been made to be this big and super sweet, then they're also full of sugar. So I would say don't kid yourself. All right.

Starting point is 00:16:21 I want to talk poo. Yes, that's. You became famous partly for making people think differently about poop, including myself. What are we still getting wrong about poop? Well, I think the thing to get wrong is just to ignore it, really. In Germany, you have two different kinds of toilets. We have one toilet where it goes into the water, which is, I think, the American and Canadian type that you know of as well.

Starting point is 00:16:46 And then we have this toilet, which has a presenter. So you will just have it presented there, and from here you can flush it then with water. But you will really see, and also not to go into too much tissue, but you will smell it a bit more too. So there it's really hard to ignore. But, I mean, you can also look at it in other ways. There's, for example, the behavior it has when it's floating.

Starting point is 00:17:09 When there's no air bubbles in it all, that means bacteria haven't really done their work at that drop there. So it sinks to the bottom immediately without sometimes swimming a little bit. So that's a sign that you're not digesting properly, for example, can be a sign. Then if you have lots of fats in your stool still, it's a sign that maybe you're not digesting fats really well. And you might even get that checked out if it's very prominently there. Then, of course, you have just things like structure and color, where you can get some hints from. As I said, really black color or blood reddish color, that's always a warning signal. There's also things like it being a bit more to the greener side or yellowish or something.

Starting point is 00:17:50 And gray is a warning signal as well. And then when it comes to consistency, I think this is for most people probably the thing that they realize. the most. You know, we have the Bristol stool scale. It's written in wonderful, like, British language where it's like, you know, smooth and soft like a snail or something. It's really fun to check it out if you want to. But there you can see that if you go more to the constipated side, what forms are already indicating that. And then you can, of course, also realize diarrhea or stool being too soft, I think oftentimes is an overlooked problem because it can mean that your or mucus is not intact or your digestion is not going so well.

Starting point is 00:18:32 There is maybe that is predominantly German, I don't know, but I can say that people were also a bit embarrassed about the topic when it all started in Germany 10 years ago. But there's like a literature piece where they describe like the wholly perfect way where you go to the toilet and you wouldn't even have had to wipe because it was so perfect that there was no wiping necessary. So I think what that actually indicates and that was way before we realized this, scientifically, is that when you have a very proper intact gut mucus lining, then it will really surround the last bit of digested stuff and really pack it up. So it doesn't really touch much

Starting point is 00:19:11 of your skin or mucus area when it comes out and it just is a clean business. What about size, the toilet cloggers? Well, the perfect toilet cloggers would be the one where they just have so much fiber that this really gives them a lot of bulk or mass or whatever. And then the not so perfect ones is when really you're not digesting so well. So you haven't taken up all the food and too much of it comes out unprocessed, basically. That is not such a good thing. And then sometimes you can see it even as a side effect of antibiotics because the antibiotics kill off all these bacteria and they have quite some weight. They have a mess, you know, they are sometimes described as an organ of its own. So you're basically losing a little bit or a bigger part of that organ and that can sometimes amount to a bigger volume. But it's a lot. But it's a sometimes It's not necessarily a bad thing if you can handle it work. How do we rebuild our gut after a dose of antibiotics? People in different life stages are more susceptible to the disadvantages changes antibiotics-induced. So we see especially small kids and seniors in studies that they have a harder time going back to their microbiome after around of antibiotics.

Starting point is 00:20:24 Then we have all the adults in the middle area of this. For them, it's like 50-50. Some of them will actually go back quite well, and others will never replenish the microbes they've lost. And some of them might have been even like some nice family inheritance pieces, so to say, that they will not get back and that used to protect them off certain diseases or things before. So it is not with an easy hand that you should administer antibiotics just for every cold you have. And especially in the United States, I have to say, we see that this is a problem that is maybe responsible for the high number of people having problems with their gut. So that being said,

Starting point is 00:21:03 what can you do? Of course, you can have probiotics, especially when you start having diarrhea while you're being on antibiotics. We've seen studies that probiotics help with antibiotic-induced diarrhea. So especially for children also and the elderly, as I said, but also with grown-ups experiencing diarrhea. That is an indicator probiotics could be helpful. Then we see that when you take probiotics after a round of antibiotics, there is two effects. One is that they can help lower your pH value by, for example, bifidobacteria or lactobacillac, who produce these acids, can have a beneficial effect, because, you know, again, good bacteria thrive in those environments, others might not, so it will help. But it can also have an effect that they take up niche and room of your

Starting point is 00:21:48 initial microbes. And then when you stop taking them, they're gone and yours don't return the same way. because they were being like kind of like pushed to the side. So it's not only a good thing. So this is where prebiotics are also really important. As I said, feeding your good microbes that will actually stay with you and that feed off like good foods. What are the warning signs that someone should see a doctor instead of trying to fix it themselves? Well, the typical warning signs are just like heavy, like extreme, like really pain that you don't usually have or don't know. Then we always have the black or the bloody stools that you.

Starting point is 00:22:24 should get checked out of weight loss, night sweats, those are like the really severe common months, but also things like if you have a tendency towards diarrhea and it lasts more than three, four days, then I would also think of having that checked. And then if you have a really bad constipation, for example, that can be something that you already know, you've had it since you were a child or you've had it for a long time, then I would always say it's not an act of immediate attention, but it can always be improved. So it makes sense to go somewhere and check some things out. But if it's suddenly starting, that suddenly you're constipated and you don't even know why

Starting point is 00:23:06 you didn't used to be like that, that's something you should also have checked out pretty soonish. Are we pooing wrong? There is an aspect that is a bit disadvantage. And this is this seat of toilet that looks like a chair, you know? And we sit on it in a posture that we usually know from, you know, sitting on it. chair. And our body has the smart mechanism of having a muscle going around the end of the gut and then, you know, holding it back a little bit so that we stand or when we sit in that position, not all of it is like immediately in the position to come out. So it creates this curve. When we put

Starting point is 00:23:40 our legs up a little bit, you could say like a 30 degree angle from just being horizontal, then this gets loosened up. And then there's not this curve anymore, but it's rather bit straight. And, you know, this is just the natural position when we squat outdoors when we go to the toilet. And this is then better, anatomically speaking, a better way to go to the toilet because you need less pressure and you're not pressing against, you know, your own muscles holding stuff back. And this way can reduce the risk of hemorrhoids or diverticulosis, which we see less of in countries where people still use a squatting position when they go to the toilet. So it is a good idea to maybe try to emulate this and you can do so with a little stool in front of your toilet

Starting point is 00:24:23 where you just put your feet on. I've heard now so many people report back to me that this has helped them or that they really miss it now when they go elsewhere. They will use like the tiny bin in the hotel toilet to put in front of the toilet so that they have this position because it just feels more natural and there's been a study on that by Dav Sikirov, a researcher who compared these different sitting positions and could show that it's much easier or it also feels better for people, but they really got everything out when they are rather in that situation than in a normal chair, stool position. The sponsor of this show is CoinChairs.

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Starting point is 00:26:16 Head to granola.com.a.com.com. slash Shane and get three months free with the code Shane. That's granola.com.ai slash Shane. What does constipation actually mean? Constipation can is, well, the problem of having the feeling you're not really emptying all the way when you go to the toilet of having a too hard, too difficult time to go to the toilet. You really need a lot of force to get stuff out or even need to like help a little bit, manipulate

Starting point is 00:26:44 so that you can get it out. It can be too hard. So these little pieces of stool like a good. goat would have, for example, is a good indicator that it has just spent too much time and the gut already got all the liquids and then some more. So it's really like dehydrated a little bit. Those are different aspects and can have different causes. For some people, it's just in the very end that they're having a hard time coordinating it really getting out. For others, it's all the way before that, that it's too slow. It's somewhere it's being like not transported fast enough.

Starting point is 00:27:12 And that can happen with a low fiber diet way, just like have pizza and pasta and white flour. and that's it, basically. So there's different causes for that, but a way to handle it is almost always easy and has really great results. And I've personally never experienced a patient that didn't get better with just some simple tricks here and there. And then, of course, there are some severe cases

Starting point is 00:27:37 where really some things of mortality disorders, where since birth you've had a super horrible hard time to go to the toilet. And there we need to be a bit more creative, but there's also wonderful solutions for that now. What are the tips and tricks when you say that? Some more fiber, some of probiotics in your diet. There's things like flex seed, chia seeds, these things that you really need to add some additional water also to really have them soak up and really have some material that the gut then can propel forwards.

Starting point is 00:28:05 Those are very simple things. How important is chewing? Chewing is a good thing if you want to take some work off your stomach, of the hands of your stomach. Because the stomach really then has to get all this muscular work. are going if things are not chewed correctly. And it's exits, so to say, will only let very tiny particles through. So if you don't chew well, it has just a bit more stuff to do. And also, you tell your brain what kind of nutrients are coming in when you're tasting them already. So actually just looking at certain foods will start the process, but then really having them in

Starting point is 00:28:37 your mouth will already get some things going and some juices flowing. It's a nice thing, but I also have to say a lot of the foods we eat nowadays don't necessarily need the chewing anymore. When you look at highly or ultra-processed foods, they're so almost falling apart into sugar particles, white bread, white pastries, white flour stuff. I mean, you can chew, but it'll be very soon just sugar in the very first, you know, inches of your small intestine, it's all sugar going into the bloodstream. Go deeper on the ultra-processed foods versus sort of nature's foods, if you will. So when you look at all these advices we get all the time about food, right? There has been an error for something. Like the Taylor Swift errors, you could almost say. There's been the error of having

Starting point is 00:29:25 low fat in order to not put on weight. There's been an error of having everything less sugar, sugar substitutes. Now when we look back at these discoveries, scientific opinions, you could say, of course, with evidence, then you can say, well, they're not entirely wrong, but they really weren't entirely true also. And what we're looking at now, which error are we in now? I think this is now the error where we say, probably it's about the ultra-processed foods that are bad. We still have some of the remaining advice. Like, of course, don't have too much sugar. That's still a very good advice. And I think here, the nice thing is to have a clear amount, which is 25 grams. This is what the World Health Organization say. This is the amount of sugar you can have. Without it,

Starting point is 00:30:08 in the long run affecting your health. And then when you look at fats, it's still true to say it's good to have like wholly unsaturated fats, a good olive oil, don't heat it up too much because then it breaks apart and can reshape chemically not be so good anymore.

Starting point is 00:30:24 But those are the things that still keep standing. But the rest of it, people say, well, rather have the full fat yogurt, you know, because not engineering it so much, or also the way it is digested as a bit more natural to the body and doesn't have all these horrible effects we earlier thought. And now when we look at people having diets without all these additives, we see how healthy they are.

Starting point is 00:30:47 And we see even when we have people stopping their usual diet with all these processed foods and going back to a more natural diet without all these additives, we can track all the effects and the right-of-way shown that it's much more healthier for their body that's good on them. So we get an idea that, oh, maybe, you know, that was the thing. How long does that take? If I stop consuming, let's say I move from a diet of highly ultra-processed foods to more natural, how long does it take for my body to adjust and start to show signs of progress? Some effects you'll see after three days.

Starting point is 00:31:27 Some it might take, you know, one, two or three weeks, but that's really the amount of time. You hardly ever take more than that in the department of the microbiome to reach all these really nice good changes. because, you know, they eat every day. So if different foods comes in, they adjust every day. And then, of course, you have more long-term things, metabolically speaking, your cholesterol, for example, also just your overall immune function or stress hormones. These things can indirectly be influenced. And those will take a little bit longer because you still have all this storage fat, for example,

Starting point is 00:32:00 when we talk about blood lipids or also just feeling better when your immune system is maybe not so angered by some additives or food processes or just a sensitive gut wall. This is, I think, a bit more individual and could take a bit longer. I wanted to see if an AI version of me could actually hold its own. So I built one with, Hey, Jen. Let's see if it was paying attention. Hi, Shane. Digital You!

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Starting point is 00:33:58 It seems like a lot of the knowledge that we've had over the years, the low-fat, less sugar, also led to much, more processed foods. So in order to reduce fat, we came up with substitutes for fat, in order to reduce sugar, we came up with substitutes to, is that true? Yeah, that's true, especially when you talk about the low fat, there were all these processes to remove, to have that. But I think what is actually a bit more the culprit here is the dopamine. And we have a lot of processed foods because we make it more appealing to our dopamine releasing cells. When they realize that you have a very high coloric density, they're rewarded because it means you

Starting point is 00:34:40 age just something very little, but it gave you a lot of energy. So little investment, a lot of turnout, and that is what those cells are about, and they reward it, not knowing what it does in the long term sometimes. And unconsciously oftentimes, but nowadays also targeted and very consciously, food industry has seen, okay, this is my target audience. Those are the cells that rave when something comes in and they will motivate you to buy it again and again and have some more of it even. So I think it's not really only the mistake or the wrongdoing of these hypotheses

Starting point is 00:35:12 nutrient-wise or health-wise, but really also a dopamine system that screens out for reward louder and louder these days. And it understandably does though, because it's being like, how do you say, wrenched? Yeah. By social media, by processes that are not so fulfilling, by time sometimes getting a bit

Starting point is 00:35:31 tougher. People want a good feeling and food is a way. to get it. Is one way to think about food when you're in the grocery store just to look at the ingredient list and a good sort of like heuristic is the fewer ingredients the better? Yes, and I do this all the time. And sometimes I'm really surprised is what I find when I look on the ingredients lists. Some things market it as super healthy. And then you look at like this nice, it has all these foods and all this fiber and you look and it has like 40% sugar. That is like, what? or some drinks, they are, oh, it's super healthy, wonderful juice, blah, blah, blah,

Starting point is 00:36:09 and it has more sugar than Coca-Cola has. I'm a bit drawn to doing this now, and I buy these ready-made foods, and I have them as well. I think it's really difficult to cut them out entirely. Whatever half God is able to do that, applaud to you. But I think if you have a good, like, 80-20 ratio, you're good. So 20% processed foods or stuff from the supermarket fine. And if you manage to get, you know, to the 80% of, like, real foods that come like

Starting point is 00:36:34 that from the soil or the tree, good balance. But yeah, check out the ingredients list. And I check for MCM, this is the methylcellulose, and the polysorbate 80, so PS80, and kerogens. It's really sometimes almost horrible to look at what substances are in these products. So really go for the companies that look out for your health as well, you know. What's the effect of alcohol on our gut microbiome, Outside of sort of the obvious symptoms that people would think of with people who consume too much alcohol, like how would it manifest itself in our poop and our digestion?

Starting point is 00:37:10 I don't know if you have this term, and it's not necessarily a pretty one either, but in Germany we have this term of beershys, which means when you have too much beer, then you will just have this ungood poo where you're like, oh, this is beershys. It's too soft, it smells funky. It's something where you realize that wasn't a good idea, you know. And it's a mixture of alcohol annoying the immune cells, alcohol not being good on the nerve cells, alcohol, getting chaos into the microbiome. So all of this comes together and gives you this weird text message on your toilet in the next morning saying, what was that? It's like our body is speaking to us, right? Like it's giving us feedback. Well, it is definitely a form of feedback, yes.

Starting point is 00:37:55 What does coffee do? With coffee, it contains polyphenols, it contains antioxidants, so it is not necessarily a bad thing. The thing that can be problematic is the caffeine in it. If you have lots and lots of caffeine, it has an effect on your dopamine system, not like drugs, but it elevates a response of the dopamine system. So that's actually also what you really wish for.

Starting point is 00:38:20 The email of your boss saying, wonderful work feels just a bit better, a bit more motivating. You're just a bit more like active fit in the day. And this is good, nice to have. We like to have it. But in too large of an amount, and that is the case when people then really have sort of withdrawal, when they don't have it on vacation or somewhere in the plane or

Starting point is 00:38:40 whatever, then this becomes, I think, a bit problematic. And then you might think also of sleep. Because we've seen all the studies and rarely ever is science so clear on one point. There's always multiple opinions usually. But with coffee, there's really not been a study where you don't see an effect. People will say, but I have no trouble falling asleep, but then you see in all the measurements, the quality of sleep after falling asleep is poorer. And then what do you need in the morning when you wake up?

Starting point is 00:39:10 Coffee. So it becomes this visual circle where I think this is a main factor that then can influence the microbiome. The pontifina is an antioxidant is wonderful. They are actually good for the microbiome, you could say. but you can have them with decaf coffee just as well. And then when you have your coffee within a time window, select 12, 2 p.m., 4 p.m., perfectly fine, and then you would be able to sleep wonderfully.

Starting point is 00:39:36 But people who have coffee after that, I don't believe them that it doesn't do anything. And I think if they could switch to decaf and just check it out for a few days and really be honest if their sleep is better now. And then they say it's not better at all, then, you know, do whatever you want. But before that experiment,

Starting point is 00:39:52 I would say have the experience. Try it. Yes, try it. What effect does snacking have? There's different approaches to frequency of food intake. For some people, they will really notice a difference when they keep a window of four hours in between meals. They would say, oh, this is so much better for me now. For others, they don't.

Starting point is 00:40:12 They get too low blood pressure. They don't feel so well. And so it is, again, something where I would rather people listen to their own instincts and then have a healthy snack, then say, oh, snacks are not good, so I shouldn't at all. There is some different opinions on the time frame, like should we only eat from 11 in the morning to 7? Should we only eat when there's daylight out? Should we only, you know, have breakfast very large amounts of food and then small dinner.

Starting point is 00:40:43 Should we, you know, there's all these different theories. And I don't think there's a common thing that is a solution for everyone. One fits all. I think there's not something like that. But it is good to experiment with it and really find out for yourself. And for example, when you look at visceral fat, like this sudden belly coming in in your 40s or something or afterwards, then oftentimes you see some improvement when you actually watch the times where you eat. And if you have some time in between where you really don't eat or if you say after seven in the evening I won't have food until 10 in the morning, people will actually realize that there are some differences then. But as always, it's not a one-fits-all, and I would just have people know about this and then experiment rather than tell them what to do.

Starting point is 00:41:28 I was talking to a friend of mine before coming to see you today, and she mentioned a gut cleanse. Is that useful? Is it not useful? What is it? In the beginning, I have to be honest, I didn't like it at all because I thought it's so invasive. It's people thinking their gut cannot clean itself, because usually after two weeks a gut really replete. It finishes all its cells. So if you just eat healthy for that time, you're good, you know. But I have to say, I've heard so many patients saying that it helped with like pain in the joints or with other things that I'm still not thinking it's this perfect solution for everything. It does have risks. We've seen patients with trouble after or complications, not many, but it's not without risk. But for some, they feel that it's good for their health. And I'm a person that says, that is the main thing. That is what health is about. So if someone reports that, then I say, okay, good.

Starting point is 00:42:25 But still, it shouldn't be done too much. It is, I think, something to resort to when things have gone really wrong and you sort of feel like you need reset. We've experienced patients, for example, with irritable bowel syndrome after a colonoscopy being suddenly way better. And it's not because of the colonoscopy, I think, because we just checked with the camera for a few minutes, But it's maybe because they really cleaned everything out and could restock their microbiome a bit easier than they could have if everything's just stuck in place and you just throw some different foods on it.

Starting point is 00:42:58 So now I'm more open to it and think it does have interesting effects that I don't disregard anymore. Talk to me about supplements. So I think supplements and this whole fascination about them tickle me in a specific way. Once again, as I said, if someone takes something, notices. immediate shift says, oh, I really immediately feel like this because of it, then go for it, check if all the dosages are right and if the quality is good because there can be some troubles with that, but then I'm not against it. But that being said, we see that normal healthy grownups usually don't necessarily benefit from it. Some supplements even have disadvantages effects

Starting point is 00:43:43 in big studies. Really, I'm talking big studies like vitamin E at a higher. risk of people who smoke having lung cancer. So what was that all about? It's because you don't know all the effects when substances will have on you. And there might be things that just occur naturally, and if you have them powdered up or concentrated or whatever, if it's still an amount that's reasonable. But what I find people will miss while they're being on this whole supplement journey is they really go for all these nice slogans, but they miss the bigger picture. And the bigger picture is the picture that we have so much solid research on. And it's the things your mama told you. It's sleeping well. It's eating well. It's dealing with your stress well. You know, having some joy in life also accounts to

Starting point is 00:44:27 that movement. And those are the things. And this is the big bug. This is the 80% of your health. And then some supplements might do one or two percent. They're good to you. But usually they don't do so much more than this. And so weigh it. You know, all this money, all this time researching, you know, and then these other things that have shown effects that are so important really maybe put some of that time and energy and money in these departments as well. That's all I'm saying. This spring, denim gets a softer, lighter update. Introducing Old Navy's drapey denim wide leg, a new fit that moves with you. It's everything you want denim to feel like for summer.

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Starting point is 00:45:42 So it's a hormonal, metabolic reason. If people stress too much, like if they walk and their heart rises and they breathe really fast, so it's a stressful walk, then it's not necessarily good because stress will then do opposite effects. But if you really have a comfortable walk, that's what you want after me. One of my close friends is doing this experiment that I think you'll find fascinating. So he believes that food is the key to healing, as I think you do based on this conversation. But he's going into hospitals, because hospitals are this place that are supposed to make us better, and they feed us crap, at least in North America. They don't always have the best food. And he's a famous restaurateur. And so he's gone in and he's gotten rid of most processed foods. He's reduced the level of processing. And the theory, which I think is starting to prove itself correctly, is we can actually increase the number of hospital beds by effectively getting people out one day or two days earlier. And we can do that through food because a lot of what happens in hospitals is people aren't eating.

Starting point is 00:46:44 They're malnourished. That slows recovery and slows healing. I'd love your take on that. I think that's a perfectly right approach. And it just goes to show that oftentimes when we try to make humans adjust to the system, instead of the system adjusting to humans, we do a stupid thing. We waste money, we waste resources, and we make it less pleasant. and less nice for people. And that goes for hospitals,

Starting point is 00:47:12 that goes for workplace, that goes for education. I think there's so many areas in life where we could just use the knowledge we already have on the body and make smarter choices that just benefit everyone. I'm not saying, you know, be all hippie, have all the flowers while you can.

Starting point is 00:47:28 It's nice. But I'm saying it also makes sense in all these other aspects, economically, emotionally, societal. And I would love to see that more often. And especially like when you talk about foods and hospitals now, it's absolutely true. And the crazy thing is we have all the research showing it. We have the research on wound healing after surgery, for example, and the quality of foods

Starting point is 00:47:48 of psychiatric diseases even. We have all the research. But you know what? We do in many other areas also when it comes to really how you put together a workplace, how you educate children, how the brain learns the best. We have all the research. We just don't do it. So that's, I think, a shared goal here where I try.

Starting point is 00:48:07 to like make this knowledge in a way palpable that you can then use it rather than just have it somewhere in the books. Your work is about listening to the body. What does it mean to listen to an organ? It I think means in the first place, and that's an easy place to start, to not cut it out of the picture, to not ignore it. We will now have people, for example, breathing dysfunctionally. So people at workplace might have this phenomena where it's called e-may-

Starting point is 00:48:37 email apnea, where they hold their breath when they hear the sound or they see a new email coming in repeatedly over the course of a day, or breathe really fast and too deep or something, which really heightens their level of stress hormones, makes their muscles in the back clench up, sometimes give them cold hands and feeds, feeling really stressed. Their workplace really can also stress them, of course, but there's an aspect of the body that we overlook and we don't use to our advantage just because we don't know of it, or other things like the gut and influencing depressive symptoms, like all these physical, like, influences on our life, on our feelings, on our performance. If we just would know them to a degree that we don't ignore them anymore,

Starting point is 00:49:20 then we can use them. Then we can have breath techniques, like for one minute at 12 and 4 o'clock during the workday. And it really takes off some of these symptoms. You'd be surprised for some people. We will have people realizing they're noise sensitive. When they travel, this is part of where their stress comes from. We will have students realizing the type of. of learners they are and be able to like learn. But so really I think what I want is people to just have this smart body feeling that they can actually use it to their advantage and not be victim to like mysterious processes that they find overwhelming.

Starting point is 00:49:52 It's oftentimes not so much knowledge that does that. If someone changed only one thing about their diet after listening to this conversation, what would you want them to change? Something easy that the person likes and maybe cooling down your starch just before you reheat them or just before you eat them, and then pick one vegetable that you like and just have it a bit more of them. And then I think, you know, we haven't talked about these things so much, but I like to have people know that hygiene isn't about disinfecting your hands all the time. One of maybe most important hygiene you can have is stress hygiene.

Starting point is 00:50:28 And understanding your way of going about stress in terms of hygiene, I think, is actually very beneficial for the gut. Go deeper on that. What we see is that there's an effect of stress that differs depending on how long the stress goes on for. Short stress is not necessarily bad because it's like challenging your body. It's like doing a spout of exercise where you're just like doing something very difficult

Starting point is 00:50:53 and then you're going back to calm mode again. But stress that lasts longer than this has more unhygienic effects because it's not only a little challenge and then going back. When you look at the gut with the camera, and then you really stress out the person, the walls of the gut go pale. So they would usually be pinkish because there's all this blood going on.

Starting point is 00:51:14 Blood flow is going great, you know. But when stress happens, the vessels really go small and the gut doesn't get so much energy anymore because your system is giving all this energy to your brain and muscles to solve the problem or run away, you know? And then when you're in stress, your gut will really give up all of its energy. It's very good-willing, good-natured organ that says, oh, there's this big problem, can't digest in all, you know, carefulness now. If you're really stressed, some people even throw up or have nervous diarrhea, and that is just to get all these tasks out of the system so you don't have to deal with digestion now. And so you can use the energy for problem-solving.

Starting point is 00:51:52 The bad part is if this goes on for too long, you're really abusing this good-willed organ, and it doesn't have enough blood flow and energy to build enough protective mucus. So your stomach might be sensitive or your food particles get too close to the gut. And you're not having enough blood flow to get all the immune cells in the right direction. Your immune cells might even get more aggressive. This can have to do with a lack of sleep. This can have to do with the mucus layer being too thin. So suddenly they're exposed to all these things. So they're like, watch this.

Starting point is 00:52:23 I don't like it. So they get aggressive. And so your gut can get sensitive to food suddenly or have problems that it wouldn't have otherwise. because it just doesn't have the resources to deal or do its job in the way it would usually do. And over a few weeks, that can have very detrimental effects. And also some microbes, and that is maybe the most hygienic part of it all, they thrive on stress hormones. They are really able to deal with them very well and others are not. You're kind of making an atmosphere for your gut.

Starting point is 00:52:54 We're selecting gut microbes that thrive in an environment of distress. And those are not necessarily the good ones we see at least. least in studies now. So seeing stress as something unhygienic, I think is very accurate in that framework. And if you disinfect your hands, you're just making a lot of room. Suddenly everything here is dead. And whatever comes next, if you touch a funny rail or, you know, something from the air flies there, now suddenly has room. So if someone's sick and you're touching it or, you know, pretty sure you touch something dirty or so, you know, go ahead. But the most important stress, I think is not disinfecting your hands, but really looking out for your inner stress hygiene.

Starting point is 00:53:34 So we shouldn't be putting hand sanitizer on our hands like 10 times a day? Maybe not 10 times a day. I have to say, I really like my skin microbes. You should really wash your hands when you go home, when you touch your face in your mouth and so on before that. But other than that, I don't think it's so beneficial. You just select some creepy ones that don't care for the sanitizer. What's one sentence you want people to take away from this episode? I think really just the vitality and the wonderfulness of being alive. And it sounds so simple. But feeling this a little bit maybe makes it easier for you to, you know, do something for your body.

Starting point is 00:54:13 Just have your body. And I've seen so many patients when they were at the end of their lives, suddenly realizing their body is so genius, was so valuable. They had it all these years. And it's good to see that, but it's also a little bit late. I want people to feel that earlier in life. So that's not one sentence, but it's really what I would want people to take away. We always end interviews with the same question,

Starting point is 00:54:38 which is, what is success for you? Success is purpose rewarded by myself. It is that I know I did something purposeful, helpful, and I myself create the rewarding feelings, not people around me saying that was great or something. And that is the success that I feel most satisfied.

The Knowledge Project with Shane Parrish - How to Repair and Nourish Your Gut | Dr. Giulia Enders

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