Fiber Fueled - An Interview with Dr. Will Bulsiewicz

i wanted so half of my half of my phd research was actually on butyrate half of my my phd thesis was like 238 pages or 237 pages and i think the the latter like 113 pages were all around all on butyrate so i know butyrate you and i both share that love and the passion for butyrate do you want to explain it a little bit i know you talk about it in the book but i think it's just an interesting topic that i think people don't know enough about or they hear short-chain fatty acid and they don't necessarily know it but at least if you kind of give a little primer to it people will know what to expect in part of your book well let me say this and i know that you can appreciate this frank i if i had my way would have written at least double if not triple the number of pages about short chain fatty acids and you know in the but the problem is like you can't write a book for public consumption that you just nerd out entirely about the science of something that i consider to be wildly overlooked and so the story here is this that fiber doesn't just go in the mouth and come out the other end fiber is actually at least certain types of fiber the soluble fiber is consumed by the microbes that live inside of us and that's their food so the food that the the the parts of our diet that are able to you know survive digestion and not be absorbed in our small intestine they make it to the large intestine the colon where these microbes live and they basically get into a feeding frenzy and they eat it that is what makes fiber prebiotic and when they eat it these microbes they get stronger they multiply and then they want to pay us back and the way that they pay us back is by transforming the fiber basically restructuring it and changing it into what are called short chain fatty acids and the ones that we're referring to are butyrate acetate and proprionate and you don't need to know the differences between these three that's like extremely high level stuff that most doctors don't know but what's key to know is that these short chain fatty acids are incredibly healing and healing in ways that are mind-blowing and fascinating because for example if you take the idea of dysbiosis where some people will refer to this on the internet as leaky guide i know that this is not something that we like to call it but you know we're talking about intestine we're talking about dysbiosis damage to the gut microbiome which includes breakdown of the epithelial layer the wall around the colon breaking down the cells and opening them up and that allows toxins to sneak into the bloodstream and you want to fix that this is the solution short chain fatty acids in the book i lay out in chapter three how they can reverse each step that's involved in dysbiosis now frank i was talking uh this morning with the shir's eyes so for the with the listeners on our call right now dean and aisha shirzai are the authors of the book the alzheimer's solution they're they're incredible neurologists and i am convinced that the blood brain barrier is functionally the same as the blood gut barrier in that it's the tight junctions that keep everything together and butyrate repairs that too butyrate repairs the tight junctions in the brain too so the healing effects involve the gut butyrate also and the short chain fatty fatty acids are capable of affecting your immune system which is very relevant these days they affect cholesterol our insulin resistance type 2 diabetes they affect our weight balance and our satiety after a meal they actually can spread throughout the entire body and as i said they can go all the way up to the brain and they can affect neurologic function so these are healing molecules that have huge effects throughout the entire body that are anti-inflammatory and if you believe that inflammation is at the root of disease which most people do then we should be striving to get more of these and that is where the problem lies which is that we haven't been talking about these we've been talking about lectins and gluten and all these things that frankly we're we're blowing out of proportion and really what we need is we need to instead be focusing on where am i going to get my fiber from because fiber is what gives us the short chain fatty acids yeah and one thing i think most people don't realize is like when you think about different different macronutrients right you want to think about which macronutrients and what they're going to do for your body most people know protein is going to be good to build up your muscles most people know that sugar is going to allow your your cells to fuel themselves and to generate atp and to be used for energy most people don't realize though that butyrate which you know is that short chain fatty acid that comes from eating fiber most people don't realize that the colonocytes the cells that that line your colon they actually use butyrate for energy production like yeah that's their that's their primary source of energy production so without that butyrate without that fiber the cells of your colon just don't have the primary source of energy that they need to be able to to do their functioning properly which i think to me is just mind-blowing that it's actually from fiber that our our cells energy attract get their energy from there's uh and i for the 117 people who are here with us right now i hope you guys don't mind me nerding out for a moment because i'm talking to my friends who i think we love to nerd out so yeah but there is a researcher at the university of michigan um his name is eric martens and he has been studying the effects of fiber on the epithelial layer and he's looked specifically at the mucus at the mucous lining and what he's found is that when you go on a low fiber diet over the course of about four weeks you will thin out that mucous lining and it's disastrous for essentially the gut and the health of the god well we two of my other topics that i wanted to talk about on my list was one was leaky gut and i think we'll come back to that in a second because i have one question but i want to i want to hit the next one and that was actually the mucosal layer because so there's there's this weird i call it like a symbiotic relationship and it's the relationship between fiber what fiber does between the colonocytes and the goblet cells that produce mucus and then also saturated fat right if you're cutting out a lot of the fiber from your diet you're gonna probably be taking in more fat right most people that's kind of the the trade-off that they get with cutting out fiber they intake their fat intake and saturated fat has been shown to reduce mucus production so it's interesting that it's kind of there's two prong effect of maybe why that mucous production is lower um based off of the saturated fat and the fiber differences i don't know if you if you talked about that or if you've ever done any research into that but that to me is just fascinating well i and i think what it boils down to is this you know when we talk about stuff like that it um it brings me back to one of my two favorite studies which is lawrence david at all from nature 2014 this is the diet diet rapidly and reproducibly alters the gut microbiome study and for the people who are listening at home this was where they took people and they put them on five days of either a completely whole food plant-based diet versus five days of a completely animal product diet like meat dairy and eggs with no plants at all and they looked to see what would happen to the gut microbiome and in literally 24 hours there were already radical changes to the gut microbiome and when you look at the changes that occurred in the animal based diet to me they were disturbing you know you saw the emergence no surprise of the bacteria that thrive in an environment with bile and these are almost uniformly inflammatory microbes these are the types of microbes that produce secondary bile salts that that cause colon cancer these are the types of microbes that will produce tmao associated with heart disease stroke chronic kidney disease and one particular microbe that emerged dramatically in this study was biophilisworthia which it has been strongly associated with the development of inflammatory bowel disease now the thing that i always always think about with this study is because there was literally no it was just all or nothing 100 plants versus 100 animal products the thing that i've always wondered is is it the absence of fiber or is it the presence of saturated fat or both and we have studies with fiber and we have studies with saturated fat and it leads me to believe that it's it is both that saturated fat not only is it it's not that it's net neutral it's that the saturated fat and animal products and full disclosure coconut coconut oil coconut milk um that the saturated fat actually is inflicting harm on the gut microbiome and we do have some animal model studies to support that yeah and then obviously the opposite is true which is that fiber is nourishing to the gut microbiome and what it needs to thrive and survive yeah and i think that that's that's probably the most important part is people need to realize that it is that two-pronged approach because we have studies that show that it's both it's not just one way or the other so let's talk a little bit about leaky gut because leaky to gut to me that's in your book that was one of the first keywords i looked up because so what what i did is i went through your book kind of the whole thing and then i went back to look up key words key phrases try to figure out you know what are the hot topics what what are you saying about it because leaky gut is an interesting thing that i think you as a gastronor gastroenterologist knows that you know it's not something clinically that we discuss it's not something that the medical profession as a whole wants to discuss or agrees with but on a on a research side of it taking the clinical side out of it me as a researcher i can measure octn2 i can measure the tight junctions or the different the the proteins that bind cells in your gut and say hey there is a change here right so why don't you kind of give me your opinion about it or what's the permitting of the profession versus you versus the research and i'll kind of maybe chime in with some of my uh my opinions or or some of the things that i've seen on their research yeah well i i think that the we are in a place now where there is no gold standard test for dysbiosis okay and researchers they know it when they see it um so you know globally speaking is this idea of a loss of diversity and the emergence of you know what we would characterize as inflammatory microbes and the diminished presence of the anti-inflammatory microbes so that's sort of where it starts from a bacterial or like a microbial populations perspective and what you end up seeing is then there's the breakdown of the tight junctions um which uh leads to increased intestinal permeability now like do i believe that there are any any tests whether it's microbiome tests or intestinal permeability tests that are ready for clinical use no i do not yeah yeah i do not i mean they've tried that with like the mannitol lactose ones and stuff like that but still yeah i'm with you and and so i i think that where we're at is this is the way that i feel about it i i think that there is no question that it this exists okay i have never seen a study by the way frank and correct me if you if you have but i've never seen a study where a person had increased intestinal permeability in the absence of the alterations of the microbes meaning that meaning that i think that increased intestinal permeability in leaky gut is not in isolation instead that increase intestinal permeability and leaky gut is a part of the entire phenotype the complex of dysbiosis yeah i know i'm i 100 i agree with you because the one part that i was going to bring up at the end and you already kind of brought it up in this is that there's it's not just whether it's not just the cells you have to think about the whole environment the bacteria and also the as we mentioned earlier the mucosal layer you could have the same in my opinion this is just personally this is this is going on the research side and less on the clinical side because i'll leave that to you on the research side as i think about the aspect of if you look at the tight junctions if you look at cells on the epithelial layer you could have the same cells you know the same you know the i would say the structural integrity in one in one you know colon with a really good mucosa layer and that mucosal layer is going to buffer any of the harsh impact of anything that's coming against it or you could have the same you know in structural integrity of the of the epithelial layer and then have no mucus that's not being buffered at all so really is kind of the whole ecosystem and you know you can't just say that it's oh it's just that but you know it's just the the tight junctions or these cells are letting things leak through it's no you got to look at the microbiome you have to look at the mucosal layer you have to look at the protective effects that what dietary components are in the gi tract that could be causing harm or or feeding the local environment so yeah i agree completely with you that it's it's that tyra dysbiosis first versus entire environment that you have to look at there yeah and i think two one of the other things that you will commonly see like so when we're looking at the entire environment you know we should include the metabolic products of these microbes and that's where to me shotgun sequencing is such a superior test to the old-fashioned way of doing things because it allows us to look into that and you know to me one of the keys here is that when they think about a healthy microbiome that includes a microbiome not just in terms of the bacteria capable of producing short chain fatty acids but the actual presence the actual presence of short chain fatty acids which are having their effect within that environment you know actively and and it's all um intertwined in a way where when you eat fiber you will initiate this process like a snowball of getting more microbes that are capable of producing short chain fatty acids which then creates a feedback loop and where you just keep ramping up and getting more and more of these microbes and there's increased deficiency so that the person who basically is constantly consuming a predominantly plant-based diet has a microbiome developed for that diet that is going to continue to produce maximum amounts of short-chain fatty acids to heal and have anti-inflammatory effects throughout the body and this is where for me you know this is this is more than just because the problem with many of the alternative dietary choices is that there are things about the ketogenic diet that in the short term are like indisputable yeah yeah right and and there there are things about it that if you're looking at it through the proper lens through certain lenses you look at it and say wow that's appealing that's a that's a good metabolic effect or or whatever it may be okay and i'm not disputing those things in the short term but here's the question this is the real question what is the diet that gives you the benefit in the short term and will actually keep you healthy when you're 50 60 70 gonna give you that health as you age can protect you from heart disease the number one killer going to protect you from cancer the number two killer and the problem is that going high fat high protein low carb and having very little dietary fiber is a set up for heart disease and cancer yeah no i th that's the one of the most important things is i think we can nerd out on the science of well what's the mucosal air doing versus bacteria versus that bacteria but it all comes down to what's your fiber intake how much fiber are you consuming and then what is the total nutritional makeup of your dietary sources it doesn't have to be a hundred percent whole food plant-based to get the maximal benefit right there there is probably a degree of of gray in the middle but it's really important to point out that without these foods without the foods high in fiber you're not going to get the benefits that you need from the searching fatty acids and in the motility you know how fiber affects motility and everything so i think that that's the important part that a lot of times we for me as a scientist i just i just i get lost in the details and forget that big picture-wise it's let's just keep eating the fiber well that's then this is where there's layers to the evidence and we like seeing all the layers pointing in the same direction and when you think about fiber we see it we see it in our you know basic science studies we see it in our animal model studies we see it in human microbiome studies we see it on in systematic reviews and meta-analyses of population-based studies all levels point to the same thing which is that fiber heals and fiber is good for our body so a a person who stands i mean look the internet people i want people to understand that um the internet anyone can claim to be an expert right anyone can set up shop on the internet and say that they know what they're talking about and at the end of the day you need to make a decision on whether or not you believe that that's a legitimate source in trades in certain trades states have put into place protections okay now that those protections are meant to be for the consumer you know like the internet doesn't have these protections but like for example i need to have a medical license in order to practice medicine all right and my medical board if i do something crazy to protect the people of our community will will potentially take my license away from me well that i mean it brings up the part that just cracks me up is before your book and you're understanding like you already mentioned shotgun sequencing i know you understand micromicrobial sequencing and what it takes to actually look at someone's microbiome not only a patient's been doing a research or whether it's acute changes or longitudinal changes but i can tell you that almost everyone that talks about the microbiome out there has never actually sequenced someone's microbiome right like and that part means it just blows my mind i don't know if it's something you do in your practice or something you don't but the fact that you know the difference between 16s rna sequencing you know the difference between you know shotgun sequencing or meta genome sequencing it just shows that you know the level of care that you've taken to put into this book and your clinical expertise from your masters of clinical investigation which i know you have it really does make a big difference because all these other people that are talking about the microbiome who don't understand that you know when you sequence someone's microbiome you're sequencing their stool you're not sequencing their epithelial layer you're not sequencing their small intestine you're not a sequencing their stomach because each part of the gi tract in each location you know topography wise from the center of the colon to the epithelial cells it has a different composition in the microbes and that is a really important part that most people don't realize or have never done or may not understand that that is a big difference well that's and that's the real challenge that we have in terms of studying this is that i wish it was so simple as just getting stool specimens from everyone you know but that's that's the challenge is that i think that there's geographic variability within the you know and not just segmented i mean we think about it as anatomic segments but i think certainly within the colon there's geographic variability and and they've shown this they've shown this you know the variability in terms of the ph within the colon in different segments and you know for example more distally in the colon typically the fiber will actually be consumed by the time that the um feculate material gets down to the distal colon and there actually it's the protein that's being used to create short chain fatty acids in the distal climate so it's just fascinating but it's hard to hard to uh study it you know the way that we really need to to fully separate but i think the bottom line is this frank is that i think that we know enough right i think that we know we're not we're not yet in a place where we have the specificity to analyze the per analyze a person's microbiome and use that information to tell them whether or not they're going to have crohn's disease yeah correct right we just don't have that yet but what we do have is this we understand the basic biology and mechanisms of the microbiome and that's really what my book is about is about using the basics of our lifestyle diet and lifestyle to swing the pendulum in our favor and heal our microbiome because there's core concepts that we may implement in our own unique ways like even though you and i eat a 100 whole food plant-based diet you and i are not eating the exact same food on a daily basis that's not a one size fits all those are unique versions of a similar concept and um so and i think that that's really to me what my book is about is showing people that there is this path to heal your gut that is clear at this point and you just need to use the book as your compass to move towards healing your gut and where you choose to ultimately settle like you know i don't know if you caught it in the back of the book but i ultimately say look if you make yourself 90 plant-based i got no argument from a health perspective yeah i i honestly think that the strongest argument to go from 90 to 100 at that point the strongest argument is actually animal welfare and the environment and i think that there are legitimate arguments to be made and people should learn about those things but if you get to 90 i mean you know that's up to you i i personally think that you're going to feel so good at 90 years why would i stop at 90 when i could go to 95. yeah you know but that's just me i mean i'm right there with you and that's the thing is i've been on a lot of other podcasts that are not plant-based specific podcasts and i think that's the important part is that it's not a one-size-fits-all you don't need to go to that hundred percent necessarily there are definitely benefits of going hundred percent but getting to that ninety percent where you're incorporating as much plants and the diversity of plants because we haven't even mentioned that is that the diversity of plants in your diet is one of the most important things for microbial health and the microbial diversity which is you know synonymous with gut health overall right yeah and um you know this is where i get concerned about things like people some people will do implement a ketogenic diet and they'll they'll say oh we we have learned our lesson through the couple years of this fat that you need some fiber and so we're not going to count that fiber we're going to call it net carbs and we're going to remove the fiber okay well look i'll give it to you that's a step in the right direction but here's the issue it's not you know this it's not grams of fiber that predicts the health of the gut microbiome yeah it's the diversity and it's what percentage of your diet is made up of plant food which contains fiber relative to the other stuff you know if you think about everything as a scale right now the average american has 10 percent of their diet that is actual real plant food fruits vegetables whole grain seeds nuts and legumes and 90 of their diet is either animal products or processed food so that means 90 percent of their diet is destroying their microbiome and that's where we need to flip the scale and have the the weight the weight of the balance being on the side that's actually protecting our gut and feeding it and nourishing it right there there is no accepted single greatest microbiome on the planet if that existed i think it would be my delgado but that's just me that's true yeah but there is no like i think that there's multiple forms of healthy and the question is what is actually changing when a person develops say euroval syndrome right we know that microbiome has changed but what is it and there may be different variations i'm sure there are different variations of what's occurring in the microbiome and that's part of probably what explains different variations on how we manifest and um and we need the ability to first i think make the connection between clinical phenotype and microbiome findings and then the next level is how do we adapt it to get it back to something that's closer to normal and validating that within a population of people you know taking people with ibs and showing because this is really where i'm like look like i saw some people who are asking questions in our little bar here about the gi map and it's like look you can collect information and you can throw information at people but if you never validate that information then what's the use of it yeah if you never if you never demonstrate that you can improve health outcomes what's the use of information that's pointless so and my mentor at unc nick shaheen would say people who order tests always you know they um what did he say it was always you get what you deserve when you order the test is what he used to say because a lot of people will order tests and then they'll get the results back and they'll go oh crap i don't know how to interpret this like you know what does this mean it's like why did you order the test yeah it's like it's like when to and when not to order a d dimer right it's like right well you know exactly there's always those tests but on the on the science front i i would say that i'm a little different at least on the value-ness of science i think that there's some things that we definitely do in science that maybe aren't clinically relevant but i think they're a building block that we need to do now so that in the future we can understand stuff so but i think on on the clinical side of it i think that's the difference that you see between you know a phd versus first person md the clinician side of it is that there's definitely research that i did that clinically we may not it may not have any clinical implication but can it be used for future relevant research absolutely and so that's that yeah and that's but that's the thing is you have to be tricky in how you're discussing that research and saying what you know it's the difference of test tube experiments first patient population experiments right well listen frank it's always a pleasure um this is the book guys fiberfield and i wanted to tell you real quick that there was a um a section in the book i think in chapter one where i talk about serotonin and i talked about the five ht precursors and i want you to know that when i wrote that sentence i was thinking to you my friends yes when i wrote that sentence you have you have made an impact yeah the serotonin thing don't give me stuff i mean i wrote a whole post on it and people got mad that i was telling them about serotonin but yeah that's a i appreciate them thankful that you thought of me when you're writing that section of the book you are correct and i want you to know that i i please do not judge me when i say 90 of serotonin is in the gut because i will i always try to go out of my way to say that the serotonin does not cross the blood-brain barrier but some of the precursor molecules we do we think do in fact across the blood very rare which is part of the reason why diet can affect mood all right i hope you guys got a lot out of that i had a great time sitting down with dr b and discussing his book and some of the highlights from the book and i will see you guys in the next video thanks for coming

Channel: The National Library of Patient Rights & Advocacy

Views: 10,425

Keywords:

Id: akQoo1JPSKA

Length: 27min 35sec (1655 seconds)

Published: Mon Aug 15 2022