The Vibrant Wellness Podcast

Inflammation, Gut Health & the Power of Fiber | Dr. Will Bulsiewicz, MD

• Vibrant Wellness • Season 1 • Episode 118

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Inflammation is at the core of modern chronic disease and the gut plays a central role. In this episode, Dr. Brooke Stubbs is joined by gastroenterologist and bestselling author Dr. Will Bulsiewicz to explore how gut health, fiber, and the microbiome influence immunity, metabolism, aging, and overall inflammation.

🔗 Dr. Will Bulsiewicz, MD

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🔗 Dr. Brooke Stubbs, MD

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Welcome to the Vibrant Wellness podcast. I'm your host, doctor Brooke Stubbs. Today I'm thrilled to welcome doctor Will Bolso X, doctor B is the New York Times bestselling author of Fiber Fueled, a board certified gastroenterologist, a research driven clinician, and one of the most influential educators online in the Gut Health and Plant-Based space. And now with his upcoming book, Plant Power Plus, he's pushing the conversation even further, offering a modern, flexible, evidence based approach to optimizing metabolic health, gut resilience, fiber diversity of the microbiome, and personalized nutrition. Doctor B is at the forefront of how diet shapes our microbiome, how the microbiome shapes our hormones, weight, immunity, mental health, and ultimately how we age. With the. Help! Well, thank you so much for being here. So excited to talk to you today. Oh, it's my pleasure. It's, it's amazing to connect with you and record this podcast. Yeah, I know we got to, record a podcast a long time ago, and now it's first time on the Vibrant podcast. And really excited to meet you in person. First time in person. Yeah. Okay. So let's dive right in because you have a new book coming out January 13th, this episode. You'll probably it'll probably already be out by the time this episode airs. So I want to dive into exactly what's going on with, the book. Let's start with inflammation. How that ties into the gut. Yeah. Well, so I think, first of all, Brooke, and I know that you can appreciate this being a lifestyle medicine doctor, that I take a step back, and I look and I see inflammation as the problem from a health perspective of our time. Yes. And and I don't think it's just me because, like, the data would back me up. Three out of five deaths are from inflammatory health conditions. And the World Health Organization has identified this as the number one problem across the globe. And so I sort of made the decision. And it really where this started, Brooke, was with patients who have inflammatory bowel diseases, who have taken care of through the years, and their experience was never up to par from my perspective, because they go most of them, they go to their gastroenterologist. They ask, what should I eat? And the doctor says, doesn't matter, take your meds, okay? And they know that's a lie because they feel the the pain when they eat certain food. Right. So then these people who are desperate to understand that turn to whatever is the popular approach, right? Which flips every three years. Yeah. And so wherever they happen to be in that moment, that's what they end up doing. Well, that's not evidence based, right? Like the way that you and I approach our problems doesn't flip every three years. We are like just refining our process ever so, ever so little. I love how you say that. Yeah. So anyway, so I felt like, you know what they these people with chronic inflammatory health conditions, including autoimmune disease, but not just autoimmune disease, they deserve an evidence based book on nutrition and the other tools that they can apply to their life to address inflammation. Right. And so but in this process, I asked the question, how many inflammatory health conditions could I go on the podcast with Brooke and pull out studies, like if she were to ask me as a medical doctor, what what what data do you have to back this up? I found over 130 health conditions associated with inflammation where I have data to back it up, and I have studies that I could show you. And so the second question that I asked was, okay, so what's going on with the gut? If we lift up the hood, what are we going to find going on with the microbiome? And I found that over 130 of those conditions, like literally all of them, where there's a study, it always shows the same thing. The gut is unwell. Right. And so you can't separate these things. In fact, I would challenge your listeners. And I don't mean this in any sort of negative way. It's a purely like, I would love for someone to prove me wrong, that you can find a study where the gut is, well, but there's chronic inflammation, okay? It just doesn't exist. So so from my perspective, inflammation. These 130 health conditions, there's this opportunity that exists through the gut, through the connection between the gut and our immune system. And we can unpack that connection in much greater detail. There's a reason why they rise and they fall together. Yeah. And we are where we are today, in part because they are fallen and we can build them back up and we can do that actually really quickly. And then you will feel the difference. Yeah. Okay. So I have so many questions now because I want to talk about IBS and IBD. And a lot of times I'll have patients come in and their doctors have told them to stay away from fiber. And it's just like, how do you make people understand how healing the fiber is for the guy that also leads into inflammation? I was just at a, a roundtable for longevity doctors at the Buck Institute in Novato, California. And I was trying to, you know, we were talking about oxidative stress. We were talking about cardiovascular disease, which is an gut disease. But we know that it's connected. We're talking about all the inflammation. And so how do we make people understand that inflammation is the number for all of these diseases. Right. And then I also want to talk about if it's connected. What is that. The gut is the starting point for immunity. So where do we want to get started all of that. Well I guess as we jump into this I just want to drop a quick little comment bomb to say that I don't understand how anyone could go to a longevity conference and not discuss fiber, because fiber is the longevity nutrient. Yes. And so and to me, there's nothing like if you want to build muscle, you need protein. And I'm not the person to sit here and say protein doesn't matter. I do think we overdo it. Yeah, I agree, but but if you want to build a longevity and you want to be healthier and you want anti-inflammatory, it's fiber and it's through the gut microbes that make that possible. This is a story about the symbiotic relationship that we share with these microbes that we have evolved with from day one. They were on this planet actually, before we were. And we have come together in a partnership that is our life where when we consume fiber rich foods, they release things from the fiber that we're not able to make ourselves. Right. And those are the short chain fatty acids. And those are the without any doubt in my mind. Those are the most anti-inflammatory compounds that exist. So acetate, propionate and butyrate and many of these elements of the connection between our gut and inflammation are the result of the acts of these microbes. Because the microbes, not only are they producing the short chain fatty acids, they are the stewards of our gut barrier. So our intestines, the entire tube, which is 20 or 25ft long, like so for me, I'm a big guy, probably 25ft, but for others 20. The whole thing is carpeted with a single layer of cells. And so we call this the epithelial layer held together by these proteins that are like the cement that holds the bricks together. They're called tight junctions. And it's the microbes that it's their job to help to place those bricks and piece them together using that cement and make the gut barrier strong. And the opportunity that exists with that is actually quite, wild. Right? Because so this is actually the area of the greatest, your turnover of any organ in our entire body. So every 3 to 5 days we actually install a brand new gut barrier, which is good news for most of us. It's great news because what that means is that the choices that you're going to make over the next 3 to 5 days will have a really quick impact on your refreshed, brand new, stronger, gut barrier that's going to protect your immune system. So this gut barrier, people hear terms like leaky gut and things like this. I actually don't have a problem with it. I don't I don't buy the whole concept of like, leaky gut syndrome as a diagnosis. Right? I wouldn't make that diagnosis. But the physiology, what's actually happening inside the body is undeniable, which is the disruption of this gut barrier because the microbes are unwell. Right. And because we're not consuming fiber. Okay. And is it the microbes that are unwell, or is it the overgrowth of the ones that aren't beneficial? Well, you don't get so. So, you're alluding to small intestine bacterial overgrowth, or also dysbiosis. Right. And it's, it's both because when the, when the beneficial bacteria, which also happen to be the ones that produce short chain fatty acids, when, when they are well populated, they suppress the bad guys, the bad guys don't exist. And we know that this is true because if you there's nothing that will destroy the good bacteria faster than antibiotics. And within the context of antibiotics, you and I have both both dealt with people who develop infections because when you get rid of the the good guys, you allow the bad guys to surge and then they can create, you know, an infection. So like for example, a C diff infection is the classic thing that developed that develops after antibiotics. But there are many others. Right. So so, so we know that like the good guys are there to suppress the, the bad guys. But when the good guys become weak, they're not capable of doing their job. Part of their job is suppressing the bad guys. Part of their job is also maintaining this gut barrier. And part of their job is producing short chain fatty acids. The whole system breaks down. And that's why in my mind, when I see this trendy carnivore diet, I get so worried for these people. I think we're going to see ramifications for decades. You know, these kinds of trends because of the lack of fiber. But also talk to me about the secondary byproducts that having a diet like that produces and what that does. That's a great question. Actually. People don't ask me this very often, so I appreciate it. Yeah. So your your microbes are going to work. Not exactly the same microbes, but in general, this global microbiome that lives mostly inside of your large intestine, and there's 38 trillion of them. They sort of are going to produce stuff no matter what. And it depends on what you sort of give to them. So if you give them fiber, then what they're going to produce are these short chain fatty acids. If you deprive them of fiber and you start loading them up with protein, they're going to start to basically ferment the protein. And this produces, many different byproducts, none of which we particularly want. So like you can start to produce hydrogen sulfide compounds, which, by the way, are the reason my farts smell so and and it comes from the sulfur rich amino acids that exist within red meat or within eggs. Or they're also but they're also toxic and they create inflammation. They're going to produce ammonia compounds. And these ammonia compounds are irritating to the gut lining. They've been associated with colorectal cancer. They've been associated with inflammatory bowel diseases. So so the bottom line is like these microbes, they're going to be active. They're anything that you put into your body is going to ultimately on some level come into contact with these gut microbes. And they're going to change it. And they're going to they're going to they're going to create transformed products. And we have a choice. We can we can either feed them anti-inflammatory stuff that allows them to build molecules that will lift us up and have a global effect throughout our entire body, not just on the gut barrier, not just on the immune system, which, by the way, there is a powerful effect on the immune system. But throughout the entire body, or alternatively, we can overwhelm them with with protein. And honestly, we're creating like inflammation. Right? And I just keep going back to this thing in my head that says food is not neutral. It's going to either give you a benefit or it's going to be deleterious here. The idea of food being neutral is insane. Yeah, I, I don't get that at all. And I sometimes feel like some of these conversations like, oh, it's just calories. Doesn't matter what you eat. Or some of the arguments around ultra processed foods. Look there, we don't. That is not where science is. I don't care how much you want to pretend that that science, that's not where science is. It is very clear that not only do your food choices impacts your health, but it's also quite clear that your microbiome, which is built on some level by your food choices, but not just your food choices, they impact your health too. What do you say to people who are, you know, like the patient I mentioned earlier who had IBD and they couldn't tolerate? Yeah, Fodmap foods, how do you help people approach that so that they can get back? And the other one that I'm thinking of is IBD with raw foods like people not really being able to tolerate raw vegetables or, salads, things like that. Yeah. So these are these are the exact things that I was thinking about as I was building the protocol for my new book. Right. And because, like, of course, I want people who are healthy and want to prevent health issues. I want them to follow this too, because I honestly think that everything that we're talking about right now is applicable to 100% of people, right? If you're healthy, you want to stay healthy. If you're not well, we want to make you well. but at the same time, I also knew in my mind that I was writing this book for these people who are suffering and so, so just to kind of walk through real quick, like the the make up of the protocol, because I think it actually answers your question because I literally was trying to do what you're asking me. So, in phase one, there's three phases to the protocol, and they're not meant to be time stamped because like, you could do them in a week if you want to. But honestly, like, I don't see any reason to rush because we're talking about healing and healing takes time and how long depends on the person and their starting point and other other factors. So but phase one, the way that I approached it is actually I'm not going to overhaul your diet. You might think I'm going to. No I'm not I like this. Yeah. So instead I'm going to supplement your diet with things that are easily digestible but are delivering the nutrients that I want your gut microbes to get exposed to and get comfortable with. So things like smoothies or like really well digested soups. And if you take those things, then you're making it actually a lot easier for these microbes. If you keep it low Fodmap, then it's even easier. And so and for people who are listening who are not familiar with this, I know you are. But like FODMAPs, these are the fermentable parts of our food. They're actually not to be vilified. In fact, most of them are good for our microbiome. But for a person who has a damaged gut, they are a struggle, right? So what we can do is we can build ism. Why is it such a struggle? Because ultimately when we say fermentable, that's basically, synonymous with saying going to come into contact with your microbes and they have to unpack them, and if you don't have the right microbes, then the byproducts are. Yeah, yeah. So if you're, well, if your microbes are unwell. Right. So if they're, if, if they're struggling to do their job, you're actually putting work on them. So imagine a person who's completely beat down, exhausted, starving. They haven't slept in a day. Right. And then you show up with like this burden of work that's going to take eight hours and you drop it on their desk right now. Right. You're not going to get much. And so, so and that's, that's the kind of the way it is when the microbes are struggling, then we, we want to actually be more gentle and make it easier for them. And so, so a low Fodmap approach allows us to do that. So we're digest we're pre digesting the food whether it be in a blender or softening it with smoothie with soup. And we're keeping it low Fodmap. All right. And those are supplements to the diet. You're you're keeping your diet. You're adding this. And then what we're going to do is we're going to pull the levers that have nothing to do with what you put into your mouth. So basically like we're going to activate your morning routine. Phase three. This is phase one. This is all this is all phase one. Because because the issue is that like I can get you healing and I can make you feel the difference without you changing what you eat. I can absolutely do that. Right. So I there's so many people are so hesitant to, to take a 180 from what they know and have to unlearn how to eat. And now we're just making the steps easier. So if you have a checklist right, here are the things that you're going to do in the morning. Here are the things that you're going to do in the evening. Right. Here's what you're going to focus on midday. And it's not going to be as much because I know you're busy. Right. I think that makes it a lot more approachable. And it really siphons out the things that aren't working for you. So if you are focusing on those good lifestyle habits, then the bad ones have to fall to the wayside. That's totally true. And and the beauty of this is, if you if you do these things like, I am highly confident that you and this could be literally everyone, right? Because I know from my own life that I feel the difference. So I'm highly confident you will feel the difference. And so. And then I gotcha. Because then I can nudge you into phase two, where phase two, it gets a bit more complicated because we're going to cook. Right. So now we're going to step into the kitchen and I'm actually going to work on your diet. We're going to keep it low Fodmap right. We're not going to go raw. There's no salads. But we're going to start to step into a more microbiome friendly diet and and step our game up. Right. And then in phase three it's really about optimization. So like you get yourself to this point where like actually you're doing really well. And now we're just going to make it gorgeous like that fine tuning. We're going to fine tune it to perfection. Oh I can't wait. I haven't read the whole book, but in the first intro you cite 45 sources, and it's so incredible to me that you are so rooted in the evidence. And I guess I want to talk to you about, because it's so compelling. When I read your books that the evidence is there. Why is there such a discordant viewpoint on what nutrition should be? There's so many, you know, there's so many arguments against plant foods or, you know, obviously protein is a big trend right now. Right now or like always is muscle is important, but it definitely is important. We can build muscle and be 100% muscles built in the gym. I just heard JJ Virgin say that at the unimonius summit, and I think you can't have me and be healthy. Totally. There's this fear mongering around plant. So oxalate or fight Aids or lectins are going to be anti nutrients and steal from you. Tell me talk to me about that. What do you think. Well I think both sides are guilty right. And it's because there's there's discourse that happens on the internet. Right. This is not academic meetings. I'm not saying academics are perfect. They're certainly not right. There's issues there, too. But that being said, like this is not this is not some like grounded in some requirement to actually back up what you say with the evidence. Yet I feel compelled because I do come from an academic background. I was chief medical resident at one of the top internal medicine programs in the country, and I spent four years on a grant from the NIH, basically working at the University of North Carolina School of Public Health, right, in addition to becoming a gastronologist Right. So so I come from this background and, by the way, our friend Natalie Crawford, she was in the exact same program. Yeah. So she was, I think, two years behind me, but because I'm an old dog. But anyway, when I write a book, I have my overarching goal is I want to change your life. And in order for me to get there, I need to give you, like, really evidence based information. Yet simultaneously, it needs to be digestible, like you need to be able to read this, get excited and want to do it. We want to run through a wall because change is not easy. I think your books do that I have to give you like I mean, I when I read Fiber Fueled, I was like gung ho, let's give this all this information to patients. It's so digestible, it's easy to understand that education is power and you do a fabulous job at it. But, I mean, it's got to be hard to do. And you have. And I love writing for fun. Yes. And I hate writing academically. I hate it, and I think it's because there's I have a creative, creative side. And so, so I feel like I'm like boxed in when I'm forced to write in a very sterile way because I want to have fun. Right. So, so these books allow me to do that, which is why I think it's worked out so well, this one. But at the same time, I do come from this academic background where I want like if there's a medical doctor out there, you are my peer, I respect you and I want you to have access to the data that I was looking at when I wrote those words. So I will back up everything. So the introduction has 45 references, but the total of the whole book, not including the table with 130 health conditions, is over 1400 references. So like basically, if you have a question, I will I will make it so easy for you. You don't have to try to figure out where was you getting this from? I'll literally give you the reference. Thank you for that. I mean, it does help to push forward the ideas that are should resonate and will help. Obviously help the general population like their health. I want to get back though, to when we're talking about all of the varying degrees, how do we come together? What is the magic formula to say, okay, we can take what's good about your viewpoint, what's good about your viewpoint? And we're all here with the same focus and the general goal. What do you see? How do you see that happening? Can we do it? Well, I mean, I think we have to be willing to have conversations. Because if we're not, then we're just tribal in in our camps. Right. So, so I think that there has to be an openness and a willingness to even be proven wrong, honestly. So I also think that it's like, and I talk about this quite openly in the book that there's no one size fits all. And I, as a medical doctor, very outcome driven. So to me is not the story of how we got there. I have nothing to prove on that. I'm about, do I make you well, do I fulfill my goal to improve your health? And so and however we get there. Yeah. I will, I will be happy to, like, see you there no matter how you got there. Right. So. But like, with, for example, the carnivore stuff, I would never in a million years recommend that for a long term health. Right. I just don't see that as being possible. And I'm quite worried that, like the longer that data, the longer that we accumulate data, the more concerning that it will become. And and we've seen where quite high profile people have had to actually walk it back in terms of like they say and recommend one thing, and then they end up having to do something different themselves because they suffered the consequences. So so I don't think that, like, literally anything is a solution. There are specific solutions. And I think that it's the evidence that guides us like a compass. It's the compass is not perfect. It's not a perfect map. Right. But the compass kind of guides us to finding this. And so and if we're willing to have discourse around these things, then I think you can start to find the common ground. So let me give you a few quick examples. So like Max and I, we had a great conversation. I have I have respect for him. I read his book cover to cover. And you know what I said to him to his face, you're way more plant based than you pretend. Seriously? Because he's got like ten, ten genius foods. Seven of them are plants. So. And I and actually, I think out of the ten, eight of them are things that I talk about and write about as being great. So we're how do I the same page and we're more alike and we agree more than we don't. Yeah. At the time 100%. And and so we're like, Paul Saladino okay, I don't agree with the general premise of how he approaches things. There are things that I do appreciate about him. I appreciate his honesty on some stuff, and I also appreciate that he's not scared to back down from ultra processed food and having that fight, because there are people that step up to fight him on that. And, and he and I on that like eliminating ultra processed foods. We are 100% on the same page. Yeah, yeah. And you know how detrimental that can be to the inflammatory process within the body. And I think, like if we can give, the patients more idea of if I'm having those ultra processed foods, that's going to in turn increase enough cap of those microbes or, sorry, those really refined nutrients are getting right into the bloodstream and immediately increasing the inflammatory cytokines. And there the benefits are that we've lost fiber, lost the antioxidant potential. So yeah, totally. I'm on board with what we and what we've done is we have created Frankenstein Foods. So did you see that movie on Netflix a curiosity? Oh, it was a bit it was a bit disturbing, but basically. Well, so they came out with it was, it was, Guillermo del Toro, who's a famous director, and they came up with a they're like modern version of Frankenstein. Right. And as I was watching this, I was like, this is our food system. Like, literally like basically you are deconstructing into pieces sugar, flour, salt, junk fat. And then you're putting it back together and you're binding it together using chemicals that are not found in nature. And and it's like to me, it's disturbing because basically you can create things like you can create ratios of like high, high carbohydrate, high salts, high fat that actually just don't really exist in nature. Yeah. And then obviously feeds that dopamine or the that craving in the brain. And you want more of it that that's, that's basically what the definition of hyper palatable is. So I propel is like a word in our world of like the, you know, it's like a quite sterile medical word, but hyper palatable is basically referring to like, you don't feel satiated, you don't feel full, you just want more. Right? And they're designed to bring you back. Yeah. And I I've had my fair share I love sweets. Who doesn't love sweets? Once you get started right. This I'm going to I'm going to say this wrong. But metabolites are going to help. You want to crave more of those sugary sweet foods? Yeah. There's actually some interesting, not to divert away from and UPFs, but, there's actually some interesting data, like, for example, with chocolate where they've shown that that people who crave chocolate, there is a metabolite that is clearly produced by the gut microbiome that is disproportionately represented in these people. So there is the idea at least, like, you know, demonstrated convincingly in chocolate that our gut microbes actually influence our cravings. Absolutely they do. And then you go cold turkey steak for 3 to 5 days and you don't crave it anymore. And that is right in line with the change in the gut microbiome. Yeah. That's true, that's true. Yeah. So I think like these, ultra processed foods, there's a lot there. But the bottom line is that as we exist here today, the average American, this is 60% of their calories. And that's the inherent problem. Yes, absolutely. Okay. Let's talk a little bit about other red flags, because we alluded to the fact that inflammation is at the core of this, that the gut microbiome has a lot to do with it. So feeding a good healthy gut microbiome biome so you can train, you say in your book you can train your immune system. So what I want to hear more about like how that specifically happens. And then, and then I want to get into a conversation. So let's talk to me a little bit about how is it that the gut microbiome can train your own immune system. Right. So this is, this is a dance that actually begins at birth. In fact, there's actually data during pregnancy that would suggest that what mom eats during pregnancy affects whether or not the child develops allergic diseases later on. I'm really sorry. So. Well. And like that, that that is actually backed up and validated by fiber. So, like, women who consume more fiber during pregnancy are less likely to have children with allergic health conditions. So, exactly like I, some, or there's this entire package that includes eczema, food allergies, asthma and, allergic rhinitis, which is like seasonal allergies. So, yeah. So this dance begins, like literally at birth. And actually the there's they're intertwined together where the microbes are training the immune systems to know what is right and what is wrong. And if you disrupt that dance, if you disrupt the development of that healthy microbiome, then there there can be reverberations into the immune system. Because allergic diseases are conceptually, in my mind, they're conceptually similar to autoimmune diseases. I'm thinking of this one nature, and there's many like this that came to me severe, which is sinusitis all the time. Allergic induce we change your diet to change your life. In two weeks you felt better, but it didn't stick. The foundation wasn't there. There was no accountability, no follow up. And then she comes back in and she has full blown Hashimoto's. And I'm worried that she might have a coma because it's that bad. And, you know, I'm just in my mind I'm going, these are so interconnected. When you have that, activation of the immune system and then the autoimmune disease that follows function. Yeah. Yeah. So. Well, so, just to like, define these terms a bit, allergic diseases are basically the immune system confused and reacting to things from outside the body. Right. So it could be food, could be pollen whatever. Autoimmune diseases are the immune system also confused and reacting to things inside the body. So like reacting to yourself and deciding that yourself is the enemy. Right. So this is like in my mind, this is like if you've ever seen that person who's so drunk and they're just fighting, right? And they don't even know who they're fighting, they don't care. They just want to scrap. Right. And so that's that's kind of where the immune system is in a way where it's like it doesn't even know who the enemy is. It just wants to fight. Right. And and by the way, inflammatory bowel disease is this is a bit of an aside, but Crohn's disease, ulcerative colitis okay. Actually I don't believe those are autoimmune okay. So because they're not even though it seems like they're attacking the intestine, the what we have found is that there are antibodies from the immune system associated with microbes. So the immune system is actually attacking the microbiome. So this it goes back to the stance that begins at birth where you are developing your microbiome during the first three years of life. So by the time you're three fully formed adult size, and in the same time you are developing your immune system and the tolerance of your immune system for your microbes, for your body. And if you disrupt that dance and you break them up, then you create problems. Because if you give a child and there's actually a bajillion studies to back this up of many varieties, I could dig into some of the interesting ones. But if you if you give a child antibiotics during the first year of life, if you bear a child by cesarean, which, by the way, I have four kids, all born by cesarean, all doing well. So I'm not this is not it's not like right. It's just information and it's just and it's just like, you know, relative risk. Right. But or if you bottle feed a baby as opposed to breastfeed a baby, any of those three things, you will increase the risk of allergic diseases. You will increase the risk of autoimmune diseases. You will increase the risk of metabolic health conditions. So which speaks to the things that are happening in the first year of life, and the way in which the microbes are training the immune system. If you disrupt that, it can have consequences later on in terms of the immune system's ability to do its job. So like there was a cool study real quick where they looked at a bunch of kids and they took microbiome specimens at three months and at 12 months, and then they followed the kids out for five years, and they tracked them for the the four different, allergic health conditions that you and I were discussing. So eczema, which is skin and asthma, which is lungs and allergic rhinitis, which is your like basically sinuses and nose, and food allergies. And what they found was that, number one, kids who were exposed to antibiotics or kids who were, bottle fed in the first year of life, they were the ones who were disproportionately developing those for health conditions. Later on. And then they turned to the microbiome at 12 months. Now, this the important part here is that this is before they have developed the actual condition. They have not been diagnosed. Right. And they could see in the microbiome a pattern that already indicated increased risk of developing these allergic conditions. And for what it's worth, just to sort of stamp with validity my entire thesis around these connections and the importance of short chain fatty acids. They also found that when they checked the poop of these kids at 12 months, they were low in butyrate. Okay, so the, the the point being that like, these things are completely intertwined and some of what I discuss in the book is like, hey, you can treat actually, you like there's data emerging that you can treat health conditions with fecal transplant. We could talk about that like this. Like sort of cutting, like it's the tip of the spear because this is a cutting edge medicine. And there also it has been longstanding data where antibiotics are associated with increased risk. Right. So even as an adult, if you give an adult antibiotics, they are twice more likely to develop inflammatory bowel disease in the next year. Wow. So and that risk goes up if you give them antibiotics more than once. If you're ready to take control of your own health. Visit Vibrant wellness.com to learn how advanced integrative lab testing can uncover root causes and guide your path to vitality. Vibrant offers one stop shop testing solutions, including the recent launch of Gut Zoomer giving you actionable insights you can use with your health care provider or with your patients to support targeted, effective healing. So for people who were delivered with C-section, who were bottle fed, who probably are low in fiber in their diet, would you just encourage them to follow your protocol, reestablish a good, healthy gut microbiome? And then would we would they be able to see enough benefit to help support any of these chronic conditions? Brooke. These oh, there's 100% hope. Yeah. Now, the opportunity for healing is like exciting and beautiful because the the choices that we make today can start to impact our microbiome by tomorrow. So even if we're not born with the microbes or are we born with them, but they're just not in a healthy population. Talk to me about that because I think I just want our listeners to understand that, you know, just because you were born with said microbiome, it doesn't mean you can't receive all the benefits, you know, because the short chain fatty acids have to come from this healthy gut microbiome. Look, there are some things I mean, this is just being honest about the way that that that, you know, medicine and health unfolds during our lifetime. There are things that we have no control over, right? You can't control your genetics. You can't control the things that happen in the first year of your life. You can't control exposure to trauma or things like big, impactful psychological things that happen during your life. At least in many cases. You can't control those things, right? So. And there, there. But there's an opportunity for healing that we have. And I absolutely believe that we can overcome those things. And that doesn't mean that we're all going to have perfect glowing health. It's points of relativity, right? Where are you today and where can we take you? We can take you to a better place. Right. And you can start the transformation can begin rather quickly, right? Because when you start to feel the difference and I would argue like, for example, if the listeners of your show were to make it a priority to step outside. And I understands this time of year, depending on where you live, this is a tricky thing. Yeah. So or you can get a light box which provides 10,000 lux. But if you step outside to get that morning light exposure from the sun, all right. And you do that sufficiently like not like two minutes, but you do that for depending on how sunny it is, anywhere from 10 to 30 minutes. Okay, I, I am totally convinced because I've seen this in my own life that literally on day one you will feel the difference, right? That is your body healing. That is your body in alignment. What are the things that I expect you to feel? I expect you to feel more energy. I expect you to have better focus. You're going to be able you're going to have more cognitive endurance so you can get more done during the day. And then the other thing is, if you check the time, like, let's pretend that you get outside at 7 a.m., I'm just throwing a number out there. All right. Add 14 hours to that. So now it's 9 p.m. you will notice at 9 p.m. you're getting tired. You're ready for bed. That's the clock. And so there are these opportunities for healing. It's not just fiber like a fiber obviously is. I can't stop pounding that drum because as we sit here, 95% of America is deficient in fiber. And the popular advice is not addressing that issue. So I have to push back, right? And I have to push back hard in order to make that happen. But at the same time, there are many opportunities for healing, and many of them you will feel very quickly if you introduce them. So you mentioned, like we were talking about this clock in our body, the circadian rhythm that's so important for all of our cells to switch from their on breakdown function to the rest and restore repair function, which can help aid in the gut microbiome healing. We can also talk to me about the other plus items in your new book that are so there that they're not negotiable, but they really are the adjuncts to the diet. Yeah. So, the book is the book is called Plant Powered Plus. And just to be completely upfront, plant powered, of course, I'm talking about your diet, but it's just talking about mostly plants. This is not like there's I'm actually not asking you to be 100% plant based unless you want to be right. If you thrive like that, you should do that, right? But I also discuss, like the value of a mediterranean pattern, a flexitarian pattern, pescatarian, where you include fish. Like all of these things are on the table. And the absolute best diet for the people who read this book is going to be the one that you're actually willing to do. So I'm happy to build that flexibility in, but also guide you towards better choices. Right. So and then the plus is the idea that there's so much more. So this concept of like morning light, we could unpack an entire morning routine. And it's really about building your circadian rhythm because, undeniably, whether you like it or not, your body is craving to know what's the time like, what time is it? You know what's happening? What should I be doing? What should I be preparing for? Right. So. And that that is like the nature of our 24 hour clock and the most important element in terms of teaching your body where you are in the day is exposure to light. That's how we evolved. We evolved to know when the light turns on, we should turn on our body, and when the light turns off, we should turn off our body. So we're supposed to be aligned with the rise in the fall of the sun, right? And unfortunately, we spend 93% of our day indoors. And many people like if you work from home, you may not even go outside, right? You literally walk into your office. There you go. So, so our circadian rhythm is a part of this package. And it's not just like this morning sun hack. You know, there's also the things, the opportunities that we have in the evening to build an evening routine. There are the ways in which we choose to supplement where, like, I believe that our supplements should be circadian, where we should have specific stacks in the morning, specific stacks in the evening. About all that. It's all in the book. I tell you exactly what to take. So and it's designs is designs where, like that would align with what your body is doing during that time of day. So during the day we're active, we're metabolically turned on, and we're also like, we need to, have protein metabolism to basically like go about and do these physical activities during the course of a day. Right. So well guess what? Our microbes are aligned with that. Right? And our supplements should be aligned with that too. And then in the evening it's really about rest and recovery. So we should have supplements that are aligned with rest and recovery. We should have supplements that are aligned with restoring our gut barrier because that's what's happening overnight. So, I give us a few of those like a couple of your favorites. Yeah, a couple favorites. So like, I'm a big believer in vitamin D and omega three supplements, which you take in the morning and then magnesium and zinc in the evening. Okay, These are all good things. These are all things that you know, I tell my patients quite a bit because they're so evidence based. Yeah, I just wrote them on. I've had a fever yesterday. But I also love turmeric. This is something that I've told patients to take when I was a hospitalist on the bone marrow transplant ward for inflammation. Talk to me about that. Do you think we should be getting it more from her diet, or do you think we should be taken as a side. I first of all I own a supplement company and we can talk more about that. Because actually the other thing we haven't discussed yet is prebiotic supplements that I really, wholeheartedly believe in. All right. Let's see it. So I own or something. I mean, we can and we can talk about prebiotic supplements in a moment, but to answer your question about turmeric, I would start by saying this. I always prefer for us to get as much as we can from our diet. Right. We should never try to out supplement a bad diet. We should take a bad diet, make it a good diet, and then we should see that supplements help us to achieve better health and what we can achieve with our diet alone. Right? And that includes the replacement of things that are missing, which no matter what diet you construct, I can poke holes. There will be things that are missing, right? In a perfect world, yeah, yeah. So one of the things that I discuss in the book is the concepts is tests then address, which is basically to say that like for these things like vitamin D, omega threes, we have tests for that. Right. So there's no there's no need to be blind and just choose whatever you think is the right number. You should test it, know where you're at and you should targeted number. And all of these things are unpacked with clarity in the book. Like, hey, here are the tests. Hey, here's the goal. This is the number you want to get to, right? So, so anyway, so with turmeric, the question that you asked was should people get them their diet? I would love for people to get that on their diet. But you know what? I am like the world's biggest fan of chana masala. I love it and I love a good curry. And how many times a month am I actually having that? Not a lot like once or twice a month. It's just not that readily available. Well, it's just not like it's not, at least in my American diet. Right? So prevalent. Right. Whereas if I were eating a more traditional Indian diet, it would be all the time, right? In the same way that if we were in Korea, we would be having kimchi every single meal, even breakfast kimchi. Okay, right. Talk about prebiotics. Well, so, so within this supplement space, again, you should eat more. You should consume more plant based food to get the fiber that your microbes are starving for. But at the same time, I am I'm of the belief, and you will never be able to knock this out of me, because I've seen it with my own eyes in thousands of patients where there is value to prebiotic supplements. And when I say prebiotic, I'm referring mostly to fiber, but I'm also referring to resistant starch and polyphenols. Okay. And so and I was in I was in practice as a gastroenterologist and basically like people who walked through that door, I was convinced that virtually 100% of them, they have dysbiosis. This is the reason why they're here, right? So my goal is to address that problem because I see that as the root of they're like, yes, they have year old bowel syndrome with bloating and constipation. Of course, I want to like get rid of their symptoms, but it's not sufficient to just get rid of their symptoms. We need to go to the root of the issue. Right. So I became convinced that the dysbiosis is the core of the problem. And if like, can I convince them to change their diet? I'm going to try. Right. But can I also offer them something that's quick? It's easy, and it does get to the root of their issue and helps them to address that problem. And those are fiber supplements. And the answer was yes. And I saw tremendous results. And I had people because I became known over the course of time, you know, especially after my first book came out, people who were plant based, people who are vegan, they have gut issues, too. This is not a silver bullet, okay? And they would come in asking for help. And it wasn't that I would change them off of their diet. They were already doing the diet. But I would add in the fiber supplement and they would say to me, but I'm already getting fiber. Yes, but it's not the same. We are not replacing your diet with a supplement. You are optimizing your diet. And then I'm layering on the supplement, which is different, and it has its own unique impact. And so. So anyway, the story behind 38 Tera was basically that I was never satisfied with the quality of the products that are out there. I kind of thought this, these products that are out there right now that are being sold and marketed to people, they are a joke. We can do so much better than this. And the other issue is there's major transparency issues. So like to me, whether we're talking about the publication of papers or the way in which businesses conduct themselves or the problems that exist around supplements, and there are problems. And I'll be the first to say that transparency would address a lot of our problems. And so one of the things that we've done at 30 Tera, my, my business partner is Simon. Hello. Yes. So we're co-founders and we made the decision that we were going to be radically transparent. So like we test aggressively every single batch that is manufactured far beyond any standard of what is required of us. And then we will put that into a report where you can basically download it and get access and know, like my specific product, this is this is what it's been tested for. And this is what those tests show. Yeah, I can't wait to use it. I'm sure I'm benefits beyond what I expect, but, talk to me a little bit about probiotics or fermented foods and species in fermented foods. Okay. So if we could I would love to separate out fermented foods from probiotics because it's it's important in the sense that I see them as different tools. So and in the book I talk about four workhorses for plant power nutrition. So these are to me the four elements of an anti-inflammatory diet where no matter how you construct it, if you focus on these four things, you will achieve your goal of building an anti-inflammatory diet. And and fermented foods are one of them. Great. Okay. And the reason why I so, Brooke, you asked me a few a few minutes ago. Hey, do people, is it possible that people lose the microbes? Right. Get antibiotics in the first year of life, lose the microbes, and they can never get them back, right? Well, what we have is data from Stanford where they, took a group of people. They started, they asked them to increase their fermented food intake. And in just eight weeks, they increased the diversity within their microbiome. So what that means is whatever number of species they had when they started, after adding fermented foods, it was much larger. And just to once again validate this entire theory of when the microbes are, well, so is the immune system. As diversity within the microbiome increased, the measures of inflammation were dropping hard. So the beauty the exciting thing about fermented food is there, right? There is an opportunity for healing by simply adding in something that most of us are missing. Because let's be honest, most of us aren't eating kimchi, right? Like so. And sauerkraut, my refrigerator. But it's still there and it's been there. So, and it's not. And it doesn't have to be sauerkraut or kimchi. We have options, but we should look at their list of options and say which one sounds appealing. Some of them to me sounds incredibly appealing, like I actually would count sourdough bread. Even those baked. How do you feel about that? Well, so the flour is transformed. So what's interesting is that you could take the exact same amount of flour. And one of them you apply baker's yeast, which is how you create bread. And the other you actually allow a natural fermentation process which actually is not complex because like you don't, you could use a sour dough starter, but you could also actually just let microbes from your environment come into the flour. So like true sour dough bread requires nothing more than flour and water. That's it. Right. So when you're shopping and you look at the label and it says ingredients, I just told you what the ingredients should be. It should basically just be flour, water and then maybe some salt. Right. And that's not a bad thing. And so, so and if you take those two and you start with the exact same flour in the exact same proportions, the one that was fermented, the sour dough bread is going to come out of the oven with a lower glycemic index, which means it has less of an impact on your blood sugar. That's a good thing. It also is going to be low-fodmap, so it's gentler on your gut. It also is going to have lower levels of gluten and lower levels of other anti nutrients. So for example, if that if that flour was sprayed with glyphosate, which is what you find in roundup and it's also used on our wheat in America. If that flour was sprayed with glyphosate the glyphosate levels will be reduced. Thank you to the microbes. Thank you, microbes, for taking care of us. So so this is just exemplifies that I'm not arguing that bread is health food, but I am arguing that if you could enjoy bread because it's delicious. Yeah I have the better I have this hour though. Right. That's where the money's at. So, so bottom line, fermented foods, we have options. Okay, let's turn to probiotics. So probiotics are the hype machine. There's been this, 20 year campaign. Media clearly affects us. We love probiotics media. Yeah. So. And when I say media, I don't mean just like newspapers, right? I just mean, like this world that you exist in, where you turn on some sort of electronic and you consume. Right. That's media. And I really like have seen, for example, in my kids the impact of like, what you share with your kids and how that shapes who they are and how they see the world. Right. So, so anyway, with us as adults, like there's been this 20 year campaign to basically sell us probiotics. All right. As a gastroenterologist, my experience is different than what the campaign would say. So what I have seen is absolutely there are some people who benefit from probiotics. I'm not here to shove them down and kick them while they're down, but we have to be strategic about how we do this. The entire idea of this one magical probiotic which addresses brain health, cardiovascular health, immune health, hormonal health all at the same time. And it'll cook dinner and fold your laundry. That is a joke. Like, seriously. And I'm not gonna name names, but there are definitely products that that's the way that they roll, right? 1 or 2 species generally in the US, and we have a variety that we need to consider, even the probiotics that have a variety and try to make these health claims of like literally touching your brain, your, you know, all of these different systems. I'm not on I'm not on board with this. Right. And this is why you don't hear me talking about them. So, that being said, there are specific microbes that do specific things. And so when as a clinician, if you have a patient and this is typically not the first visit, right, you're moving to like phase two. And you have a patient who okay, I want to address this, this specific health condition which could be a digestive issue. But there's also data for probiotics and other spaces. The way that you would approach it is you would say, do I have a product where there's a human clinical trial to prove that a specific probiotic in a specific amount had a beneficial effect? Because if you do, then it is definitely fair game, and then you try you apply that to your patient in that amount. Right. And then you observe to see what happens. Because if they get the benefit from it, they should know. And if they don't get the benefit from it, then we should move on. Right. So the issue is that you have a unique microbiome. There is no one in the planet. If you had an identical twin, you don't do okay. It'd be cool if you did. I could use an identical twin because I could use some help. So but anyway. All right, if you're an identical twin, you would only share about 30% of the same microbes. So you're 70% different in your microbiome. Even though you grew up in the same house, eating the same food, like a lot of the same exposures, have the same genetics. All right. And so that uniqueness, it's like when you introduce a kid into a new high school, right? They're rolling in. There's a pre-established ecosystem of like social dynamics. How is that kid going to fit in? We don't know until we actually put them into the school. And so and the same is true of probiotics. You have this established sort of click and that's your native microbiome. And you're going to introduce this new guy. And we're going to see what happens. And it might help you or it might do nothing. Or in rare cases it can cause harm. And so so we just we I think the to me give me prebiotics 100 times out of 100 before probiotics. And the reason why was because I know with total clarity that if I give you, for example, or 32 or a daily microbiome nutrition, if I give that to you, I know with total clarity, regardless of what your microbiome is, they those microbes will come into contact with the fiber, the resistant starch, and the polyphenols that we have handpicked for this product. They're going to get there, right. And then those microbes are going to adapt to this product. And if they're going to produce short chain fatty acids, and then those are going to have the healing effects that you're looking for. So then to wrap up, because so far in my mind I'm going okay, inflammation immune system regulation. We know that these are all coordinated with other diseases right. They're not it's not just single guy focus. It can be cardiac disease or osteoarthritis or you name it. And so I know we have listeners out there going, well this is a for me, my gut is fine, but I have headaches or I have painful periods or I have joint aches. And so in my mind, I want to just drive home for the listeners that we can help all of those when we focus on the gut, right. And lower inflammation and, you know, with all of the things with diet, with this repeating rhythm, with exercise, and one of the things that you really can follow in order to know if your gut is doing well and we never talk about it, but I want you to bring it home for us. What should we be looking for? To know that we're really on track? What the hell? Yeah. So you're you're poop is the window into your microbiome? Because most of us, we are under the false impression that it's just the excrement of your food. Like, whatever the food waste is, that your body doesn't absorb turns into your poop. That's not actually true. Like on a minor level, that's true. But actually, what is true is that the majority of the weight of your stool, 60%, comes from your microbes. So this is a reflection of what's actually happening within this gut ecosystem. And so in a way it tells a story. And when you are well, then you should have, large, sausage shaped, soft, but formed and, dare I say, deeply satisfying bowel movements. Okay. So, like it should be a pleasant experience. You actually you feel that urge, you're like, oh, cool, I'm ready to go. I'm ready to go. This should be a great like ten minutes, right? Evacuated, fully evacuated, and you feel fully satisfied. And then you walk out of that restroom, out of that bathroom in slow mo, in slow motion. Doves are flying in the background, fireworks are going off, and my wife looks at me like, yo, that's my man, right? That's what I'm talking about. That's the glorious bowel movement that I want you to have. So. And, the flip side is like the idea and it's it's depressing for me as a gastroenterologist to know how many people are going through this, because it's a lot. It's a lot where you you don't look forward to that time you step into the bathroom. It is a struggle, right? You might be straining to go right. It's uncomfortable. What comes out is not that sausage shaped. It could be a deviant over towards constipation where it's getting hard, lumpy, bumpy, maybe even pellets. Or it can be a deviant. Over to the other side where it's getting so loose it's getting urgent. Explosive. Watery. Right? And in both of those cases, what we know with total clarity is it's not just that your motility, which is the rhythm of your intestines, it's not just that that's out of whack, which it is, but your microbiome is also out of whack. So anytime that we drift away from this gold standard of the of the sausage shaped bowel movement, you are actually changing the microbiome in a way that we don't actually want, right. So so there is this entire story that that can be told. And then the last part of this is it's not just, so there's an overemphasis on how often we go. That by itself is never enough information for me as a GI doctor I always need follow up. So I want to know what it looks like. So that's what we just discussed. And then the question that not enough people ask that should be asked is what how do you feel like what's the experience like. Because some people they're like, hey, like it's formed. I go three times a day, okay. That by itself would sound totally fine. Yet they're here in my office and they're suffering with GI issues. And then you dig deeper and you discover, okay, so like, what's your experience? Like, how do you feel? And they say, oh, well, like I strain and I have to fight to get this like little nugget. And I didn't really feel like I fully went. And then like 30 minutes later I go back and I do it again. Right? Okay. Like, you never really fully pooped in the first place. And that person who pooped three times that day, every single one of those poops was a 20% poop. So during the course of the day, you only got 60% of what you're supposed to, and the other 40% guess what it's doing? It's backing up and it compounds and now all of a sudden you have a constipation problem even though you are pooping three times a day. Right? And you need to be like my son when he has like a really big one. Look how big my poop is. That's my boy. That's my boy right there, I love it. All right, well, we gotta let you go. Thank you so much. Is there anything else you want our listeners to know that we didn't touch? I mean, I so I guess real quick with going back to the book for a quick moment. I'm so proud of this book because I took three years to write it, and the first year was entirely research based, just trying to understand the complexity of the immune system in the gut. But the other big part of this book is that, like, I think people expect me to talk about fiber. Of course I'm going to talk about fiber. I'm really pissed that we're not addressing this issue, right, that it's not a big enough part of the conversation should be it should be the number one conversation. Nutrition. But that being said, there are these other elements. I think the healing comes in many forms. And I want people, your listeners, to hear that we haven't even touched on my favorite chapter I've ever written, which is chapter eight. So chapter eight of this book is about the brain gut connection. Oh gosh, I'm sorry. We know this. Okay, well, you know what? We'll come back and we'll do it again. But the reason I want to bring it up is because actually, it's not just brain gut that makes it sound very like engineered. No, no, no, this is about like us as humans. What are our natural human needs? We have a natural need for connection. We have a natural need to feel love, to give love. And we also have a natural need to see and understand who we are within the broader fabric of this world. What is our life mean? What is its purpose? What's it going to be when I'm gone? Right? And part of that is like tapping into the idea that there's something bigger, right? So anyway, this chapter is my proudest moment because I get to me feels like my masterpiece because I kind of got some things off my chest that I needed to talk about. So I hope that your listeners look forward to, like, checking out this book, Plant Powered Plus and, and and I really look forward to hearing what they think about it as they go through these chapters that you and I have discovered, but also as they enter into some of the content that we haven't really dug into. Yeah. And that's beautiful. I love it because it is, at the end of the day, gaining all the knowledge or making all the changes. What is it for? Right. And that's a beautiful way. I can't wait to read the chapter and very, very well You. I'm very proud of it. So anyway, for people who have enjoyed this conversation, they can come to the health imdb.com. That's my website. That's my main hub. And in that location you'll find free resources. You'll find access to my email list, which is completely free and is basically a Substack. And and then you can learn more about, you know, the different things that I do that include 38 Terra supplements that include my courses that include my clinic and all these other things. And they can follow you on Instagram at the health MD. And actually, I'm launching a YouTube channel so that by the time this comes out, you can also dig into some fresh content on YouTube at the Gut Health M.D.. That's right. Well, thank you, And thank you for joining us today on the Vibrant Wellness Podcast. Don't forget to check back every Wednesday for more insightful conversations! Inspiring health journeys, and the latest breakthroughs in integrative medicine and wellness innovation. If you're ready to take control of your own health visit Vibrant wellness.com to learn how advanced lab testing can help uncover your root causes and guide your path to lasting vitality. and be sure to like and subscribe to the Vibrant Wellness Podcast for more conversations with leading voices in health, longevity and personalized medicine.