The Wellness Scoop - How To Have a Healthy Gut

Episode Date: September 24, 2019

What is a healthy gut? How do I know if I have a healthy gut? What’s normal? We’re talking to Dr Megan Rossi from Kings College about bloating, gas, constipation, heart burn & reflux, IBS, food intolerances and so much more. From how to nurture your gut microbes to the impact of caffeine, alcohol, sugar, yo-yo dieting, high protein diets, exercise, restrictive eating, antibiotics and probiotics on our bodies; plus the extent to which stress affects our wellbeing, why fibre is so important and the practical solutions to understanding what’s going on in your body and how to feel better. Books: Dr Megan Rossi – Eat Yourself Healthy Earlier podcast episode – The Gut; Why it Matters, season 1 See acast.com/privacy for privacy and opt-out information. Learn more about your ad choices. Visit podcastchoices.com/adchoices

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Visit BetterHelp.com today to get 10% off your first month. That's BetterHelp, H-E-L-P.com. Hi, everyone, and welcome back to the Delicious Riella podcast. This is episode two of season four, and today we are going to talk about how to have a healthy gut. So it's one of those topics, I think, and maybe again, it's being a bit English. Sometimes we get a bit nervous talking about, but actually it's so normal to have some kind of tummy troubles, you know, whether that's IBS, bloating, heartburn, reflux, or just feeling kind of a bit lethargic and just not feeling amazing in yourself. And obviously also there's huge conversations at the moment going on about gut health, the gut

brain axis, the way that maybe our gut health links to our mental health. So it's quite a hot topic. And we did an episode right at the beginning of the podcast in season one with Dr. Megan Rossi all about the gut and why it matters to have a healthy gut. So this is basically version two of that. So we're completely honored to have Megan back with us today. We're going to do a little overview of why a healthy gut matters and the impact that it can have on both our physical and mental health. But there's so much detail in that first episode as well. So go back and listen to that if you can. So welcome back, Megan. Yeah, thank you. It's absolute pleasure.

Can we just start with this as a kind of quick overview of everyone's talking about gut health and sort of, you know, we've got fermented products and probiotics and everything here, there and everywhere. Why do we want a healthy gut? What matters about it? Yeah, I think one of the biggest misconceptions actually is what is gut health? You know, like you said, it's always in the media. Everyone's always talking about it, but what it is exactly isn't often explained. So gut health actually relates to the functioning of our entire digestive tract. So that nine meter long tube that delivers food from entry all the way to exit. Now that nine meter long tube is so important for many, many reasons. But if I was to really distill down the main reasons, the first one would be that if you don't have a good gut health,

then you're actually not going to be necessarily extracting all the nutrition out of the food you're eating. So I think a lot of us are very focused on what we're eating, but we don't really think about what happens after we swallow it. So ensuring we have good gut health will ensure we can really extract all that nutrition out. Now, the second element is our immune system. I think we spoke about this last time, but 70% of our immune cells actually lay along that nine meter digestive track. So if we want less sick days, we need to have good gut health. And then the third element, which really has brought the fame, I guess, to the concept of gut health, is the fact that we all have the trillions of microbes, mostly bacteria, that live in the lower part of our digestive tract. And this is what we consider like an acquired organ because we're not born with it. And the scientific name for it is actually our gut microbiota.

And it's this organ which is really, I guess, revolutionizing what it means to be human. So it's a major scientific discovery and that, you know, we're essentially more bacteria than we are human cells. And these bacteria in us can do things like talk to our brain, you know, look after our heart health, our kidney health, etc. So we actually need to start looking after them, those microbes within us. Okay. And that's what we're, that's what people talk about a lot when they're talking about gut health, basically. Yeah. Okay. So as you said, we're not born with that. So we obviously develop it and we can, I guess, develop it in a good way and not such a good way. And I wanted

to understand what is it that first of all, helps us develop it and how does that work? I guess particularly interested in that, thinking of Skye. But then also what then damages it? So our first, I guess, exposure to these microbes is actually when we're birthed. So what we see is babies who are birthed vaginally actually have a more diverse range of gut bacteria, which we think is probably better for their overall health in the future, versus those bubs who are delivered via C-section. Now, they're not exposed to as many gut bacteria during the surgery, the C-section, and therefore they don't tend to have as many

different microbes in their gut initially. But if that does happen, you can improve, I guess, the diversity of the bacteria, which is a good thing. That's what we want in us through things like breast milk. Breast milk actually contains live bacteria. So probiotics, and it also contains prebiotics, which is a food that feeds the baby's bacteria. So breastfeeding, again, is really, really good for helping the bub, exposing them to a wide range of the gut bacteria and feeding the good bacteria. Oh, my God, that's so interesting. Yeah, I know, it's crazy.

And then as the baby gets older, of course, food is going to really change the baby's bacteria. And we know, you know, there's heaps of bacteria in our environment. So actually getting the baby to, you know, play in a little bit of dirt and things like that, maybe not a young, young baby, but as they get older, you know, crawling on the floor, playing with puppies as well has been shown to help increase the bub's bacterial diversity. The baby's more likely to have better gut health and therefore lower risk of allergies, lower risk of getting obesity when they're older and things like that. Now, at around the age of three, that's when our gut bacteria have kind of normal normalized, so to speak. That's kind of what you're going to have as an adult.

It looks more similar to an adult. But then, of course, as we grow, we expose our microbes to so many different things. Again, if we travel to a different country, we're going to be exposed to different microbes there, to different foods, to fermented foods. They have some microbes in them. But then if we think about how we can do damage, then things like medications, antibiotics is a main one that people know about because it doesn't just kill the bad bacteria, it can also kill the good bacteria. So ensuring that you don't take antibiotics unless your doctor said you need to take them. But then other medications, things like sleeping tablets and

reflux medication. Now, some people actually do need them, but if you're taking sleep tablets because you're struggling with sleep and actually haven't worked on things like your stress or your sleep hygiene, which is something I talk about in the book, like a strategy to help with that, then I'd probably suggest you try those lifestyle factors before you just go to the kind of the easier fix with the medications. Similarly with reflux, some people definitely need to be on them for long periods of time. But if it's because actually you're having really high fat foods, you're drinking too much, you're really, really stressed, then actually, again, looking at lifestyle factors before you go to your medication. And I know in the book, Eat Yourself Healthy, which is what we're kind of, I guess,

using as the springboard today for some of these conversations, which is amazing. Everything she does is amazing. But one of the other things you talk about in there that damages it is dieting, which I thought was really interesting. And obviously we've had so many conversations and it's something we talk about a lot in Delicious Yellow and on the podcast is about trying to create a really kind of positive relationship with food and one that's really nourishing both your kind of mental health and your physical health and not doing those kind of swing yo-yo diets. But it's interesting to see that that's really nourishing both your kind of mental health and your physical health and not doing those kind of swing yo-yo diets. But it's interesting to see that that's actually then damaging your gut. Yeah, absolutely.

Any sort of restrictive diet we know can affect our gut microbes. Because when we go on these diets, often we actually have less dietary fiber, which is our gut bacteria's favourite food. And we can also tend to, you know, grab for things like the sugar-free products, which have a lot of different additives in it, which we think probably aren't very good for our gut microbes. So there's actually been some really interesting studies in animals where they've shown that through transplanting the poop sample of a mouse that's kind of yo-yo dieted into another mouse, the mouse who got that poop sample was more likely to gain weight. So we think that that yo-yo dieting does actually predispose us to, I guess, gaining weight faster, that regain cycle that happens in a lot of people who do dieting often. I've read a couple of things recently that I thought were really interesting about kind of, I guess, ultra processed food and the kind of stabilizers and additives

and E numbers, as you mentioned. And I know it's kind of quite early days with a lot of this research also because it's just early days in the research of the gut, but what's the kind of general thinking at the moment about how those can impact on it? Yeah. So there is so many different E numbers out there and we think that some are probably completely fine where others might have less of a beneficial impact on our gut microbes. And like you've said, it is very much early days. You know, me personally, I recommend if you can try limit the food additives, but I don't necessarily want people to fear them before we really understand, I guess, the extent of what happens in humans. I also have listeners to share some questions for you. So I've got a lot to come. This is a hot topic. But one question that I saw quite a lot, which is really interesting, just in terms of looking at, I guess, like popular diets at the moment, there got a lot to come um this is a hot topic but one question that I saw quite a lot

which is really interesting just in terms of looking at I guess like popular diets at the moment there's a lot of conversation around keto diets again we did talk about that in quite quite a lot of depth with Rhiannon Lambert last season so if anyone wants more information please go back and listen to that so now kind of nutrition 101 episode but there is obviously a lot of trend around these kind of ketogenic diets but we've also seen with like the Atkins diet and the Dukin diet and the general kind of obsession with a lot of animal protein and very very little carbohydrate which means obviously not very much fiber that's not brilliant for your gut then I'm assuming yeah it's really not and I think an important thing that not many people realize is actually yeah fiber is a type of carbohydrate and fiber is found in all our different plant-based foods.

The really cool thing about dietary fiber is that humans actually can't digest it. Its sole purpose is to feed the trillions of bacteria in your gut. So if you're cutting out these really important plant-based fiber sources, then actually you're starving your gut bacteria of their favorite food. And they're very powerful. If they are hungry, they will get hangry. And some studies have suggested they may start to eat away at the gut lining, particularly in the animal studies. So we want to feed them all the time. So although those diets in the short term can help people lose weight, what we're seeing is actually in the long term, they're going to regain that weight and, you know, they're at higher risk of things like heart disease, diabetes, et cetera. Because they're not looking after the body as a whole. It's solely a

kind of aesthetic thing. Absolutely. And our gut microbes, again, do things like talk to our pancreas, which is involved in diabetes, talk to our heart. So if we're not feeding them, they can aggravate those sort of diseases that may occur it's so amazing thinking exactly that the body it works as one and you can't see everything in isolation and so if people listening to this and they're thinking okay but how do I know if I have a healthy gut is there a kind of I guess a list of questions that we can ask ourselves things to be thinking about kind of I guess signs and list of questions that we can ask ourselves, things to be thinking about, kind of, I guess, signs and symptoms. Like how can we do a bit of a kind of assessment on how we're doing? This is a really great question because everyone always asks me, how do I know if my gut's healthy? And the thing is, there's no single one question

that will answer that. In fact, in the book, I've got 10 different assessments, which I get people to complete to really piece together the different elements of gut health. So things like, firstly, obvious ones, are you getting gut symptoms? Your poop. So checking in with your poop, which offers so much information of what's going inside you, both the consistency, the frequency, the color, et cetera. Now, a lot of people think, well, if I don't have symptoms and my poop is fine, then I've got good gut health, but that's actually not necessarily the case. Other really important aspects, like we mentioned, immunity. So are you always the one to catch the flu first? And if you have the flu, are you struggling to shake it? Your mental health, how happy are you? Your physical activity, are you moving frequently?

Your diet, how many different types of plant-based foods are you having? Are you on a restrictive diet because you think you've got a food intolerance? So there's so many different elements which I get people to pull together to start to get a better picture of, I guess, where they are on their gut health journey, because it is a progressing thing. So you talked about poop just then in terms of our assessment of our gut health. And I just wanted to bring that up. And Matt said, Ella, don't talk too much about poo, which is fair. I find bodily functions quite fascinating. Because they do offer so much information and people don't need to go and share it with the world. But I just think having an idea of what you're producing is really important. Exactly. And I just wanted to flag it. There was an amazing campaign. It was quite a while ago, but it was, you know, don't die

of embarrassment. And actually, you know don't die of embarrassment and actually you know these things are so human like we do all you know poo and wee and all the rest of it and it's it's just I thought it was a really interesting campaign because actually like what we take out every day does have a really interesting way of showing us how healthy we are and so I think I just wanted to flag it as though, you know, for people listening, like, please don't be embarrassed about it. You know, these are so normal. We all do it. And it can be so indicative of how we are in terms of our overall health. And as we've seen, all these things are so, so, so linked. So if you are struggling with energy, mood, etc, etc, it's worth having a look at these things. Absolutely. And then if something's not quite

right, and it's ongoing, then definitely always go to your GP. Because, you know, if we look at things like bowel cancer, it's actually the third biggest cancer killer in the world. And a lot of that could be prevented if people were diagnosed earlier. They don't want to go and say, oh, look, you know, I've got some blood in my stool or, yeah, my poop has gotten really runny or changed consistency and I'm feeling really bloated. So those sorts of things are always worth just chatting to your GP first, particularly if you're over the age of 50. So I wanted to now go through some common issues because I know that, you know, having some kinds of tummy troubles is quite common. And I was really astonished. I put up a question this morning on our Instagram stories, just saying, you know, does anyone have any questions for you basically on how to have a healthy gut but honestly within minutes there

were hundreds and hundreds of questions because having some semblance of bloating or IBS or indigestion is just so common and so I wondered if we could kind of I guess run through the sort of seven hot topics being bloating, gas again we're not going to shy away from awkward topics, heartburn and reflux, constipation, upset stomachs, IBS, and food intolerances. Yeah. So like you said, they are so, so common. And I think before we get into each of the individual ones, it can be really helpful for us to understand what actually happens to food when we swallow it. Again, we're quite fixated on what we put into our bodies, or many of us are, but when we swallow it, often people have no idea. And having an idea of what happens

can really help people in several ways. It can help debunk a lot of the myths out there about certain nutrients, particularly things like that sugar is bad for your gut microbes. It doesn't actually reach your microbes, and I'll explain more about that. And the other aspect is when people get gut symptoms, if they understand what's happening with digestion, they may feel a little bit more comfortable and understanding and accepting because sometimes people go, oh my God, what's happening? They freak out and that can actually be a vicious cycle, which worsens their gut symptoms. So if you think about that nine meter long tube, the digestive tract, there is essentially four elements to it. So first we have like a food pipe or known as our esophagus. And that's where food, after you've chewed it,

it zips down there. And then there's like a little trap door, which allows food to go from the esophagus into our stomach. Now our stomach's kind of like a washing machine. It really does throw our food around. It also has a range of different acids and detergents to kind of break down our food and kill off some of the bad guys that might be trying to get into our body. And then once it's kind of like a puree consistency, it makes its way into the third element, which is known as our small intestine. Very weird name because the small intestine is actually six meters long, so it's not small at all. Now, in the small intestine is actually where most of our nutrients get digested. So they get from our

gut into our blood and then go and feed all of our cells. So things like most of our protein, most of our fats, and most of our carbs get digested there. Now in that small intestine, the very high up part of it is actually where sugar is absorbed. So if we think about the fourth element called the large intestine, that's where the trillions of microbes live. Now, the sugar, like table sugar, for example, doesn't actually reach that lower part of the intestine, so it doesn't get to the bacteria. But of course, I don't want people to go and have loads of added sugar because that means

that they typically fill up on that sort of nutrient and therefore don't get in the fiber, which feeds the gut bacteria. But I think having an understanding that having little bits here and there is actually not devastating for your gut microbes. So like I said, the fourth component is where the trillions of microbes live. And some of the nutrients which don't get digested in the small intestine make their way into the large intestine. And that main one is the dietary fiber. And when the bacteria get the dietary fiber, they start to eat it. And one of the things they produce is a little bit of gas. Now that's completely normal. In fact, having that little bit of gas is actually a sign of a well-fed gut bacteria profile because the bacteria, when

they ferment it and release that little bit of gas, they produce a range of different chemicals, which can do things like talk to our brain, strengthen our gut lining, et cetera. So that's kind of the gut 101. So the first one, was it bloating? Yeah, bloating, because that was our most common question. Yeah. Again, it certainly is the most reported gut symptom. And if we think about bloating, I guess there's probably three different mechanisms we could kind of pool it as to understanding. So the first mechanism is around the food. I think this is probably what people often blame their bloating on, but it's not always the case. But if a large amount of undigested food makes its way into

the lower part of the intestine, the large intestine where the bacteria are, the bacteria are going to rapidly ferment it and release a lot of gas. Now, things that can trigger that is, you know, if you're having large amounts of some artificial sweeteners like sorbitol, xylitol, which is found in some protein bars and some chewing gum and things like that, those sweeteners aren't very well absorbed in the small intestine. So they make their way into the large intestine, the bacteria ferment them. So that can cause some of the bloating. Other things like if you actually have a food intolerance, so things like lactose intolerance, milk sugar intolerance is quite common in some populations, not in the

British population, more of the Indian and Asian populations. And that is when they can't digest the milk sugar lactose. So what it does is when they have it, it goes through the small intestine, not digested and makes its way into the large intestine. And that's where the bacteria start to ferment it. And again, that can cause, trigger the bloating. So there's many other things. And again, in the book, I've gone through all of the common dietary triggers, which can exacerbate bloating. So that's why I recommend people check that out. But the two other mechanisms are really, really common. And I think people don't realize how much of an influence they can have. The second mechanism is around if you've got a very tense gut. So if you are really stressed, often we tense our gut without even realizing it. And you wouldn't necessarily be able to feel that, right? No, no, absolutely not.

And what that can do is actually trap the gas in your gut. So instead of the gas being absorbed through the rest of our body and out through our breath or out through the back end, it can kind of get trapped in there and that can create some aggravation and that can lead the feeling of bloating. And then the third element is similar, but it has to do with the sensitive gut. Now, many, many people have a sensitive gut and that is actually related to stress. And what happens when you have a sensitive gut is even if you have a teeny amount of gas in your large intestine, which remember is a good thing, that actually triggers up to your brain via that gut-brain axis we spoke about in the previous pod. And what it can do is tell your

brain that there's a lot of activity in there. And subconsciously, it causes your diaphragm, your breathing muscles to push down and your external gut muscles to actually relax, which is why some people can get quite a potted belly. And they might not be pregnant, but they call it like an air baby. And a lot of that is actually related to that sensitivity of the intestine. So that little bit of gas from a range of different things they could have eaten, then triggers up via the gut brain axis and causes that expansion of the gut. And that's so often connected to stress. Yeah. So the last two mechanisms, so the trapped gas and that sensitive gut, you know, the main causes of them is literally stress.

Yeah. So, sorry, I'm really, I'm very excited about this because I think it's so interesting because we get so, you know, look, I'm the biggest advocate for plant-based food and for healthy eating. It's so powerful, but I just think we can get really obsessed with it. And so often people start to say, okay, I'm never going to eat this again. I'm never going to eat this again. And they get themselves into what can be a really negative cycle and totally take away the enjoyment of food and meals, which is such a kind of social thing as well in our lives. And you never want to get to that point and it's so ironic because it's actually being caused by stress and you're making yourself more stress and therefore you're making the problem worse and I just think it's so so so important that we focus on that kind of holistic view of our lives and not get so kind

of obsessed with every single thing we're putting into our mouths but see it in the context of the way that we're living and being happy and relaxing and taking time to do things that we like. Yeah, absolutely. I see it so often where people blame certain foods and they think they've got a food intolerance when actually that's quite rare. It's more of the fact that they are really stressed. So no matter what they eat, it's going to trigger the bloating. So things like, you know, diaphragmic breathing, which I'm sure you do in yoga all the time. And I've also got a gut-directed yoga flow, which can really help relieve any trapped gas and again, relax that gut-brain axis.

So I think we now have a lot of the evidence to support many different strategies out there that can really help relax the gut-brain axis and those stress levels. And I've seen it, you know, in clinic all the time that really without touching diet, people can dramatically improve things like bloating by relaxing that. Yeah, we did another episode with Dr. Chatterjee on stress last season, which again, please listen to if you haven't, it was so interesting. And he was saying exactly that about the effect of stress, not just on IBS, but on a whole humongous range of issues, you know, including things like diabetes, which I found so interesting. I had no

idea about that link. And that actually, this chronic stress that we live in now, which is so normal in our modern society, and we almost don't even realize we're living with it, is actually having such a devastating impact on our physical health, and that we've got to have such a big focus on that and not just on our exercise and what we eat and also on the fact that sometimes we make it so much worse by then getting stressed about what we eat or you know getting up at 5am and doing a really high intensity workout to try and make our stomachs look better but actually what you need is sleep and calm and the polar opposite of what you're doing yeah absolutely if we talk about constipation actually doing those really high intensity workouts for people who are prone to constipation early in the morning actually can make them less

likely open their bowels and therefore make their constipation worse. So yeah, it is really about kind of looking at that balance. Let's take constipation as our next hot topic, because again, it's really common. It's so common it costs the the nhs like millions and millions of pounds every year and other kind of key reasons again like the bloating and kind of key things that we can look at to help us yeah so again similar to the bloating and when it comes to constipation it really needs to be a personalized approach and again i'm not talking to refer back to book but that's why i've got the flow diagrams which asks people like like a range of different questions. So we find out firstly, are you having the basics? Are you having enough dietary fiber? Because that can help keep you ready. And how much is that? your seeds, your legumes, your fruit, and your veg really can help stimulate the bowel to have

a bowel movement. And I think when we talk about fiber, we just think of this one nutrient and go, oh, you know, I get my fiber from vegetables. I don't need to have any whole grains. Well, actually there's close to a hundred different types of fiber and each fiber does different things in our body and feeds different bacteria. So we need that diverse range from each of the food groups. So yeah, when it comes to constipation, looking at the fiber element and also the hydration, are you getting enough water? That's kind of like the basics. We want to make sure that you are getting that.

Most of us are not getting enough fiber. Is that correct? Yeah. So in the UK, I think around 10% of us are reaching that 30 grams and the other 90% aren't. So that can be a really common one. But often when I see people in clinic, actually they are reaching the fiber. I think in, you know, our younger generation, there's, you know, a lot of people are having quite a lot of fiber and they're kind of like, well, why am I constipated?

It doesn't make sense. And that's where other elements come into it. So things like your pooping technique. So often we're not positioned in the right way and we're also not pumping our gut muscles in the right way when we're pooping and that's actually preventing the poop from coming out. So again in the book I look at different ways that people can improve their pooping position and how they push their poop out and that alone for some people can be enough to completely resolve their constipation.

When we look at other elements of things like exercise, I mentioned before, if you do really high intensity exercise in the morning, it can actually prevent the poop from showing because our bowels can be really sensitive. And if we're doing like this really, really high intensity workout, what happens is the blood draws away from our gut and goes to our muscles. And therefore, our gut doesn't really want to move. And there's other things like really making the most of our natural gut movement. So in the morning, we have this big push called the mass movement. And that can help push the poop out. Now, adding a little bit of caffeine with that and a meal that contains a little bit of fat and carbohydrate, again, can further support that mass movement and make it that little bit stronger. So there's so many different elements that can help. Things like actually kiwi fruit. Two kiwi fruit a day have been shown in clinical

trials to actually improve people's frequency and people who have constipation. Wow. Yeah. So I know I've chucked a lot of different strategies out there. But what's powerful, I guess, is in all of these things, coming back to the fact there's actually so much that we can do ourselves, little easy things every single day, which I definitely found really empowering. So moving on to our other hot topics of today, we've got kind of excess gas, which I think we've kind of touched on, but we also had heartburn and acid reflux.

And then I'd love to kind of get onto IBS and food intolerances. Yeah. So just quickly on the gas, I think people need to accept that actually we all pass wind. In fact, 10 to 20 times is normal. It's considered normal. But for some people, it's not just about the frequency. It's more about the fact that it's really, really stinky and they're quite embarrassed because they might not be able to hold it back. So actually identifying what element is making you uncomfortable or making, you know, I guess your quality of life worse is really important to ensuring that the strategy is right for you.

For example, if you struggle to hold it back, there's actually some really helpful pelvic floor exercises that can help strengthen your anal sphincter, so the lower part of your butt muscles, and that can help actually keep the wind in if you're in a meeting and you need to hold it in, in that scenario, then having those exercises can strengthen those muscles to allow you to do that. If you're outside, I think let it go. But there are social situations where we need to kind of keep it in so those exercises is important for those who are bothered by the fact they can't hold it back then there's other things like the smell I'm sure people who or anyone who's followed a really high protein diet

will know that that can trigger really bad smelly gas and that happens when like I said before the protein mostly gets absorbed in the small intestine. And some types of the animal protein, the bacteria ferment and release sulfur, and that can be really quite smelly. So that's why if you're having a really, really high protein, animal protein diet, then you can have quite smelly gas. So cutting that down a little bit. And again, that's another strategy we talk about in the book to assess how much you're having and if you're having too much. And then what's the main cause of heart burn and reflux then? Yeah. So if we think about what it actually is, so like I said, we've got that food pipe around our esophagus and there's a little trap door on it that prevents the stomach acid from going back up. Now in certain situations, actually stress is the main one. When you are

really stressed, that's going to squeeze the stomach muscles and actually push that trapdoor open, allowing some acid to go back up. And your esophagus is actually really, really sensitive. Your stomach can handle the acid, your esophagus can't, and that causes that burning sensation that people can experience. Some people have structural issues and therefore they need to see their doctor and some people get surgery or they do need medications. Other aspects, things like caffeine, alcohol, spicy food and fatty food are also common triggers for people because what that does is put more pressure on their stomach and then pushes that flap door open. So there are, you know, a range of different diet strategies you can look at, but also things like we mentioned

the stress. Lowering people's stress over time can be enough to help with their reflux and heartburn and they get off medication because of that that's amazing yeah when i was sick i had really bad reflux and i was on medication for it and i was really determined not to stay on it yeah and um it was really amazing kind of changing my lifestyle as a whole not just my diet my diet definitely had a really big impact but exactly getting into yoga and meditation and kind of calming yoga as well it was so powerful the effect that it had because gut health was like one of my biggest problems I look like I was I forgot a picture when I was pregnant with

sky and a more my stomach is more distended when I was sick with all these issues than it was when I was six and a half months pregnant yeah which is extraordinary and it was yeah diet did help but it was also yoga and things like that, just kind of taking down the tempo made all the difference. And the thing is, people don't need to go to a big yoga class. It's about small little things they can do at home in their bedroom. Yeah, I didn't go to a single class to start with. I did it all online and then using kind of meditation apps and things like that,

just like little bits here and there. I think it's also important for people to realize that these changes don't happen overnight, like as obviously you've experienced, like particularly when we're trying to relax that gut-brain axis, it can take, you know, 12 weeks before we start to see a benefit. And I think that's why people get a bit frustrated with it. They go, oh, it's not working. Well, actually, you're shifting quite a big thing in your life, that gut brain axis, that really sensitive one. Therefore, it's going to take some time. It took me months, if not like a couple of years to genuinely see a difference.

So our other kind of hot topics of today were IBS and food intolerances. And I guess, I think it'd be interesting to understand from your perspective, what is IBS? Obviously, we hear about it a lot. It's super common. How does it differ to all the things we just talked about before? I know they all come into it, but what's the difference between just having some bloating and actually having IBS? I think we're very quick to jump on, oh, I'm intolerant to this, I'm intolerant to that. But how do we know that something's an intolerance, not just a kind of gut not being in a great space kind of thing or stress actually causing the problem? Yeah, that's a really great question. So I'll try to break it down. There's a lot in there. of kind of gut not being in a great space kind of thing or stress actually causing the problem?

Yeah, that's a really great question. So I'll try to break it down. There's a lot in there. So firstly, irritable bowel syndrome or IBS affects around 10 to 15% of the population. So it's really, really quite common. And what we see is that, you know, historically, we didn't quite understand that we thought it was really just someone who had a grumpy gut. But now the research has evolved quite a lot to understand that the underlying mechanism is a dysfunction between the gut and the brain. So like I said, our gut and brain is constantly speaking. In irritable bowel syndrome, that communication is dysfunctional. And how we diagnose it, there is actually a strict diagnostic criteria. So if you think you have irritable bowel syndrome, the most important things always go to your GP because they can rule out things like celiac disease and inflammatory bowel disease.

Now, it's important to rule out them because a lot of the symptoms can overlap. So you don't want to be saying, oh, it's just IBS when actually you have celiac disease and even a hundredth of a slice of bread. So even a teeny crumb, if you have celiac disease and even a hundredth of a slice of bread, so even a teeny crumb, if you have celiac disease, can actually do long-term damage. So you really, really want to make sure that it's not one of them. Then if your GP has ruled them out and you have stomach pain at least one day a week, and it's an ongoing thing, so it's lasted for at least six months, and that pain's related to your pooping in some way, whether it gets better or worse when you poop.

And that's actually the criteria for irritable bowel syndrome. So a lot of people I see actually have funky stools and bloating, but they don't have any pain. And therefore, they probably have what we call another functional gut disorder, which is like this big umbrella term where IBS actually fits under it. But they don't actually have IBS. They probably have functional bloating. And there's also functional constipation, functional diarrhea. So it's all these different conditions which we come under this functional gut disorder,

I guess, criteria. And I know that sounds a little bit sciencey, that functional word, but what it means is structurally everything looks normal, but the function isn't quite right. So things like how your gut moves, how the enzymes are released, and obviously that gut-brain axis, which really triggers the movement, et cetera, is dysfunctional. So that essentially is what irritable bowel syndrome is. And we do know that there is a clinical diet which can be really beneficial and helpful in the short term for irritable bowel syndrome. And probably a lot of listeners have heard of that, which is a low FODMAP diet, but they're so, so important to be aware of that actually following a strict low FODMAP diet should only ever be done for four to six weeks because it's a very restrictive diet and it's

not good for your gut bacteria because it actually deprives them of a lot of their favorite foods. But it's just a short term diet that we give people to give them a bit of gut rest. That's really interesting. Because again, I think people feel like a low FODMAP diet is something to have forever. And I know we get loads of research questions like, why don't we have lots of low FODMAP recipes? And for me, that's what I've always understood as well from you, is that that's why it's because it's something to do one-on-one kind of not a sort of willy-nilly thing but then also it's not something that you're doing for the long term absolutely and it should only be done with a FODMAP trained dietitian because it's a very risky diet people should

only only ever do any of this sort of stuff for their diet if they're targeting that underlying gut brain axis by doing things like the mindfulness and the gut directed yoga flow I see in clinical practice all the time if people just do the low FODMAP diet don't worry about the mindfulness strategies then they try and reintroduce they can't reintroduce because the symptoms come back because they haven't fixed that underlying cause which is that dysfunctional gut brain access it kind of comes back to what we talk about all the time i mean not just with this but that it's all about that kind of 360 holistic approach isn't it and it's we all myself included who doesn't want like a quick fix a silver bullet like a magic answer to

do this this and this and all your problems will be solved you'll be happy and healthy forever and ever but it just it just doesn't work like that does it like we you've got to be living in a kind of I guess a slightly calmer more nourishing slightly more holistic view to create that kind of health and happiness and and that's that's hard and it is slightly counter intuitive to the way that modern life is is designed it feels like where you know it's so normal to rush around and and be so busy 24 7 be-7, like fitting everything into any one day. Both, you know, yeah. So you go to get up really early,

go to a high intensity class, work a really difficult job, meet all your friends after work and this and that. And you think you're doing all the right things, but you're just burning out and then you're having these issues. So then you cut this out and cut that out and it just gets more and more stressful.

Yeah, and that vicious cycle happens. And actually, you know, Ella, that's why I've written the book the way I have, to be like a very practical action-based plan because people live all these really, really busy lives and it's not practical to say to people, okay, you need to stop working, you need to go on these yoga retreats because that's never going to happen.

No. But literally five minutes a day, then working up to 10 minutes a day, just looking after your gut through the different strategies can have a huge impact in the long term. And you know, everyone's got 10 minutes a day. You know, even if we don't like to think we do, it's about prioritizing because your health, you know, is essentially in your hands. It just takes that little bit of time. Yeah, it's true. It's funny you say that because since having Sky, I've noticed that so much, like my priorities have definitely shifted a bit because obviously your time is more precious and you want to be able to focus it on her and you realize i think i've realized how much time i've wasted even though things have been so busy yeah

i do waste a lot of time just like scrolling you know mindless scrolling we all do it hey oh my god completely but it's been interesting i've kind of checked it on myself quite a lot um so that our last buzz topic of day is food intolerances and i But it's been interesting. I've kind of checked it on myself quite a lot. So our last buzz topic of today is food intolerances. And I guess they're very common in the way that we talk about them, but how do we know what's actually a food intolerance and what's just kind of, I guess, stress or not looking after our gut properly in some capacity? Yeah, look, food intolerances, again, there was a study which suggested around 20% of people thought they had a food intolerance, which then leads to a lot of restrictive eating. And what we see is those who have a restrictive diet are less likely to have healthy bacteria.

So it is, again, that vicious cycle. In my clinical practice, I go through this process called the 3R method to help identify whether someone really does have a food intolerance. Because the thing is, none of these online tests are valid for assessing food intolerance, which is just such a shame. I wish there was an easy way to assess them, but there just isn't. The exception to that is actually lactose intolerance, milk sugar intolerance. There is a breath test you can do for that. So the other test, you actually boringly have to go through this 3R method. So it is about recording what you're eating alongside your symptoms for about a week or two. If you identify that there is a link between a specific type of food and your symptoms, you would then go through a period of two to four weeks of restricting it. And then the

third step, which a lot of people don't do, but it's so, so important is actually reintroducing it to make sure that if you did see any benefit during the restriction stage, reintroducing that food actually will trigger it and it's not just a chance finding. And that's kind of a very robust method to identify whether people have a food intolerance. this 3R method safely at home without being overly restrictive, looking at things like wheat intolerances, gluten intolerance, and lactose intolerance, which are kind of like the three most commonly reported. And what I hope is actually a lot of people identify, actually, they're not gluten intolerant. It might be that they have irritable bowel syndrome or another one of those functional gut disorders. Now, I'm not saying that we should be having loads of gluten in our diet, but what we've actually seen is people who cut out gluten and they don't have celiac disease actually have a lower diversity of gut bacteria in their gut because they actually

end up probably having less grains and they end up having more of an overall restrictive diet. Now, it certainly doesn't have to be the case. You can have a gluten-free diet and have plenty of grains like quinoa, buckwheat, and have really good gut bacteria, but you're just at a slightly higher risk of not looking after your microbes if you are having a restrictive diet and it's unnecessary. That's so interesting. So I have asked you a lot of questions.

I have a lot of questions from our readers. I'm just going to pick out some of the favorites and some of the really frequently asked ones, if that's okay. Are there any foods you'd recommend after antibiotics? Because as you said, sometimes we need to have antibiotics. What can we do to support ourselves after that? Yeah. So there's actually really, really good evidence to take a specific type of probiotic throughout your antibiotic period and for a week after. And what the research has shown is that a specific type of probiotic can reduce your risk of antibiotic-associated diarrhea. So around 30% of us will get diarrhea when we take an antibiotic.

So that probiotic is a really good one to take. Now, the thing with probiotics, which is just really, really important to be aware, is that there's thousands of different types of probiotics and each type of probiotic actually does different things. Think of it like vitamin. If you have vitamin D deficiency, you're not going to go and take an iron supplement and think that's going to cure your vitamin D deficiency. The same with probiotics. We need to be very, very specific. And again, in the book, I talk about the specific probiotic prescriptions and the type of bacteria and other microbes you should take, as well as the dose and the duration for these different conditions. Now, when it comes to diet, you want to really, I guess, nurture the bacteria in there. So what I recommend is people trying to get in 30 different plant-based

foods a week. Now that sounds like a lot, but things like adding a teaspoon of mixed seeds to their breakfast, or, you know, instead of just getting the steamed broccoli getting the mixed vegetable pack will really help regrow a lot of the microbes because they all like different types of plant-based foods so getting that diversity in it's so funny because on the first episode we did together you mentioned trying to get 30 different plant-based foods a week and just to preface that that is um nuts seeds grains as well as fruit veg etc but my mum has been obsessed with it ever since you said it and like she like started writing it down and I've noticed myself doing it too and just kind of roughly checking you know did I have a range of stuff because it's super easy to eat the same veggies again and again you know like broccoli and sweet potatoes say which are two of

my go-tos but actually now I'm like trying to be like no buy the cabbage you know and then make like a slaw for example and things like that and then someone else is asking if you are you know struggling with bloating and you've got a big event are there any like kind of little things you can do then and there or in that day the next day to try and help yourself because obviously that can make people feel self-conscious absolutely so there are many different things chewing your food really well is actually quite important. People don't realize that digestion actually begins in the mouth because we not only physically break down the food, but we actually have the enzymes in our saliva, which start to chemically break down our food. So it helps with digestion, which means less food will enter the

lower part of the intestine where the bacteria are. So chewing your food really well. Peppermint oil capsules have been shown to be quite beneficial for some people with bloating because it can help relax their gut muscles a little bit more. That diaphragmic breathing can also really help. A heat pack can help as well because it diffuses and it kind of attracts more of the blood vessels to our gut, which can then help, again, relieve any tense gut muscles. Other things like having the smaller, more frequent meals can also really help. And yeah, I think a lot of people are having smoothies these days, and we can end up having quite large

amounts of fruit in these smoothies. Now, fruit is really, really beneficial, but the fruit sugar called fructose, a lot of people can't absorb large amounts at once, which is why if you have, you know, a whole punnet of strawberries or something, you know, people might get slightly more bloating or lose the poop. So, you know, still having, you know, three pieces of fruit a day, but having around 80 grams instead of, you know, the whole punnet at once can help prevent bloating for some. And so, yeah, again, spreading out. So on food and another really common question that's jumping up is a lot on like sauerkraut and kimchi and kombucha first of all

are these things worth the hype second of all how do you know which ones to have because i know like for example kombucha the whole idea is that it's fermented but then often when you buy it then in the supermarket rather than maybe from a smaller brand, it's actually then pasteurized. So is the benefit still there and likewise with kimchi and sauerkraut? Yeah. So there is so much hype around these fermented foods. And when we look at the clinical evidence, in fact, my research group just published a scientific paper reviewing all the evidence for things like kimchi, kefir, sauerkraut, et cetera. And there actually isn't a load of scientific evidence for it. However, I actually am very pro it because if you think historically, our ancestors have been having these fermented foods for thousands of years

and associating them with benefit. But the thing is, it's not going to be, again, a quick fix. I don't think people should be paying like 10 pounds for a teeny little pot of sauerkraut. It's super easy to make. Again, in my book, I've got the recipes and I know Ella, you've probably got recipes online as well if people want to have a look at them. And yeah, so I definitely recommend people try start to include these fermented foods

in their diet, but they don't need to necessarily have them to have good gut health. So don't be obsessive about having them. I personally have kefir every day, and that's probably the type of fermented food that has the most clinical evidence for it. And it's really, really easy to make. It literally takes two minutes. So when it comes to a lot of the commercialization of these foods, they do pasteurize it. So they kill a lot of the good bacteria. However, when the bacteria are fermenting the different drinks or whatever they're having. So for example, kombucha is fermented tea with sugar in it. So the bacteria actually start to ferment that sugar

and they produce a range of different organic acids, which can actually be quite beneficial. So even if they do pasteurize it and heat it and kill the bacteria, it still does contain some of those organic acids. Just kind of, I guess, summarize all the amazing information that we've gone through today, as we've seen, it's super common at some point in life to struggle with your gut in some capacity. What are the three things that we should be thinking about in terms of having a healthy gut and looking after ourselves? So I think one of the main ones is around taking 10 minutes each day to help relax that gut brain axis. It is just such a powerful strategy that I see

work time and time again for people who are struggling with gut issues. Whether it's something like mindfulness or a little bit of gut-directed yoga flow, literally just starting the day with 10 minutes. If you don't have 10 minutes in the morning, then the end of the day is also really beneficial. The second one is if you're having these symptoms and they're ongoing and they're really quite burdensome, you shouldn't have to live with it. Don't suffer in silence. Obviously, the first thing you should do is go to your GP to rule them out, rule out things like the celiac disease and the inflammatory bowel disease, et cetera. But then also ask for a referral to a dietician through the NHS. You should get it for free. Or if you can afford it,

then go and see a private nutritionist or dietitian. Or I really do hope there's a lot of practical and easy to implement strategies in my book, which I hope people kind of see as a first line before they then feel like they need to fork out a lot of money to go and see someone privately or wait the six month waiting list in the NHS. Three would be around not restricting your diet. Now, I know that can be really hard when you think, oh, look, chickpeas make me bloat. I'm just going to cut them out. But actually, it's important to still include small amounts. And over time, remember, your gut will adapt to that. So for a short amount of time, you might need to cut down on your plant-based foods, but it's really important to

reintroduce and have small amounts. Some people start with just one tablespoon of chickpeas and have that every day open up a can and then over a couple of days they you know have the one tablespoon second week they might start to have two tablespoons etc and they build up to having you know half a cup at once don't cut them out because you know in the end you're actually starving those gut bacteria who are so important for your overall health and happiness and you know that's not just me saying it but all of the scientific evidence has is suggesting they are so important yeah I mean honestly my biggest takeaway from everything you've said is that it's such a a long-term view don't look at what's happening today look at you know what's happening in the long term but be about the whole way that you live it's normal to have gut problems but there's also fixes for them but you've got to look at your

your whole life and not just the way you're eating and um I always feel a bit bad saying that because it's it's harder to do but it's so worth it isn't it it is it really is so Megan honestly we we cannot thank you enough for giving up your time again to come and talk to us. We're quite obsessed with your work. It's just absolutely amazing. Megan's book, Eat Yourself Healthy, came out last week. I'm not just saying this, but it is genuinely really, really good. I think it's very sensible and also feels very doable, which is obviously the main thing because we don't want to make our lives too difficult. And thank you guys so, so, so much for listening. We will be back again next week. Cannot wait. And have a lovely week, everyone. like yourself with podcast advertising from Libsyn Ads. Choose from hundreds of top podcasts offering host endorsements or run a pre-produced ad like this one across thousands of shows

to reach your target audience with Libsyn Ads. Email bob at libsyn.com to learn more. That's B-O-B at L-I-B-S-Y-N dot com.