Gut Health Matters

When Kate Scarlata's health teetered during a precarious pregnancy, it was a wake-up call to the importance of nutrition and digestion for gut health and beyond. However, at the time of that pregnancy, very little science-based nutrition support was offered. In today's episode, Kate, along with Dr. Megan Riehl, will guide you through the complex world of the gut microbiome and its fascinating link to not just our physical health, but also, our mental well-being. 

Welcome to The Gut Health Podcast. This episode highlights how and why Gut Health Matters!

From the foods that nourish our inner gut microbes to the undeniable brain-gut connection contributing to our emotions, we leave no stone unturned. We're also giving you a peek at the evolution of our own careers in healthcare, revealing how our individual journeys have enhanced our intention and compassion to help those struggling with GI challenges. 

With the rise of psychological therapies in the management of GI conditions and the spotlight on diet's role in influencing our inner gut microbes and digestive symptoms, we're here to guide you through the maze of misinformation and provide everyday tips for nurturing your gut ecosystem and digestive well-being.

But it's not all heavy-duty science in this episode; we dive into the day-to-day reality of managing stress and prioritizing overall health. Discover why simple acts like diaphragmatic breathing can be a game-changer for your gut and how embracing regular self-care through nutrition and lifestyle changes could help your health journey. 

And as we look ahead to our next episode, we hope you join us as we have the opportunity to ask all the burning questions about something that we all do...poop. We'll explore what your poop reveals about your health with Mayo Clinic Jacksonville gastroenterologist,  Dr. Jami Kinnucan.  

Join us for the first episode of The Gut Health Podcast as we provide you with practical, real-world strategies to give your gut the love it deserves.

Learn more about Kate and Dr. Riehl:

Website: www.katescarlata.com and www.drriehl.com
Instagram: @katescarlata @drriehl and @theguthealthpodcast

Order Kate and Dr. Riehl's book, Mind Your Gut: The Science-Based, Whole-body Guide to Living Well with IBS.

The information included in this podcast is not a substitute for professional medical advice, examination, diagnosis or treatment. Always seek the advice of your physician or other qualified health care provider before starting any new treatment or making changes to existing treatment.

Transcript

Speaker 1: 0:00

This podcast has been sponsored by QOL Medical and Schar. Maintaining a healthy gut is key for overall physical and mental well-being. Whether you're a health-conscious advocate, an individual navigating the complexities of living with GI issues, or a healthcare provider, you are in the right place. The Gut Health podcast will empower you with a fascinating scientific connection between your brain, food and the gut. Come join us. We welcome you. Hello friends, and welcome to the Gut Health podcast, where we talk about all things related to the gut and well-being. We are your hosts.

Speaker 2: 0:47

I'm Kate Scarlata, GI Dietitian, and I am Dr. Megan Riehl, and we are so excited to be recording this podcast and be starting this podcast, and we're going to be zooming out and talking about why Gut Health matters. We feel like it's necessary to have a safe space to unravel myths and bring tangible everyday tips to our listeners, and Kate and I are so excited to have these conversations about such an important matter that really impacts all of us.

Speaker 1: 1:19

So, Kate, why does Gut Health matter to you? Well, I'm so glad you asked, Megan. You know, when I think about overall Gut Health, I think it's just amazing that these little microbes that we really didn't pay attention to you know until recently that they play such a crucial role in maintaining our overall health and really preventing a variety of diseases. And I think, like learning that these microbes can get imbalanced in how that is associated with things like heart disease that is like a number one killer in America in cancer, and then all these like neurological conditions like Alzheimer's and Parkinson's disease. And of course, you and I, being in GI, you know we definitely are learning the connection between these alterations in our gut microbes associated with irritable bowel syndrome, gastroesophageal reflux disease and inflammatory bowel disease.

Speaker 1: 2:14

It's very interesting, I have to say. You know we can't jump the gun because this is really new. It's not like we really know what we're doing here. We're just tapping into the science really relatively, you know, in the last probably 20, 25 years. But what do you think, Megan, like what gets you going?

Speaker 2: 2:34

Well, I think we're lucky right Because on our show we're going to be bringing some of the scientists and leading experts in this area. That is still, like you said, it's new new in medical terms in the last decades and you know 20, 25 years. So what we know, even in terms of how intricate our brain gut connection is, and there's so much interest in how our body is impacted by our environment, which you know trickles down to affect the inner workings of our body. So, as a psychologist and we'll talk a little bit more about each of our history and our areas of expertise but from a psychology perspective, the fact that these microbes can impact our mood and the regulation of different neurotransmitters in our body, one that comes to mind is dopamine, right? So when we think about dopamine, it's a feel-good neurotransmitter and the microbes can be this precursor to also serotonin. Serotonin is another one of those feel-good neurotransmitters that can induce calm, and when we think about calm, we think about kind of the emotional state of calm. But these aspects of chemicals within our body also produce calm in our gut and our system.

Speaker 2: 3:57

And so I think that you know, as a psychologist and the work that you do as a dietitian, the reality is we need all of us to help people achieve gut health, and we're certainly going to dive into that in this podcast series this reality that approaching gut health is important for everyone and a lot of the tools that we provide to our patients every day. One of the reasons we came up with doing this podcast is because 45 million Americans are affected by a bowel disorder IBS and why don't we help everybody? Why don't we start to broaden the conversation to people that might not have IBS but are curious about their overall health?

Speaker 1: 4:43

It is remarkable. I mean, I think it makes sense that if there's alterations in our gut microbes that would affect a GI disorder. But to me, you know, seeing, you know heart disease and all these other areas being affected is really exciting because maybe we will really develop some new therapeutics to really reduce risk of all these chronic diseases that many people are suffering with. You know, from a dietitian perspective, I think you know it is interesting because what we eat, we are what we eat. Well, we are what we eat, for us, I guess. But then what about those trillions of microbes that are living in our gut that help regulate our immune system and help create vitamins for our body and keep us from some of these chronic diseases? We're feeding them too. So what we're eating, we're feeding them and basically it comes down to what we eat.

Speaker 1: 5:37

What escapes digestion by the human body ends up in the colon and that's where the bulk of these microbes are residing. And they're waiting there Like what's for dinner and you know it might be a lovely salad, you know residual fiber from salad, or a beautiful smoothie that your body couldn't process all of the fiber, and then we're fueling them to do good things. So what? We feed our gut microbes matters, and we're learning that more and more that diet plays a big role in keeping the good guys going and minimizing some what we often call as potentially pathogenic microbes. We all have some of those potentially pathogenic microbes in our gut, but it's about keeping the good guys in charge, and so there's not a lot of bullies in there, basically, and so the role of diet here does really play a role in fueling those health-promoting microbes. So what we eat matters clearly.

Speaker 2: 6:35

But it's not an end-all be-all and I think sometimes we can get fixated on trying to control things. You know I can control what I put into my mouth if you have that luxury right. We know that food and food choices are a privilege, but if we have some control over what we put into our body and yet maybe we're still not functioning as well as we want, we have to zoom out a little further and recognize that our mood can impact how we feel physically, and our mood can be impacted by a variety of things our environment, our physical activity level. And so when I'm working with my patients, I really like to remind everyone that we all have our own individual fingerprint of what's happening inside of our body through those gut microbes, and that means that we have to take a personalized approach and really do some self-assessment. And if you're struggling with your own self-assessment, maybe that's when you step in and you ask for the help of a psychologist or a dietitian, or maybe it begins with your primary care doctor just having a chat about your overall health.

Speaker 2: 7:46

And so our goals of talking on the podcast are going to be well-being and giving so many options for really optimizing health from this holistic perspective. But you are going to kind of speak to what really makes you happy and excited about a health journey and I'm going to talk about what makes me excited and motivated to engage in a healthy lifestyle. And along the way we're going to give lots of different opportunities because each of us are individualized and each of our experience has to really be catered to Absolutely. So, with that kind of in mind, maybe we should pull back a little bit and share some personal information. So, Kate, I know you have a personal experience in the GI world, so can you share a little bit more about that and how you came to be a GI dietitian?

Speaker 1: 8:43

Absolutely so. I was about seven years into my career as a dietitian at the Brigham and Women's Hospital and I was pregnant at the time. And, just backtracking a little bit, I was a very generalist dietitian. I covered a lot of different clinics. I did a lot of oncology and cancer treatments. Aids was really a big thing and at the time when I started and we didn't really have therapeutics, that was another area I was interested in.

Speaker 1: 9:09

So I developed this like colicky pain. I was three months pregnant. My belly just did not feel right. It was nothing that I had ever experienced before. So I went to my OBGYN and just said you know, I'm not feeling right. So they brought me into the hospital and you know, quite honestly, it was a little traumatizing because they didn't really believe me, you know, and thought I was a little pain seeking and I'm like I don't want medication. Actually I'm pregnant, I want my baby to be healthy.

Speaker 1: 9:36

And they kind of sat on me for about 24 hours just under observation and I remember my OBGYN came in and just looked at me and said she does not look right, take her to the OR right now. So they took me down with a presumption that I had an appendix, you know inflamed appendicitis, you know kind of thing. So just a spinal. Here we go, and I just remember like the five minutes into the surgery they said we need to put you out. Then I woke up and realized that they had found that I had eight feet of strangulated and small intestine. It was dying inside of me. So I lost about a third, a little more, all of my ilium, a little bit of my jejunum in the small intestine, and so the surgeon sent me home. My baby lived, thank God.

Speaker 1: 10:28

It was very, very scary time. I was in the hospital for almost two weeks and the surgeon just said go eat a steak. Well, I didn't have an ilium, I wasn't tolerating fat, I was just a mess, and so it really catapulted me into wanting to learn about GI nutrition and what works, because I was gassy, I was bloated, I felt so uncomfortable, I was growing this baby at the time and I'm, like this got to be a better way and grateful because I found the better way and I've been able to really utilize what I learned for myself, for thousands and thousands of patients, and it's been just such an incredible journey and just such a rewarding career. It's been amazing. So having that experience was awful, but it made me a really empathetic, compassionate provider and just a thirst to learn more and more about this area personally, but also to help people. So that's a long story, but that's mine.

Speaker 2: 11:29

It brings up this reality that unforeseen, unpredictable, uncontrollable health issues. Nobody is immune to them and pregnancy in itself is an anxious time and every pregnancy is different, and I'm sure that this experience shaped and has probably impacted the way you communicate with patients and hear them and validate them, because I know so many of the people that I've worked with have not been believed, and so if you can validate for somebody their experience and guide them to better health as a practitioner, that's beneficial, but you know that single-handedly, so your story is really powerful.

Speaker 1: 12:19

Well, thank you. No, I definitely. It's like I always say when life gives you lemons, make lemonade. I know it's a little cliche, but it definitely. You know, it's like a terrible situation that created a beautiful career and really a rewarding space for me, meeting beautiful people like you. Tell us a little bit about your story, megan, because GI psychology is relatively new, and how did you land in this area?

Speaker 2: 12:46

Yeah, I was fortunate to go to graduate school in Chicago and through my doctoral training as a clinical psychologist I had these diverse learning experiences. I had the opportunity to work with people from a variety of diverse backgrounds. I got to see and treat many different psychiatric conditions and I felt as I was graduating and kind of starting to think about where I wanted to head with my career. I had a strong hold and a good understanding of how to help people manage their mental health. But when you help people manage their mental health, you also are helping them with their physical health, and an opportunity at Northwestern presented to join a behavioral health fellowship that was really the only of its kind, and so I got training in gastroenterology with two of the leading experts, Drs. Laurie Keefer and Sarah Kinsinger, and I fell in love with being able to work with patients using evidence-based psychological therapies to improve their gastrointestinal health. And I treated a lot of upper GI conditions because at Northwestern there's a lot of experts in the area of the esophagus and I was treating patients where this was their fourth, fifth, sixth doctor's visit and what really started to happen in a lot of instances were the esophageal MD specialists would see the patient, diagnose them or confirm their diagnosis and then make a referral to our GI behavioral health program to really approach their issues from a multidisciplinary perspective. And I'm encouraging people the benefits of stress management on how their brain and gut communicate. And in a short period of time, when we think about psychology, you know sometimes people are in therapy for months and years at a time and there's certainly room for that and that can be important. But in our area of work we do things pretty quickly. We have five to seven sessions and so being able to offer that and grow that program here, grow the program at the University of Michigan, I've just found such joy and such excitement for the field and you know again getting the opportunity to kind of work with my dietitian colleagues, my gastroenterology colleagues. There's no eye and team. That's really the important thing here.

Speaker 1: 15:22

Absolutely cannot agree more. It is amazing when we think about GI conditions particularly maybe because we're both a meshed in this area it's the multidisciplinary approach is just so therapeutic and shown to be more effective in treating patients. So it's nice that we're seeing both fields GI dietitians and in GI psychologists growing in numbers throughout the US and being available to help people. So I thought we would transition a little bit from ourselves and then into a little bit about the gut microbiome, because you know we talk a lot about gut microbes and the microbiome and just some clarification and some common terms and a little understanding, because I think when people think about gut microbiota they're just thinking it's bacteria. But there's a lot of other microbes in there, from viruses to fungi or yeast archaea, which is like an ancient, one of the most ancient microbes a little different from bacteria protozoa, and these all play a role, like Lee and our gut health.

Speaker 1: 16:25

But we really haven't expanded much beyond. We're starting to tap into the role of viruses and fungi in the guide, but bacteria definitely much more tapped into an understanding that. So when we talk about gut microbiota, we're talking about the different types of microbes that reside there and gut microbiome is a little bit different because they're talking really more specifically about not only the gut microbes but also the genetic material they contain. So there's so many more microbes than just human cells. So there's so much more genetic material that is really impacting our overall health and well-being. They're a big player here because they might be small but they have a lot of genetic material that contributes to our overall health. The other thing to really understand and Megan kind of mentioned this is that diet can affect who's there and what they're doing. But there's so many other factors that affect our gut health and what the gut microbes are doing and who's there, whether we were breastfed, whether we were born by cesarean section, whether we had a bunch of antibiotics as a kid like me or and my kids, my gosh.

Speaker 1: 17:39

Right, like sometimes we can't help the things that may alter the gut microbiome. But in various things, whether you have a pet or not can favorably which I'm getting a puppy, so I guess I'm going to get a better gut microbiome. But lots of factors play a role here. It's not just diet and I think sometimes people really hone into the diet and diet's important. I'm a dietitian but it's not the one all be all. There's lots of factors that can affect these microbes that live in our gut and what they're doing and how you know really they overall affect our health.

Speaker 2: 18:13

I think that's fascinating and it just reminds me every time one of my kids is given another round of antibiotics, the more I know about GI, I just start to go, oh gosh, like here we go again. But we do the best with what we can, right? So if I can avoid an antibiotic, then I try. But if we need one, then we have to do one. And you know, if you can try to breastfeed, great. If you can't, you know what A fed baby is, a happy baby. So I think it can be anxiety provoking when we think about, you know, especially when we think about our kids, right. So we're trying to do the best we can for our kids. But what I'm also hearing is like a little dirt isn't going to hurt, right? So if the dog licks the face sometimes, that's, you know, just increasing the potential of gut diversity. So you know, I think here we are, we're going to give you the facts, but we're also going to be real with you.

Speaker 1: 19:05

Absolutely, absolutely.

Speaker 2: 19:07

All right, let's talk a little bit. We are in the world of GI, but we've made this clear that our gut health is important to everyone, regardless of whether you have a GI condition. However, a lot of people have GI conditions. I'm going to give you some numbers, but these numbers are probably even bigger because so many people don't even go see a doctor to talk about their symptoms because maybe it's normalized in the family, maybe we just don't talk about how often we poop or we don't poop. So about 40 percent of the global population and this was a big survey study that was very recently done is impacted by a GI condition. This might be IBS, this could be other what we call disorders of gut-brain interaction, and about 10 to 15 percent of Americans are impacted by IBS.

Speaker 2: 20:05

I always like in a large room of people. So let's say you're a college student and there's 200 people in your classroom. If you look around, there's a whole handful of people that are probably anxious about possibly needing to go to the bathroom in their college room. So this impacts a lot of people. You might know IBS is a condition where you have these alterations in bowel habits and then you also have frequent abdominal pain. Constipation impacts about one in five Americans, and three out of five have never discussed their symptoms with their health care provider. I've sat in rooms of gastroenterologists where they have highlighted that this stat is probably very much under-reported, because the gastroenterologist was saying I have IBS and I've never received treatment for it.

Speaker 2: 21:02

There's so much here that we stigmatize, we don't talk about it, we suffer in silence, we don't know that it's uncommon and we are going to talk about these issues. In fact, we have a really great podcast coming up because Kate loves to talk about constipation and poop. So we're going to give so many different hidden tricks and tips to keep you regular bloating. That's one other thing. I have to bring it up because how many times have women and also men but you get home at the end of the day and you want to unbutton your pants or you're wearing the beauty of the Lululemon legging? We're all wearing leggings. They're more comfortable because probably we're putting tight pants on our bodies and our bodies need that room to pass gas and bloat a little bit. So we're going to talk about all these things and really I think now would be a great time for us to introduce some of our myth-busting, myth-crushing hot topics here, so let's jump into this right, I love it myth-busting.

Speaker 1: 22:13

Let's crush a myth. Yeah, okay, so everyone needs a probiotic. This is one of my favorite topics because I'm not anti-probiotics, but I think we really need to understand what they are and maybe are they one-size-fits-all. So does everyone need a probiotic? Dr Reihl, no.

Speaker 2: 22:35

No, no, they don't.

Speaker 1: 22:38

That's right. So let's back up. What are probiotics? So probiotics are live microorganisms. So keep in mind they're alive, okay, and they're administered in a certain amount that we know offers health benefits. So that means they have to be studied so that we understand that that certain microbe helps a certain condition. So if there's a microbe floating in the sky and you're making sourdough bread and that microbe lands and contributes to some of the fermentation in that bread, that's great, fermented bread's good. But that microbe's uncharacterized, you don't know anything about it. It doesn't classify, for instance, as a probiotic. So there's a couple things that we know.

Speaker 1: 23:21

We know that some probiotics are beneficial. There's some probiotics that have been studied for irritable bowel syndrome that have good evidence to show some benefit in certain patients. But it's important to know that probiotics as a general rule are not regulated. No one's really checking to see if they have the amount of live microbes they say that are in them, unless they've been third party tested randomly. But that's not normally done. And while they do appear to be fairly safe based on the scientific data, there's certain patients and individuals where they actually can increase mortality or lead to negative effects, and particularly immunocompromised, elderly or premature infants, for instance, may be higher risk for using a probiotic.

Speaker 1: 24:09

So if you choose a probiotic, you want to always start with asking your health care provider is it appropriate for you and which probiotic would they recommend? When we're usually recommending a probiotic, in my practice I'm trying to correct a situation so patients experiencing bloating or constipation or has IBS I'm selecting a probiotic with scientific evidence proven for that particular condition. It's also important if you have a provider to ask for data. You're recommending this probiotic. I can buy it in your office. Do you have a scientific study on that? So some people are out there. They're making money on you buying their supplements and you just want to make sure that they have science to suggest that this product is appropriate for you.

Speaker 2: 24:58

And the most expensive probiotics out. There are they the best?

Speaker 1: 25:03

Absolutely not.

Speaker 2: 25:05

There we go One other thing when you have a probiotic that sits right up next to the desk at the pharmacy. Should we be doing probiotics while we're taking antibiotics?

Speaker 1: 25:17

Oh, good question, should we? I don't think so. I don't think so either. Now there is some data with some probiotics showing benefit to antibiotic-induced diarrhea. So there is some data that's out there that might help with diarrhea. But there's also information looking at probiotics post-antibiotics showing that the microbiome took longer to sort of reassemble itself after the antibiotic when an individual was taking a probiotic. And we want our gut microbiome to bounce back to its normal status after an antibiotic quickly. So if something's impacting that, that's never going to be the goal.

Speaker 2: 25:56

Yeah, so it's important to talk with your provider about what they think and what's probably going to be best for you.

Speaker 1: 26:02

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Speaker 3: 26:57

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Speaker 1: 27:55

So I think in the next, you know, 15 minutes or so we'll see how this all goes. Why don't we segue into some some key topics? So, as a GI dietitian, I want to just bump into nutrition and your gut microbes. Diet does matter here and again, I don't want it to be a one all be all. Put all this pressure on you to have the perfect gut microbiome, healthy diet. That's going to add stress and we know stress alters the microbiome. So don't we don't want a diet to be stressful.

Speaker 1: 28:25

But we do know that eating more plants or more fiber rich foods, foods that are rich in polyphenols, which are plant chemicals that have antioxidant benefits so an example would be a flavonoid like olive oil extra virgin olive oil has a lot of those flavonoids in them and those extra flavonoids are health promoting. They have this antioxidant effect, which basically means that they can help sort of help your body fight things that are going to drive inflammation, for example. So plants, fiber rich foods, foods that have these polyphenols which we often see in really brightly colored fruits, vegetables, those really dark olive oils, also chocolate, just throwing it out there.

Speaker 2: 29:10

I know I'm like I love a good olive oil and I didn't know about the chocolate, so that makes me feel good too.

Speaker 1: 29:17

Okay, there we go. Right. I wanted to talk a little bit about science, because we are science here. This isn't going to be just, you know, smush, we're just throwing out stuff at you like we know what we're talking about. So a couple studies I want to talk about briefly. So, as a study, it was really got a lot of media attention and it was primarily out of Stanford University and they were looking at healthy individuals. These individuals didn't have IBS or health conditions related to their gut, just FYI. They were healthy and there was about only 36. So it was a small study. But they split them up. They put one half of the group on a high fiber diet 40 grams of fiber per day. The average American, by the way, has about 15 to 18 grams, so we're talking lots of fiber. And the other half of the group got fermented foods. What they had that group do is six servings a day of fermented foods Again, a lot not normal what we do.

Speaker 1: 30:10

That's a lot. Yeah, a lot of kimchi, a lot of kimchi and a lot of kombucha. So anyway, when they looked at the microbiome and different factors within the gut microbiome similar population but different diet they found that the fermented group did have greater microbial diversity in their gut microbiome, and when we have more diversity, that tends to be associated with a healthier gut. So that was interesting. They also found that some of these, like inflammatory proteins that can kind of float around in our bloodstream, were reduced, particularly one this is again is in the fermented food group interleukin six, which is a particular protein that's associated with rheumatoid arthritis, type two diabetes, and so reducing this seems like a favorable effect.

Speaker 1: 31:08

The other thing that's important in this group when they used fermented foods, these weren't just anything fermented, like sourdough bread is a fermented food, but then you cook it and there's no live microbes in there. This benefits to sourdough bread, absolutely, but they were sticking with fermented food that had live and active cultures. So if you get yogurt and it says live and active cultures, or if you got sauerkraut, for instance, and you got one pasteurized and one was unpasteurized, the unpasteurized, the unheated, in other words, didn't kill off the microbes, would have those live and active cultures. So that was really interesting. And then, briefly, I wanted to talk about another study. This is out of the American Gut Project. This is a research initiative to really better understand the human microbiome and it's sort of citizen crowdfunded, so anyone out there can send in their poop and fill out a lifestyle and diet history.

Speaker 2: 32:06

Okay, I've got some people that would love to do that. For all those people that are really paying attention to their poop. Think about this project.

Speaker 1: 32:14

Exactly, the American Gut Project write it down. So what they found here when they looked at the data is that in individuals that ate 30 different types of plants per week, versus those that only had 10 different types of plants so plant variety here is really important they had a greater gut bacterial diversity and then they had less genes that helped bacteria avoid antibiotics. So less antibiotic resistant genes, which is good for what they call antibiotic resistance, so the individual would have more likely to benefit from antibiotics they didn't resist certain ones. So again, just showing diet effects on the microbiome variety, plant variety seems to have a more favorable effect. So let's drill this down to an everyday tip Eat more plants, eat a lot of diversity of plants and include fermented foods, particularly those with live and active cultures. This tends to be associated with a more diverse group of microbes in your gut, which is associated with better gut health.

Speaker 2: 33:21

You know I'm not a dietitian but I work with them, I try to. When I'm putting together a meal think about eating the rainbow right. So, even with my kids, I'll point out what colors are on our plate, knowing that those different colors all signal different kind of key benefits for our gut. So I think that that's a simple takeaway of just variety, color and knowing that it's good for your gut and promoting gut health.

Speaker 1: 33:51

Totally and I agree with you and I think we're creatures of habit. So even if you have variety, but if you're buying the same vegetables every single week and you go and just get your blueberries and strawberries and hit out the store, think about trying something you've never had, or zip in and get a mixture of vegetables that you can add a little variety to your stir fry. So I think again, just getting the color of the rainbow, but also breaking outside of the box a little bit and trying something new.

Speaker 2: 34:23

Okay, I'm adding that to my to-do list here, All right. So new topic, but also related, right? I want to highlight a little bit about stress in the gut a little bit more. So we've talked about how stress can impact our gut microbiota, and that happens by how neurotransmitters and the chemicals that are being produced within our brain and our body interact, and also recognizing I think a lot of times people again think stress as emotional, and really stress impacts us emotionally, but also physically. We have physical signs of stress that could be feeling butterflies in your stomach before something that you're excited about or something that you're nervous about. That's a signal of how your brain and your gut are functioning, and it's also a signal that different chemicals are being produced in your body and even some of our serotonin the majority of our serotonin is actually produced in our gut. So we know that stress exposure and none of us are again immune to it. We have to think about it when it comes to our overall health and how do we manage our stress, and I'm going to provide a lot of everyday tips on stress management, but I'm going to start today with something that we can all do, and that's thinking first how am I doing with my stress management, Thank you. Do you feel overly stressed? Do you feel like you're managing your stress well? Do you even acknowledge and understand whether you're impacted by stress? So start with that simple question. I really think we could all reflect on that and for those of us that can acknowledge we can probably do better at stress management routine.

Speaker 2: 36:11

So let's start with routine. Is there something that you're doing regularly that is of benefit to reducing your levels of stress? And this might be regular implementation of a deep diaphragmatic breath. So we know that when we take deeper, fuller breaths from the belly, that's a different breath from the normal breathing that we're doing from our chest, and that diaphragmatic breath is not only beneficial from an emotional perspective. So a lot of people think about deep breaths as helpful for calming down and for relaxation, but it can also relax our body physiologically, so helping to reduce muscle tension and even digestive distress.

Speaker 2: 36:57

So if you don't do diaphragmatic breaths or just deep calming breaths a couple of times throughout your day, I'd challenge you to begin to think about how you can incorporate that and maybe anchor it to something that you already do. So brushing your teeth, eating breakfast, brushing your teeth at the end of the day taking a shower. So when you do those things that you already do, you might add in 60 seconds of just slowing your breath down, getting present in the moment, starting to shift from maybe a busy day to winding down. Also, we can implement other aspects of self-care, and exercise are so important to our overall stress management and, again, the routine of that.

Speaker 2: 37:46

So if you're only exercising, maybe you're not exercising or you're doing it once a week challenge yourself, schedule it like you would any other appointment. I point this out to my patients when somebody is just starting to get into exercise and I'll say look, you showed up five minutes early for our appointment today, so you got yourself to someplace. That meant something to you and we need to treat ourselves the exact same way. So schedule your self-care, your relaxation, your time for exercise in the same way that you would schedule any other appointment with somebody else. You deserve it.

Speaker 1: 38:26

So I just wanna say one thing about the diaphragmatic breathing, because I love this technique. It does engage that parasympathetic nervous system, so that sort of rest and digest. So do you think it's a good thing for individuals to try to do that before a meal?

Speaker 2: 38:42

It can. I've made the recommendation before or after a meal. So if you're somebody that is rushing so much to like get in your lunch and get in your dinner and you're not stopping to kind of pause, then I think maybe it's a good idea to, just before you take that first bite, take a couple deep breaths, chill, go into your meal with a little bit of relaxation. But also, if you're somebody that maybe does struggle with some digestive symptoms or you're gonna transition into maybe exercise after a meal or going for a walk, I think that diaphragmatic breath afterwards, for even just five diaphragmatic breaths, is gonna help a lot. I think that that's a nice way to kind of wrap up a meal.

Speaker 1: 39:28

I love that, I love that idea. So last kind of tip for today is just that gut health is personal to you. When I you know, dr Reel mentioned this that you have your own gut microbial fingerprint. So diet will be not one size fits all either because you've got your own microbes and some of the microbes in your gut can digest fibers that maybe your neighbor's gut can't digest, or you both can digest the same fibers but your gut produces butyrate, which is a short chain fatty acid. That's a fuel for the gut, and then they don't make that. They can digest that, but they don't produce butyrate. It's complicated.

Speaker 1: 40:07

So you know, just a reminder, that same with certain therapeutic diets they're gonna benefit, like the low FODMAP diet which we'll get in on a further episode, which is a diet that's out there for irritable bowel syndrome. It's not gonna work for everyone. In fact it only works in about 50 to, you know, 75% of people. So there's up to 50% that will just not benefit from that diet.

Speaker 1: 40:28

So I think, from an everyday tip, from the fact that gut microbes are really personal, it's important to really listen and tune into your body's messages. And when I say that I'm not encouraging hypervigilance and like I feel a gas bubble. It doesn't hurt, but I could feel it, not that kind of thing. But if you're feeling continued, repeated pain every time you take the probiotic supplement, maybe ditch the probiotic supplement. It might not be for you. Maybe it works for your neighbor. They have a different gut microbiome. So just to remember that diet and lifestyle to really manage your gut microbiome is gonna be personal and just listen to the messages, gently to your body, to do what feels right on the inside for you and don't go at it alone, right?

Speaker 2: 41:17

So if you feel like you know you could use a little guidance, talk with your medical providers and start. We'll give some resources in terms of how to find people like us dietitians and psychologists, mental health providers. But a team approach is oftentimes really helpful and, again, we can personalize strategies that make sense for you, love that, so I wanted to you know as part of our podcast.

Speaker 1: 41:44

We wanted to do just like status update, right? So why don't we start with you, Megan, what's going on in your life, and why don't you share it with our audience?

Speaker 2: 41:53

All right. So I'm a working mom, right. I've got three little kids, seven, four and two. I'm a little bit myself a germaphobe, right, like I'm not phobic, but I like to keep things clean. You know, before the pandemic I was somebody that was scrubbing the airplane seat before I sat down, okay. So we recently traveled. I had to completely let go of my germophobia as my three kids were basically licking every surface in the airport and then you know, every space that we went from there on forward. So I let go of control there. We were having fun.

Speaker 2: 42:33

I think that life is just busy right now. I'm gonna be traveling next week, solo, solo. So it's gonna be a little different, a little less germy, I think. But as a psychologist and you know I always have my anxiety management hat on my kiddos are starting to recognize when I leave and that's, you know, a little bit tough on the mama heart. So one of the things I'm working on is kind of talking ahead of time, because you know when kids get anxious they're prone to tummy aches my head hurts, my tummy hurts. So we're starting to just talk openly, communication with my partner doing the same thing, talking about what's coming up for mom with travel, when I'm gonna leave, when I'm gonna come back, what I'm gonna be doing. You know giving them details because they're curious and you know doing it in an age-appropriate way. And I think that that's gonna help with this trip, because my seven-year-old has been asking now for the last two weeks like when are you going, how long are you gonna be there? So we're talking about it and I can feel, you know, his little anxiety is getting a little bit better. And then to manage my own anxiety, you're gonna hear me talk about Peloton.

Speaker 2: 43:46

Self-care for myself is something that I try to prioritize and I do it on that bike. Prior to the pandemic I would have said I was never gonna own a Peloton, but like, here I am. And so for all the working parents out there, especially with littles, come with me on this journey of relinquishing the guilt of hopping on a bike or a yoga mat or heading outside for a walk. Give yourself. You know you probably don't have a full hour. Most of the time I aim for 20 minutes and that might mean bedtime gets pushed a little bit. It might mean that I'm exercising and I know the kitchen is a disaster, but I have really, over the last several years carved this time out and I think it's so important and I need it for my own wellness. So Alex Toussaint is my guy. He's my coach. I am big fan, big fan over here, but that music just pumps me up. I'm motivated by him and I don't have to be the therapist.

Speaker 1: 44:53

I love that, I love Alex too, and I have a Peloton and I never thought I would have a Peloton either, but I'm definitely an outside person. Like being in a forest or walking outside is like totally my jam. That is where I feel totally at peace and so I try to get outside and do the walking. It's getting a little harder, it's colder here, kids are grown so I don't have that sort of stressor, but I definitely, you know, writing a book, starting a podcast, getting a new puppy, got some, you know, a little bit of anxiety creeping in and I have to say that learning from you a lot Megan has really helped with, you know, helping manage some of my anxieties and any like just quick tip for outside of diaphragmatic breathing, other ways to just sort of decrease the anxieties of life.

Speaker 2: 45:41

Yeah. So a daily check-in of just how am I doing today and what do I need? Because I think you've been like preparing for your puppy and how that's gonna change your life a little bit. You and your husband you get to jet set, you talk around the world, I mean, and so some of that's gonna change a little bit. You're gonna have a baby in the house again, I know, and it's really easy to get way up into the future thinking about things that are out of our control and you won't know what it's like until you get up there. And so if you can kind of dial back and say you know what, today I need self-care or today I need to, you know, only address the must-dos on the to-do list, or you might find that your answer is dang, I am like feeling great today I'm gonna like bust through a bunch of to-dos. So I think that when we're able to scale it back and not get so caught up in the future, that can be really helpful for our anxiety management and even just daily stress.

Speaker 1: 46:42

Absolutely, which all dials it back to stressors, gut health. It all is, you know, like a big, big fat web, right, Yep, yep. So should we like talk about what's coming up, or you know, what do you think?

Speaker 2: 46:57

Well, okay, I could use some help and I'm gonna ask and use you as my accountability person. I admit like sometimes my nutrition is not the greatest and the psychologist in me says, you know, it's can't be perfect. You don't have to be perfect, but I think sometimes if I have like a challenge, the Stick to it Ness of me will go for that. So, as a busy working mom, what tip can you give me so that I can feel like I am really boosting my nutrition this month and I'm gonna do it, okay. So give me one and I'm gonna feel good about my nutrition when we record again. I love it.

Speaker 1: 47:38

Okay. So when I talk about nutrition, I one am I. I really feel like it's important to think about what we can add, not focus on everything we can take out of the diet, because I think a lot of people focus on, avoid this, avoid this, avoid this. One of the things that I feel most of us are really falling short on and the data shows it is vegetables. There was a survey study looking at Americans intake and it was like 10% of Americans are eating the amount of vegetables they should 10%, okay. So the goal veggie intake for adult women like you, Megan, is two to three cups a day. You know, if you had a large salad you could be hitting that easily. But you know, sometimes people are grabbing a bagel for breakfast and then you know who knows they're eating some tortilla chips On the car, chips and quack, chips and quack, and who knows right.

Speaker 1: 48:30

So a couple goals and I think this might be fun for the kids is try to look at the grocery store, look at pictures online, pick out one vegetable that you've never tried, do it together and just try the vegetable. So that's just one thing I want you to work on. Once a week, pick out a new vegetable, all right. The other piece of this is I want you to think about at least a two meals a day have two different vegetables. So at breakfast, that could be that you're adding spinach and mushrooms to an omelet, or you're adding spinach and carrots to one of your you know, veggie smoothie, fruit smoothies in the morning, or or you roast a huge pan of different types of roasted vegetables and you throw that on top of your rice or throw that in a stir fry or have that around. But I want to make sure that you have two different vegetables At at least two different meals a day. So you're having, you know, ultimately you're meeting that two to three cup need, but you're also getting some variety of different ones. How's that sound?

Speaker 2: 49:35

So that's a challenge, but I think that we are up to it, and by we, I mean don't make me do this alone. Listeners, come on, I know I'm not the only one. So yeah, I will report back.

Speaker 1: 49:47

I love it. I love it outside of the diaphragmatic breathing. Any other tips for me for my little bit of anxiety with being a dog mom?

Speaker 2: 49:57

Yeah, get outside. I know you like it already, but you know, bundle up. If it's cold, don't stay inside, although I think you're pretty good at this. But you'll just have me in your background just kind of reminding you. We live in the Midwest, or I live in the Midwest, and so when it gets cold we tend to not get outside as much. And I think if you have the essentials so you've got a warm hat, you've got the gloves, you've got the boots Don't be afraid to get outside if it's cold, because that fresh air is so good for our brain and our body, our mood. And so I'd say you know, if you're feeling anxious, go for a walk, change the environment, get outside. Just even if it's a brief walk, give that a try.

Speaker 1: 50:39

Okay, I love that, so I love that, and I'm gonna do that and I'm gonna think of you. I'll hear you in the back of my head. So what should we expect on our next episode?

Speaker 2: 50:50

We have a very exciting and dynamic guest, Dr. Jami Kinnucan, and she is a gastroenterologist at the Mayo Clinic in Jacksonville, Florida, and we are gonna be talking all things poop, what's normal. I love it. It's gonna be good. All those burning questions that we're all too embarrassed or we don't have the opportunity to ask or we don't know where to ask. We're gonna be able to ask Dr. Kinnucan and so we are going to be in for a very informational treat and we're all gonna walk away learning a lot about our poop so exciting, one of my favorite topics, so we'll see you then.

Speaker 2: 51:33

Thank you for tuning in. If you are enjoying what you're hearing, give us a subscribe, a like, a follow. It means a lot to us and we really want to build this community. So right now, stop do it for us. That way you won't miss an episode. And join us for the poop episode. You won't want to miss it. Thank you for joining us as we grow this gut health community. We hope you enjoyed this episode and don't forget to subscribe, rate and leave us a comment. You can also follow us on social media at the gut health podcast, where we'd love for you to share your thoughts, questions and experiences. Thanks for tuning in, friends.