Raw Food vs. Cooked Food | Gut Health Q&A with Dr. Will Bulsiewicz

[Music] [Music] welcome to the exam room live brought to you by the physicians committee hi i am the weight loss champion chuck carroll and this is the healthiest half hour anywhere online today we appreciate you watching us live here on facebook and on youtube as we try to raise your health iq by a point or two over the next 30 minutes coming up today we are going to get a fiber-fueled gut check with our friend gastroenterologist extraordinaire and best-selling author dr will bolsoewicz is here with us today as we open up the doctor's mailbag and answer your questions so if there's something on your mind that you would like to ask about gut health go ahead right now post it in the comments or the chat box you can also send that to us on twitter and instagram using the hashtag exam room live send that on over to carol wlc or at pcrm or at physicians committee on the gram so plenty of places to send in your questions let's go ahead and stuff that mailbag and i got to tell you there is a really good question in there already about raw food versus cooked food and what the difference is in your gut and is one healthier than the other so we're going to get into that with dr will bolsoes here and just a matter of fact let's just go ahead and get into it right now shall we let's welcome dr bull switz to the show dr b how you doing man i'm doing great chuck though i wasn't expected to get into it right now but you're calling me out here we go um i wanna i wanna just say that i feel really good this week i feel like we are finally it feels like we're emerging from this pandemic a little bit we have beautiful weather here in charleston signs of progress we have beautiful weather here in charleston we have wrestlemania for two nights over the weekend with fans in the seats yes we do and we have chuck curl wearing syracuse orange colors signs of progress people let it be known that you are the only person i would rock the q's colors for because i am a notre dame guy but i appreciate you being here so this is my way of saying thank you there's different ways that we express our love and what chuck just said right there that is like the sixth love language that he just provided for us [Laughter] all right let's go i don't i really don't know where to go with that let's go ahead and open up the doctor's mailbag right now dive right in so again post your questions in the comments or the chat box and uh we will do our best to get you an answer on the episode today dr b you ready for question number one let's go all right the first question comes to us from pam wants to know what is your opinion on raw food versus cooked food is one healthier for the gut yeah this is a great question and i really i really dig it because i find the answer to be fascinating we know that every food has its own unique types of fiber those types of fiber feed unique families of microbes and what's interesting is that there's a researcher at the university of california san francisco his name is peter turnbaugh and he did a study looking at raw versus cooked so basically he took the exact same food and he saw the effects of the of these foods on the gut microbiome depending if they were raw versus cooked and what he found that i thought was really interesting is that you had differing effects based upon whether you cooked the food or you didn't cook the food now is one superior no i would not claim that one is categorically superior and that you should exclude the other instead what it is is we want you've heard me say this before i'll probably say it again in the next couple of minutes diversity of plants is the number one predictor of a healthy gut microbiome and so effectively what i'm saying is if you take the exact same food and you cook it it's almost like getting two different plants because you are feeding different families of microbes we want all of our microbes to be fed so i would not claim that raw versus cooked is superior one versus the other instead what i would say is that we want both and for the person who's suffering with digestive issues it is easier to start with cooked food and work your way towards including the raw foods but that you know a little nibble on some kale or some collards before you go to steam or cook them that's a good idea because then you're feeding those microbes too we want both that always comes back to variety whether you're talking about a variety of different kinds of foods or in this case a variety of ways to ingest the food itself i think that you know variety just seems to be the theme when it comes to a healthy diet overall well variety's variety is the theme and it goes beyond i mean in my book fiber field i make my argument that variety is the key to a healthy gut and we have science we have several studies at this point now to back that up but this is not just about gut health this is also about the reality that every single food even if we call it a superfood every single food has its own strengths and weaknesses they'll have certain vitamins and minerals and phytophytonutrients but it will be missing in others you know if if i ate just kale all day long i would not be that healthy even though some people would argue that's the healthiest food on the planet and so you know what you're missing in the kale you can pick up and find when you add in and sprinkle in some other foods and that's that's the beauty of eating a broad diverse diet is that there are no longer any weaknesses because you're playing to the strengths of every food let's go ahead and do a little gut health 101 here help beatrice out she's wondering uh if you could talk about the best practices for gut health overall best practices for gut health overall okay well i think that you know we have to start with diet i mean that's very clear we eat an average of three pounds of food per day a thousand pounds of food per year so if we start doing the math each one of us is going to eat about 80 000 pounds of food during our lifetime and all that food is coming into contact with your gut microbiome and that really is the principle driver that shapes what the gut microbiome looks like now the exciting thing about this is that you were not born with a microbiome that you're stuck with for the rest of your life you can shape it you can mold it and make it what you want it to be your dietary choices are what do that and we know that the main source of fuel of positive energy for your gut is dietary fiber not talking about supplements i'm talking about food fruits vegetables whole grains seeds nuts legumes when we call them plants they're good for our gut microbiome and when we get outside of that category into highly refined processed foods animal products dairy eggs and meat that's when we actually are feeding our gut microbiome the food that it doesn't prefer and can create issues but it's not just diet you said it's gut microbiome 101 so i would be remiss if i didn't mention that our lifestyle matters a lot too getting a good night's rest exercising staying physically active spending time with people you love believe it or not believe it or not the people that you spend time with have an effect on your gut microbiome having a pet has a has an effect on the gut microbiome um so really it's about seeing this big picture which is that we are not just these humans living our lives that we are humans with 39 trillion living microbes each an individual microorganism living inside of us and that integrates us with our environment and with our diet and lifestyle and ultimately that microbiome is an expression of our diet and lifestyle 39 trillion that is a lot that is a number that's incomprehensible in all honesty that is just insane take all the stars in the sky and you would need a thousand galaxies full of stars compress it all down put it inside of you it's there right now it weighs more than your brain does believe it or not but it's invisible and so it makes it very hard for us as humans to wrap our mind around it because we don't do very well with things that we don't see that is crazy all right man all right we're not gonna count that high on the show here today um let's uh grab another question this one comes to us from kerry this is an interesting one is wheat bad for the digestive system wheat is not inherently bad for the digestive system in fact wheat has been attacked and vilified in our food culture over the last 10 years some very popular big selling books told us that we shouldn't be eating wheat and if you take a step back and you look at wheat the food in isolation you walk out into a field you pick some wheat raise your hand if you've done this before yeah none of us have right because we none of us go out into the field to get raw natural wheat but if you were to look at that food it's actually incredibly healthy for our gut microbiome it has fiber it has complex polysaccharides it has resistant starches all of which are prebiotic meaning that they feed the gut microbiome when they have studied the effect of wheat on the gut microbiome they have found that actually the gut microbiome benefits with the growth of more short chain fatty acid producing microbes when you are consuming wheat when a person goes on a gluten-free diet we actually see that it appears that they are causing harm to their gut microbiome because they are withdrawing the wheat which is the number one source of whole grains in the american diet again with the fiber the complex polysaccharides the resistant starches that feed our gut microbiome now that being said chuck wheat is in everything wheat is in processed foods left and right everywhere wheat also is being processed with our modern farming systems that include the spray of roundup roundup is sprayed onto wheat to dry it out we need dry wheat in order to process it you can accelerate that process by spraying it with roundup and i have concerns based upon the studies that i've seen about the effects of roundup in our diet not to mention the effects of roundup on our environment so the point being from my perspective wheat in organic minimally processed form is not a problem in fact it is good for our gut microbiome wheat in highly refined processed foods in foods that are being sprayed with roundup glyphosate i have concerns about that form of wheat and unfortunately that's what makes up most of the wheat out there so what i would encourage people to do is yes if you do not have celiac disease include wheat in your diet but make it high quality sources of wheat like organic bread like sourdough things like that next question is one that touches on fasting this is another popular topic that comes up here uh this person is wondering how does regular fasting affect your gut health our gut microbes uh so it's interesting before we jump into fasting let's take a step back for a moment and ponder this the first living creatures on this planet were archaea as far as we know they've been around for about four billion years now to put that into context us humans have only been around for about three million years we believe so four billion years of archaea that's before we ever even had oxygen on this planet these archaea can live inside of us and the the key here from my perspective what i'm trying to point out is that all microbes all humans all living creatures period evolved with one characteristic in mind which is the sun would come up and the sun would go down every single day that was true four billion years ago and it's true today it never changed it's the only thing that's been true for all of us from an evolutionary perspective so we developed what's called the circadian rhythm the circadian rhythm means that we have an intrinsic clock within our biology we have it as humans and guess what these microbes have it too so these microbes they are living creatures and they need a break they need rest and they also have a circadian rhythm where they like to have a rhythm and so the point from my perspective when it comes to fasting in its role with gut health is that our microbes like it when we have an early dinner when we don't eat late night snacks when we don't drink alcohol late at night when we allow them to take a break when it is dark outside and then we can pick back up 12 14 or 16 hours later and we may derive benefits in terms of our metabolism and our gut health as a result of that next question comes to us from jamie wondering if you could answer this one about what effect do bad bad carbs from processed foods what effect does that have on gut health well we call them carbs and i i have to say that i regret that we use terminology like this because we're talking about a macronutrient which is a very broad category of food i mean within carbs there is a ton of stuff that is incredibly healthy fiber is a carb and then there's the stuff that is the highly refined processed stuff where we're creating things that are unnatural and so i think that the reality when it comes to this conversation is that rather than defining things as carbs we should define them as ultra processed foods because that's what they are these are ultra processed foods you can't create this at home can you i mean if you could i would love to see it but when you look at the ingredient list and many in most of these foods that we're referring to right now i was a chemistry major in college i have no clue what most of these things are that are on that ingredient list and seriously and when you have this kind of stuff in there clearly this is not coming in anything that is anywhere close to natural and this is not something that existed 100 years ago this is something that was developed in a chemistry lab and then brought forward into our food system and so the concern from my perspective is that those chemicals that are in there many of them we don't know what they do to humans particularly when they're consumed over the long run and so from my perspective i i feel that the safest position to take when it comes to ultra-processed foods and i mean we could dig into some of the studies that show us that ultra processed foods are not healthy foods but i think the point is this at the end of the day the healthiest position to be in is to be maximizing the fresh fruits vegetables whole grains seeds nuts and legumes in your diet no one's perfect i eat processed foods too but we really want to try to minimize it as much as possible that way we can really be getting the the beneficial foods overpowering these foods that we have concerns about a lot of nice comments coming in the chat room right now about your book fiber fueled and one particular group who's watching the nurturitionists i love that name they wanted to let you know that they've even made a video about your book so if you haven't picked up a copy of fiber fuel just yet you should really give it a read and you can find a link to purchase that right now on amazon that is in the show description so go ahead and check that out i i seriously i'm not just saying that because you're on the show it is literally one of the best books about nutrition i have ever read bar none thank you man i mean coming from you that means uh so much and then i appreciate the nutritionists i i love that name too i think it's really cool i'm gonna have to go check out what they're talking about after this um but it is it is a great honor and it's been amazing i i'll be honest with you chuck i feel like i get more credit than i deserve many times because i have people reaching out to me every single day from across the world like people from new zealand australia reaching out to me and telling me that their life has been changed yesterday a doctor reached out to me she's a gi doctor in training and she she said that she completely changed her perspective and how she's treating her patients after reading my book and so from my perspective it just it really warms my heart and makes me feel so good that the effort that i put into the book waking up at five in the morning to do it you know bird dogging all those references trying to find them at the end of the day it really feels like it was so worth it to be able to provide something that helps people no doubt man and you are helping people on such a large scale so again you know thank you for putting that out i know that you did you poured your heart and your soul into that and it definitely shows um let's go ahead and continue on with the questions this one comes to us from leslie writes i have to take antibiotics prior to my dental visits how much damage am i doing to my gut and is there anything i can do to minimize it well this is a great question i get people messaging me almost on a daily basis asking about this the good news is this to to a large degree the amount of damage that's being done would be proportional to the extent of the antibiotics and the strength of the antibiotics and typically the doses of antibiotics that are being taken for dental procedures are quite limited it's usually a one-day affair and that's about it so so first of all i think that that's a really positive for this person i believe you said her name was leslie i think that's great um it's a good place to start what do we want though if we just remove that for a moment let's talk about antibiotics and how do we handle this what do we want to protect ourselves you know if we have to take antibiotics first of all you are in the best position possible if you are already eating a plant-based diet before you ever find out that you have to take antibiotics they did a study and they looked at this and they actually showed that in terms of the damage done to the microbiome there was less damage and a more rapid recovery of the gut microbiome if you are already consuming a plant-based diet so you want to be taking advantage of that before you ever discover that you need to take them what do we do after the antibiotics well the key from my perspective is let's support and nurture the gut microbiome and let's not be let's not be you know damaging our gut during this period of time where we are vulnerable let's not sabotage and so really what that means is we want to be getting our dietary fiber we may want to consider a fiber supplement eating a plant-based diet getting a good night's rest getting some exercise and then when i talk about the sabotage what i really mean there is not consuming an excessive amount of alcohol or really minimizing the alcohol avoiding the animal product consumption and the highly processed foods and so again you know get as many positives in there as possible reduce the negatives and one last thing that i think your listeners would find to be interesting chuck if you went back five years ago in this setting i would put you on a probiotic not true in 2021 there was a study published in the nature in the journal cell in 2018 out of israel showing us that probiotics after antibiotics actually slow the recovery of the gut microbiome and so there are some rare moments where i will put a patient on a probiotic for a specific reason but the vast majority of people in 2021 if you need an antibiotic i do not recommend probiotics afterwards very interesting and a follow-up to that is one from kit who was wondering do prebiotics also feed the bad bacteria no by by definition a prebiotic only feeds the good bacteria and so in order to qualify as a prebiotic you have to demonstrate that it is something that has an effect on the gut microbiome and that effect is beneficial for human health so what this means is that if we're talking about dietary fiber dietary fiber has an effect on the gut microbiome and that effect is beneficial for human health it produces short chain fatty acids dietary fiber is a prebiotic polyphenols most people don't realize most polyphenols are not absorbed or processed in the small intestine they arrive in the colon untouched unchanged we're talking about things like resveratrol here and they are changed they're altered by our gut microbes we need our gut microbes to process our polyphenols to get the health benefits out of them polyphenols are prebiotic you know pomegranate for example but if we talked about doing carnitine all right so carnitine is something that has been known to be processed by our gut microbes to produce tma which gets converted in the liver into tmao and tmao has negative effects on human health it's been connected to increased risk of coronary artery disease stroke chronic kidney disease peripheral vascular disease tmao is not good for us tmao is toxic to human health carnitine is not a prebiotic even though it can have an effect on the gut microbiome that effect is negative so if something achieves a prebiotic label you know it is good for your health a few people are now wondering about acid reflux this particular person meewa is saying that she gets heartburn when you drink vegetable juice or even sometimes eating a salad what generally speaking do you think could cause that well it depends a little bit on what's going into the salad and into the vegetable juice to some degree and when you know when it's this type of food that is triggering or you know creating the heartburn symptom i want people to understand that the root cause there is zero evidence that plant foods are the root cause of acid reflux if anything the opposite is true recent in recent years we have studies indicating that fiber improves acid reflux which is fascinating because it has nothing to do with stomach acid so the presumption is that fiber is affecting the gut microbiome which reduces your risk of acid reflux we have a study recently chuck using a plant-based mediterranean diet again like a predominantly plant-based diet and using that predominantly plant-based diet improvement of acid reflux on par with medication so it's not these foods that are the root of the problem here's the issue if you have acid reflux if we were to zoom in on a microscopic level i would show you under that electron microscope how there are changes to the lining of the esophagus that may not be visible during an endoscopy but on a microscopic level there are changes which make it so that you are far more sensitive to acidity you feel it and any sort of acidic food that's in the diet tomatoes come to mind pasta sauce is pasta sauce the root of acid reflux no but if you have acid reflux you will exacerbate your acid reflux you will feel the burn when you consume pasta sauce because of the acidity same is true with orange juice or something of that variety so the point is this you want to control your symptoms you don't want i mean i'm not telling you to hurt yourself by eating foods that make you uncomfortable but what i am saying is we want to have an understanding that the root of the problem is more of a motility disturbance probably related to the gut microbiome and that plant foods are the ones that actually can reverse and improve this issue from a dietary perspective you mentioned feel the burn man you you eat a hit of that spicy kimchi you definitely feel the burn twice uh so that brings us to our next question from yazar are fermented foods such as sauerkraut and kimchi okay to eat they say that they've been advised to eat as much fermented food as possible because it's good for the gut flora well so this is a very interesting and evolving question and let me start with the caveat that i'm i actually really believe in fermented foods and part of my reason for planting my flag and saying that is that fermented foods are not really a part of the american diet and so when i say that i'm simply saying that i think they should be a part of the of the american diet that we have lost track of these foods that are traditional foods in cultures around the world you know sauerkraut that's eastern europe those are my people kimchi that's korea and that general part of east asia so the um the thing about these foods when we look at them in terms of research what we're seeing is that many of the microbes that are in those foods because these are living foods many of the microbes that are in those foods actually start to show up in the gut microbiome that's a beautiful thing we also know that through fermentation you are transforming the fiber so you are making fiber even more accessible to the gut microbiome you also are releasing nutrients for example b vitamins can be released through fermentation so i see advantages to fermentation but i want to give this caveat i'm not i wouldn't sit here and say this should be the backbone of your diet no the backbone of your diet should be fruits vegetables whole grains seeds nuts and legumes but you should have some fermented foods in your diet and they should be consumed in moderation small portion size as as something that you have in addition to your meal so quick example yesterday let me describe my lunch for you i'm very proud of it to be honest with you chuck because i grew a lot of it i grew a lot of it that's why i'm proud of it hey okay yeah this was not all purchased at the supermarket some of it was but i um i had kale and i had um some napa cabbage that i've grown in my garden and i also had lentil sprouts onion sprouts and purple amaranth sprouts that i sprouted myself so those five things plus i threw in some walnuts and some sweet peppers and i'm trying to remember if there was anything else but i the bottom line is that i put a big old dollop of sauerkraut on top and i actually didn't really need dressing i squeezed the lemon i had the sauerkraut and i didn't need dressing because the sauerkraut get it in there it was almost like you had the dressing from the sauerkraut because the juice and it was delicious and i sincerely believe because this was a very raw salad oh i had asparagus in there too this was a very raw salad but my gut felt fantastic and i sincerely believe that the sauerkraut was helping me there all right you ready for the for your big follow-up to fiber fueled it's a companion cookbook the fiber fueled farmer work with me work with me here all right so now that we know that you have the green thumb i'm just planting that seed for maybe something coming out in 2022. that's all i'm saying that's all right i'm saying you're making me a little bit nervous here's why i don't want to start rumors that dr b has this green thumb because i let me let me just take the picture chuck let me just paint the picture of what's happening here okay i open up the back door to my house i walk out onto the deck there connected to an electrical outlet is is my uh tower garden it is my farm stand okay and so i have a lettuce grow farm stand that has 24 plants and it is doing amazingly well i mean i'm i'm blown away by the amount of kale that's coming out of this thing i can't keep up with it okay so but the point being like this is this is not dr b has a green thumb i wish i could claim that i really wish i could um but what this is is that i do enjoy growing my own food i know that it's grown organically i it is grown in soil even though it's a hydroponic system my kids absolutely love it my son who's four walks out there and is grabbing handfuls of stuff and throwing it into his mouth which as a dad that makes me very happy because i know that he's setting himself up for a healthy diet for years to come so those are the advantages but green thumb fiberfield farmer oh man i would have to rebrand myself that would be a new image oh well it's just a thought anyway uh but you did you did touch on something with your kid there because we have so many parents who have written in over the years asking how can i get my kids interested in eating healthy and one of the recurring themes that comes up is get them involved in the growing process and then they take a real supreme interest in what it is that they're growing and of course they're going to want to eat it and you're saying that that's exactly what's happening at the balsa woods household [Music] first of all that was a fantastic pronunciation of my name gotcha i love that that was great okay so i i have a few comments on this because i'm a dad my my son is four my daughter is six by the way my son who's four is the size of a seven-year-old right now so this kid anyone who says like you can't be tall and strong on a plant-based diet i have no clue what you're talking about you should come and feed this kid because it's i have to do extra colonoscopies to keep up with the amount of food he's eating so um quick shout out for everyone who's here today to um alex caspero and whitney english who are two registered dietitians who are publishing a much needed book in the next like three weeks and it's it's called plant-based juniors and basically it's an entire cookbook and process for understanding how to raise kids plant-based from birth all the way through all right so with that in mind a few things that work in our house if they grow their food they want to be a part of it if they cook their food and you empower your child in the kitchen they're super proud of themselves like literally they come in and we have tomato sauce and they start dropping ingredients in there and 10 minutes later when we're eating the food hey liam who made this i did daddy and he's like super proud of himself and he's devouring you know this plant-based meal um so getting your kids involved colors kids love colors fun like creativity like shapes kids like young kids love creativity they love shapes and then the other thing that i've heard from other parents and is true in our house too chuck is that in my book fiberfield i talked about plant points and challenging people for fun like just like a challenge hey let's see who can get more plant points you can bring this into your family and it's just good solid fun like let's see who in the house can eat the most plants for dinner tonight right and that type of like just gamifying the entire process you don't want to make it an obligation you don't want to force people to do things against their will that's just simply never going to work what we want to do is we want to empower people we want to make it attractive we want to make it fun and then it just starts happening naturally and then your kids don't even think twice about it because now this is not that you are basically forcing them to eat something they don't want now this is oh my gosh that's such a good time and i love challenging my dad and seeing if i can beat him and get more plant points that's that's pretty cool plant points that's the new concept man i am on board with that one hundred percent i'm like it's fun you can challenge your friends you know yeah you challenge your spouse yeah okay uh we got time for a a few more questions here um let's do a departure from nutrition really quick and just flat out let's try to save a life here rosa linda is asking what are the signs and symptoms of colon cancer okay so first of all we don't want to wait until we have the signs and symptoms and this is the reason why that i'm a big proponent and a believer in taking a proactive approach what that means is that when you are eligible for colon cancer screening which for most adults in the united states is 45 right now when you are eligible you should get it done as soon as possible if you have a family history particularly a first degree family member who's had colorectal cancer or an advanced colon polyp you can start even earlier than that so that is something to discuss with your doctor if you are in your 30s or you are before the age where you get a colon cancer a colon cancer screening and you see blood in your stool that's an opportunity get checked make sure there's nothing going on there the symptoms of colorectal cancer things that we would look for we look for bleeding unexplained anemia particularly when you are low on your iron we would want to know why is that occurring and that's an automatic indication for colonoscopy abdominal pain that we can't explain change in bowel habits not necessarily a pencil thin stool but any sort of change in bowel habits unexplained weight loss um these are some of the things that we're looking for in people to say like could this be colon cancer but here's the thing like i never want it to be that thought in the clinic i never wanted to be could this be colon cancer i prefer to be like okay here is the symptom let's be proactive about this let's go in and make sure that there's nothing going on and once we have that information we can have confidence knowing that we are safe and i myself chuck i'm actually going to be having my colonoscopy in the next couple of months here and i'm 40 years old and the reason why is due to family history and i want it's because i want to make sure that i'm safe i got these two kids they're four and six i want to see them for another 50 years is family history the reason why you became a gastroenterologist no that wasn't my motivation my motivation for becoming a gastroenterologist is a little bit complicated i want to spend too much time on i actually thought i was going to be a pediatrician believe it or not and ultimately what i ended up discovering is that i really love using my mind to peel apart the complex layers of figuring out prop like medical problems for patients and then creating solutions but there was a second part to me that wanted to use my hands at least a little bit and there's only so many fields that combine those things where you're really using your mind that's what an internist does an internist uses their mind a surgeon uses their hands as a gastroenterologist i am an internist but by becoming a gastroenterologist i also get to spend about half my time using my hands and performing colonoscopy and upper endoscopy so it's the best of both worlds for me all right uh let's go ahead and switch gears here and uh you we talk about you you you are famous on the show for talking about fully emptying when you go to the bathroom and uh matt here is brave enough to ask this question wants to know what should we do if we are constantly going to the bathroom but not completely emptying okay so i didn't realize i was famous on this show there's been some conversations about this and that's okay because i i love talking about bowel movements this is literally what i do for a living i do it all day long and my goal is to take my patients and get them into a rhythm rhythm is key and the problem is that if you're going multiple times per day but you don't feel like you are completely empty if you go once and then 45 minutes later you have to go again these are all signs of of issues with defecation specifically at the pelvic floor all right so now look i talk about this all day so i have to preface by saying i'm about to zoom in on what happens during a bowel movement all right but before i go there consider this think about a swallow we take for granted a swallow we expect that during the entirety of our life potentially up to 100 years every single time we ask our body to trigger a swallow it's going to work perfectly but a swallow is a symphony of muscles one individual muscle may be contracting and relaxing in a specific pattern based on what's happening with the other muscles that's what's happening when we poop too this is not just simply that things open up and you know it's like the parting of the red sea here there is a symphony of muscles that are squeezing and relaxing down at the bottom in order to make healthy bowel movements possible now i'm going to do something weird and you probably are going to call me on this and refer back to this into the in the future chuck i'm gonna use my hands and let's pretend that this is the anal canal so that's your bottom right there and this is the rectum okay and i want to first show you the way that it works on a normal healthy bowel movement in the rectum in a normal healthy bowel movement there will be a pinch and that pinch will start to propagate forward all right and as that's happening now this pinch is like the poop is right here so it's pushing the poop down this pinch is pooping pushing the poop down and then as that happens the pelvic floor and all the muscles that are down in the bowl of the pelvis they relax out goes the poop that's a normal healthy bowel movement now what happens in people that have pelvic floor this inertia meaning that their muscles in their pelvic floor this are dis-synchronized here's what happens you get the pinch you get the push but unfortunately these pelvic floor muscles are not relaxing so you push push push push push push push you're bearing down and then you get it like a trap door to open up real quick and a nugget falls out seriously because you forced it because you forced it because you built up such pressure in your rectum that you were able to overpower those pelvic floor muscles but the pelvic floor muscles when you are trying to have a good bowel movement are not meant to be obstructing they're not meant to be standing in the way they're meant to be relaxing and getting out of the way and this is what we call pelvic dys inertia it's it's a very common cause of constipation and actually the solution is not to try to overpower it with medication the solution is to retrain the muscles so chuck if i hurt my shoulder look i can take ibuprofen for pain right but ibuprofen is not going to restore the ability of me to do this the way that i do that is by gradually working into it probably with a physical therapist to restore function and rebuild strength so that i can put my arm back up to the sky again and in the same way if our pelvic floor muscles are not functioning properly then we need to work with a physical therapist who specializes in the pelvic floor to retrain these muscles most of their clients are women i say this because these pelvic floor specialists they also deal with women's health issues with urinary incontinence with burning with urine with uh with pain with sex and also with incontinence of bowel that is why you need to watch the show on youtube and facebook and join us live because that was perhaps the single greatest physical demonstration ever on this channel that was fantastic and you're right i'm stopping that like i'm gonna isolate that and i'm just gonna put that clip i'm gonna pin that to the top of my twitter and my ig that's what's going to happen there that was outstanding sir thank you thank you jack i would i would bow but i don't know that i can really do that here but anyway all right let's go ahead and grab uh one more it's an often asked question uh completely on a different subject but going back to fermentation we have somebody wondering uh kombucha because that is fermented what is your opinion on that in terms of overall gut health my pendulum has swung a little bit on kombucha i have to be honest with you um if you check out my book fiber fueled you will definitely this is one of the things is you write a book i wrote that book you know in 2018 into 2019. you write a book and then sometimes you're like you know what i'd be a little bit different about that in 2021 than i used to so i'm not anti-kombucha but i think at the end of the day as you know chuck nutrition is like really basic nutrition that i wish everyone would understand is that it's just quite simply about substitutions what are you replacing with what so if you take soda and you replace with kombucha i would make the argument that you have upgraded your nutrition and i give you a thumbs up but if you take kombucha and you replace it with water which by the way is completely free i would once again argue that you have upgraded your nutrition there is sugar in kombucha we don't have great studies to make it completely clear that kombucha is good for our health most of the commercial brands that are available are very high in sugar because they want you to become addicted to their product and come back and buy it again um so from my perspective if you enjoy kombucha as a substitute for soda you are drinking it consuming it in moderation and one thing that i would add is kombucha is very acidic so i always when i drink it which i do when i drink it i always dilute it so i will make it at least 50 if not 60 or 65 percent water kombucha becomes the minority and um it still tastes great and so that's that's the approach that i would take with kombucha if you head over to the plantfedgut.com you can take dr b's free plant fed gut five day challenge just five days go ahead and take that challenge i'm telling you it's amazing what can happen in five days isn't it i mean it's it is definitely amazing what you can do in five days literally chuck in 24 hours you've got microbiome is already starting to change i mean it's incredible the power that we have it's so cool man i i love nutrition science and i love nerding out with you here on this program like your monthly appearances here on the exam room live absolutely live for them man you you are just a delight and so i encourage you uh to go ahead and give dr b a follow on instagram that's at the gut health md or check out his website the plantfedgut.com and for goodness gracious sakes if you have not already done so go ahead and pick up a copy of fiberfield again you can find a link to do so in the show description or if you're listening to the pod it's in the episode notes dr will bolsowitz you are a joy to work with my friend thank you so very much for being here thank you chuck it's always fun to work with you too man i love you you are the man and if you would like to go ahead and subscribe to the podcast the exam room podcast by the physicians committee go ahead and do that apple podcast spotify wherever shows are available and first thing tomorrow morning you can relive all of the fun that we just had here today on the go so look for the exam room podcast by the physicians committee everywhere podcasts are available and if you would be so kind you thought you got something out of it today go ahead and leave a five-star rating as well but for today that my friend is all the time that we have i want to say thank you one more time to my friend dr bolsowitz for being here and also to the crew behind the scenes that makes the magic happen thank you all so very much and to you my exam roomies thanks for hanging out and raising your nutrition and health iq's with us today appreciate you more than you will ever know and for everyone here at the physicians committee i am the weight loss champion chuck carroll we'll talk to you again soon but until then just remember keep it plant-based

Channel: Physicians Committee

Views: 121,556

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Id: 58MQ68R0oVY

Length: 45min 42sec (2742 seconds)

Published: Wed Apr 14 2021