Well with Arielle Lorre - 63: Dr. B the Gut Health MD - All Things GUT HEALTH!

Episode Date: July 1, 2020

In this episode I talk to Dr. Will Bulsiewicz, also known as The Gut Health MD, about what exactly gut health is, why it's so important, and why we are seeing so many problems associated with the gut today. We talk about the damaging effects of physical, emotional, psychological and sexual trauma and how that affects our guts long-term; why restricting foods causes dysbiosis; how to train our guts like a muscle and be able to incorporate a wide variety of foods into our diets; the pitfalls of modern trendy diets; SIBO, parasites and candida and what supplements are helpful. www.blublox.com/BLONDE for 15% off plus free shipping! Produced by Dear MediaSee Privacy Policy at https://art19.com/privacy and California Privacy Notice at https://art19.com/privacy#do-not-sell-my-info.

The following podcast is a dear media production. Hey, welcome to the Blond Files podcast. I'm your host, Ariel Lori, and I'm here to talk all things wellness. From how to achieve optimal health and well-being to the best beauty tips and everything in between, no topic is off limits. I know there is so much information out there, so I'm here to help you navigate it all and live your best life. Thanks for listening.

Let's get into it. Hey, everybody, welcome to the show. If you have followed me for any amount of time, you've probably heard me talk about gut health. So many of you have had issues around this, but there's also a small percentage who don't really know what it is and why it's important. So this episode is for all of you. I am talking to Will Bullsewitz, the gut health MD, about what it is, what it affects, why it's so important, why we are seeing more problem. today than past generations, why restriction is damaging, how to train our guts like a muscle to be able to eat a diverse diet. And we also get into identifying sensitivities, various trendy

diets, issues like SIBO and Candida, and we also talk about supplementation. So Dr. B is a graduate of Georgetown Medical School. He did his training at Northwestern. And he's board certified in both internal medicine and gastroenterology. And he's also an avid published researcher. So he's a smart cookie. Most recently he published the book Fiber Fueled, which is now a New York Times bestseller. And it is a must read. So this is a really fascinating conversation that will totally change your perception of gut health and how to achieve it.

even my husband who could not care less about this stuff was really fascinated by this episode. So that's the stamp of approval. Anyway, enjoy. All right. So welcome Dr. B. I'm not even attempting your last name. Sorry, it's a Monday thing. No, it's all good. It's all good. Everyone calls me, Dr. B. This is what my patients call me. That's what I am in my clinic. And so I like it. I love it. Okay. Dr. B, the gut health MD. That's right. It's got a little ring to it. Yeah. Amazing. Well, thank you so much for coming on. This is such a hot topic. And it's something that I know my audience is like just dying to hear about. So we have a lot, a lot to get into. Why don't we just start out by having you tell us a little bit about your background and your training? Yeah, happy to. So, hey guys, it's great to meet everyone at home listening to this episode. I am Dr. Will Bolsowitz. I am a gastroenterologist. And I have a practice in Charleston, South Carolina. Carolina, where I live with my family. So the story with me is that I am traditionally Western trained. I went to med school at Georgetown. I was at Northwestern for my residency, chief resident, and went to the University of North Carolina for my GI training, which in my specialty, many people consider that to be the top division in the whole country. And while I was there, I'm a nerd. I'll just tell you that up front. You

guys will learn that very quickly about me during this episode. While I was there, I was on a grant from the NIH, the National Institute of Health, and I studied epidemiology. And at one point, you know, at that point in my life, I considered myself to be a cancer epidemiologist. And I came to the end of my training in 2014 and I was faced with a tough choice, which was, do you become a clinical researcher? Or do you take care of patients? And because you can't really do both. And I just, I love taking care of people. And I love those relationships and helping to guide people to better health. That's what this has always been about for me. This is, you know, being a doctor has been my passion and my goal since I was a kid. So anyway, I finished my training and went out into the

real world in 2014 and happy to talk about sort of how my practice transformed through the years. But the short of it is that I actually became sick myself when I was about 30 years old. I was having a ton of professional success, but I wasn't feeling well. I was 30. I felt like I was 60. I had gained 50 pounds compared to what I weighed in high school, which is a tough pill for me to swallow because I was a three sport athlete in high school. And had high blood pressure, tons of anxiety, had like really shockingly low self-esteem

for a guy who was doing really well professionally and didn't really understand what the issue was and I tried to exercise my way out of it and that just didn't work even though I was like I'm such a type A so I was working out six days a week for more than an hour a day and I still couldn't lose the weight. And what I ultimately discovered when I met, believe it or not my wife,

we went on a series of dates and she ate different than any person I'd ever seen before. She ate plant-based. I'd like literally never been around anyone who was even vegetarian, let alone vegan. So I saw this and I saw her eating food that she loved. She was satisfied by it. She was eating in abundance. She was not restricting herself.

And she had complete control over her weight and she looked amazing. And it sort of set off a light bulb in my mind because here I was grinding out, you know, six plus hours of exercise per week and not getting anywhere on my weight. And it set off a light bulb, and one day I decided that rather than going to get fast food for dinner, I just went home and I made a smoothie. And I felt amazing and energized. And that motivated me to come back and try that again. And then I just started kind of leveling up in terms of my nutrition and making healthy substitutions, dropping soda and replacing it with water, taking the cream and the sweeteners out of my coffee, stuff like that. And next thing I knew, the fat was just melting off my body. and my blood pressure normalized and my anxiety went away and my self-esteem and self-confidence

started surging and I got to feel like the person that I feel like we should, you know, I became the man that I should feel like as someone who's in their 30s. And so I had such a radical transformation that I needed to know like, is there any science to back this up? I mean, like I told you guys, I'm a nerd. And so I turned to the medical literature. or thinking there's no way there's anything because I mean I trained at these top institutions how how come I haven't heard anything about nutrition and I was shocked when I found thousands of studies what are we thousands like great studies and so I started devouring this stuff and I brought

into my clinic and I saw my patients having radical transformations people with iro bowel syndrome that were going like basically curing themselves people with all sort of colitis that were coming off of medicine. And it was so profound that I did something that is completely out of character for me. I, like this is weird. Many people know me for my Instagram account, the gut health MD. But like, I can't stay in social media. I really don't like it. I would rather be talking to a real person. But I felt so compelled to share the story that I started a social media account in 2016. And one thing went to another. I had a podcast episode in 2018 that went viral. And that showed me that, you know, people were like really reacting to what I was putting out there.

And then I felt compelled to like, okay, you know, you got something cooking here. What are you going to do? Are you just going to be a podcaster? Or are you going to step up to the next level and like really organize and structure this message in a way that people can like actually change their lives with it? And that to me was writing a book. And that's why I decided to do. So I made that decision back in August of 2018. and I basically worked every day, most of the time from 5 a.m. to like 7.30 in the morning. That's when I did most of my writing. And I did that. And the book finally launched May 12th. And it's called FiberFueled. And it was an instant New York Times USA Today and publisher's weekly bestseller. And the best part about it, honestly, Ariel, is that I'm getting these messages from people from around the world. And like when they,

call it to me and said, you know, the words that I think any author hopes to hear one day, you're a New York Times bestseller. I was just like, I was like, okay, I don't even know what to do with that. Like, I'm not even sure what to make of that. But when I get these messages from real people who have been suffering and they tell me how they're feeling so much better, they're losing weight, they are coming off their medication, that I know what to do with. And I celebrate and I feel amazing and excited because that was the entire point of the book. So now here we are. Okay, guys, I am on my phone and or computer for way too many hours a day for work and school. And this can cause a lot of issues for me, namely anxiety, agitation, and eye strain.

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they donate a pair of reading glasses to someone in need. So you're not only helping yourself, but you're helping someone else too. So again, you can go to. to blueblocks.com slash blonde. That's B-L-U-B-L-O-X.com slash B-L-O-N-D-E. Or use the code blonde B-L-O-N-D-E for 15% off. Hey, girl, hey, welcome to Taste of Taylor, my weekly podcast. I'm your host, Taylor-Strecker. You might know me from Sirius X-M radio. I mean, I was there for like 12 years after all. but then Howard Stern allegedly got jealous to me, so I had to leave. I was actually able to pull myself up by the bootstraps and start my own podcast, Taste of Taylor,

which is now officially with Dear Media. I'm so excited to say that. So I promised you in this podcast you're going to either learn about something. You're going to be inspired by someone that's like always coming from a perspective of like humor. Then this is the place for you. I hope you enjoy this little snack. Amazing. Well, such an accomplished.

and there's a lot there that I want to unpack, but I'm curious, like, why to go back to something that you said earlier, you said that there were thousands of studies. I'm curious why this more kind of holistic approach to health and specifically gut health is more of the exception and not the rule. So I have, in my own experience, I've gone through gut issues, which kind of climaxed around three years ago where, I mean, they were just so acute. It's so overwhelming, and I was working with one of the best gastroenterologists here in L.A. and Santa Monica, and I love and adore him, but for a year, we were just throwing steroids and all these different medications at it, and diet was never mentioned even one time. So I'm curious with the studies

and the evidence to support this, does it just come down to money and drugs, or? What is your opinion? I have a theory. So this is what I think. The problem is this. Anytime you set up a system, it starts to take on a life of its own and you can't just walk it back. Right. So like Bill Gates created Microsoft back in the 80s and the idea of Microsoft took off into something that you can't just like transform Microsoft into something totally different now.

Windows is Windows. We all know how it works. Right. So, and that's true of our health care system. system. You know, what I see is this. We came back from World War II and we had just discovered penicillin. That is the biggest invention from a healthcare perspective of the last 100 years. I don't care what else they invent. That has added literally years to every single one of our lives. All the top killers were infections up to that point. So when you find a discovery of that

power and magnitude, you get seduced by it. You're just like, whoa, this is incredible. Look at what we can do with a pill. Can you imagine it being the 1950s and you discover that you could like transform a person's health with a pill? You know, to us, we're not enamored with that idea anymore. But like back then, that was a radical thing. Right. And they doubled and tripled and quadrupled down.

And I understand why they did that. And what you ended up doing was creating a health care system that is entirely reliant on pills and procedures. and there is no healthcare system in the entire planet that is as good as ours at acute care, meaning that like if I get COVID-19 and crash, we have the best hospitals with the best doctors to give me the best fighting chance to stay alive. But what we lost in that process of becoming seduced with the pills and the procedures is we completely lost sight of prevention because pills and procedures don't do that.

We lost sight of the root of the problem, which is diet and lifestyle. And, you know, now here we are and it's hard to walk it back. And, you know, medical schools don't provide the education that doctors need. And then doctors go out into the workforce and they're not actually paid to do it. Right. You know, there's tons of people who, there's tons of doctors here in my community in Charleston, South Carolina, who think I'm an idiot for spending time on nutrition with my patients. You know why?

Because I, it certainly costs me six figures per year, for sure. because I could spend half as much time with my patients and see twice as many people, but instead I'm having conversations that I'll get paid for. And that's how many people look at it. And I think that's unfortunate because to me, it shouldn't be dollars and cents. We shouldn't be viewing patients as receipts. We should be viewing them as real people. And if that was someone that you loved and cared about,

you should be giving them everything that you got to try to help them. That means diet in nutrition. Do you foresee a shift at all, or is it just too hard to tell? Because it does seem like more people are kind of waking up to this idea that our health care system treats symptoms and doesn't necessarily address root causes. The patients are demanding it. So if the patients demand it at some point the doctors are going to have to change or else they're going to hurt themselves. And what you see is there are movements that are underway in this direction. One is the functional medicine movement.

And another is the American College of Lifestyle Medicine. And these things are rapidly growing. Now, these are not the doctors who are five years from retirement. Those doctors, I mean, like they're not, they're coasting to the finish line. But the young doctors are like, yo, this is important. We can't be ignoring this anymore. And the conversation has gone mainstream. And so any doctor who's paying attention to the mainstream conversations realizes that they need to be educated on these topics of nutrition because patients are going to be asking.

Do you think that it will be integrated into the med school curriculum at any point? I think I heard somewhere that it takes like 30 years for things to reach the curriculum. There are some schools that are starting to integrate it. Let me give you an example. when I was at Georgetown. Okay, so part of the issue here, Ariel, is we need a cultural shift. We need to have doctors taking this stuff seriously. But the problem is that the education of our doctors occurs in the hospital.

That's where I was trained. I was trained at Northwestern working in that Chicago hospital right off of Michigan Avenue for three years. And so that's acute care. These are the sickest of the sick patients. And in that setting, like I think diet, and nutrition still is very important, but it's not quite as important as it is for prevention. But there are some things that are happening.

I went to Georgetown for med school, and they have a culinary medicine elective now, where they're actually teaching doctors how to cook so that you can talk to your patients about how to cook meals. That's encouraging. So, yeah, totally. I mean, I have friends, like I have a friend who's at the University of Chicago. His name is Ed McDonald. I actually featured him on my social media about two weeks ago with everything that's happening and with the Black Lives Matter movement that's underway.

I wanted to bring forward my friend because he's at the University of Chicago and he's basically going into neighborhoods on the south side, going into churches and going and talking to these people about diet and lifestyle because he thinks it's important and that's where he grew up. And I think that that's so commendable and amazing. And you would never know that he's doing that because he doesn't have the powerful voice on social media that other people do. And that's why I felt compelled to amplify him. Right. Yeah, I saw that. That is amazing. Okay. Well, let's get to the issue at hand today, gut health. So why don't we start by defining gut health? Because I think a lot of my audience, a lot of my audience is really into all of this, but I do have probably a small percentage

who don't even quite understand what gut health is, why it's important. And I often get the question, well, how do I know if something is amiss? So why don't we start just by kind of defining in general, what is gut health? Sure. Yeah.

And this is, you know, to me, this is what I'm so excited about bringing forward with my book Fiber Field, which is this conversation about gut health and how we can manipulate it. You know, gut health, when we talk about this, I want people to understand that we are these humans. You know, I'm this big six foot four guy. But covering me from the top of my head to the tip of my toes are these invisible microbes that the human eye can't see, but they're there.

And if you like literally take a look, you know, for everyone who's at home right now, look at your thumb. And like literally on your thumb, there are as many microbes as there are. are people in the UK. Okay, that's how many are there literally right now, but you just can't see them because they're invisible. They're microscopic. And the main place where these microbes live is deep inside of us in our colon, which is the large intestine.

In that place, you will find 38 trillion microbes, 38 trillion. Now, that is a ridiculous number. And it's so large that it's like this. if you had every single star within our galaxy, the Milky Way. You would need 100 Milky Way to equal the number of microbes that you have living inside you literally right now. They're there. And there's never been a moment in human history.

Go back all the way to the first human. There's never been a moment in human history where we were sterile. We've always had a gut microbiome. They've been a part of the human story from the very beginning. people think about human evolution we evolved with our microbes we rose and we fell together it was a buddy tail and because we evolved with these microbes through time and through evolution we learned to trust them and we trusted them with really seriously important stuff stuff that makes our gut this invisible i mean honestly i would call it an organ this invisible organ this invisible organ

it is the most central important thing to human health. It controls our digestion, which basically means our access to nutrients. But it also connects directly to our immune system. 70% of our immune system lives literally right there in our gut. If you're asking like, where does the immune system live in the body in the gut, talking to the microbiome literally right now? You can't separate them. It connects to our metabolism, you know, obesity,

diabetes, both connected back to the health of our microbiome, connects to our hormones. This is the reason why things like endometriosis, polycystic ovary syndrome, endometrial hyperplasia, endometrial cancer, ovarian cancer, breast cancer. All of these things have been connected back to the health of our gut microbiome. It connects to our brain. The gut is sometimes called the second brain, but your brain's best friend is actually your gut. They are talking to each other right now. a number of different ways that your brain can communicate to your gut and your gut can communicate to your brain and they affect each other and this is why damage to the gut is associated with anxiety depression Parkinson's Alzheimer's ADD autism and finally the gut regulates the expression

of our genetic code which is crazy because you know we think that our genes determine our disease that's not really true. our genes are more like a list of possibilities and it's our diet and lifestyle that ultimately determine the expression of those genes and we're learning more and more that these gut microbes are really critical and it's almost like they're in there pulling levers determining what genes are being expressed versus not expressed. So when you think about this it's like whoa hold up digestion the immune system our metabolism our hormones, our brain, our mood, our cognitive function, our genetic expression, that's like,

that's everything. That's literally the entirety of human health. If you can balance all of those things, then you are healthy. And this is why people have been talking about and shouting it from the hilltops for the last few years, how important gut health is to human health. And I sincerely believe, Ariel, that I don't think it's possible to be healthy if the gut is damaged. You need a healthy gut if you want to be healthy. And that's what my book, FiberFueled, is all about, is how do we actually make it happen?

What is the secret to optimizing our gut? And that's what it's about. And that's why I think it's honestly for everyone, because whether you are someone with digestive issues or immune system issues, autoimmune disease or trying to lose weight or hormonal issues, whoever you are, even if you're flat out stone cold healthy, this book is for you because this is so central to human health that we all should be taking care of it. Yeah, absolutely. And I want to, I'm curious why gut issues seem to be so prevalent today compared to past generations. I've been dealing with these issues. my brother is dealing with issues, my friend is dealing with issues, my cousin, like everybody

my age, it seems like, has something. Whereas my parents are like, oh, I don't even know. I've never bloated in my life. I mean, do you think it's just that we are more aware, like we're learning more, like you said, so we're more cognizant of it, or does it have to do with food quality or toxins or what is your theory on that? So, first of all, we need to understand. and how the gut is manipulated or changes, we are not necessarily just born with our gut microbiome and that we keep that gut microbiome the entire, like the rest of our life,

we have the ability to change it. In fact, things that you do today could change your gut by tomorrow. There were already be changes underway, literally within 24 hours. So this is not like somewhat locked in things, So what affects our gut? The food that we eat is the number one thing that can change the balance of the microbes

within our gut. But beyond food, it's also our lifestyle. Like, do we exercise? Do we get a full night's rest, eight hours or more? Do we spend time outdoors? Do we spend time being exposed to other humans or even to animals? all of these things play a role in determining the constitution and makeup of your gut. And if you think about, so I'm guessing that you and I are pretty darn similar in age that we were kids in the 80s.

Is that fair? Yes. So think about how much life changed for our generation compared to our great grandparents, like people who were around in the early 1900s. Right. When they didn't really have cars, when there was no fast food, that literally didn't exist. There's very little processed food. They didn't go out to the restaurant very often. They had all their produce sourced locally.

They probably knew their farmer. They knew the butcher. There was no antibiotics at all. There were no medications or very little medications. We certainly were not as dependent on medicine as we are today. they walked to school. They spent time outdoors playing, right? There was no television.

There was no video game. There was no phone. There was nothing to keep them up at 10 o'clock or 10.30 at night, like, you know, on Instagram. They, I would imagine, didn't have as much pressure on their day-to-day. So, like, I don't know. Maybe I'm wrong. Maybe I'm not sure. But I feel like there weren't some of the stressors.

that we have in today's world, because stress affects the gut too. And so if you think about how radically life has changed in the past 100 years, all of those changes, the changes in our diet, the changes in our lifestyle, the lack of exercise, the lack of sleep, the exposure to blue light late at night, the amount of stress that we carry, all of these things are having a negative effect on our gut. And it comes as no surprise that at some point those negative effects on the gut, when you damage the gut, at some point, it's going to manifest with disease. That's the reality of the situation. Not to mention antibiotic use, medication use. Think about the average Americans diet. The average Americans diet is 60% processed food. What is

that? That didn't exist 100 years ago. That's basically plant food where they remove the fiber and they keep the unhealthy parts. and our diet is 30% animal products where it's like they're cutting corners they're pumping these animals up with antibiotics and with hormones and then we are the ones who get fed that and it still has antibiotics in them all of these things are contributing and you know what we're missing is I said that the most important thing is our diet what we're really missing in our modern lifestyle is that our microbes thrive on fiber. The fiber that you find in plants is food for these microbes. They love it. This is their preferred food. They are as alive as you and I. They need

energy. They can't, like, if you don't feed them, they starve. And unfortunately, we've basically been starving them because the average American eats 15 to 18 grams of fiber per day. And that that's ridiculously low. The recommendation is 25 grams for women and 38 grams for men. And 97% of Americans are not hitting that minimal mark. So here we are and we have this diet that we have stripped of all the fiber and basically we're starving these microbes and then we blast them with antibiotics not only by pill, but even in the food that we eat contains antibiotics.

And I mean, we're just not supporting these microbes. the way that we need to. Right. Right. So one of the questions that I got a lot, and I think I'm, as I'm listening to you talk, I'm seeing it relate to a lot of questions that people ask so we can kind of just transition into those. But I did have a lot of people message me and say, I eat so clean. I don't eat, you know, X, Y, and Z, maybe some of the more common irritants. You know, I think the people who follow me are pretty health conscious. And a lot of people say, I eat perfectly. I eat clean. I, you know, I have this healthy lifestyle, but I still have gut issues. So I know that there are a plethora of things that could be causing that. And you kind of

just talked about them when you mentioned all the different lifestyle things that affect our guts. But what, what would you say to somebody if they came to see you and said, you know, I'm eating plant-based, I'm eating clean, but I'm, I still have these horrible gut issues. Totally. So this is something that I deal with like literally. I mean, I literally was dealing with earlier today because I was seeing patients and that's what I do for a living. So, you know, a person who comes to my clinic, I mean, I realized that I wrote this book all about nutrition. But when they come to see me for the first visit, I'm not necessarily just diving straight into nutrition recommendations and then ignoring everything else. You have to start with the foundation, which is what are we treating? A person who has digestive issues more than likely has damaged. to their gut, but I need to understand exactly what we're treating. Could this person have celiac disease? I need to answer that question. Could this person have chronic constipation and not realize it? You can poop every day and still be constipated. And that will make you miserable on a plant-based diet. So from my perspective, I start with an individualized, personalized investigation

to try to understand. You know, it's hard for me to sort of categorically give all the answers over the course of 45 minutes to an hour on a podcast, but I start with investigating to make sure that I understand what we're treating. And, you know, one of the things that I come across that I think is important for people to understand is that, number one, we need to be careful not to be sabotaging ourselves. You can eat really well, but if you're not sleeping, or if you're a shift worker, or if you drink a lot of alcohol,

you know, all of these things can be holding you back. so it's something to keep in mind. But the other thing that I think is really important to bring forward is that I tend to get these patients who have been everywhere. Like literally today, half the patients that I saw were a second opinion of some variety. And what I find many times is that my patients can try to do everything right, eat well, sleep, exercise, like follow the rules. And they still aren't better.

And that's because many times there is something that's holding them back. And it may be a disease, it may be a condition, it may be constipation or celiac or something else. But the other thing that is much more common than people realize is trauma. And if there's a history of trauma, whether it be physical, sexual, emotional, emotional, psychological, those things can manifest with long-term gut issues. and until that subconscious stress is dealt with, it will continue to manifest with GI issues, even though you do everything right.

And the same is true with a history of disordered eating, which can occur on a spectrum. We always think about classic, you know, sort of labeled diagnoses like anorexia or like bulimia. But disordered eating really truly is an unhealthy relationship with your food. And it can bridge an entire spectrum. room. And what I find is that many times after four or five visits, my patients get much more comfortable with me. They trust me. And then these things may come to the surface and they may talk

to me about a history of disordered eating pattern. And in that moment, once we have that conversation, it becomes clear to me, okay, now I get it. This is the reason why they're struggling so much, even though they're trying to do everything and they're doing it right. And this needs to be dealt with. and people that have these, you know, first of all, it's extremely common. We don't necessarily talk about it openly because it's been stigmatized, which is unfortunate. But having an unhealthy relationship with your food is a thought pattern that doesn't just go away. It's something that is managed on a daily basis by these people. And it can really hold you back.

And so for me, those are things that I'm thinking about as well. And my patients who are doing everything right, yet they're still struggling. I love that you brought up trauma because I talk about this a lot. I'm very open about my own history and I have a lot there. I mean, I was a hope to die drug and alcohol addict until a little over six years ago. And in that time, I experienced a lot of trauma, including like a big, big T trauma that I really only started dealing with a couple years ago right around the same time that my gut issues started happening. And I am that patient where I'm like, I'm doing everything right. I could not eat cleaner. I have a clean environment. I sleep eight or nine hours a night. I meditate. I'm active.

All of these things. And yet I keep having these issues. Like I'll get it under control and then it will crop back up. And I really got to a point where I was like, this is the trauma that I never dealt with manifesting. And it's so interesting because I, I've been doing trauma therapy with my therapist who I've been going to for a long time. And we do this thing where now I'm totally blanking on the name of it, brain spotting. I don't know if you're familiar with that. But it's like a way of processing out trauma from your body. And it's so interesting because when I have to kind of relive it in my mind while we're doing this,

she always asks me, where do you feel it? And I will never forget the first time I had this epiphany where I was like, it's in my gut. That's where I felt it, but, you know, it's like a whole, it manifested as kind of a full body tension, anxiety thing, no matter what I was doing. And I really am a big proponent of dealing with the emotional stuff because I, I know how much it can affect physical health. Yeah. No, I mean, I think that, by the way, thank you for sharing those things. And, you know, To me, when I hear about these types of experiences, it immediately opens up the way that I think about my patient where this is not an isolated digestive issue anymore. There's this second element or third element, however it may be, that needs to be dealt with. So if there's a history of dependence, that needs to be dealt with. If there's a history of disordered eating, we need a plan for that.

And if there's a history of trauma, we need a plan. for that too. And all those things need to, we need to acknowledge that there's no cure for that. And it's a daily battle that you wake up and you fight. And unfortunately, in most cases, you're the victim. Someone else imposed this on you. But you don't deserve to be suffering with that. You deserve better. And this is why you do it for yourself. As you wake up and you put up that fight to basically get control of those emotions which are living in the subconscious. I want to talk about SIBO because it's something that I've also dealt with over the years and I couldn't understand why it kept happening again because of my lifestyle.

And it's something that a lot of people asked me about. But I was actually told that because of the trauma, because of the stress, it was making me more susceptible. So is that valid? And maybe we can just tell people like a little more about what SIBO is for those who don't know and about treatment. Yeah, totally. So SIBO is, let me just preface everything by saying that SIBO is complicated. There's a lot that we are learning and don't know.

and it's a little bit tough because I feel like the cat is out of the bag or the genie is out of the bottle in the sense that the genie is already here. People are talking about SIBO and yet the doctors don't really fully understand it. And that creates challenges. So SIBO refers to small intestine bacterial overgrowth. It basically means that you have bacteria growing in your small intestine where there's really not supposed to be. They're supposed to be growing in your colon. and this can create issues for many people, gas, bloating, sometimes diarrhea, sometimes constipation,

abdominal discomfort. These are sort of the manifestations of SIBO. Now, don't get me wrong, not every patient who has gas and bloating has SIBO. There's many different things that can cause gas and bloating. I think of SIBO as being a form of dysbiosis. Disbiosis is the medical term that doctors use to say damage to the gut, damage to the gut microbiome. CBO to me is a manifestation of dysbiosis. And so the challenge with CBO is that we don't have effective therapies in a traditional pill

sense for a long term. We have short-term therapies. The question is, do the short-term therapies that work actually help us in the long run or actually are we paying the price in the long term? So the current approach is to treat with antibiotics. But virtually everyone who gets antibiotics is back to having CBO in the future. And that's the problem. And I believe the reason why is because you haven't addressed the root of the issue,

which is that when a person has CBO, what they really have is damage to their gut microbiome dysbiosis. And you have to correct and rebalance the microbiome if you want the CBO to go away. You have to strengthen the microbiome if you want to fix the issue. And antibiotics don't strengthen the microbiome. They just destroy it. The problem is that I think that there is a conversation that needs to occur at sort of the academic medical meetings for us to really hash out what we're dealing with and what's the best way to handle it. And the problem is that now the conversation is very public because people are demanding they want to know. do I have CBO and how do I treat it?

And that just sort of adds to the complexity of trying to take care of this. When you say, you know, I feel like my trauma was affecting my CBO, there's no doubt. There's no doubt because CBO is a manifestation of a damaged gut. In trauma, we know stress. When you have stress, it activates the brain to release stress hormones like C.R. And CRF actually has an effect on your gut microbiome inducing dysbiosis, meaning that just the process of having stress harms the gut microbiome. So I am not surprised by the way that you're describing it. Yeah, I feel like there's maybe a misconception that SIBO is something that you catch or that you can get it from the food that you're eating, the way that a lot of the questions.

about SIBO were phrased to me kind of insinuated that, that it's something, it's this bacteria that you get from some external source. No, this is more a manifestation of dysbiosis. It's a weakness in the gut that comes along the same way that other weaknesses, you know, you can manifest Cibo, you could also manifest your oral bowel syndrome, or in severe cases with a damaged gut, you could manifest Crohn's disease or ulcerative colitis. There's different ways that a damaged gut can manifest, and this is just one of the examples, and it's not transmissible. You can't spread it from one person to another. It's innate to you, and it speaks to an altered balance of your microbes. So I think a lot of people feel like in order to have a healthy gut, you have to restrict a lot, right?

So restrict gluten, restrict dairy, grains, lectins, legumes, sugar, soy, corn, eggs, fadmaps. Seems like kind of a never-ending list. So I want to talk about this because you are not a proponent of restricting all of that. And in fact, you are an advocate for maintaining diversity, right? Yeah, 100%. So let me bring forward the argument. I mean, let me first say this. We have been told for the last 20 years through a series of popular, you know, mainstream diets, calm fat diets, if you will.

We have been told for the last 20 years that the path to healing your gut is through elimination. That if it hurts, it must be inflammation and therefore you should get rid of it. But I want people to understand that that was never scientifically oriented. claim that was an intuitive approach. That was just, hey, we don't have the science yet to figure this out. So this is what feels like it makes sense. But now we have the science. It's 2020.

We have great studies. So let's let the science do the talking. And when we let the science do the talking, what we discover is that in the largest study to date to allow us to connect the health of our microbiome to our diet and lifestyle, the most well-positioned study to answer the question, what is the most powerful predictor of a healthy gut? The answer is the diversity of plants in your diet. In this study, if you wanted a healthy gut,

the most powerful way to accomplish that was by eating as many different varieties of plants as possible. This was more powerful than any dietary philosophy, including being a vegan. this was more important. And so what this says to me is number one, no matter who you are, you can introduce this into your diet. I don't care whether you are vegan or paleo or keto or whatever, agnostic or standard

American diet like I used to be. No matter who you are, I'm telling you right now, science is saying this is the most powerful predictor of a healthy gut. You need to do this. And if there's only one thing you take away from this podcast, let it be this. And the way it works, Ariel is this. Let me just kind of explain and break down what's actually happening on a microscopic level so that everyone understands. This is not just an epidemiology study. This is actually validated by additional studies. The way that works is this. The preferred food of our microbes is fiber. That is what they eat. That is what they thrive on. not all fiber is the same.

Each plant has its own unique types of fiber. And these microbes that live inside of us, they're just like us. They're picky eaters. You and I don't eat the same food. We have our own preferences. So do these microbes. They have their own preferences.

And when you take something like, for example, a black bean, and you eat a black bean, there are certain specific microbes that love black bean. and they will thrive and they will multiply and grow stronger, and then they will be able to take care of you and affect your digestion, your immune system, your metabolism, and all those things that we were talking about before. But the flip side is also true.

You take black beans out of your diet? Guess what happens to those same microbes? They starve. They grow weaker. They become inept. They're no longer capable of doing the job that you've asked them to do. And so when we restrict our diet, we are effectively starving specific populations of bacteria that thrive on the foods that we just removed.

And we see this on individual studies where they look at, for example, the Wofodmap diet, or a gluten-free diet, or the paleo diet. And what they see when they study the microbiome in these restrictive pattern diets, even though they each are different in their own way, they see in every single case that the microbiome gets weaker. And it's very common. I see this in my clinic. Like every single time I'm in the clinic where the person will describe to me, my patient

will describe to me. So I started off, you know, eliminating this and I felt better for maybe a few weeks. But then I was sick again. So then I eliminated that. And then I felt better for a few weeks. And then I was sick again. And they just get progressively more and more and more. restricted until there's nothing left and they're eating chicken and white rice because they just

can't tolerate literally anything and the issue is that our gut is designed to be fed a wide variety of plants and when we eliminate them it weakens the gut and most people like our food system is not going to give you dietary diversity our food system wants to give you wheat corn and soy, period. End of story. If you want dietary diversity, you have to do it. You have to make it your dietary philosophy. That's what I do.

And I'm telling you, like my book is called fiber-fueled. I am obsessed with fiber. I think it's sexy. I think it's sexy. Okay, I'll put it out there. But I don't count grams of fiber because it's not about grams of fiber. It's about diversity of plants. That's what I count.

I counted every meal and I try to amp it up and max it out. And I'll give you a quick example. I hope you don't mind, Ariel. Is that okay? Yeah, go for it. Okay. So I am a dad. I have two little kids.

My daughter's six. My son is three. I'll come home from work. I'll be tired. And neither my wife and I want to cook sometimes. So here's what we do. We'll get some organic whole wheat pasta and some tomato sauce. Okay, two plants.

Dr. B, that's not a lot of diversity. So here's what we do. Get the kids in the kitchen. Hey guys, come over here, help me out. We'll get the sauce simmering. Throw in some garlic, onions, mushrooms, zucchini, maybe some spinach.

The house smells amazing. The kids are psyched because they helped to cook it. They feel like they're a part of it. They can't wait to devour it. You serve this dish, smash some fresh basil, some fresh parsley on top. It is delicious. Everyone is loving it.

And your gut microbes are dancing a jig because you just fed them. And so it doesn't have to be that complicated. Right. So if somebody has been eating, say, gluten-free, dairy-free, low-fodd map, whatever, they've been restricting more and more, like you mentioned. How can somebody start to reincorporate these foods without causing more GI distress? us. So first, let me say that I actually think that dairy restriction is perfectly fine. Like, if you want to eliminate dairy, I'm cool with that. When it comes to gluten, there are some people

who should eliminate gluten. But it's not one out of three people in the United States. And right now, in the U.S., one out of three people is either gluten-free or trying to be gluten-free. I mean, honestly, where you live in California or in New York, it's probably more. like 60 or 70 percent. Yeah, I was going to say in LA, I think it's probably a majority. Right. And in my book, I break down the science of gluten and I'll spare you the details of that right now because that would take me 10 or 15 minutes to really break it down. But the bottom line is that it's not that I think that gluten should be the backbone of our diet, but when we eliminate healthy wheat containing products like sourdough, when we eliminate that, it actually

affects our gut microbiome. Now, to answer your question, how do we read? introduce these things. It's about understanding the way that your body works. Your gut is a muscle. I want you to think of it as a muscle. I want you to treat it exactly like you would a muscle, which means that it can be trained. You can make it stronger.

But an injured muscle sometimes needs to be rehabbed. So if I have a bum shoulder, I'm not going to go to the gym and lift 25 pounds with a bum shoulder because that's going to tear my shoulder up even more. If I have a bum shoulder, I'm going to go to a physical therapist and I'm going to rehab it and I'm going to slowly work my way up to where my bum shoulder doesn't need rehab anymore and now I'm ready to go to the gym and I'm going to start off with like five pounds and I'm going to slowly ramp up from five to ten to fifteen and work my way up. That's exercise,

right? I mean, we all know that. When you go to the gym, you do the appropriate amount of weight for the individual muscle group that your body can handle. Our gut is the exact same. When you go to eat your food, there is a certain amount of each type of food that you're fully capable of processing and digesting without having gas bloating or pain. That includes beans and whole grains.

But if you haven't been eating them, if you've eliminated them, the problem is your gut microbiome has not been exposed to them in forever, and it's not built for that. So that's like, you know, someone who hasn't been to the gym and they're showing up for the first time, you don't walk into the gym and grab 300 pounds if you haven't been working out. You start way low. You see what you're capable of doing and then you start to increase slowly over time.

So that's the approach is with each food, you identify where your sensitivities lie. You start low, you go slow and you train your gut and you make it stronger. So say that you start to reintroduce something, say like, I don't know, some kind of wheat. And even at a really, really low threshold, like it's just too much. Do you continue to try training, so to speak, or should you chalk it up as a sensitivity or an intolerance? So, you know, wheat has this added layer of complexity because wheat that could potentially. indicate that you have celiac disease. So if we're talking about wheat specifically, then I would say, we need to make sure you don't have celiac. Okay.

What about like a fad map? So with the fad maps, what I want people to know is that food allergies are different than sensitivities. A food allergy, which often will manifest with like hives or, you know, skin rash or lip swelling, something like that. That is your immune system. Food sensitivity is not your immune system. Food sensitivity is a damaged gut struggling to keep up with the food that you're putting in there. And food sensitivities, you can train. So, for example, take lactose intolerance. Now, like I already said, and just to be clear, like, if you want to be dairy free the rest of your life, I support that. Okay. But the reason why I bring up lactose is that lactose is a FODMAP. And we have the most

studies in terms of navigating lactose intolerance of all of the FODMAPs. This is the FODMAP that we have the most studies on. And what we know is that two things. Number one, you can make yourself less lactose intolerant. So what I'm saying is you can train your gut to deal with lactose. And the second thing is that, and the way that you do that, by the way, to train your gut, is with the introduction of small amounts of milk and then slowly increasing it over time. You know, there's no, if it's wheat, for example, there's no requirement to eat an entire piece of bread.

Right. Right. You can take a bite and then put it down. But the other thing with lactose, that's kind of interesting. And this is, I believe that this is true with all the FODMAPs and all food sensitivities, is that when you heal the gut, you will also become better at dealing with lactose. And so we have a study where people who are lactose intolerant were treated with fiber, not with lactose, treated with fibrates, treated with fide. fiber and that strengthened the gut. And by strengthening the gut, it actually became better at processing lactose. I tell you, I'm a nerd. No, it's fascinating. I'm just like soaking this all up.

Okay. So can we talk a little bit about supplementation and like prebiotics, probiotics, when and if those are appropriate or if we should just be getting it through our food? All right. So it's interesting. And by the way, I wrote, there's an entire chapter on this exact topic. Pre-biotics, probiotics, and... Yeah, everybody go get the book. Yeah. And postbiotics are like the cool stuff that people haven't even heard about. So let me just define these real quick.

Probotics are the living microorganisms. We have probiotics living inside of us. It's not just the only way to get probiotics is to take a capsule, which is what we classically think of. But like, they're already there. They're a part of our microbiome. prebiotics are the food for these microbes. I said before the preferred food is fiber. Fiber isn't the only prebiotic,

but when we think of prebiotics, basically we're usually talking about fiber. And what's cool is when you take fiber and you combine it with probiotic bacteria, the microbes, these microbes actually consume the fiber. And they release what are called post-biotics, products. When I'm referring to our short chain fatty acids like butyrate, acetate, and propionate. So maybe some of the people who are interested in gut health, they've heard of this stuff,

butyrate, acetate, and propionate. This is our microbiome gifting us after we feed it. When you feed the microbes with fiber, they will consume it and they will release these healing anti-inflammatory molecules that have been shown to reverse leaky gut, that a affect our immune system, lower cholesterol, reverse type 2 diabetes. They actually activate our satiety hormones so that we know exactly when to stop eating so we don't overeat, which helps with our weight control. They actually travel through the blood. We think that they reverse coronary artery disease. They can affect the lungs and the immune system in the fight against viral infections. They can actually go to the brain and we have studies that suggest that they prevent Alzheimer's.

So they are powerful. They are healing. You only get them from eating. fiber and I said earlier in the show that most Americans, 97% are not even getting the minimal recommended amount of fiber. We need to step our fiber game up and that's what prebiotics are. To me, diet and lifestyle needs to come first. You can't supplement your way from a C minus gut to an A plus. You just can't do that. So diet and lifestyle has to come first. You optimize those things. but I think that there's value to prebiotics for all of us. So for what it's worth, I use pre-biotic supplements every single day. I put them in my coffee.

And I feel like even though I'm 100% whole food plant based, I feel like there's value to adding these into my daily routine. I do notice a difference. What supplements do you like? So there's a couple of options. Let me tell you, Ariel, that there's not like a correct answer of, hey, this is the best fiber. That doesn't exist.

The best fiber is all of them because that gives you diversity. Right. Right. So, but like ones that I like, acacia powder, beta glucan, glucaninin, wheat dextrin, guargum, all those are potential pre-botic fibers. And I actually put them in my coffee. Like acacia powder, you can get organic and you can put a scoop into your coffee and stir it up and you won't even know it's in there. Okay. So, you know, one of the things that I want to say about prebiotics is this.

Here's why I think that there's a benefit to each of us. Ariel, if we talk about you for a moment, you have a completely unique gut microbiome. There's literally no one on the planet, not even your own family, not even your parents, that has the same microbiome as you. It's like a fingerprint. And the beauty of prebiotics is I don't need to know what the makeup of your gut microbiome is to know whether or not it's going to do. something because I already know what's going to happen is the fiber is going to get down to

your colon and it's going to feed the healthy microbes and they will grow stronger and then they will reward you with short chain fatty acids. I already know what's going to happen. The flip side of that is probiotics. We have been told that, you know, probiotics are the hype that this is what we all need. And then we drop 40 to 60 bucks a month and most people don't really notice the difference. Now, I'm going to say up front that there are definitely some people who benefit from probiotics. The problem is, your doctor, including me, doesn't know ahead of time who exactly is going to benefit, and here's why. Again, Ariel, you have a unique gut microbiome. And if I say to you, hey, Ariel, I want you to take it this probiotic. Basically, what I'm extending

to you is a generic formula. Hey, here's this generic formula. But you have a unique microbiome. I don't know whether this generic formula is going to mix with your unique gut microbiome and create something really good. I don't know. So we're just going to try it out and we're going to see. And that's the nature of probiotics. It's trial and error.

They may help. They also may do absolutely nothing at all. And that's because you have a unique microbiome and you won't know until you try. So to me, diet and lifestyle always come first. Pre-biotics second, probotics third. And can you talk about postbiotics? The postbiotics are the short-chain fatty acids that you get. Oh, okay. Yeah, and those ideally we're getting predominantly from our diet.

And again, going back to the core, like golden rule of a healthy gut microbiome, the golden rule is eat a wide diversity of plants. And when you do that, you will get the post-biotics. Got it. And then to go back to FODMAPs for a second, they contain a lot of prebiotics, right? Yes, that's the thing. Thank you for bringing that up. That's so important because it's so easy to vilify FODMAPs, like, oh, the cause of your gas and bloating are FODMAPs. And then it makes them sound like they're horrible.

When in fact, the FODMaps are actually prebiotic. They feed the healthy bacteria inside of you. The problem is that if you're not adapted to the FodMaps, you struggle to process them. and get the benefits. So this is where it goes back to, there is a certain amount, whether it's beans or whole grains or garlic, there is a certain amount

that your body is capable of processing. And rather than binging all at once, we need to make sure that we're keeping ourselves in this little window where we feel good and then we get the benefits from that. Right. Okay.

Switching gears a little bit. A lot of people asked about Candida. This is another kind of hot topic. I think a lot of people are being diagnosed with Candida overgrowth. And again, like I'm getting all of this from my pool, which is my followers and my audience. I'm not sure about, you know, the greater population. But from what I hear and the questions that I get whenever I do an episode on gut health or talk about it, is that it's unrecoverable. Like, people just cannot beat Candida overgrowth.

So can you talk about what that is? And, and again, like, treatments, which I'm assuming are lifestyle treatments. Yeah. So let me first say that, you know, I've been talking here about our microbiome, and I've referred multiple times to the bacteria. But to zoom out for a moment, our microbiome is made up of more than just bacteria. It also includes yeast, yeast, which you can also call fungi.

Candida is one of them. And it also includes archaea, which are these microscopic organisms that are not bacteria, they're not yeast, and they've literally been on this planet for four billion years. We think that Archaia are the first life on the planet. I think they're fascinating. You'll find them inside of a volcano.

You'll find them at the bottom of the ocean in a rift vent, and then they live inside of us. and we may also have protozoa or parasites and viruses. Viruses are a normal part of our microbiome. So there's this community and they all live together. And some of them we may vilify and say they're bad. Well, they're bad when they are found in excessive quantities. But I want to go so far as to say that they're categorically bad

and shouldn't be a part of our microbiome. Candida is a normal part of the human microbiome. We all have it. we all have it and the time when you see it emerge you know think about this when do we see thrush you know thrush where you have the white plaques in your mouth when do we see that we see that when we take antibiotics right because what happens is the antibiotic weakens the bacteria and when you weaken the bacteria and you destroy the good guys you basically create an opportunity for the fungi the yeast to multiply grow and thrive and take over and that's what happens when these people that have yeast over

damage to the good bacteria creates an opportunity for the bad guy to take over. And here's the key. And by the way, I have a book recommendation at the end for people who specifically have yeast overgrowth. The key is this. Many of the protocols around candida have fixated on two things. How do you destroy the candida and how do you stop feeding it? And like, I get it.

But the issue is that we have shown time and time again that protocol is designed to destroy microbes. It doesn't win in the long run. What wins is empowering the good guys. When you build and fortify your gut, you will make it stronger. And then the good guys will take care of the candida for you. And we see this in studies where Ariel de will give people, there's an interesting study where they gave people antibiotics, and they monitored both the bacteria and the fungi on a daily basis

in terms of their microbiome, because actually it's different testing that you have to do in the laboratory. So they monitored both, and here's what they saw. As these people took antibiotics, they witnessed on a daily basis the decline in the bacteria and the growth and multiplication of the candida. Basically, when you destroyed the bacteria, the candida gets bigger, gets stronger. But when they withdrew the antibiotic, the opposite became true, which is that as the bacteria

grew back, the candida started to disappear. And that's the key. If you feed the healthy bacteria that live inside of you, they will multiply, they will grow, they will become stronger, and as a result of that, they will eliminate the candida for you. So, and my, you know, my book Fiber Field is about building a healthy gut. I believe that the concepts that are taught in the book are the solution for a person who has candida. But if you want specific reading, discussing fungi and yeast in greater detail, there's a book

called Total Gut Balance, which is by my friend, Dr. Mahmood Kanum, who is at, he's at the Cleveland clinic. And I'm sorry, he's at Case Western. and he actually, you'll find a quote from him in the front of my book because he supported my book as well. But his expertise is the fungi. This is what he has dedicated his life to. Amazing. Okay.

I'm curious if there is a trend that you see happening when it comes to gut health. I'm sure you see a lot. But I'm curious if there's one that you wish or that you hope goes away. Just one. Oh, gosh. All right. Well, I think the most important thing is this. This is what my book is about is that the science is telling us one thing the fads are telling us something different.

And at the end of the day, if we don't follow the science, we're not going to make ourselves more healthy. And this is the reason why I feel like these diets that we've been fed over the last 20 years are not. not actually making us healthier. I think in some cases, now, don't get me wrong. There's a lot, like, there are things that I love about every single one of these diets that I would celebrate. But the problem is that if the foundational element is restriction and elimination, ultimately we're causing harm to our microbiome.

And so if I only have one choice, to me, I think the people deserve better. I think we deserve to have a healthy relationship with our food. I think it's time to move past vilifying and demonizing the food and the food choices that we make. And it's time for a new era where we, rather than running away from the food that we're scared of, we instead start running towards the food that we know nourishes our body and enhances our health and makes us feel wonderful and balanced and gives us all of the things that we're looking for. That's what I hope. I hope that we can move past the eliminations and into a place where it's about diversity and abundance and enjoying our food again because I feel like we deserve that.

Yeah, I totally agree and I love that. And your book is an excellent place to start if anybody wants to start on that journey. So maybe we can have you back for part two and see if people have questions after this episode because I'm sure it will spark a lot. So where can everybody find you in the meantime? Well, you can find me on Instagram as the gut health MD. I'm on Facebook too under the same name. And you can come to my website, which is theplantfedgut.com. And at the plantfedgut.com, you will find a COVID-19 guide.

You will find, I actually built, Ariel, I built a clinical research guide because I feel like we're living in this area where people are confused and they don't know what to believe. hearing too many things from too, from too many people. And I feel like just giving the foundational tools, you know, will allow you to better decipher what's real and what is someone just trying to sell you something. That's very helpful. Yeah. So that's on my, that's on my website. I have, I mean, there's a ton of resources there. So I have an email list that a lot of people love. And the other thing I'm excited about, I hope you don't mind me sharing this real quick, is that

I'm actually launching in a couple of weeks an online course that I have been building for more than six months now. It is something that I've beta tested with two groups and had amazing results. Like blew me away. I just couldn't believe how well it went. Some people who have had symptoms for more than 10 years that we found what the issue was and they're better. And the course is a seven-week, you know, immersion in basically healing your gut and optimizing your microbiome. It includes daily videos, private, like, exclusive podcast content, a workbook, a community. It's about connecting with other people who are going through this too. Live Q&A is with

me. So the bottom line is that what this is like, look, the book is the best bang for your buck, period because for 30 bucks or whatever it costs, you get to have like literally me focused for an entire year creating an organized structured tool that you can use. But many people want to go be on the book. And so the course is the best way to do that because I can give you, you know, it's like hanging out with me for seven weeks. And that's amazing. Yeah. Very exciting. We will link everything in the show notes too so that everybody can find it really easily. And I just want to thank you again for coming on. Oh, that's my pleasure. Thanks for having me on. I hope you enjoyed that episode. If you liked it, and if you like the show in general, please take a second to rate,

review, and subscribe. It goes a long way, and it's actually the best way to support the show. Also, If you want to see more about each episode, you can head over to The Blonde Files podcast on Instagram. I'm always posting about each episode there or over on my personal page at Ariel Laurie.