Dr. Will Bulsiewicz: Help & Heal Your Gut

there's a systematic review and meta-analysis done that showed that dietary fiber reduces our likelihood of having a heart attack reduces the likelihood of dying from heart disease reduces our likelihood of getting esophageal cancer colon cancer breast cancer less likely to die of cancer leslie could have a stroke less likely to have diabetes less likely to have kidney disease how is this not on the news why do i have to talk about it on my youtube channel right like what what the [ __ ] is wrong with our system hi i'm ian bialik and welcome to my breakdown this is the place where we break things down so you don't have to it's mine be alex's breakdown she's gonna break it down for you because you know she knows a thing or two [Music] alex breakdown is supported by ring everyone knows about the ring video doorbell i mean everyone knows about it but did you know ring makes an award-winning alarm well it's what is in this podcast studio right now ring alarm is an award-winning security system you can easily install it yourself i got help from a friend and you get extra protection with available professional monitoring if you subscribe now this whole studio has the security of the ring alarm that we love and a secure wi-fi network with a consistently strong signal across this whole house ring alarm pro is whole home security with available professional monitoring when you subscribe to ring protect pro for peace of mind day and night no long-term commitments because we know i don't like that if anything happens professional monitoring will call you you can request emergency services and it's an amazing deal it's true ring has an award-winning alarm to protect our studio we've gone pro with ring alarm pro jonathan where can they learn more to learn more go to ring.com forward slash breakdown that's ring.com forward slash breakdown [Music] today we are truly gonna break something down so you don't have to do it we're gonna be talking to dr b why do we call him dr b because his last name is bulsawitz and it's spelled with w's c's and z's dr will bolsowitz is a gastroenterologist and he is gonna fix our poop and our mental health at the same time but first i'd like to introduce you to the person who really fixes our poop and mental health and that's jonathan cohen hello mime jonathan how are you i'm doing pretty well i'm wearing your uh jewelry today i just found it lying around the studio i collected it and it's uh you know it's now mine for the episode is it helping your mental health it's not hurting it i think we should also acknowledge that you stole one of my socks and so now i'm just have a one-socked foot moved from your body a sock that i don't feel reflected the glory of who you are it was a little ratty it had some problems but it had two enormous holes it wasn't my best sock and did you feel your best in that sock i mean my foot was less cold than it is now jonathan we're talking to someone who is really at the intersection of mind and body mind and body you and me this show and our listeners i'm very excited i would like to just point out that i always say mental health has huge components of the body i thought pain is mental health physical movement has mental health and what you're about to say ties that together five years ago if you'd have told me this has anything to do with mental health i'd be like that's crazy that's for people like jonathan who want to believe there's connections between everything well folks jonathan and all those hippies were right i'm not saying the scientists are wrong this is an example of a scientist who is right but you're you're absolutely right our culture was not having this kind of conversation and what the conversation is revolves around the fact that you are what you eat is like the simplest way to say it there are actually ways that we can eat if we would like to take into our own hands many physiological problems that we have many diseases that we are told are unavoidable such as diabetes heart disease high cholesterol right we can literally if you want to your mood your irritability your restlessness your anxiety we now know for reals yo that what goes in your gut absolutely impacts all of those things and more and dr b yes he is the new york times best-selling author of a book called fiber-fueled because one of the things that he has sort of used as an approach to gut health is a strong concentration on fiber and in particular not having foods in your body that stay there for an excessive period of time and one of the first things that makes people uncomfortable up these conversations is i don't want to eat every two hours that's what newborns do right so in our modern diet our sad diet our standard american diet as our pediatrician calls it we eat a lot of foods that just stay in your body for like a long time and also leave residue in your body and what that means is you don't get hungry every two hours or every three hours or four hours but you often are not literally emptying your body of things that are hurting it a lot of people hear things like plant-based and they get very very upset because they want to go to the barbecue because they want to go to the barbecue and here's the thing i don't think me or dr b is saying you know don't go the barbecue like one of his fiber can help you pass the barbecue through one of the things he talks about is this notion in in american culture in particular and western culture but american culture that like the main thing on your plate is a hunk of protein i mean even if it's a steak right like a big steak and that's how i grew up a big chicken like that like what are you eating well i'm gonna eat meat and then a couple things on the side and what we've learned and what um the china study and you know many vegan physicians have been talking about for decades and decades indeed is that countries that place plant-based protein at the foundation of their diet even if they eat meat have meat those people don't get the same diseases that we get and i mean cancer diabetes type two this is not an episode you should turn off because this is not a scolding episode this is not a judging episode this is basically me needing to ask dr v why i can only have successful poops if i eat gluten slightly off course but we're also going to cover how serotonin is made in the gut we're going to talk about the actual mental health connection uh between uh what we eat and sort of how we be how we behave another thing i want to talk to dr b about is this notion of food sensitivity everyone has food sensitivity every one well the word that people use is allergies and i'm very particular about that because i come from a highly allergic family like proper clinical allergies and when people talk about food sensitivities i'm not real i'm just being honest i don't always understand what's going on meaning is it your tummy are you grumpy maybe you just need a nap like what and then you in particular have a lot of food sensitivities that you like if you eat something you're not supposed to it's not just like oh [ __ ] i shouldn't have eaten that thing it's like i'm feeling unstable in my soul and i need to regroup in an environment that supports the regrouping process because that piece of egg snuck in and i don't think i should eat eggs i am filing an objection [Laughter] sustained i've been mischaracterized this reenactment is slanderous so dr will bolsowitz is a gastroenterologist he is a gut health expert and the new york times best-selling author of fiber fueled and there's a cookbook that's right folks he's authored more than 20 articles in peer-reviewed scientific journals which is a very big deal especially if you're not like a tenure-track professor type in a laboratory he's given i mean tens and tens and tons of presentations at nationally recognized meetings he's presented to congress to the usda and he is committed to a really active and really helpful social media presence with very simple things that jonathan would like us to try but before we talk about why that doesn't make sense let's get dr will bolsoewitz over here dr b break it down we're very excited to have you excited to be here so first of all i bring regards from a friend of mine whose name is lisa sherga and the reason that i'm so excited to talk to you is that lisa was this friend of mine who was gluten-free and she was like oh she's gluten-free like years ago she was gluten-free before it was like a thing that's the sound you make anytime anyone says they're gluten free so what i know is that lisa has lived the dr b life and lisa is no longer gluten free and for me this is so phenomenal not just because she can eat more things but because i have become more and more curious about the foods that i put in my body yes largely since this gentleman and i started spending more time together i was vegetarian since i'm 19 and i've been vegan i don't know 15 almost 15 years wow i'm incredibly impressed as a sciency person by just your studies and your credentials and the life that you have built because also i was a pre-med student and it's a it's very difficult to get an md and then come out like thriving and positive with color in your face like you seem to be thriving in your career as an md which is already very exciting but your specialization is very interesting to us because jonathan's been talking about things that you talk about for a long time and i was like he's nuts he's crazy he's thinking too much about it i don't believe this and he's right about many many things and finally our culture has come around to talking about the things that we're going to talk to you about and you you wrote this book and i think is this the first guest i've made this kind of list for like i have a list of the things that i need to talk to you about but the first thing i want to ask why can i only have a satisfying poop if i eat gluten so first of all i am so glad that right off the bat we're talking about poop we're not wasting any time cutting to the chase of what we actually care about and what we want to talk about why beat around the bush let's just get to it yes well first of all i think gluten and we could unpack gluten if you want to your friend obviously read my book and you know there are some people who are like dr b you're cutting against the conventional messaging like what everyone's talking about with gluten and i'm like well i don't know what to tell you other than i'm just reading the science and explaining what i see in these papers and so it's not about like echo chambers or what you hear on youtube and repeating it again it's about ultimately going to the source of truth there is truth that exists or at least it's the closest that we can get to the truth and this is this is what science is about so i go to that place and i take a look and what is it telling me let me interpret that and then bring it to you and the answer is that there are many forms of gluten containing foods by them some of them are super unhealthy ultra processed foods they're not really good for us but the flip side like are you really telling me that a whole grain delicious sourdough bread is actually bad for me i'm not we no i know you're not i know you're not i know there's people out there that are you're talking about if you were to compare that to a fast food restaurant bun exactly right and eating healthy food right empowers our gut microbiome these 38 trillion living microorganisms that are inside of us that like outnumber our human cells we are less than 50 human and they make up 99.5 of our genetic code and when we eat delicious sourdough bread we are feeding them we are fueling them they grow stronger and then they give us delicious like perhaps i shouldn't use the word delicious but they give us great bowel movements that are deeply satisfying and make us walk out of the bathroom in slow motion as dubs fly blx breakdown is supported by better help online therapy jonathan there are so many physical symptoms that you have which i also have that we often don't realize are actually from stress stress shows up so many different ways and jonathan you of all people know we live in a world that tells you to do more do more with less sleep like work harder work more we are reminding you jonathan and everyone listening try therapy do less reduce your stress jonathan what has therapy done for you it's such a good way to process to just get out that mental inbox put it all out there see what's really going on and reevaluating just getting it outside of your head has such a big impact on how intense it feels for you exactly and it absolutely can impact physical symptoms that we have so what's better help well it's online therapy it's customized just for you there are video phone even live chat sessions if you don't want to see someone on camera if you're not ready to do that that's fine also it's more affordable than in person therapy and you're matched with someone right away there's not like this big long process under 48 hours you can be matched with someone see if online therapy can help you manage your stress we are sponsored by better help our breakdown listeners get 10 off their first month at betterhelp.com break that's b-e-t-t-e-r-h-e-l-p dot calm slash break my be alex breakdown is supported by athletic greens we use athletic greens daily because i don't always eat well i'd like i'd like to think it's not my fault i have a very very busy schedule and i want to fill in the gaps in my diet like dinner last night was pretzels that's not okay but with one delicious scoop of athletic greens i absorb 75 high quality vitamins minerals whole food source superfoods probiotics and adaptogens to start your day right when dinner was pretzels on an airplane it's something you can do every single day to take great care of yourself right now reclaim your health arm your immune system with convenient daily nutrition one scoop in a cup of water every day you don't need a million different pills and supplements athletic greens is also going to give you a free one year supply of immune supporting vitamin d which is so important and five free travel packs with your first purchase just go to athleticgreens.com breakdown athletic greens.com breakdown take ownership over your health pick up the ultimate daily nutritional insurance for my body what i what i've picked up on is that it seems that there's certain things that i eat that are glutinous which make me really uncomfortable like it hurts my tum tum and i get like really gassy like like literally bloated like really physically bloated and if i if i eat other things that have gluten i sometimes don't have that reaction so then i'm like well maybe there's variability because of all the things that i know about let's say stress like stress is increasing your immune response to anything and if i'm eating other things that are inflammatory but i really i tried being gluten free and i was not having satisfying bowel movements is it because i wasn't eating enough fiber let's unpack this a little bit and talk about gluten because first of all gluten is a protein gluten is typically found in foods that are made from wheat barley and rye those are the grains that involve gluten and this is a news flash this might shock people but there are other things in wheat barley and rye it's not just gluten like wheat is not just gluten there are other things and they did this interesting study mayam so like again let's go back to the research and let's see what the research shows us they did this interesting study with people who first of all they proved that they do not have celiac disease celiacs don't like to hear that they don't want to hear that from you yeah exactly well because if you have celiac disease i'm telling you right now you need to be gluten free there is no no there's no negotiation here you are gluten free if you're my patient and you tell me that you're not going to be gluten free then you're not going to be my patient anymore so because this is this is the treatment for celiac disease and it's actually quite dangerous if you don't stay gluten free but once we get that out of the out of the equation and we're talking about a group of people who they don't have celiac but when they eat gluten containing foods like you described they have symptoms gas bloating discomfort cramping maybe diarrhea or constipation what's the deal so they sent them home with three weeks worth of breakfast bars and there's three types of bars one was a placebo okay cool that's our baseline we're going to compare to that it was just a sugar bar one was a breakfast bar that had gluten in it and the third was breakfast bar that contained what are called fructans f-r-u-c-t-a-n-s now fructans are almost like fiber and you find them in gluten-containing foods it's part of wheat so people ate these three bars and they marked down what they're doing in terms of their gi scores and it was quite shocking because when they analyzed the data they discovered that when people were eating the high gluten containing bars they had less symptoms than with the placebo the placebo was causing more symptoms than the gluten flip side which i love i was like yes that's awesome flip side when they contain when they consumed the fructan containing bars they got triggered it's not even a reaction to gluten it's a reaction to the fructans fructans are almost like fiber they're actually really really good and healthy for us we want them they feed our gut microbiome the proper term for fructans would be prebiotic people have heard of probiotics i'm talking about prebiotics which basically means food for your gut microbiome fructans are that we want them but the problem is that when you have a damaged gut and you consume too much of them all at once you may find that it causes symptoms that's not gluten that's fructans i jumped in with like the poop and the gluten just because i had to but let's take it back a step why are most people's guts damaged i think it's a large part of it is this society that we live in it's our diet but it's also it goes beyond our diet let's look at the diet first all right what is the average american eating if you break it down 60 of our calories come from ultra processed foods these foods did not exist a hundred years ago we don't have microbiome studies to know what most of them do to our microbiome and there are literally 10 000 food additives that the fda has approved and allowed into our food supply and by microbiome just for people who don't know you're talking about literally like the environment of your insides of your kishkas as we call them i'm thinking like when you god forbid get a yeast infection like the ph is off is this kind of the equivalent for your gut like things can be out of whack a yeast infection would be like an imbalance of the vaginal microbiome right so it's interesting miam we are covered from the top of our head to the tip of our toes in these invisible microbes right and it's quite hard for us to imagine that they're there but they are there they're as alive as you and i are and it's kind of like look if we zoomed out from earth if we're up in an airplane and you look down at earth you don't see anyone there but when the plane lands you get off the plane and here's all these people there's eight billion of us and if you took a microscope and you put it and you took a look at what's happening inside your body right now what you would discover is that concentrated inside your large intestine which is your colon there are 38 trillion microbes tell people what a microbe is so with mostly bacteria these are mostly bacteria now we have to like kind of evolve in our understanding of bacteria because we spent the last 100 years saying how horrible they are and they need to be destroyed and yet here we are in the last 15 years we're starting to understand that actually most of these bacteria are good for us and they want us to thrive and do well so we have bacteria we have these fungi which are almost like yeasts that's what you're referring to with the vaginal yeast infection thank you for taking us there and we have the archaea um these are kia are quite interesting because we think that they are the oldest life on the planet they've been around for four billion years we've only been around for about three million and um actually we've only had oxygen on this planet for two and a half billion years so basically there i kind of scorched earth i don't know what they were doing but they were there for 1.5 billion years and there was nothing here so anyway this community miam they live inside of us they live in harmony they live in balance they are an ecosystem just like the amazon rainforest just like the great barrier reef and when they are healthy then basically what you get is there's this functionality where they all work together as a team in support of human health it's quite i mean i'm just speaking as a doctor that it is very clear to me how much we grew to trust and rely on these microbes because they have taken up residence in a way where our physiology actually is completely dependent on them so we need them just to run through this we need them for proper digestion like we can't process and break down our food without them they support our metabolism our immune system our hormones our mood our brain health they can actually manipulate our genetic code if you take a moment and you think about everything i just described basically what i'm saying to you is i think that we found a new organ it's called the gut microbiome it probably is the most important organ for human health and it's not even human so definitionally an organ is a group of specialized cells that have the same function and so it's a it's a little bit different but it's almost like a it's almost like a satellite organ i mean i think you we have to look at it as such because it's so central to human physiology that we can't get by without it and so if it's if if we care about our heart beating properly or our liver or you know you go down the line then we have to care about this too and the problem is that we couldn't see it on a cat scan right it's invisible to the naked eye yet if you take it and pull it together it actually weighs more than your brain and these 38 trillion microbes like it's hard to define what is 38 trillion i don't know if we open up to the sky and we take all the stars in our galaxy there are 100 billion stars and we take jonathan's colon hello jonathan and we're going to start putting microbes into your colon one galaxy at a time we would put this is the weirdest audio porn ever [Laughter] not to be too too visual with jonathan's colon but i'm gonna put 380 galaxies full of stars into your large intestine and that represents the number of microbes that not only you but i have and that mayan has and the listeners at home have that's how many we have it's crazy is it that people who have you know serious problems have less microbiome or just not a high functioning microbiome that's like supportive of each other and so you have like you know some of those trillion going in one direction and some of them going in the other they're not communicating properly if you ask any biologist what is the measure of health within an ecosystem they will say biodiversity means as many different varieties of species as possible now what's interesting is if you look at the microbiome when biodiversity erodes when we are less diverse in terms of the number of microbes this is when we see the manifestation of disease and the microbiome like when it is damaged the word that i would use is dysbiosis the word that exists on the internet is leaky gut be careful what you read about leaky gut correct i well that's the next thing i need to talk to him about just before you go where you're going yeah we're quick list of why everyone's so messed up so they're out of balance they're eating things horrible horrible diet even the food 60 processed foods 30 animal products eating more than your body weight and meat on a yearly basis more than any country in the world and we get upset that china eats meat and they're eating like literally one sixth of what we eat in the united states uh we don't sleep we don't exercise we are on our tablet or our phone or a television at 10 o'clock at night which is completely disrupting our circadian rhythms we're putting weird stuff on our body when we shower we clean our home to the point of making it like like ultra squeaky clean and then we're just killing everything in the process of doing that and then we never actually go outside to spend time in nature well i i do want to say that you know and this comes up you know as a person who's um who is a vegan as well as a lifestyle vegan and you know has been vegetarian you know i was vegetarian when like literally you didn't even tell people because it was so embarrassing what people would say to you and like my parents were like mortified and you know like so i've you know i've been through a lot of years i'm 46 and i've been like on this journey you know for a very long time and many of the things that people say about this category of things that we're talking about are absolutely things that we can talk about now because a hundred years ago we were worried about other things like wars and learning about vitamin c like you know we're we're at a developmental stage in our culture where we can talk at this level and we no longer get to say oh well poor people are going to eat fast food and tough right we are now having these conversations that are not just for wealthy people they are not just for people who can afford to think about these things what dr b is talking about is things that impact everyone and these are things that we all should be thinking about meaning even good sleep even reducing stress not being on technology these are things that that are for everyone this is not some hollywood trend it's not a thing that celebrities are doing and actually dr b specifically talks a lot about challenging some of the highly restrictive eating practices that many people especially in the city that i grew up in and live in that's just like that's just normal like it is normal to meet someone who basically can't eat anything in los angeles but what what i did want to talk about i like sharing things from my personal life and i mean we've already shared about poop i had a situation i'm not gonna be specific i will deliberately be vague i had a situation when my kids were young it was just a very stressful time you know i had two young kids and i you know had gotten my doctorate but i was like teaching and like it was a hard time and i um i'll just i'm trying to be delicate about this i found out some information that was deeply deeply troubling but where i was at in my life i did not share that information with anyone and i could go into a lot of depth about why i held this but what started happening is something that had never happened to me before i started not being able to eat meaning i started being not being able to process food and what would happen is things that had never happened to me bathroom wise like i was constipated or i had like very strange because for me i had never had those symptoms i never connected it to this thing that happened until like almost a year later of like doctor after doctor what is wrong with me like god forbid you think do i have stomach cancer like what is going on and i was diagnosed with sibo small intestinal bacterial overgrowth i was tested for leaky gut they thought i might have a worm or you know like all the things i then started becoming i don't want to say allergic but so highly sensitive to the main staples of my diet which as a vegan were beans nuts tofu my diet shrunk and when i and i was also actively breastfeeding exclusively breastfeeding a child for part of this and he relied mostly on breast milk his stomach would go bananas when i ate these things so i had me and a child having these severe reactions so what i did is i went holistic because western doctors were like we'll just put you on antibiotics for 62 years or you constitutively need to be on antibiotics sorry this is your life and i'm thinking what nothing runs in my family like this like all the other things run in my family so i ended up going to a very a lot of people would consider this an out an out there healer and she talked a lot about food sensitivity and things like that and long story short i did end up being able to add those things back to my diet as did my child but no one except this holistic person said is there anything going on is there anything emotional going on in your life and you know you think about some people have a nervous stomach that's my favorite example when people like what's mind-body syndrome it's like people who lose their stomach before a date before a job interview that's mind-body connection right but what was fascinating to me is i didn't i mean they thought i might have atypical ibs like they did not know what was wrong with me and so as given all these diagnoses it would have been so easy for me to be put on antibiotics that i did not need many people said well you just need to eat meat and dairy right i mean like people suggested everything and what it was was that i was dealing with an incredibly stressful thing that was not being dealt with what you eat and what happens in your gut i mean it's kind of chicken and eggy right but it is directly linked to stress to mood to a wide variety of mental health maladies so can you kind of talk about that i am like shut out of a cannon right now because i have so much that i want to say mind be alex breakdown is supported by ritual symbiotic plus and ritual are here to celebrate not hide your insides there's no more shame in your gut game that's why ritual is offering our listeners 10 during your first three months go to ritual.com breakdown to start ritual or add symbiotic plus to your subscription today does your probiotic contain clinically studied strains meet one that does ritual synbiotic plus contains two of the world's most studied strains with over 350 publications of human clinical trials one of the things that we love about ritual is how much they are constantly committed to growing where necessary and synbiotic plus is a perfect example of that synbiotic plus and ritual are here to celebrate not hide your insides no more shame in your gut game rituals offering our listeners 10 off during your first three months go to ritual.com breakdown to start ritual or add synbiotic plus to your subscription today mine be alex breakdown is supported by air doctor clean air is one of the things jonathan talks about the most in the time that i have known him it's important it's very important and it's one of the easiest ways to have a positive impact on your health and this is something i have learned from jonathan improving the quality of your indoor air with a high quality air purifier is really really important and all you have to do is check out air doctor and breathe and don't worry about the noise it's really it is very quiet which is important for us especially in the studio a professional quality hepa air purifier is recommended by leading medical experts and jonathan as an effective way to reduce airborne germs and viruses and protect your home make sure you get an air doctor to keep you and your family safe air doctor comes with a no questions asked 30 day money back guarantee if you don't love it send it back for a refund mine is shipping go to airdoctorpro.com use the promo code breakdown you'll get a 35 discount on their classic air doctor 3000 purifier that's like the biggest discount we've ever given on anything 35 off but you have to go to a-i-r-d-o-c-t use promo code breakdown [Music] it's so important for us to understand that we are a complete human being that we are not organs functioning in isolation we are not just like proteins fats and carbs coming into contact with digestive enzymes or gut microbes and that equals you know your digestive apparatus we have a soul we have a spirit our body is intertwined and connected one organ is talking to another will they revoke your medical license for saying that absolutely not are you surely not yeah well so look our healthcare system just to comment real quickly on that our healthcare system it's i feel about healthcare the way i feel kind of about my parents which is that when you're a kid you think that they're god like they're perfect they're infallible when i was a medical student i looked at these doctors and they are a god they walk on water and then like 14 years later i finally emerged from my training and came out the other side i was 34 years old and i realized that this is flawed and part of the reason why i realized this is because it affected me personally so this was actually like one of these moments in my life i'm sure you guys have had these where you feel like you're being cursed and then you discover five years later that actually you were being blessed because you're getting exactly what you need in that moment to transform you into something better but 10 years ago so i'm in my 40s now 10 years ago i'm like looking in the mirror at this man who's 50 pounds overweight and there's the blood pressure pills on the sink and high cholesterol and i just wanted to curl up under a blanket in a dark room and be left alone i was clinically depressed and i knew that something was wrong i knew that something had to change i tried to exercise my way out of it and it did not work and ultimately it was changing my diet transforming my diet in the way that you're describing my um that changed my life and honestly i feel like it also set back the clock where i i'm feeling younger in my 40s than i did in my 30s but to move back into talking about what you're describing miami this is so important because you can do everything right you can eat the right food exercise sleep meditate do yoga drink juices and not be well and that's because we are a complete human we are far more complicated than that and we have to treat the whole human not just the digestive system and we have to recognize that our mood affects our gut and vice versa so i'm going to focus on how our mood affects our gut and then if you want me to expand beyond this i will we have evolved defense mechanisms that protect us in moments where we need a surge of energy where we activate our sympathetic nervous system if the dog is trying to attack us then like i need that that's going to save my life and stop me from being mauled and what happens in that moment is your brain the pituitary glands will release a hormone called corticotropin releasing hormone crh the crh basically what happens is this initiates your stress response and there's a cascade of events that take place and if you're trying to survive that dog coming at you the cascade of events are to your advantage we want this but we pay a price because down at the bottom if you follow that waterfall down you will discover that you have disrupted and damaged your gut microbiome this is why in moments of stress 85 of us will suffer digestive symptoms of some variety and 15 of us will get headaches very common for people to like hit like boom acute stress and then boom you know you're in the bathroom with diarrhea or you get constipated or you get bloated now that's an acute issue but what you're talking about is something different you're talking about something that is unsettled in your life something that is disturbing you and it may not even be a part of your conscious mind this may be a part of your non-conscious mind and it may be something that you're thinking i dealt with that that's not an issue it's out of the picture but it's not it's still there the memory exists it's a part of who we are it's imprinted in our brain and unfortunately because we have not adequately dealt with it and it remains unsettled i'm talking about in the on in the non-conscious mind because it's unsettled it is activating your stress response so then what happens when this pathway that was supposed to protect us in acute moment of stress where we need an extra little surge what happens when we're activating this 24 hours a day seven days a week this is how you can be perfect on every level doing everything right you're still not getting better and that's because you're being held back by what's happening with something that's completely unrelated to nutrition frankly well this ties back to so many people have gut issues in our society and you know mime and i talk about uh somatic release somatic works connecting the emotions with the body and there are sort of multiple paths to understanding what you're holding consciously or not consciously you can work through the mind or you can work through the body and connect the mind and if you're working through the mind then you want to connect it to what's happening in the body or the other way around and in the work that i've done every single person out of thousands and thousands of people that i've worked with i've only met one who didn't have some like pretty significant thing that they were carrying around either childhood or recent stress or stuff that's just like totally unprocessed that you know there's a reason why we're sitting on our tablets at 10 o'clock at night because we don't want to feel anything right that's so interesting we have no as a society we don't have any tools to process or not it's not that we don't have any but for most people we do not have the right tools the active practice of clearing the mental inbox of understanding what's happening emotionally and so it just all accumulates and then we realize oh we have this massive health issues and so we we you know either have an emotional problem or some massive health issue and that's the only way we start to deal with this stuff that is otherwise you know tucked underneath the rug jonathan do you think that it's actually that we don't have the tools and that we require the tools for us to do this or do you think that it's that the modern lifestyle has disconnected it disconnected us from what it means to be authentically human i think it's i think that's a trick question well i think it's this ecosystem and when you talk about the balance and harmony of our gut microbiome like our life has evolved in a way that it's very easy for us to prevent you know the slowing down practice we don't have community we don't have a lexicon or a dictionary or you know any of the language we talk a lot about therapy and self-understanding and if you speak to someone who's been in active therapy no matter what it is it could be a meditation practice it could be with talk-based therapy it could be with hands-on body work of some kind to do somatic work any sort of self-reflection if you talk to anyone who's had a extensive practice they have a different lexicon of like if you ask them how they are and they know that you want to hear how they are and you know you have the time and space to have that conversation their ability to express what's actually going on for them and and communicate their overall stress levels and you know what's being dealt with what's triggering them in the current moment is completely different than someone who has never had any of that experience and it to me it's a learned behavior a practice of identifying stress understanding its impact its origin your role in it making yourself not the victim of circumstance and understanding what you can choose to change what you can't and yeah i would say that most people are illiterate when it comes to beginning to understand how their lives are impacting them from an overall stress standpoint i appreciate this and i think first of all i think this is a great and important conversation that we're having on this particular topic because it's important for people i tend to go on podcasts and i write these nutrition books and i myself know that there's so much more to this than just nutrition and we fixate on it and we really need to broaden out the conversation and talk about stuff like this now i here's what i would add this is just from my perspective i think you know we all have our context right so we all are sort of contributing based upon what we've seen what we've experienced and i feel that the modern lifestyle is anti-social and we are social creatures you want to bring out the best in a human being tell them that you love them support them make them feel safe surround them with other people it's impossible to be the best version of yourself by yourself but this you're right i mean it's if you want to torture a person you isolate them right i mean you literally can torture a person by doing that and in my life the things that i'm doing the things that i'm doing now are only frankly made possible because my wife and my family support me i would like you to talk a little bit about your wife because i know she is a significant part um not obviously because she's your wife and you had babies together um but she also was an important part of kind of your personal transformation is that correct yeah yeah yeah yeah so if you go back to 10 years ago you know i i sort of described this vision of a guy who's in his early 30s i'm actually in my medical training i'm in chapel hill north carolina i had completed medical school many years earlier i was a board certified internal medicine doctor i could have been a primary care doctor but i was training to become a specialist and um again like i was not in a good place and i didn't love the man that i was in that moment and i was on a date with this person who is now my wife and we have two children we're about to have three very soon she's um congratulations pregnant thank you and so but like i would have never known that this was where we were going to be 10 years later in this moment we're just on a date and we're um in cardboard north carolina and like smithfield which is like the sausage capital of the entire planet outside of germany smithfield is like 30 minutes away i mean this is pork country in north carolina we're out at dinner and i'm getting the pork chop and here's this person you know this like 2012 and she says i'm not even going to order from the menu she says to the waiter can you bring me the collards black eyed peas the green beans and some mashed potatoes and just make it look nice on a plate and so i'm just like yo who is this person like i've never even been around someone who's vegetarian or alone vegan but what i noticed is that this is just my observation that she enjoyed her food just as much as i did she cleaned her plate she did not restrict she ate until she was full she looked amazing she was completely in control of her health and i'm over here and i got the meat sweats and seriously you know they've actually proven that the meat sweats is real well the microbes can metabolize and make our microbes create our pheromones oh that's why people smell meaty you actually are smelling the product of these microbes and it comes to other sort of conversations like why do we kiss and they've shown that we actually share 100 million microbes when we kiss it's like a compatibility thing with our microbiome so yeah pheromones like pheromones come from microbes like when you when you're on a date you're like oh this person smells good it's microbiome compatibility it can even be unconscious as well don't even realize that you're thinking that so well so anyway so i i witnessed this and and we finished the day and i'm like hungover i haven't even had any alcohol i'm hungover from this meet and she is like energized and ready for round two of the day and it just opened my mind to being forced to look in the mirror because you have to understand that the training program that i had put myself through was intensely rigorous where i'm working basically six days a week you know 15 or 18 hours a day sometimes 30 hours in a row without even eating that's how we make good doctors is to do that to them it's i mean it is complicated because we also do need to get enough experience taking care of patients to be be independent um so that's part of the challenge is like how do we strike the proper balance because there is a balance it's not such a thing as like let's make it easy for people but um anyway you know it's like i'm getting smashed i'm getting slammed constantly and convenience emerges as the most important thing in my life and food like heck it needs to taste good i won't lie i loved the food that i was eating it was like philly cheese steaks and cold cut subs i loved it it tasted great it was convenient it was quick and i was paying the price with my health and i didn't realize it and i was forced ultimately to take a look in the mirror at the food that i had been raised on the food that i had prioritized in my own life and accept that maybe the stuff that i really enjoy eating is actually causing harm to my body so can you say that can you say that again maybe this stuff that i love to eat is actually causing harm to my body i did not make a radical change i did not become vegan uh i made one small change i still needed convenience and i felt like you know what blenders are convenient you don't need to be good at cooking for that so let me go home and instead of going to hearties and getting like 2500 calories for four bucks let me go home and take out this blender and i'm just gonna throw in some bananas some blueberries some greens maybe some walnuts and then like you know some soy milk buzz blend it up drink that for dinner and like i just have to say that i instantly was energized so the point that the important point from this point forward what i want people to know about my personal health journey is that because i had suffered with my own health issues this has inspired me as a doctor and i made small smart sensible choices but i just kept doing them consistently and then they became habits and then i stopped thinking about them and then i started craving those foods which i'm pretty sure is because my microbiome adapted to them and then next thing you know like you find yourself on a predominantly plant-based diet with some fish and you're feeling way better and you've lost 35 pounds and you say well what if what if i could just try going without it and that's what i did and i got back to my high school weight but i was in my late 30s it's the first time i got back to it in like 20 years i think it's super important to the this notion of like the steps towards training your body to like lots of people think that oh i'm just going to switch and now i'm only going to do this other thing and it's like they have massive shock and and their body isn't ready for that transition your body in general is adapted to whatever the life it is that you've been weeding for the last three months and adaptation is required anytime you're going to change in any capacity so i used to play soccer in high school i thought i was in great shape and then we would switch to basketball season and i would be completely out of breath yep it's a different sport when you change your diet your gut microbes like here's the beautiful and empowering thing that we haven't had a chance to say yet they are adaptable they can be shaped they can be made what you want them to be they can actually be like you can restore functionality you can heal them they will forgive you so anyway to that point jonathan like when you make a change if you like cannonball into the pool you're like not adapted to this diet at all and you should expect pushback in the form of a pissed off upset digestive system flip side you make small incremental changes in the same way that like if you go to the gym you make small incremental gains these small incremental changes over the course of time allow you to shift and move things wherever you want to take them so if you want more plants in your diet you are 100 capable of doing that you just have to slowly introduce them and allow your body to adapt over time this is something i when people ask me about like veganism like this is something people ask me about a lot and you know i'm i'm sure dr b gets this you know it's a lot of like i could never do that you're so amazing and it's like no that it does not take a superhero well well one of the things in particular i love my cheese people love to say that and here's the thing about any change that you're gonna make there is an adjustment period and part of what i say and i literally think that this is there's an emotional correlate for this when you try something new if you directly compare it to what you had been doing it's going to be very painful shocking and you're not going to keep it up so if you say today i eat cow cream cheese and tomorrow i'm gonna start eating vegan cream cheese it's not gonna work because your brain biome whatever it like all the things are going to only compare it's the same way if you try and break an emotional bad habit it's like it's gonna feel shocking to for example stop micromanaging everyone's life around you it has taken me you know a lot of years just to start chipping away at that you cannot try and do it all at once and this is part of what you just said is a problem in our culture because people don't want to take time well because people want shortcuts the idea of a health hack is a flawed idea you know what a health hack is honestly a health hack is you doing something consistently sustainably for a long enough period of time that you stop thinking about it because it's a habit and then that's actually a health hack because now this habit that you created is actually paying dividends in perpetuity as you move forward and it's helping you to heal and you're not even thinking about it like i don't even think about it anymore in terms of my diet but mine you're exactly right this is you need to allow your body to be educated in this new approach you wouldn't wake up one day like i don't care how smart you are you don't go on jeopardy without studying you don't run a marathon without training totally right you have to train so i totally agree and just to give people i'm giving people a little bit of the benefit of the doubt which is not always my strong suit because look i've i've read a lot about different diets i've had experimented with different diets it was never really explained to me this level of adaptation that's required and it's pretty easy to think that like oh if eating plants is good for me then i should be eating a lot of plants and just switch over and the fact that we're acclimatized accustomed we have to sort of transition and have our body adapt to something to a new routine i think is new information for a lot of people even though jonathan i don't know exactly what you eat but even though maya and i are eating vegans three things all day nice we need to work on that uh even though we may be eating this way i i do think it's very important for people to understand that there are many forms of a healthful diet when you go to look at it when you go to look at it though like if we look at the science if we're being sincere about evidence-based nutrition what you're going to discover is that in populations across the globe all of these different forms of healthful diets are at least predominantly plant-based diets period peri there's no caveat to that okay i'm gonna play the devil's advocate just to give voice to some of the people out there who have heard other information sure do blood types impact it they've studied this they've studied the boiler type diet and here's what they found it's interesting the type the type a diet was the diet that actually did best for people regardless of whether you were a type a or not a type a and when you look at the type a diet guess what it is it's plant-based diet it's a plant-based stuff so all those uh seas who are like all i need to eat is meat you're like eh not so much well um so look you're not actually fixing your gut if you if you eat these foods and you get gas and bloating and you run away you are scared of your food you are running away from a food monster you are not finding joy in your food and you're not actually addressing the underlying problem which is that you have a damaged gut right so instead you're avoiding that's effectively the equivalent of the person with the injured knee who says i'm not going to walk anymore and the problem is that when you go down this path and let's pretend you eat a completely meat-based diet okay so you're not actually healing your gut your gut is growing weaker because you're no longer exposing it to any food other than literally just me and simultaneously i can assure you that with 100 certainty if you actually are following this diet and only eating meat your ldl cholesterol is absurdly high absurdly high and ldl cholesterol is a known risk factor for coronary artery disease i have never heard if you want jonathan you mentioned like am i going to be you know lose my medical license for this conversation i'm pretty sure if a cardiologist recommended that diet they would lose their medical license for it and part of the reason why is because just to i mean i can't help but like share this as a medical doctor because it concerns me that people are doing this not only is ldl cholesterol a known risk factor for coronary artery disease we have different drugs that lower lddl cholesterol and the drugs actually work through different mechanisms but they all work to the same endpoint of lowering ldl cholesterol and when we study people with heart disease they are less likely to have a heart attack and less likely to die of heart disease our number one killer is coronary artery disease we should not be running towards a diet that enhances our risk of the number one threat to our life that makes no sense to me i'm just gonna say that's an amazing response he's an amazing person i wanted to get a little bit back to some of the kind of um you know regulatory mechanisms let's say of the gut this is not a facetious question but okay i'll start like this so i grew up in a home with four people and we had one bathroom until i was 15 and my brother was 19. and that's four humans in with one very small bathroom i rarely if ever thought about like how my bowel movements were like i just didn't think about it as a teenager i just like whatever i just you went like you just be as efficient as possible because there's four people who need the same bathroom right and once i got to college and like i became a vegetarian you start like meeting other people and like you know it was like my first boyfriend in college and like he had a whole thing about like his diet and i was like what and i'm like he's from northern california they must think about all that stuff in northern california but what i discovered is that there is a whole world of people who are connected to their bodies in ways that i just wasn't raised to be and i'm sure there's a lot of reasons but one of them was that we didn't have time to like talk about that it was just like getting get out fine what i noticed as an adult i only learned this as an adult sometimes i feel nauseous and i get a headache and it's often because i have to poop and then i had children i have a they're now 13 and 16. and we're the variety of people that were part of the diaper free movement i don't know if you know about this um there there are those of us who um pick up on a child's cues which they do give when they go to the restroom when they're infants and if you reinforce those cues they will give them stronger and basically my children could sign for potty before they could walk eat solid foods or talk and it's brilliant i learned a lot about the digestive system with also with breast-fed babies it's a little more predictable but what i learned is that babies and toddlers often have a very bad mood before they have to poop or when they have to poop and if they are constipated they are very very ornery and i realized i know adults with this same kind of pattern and i thought my gosh like this is just a consciousness that i didn't even know about and when you when we talk about you know we're kind of like poking fun at like oh it feels so good to have a healthy bowel movement but can you speak a little bit about not kind of i'm not asking you to be funny although you are funny why does it feel good to have a particular kind of of emptying of that part of your body well we're supposed to be having this i mean honestly having a good healthy complete evacuation is supposed to be one of the highlights of our day i'm being serious i mean so this is a very very important bodily function so easy for us to be taboo about it because it's poop but like i just talked about how powerful this microbiome is digestion metabolism immune system hormones mood brain health genetic expression and guess what makes up poop it's not the excrement of your food sixty percent of the weight of your bowel movement comes from your microbes so when you poop you are actually this is a window the health of your bowel movement is a window into the a the health of your gut microbiome and when it's working the way that it's supposed to much like the heart it is in rhythm your body thrives on rhythm so it should almost be effortless where you get those cues you know it's time to go you head to the restroom it's a nice relaxed complete evacuation it's not traumatic you feel satisfied yes it's not effort based right you're not grunting you're not bearing down you don't feel like an incomplete bowel movement which by the way is like one of the things that i always ask my patients is like do you feel like you're completely empty because there are many people there are going to be people who are listening right now they don't think that they're constipated they say dr b i poop every day you're crazy but if you poop every day but you don't completely empty or you poop and then you have to poop again 30 minutes later that basically means you didn't completely empty in the first place you are backing up and you are constipated and constipation can manifest with really funny interesting symptoms with people like the number one symptom is gas and bloating but you can get nausea yeah you can lose your appetite you can get fatigue some people get hangry or get headaches you can definitely get pain the pain can be so intense people think they need surgery yeah you're just full of it in the book you also give a bit of a a glossary to looking at our movements as a sign of of health it's like it is a window into how our body is doing and lots of people again just in terms of like not knowing most people don't look at their movements and if they do look they're they have no idea what they're looking for could you give us a little bit of info on sort of like a shorthand of what we should be paying attention and what that might mean i'm so glad we were talking about poop this is like this is literally i'm like the only guy in america that you can bring into an interview and i'm like yes let's get into this so all right there's this thing someone i don't know who this bristol person is but their name has been forever attached to bowel movements because whoever professor bristol is we have the bristol stool scale and there are seven pictures of bowel movements and if you look at your like you just some people are like i don't look i just flush i'm like come on give it a look what's going on down there and you can look and there's actually like images or cartoons that illustrate what the bowel movement might look like so now there's seven types type four is right in the middle that is your glorious like you know strutting out of the bathroom with a little bit of a weird grin that's you're the type of bomb movement that you want this is the type of bowel movement that we vegans brag about because i have two vegan children and this is they never have trouble in the bathroom it doesn't take a long time we are efficient and you feel great this is the vegan poop yeah and you're dropping bombs at least twice a day sometimes three and every single time you're like that was great feeling good i enjoyed that right i have a t-shirt that i've been wearing for years that says eat plants take epic days i've seen it on your instagram account well and the problem is now my daughter can read so i'm like oh no what am i what kind of example am i setting for my kids here a healthy one but anyway type 4 the way that a normal bowel movement should look is like a sausage it's soft it's formed it's tubular okay this is a type four healthy bowel movement this is where we want to be this is glorious now if you move all the way to type one type one is constipation these are like hard balls pellets hard balls of stool uh yeah pellets and it hurts it actually hurts to get them out because they're not they actually can't easily pass through the anal canal so it's like birthing a child it hits i mean go there hold on a second oh you got in hot water now yeah and well and i'm also getting myself into trouble because if my wife hears this podcast before the baby is born i'm probably he'll slap you could tell her i know exactly how you feel i had a number one 15 years ago exactly flip side the type 7 is liquid it has no form it has no shape it comes out urgently and this is diarrhea now if you are on one of these extremes type 1 type 7 it's actually empowering to understand that this is indicative of injury to your gut microbiome you are a person who deserves to be healed and we shouldn't wait until like the bomb drops and some major medical diagnosis comes along your body is already telling you the warning shot across the bow is there let's go ahead and take the steps necessary to get this fixed i wanted to ask about the issue of food sensitivity because this is like the most often spoken phrase at least in los angeles that i have heard in the last two years of my life can you talk about what is food sensitivity versus an allergy yeah so let's separate these two i'm gonna call it a food intolerance versus a food allergy we'll start with food allergy this is very important an allergy by definition before we even get into the food is your immune system activating in response to something from outside your body like some sort of foreign thing so like it could be pet dander it could be pollen you know the flowers are in bloom okay now you got seasonal allergies it could be asthma hyper reactive airway diseases um when it comes to food and food allergies is that your immune system is responding to something in your diet and there's a specific group of foods that we know account for the vast majority of food allergies what are they dr b so these include dairy and eggs and fish and shellfish and nuts and peanuts and soy and corn and wheat now here's the thing when you have a food allergy your immune system gets activated it can be scary if your throat is closing you need an epipen and you need to be in an emergency room now so in that setting literally any exposure even the most trivial amount where you don't even realize it's there could activate the immune system this is why like a person with a severe anaphylactic reaction to peanuts we can't have peanuts in the airplane now as a result of this this is very different from a food intolerance food intolerances by the way are far more common they affect we believe about 20 of people and it is manifest with discomfort of some variety gi symptoms gas bloating cramping pain diarrhea constipation like these are the manifestations of a food intolerance it is symptomatic can they manifest other places because what i'm hearing a lot is like when i eat this i get a pain in my lower left back and i know that that's because i ate the cantaloupe like can it manifest other places all right so it's a little bit there is some complexity to this where right if you have histamine intolerance which is a specific food intolerance that does not involve the immune system but because histamine has receptors throughout the body we can manifest a headache or um runny nose sinus issues or skin issues you could get hives you could get flushing you get a rash and that's not actually an allergic reaction that's histamine and it would actually require a trained health professional to help you to disentangle those possibilities to understand what's what you don't want to figure this out on your own when there's the possibility of a food allergy because food allergies are dangerous but with food intolerances you know a person has an allergy you put one drop of milk on their tongue you might initiate this problem you take a person with a food intolerance i can assure you one drop of milk is not going to activate their food intolerance there is an amount of each of these foods but here's the key so two things i want to say allergy immune system intolerance not immune system it's very simple not inflammation not inflammation it is not inflammation is sloppy digestion and the second thing is that the intolerance can be fixed you don't have to live with it but when you run away from it when you say that food causes problems i'm going this way and that food's going that way okay you are creating disordered eating so okay i want to respond i want to respond because what you just touched on is also this like this tremendous intersection of mind and body where you know a physician a gastroenterologist can have this conversation with us because the mental health impacts of both dietary challenges right meaning it's upsetting to constantly feel afraid of food it's upsetting to constantly be damaged by food but the mental health impact of both that fear which is completely legitimate and then also the compounding of the things that we do to try and fix it is what creates to me this like cadre of people who are like oh i don't eat that i don't eat that you can't you cannot engage in the world with and to me it's like i wonder what comes first are these people who kind of want to be removed you know from a normal eating environment are there things that they could be doing but also the fear that you'll have that reaction is enormous we are creating a negative feedback loop first of all before i go any further i want to say that what what i'm describing i have seen thousands of times and thousands of patients and it's very human and you are not a flawed human for having this happen to you it is actually just indicative of the fact that you are a human being and we are all doing our best myself included so but what we do is we create a vicious cycle and the vicious cycle basically is it occurs in a person who has chronic health related issues specifically any sort of symptomatic thing because you start to become neurotic about it you wake up in the morning and you have no control over this this is like you're not making this choice trust me you wish that you were feeling better but you wake up in the morning and you say i i hope that today is a good day i hope that we're gonna have a good one and then something happens triggers your symptoms immediately your brain goes there you fixate on it you focus on it you can't think about anything else it activates your sympathetic nervous system your sympathetic nervous system then actually heightens your acuity in terms of how closely you're paying attention to these nerves that are sensing and feeling and so you actually feel an intensification of the symptoms it actually starts to get worse this is mind-body syndrome that's literally i mean that's it's a male adapt it's a male adaptation to chronic health related issues where we wake up in the morning and hope that we're going to have a good day and the minute that we don't it destroys our day this is also true of people and i'm speaking because i'm one of them with significant psychiatric history meaning my level of hyper awareness to my emotional state can this can happen emotionally right so i there's also an i you know i don't know i don't know what end you would need you know to to have a significant correlation here but for people like me you know who have chronic pain that will move around right it is so intertwined with this kind i mean it it it can happen in your gut just like it happens in your mind this this is why this is why when you're having gut related issues one of the things that i teach in my new book is that you can do belly breathing right which has nothing to do with nutritional choices but yet by belly breathing and just practicing that and becoming good at that you can actually take control of how you feel and so this is the type of empowerment that we need if someone is having a food reaction and as we described lots of people are like okay i'm not going to eat that and you move away from it how do you reintroduce that food or if you know you're having a reaction or if you're having a reaction what are you what are you doing outside of like if you take a break from that food how are you sort of building yourself back up to rehab and then reintroduce that so that you're not having this elimination uh diet give me an example jonathan with the type of food that you would use here okay someone says for example apples they have this bad reaction to apples so they remove it and maybe it's like they are a little cramping they have a little bit of gas whatever it might be and then okay so i remove it and maybe it's not an actual allergy because they're not like you know freaking out or having hives or um having a more heightened response but right you know they want to sort of like get back into it is it like take a break and diversify your food so that your body reacclimates and then slowly reintroduce like what's the approach so the approach so actually in my new book i described what's called the growth strategy g-r-w-g-r-o-w-t-h and it's actually a step-by-step process that you follow to address exactly what you're talking about so the first letter is g genesis you have to know the root of the problem if you actually are going to create a treatment strategy if you don't know what you're treating then you're just throwing stuff against the wall and hoping something sticks and hoping you get lucky that's not really a way to approach healthcare or life right so so we have to start there because if a person jonathan if a person is constipated they will manifest symptoms with the fiber content that's in an apple yeah and they will think the apple is the problem when in fact if i made you poop you would have no problems with that okay wait so g is genesis yep then we go into i'm going to pair r o w together restrict observe work it back in and basically this is the method that you take in terms of using these foods and isolating them where you create counter currents you stop it you see how you feel you restart it you see how you feel and in creating these counter currents you actually are empowering yourself with information about how your personal body because we're all different how your body responds to this individual food so once you know what the food is that you're intolerant of then t stands for you train your gut so and then the last thing h stands for holistic healing and really this is just my way of of reminding everyone that you know like we talked about before you can eat you can sleep you can exercise and yet you are a complete human being and there can be these parts of who you are that may be affecting your digestive function and they may have absolutely nothing to do with nutrition and you may not even feel that they're connected to your gut microbiome real quick i had a patient recently who has ulcerative colitis i tried everything to get her better she was not getting better we were both frustrated and then one day she comes in she's in remission meaning that she's not having diarrhea around the clock anymore she feels like herself again and i was thrilled but i wanted to know what did you do because i couldn't fix you and i'm the freaking new york times bestselling gi doctor she realized that her job was holding her back she dreaded going to work every single day her boss would demean her in front of her peers publicly and she finally got the courage to walk out she found a new job she was happy they treat her with respect and now her ulcerative colitis this complex inflammatory chronic uh functionally autoimmune disorder is actually in remission it's like she doesn't even have it she didn't change her diet growth people love talking about how like 95 of serotonin's in your gut now one of the things that is dangerous about the popularization of science which i appreciate and i think mostly it's amazing and it's great but when people hear things like that it it often you know kind of skews and can become very sensationalized so the the notion of kind of like what serotonin does obviously we think of it for ssris and we think of it as you know maintaining more serotonin and the synaptic cleft and like all those things and antidepressants and great fantastic but serotonin also it's it's part of motility function correct totally it's not so much that like your gut is the center of happiness which i think is the way a lot of people interpret that it's that serotonin is it's a neuro it has a neuroendocrine function which means that it innervates parts of your body and the gut has a a vast a vast representation of binding for serotonin but not necessarily like to make you happy it has other functions that it does yes i'm actually i'm glad that we're sneaking this in at the very end because we talked earlier about how the brain affects the gut now we're talking about how the gut affects the brain so yes 90 to 95 of serotonin is in fact produced in the gut serotonin is the happy hormone lifts our mood uh makes us feel energized and as you mentioned we treat with selective serotonin we uptake inhibitors to boost serotonin levels the serotonin that's produced in the gut does not cross the blood-brain barrier that is not directly affecting your mood thank you it is involved in bowel motility right actually mayam many times in people that are suffering with complex uh functional digestive disorders we will actually treat people with medications like serotonin at baby doses at baby doses like the lowest dose that you can take and then you cut it in half because if you can restore those nerves and basically like take away the visceral hypersensitivity because you actually have five times more nerves in your gut than you do in your spinal cord it's the second most populated place of nerves in the entire body outside of the brain because evolutionarily this is a very very imp like next to genitals and face if you're a primate is a very important part of your body because it is life or death this is where we're interacting with the outside world right like our skin is a wall our skin is a barrier whereas our place of vulnerability is where we is our gut this is where we're interacting with the outside world this is why 70 of the immune system is right there in the gut now does our diet and our gut microbes have the ability to affect our mood i love that we get to end on this because it's such a fascinating topic science is emerging to say that the answer is yes we have dietary studies interventional studies where they have demonstrated the ability to improve for example a major depression one is called the smiles trial professor felice jacka who's in australia she randomized people to either a mediterranean diet or control and what they found is that in the control group this is moderate to severe depression so like not mild in the control group only eight percent were better [Music] and in the diet group 32 were better so if you take four people who have moderate to severe depression and you give them this diet one of them this is going to change their life that's pretty amazing i always say to jonathan how many people were in the study where was it published meaning has it been peer-reviewed and what are the other factors that have been controlled for statistically because what you can't do is say and this is kind of like the notion when i was a teenager i remember like when your parents would be like don't smoke cigarettes it's like but everyone in france smokes cigarettes and they don't get cancer that's not a proper study because what you have to look at is not just the diet where are they eating this diet what's the rest of their lifestyle like so the reason that i'm so anal retentive about studies is that you have people hearing things especially in popular media about things that diet can do without fully understanding the kind of studies that you are working from and that you are trying to show people we don't just say something for fun and build a diet around it and sell a book we look at the science right we look at the science we make sure things are controlled for like where do they live what's their socioeconomic background what is the rest of their mental health like so that we can identify and say the diet is working because the science of the body is predictable well and no one's study proves anything either that's the other thing is we need we need patterns we need verification we need to see this with different populations this is just the start of this but the point though is that we do believe that the gut microbiome is involved in affecting our mood and if you take a look under the hood at people that have for example major depression what you're going to see is a reduction of the short chain fatty acid producing microbes that produce anti-inflammatory compounds you're going to see this in anxiety disorders as well so where we are today is we have data that suggests like not like with complete clarity we need more data we have data that suggests that food affects mood we have data that suggests that microbes affect mood probably not through the direct serotonin but it could be 5-ht which is a serotonin precursor for all the nerds who are out there at home this is what we're talking about and also i think more than likely the short chain fatty acids which are what we get from consuming dietary fiber and so it's an interesting place that we're in now here's what i'm doing um i'm involved with a personalized nutrition company called zoe because i don't believe that there is one size fits all and also because i believe that we can do better than randomized controlled trials minimize control trials are great but the problem is that they are population averages and they are not necessarily you how do we create information that we can apply to the individual user but the answer is that what we're starting to this is what i'm actually involved in is like what if you have 10 000 people and all 10 000 people gave you a microbiome specimen wore a continuous glucose monitor did blood lipid testing had an app and entered into the app exactly what they're eating and every single day they told you how anxious they are but we have twenty thousand people and some they will be a hundred thousand people and i'm actively involved i was actually just looking at some of the data today you know the question is can we fully connect the story food microbes mood right like we have it in separate compartments right now and we have it with small studies the study that the randomized trial that i just cited was like literally 65 people all right but i have a database of 20 000 people they've all given me their microbiome they've all told me what they're eating and they've all told me what their anxiety level is that's going to be incredible i want to give you my microbiome there's interesting data now where we traditionally have just kind of described the microbiome and now we're starting to move into a place where actually we're we're manipulating it and so in melanoma research at md anderson they're actually so first check this out they treat melanoma with immunotherapy all right so they're like shaping the immune system to fight the skin the skin cancer first they noticed that when you give antibiotics prior to immunotherapy people do way worse [Music] they did a randomized trial because they thought oh this is just like oh they're just sicker so that's you know if they're sicker they're getting antibiotics they did a randomized trial people did way worse when they received antibiotics then they did a fecal transplant trial people did way better and they got a fecal transplant prior to immunotherapy bacteria is very important yeah they did a fiber trial and in the fiber trial this is think about this this is insane for every five grams of fiber that you consume you increased your likelihood of survival by 30 wow and 19 out of 20 people out there on the street right now in the united states are inadequately consuming fiber can you supplement with like a psyllium husk or does that fiber have to come from vegetables that you're sort of breaking down yourself and consuming you can't take a c minus diet and gut and take psyllium husk and turn it into an a minus that's not possible you can take a c minus and turn it into a c yeah right i think ultimately the three to five pounds of food that you consume on a daily basis needs to be the dominant driving factor eat the food like like the the the data on fiber is ridiculous there was this there's a systematic review and meta-analysis done that showed that dietary fiber reduces our likelihood of having a heart attack reduces the likelihood of dying from heart disease reduces our likelihood of getting esophageal cancer colon cancer breast cancer less likely to die of cancer leslie could have a stroke less likely to have diabetes less likely to have kidney disease how is this not on the news why do i have to talk about it on my youtube channel right like what what the [ __ ] is wrong with our system that we don't want people to know this because there are ways you know i lobbied congress and but only two percent of subsidies go to like real produce and you're never gonna get these people to buy this food when it's unaffordable there you go you're never gonna get people to buy this food if it's unaffordable also our society doesn't give anyone time to cook you know the whole rise of most packaged food is that you know they set out to be like oh it's so convenient you never have to cook again and people have bought into that well but look this is also post-world war ii it was like the first time that women were like going into labor force people freaked out because like you took my woman out of the kitchen this is when we started having an emphasis on convenience efficiency so it wasn't it wasn't a horrible thing you know polyester fabric you never had to iron it like because the lady didn't have to you're the woman of the house didn't have time to iron your freaking shirt so all these things start from an attempt at efficiency but now that we know this should not be the way we live such an interesting conversation because the other thing that happened in world war ii was the discovery of penicillin which is the greatest medical discovery in the history of humanity but unfortunately it's been it's so um you can see where a doctor this these are the top three causes of death and all of a sudden we have a way to get rid of them that is so sexy and attractive we got seduced by it and we went way too far with it but i think the other thing too is that i don't know how you guys feel about this we're fairly similar in age i feel like there's a quality of life standard that has become problematic for the united states because i think that wealth was growing in the 50s the 60s and the 70s and wealth is no longer growing in the united states and so our generation is working harder because none of us want to take a step backwards relative to our parents yep but education is way more expensive and houses are way more expensive and food is more expensive than gas and you just keep going and the problem is so we are forced into this like most of my friends everyone in the house works yeah they work constantly someone else is helping raise the kids and it's just right so we've like lost track of who we were because we're trying to maintain our wealth standards but what we haven't done is taken that next giant leap back which is oh we actually need to be living more communally because there are people at different phases of their life who can cook and who may want to participate in child roaring but we've maintained uh a shrinking income pool against a higher cost of living while also trying to do it ourselves and not having any family not having any community and we can't do it all it's a major black eye i think it's a major black eye for our culture that we don't take care of our elders and integrate them into our households dr bosowitz i think you're an incredible person i think you're an unbelievable physician and i think it's incredible what you are doing that so many so many people have not done in your field and we you are really a hero of ours and thank you so much that is like very surreal to hear from you [Laughter] and my wife is going to freak out when i tell her this later so i'll be back on track with this one his books check them out if you haven't already cookbook check out his instagram it has to happen he's such a cool he's such a cool dog i mean i've met a lot of doctors in my life like i just i like the way he talks i like the way he explains things he is very calm and unfazed i feel like because he yeah i i feel like everyone everyone deserves a doctor with that level of like expertise knowledge like he seems reasonable like i i feel like i just i think he's a very good doctor um and now i'm just like super fascinated about like everything i eat and what's gonna happen to my body and i just he he cleared up a lot of things for me and um just wow i'm very very wowed by him this is a man who has you know he left the sector of medical care as we know it to pursue a life of literally i mean of course people like he just wants to make money like that's i'm not going to go there what i'm going to say is that this is a person who innately felt something was wrong both with his body his the way he was functioning and the way people practice medicine and he ha this is a very different life that he has now you know he's a spokesperson for an entire aspect of care that chinese medicine and ayurvedic indian medicine has been talking about for thousands of thousands of years i wondered about gut stress and isolation we talked about that how being isolated increases gut stress i wonder and i'm sure there's no date on it yet if there have been more stomach and digestive issues since covid given how isolated people have oh yeah yeah why do you think people are drinking and smoking weed all the time no not winter people because they're bummed out but when is this is kind of like a fascinating exercise we've never been so isolated from one another and to track that but there's not a scientific study that's why it's too many variables i understand good but just think about the impact if there had been like you know whatever measures could be yes he made me feel very like knowledgeable about things that like i was always like i don't get like i i've never had this many questions for someone specifically that's really great well jonathan thank you for letting me talk about your food thank you still going on the record to say that slightly mischaracterized in my food stuff just saying are you in denial no [Laughter] from our breakdown to the one we hope you never have we'll see you next time it's my ambialics breakdown she's gonna break it down for you she's got a neuroscience phd or two non-fiction and now she's gonna break down it's a breakdown she's gonna break it down

Channel: Mayim Bialik

Views: 110,041

Keywords: mayim bialik, big bang theory, amy farrah fowler, mayim, celebrity news

Id: JwN_QYRIq40

Length: 95min 52sec (5752 seconds)

Published: Tue Apr 19 2022