speaker-0: Tell me if this sounds familiar. You're feeling bloated, fatigued, foggy. You've changed your diet. You've cut out certain foods. You've tried protocols. You've taken various supplements and some things improve, but you just don't feel right. And here's what I hear from patients all the time. Dr. Rock, I've tried everything and I don't know what's wrong with me. And that might actually be the problem. Not knowing what's actually wrong.

speaker-1: did.

speaker-0: Hi, I'm Dr. Rock, host of The Health Feast, the podcast where health stops feeling like a chore and starts feeling like a feast. And today I brought in someone who I think explains this better than anyone else. Dr. Will Bolsevich. Dr. B, as he's known, is one of the most well-respected gastroenterologists in the world when it comes to gut health, the microbiome, and the connection between what's happening in your gut and the rest of your body, your energy, your mood, and your immune system. He's the author of Fiber Fueled. It's a book I've recommended to more patients than I can count, as well as the Fiber Fueled Cookbook, one of my favorites. And his brand new book, Plant Powered Plus, already a New York Times bestseller, is all about why chronic low-grade inflammation may be the thing tying your whole health history together and what you can actually do about it. In this conversation, we talk about why you might be constipated and not even know it, why the gut is running 70 % of your immune system, how sleep, your relationships, stress, and even your sense of purpose and spirituality are all showing up in your microbiome, whether you realize it or not, and the simple and mostly free things you can do starting tomorrow morning to start shifting your own health. This one is definitely a feast for the mind and the gut. So let's do the show. Well, in clinic, and I'm sure you see this and actually an online, there's this pattern where people are, they're feeling bloated, they're feeling fatigued, they're feeling foggy. Oftentimes they're attributing it to being inflamed. ⁓ and I think they understand they're just not quite right in their bodies. And in response to that, people are changing their diet. They're eliminating all sorts of foods. They're following protocols. They're taking supplements and sometimes things improve, but often people are just sort of spinning their wheels. And so I'm going to ask you, when you see this pattern, what do you think that, ⁓ that all of us are misunderstanding about what's actually going on?

speaker-1: First of all, thank you for having me on the show. I, these can be unfortunately like it or not, the solution sometimes requires nuance, right? So you can't take a symptom and then necessarily say, well, here's your generic answer of what will work for literally everyone. So on some level for the people who are listening to this and they're trying to actually solve that particular issue of like, I feel bloated. don't feel, I don't feel well. My guts not where I want it to be. I can't sit here and say there's this generic answer that's applicable to all. know, in fact, Dr. Rock in the, in the beginning of my new book, I wrote an author's note that I felt compelled to share as the very first thing because I can only write as an author, I can only write one book, but I want the reader to understand that the experience that they have is actually quite personal, deeply personal to them, that their, their environment, their context, informs how they receive the information and that there will be an aha moment for them that is unique and special. So, and the framework, like the book is like built around the framework of helping people to reduce inflammation, which is not exactly what you just asked me. So I just want to make sure that that's clear. But the point that I'm trying to get at is that I expect that in the pages of that book, each individual person, it's not going to be the same solution or answer for every single person that you're going to work your way through and you're going to find that thing. And you go, ⁓ my gosh, that's the thing that I've been missing. That's what I need. So as a medical doctor, I would tailor my approach. It's personalized, right? This concept of personalization ⁓ is a bit like to me in some ways, the hype is around the word and the concept. ⁓ we're talking about automation to personalized yet like as a medical doctor, both you and I with thousands of patients. It's always personalized. always been personalized. It has to be. So my approach, I'm sure that you share this approach because this is what we're taught to do. This is what good medicine is, is you have to first start by understanding and identifying the problem.

speaker-0: It always has to be,

speaker-1: So the first step is always the same. So every single person who's listening to us, step one, we got to know what is actually causing those symptoms. And there's a number of different things that could be contributing to those symptoms. ⁓ Off the top of my head, when I hear people talk about bloating and I don't feel well and my bowels are off, the very first question as a gastroenterologist that pops into my mind is, is this person constipated? Number one cause of bloating in my experience is constipation. And there's a very large number of people that are constipated and don't realize. Constipation is not just how often you go.

speaker-0: Yeah, how do you define that for our listeners? what, who out there doesn't know that they're constipated? Like what, do you use to define that?

speaker-1: Sure. So I'll give it, I'll give a few examples, but let me, let me first say like there are definitions that are sort of the clinical definition of constipation, right? That you poop ⁓ less than three times per week. ⁓ Or that you have an appearance of your bowel movement according to the Bristol stool scale. So for the listeners who haven't heard of this before, there's like this, ⁓ Basically like scoring tool that allows you to choose one of seven types of vowel movements, least upon a picture. So you can look in the toilet bowl and be like, ⁓ my poop looks like that. A number one, a number two, a number four. A four is a sausage that's, that's soft informed. That's where you want to be. That's the goal. It's right in the middle. And one is like a rock, right? It's like a rock, like a, like a, like a,

speaker-0: Yeah. And in there.

speaker-1: pebbles, right? Severe constipation right there. And then the opposite is seven, which is basically water and that's diarrhea. Right? So these are the, these are sort of the like clinical ways in which constipation might be described. But to me, I think of it just from a functional perspective in terms of, to me, constipation is the inadequacy of defecation. Like quite simply. Right? If you are not sufficiently, ⁓ relieving yourself, then you are backing up and that doesn't necessarily fall beautifully into this, into this form of like, what does it look like or how often do you go? Because there are people who are constipated that actually completely defy these things, these rules. So, so to answer your question here, I'll give you a few examples of people that are constipated. don't realize it. Okay. There's the person who they poop every single day. And they heard, if you poop every day, you cannot be constipated. they're bloated, they're little nauseated, they have fatigue. And then when you get an X-ray, you see the colon is filled with stool because they're not completely emptying. so they're getting a partial. But in their mind, if they poop every day, they couldn't possibly be constipated. There's the person who poops three times a day, but each time they're straining to go and it's a little nugget that comes out. And that little nugget is like a 20 % poop and three nuggets a day is only a 60 % poop. that means there's 40 % compound interest day after day to contribute to bloating. Okay. There are some, there are some diarrhea forms that can be constipation. There's the person who goes to their doctor and they say, have diarrhea. And when you dig into the pattern, you ask for details. Tell me about what's happening. They go, okay, here's what happens. I will have a day where I poop like five times. It's urgent. have to rush to the restroom and then I won't poop for three or three or four days. So in their minds, that poop day is a diarrhea day. And then they basically have emptied so much that they won't poop for three more days. That's the way that they interpret that. But what I hear is something very different as a gastrologist. What I hear is you didn't poop for three or four days. That's abnormal. You should be pooping more regularly than that. And because you didn't poop, you backed up, you backed up, you backed up, you backed up until you had a day where it all came out at once. And on those days, the first poop is formed or sometimes even hard. But then it gets booser, booser, booser as the day goes on because basically the Your colon in a way is almost like a slingshot. more that you sort of stretched it out, the more that it's just applying force to get everything out. ⁓ Okay. And then the last one is you. First of all, let me apologize to the listeners. ⁓ I, as a gastroenterologist, my wife has informed me I'm far too comfortable talking about this stuff. So

speaker-0: mean that occurred to me I was like ⁓ yeah he's just getting straight into poop but like he talks about poop all the time so there's no there's no issue here right

speaker-1: Two seconds into a conversation, I barely met you. Here we are, we're talking about poop and getting into the details.

speaker-0: People must love going to dinner parties.

speaker-1: Well, they pull me aside privately later on and they have questions, anyway. right. So, and then the last one, which I think it's really important for people to hear is that there's also some people that they, they are having diarrhea and it turns out that what's actually happening on the inside is what we call overflow. So they're like very backed up. with solid stool that's not moving at all. And the liquid stuff sneaks through the cracks and the crevices. It comes down your bottom and when you get the liquid down there, it basically comes out with urgency. so this is an example where the patient experiences diarrhea, goes to the doctor, says I'm having diarrhea. And if it's misdiagnosed, you're going to put them on like a modium or a modal.

speaker-0: Yeah, make the problem work.

speaker-1: And you make the problem worse because you didn't properly diagnose it. the point, ⁓ we started with a very basic question of like, how do you approach these issues? And what I'm saying is you gotta get the diagnosis right.

speaker-0: I think that's part of the issue is like people don't really understand what is wrong with them. And, yet they're putting in all sorts of effort. know, it's, what strikes me is that the effort is increasing and that relief is elusive. Right. And I think that's what, ⁓ is frustrating to people.

speaker-1: Well, they, and, and it's a bit, it's a bit that the system has misguided them because, let's first of all, acknowledge that people are frustrated with the healthcare system. And I, I believe that if doctors were given, you know, control or actual control over the healthcare system, we would radically change it.

speaker-0: Yeah Yes. Yeah.

speaker-1: But we don't actually have a say. We don't actually have control. We unfortunately are the least powerful part of the entire equation, which is that like, we have no money. mean, people know that sounds crazy.

speaker-0: Yeah.

speaker-1: but a medical doctor graduates with hundreds of thousands of dollars of debt. And by the time they paid off, they're in their fifties. So they're getting close to retirement. Right. Right. So, like, anyway, so the point being that people are frustrated so they're looking for solutions. And when you turn to the internet, you get bombarded with solutions. But are they the solution to the problem that you have? So rather than like, ⁓ let's like pause for a quick moment. Let's make sure that we properly understand what the problem is. And then let's tailor solutions to the problem as opposed to just trying stuff. So it's how we get ourselves in a confused position. Cause you're like, I heard that this was good for me, but I don't feel any different.

speaker-0: That's right. Right. And then it seems like, people just give up. I guess, I guess, I guess I, this is just the way things are. go, or, or they go searching, ⁓ and want to believe some of the most ridiculous claims. You know, I think a lot of people like to your point on the internet are taking advantage of people's desperation.

speaker-1: Well, if you take what is common knowledge, to the internet and try to build a career around common knowledge. It's actually very hard. Sure. Right. And I kind of know this because I've built my platform around fiber and it's like not the easiest thing to get out into the world and try to make that sexy. ⁓ Whereas if you are the voice that's alternative and out of a thousand people, you're the one person who's saying something different. ⁓ then you end up commanding a lot more attention than you deserve just because you're different.

speaker-0: And I get to eat steak and sausage and all day, all time. Why wouldn't I want to be a carnivore? Well, no.

speaker-1: Well, I mean, it's, ⁓ there are things that exist in our life that are short-term, highly pleasurable and long-term create a lot of pain. And unfortunately we have a very strong track record of as humans of kind of not really, ⁓ measuring that calculus very well.

speaker-0: Okay. So I want to get, you know, one thing I think you do, you, you do very well. And it seems like the impetus for your new book, which you can, you can tell us more is that you're sort of translating this disconnect between how people feel and what's actually going on. And, and the word, you know, the word that is a very buzzword is inflammation. And when people hear that word, I think they often think of it as something they need to suppress or eliminate. Now, how do you think about what is actually happening in the body?

speaker-1: If we didn't have the ability, so it's a, it's a complex, ⁓ topic. So let's, let's break it out into two main types of inflammation. Acute versus chronic. Right? So acute is, ⁓ short term and serves a specific purpose and chronic is never ending. And, ⁓ we'll discuss more the point of that. So. Anyway, with acute inflammation, our body created an immune system with a specific goal and intent, which is to help us to survive. It protects us from infections. Whatever our body comes into contact with, that's a pathogen from the outside world, our environment, we have the capacity to learn from it and to enhance our immunity over the course of a lifetime and to defend our body. and that's all the that's all the result of acute inflammation, defense against infections. ⁓ And simultaneously, if you were to hurt yourself, whatever it might be, some sort of bodily injury, it's inflammation that allows you to repair and restore tissues to the greatest extent possible. Or among those same lines, there is a resilience that is the result of acute inflammation. So if I go to the gym and workout, I actually was just working out an hour ago. I go to the gym and I work out. That's actually inflammatory process. The soreness that you feel, and I'm not arguing that the soreness is necessarily good and that you want the soreness. That's a, that's a different conversation, but the soreness that you feel after like a day or two after a good workout is the result of inflammation that is repairing tissues that have been like injured on a micro level. so now all of these things, those are good. That's acute inflammation. That's the reason we evolved to have an immune system and it protects us and enhances our survival, particularly prior to the development of antibiotics, which was still less than a hundred years ago, Rock. It's crazy. ⁓ And so now the counterpoint though is chronic ongoing inflammation. call chronic low grade inflammation, which is the disruption and breakdown of our natural defense systems. and because of environmental. impacts. So by environmental, don't just mean like the world outside of our home. mean the world inside of our home. mean the food that you eat. mean your relationships with other people. mean the amount of physical activity that you have in a given, in a given day. Um, that forms your environment and that impacts your body in many ways, but particularly that impacts your gut microbiome, which is this community of 38 trillion microorganisms that live mostly inside of your large intestine, your colon. They are deeply intertwined with our physiology. impact not only the digestion of your food, like clearly they do powerfully there, but they also impact our immune system, which we'll talk about more in a moment. Our metabolism, our hormones, our mood, our brain health, even the expression of our genetic code, which we call epigenetics, is the result of these microbes. So they're highly, highly influential in our health. And so... ⁓ When they are well, they do their job. Part of their job is to actually repair and restore the gut barrier. So your entire intestinal system, which is like on the order of 20 to 25 feet long, is lined with a layer of cells, which we call the epithelial layer. And its purpose is to keep the pathogens and the bad stuff out, but to allow the nutrients and the good stuff in. And so it's I would argue that it's our largest ⁓ immune organ. I guess we could look at surface area of that versus the skin, but at least to me, it's the more important immune organ. And so this is our largest immune organ. It's constantly turning itself over every three to five days. have a brand new gut. And it's the gut microbes that are responsible for helping us to maintain that on a number of different levels. play a really essential role in protecting and maintaining that gut barrier. Now, if those two things, the microbes and the barrier, if they falter, which they will falter in tandem because when the microbes are unwell, then the gut barrier starts to suffer. If those two things falter, then what we have is we have a gut barrier that's breaking down and a allows things to get across. And some people might call that leaky gut. And I actually don't have a problem with that because that's an accurate term of what's happening. And the stuff that gets across that gut barrier, comes into contact. 70 % of your immune system exists within the lining of your intestines. So if you ask the question, where is your immune system? this army that protects you, way that I would characterize this is they get basic training in the bone marrow, in the thymus, and then they get deployed and 70 % of them are deployed into your gut barrier because that's where the action is. So something sneaks across, Rak, you and I learned about this in medical school. call it lipopolysaccharide or bacterial endotoxin. It's something that's, that is like basically like a coat of armor that covers pathogenic bacteria like E. coli or salmonella or shigella. If they get across this, this boundary, the only thing that's going to stop them before they get into your blood is going to be your immune system. So your immune system steps up to fight them and destroy them.

speaker-0: Yeah, right.

speaker-1: That's inflammation. the problem is that that's pointless inflammation because if we had an intact gut barrier and an intact microbiome defending ourselves, we would have never gotten into contact with the immune system in the first place. And every time the immune system gets activated, unfortunately there's consequences. like you can't, I don't really love that I have to give a war analogy because I don't want to celebrate war in any way, but. ⁓ It's like a forever war and forever wars result in decimation. You can't have that happen and not destroy. so it's our tissues though that take the brunt of it, this chronic inflammation. this is, this is the basic thesis of the book is that the gut microbiome and the immune system are completely interconnected for the reasons that I just described. And that is harming us in the modern context when we live a world that's sort of disconnected from the way that our analogy was designed. But it can actually be our greatest tool, our greatest opportunity for healing because we could, we could actually reestablish those microbes through simple daily choices. And when we do that, we store the gut barrier and when we store the gut barrier, protect the immune system and how the immune system cools off, stops fighting. Chronic inflammation dies down. And now it actually can get back to what it's supposed to be, which is just responding to real threats, acute inflammation.

speaker-0: Yeah. So one thing that's standing out for me is that, you know, gut health often gets framed as a food, a food only issue. And I'm hearing you, you point out all these other lifestyle factors. And so, you know, because people often are focusing a lot on nutrition, right? They're, they're like Uber focused on nutrition while they're living with constant stress and poor sleep. and wondering why they're not getting better. How is your thinking about the gut health and these other lifestyle factors beyond nutrition evolved? Talk a little bit more about that.

speaker-1: Sure. um, I think there's always been in my mind, the, the reality, I guess the way that I would describe this and it has certainly evolved and matured through the years is that your gut microbiome tells a story and it's the story of your life and it's, and it's going to be like so brutally honest and truthful. You can't hide stuff. Right. Because basically it's going to reflect the food choices that you've made for better or worse. Right. And your physical activity and your sleep, your daily patterns, your rhythms. It's going to reflect how well you're having about movement on a daily basis. It's going to reflect your relationships. Actually, it's like each of these we could double click on. There's evidence of how we're connected to other people. Right. People that we live with the people that we love the most. Our pets, connected to our pets, whether you have a pet.

speaker-0: Go

speaker-1: ⁓ And connected to your emotional state, which is informed by what you're thinking of and like clearly obvious outward stress moments in time where you're like, gosh, my heart rate went up and my blood pressure is like, can hear my heart pumping right now. Right. That's outward stress, but there's also less obvious stress, which are things that may exist in the non-conscious mind. that are from the past like trauma. so, and all of these things, even the things that are in the past and our non-conscious mind that you're not even thinking about, you're trying to keep it out, actually end up getting reflected in the gut. so, diet is a big part of that, Rock. Like the food that you eat comes into contact with these microbes. And so, ⁓ if I were to argue what is the most powerful lever, particularly within the context of the standard American diet where people are like consuming just about the worst diet you could possibly consume for gut health. That to me is where the opportunity exists for many people. But there are some people who are listening to this that are already following your advice. And if so, it may not be, it may not be nutrition for them. It may be other things. So I think it's just important to see and hear that there's so much more to your story that exists in your gut and the opportunities for healing are also continue to be deeply personal. There's many paths to healing and they aren't all the same.

speaker-0: That's right. That's right. ⁓ if somebody, let's say is doing a good job with nutrition and you see them in your practice, for example, ⁓ what do you usually try to focus on next? ⁓

speaker-1: I think. Um, great question. So let's imagine that the nutrition is like pretty darn locked in. And I will say there's typically opportunities for improvement for all of us. And it's, and it's not about perfection. Um, but like, you know, here's a quick example. Most people are familiar with the fact that I'm like a big advocate for fiber, right? So you might be following my work. You might already be doing the fiber thing, but are you doing the fermented food thing? Cause the vast majority of us are not. So even those of us who are, there's a huge number of people that eat a healthy diet and tons of plant-based food, but they're not even fermented food because they just haven't introduced that into their pattern. So, you know, so there's typically opportunities, but that said, like, where would I go number two? would, I would, I would want to open up a conversation. Like if, if in theory you were my patient, I would want to open up a conversation to start to hear more about your lifestyle. Like what are the patterns? What are the ways in which you live? Right. ⁓ and so that would include things like exercise and sleep. see those as quite low hanging fruit. If you were to just take the sleep and do a few quick little things, and I'm happy to share like what they are in my mind. If you were to do a few quick little things, you, you can improve the quality of a person's sleep. profoundly real fast.

speaker-0: Well, I want to hear those few things, but also just thinking about myself and I used to see this in the hospital a lot too. And I worked in the hospital when somebody didn't sleep well, they, they were more likely to be constipated or like have a harder time. Like their gut motility would slow down from, from, from less sleep. I don't, I don't know if that's directly related to the gut microbiome being affected by that or, more just the muscular contraction, but there was definitely some. connection there. And I feel that too, when I don't get a good night's rest, have, you know, cause I'm pretty regular. I'm more regular than I'd like to admit. Yeah, yeah, yeah, yeah. No, I am. can't go anywhere. Like the first hour, hour and a half of the day, it stresses me out actually. mean, if there were a downside to eating that much fiber, it's my morning pooping cycle that my family.

speaker-1: It's a good thing, should be proud of that, Rock. No. ⁓

speaker-0: I'll affectionately call it, but that's good. No, I feel great then. I'm good to go. That's my morning power hour. But yeah, anyway, so back to the question.

speaker-1: Yeah, the question, the question, you know, you basically you're asking me like, is there a connection between sleep and, and constipation? And the answer is that sleep is like a quite powerful representation of our circadian rhythm. Right. So let's not lose the context here, which is that our body functions on the 24 hour clock every single day. If your body were able to predict what you wanted to do at specific times, It would support you. It would help you to do that. It turns out that about 50 % of our genes are flipped on or off at specific times of day. And more than 50 % of our microbes are rising and falling during the course of a 24 hour cycle to meet the moment. like ⁓ the metabolic output of your microbes during the day is different than they are at night. So during the day, your microbes are actually very focused on protein metabolism because we're physically active. So we hear the word protein and I think culturally it's a different thing than what I'm trying to say, which is that like during the course of a day, there's all kinds of signals that are happening inside your body and you're physically active and basically protein actually is very relevant.

speaker-0: mean, Will, if you want to get people interested in gut health, just use protein. Just use that word. People's ears just perk up. They're like, what, protein?

speaker-1: ⁓ people love it. get enough. Can't get enough. right. So, but, and at night we're in rest and recovery mode, right? So, and if you, if you could, ⁓ establish a pattern to this 24 hour cycle that includes consistent sleep, change, nothing else, change, nothing else. Just make it consistent, right? Don't add anything. Don't subtract anything, but do it at the same time every day. I promise you people will feel the difference. Their sleep will improve. And they will feel more healthy. ⁓ And so, ⁓ and then to this end in the morning, when we wake up, there's actually a circadian reason why we tend to have a bowel movement in the morning. So now part of it is like the introduction of food and coffee and things like this, but it's not exclusively that because I could have a cup of coffee in the afternoon and I'm not going to go take a dump. Right. So there's definitely something circadian there. The fact that there's a pattern. Which by the way is very healthy. If you are having the bowel movement at the same time every day, I celebrate that. Because that basically means your body knows the time to go.

speaker-0: Oh it knows. 5.30. I don't have coffee or anything. No, no, no. It wakes me up actually.

speaker-1: Yeah, well, no, that's a, that's a different story, rock, but.

speaker-0: No, no, no, like at the right time, not too early. Like I wake up that early anyway. Cool, cool. It gets me out of, I guess what I mean to say is it gets me out of bed. It doesn't wake me up, but it gets me out.

speaker-1: Okay. Okay, so cortisol, there's two main hormones. This concept of a 24 hour clock is actually rather simple from a hormonal perspective because there's two main hormones that are basically defining the time of day for the rest of your body. And at night it's melatonin. So when we hear about this melatonin, the sleepy time hormone. Actually, by the way, melatonin is quite interesting because there's 400 times more melatonin in our gut than there is in our brain. And in the gut melatonin is actually helping to repair and restore your gut barrier at night. in the morning, it's cortisol. A cortisol is like the body's prednisone. It's a steroid hormone. And it sounds like a bad thing because it's like, ⁓ isn't that the stress hormone? Isn't that what we're trying to avoid? Cortisol, when it's properly timed to your 24 hour schedule is perfection. It's chef's kiss. Right. In the morning, when you first wake up that first hour, that's actually when we want a nice spike of cortisol. It defines our day. It's basically a timestamp to tell your body, this is when the day begins. It actually helps you to get focused. So many people, myself included, like I've written all my books at five in the morning, because the amount of focus that I can, like my ability to get things done is, is profound from five in the morning until nine in the morning. And then it starts to drift as the day goes on. Right? So that's the response. That's the result of cortisol. You also get the energy that you need to basically start your day. And so, ⁓ it also stimulates motility. So it's the, it's the alignment of that morning cortisol spike that we get when we wake up with our gut motility, basically turning on the entire system and getting the bowels moving. ⁓ disrupt that, then you're disrupting that. When you disrupt sleep, then you're disrupting that process that I just described, which helps to maintain rhythm and motility.

speaker-0: It's fascinating how these systems, of course they're all connected, but that, you know, the downstream effects, we would never, you know, in the past think like, something, you know, everyone's always so concerned about their system. The gastroenterologists are concerned about their system. But really you're speaking to just such a holistic view of the person that everything, downstream effects are a result of these systemic ⁓ factors that we all. that we all often neglect.

speaker-1: Yeah, cause your body doesn't care that we've decided to devise a system. The reason that we've created the systems based approach to medicine were the limitations of the human mind. Right? Because like I can, as an internist, I've realized that ultimately we all are forced into some form of specialization, right? Because I may come from a background of internal medicine, but that doesn't make me capable of being an expert in all of the subspecialties all at once. Right. So ultimately because of the limitations of our brain, we are forced to like have a space that's like, that's our space. We're defined by the space. We're a true expert in that space. Yeah. And, the body doesn't care. Right. The body is working. So, and this word holistic, uh, I think like needs, we need to sort of update to the modern world because like holistic used to mean alternative. I'm not talking about alternative. I'm talking about just like the

speaker-0: Yeah.

speaker-1: realization that not only are you one body, but you are one body that is actually deeply integrated to your environment because of the microbiome.

speaker-0: I hear that I hear, you know, as you said, nutrition is probably the biggest lever. Of course you wrote, ⁓ an excellent book on this. often tell people when I'm meeting patients who are transitioning, tell them this is. If not the book, one of the books they should read when they're first transitioning to a plant-based diet. know maybe that's not how it, it comes off when you just see the title, but really it's a great, it's a great, like how. to, make that transition. And, ⁓ the cookbook that it goes along with it is also like really, really good. ⁓ but. ⁓ good. Yeah. No, no. I want to give that appreciation. Cause it's such a good book. mean, I, I, read it first when it first came out during the pandemic and I was like at home and I couldn't, couldn't see anyone. And I was like, ⁓ this is really cool. ⁓ but, but I've recommended so many people.

speaker-1: It's good to say this, by the way.

speaker-0: since then and it's helped so many people too. mean, I love that you have those protocols in your cookbook that are so like step-by-step on how to do an elimination, histamine elimination, like things that I, you know, really are not accessible to, you know, someone like me, just a general internist or even the general public that you've made that so accessible. So I want to point that out if people haven't seen those or read those.

speaker-1: I'm very proud of my books and in my mind they are tools for healing. This is the way that I see them. And one of the challenges that any author writing on health faces is that the language that I could use with you right now is very different than the way to discuss health and, and, know, medical history and physiology and things like this is very different from the language that I would use if I were talking to a person. who has no background in health at all, right? And simultaneously we have to take, if we want to take a topic of health and make it compelling and interesting, we have to actually write it in a way that people are willing to read it. So you have to be willing to take the risk of putting yourself out there. And inevitably when you make a translation, it's almost like translating the Bible because like a purist will say, you, you misdefined this one word. And it's like, look, at the end of the day, if I can motivate people to change and start to add more plant rich foods to their diet, ⁓ that's a win. And it's not a complex thing. That's a very basic thing. And the science is all there to back that up.

speaker-0: So you wrote Fibro Fuel, I think in 2020, right? And I think it's helped a lot of people. What made you realize you needed to write this upcoming book Plant Powered Plus? Did something feel incomplete about the earlier conversation?

speaker-1: It's not so much a replacement. I don't see it as a replacement to the book. guess so to expand on the earlier thought that I see these books as tools for healing. Fiber-fueled to me was I'm a gastroenterologist in clinic dealing with dysbiosis on a daily basis. Dysbiosis is basically a disruption loss of balance within the microbiome.

speaker-0: Yeah.

speaker-1: I saw it as the people who are coming into this clinic. call it different things. call it irritable bowel syndrome or acid reflux or ulcerative colitis. Those were the, those are the outward manifestations. Those are the patterns, but the root of the issue is conceptually the same, which is a disrupted gut microbiome dysbiosis. so fiber fueled was the quite simply, me putting to paper the experience that I had had for the last like six or seven years in my clinic and how I had seen this approach of incorporating diet and lifestyle to transform people's lives. But it's general gut health. It's a basic introduction to gut health. And then people wrote into me and said, Hey, I'm having trouble ⁓ tolerating this plant-based diet that you're encouraging us to. And in my mind, there are things that I would do in the clinic. If a person reaches out to me through social media or whatever it may be and says, hey, I'm a fan, I'm really trying, I really want to do this, but I'm struggling. If they were my patient, there are things that I would do. So I thought, well, let me put that again into words and try to empower these people with the knowledge. It's not a replacement for your doctor or your dietician. It's in addition to your doctor and dietician. I'm of the belief that ⁓ people really need to be empowered today. that it's inadequate. could have the world's best doctor. It's not adequate though for you to go to that doctor and put whole trust, whole trust that everything will be perfect and that you shouldn't ask questions. So I'm of the belief that like we need to start with that foundation of empowering people. then, ⁓ so I've then completed these two books and I feel like a more mature author. I have an opportunity. It's a beautiful, unique opportunity. to write books that impact the lives of people that I've never met. And I take that very seriously. I'm very grateful for this opportunity. And I look out at the world and what I hear are conversations about protein and metabolism all day long. That's what's on my social media all day. Right. And it is on some level a bit frustrating to me because that's not the problem in my opinion. It is a problem, like in the sense that metabolism clearly is a problem. But is that the primary issue that we face or is there more? And to me, the primary issue that we face, I understand it's a buzzword, but we have to be willing to ⁓ talk about the things that are real even if they are a buzzword, right? So inflammation to me is the problem. It contributes to metabolic disease. also contributes to mood disorders. It also contributes to cognitive health issues like Alzheimer's and Parkinson's. contributes to hormonal issues, includes ⁓ in women, polycystic ovary and endometriosis, but also fertility and also menopause symptoms. In men, it contributes to testosterone levels and erectile dysfunction, which these are, we're talking about issues that like, there's a lot of people who are looking for solutions here. And of course, digestive issues. And you could go to, you could go to five different doctors for five different health problems. They're going to give you five different diagnoses, five different medications. That's the way the system is built. It's not their fault. Right? But what they're not going to do is they're not going to say to you, which they should, I wish that they would, they don't have time. They're not going to say to you, Hey, there's this one thing that's tying your whole health history together, which is inflammation.

speaker-0: Yeah. Well, and not just, mean, what, what's fascinating about, ⁓ the way you are explaining this is not just the inflammation. It's one, it's a specific type. It's this chronic low level inflammation. Let's be clear about that. then two, it's, it's coming from, overwhelmingly, a lot of it is coming from, ⁓ unintended consequences of having this inadequate or, or, or, or unhealthy gut lining.

speaker-1: Yeah, that's right. think that I'm not making the claim because I'm sure there are some wonderful medical doctors listening to this conversation. I'm not making the claim that inflammation is the sole cause of everything, nor am I claiming that the gut microbiome is one-to-one associated with inflammation so perfectly. But what I am saying is that these are factors that are contributing massively to the epidemics that we see on a daily basis.

speaker-0: Right. Yeah.

speaker-1: in our offices and that these are not something where we are stuck. There is an opportunity because the gut microbiome can be healed very quickly.

speaker-0: I mean, you're connecting the dots in a way that, you know, most people who certainly are colleagues who have gone through medical school, like that is not how we were taught to think about systems or to think about inflammation. Even, ⁓ yeah, we were taught like, can, you know, have these endotoxins and, never really thinking, ⁓ that's the pathogenesis of a large burden of inflammation that the body experiences that ultimately then can have these downstream effects. That's the dot I feel like you're connecting. And it's like, it's not, you're right. It's not everything, but just as you said, 70 % of the immune system is right there in the, the lining of the, the, the, the gut. So it's a, it's certainly probably a big portion and could be even more depending on the health. You're to be more of a factor depending on the health of one's gut lining. Well,

speaker-1: And you know, the way I see it is I've to the best of my ability, rock. I have taken very seriously. The information that I share in this book. So like everything is referenced in the same way that I would reference if I were writing a mega, mega, mega review article. I've over 1400 references in the book. Okay. And I share them publicly, whether you buy my book or don't buy my book. Anyone can, will be able to, when the book comes out, anyone will be able to get access to those references so that you can basically see like, this is where I'm getting my information from. Yeah. That being said, that being said, ⁓ let's also be a bit more pragmatic for a quick moment. We can debate topics, right? In, in academia, this is what happens. You go into the podium or you go to the microphone and you debate topics, but we also need to be real, which is that there's people out there that are suffering. They're unwell. They're looking to feel better. And if they're willing to change, which not all of them are, but if they're willing to change and we can offer them a path that we believe is evidence-based, what do they have to lose? And if they discover something, the way I feel, this is not like some hidden thing that you would never know. If you discover something that's impacting your body, you feel the difference.

speaker-0: Yeah. Yeah. Right. Right away. mean, it's sort of, ⁓ your natural connection with your body that we sometimes lose sight of. also hear that, you know, that's why you created these resources. You don't want this to be some, like only certain people know this. Like everyone should know this. Like everyone should know through like certain practices and not, not, not even very necessarily complicated practices. can restore health and. kind of balanced here to your gut.

speaker-1: There, there's this old saying, there's no such thing as a free lunch. mean, I understand. It's mostly true. It's mostly true. There's no such thing as a free lunch, except, except actually there kind of is sleep is free. ⁓ If you, I understand that like some of us, we have life challenges that could stand in the way of that. But like, if we can structure to address to the best of our ability,

speaker-0: ⁓ huh, right.

speaker-1: Sleep is free. You just have to take it seriously and value it enough to make time for it. Right. And, ⁓ morning sunlight is completely free and exercise. You don't need a fancy gym membership. You can drop down and do a bunch of squats or a bunch of burpees. promise you, your heart rate goes up. Right. so I think like on some level, the, ⁓ the tools that we need are available to us. Even nutrition, I hear people all the time push back that a plant-based diet cannot be done at a low price. And I don't actually buy that at all.

speaker-0: I bought a two pound bag of dried black beans for like 350 or something.

speaker-1: I have four kids. Life has become expensive for a family. I go to Costco and I'll get 10 pounds of dried black beans, 10 pounds organic, organic for 10 bucks.

speaker-0: ⁓ wow. I didn't realize. I didn't even realize they had such big packs at cost. have everything.

speaker-1: ⁓ some Costco is carried and some don't. So forgive me when they, when you can't find them there, the, you know, the, but the point though is like a solid plant-based diet is not built on salads, fresh organic produce. A solid plant-based diet is healthy whole grain, healthy legume, and a couple of toppings. Yeah.

speaker-0: Speaking of organic, mean, since you mentioned it, is there, is that something, I know that's like an optimization step. I always tell people if you can eat produce, regardless of it's organic, inorganic, you should eat produce. And like, what evidence do we have about like inorganic produce versus organic produce for gut health? is there some, you know, is that something that is beneficial if we're able to optimize for that?

speaker-1: Okay, so first of all, thank you for asking me this question because I really actually value the opportunity to unpack this and on social media, in 60 second clip, people can lose their minds on something that's like completely taken out of context for a broader conversation that like you and I are having right now. So, all right, number one, eating plants is healthy regardless of whether they're organic or not. Period. All right, so we have... tons of studies showing the benefits of eating plants and ⁓ nearly none of them are specifically using organic produce. So the point is when you see these studies like Adventist 2, was it a requirement for people to buy organic produce in Adventist 2? No. People are just eating plants. It's very straightforward and simple. so don't ever, ever that people scare you away from eating plants when the data is so overwhelming. So, now the organic question though is a complex question. Here's why. I'm of the belief, I understand that like people will argue things to try to sort of blur the lines. I understand the argument that well there's pesticides or herbicides that are used for both. Right? That there's pesticides that are used for organic, there's pesticides that are used for non-organic produce. Sure, are they the same? Or do they have a differential impact on our body? ⁓ And do we have concerns about that? ⁓ And I'm of the belief that like, sort of starts here. think this is the true crux of where you will hear different things from different people. I'm of the belief that because these are ⁓ human developed ⁓ chemical compounds. Okay. doesn't mean they're inherently bad, but you need to prove to me that they're safe. not going to allow you a predetermined definition of safety and then you're forcing me to prove that they're bad.

speaker-0: That's basically what we have created an industry where that exists.

speaker-1: Yeah. So the, so the, current regulatory is where there's like, it's basically like very, very limited restriction on not only our food system, but brought more broadly environmental chemicals that are allowed without sufficient, ⁓ regulatory prior to approval and without sufficient monitoring after approval. And without circling back to new technologies that emerge that allow us to more thoroughly vet and assess the safety of what we're putting into the world. So for example, microbiome testing is not a part of regulatory at all, at all. Actually, in fact, consumption, basically a feeding study, whether it be feeding a human or even frankly, feeding an animal. That's not required either. Like 80, 80 % of what's approved into our food system has never actually been fed in a study. So what I'm, what calling for is that our, ⁓ our baseline hypothesis be that we need to prove safety before we will accept, not that we will accept. then you have to prove injury after the Right. So, this is, this is my general position with these things. But we're stuck because they're already out there. Right. And what we see is we see widespread dysbiosis across America and people are suffering the consequences of that. And I'm not arguing that the only thing is like frankly food at all. Right. Like we're having a conversation about how there's a much broader, much broader, more issues there, but where we can control what we can control. I want to make choices that I believe are more helpful. And so I have concerns about glyphosate. The data with glyphosate are, highly disturbing that they negatively impact the gut microbiome. And when we talk about human safety,

speaker-0: Yeah.

speaker-1: gut microbiome will be impacted before the human will develop disease. You will see it in the microbiome first. So if we see something that's negatively impacting our gut microbiome, we should take that seriously. It doesn't, it doesn't take much to see these studies that you literally could go to Google type in gut microbiome, glyphosate, pomatum, period. And you will find dozens of studies and discussion among experts that raise this concern. And so then if we have that concern, again, I feel that we should be coming from a position of safety first.

speaker-0: That makes sense. Yeah. I think, it's, it's kind of littered throughout our food system, especially our inorganic food system, right? Roundup is kind of used on, ⁓ the politics of that is really fascinating too, because farms sort of like they got roundup ready seeds and then like their neighbor farms would basically like the, pesticide would blow over and kill their crops. And so they felt like they needed to get roundup ready seeds. So basically like all these farms. across the country, like just sort of felt strong armed into switching into.

speaker-1: Well, you can, know, mean, a, gosh, I remember like what farming, I grew up in upstate New York. grew a lot of farms around. Yeah. and I remember like seeing how that was like a family generational farm that then they have been sucked up by larger systems. Like it's not possible, right? In the same way that healthcare has changed. So too has our food system. And ⁓ you can increase efficiency dramatically with the use of these chemicals. And there are arguments that people make in the same way that there are arguments that drug reps make when they come to the doctor's office that like basically are highly compelling because they've been thought through and they've been trained to make these arguments. But I think what I come back to is really a position of safety first. And if we have safety concerns, then we need to properly address those safety concerns or we need to take steps to protect ourselves. So I'm sure I'm of the position that I don't think our government is ever going to take away these things that I'm worried about. So we need to ultimately advocate for ourselves, which means we make choices. We make choices with our own dollars.

speaker-0: That's right. I don't know our government and also, mean, our healthcare system, man, because really the healthcare system just waits for us to get sick. nobody's going to, you know, not many people, know, unfortunately yet, I mean, it's changing. We're, we're, we're leading that change, but not unfortunately right now, people are proactively telling people these types of things on how to optimize their health.

speaker-1: Yeah, that's right. Yeah. And it's a, I think, if we had our way, as I said before, if we had our way, would change it. And the lifestyle medicine movement is filled with people who are like truly passion driven, in many cases it's really hard from a financial perspective. Yeah.

speaker-0: Yeah. You can't, ⁓ fund these things with hopes and dreams. Sometimes I wish we could, ⁓ at speaking of which, you know, one thing that when I heard you speak recently, you spoke very openly about this human layer that about connection, about purpose and about belief and spirituality. And in your clinical experience, you know, how often do those factors turn out to be important when. when somebody is coming to you when they're not feeling well.

speaker-1: Well, okay. So a few moments ago we were talking and I mentioned the idea of like, Hey, like stress where something happens, your heart rate goes up, your blood pressure is pumping. can hear your heart in your ears. All right. Well, that is the physical manifestation of what we call the sympathetic nervous system, right? And that you could use the word adrenaline. That would be appropriate. Or I would use the word activation and Those systems are put into place to actually defend our body. So once again, this is an evolved mechanism to enhance our survival in the world that we used to live in and because it makes you more vigilant and more ⁓ Sharpen on when there's a serious threat So like if there was an attack of some variety animal or another tribe or something like this like boom you're turned on right? It occurs faster than your ability to process. like think about you get cut off in traffic. Your heart rate is already pumping before you even knew know what happened. Right. That's how quick it's occurring. So you don't have total control over that, that reaction. And we live in a world that is activating that. And the counterpoint to that is what we call the parasympathetic nervous system. And the parasympathetic nervous system, if I were to apply a single word to it, it would be safety. activation when there's a threat, but when there is no threat and you like, if this were, you know, hunter gatherer times, we would be hanging out, we would be laying around, we would be joking with each other and laughing, right? And we would be digesting our food. We would be resting and recovering. Right. So then, that's because we feel safe. If we didn't feel safe, we wouldn't be able to do that. So in the modern world, we have, are on sympathetic overdrive.

speaker-0: right?

speaker-1: The vast majority of our life, we wake up, we have demands, we don't have time. We have to get things done, check, check, check, check, check all the boxes. Then you go to work. You work, you fulfill the obligations that you have to your boss or whoever it may be. Right. And then you come home, you're exhausted, but you have to cook dinner and provide for your family and then put the kids to bed. And then you have 90 minutes. And so you're going to pull out your tablet and you're going to open up Twitter and you're pissed. Right? This is the modern world. Have you defied, have you defied this or? So you're laughing because you're like, that's me. Right. We all are guilty. Yeah. And we all are guilty. So, like, gosh, rock, think about this. Like I'm, I'm basically one of the youngest generations. was born in 1980. I'm one of the generations. Yeah. So, okay. So us, we, we, well, first of

speaker-0: Oregon trail generation. you heard that?

speaker-1: Oregon trail is awesome. We are Gen X so we have, you know, there's some advantages there, ⁓ but we remember the world before the internet. It makes me a little sad that my kids will never actually know what that like. Right. So, cause it's changed everything. Yeah. So, but the point is that, ⁓ if we could, we would take our foot off of the gas and we would gently apply it to the brake, which basically means we would shift from sympathetic overactivation into parasympathetic mode, which means safety.

speaker-0: Right.

speaker-1: And the reason why these things rock are important. spoke about the power of human connection and I spoke about the importance of spiritual purpose because I think it comes back to this word of safety. When you feel connected to other people, you know, you are loved, you know, you are supported and this insulates you from threats, ⁓ even very real threats because like, ⁓ my

speaker-0: That's right.

speaker-1: You know, life as an author, my book could flop and that could be the end of writing books. But I also know that like, despite that, that would be scary, but my family would help me to get through that. And then the second part to this, spiritual element is I feel that people are a bit lost right now. And it's because we've stepped away from a traditional, mean, we can talk about, ⁓ organized religion, there are flaws and issues there for sure. Right? Because those are human constructs, humans make mistakes. ⁓ But because we have become cynical of that, we have stepped away from that. And then what I see is like people who they're either totally lost in searching for meaning or they're defining their purpose as something that's more like transactional. ⁓ And in some cases really wonderful, could be activism. But the problem is they never actually feel the fulfillment that they're searching for. They're never satisfied. It's like junk food for the soul, sugar for the soul. they keep, they get a taste and they're like, that's good. I need that. And you keep going back and getting more more and more. You're never actually satisfied. Right? So there's a part of me that believes that what we've done is we've abandoned something that actually is deeply embedded inside of us, which is a

speaker-0: Right.

speaker-1: a search for meaning, a search for purpose. And I find it interesting, again, this is completely independent of what your organized religious views are. I find it interesting that when I look out at world history, You would think that the way in which we would interpret our lives as humans would at baseline foundationally be based upon our human experience, the things that we see, the things that we experience. Right? And if that were true, you would take this entire world to just be as is. It is what it is and then it's done. And you would just accept that. And yet, When I look out, I'm not where is there such a thing as an atheistic society? Like I don't think that there was. honestly believe that every single culture in human history across the globe, all different, different people, different environment spaces, and yet all actually reaching the same conclusion, which is that basically in a way, like not to oversimplify, they point to the sky.

speaker-0: There's a higher.

speaker-1: And they say there's something up there. And I think that when you, ⁓ the reason why I bring this up is that if you, if your life is aligned, if your life is aligned with your purpose, because of that belief system, which could be completely personal, it's not necessarily an organized thing, if your life is aligned with your purpose, then you, ⁓ experience great satisfaction in your life. You know what it all means. But when your life is disconnected from your purpose, which is what we get from this leaning into our spiritual experience, if you're disconnected from that, then in a way, deeply inside, whether you can consciously acknowledge this or not, deeply inside, you're actually feeling a bit sad. Because you know that your life is worth more. not actually chasing the thing that would make you realize the value of your life. So, so to me it's like, I believe that human connection is essential and we should be talking about this more. Loneliness has the impact on mortality that smoking does. And that to me is like that conversation about human connection. And I think that spiritual purpose is a compliment, not the same, a compliment to our innate desire for human connection. We also have an innate desire to understand why we're here. and to acknowledge our life as having some specific meaning within this broader framework.

speaker-0: Yeah. And does all of that affect gut health?

speaker-1: Yes. So thank you for asking because sometimes people hear that and they go, oh, well, that's holistic. Right. So, all right, let's get back to this idea of sympathetic versus parasympathetic. What I'm saying is that when your body feels threatened, it's an activation of the sympathetic nervous system. And the threat isn't necessarily you seeing a monster. The threat can be how you feel.

speaker-0: reading an email.

speaker-1: It could be reading an email. could also be ⁓ that you feel disconnected from your family. ⁓ Right? Or don't feel like you have strong social bonds. Right? Which the internet does not provide. Ever. ⁓ the composite value that I get from the 630,000 people who follow me, I appreciate you if you're one of them, but the composite value in terms of enriching my life is very close to not much, right? As opposed to the composite value that I get from just one member of my family is off the charts. So anyway, so the point though is that when we feel that safety, then we actually are taking off of the sympathetic, activating the parasympathetic and research has shown us that when you actually activate the parasympathetic is associated with increased gut diversity. They've done this with HRV studies. So, so, ⁓ heart rate variability studies, which is sort of a, ⁓ a marker for sympathetic versus parasympathetic tone. Yeah. So people that have a higher heart rate variability, that's, that's associated with less sympathetic, more parasympathetic. And people that have a higher heart rate variability have a and they tend to have more bacteria that produce short chain fatty acids.

speaker-0: I meditate and I can clearly see in my like Apple health trends when I started and when I've been more consistent in my practice, my HRV goes up, which is fascinating to think how that, meditation might, well, it's doing just that you're downshifting your nervous system, but how it might be affecting your, gut health at the same

speaker-1: Well, so think about this for a quick moment. just to be practical and then I'll explain the physiology. ⁓ something stressful has occurred, right? A loss in the family. ⁓ for many people you have to step on stage and give a talk, speak publicly, ⁓ or like a near miss in a, in a car accident. Right. In that moment, how do we feel it? Yes, we may feel our heart pumping. But we also simultaneously, you might feel butterflies in your stomach. You might just start feeling nauseated. You might get diarrhea or constipation. You may get waves of cramps. Right? We manifest our stress in our gut. What's occurring there on a physiologic basis is, and that's like a true real world manifestation of the brain gut connection. We have just demonstrated that what's happening here is impacting you down there. ⁓ What's happening on the inside is that when we're exposed to stress, the sympathetic activation involves the release of a hormone from our brain called CRH, corticotropin releasing hormone, which activates the pituitary glands and sets off the entire cascade of many hormones that we see as our stress response. ⁓ The is that in that moment, if you were getting attacked by a saber-toothed the entire point to activate these hormones is to pump blood to your brain, pump blood to your muscles, so you can be vigilant, focused, and if necessary, do heroic physical feats like climatry. You don't need to digest your food, you don't need your gut. In this case, there is no free lunch. Okay. you come back to you sacrifice your gut in order to get these short-term benefits from sympathetic activation. then the problem is if we live in a sympathetic overdrive world where we have perpetual sympathetic activation, we're basically like, ⁓ sacrificing our gut health in the process.

speaker-0: Yeah. Right. Wow. That's it. Thank you for explaining it that way. That makes perfect sense. What I actually love actually about you and the way you write and explain things is that you take these very seemingly complicated things or black boxes and you actually break them down in a way that's, you know, makes sense. So appreciate it.

speaker-1: appreciate you saying that. This, the immune system in my new book, Plant Power Plus, you know this being a medical doctor, we could get lost for days. ⁓ gosh. It's so complex.

speaker-0: but at the same time.

speaker-1: I feel like if we can just get the basics down to understand, like to me, what I found, and I challenge anyone and the listeners of the show, if you could find me a study, I don't mean this in like, I'm mad at you. I mean this in a sincere, like if you can find me a study that shows me that the gut is well, but the immune system is inflamed, I would love to see it. I have not found it, Rock. So they're so interconnected that the gut is unwell. So is the immune system and vice versa. And this is, this is, this is to me why, ⁓ you know, this is part of why we have such an inflammation epidemic, but this is also part of me, why I'm optimistic because we have an opportunity there. can, we can change the gut.

speaker-0: Yes. So what, yeah, so let's, let's just quickly like maybe pivot to that. Like what are some practical things someone listening, they have, they're having symptoms. Of course they should talk to their doctor, but like, what are some practical things they might, where they might want to start?

speaker-1: I would basically say that I see the book in terms of the action sections as broken into three major parts. So one is nutrition, one is circadian rhythm, and one is basically the brain gut connection and the opportunities that we have in all three. So in a way we've talked about the brain gut connection because what we want is we want to ⁓ Activate our parasympathetic nervous system, which can be done. You mentioned meditation in the digestive health world, diaphragmatic breathing, which is basically slow breathing is a powerful way actually to do that. ⁓ I would add given the context of our conversation about spirituality prayer, right? Or reading ⁓ a scripture that's, ⁓ informs your belief system. but also. Like the fun stuff, so sauna and massage and acupuncture, they activate the parasympathetic nervous system. And then ⁓ human connection, like why do we hold hands? Why do we hug? Right? Or like shared intimacy. These are actually expressions of bonding.

speaker-0: spending time with our pets, right?

speaker-1: Spend time with our pets. our pets, our pets are actually great for our microbiome. ⁓ so yeah, so that's, that's the brain, that's the brain gut connection. The other thing that we haven't really discussed, but we're at least we've just kind of like very much touched the surface as trauma. So there's an entire conversation there because what we found, so I described a moment ago, this concept of sympathetic overdrive. All right. People that have had trauma, what that's like for them. is basically their foot is on the accelerator and it's a lead foot. It just won't let up. Right. I think about it a little bit like the movie Speed. Yeah. Where you got the, you got the bus.

speaker-0: the bus that you can't go below 85 miles an

speaker-1: Is it? You gotta give him every is 85.

speaker-0: I don't know that was the back of the future actually.

speaker-1: Yeah. So, yeah, so the boss, you know, with Keanu, who, by the way, I, he's come full circle. think he's a tremendous actor considering where he started with Bill and Todd. But definitely the idea is that trauma is that boss that's cleaning down the highway and it, and it's very, very hard to stop. And so they've actually shown that the functional MRI in the brain. people who have been exposed to trauma is categorically different than people who have not. There's hyper activation of the amygdala. So the amygdala is the fear center. So I said that parasympathetic is safety. These people, because of their trauma, it's like impossible for them to get from sympathetic to parasympathetic because they constantly are living in fear. so There was an interesting study rock just real quick and then I'll move on. Yeah. Where they looked at kids who were less than two years old and they were adopted. All right. So this idea of like, there was a book, the body keeps the score. I actually haven't read the book, but the title is perfect because it actually is completely true. So what they found in this study is that these kids who were adopted before age two, As adults, they had less gut diversity. They were more likely to suffer with gut symptoms. And when they studied their brain, their brain had different patterns of activity. It was like hypervigilant. ⁓ compared to kids who are not adopted. But they can't remember.

speaker-0: Right?

speaker-1: They can't remember, but yet this has all happened and is affecting them years later. So, all right.

speaker-0: later. I wonder if there's like an epigenetic... Anyway, okay, well I want to kind of tie it. Thank you for that. That's really... and I'm looking forward to your book. Your book comes out I believe January 15th.

speaker-1: January 13th in the US, 15th in the UK.

speaker-0: ⁓ okay. All right. January 13th. So I'm looking forward to that. I'm sure, ⁓ there's a lot of good insight and advice in there. ⁓ well, I like to end all our conversations with a couple of questions. One is, ⁓ how do you personally make your own life into a health feast? And what I mean by that is how do you make it feel nourishing and abundant? ⁓ and something that you look forward to in your own life.

speaker-1: Okay. So my first book, fiber fueled, the takeaway message, just to shorten the whole thing for everyone is to eat a wide variety of plants that continues to be true to this day. In fact, it's been further validated by additional research. And so this is something that you can gamify in your own life and with your family. But now what I'm here to say is I have a non-negotiable. which is to have a great morning routine. I have specific things that I do every morning and it doesn't take a lot of time. It doesn't take a lot of time. It doesn't require a lot of effort, but it changes the way that I feel. And if I were to say, what are the top two most important things that I do? It's making sure that I get exposed to light within the first hour of waking up. So ideally get outside and take a walk. But if you can't do that, like this time of year, then it's perfectly fine to use a light, which is they have these special circadian lights that have 10,000 lux. All right. I'm telling you, I'm telling your listeners, if you do this, you start getting light every morning within the first hour of waking up. You will have more focus. You will have more cognitive endurance. You will feel it on day one. By the end of the week, your mood will improve and you will sleep like a baby at night. You will find that your sleep improves. So get that morning light. And then I said that there were two things in the morning. This is the second is light exercise. So it doesn't have to be aggressive. I'm not talking about CrossFit. Light exercise, meaning like just quite simply taking a walk. Right. Or like doing a couple squats, just to get your heart rate up. Right. You do those two things when the first hour waking up, I promise you, you will feel the difference.

speaker-0: Amazing, amazing. Okay, and last question we ask everyone. You're coming to our proverbial health feast and everyone is bringing their mindset tip or life philosophy. What is Dr. B bringing to the health feast?

speaker-1: I feel like we've talked about quite a bit within this space today. So, I think that if I were talking to my own children,

speaker-0: Yes.

speaker-1: something really important to me, I would want them to know two things. Number one, the best things in life are free. ⁓ Lean into that. ⁓ Don't get lost in keeping up with the money. Focus on the best things in life that are free. And number two, it may take you a long time. It took me a long time. But if you can find your purpose, it's a part of self discovery. If you can find your purpose, once you know, You should never stop chasing that because it will bring the greatest satisfaction in your life.

speaker-0: Amazing. Wow. Thank you. If folks want to, ⁓ we'll put all your links in our show notes. You are the gut health MD on Instagram. Is that right?

speaker-1: The Gut Health MD on Instagram, on Facebook, I have a new YouTube channel. ⁓ Yep. I have a new podcast that I'm launching. ⁓ So we're going to be, depending on when this comes out, we're going to be launching Monday the 29th with our first episodes.

speaker-0: Okay, right on. Cool, when is that launching? ⁓ of December.

speaker-1: of December, the 29th of December.

speaker-0: a week from today. we'll probably, this will probably come out a week or so, a week or two after that.

speaker-1: Okay, perfect. So yeah, so check me out on YouTube ⁓ at the Gut Health MD. And then finally, if you come to my website, the guthealthmd.com, ⁓ free email newsletter, it's basically a sub stack, but it's free. ⁓ I have free resources and tools for people who purchase my book. So please take advantage of that. And I want to thank everyone for taking some time to listen to us today.

speaker-0: Yeah, thanks man. think thank you for taking the time on this busy holiday week to be here with me and we do a requisite fist bump to the camera. Boom. Boom. All right everyone, have a great day and thank you for listening. Until next time, live well and rock on.