Gut Health Trends: Which Ones Deserve the Hype and Which Ones Need a Reality Check?

Gut health trends are everywhere, but which ones deserve a closer look, and which ones need a reality check?

In this episode, we break down the biggest gut health trends getting clicks, likes, and follows online. From our "hard no" to "I'm curious," we share where each trend lands on our hype scale and explain the science, physiology, and gut-brain connection behind our take.

We explore what actually helps symptoms like constipation, bloating, and digestive discomfort without fueling anxiety, wasting money, or creating unnecessary health risks.

From viral wellness trends to evidence-based advice, here's what we're discussing:

• Does the viral chia seed "internal shower" actually cleanse your colon or is that just clever marketing?
• Are colonics and coffee enemas detox heroes, or do they go against how your gut is designed to work?
• Can lemon water and apple cider vinegar really "wake up" your digestion first thing in the morning?
• Can a simple self-care routine improve your gut symptoms, even if it doesn't "heal" your digestive system?
• Are fermented foods always packed with probiotics or is there more to the story? (Tune in for a revisit of Episode 20!)
• Can you make colonoscopy prep more tolerable with "prep mocktails" without interfering with the procedure?
• Can you have too much of a good thing? What happens when "fibermaxxing" goes too far?
• Are gut-healing protocols and at-home microbiome tests helping you understand your gut or making you more confused and anxious?
• Do lactose intolerance patches actually work, or does the science tell a different story?
• Are castor oil packs a legitimate digestive therapy?

Whether you're tempted to try the latest gut health hack or just wondering what's worth your attention, this episode will help you separate science from social media. 

Resources:

Chia seeds (Salvia hispanica L.): A therapeutic weapon in metabolic disorders. Food Sci Nutr. 2022 Dec 15;11(1):3-16. doi: 10.1002/fsn3.3035.

Guide to Utilization of the Microbiology Laboratory for Diagnosis of Infectious Diseases: 2024 Update by the Infectious Diseases Society of America (IDSA) and the American Society for Microbiology (ASM). Clin Infect Dis. 2024. doi: 10.1093/cid/ciae104.

Fermented Foods via ISAPP

Misselwitz B, Butter M, Verbeke K, Fox MR. Update on lactose malabsorption and intolerance: pathogenesis, diagnosis and clinical management. Gut. 2019 Nov;68(11):2080-2091. doi: 10.1136/gutjnl-2019-318404. Epub 2019 Aug 19. PMID: 31427404; PMCID: PMC6839734.

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

Welcome And Viral Does Not Mean Valid

Kate Scarlata, MPH, RDN 0:02

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. I'm Kate Scarlata, a GI dietitian. And I'm Dr.

Dr. Megan Riehl 0:40

Megan Riehl, a GI psychologist. And today we are doing a fun dive into things that we are seeing online that either get us really excited or get us rolling our eyes, shaking our head, and giving that like, uh no, no, no, no.

Kate Scarlata, MPH, RDN 1:00

Or maybe they're making us a little curious because, you know, science is evolving. That being said, Dr. Real, I'm a little afraid of what you've been scrolling lately.

Dr. Megan Riehl 1:10

Well, I think maybe you should be, because we never know.

Kate Scarlata, MPH, RDN 1:14

That's right. That's right. So we're talking gut health trends, the ones that are all over social media, as Dr. Riehl mentioned. And some of these are grounded in real physiology, and some are really quite a stretch. And so we really wanted to talk about it.

Dr. Megan Riehl 1:31

So we're gonna give you like a trend by trend today with our hard takes on is it an absolute hard no? Is it an I'm curious or a sign me up? I'm into this.

Kate Scarlata, MPH, RDN 1:44

That's right. And a gentle reminder that viral does not mean valid.

Dr. Megan Riehl 1:49

That is right. That is right. It really never does. And so today we're gonna get into

Chia Internal Shower And Detox Claims

Dr. Megan Riehl 1:55

it. Really excited to share this with everybody.

Kate Scarlata, MPH, RDN 1:57

Exactly. So if you know me, you follow my Instagram feed, you know I'm a seed queen. I love seeds. So I was really kind of interested in this chia internal shower. Tell me more. Tell me more. This is one where I'm like, I don't know. Let's hear it.

Dr. Megan Riehl 2:14

Let's hear your perspective.

Kate Scarlata, MPH, RDN 2:16

Yeah. So, you know, basically this is mixing chia seeds, which are, you know, rich and soluble fiber with water and lemon and calling it an internal shower, like a natural colon cleanse to relieve constipation. And certainly fiber is helpful for constipation. But also this mention about detoxing the intestines. Hmm. Yeah, that word, that's the word that gets me going.

Dr. Megan Riehl 2:40

Hmm.

Kate Scarlata, MPH, RDN 2:41

Hmm. So it's really a viral TikTok natural cleanse social media trend. And it feels simple and certainly food-based, which is great and inexpensive, and you know, promises relief of constipation and bloating, which are two very common symptoms for many people, right? So, yeah, there's some science here in the fact that yes, chia seeds are a great source of fiber. They're a soluble fiber. When they're hydrated, they form this great gel. I love using chia seeds, for instance, to make like a homemade chia strawberry jam or something that gel forming gives it a really nice consistency. There's no science to say this is a cleanse for your colon. And I think with this big sort of surge in interest in gut health, everyone's looking for detoxifying everything. We know that fiber supports regularity and stool form, but again, none of this detoxification effects. What do you think from a GI psychologist's angle?

Dr. Megan Riehl 3:46

I think bloating, constipation are, as you said, really common symptoms. And I think also they can be normal, that we can have some bloat, we can have some distension, and we don't need to jump to a quick fix for that. If this is something you're struggling with, I would certainly, and this is, I guess, probably our disclaimer for many of these things, that if you're having symptoms and you haven't spoken to a medical professional about them, do that first. You know, and if you get a proper diagnosis for something, then again, some of these trends may be beneficial from a lifestyle perspective, but we don't think that the majority of them are going to be a cure. And anything that promises a cure, we want to kind of have a little bit of a red flag that waves around that. But I just think that some of these trends can be putting you on a more hyper-vigilant kind of wavelength of paying very close attention to your body, looking at how the chia seeds are going to help you feel. So I think with the internal chia seed shower, I'm a hard no, though I'm open to, hey, slowly introducing chia seeds to your diet. That I'd be a yes.

Kate Scarlata, MPH, RDN 5:03

Yeah, I'm with you. So I'm a hard no for focusing on one type of fiber in excessive amounts for gut health. It's a great fiber for gut health, but there's lots of different types of fibers. And I think the science really shows you that different varieties of different plant fibers are really much better for gut health. I will say that chia seeds are rich in omega-3s and fiber, as we know, and they may help lower cholesterol and have antioxidants and polyphenols. So again, love my chia seeds, but I don't love my internal chia shower.

Colonics And Coffee Enemas Risks

Dr. Megan Riehl 5:37

Another trend that we are seeing are the spa-based colonics and coffee enemas. And these get marketed for detoxification. Again, that detox word, bloating, gut resetting. And, you know, I hear this both on social media or on different podcasts where people are going off to a wellness spa, maybe for weight loss, you know, they're going to be doing these cleanses, they're going to be doing liquid diets for a week and they're going to drop a bunch of weight. It just makes me so sad for these people because it's not sustainable. And quite honestly, I think most of the time they're pretty miserable while they're doing this. But my main kind of takeaway with this trend that I want people to be careful with is if they are incorporating colonics and coffee enemas, these can be really, really dangerous. And from a science-based perspective, especially from a wellness spa perspective, you are putting yourself at some serious risk for bowel perforation. Even the skill set of the person that is doing the colonic is not going to be a gastroenterologist in most cases. And so we just want to be really mindful around what recommendations we're following, what are our health goals? And again, probably talking with a medical professional before going and doing some of these well-missed practices.

Kate Scarlata, MPH, RDN 7:02

Absolutely. And it's concerning when they involve things that are dehydrating, right? So you have an enema, there could be risk of electrolyte imbalances. You mentioned the bowel perforation, which no, thank you. Don't want that. There's also been notes of like infection that equipment isn't maybe not sanitized properly. So yeah. And most of these organizations and spas really have no credentialed providers, which is really concerning. We won't get into it today, but what about all those IVs that are out there too for vitamins, etc.? It's a lot of a lot of.

Dr. Megan Riehl 7:41

Yeah.

Kate Scarlata, MPH, RDN 7:41

So we're a hard no.

Dr. Megan Riehl 7:43

If you're off to a spa day, stay away from, you know, you can drink your coffee, but do not have anybody inserting any tubes into your butt for cleansing.

Kate Scarlata, MPH, RDN 7:54

Hard no. Absolutely.

Morning Gut Stacks And Acid Shots

Kate Scarlata, MPH, RDN 7:57

So, what do you think about some of these gut-friendly morning routines that we're seeing online? You know, curated gut stacks, including things. The stack. Yeah. Yeah. Let's get into the stack. Let's do lemon water and apple cider vinegar, coffee, magnesium probiotics, a number of supplements to really wake up your digestion. You know, again, they're really targeting people that may be experiencing some bloating and constipation. There's many people out there, and certainly all of us experience some bloating and constipation periodically. And it gives people this sense that they're doing something, they're in control, right? Structure, preventative. It's easy to take a little lemon water, apple cider vinegar is very, very inexpensive. And we know that consuming anything in the mornings does stimulate that gastrocolic reflex. And that's a good thing because that is stimulates peristalsis, gets the colon ready for elimination, which, you know, having a good bowel movement in the morning is a good thing. However, I'm not really sure that having apple cider vinegar is necessarily waking up your digestion, or that lemon water is really waking up your digestion. And I'm concerned with certain individuals where taking a very acidic beverage, would we call it your apple cider vinegar shot? A shot, yeah. For some people, it can be really irritating to the esophagus. So I'm a little concerned with sort of the evidence around these as really being a tool to wake up your digestion. What wakes up digestion is eating. Even thinking about eating will stimulate your gastrocolic reflex. And I think keeping up with normal meal times, regular meal times, not skipping, especially breakfast, where the gastrocolic reflex is most active. So if you're constipation in particular, do not skip breakfast. But I'm not really seeing strong evidence for lemon water, apple cider vinegar, or probiotics as morning resets.

Dr. Megan Riehl 10:13

I agree. I think that if you're somebody that's doing this for a health benefit or to address a certain type of symptom, that anxiety about the symptom drives this desire to control something. If I have this routine in the morning, that's something I'm in control of. And there is something to be said for following habit and, you know, feeling like you're doing something that's good for yourself in the morning that gives you a little bit of an endorphin boost. And so I think from, like you said, and if it's inexpensive, if it is not causing you harm, it's not going to be the worst thing for you to have a bit of a nice gentle routine in the morning. What I do get concerned about is the people that are shelling out hundreds of dollars with the additional supplements that they're taking in the morning as part of these stacks. The majority of people do not need to be taking hundred dollar vitamin stacks on a regular basis here. And again, I think you're doing that out of some of this misinformation myths about why you're taking these things and what they're actually doing. So from a psychologist perspective, I might say, you know, doing something gentle in the morning out of habit, great. Take some warm water and apple cider vinegar. That's great. But what about doing some breathing? What about a nice gentle muscle relaxation? Similarly to eating breakfast, you know, when our feet hit the floor and we do some gentle stretching, that also helps stimulate the gastrocolic reflex. So I want to be just mindful that I think where this leans in terms of morning routine is, you know, having some control, taking your time, easing your way into the day. And that is likely going to be more beneficial for your health than the ingestion of some stuff.

Kate Scarlata, MPH, RDN 12:03

Exactly. And I'm thinking like apple cider vinegar shots sounds really not very tasty. I think it's also important to remember that your stomach is very acidic. It's the pH is like one to two. This the lower the number, the more acidic. And apple cider vinegar is like two to three. You're just adding a little acid on top of something that's already pretty acidic. So I'm not sure where the benefit really, really falls there. But like you said, I think the routines, eating breakfast, waking up slowly, warm fluids can stimulate your gut motility. Coffee, certainly with the caffeine, can give it that extra kick. And for some people, that is a really great little boost for their gut if they're prone to constipation. So healthy routines in the morning, all about it. A little coffee, all about it. Listen to your body if your gut burning in your esophagus after your apple cider vinegar shot, you know, you may want to dial that back a little bit. But I think what they're promoting of waking up digestion, not sure, that's totally on point. And there may be some risks. And I'm gonna say I'm curious here, but truth's in the middle. I will remain curious and be mindful there. I love it. I love it. All

Fermented Foods And Probiotic Confusion

Kate Scarlata, MPH, RDN 13:21

right. So next up, let's talk about the fermented food train as daily medicine. So I think one of the things that I really want to talk about in this sort of discussion is that most fermented foods are not probiotic sources. I just want to get that out there before we get into this topic because if you're looking at it as a source of probiotics, most fermented foods just don't meet that criteria. And the reason being is that probiotics have to be had some study behind them. They're designated down to the strain level as showing health benefits. And many of the fermented foods that we get out there in the market are made from uncharacterized strains from the environment or on the cabbage, in the environment when the sourdough is rising. So keep that in mind. When you say fermented foods are a source of probiotics, that's actually most often incorrect. So people love it because, yeah, it's natural. Fermented foods have been around forever, they're touted as safe and they are, most pathogenic bacteria and doesn't survive the acidic environment that occurs in a highly fermented food. And they're linked to this like wellness identity, like sipping on your kombucha while you're buzzing down on the beach. But the effect here is really variable. I will say that fermented foods are of interest to me because it's not just the microbes in the food that are fermenting, it's also what are they making. And in many cases, we're eating those metabolites they're making. And there's been more and more interesting data really looking at those metabolites as health promoting. So there's some truth here. I think it's important to note that some populations may not tolerate fermented foods or may not be indicated based on their medical conditions. For instance, if you have some medications on board or a condition that makes you highly immunocompromised, fermented foods are very high in histamine. And so if people have histamine intolerance, they may not tolerate them. So again, interesting. And we did a great episode.

Dr. Megan Riehl 15:36

I might be biased, but I thought it was a great episode a year ago with Elisa Caffrey, where we talked about lots of myths and science associated with fermented foods. So if you're curious about this, I would suggest going back to that episode. It was great. And I think from even just a taste bud perspective with this one, my thing also is yes, it's great. I think the science is emerging. And you can have a little fun with this, with introducing some of these flavors to your taste buds. If this is not something that you have historically been eating with regularity. And so don't stress yourself out over, you know, if you hate kombucha, then, you know, that's okay. If you want to just kind of try to introduce it slowly to feed the microbiome, I think our evidence on how we're exactly incorporating that into the microbiome is still emerging. I'm curious about this. I'm curious too. Well, let's stay curious. All right, here's something else to be curious for, Kate.

Colonoscopy Prep Mocktails Done Safely

Dr. Megan Riehl 16:41

I've been seeing several of our colleagues actually on social media who are pulling out their cocktail shaker. And the thing that comes out of their mouth next, I find, oh, okay. So they're doing that because they are prepping for a colonoscopy. So they have the cocktail shaker out, and they are getting creative making mocktails out of the approved clear liquids for colonoscopy prep. And so I've seen this as a recent viral trend. I think it's kind of hilarious, but also the reality is, and and I had my first colonoscopy recently. Prep is not fun. It is not fun. It is not fun. Yet I would do it over and over and over and over again to get the benefits of a colonoscopy. The prep, while it not be fun, it's better than the outcomes of cancer. Absolutely. So people are turning to this, I think, with some kind of fun, excitement, energy as they prep for their colonoscopy. I think it can reduce some of this anticipation anxiety associated with getting a colonoscopy. It might improve some of the taste of some of these prep things. And yet also we have to take this seriously. You have to do your colonoscopy prep correct. So if this is something that you feel like, hey, you know, I'm gonna be spending a day where I'm at home thinking about this, I can get the materials ahead of time and have a little bit of mocktail prep fun, go for it. But I do think that we have to really adhere to the strict guidelines of prepping well for a colonoscopy. So don't overly stress yourself. If this is just more so something you can watch on social media and kind of have a, hey, you go do that. I'm gonna stick with my Muralx prep.

Kate Scarlata, MPH, RDN 18:38

Right. I think it's more, you know, making those clear liquids a little more enjoyable. I get so sick of the same thing. And so, you know, if there's something that's like someone mentioned, like a ramen packet, does that fit the clear liquid sort of definition? I'm I'm not quite sure that it totally does. It depends what's in there, if there's herbs, spices. Even things like spindrift is a drink that I drink all the time, but there's fruit particles in there. It wouldn't classify as clear liquid. So, you know, it's just a matter of sticking with you want that colonoscopy prep to be a good prep. And so you don't have to do it again.

Dr. Megan Riehl 19:19

You do not want to do it again.

Kate Scarlata, MPH, RDN 19:21

Not gonna do it again. So just make sure you're following the rules. So I'm gonna say I'm curious on this one.

Dr. Megan Riehl 19:28

I'm curious too, but I am here for it. I will continue to watch our colleagues, you know, have at this one. Absolutely.

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Fibermaxxing And Variety Over Perfection

Dr. Megan Riehl 20:49

Okay, Kate, we talked about getting enough fiber, but there's also something called "fiber maxxing". I think this comes from this maxxing trend that we are seeing all over mainstream platforms. There's health maxxing, sleep maxxing, gym -maxxing, looks maxxing. And essentially it just means like maximizing one's whatever it is. And it is a bit concerning, I think, especially for some of our younger generations who are going to even like dangerous levels with these practices. I think about the idea of orthorexia, where you know, people are going to extremes with really healthy, clean eating that, again, is unnecessary and really can put a lot of pressure on somebody. But fiber maxxing, what are your thoughts?

Kate Scarlata, MPH, RDN 21:45

Tell me about this trend. I know I have a lot of thoughts here. And I agree with you. I'm concerned about like the whole notion if some fiber is good, more is better. It's that whole like, let's get the most we possibly can. So it's It's definitely concerning. And in some instances, you know, they're fiber maxing up to 50 grams per day. And to your point about eating, disordered, disordered eating, if you're eating so much fiber, you really don't have much room for the other nutrients in your diet because it's filling you up so much. So I'm all about balance. You'll see it in every single book that I've ever written about the balanced plate because nutrients need to be balanced, I think, to make your body feel balanced. And when it's so tilted towards fiber, it definitely can be a little bit concerning to me. So I like fiber. Anyone in gut health loves our fiber. We love fiber. We love fiber. The majority of people are not eating enough fiber. So 90-95% range, you know, particularly women are under-eating fiber, interestingly. So it is important that we eat our fiber. And I think eating fiber can be a positive nutritional approach. I love the idea of a variety of different plants for gut health. I like that it can be potentially good for the microbiome, although the data on the 30 plants per week is really weak and based on just one population study. So got a lot of press, but the literature is relatively weak. However, diets like Mediterranean have really shown some health benefits across all chronic disease states. And we know that's a very plant-based diet with lots of data. So I think I can say pretty safely that eating a lot of plants is a good way to go. However, I do think we want to be more flexible. We want to be more gradual with our fiber intake, particularly for those with sensitive guts, individuals with IBS, IBD. It's really go slow, go low with fiber and assess your tolerance. So take your time. Yeah, take your time. Variety over perfection here is the goal. And I'm just not really a fan of maxing anything, to be honest. I think we we move away from health, real health goals in many ways when we overdo something.

Dr. Megan Riehl 24:17

I think for some people, when a certain number gets a lot of press, you feel again that pressure, that anxiety of like, oh, you know, I only got 20 this week. And, you know, I was supposed to get 30. So I'm not doing well enough. When really I could eat broccoli every single day and feel pretty good. Hey, I got a green vegetable in today. So I'm gonna call that good. I would rather have that perspective as opposed to I missed out on 29 other plants and vegetables. Now, granted, again, I think taking a gentle approach to look at your plate and say, like, okay, there's some green on this plate. Is there anything else I could add? Is there another color I could add? Oh, look, there's some tomatoes over on my counter. Let me throw those on the plate. That's more of my kind of lifestyle stage. Totally, totally easy. It's got to be accessible. Remember, people too, frozen is okay. You can go into the freezer and grab some frozen vegetables and call it good. So I remain curious about these maxing trends. I want to be very cautious too. Sign me up for fiber variety, but yeah, just be gentle with yourself here.

Kate Scarlata, MPH, RDN 25:33

I'm gonna say I'm curious too. And I, you know, my little sort of add to that is variety is important, but if you become hyper-vigilant counting every gram of fiber, it's gonna backfire on you. And too much fiber too quickly is probably not gonna feel too good in your gut. So go slow and low, but I'm curious. There we go.

Gut Healing Protocols And Microbiome Tests

Dr. Megan Riehl 25:56

All right, another trend, gut healing protocols. Kate, in our book, we talk a lot about being mindful of the snake oil. We encourage people to be cautious of any protocol, cleanse, or cure that promises to completely heal your gut or eliminate every symptom. A lot of these protocols start with eliminating long lists of foods—gluten, dairy, sugar, seed oils, nightshades. I’ve seen candida cleanses described by influencers on social media. And sometimes these recommendations are based on direct-to-consumer microbiome testing. Now, we've talked with leading microbiome researchers on this podcast, and the reality is that, at this point, most gastroenterologists and microbiome researchers do not recommend these commercial microbiome tests to diagnose GI conditions or guide treatment because the science simply isn't there yet. They can generate pages and pages of results, but they often don't provide information that's clinically actionable. Another thing we sometimes see is people being told that their microbiome test shows they have parasites. That's understandably alarming. But it's important to know that a microbiome test is generally not a parasite test. These commercial tests are designed to characterize the microbes in your gut—they're not intended to diagnose parasitic infections. If someone has symptoms or risk factors that raise concern for a parasite, physicians use dedicated medical testing and consider the entire clinical picture. That includes asking about things like recent international travel, drinking untreated water, certain food or environmental exposures, persistent diarrhea, or other risk factors that make a parasitic infection more likely. The bigger concern is what happens next. People are often given a diagnosis—or at least the suggestion of one—based on these commercial reports, and that can send them down a path of anxiety, highly restrictive diets, supplements, cleanses, or treatment protocols that may not be necessary. We really want people to work with clinicians who can interpret symptoms and testing in the context of the whole person, not just a commercial report.

Kate Scarlata, MPH, RDN 28:35

Yeah. And I would say, just as a reminder, like there are parasites that people do get if you live in a rural area where there's a lot of deer roaming and you have well water and it hasn't been tested. Giardia is something that is common in where I am in Maine and some of the northern territories. So I think that it's important to talk about your travel and your well water and your, you know, travel out in a different country and all of that if you're concerned about it. And Dr. Riehl mentioned there are actual parasite tests that your doctor can do. I'm very concerned about the low candida or low carbohydrate, no sugar diets that are the result of these tests that show that someone has a fungus in their stool and fungi live in our stool. It's not uncommon. And putting people on these very highly restrictive diets. In fact, I had a client recently who had lost a significant amount of weight because of a very highly restricted diet due to some random fungus in her stool test. So yeah, I'm a little, a little worried about some of these trends leading people down highly restrictive diets and perhaps antifungal agents and other things as well. Yeah.

Dr. Megan Riehl 30:04

And another suggestion that we give our patients is, you know, if you've been trying a certain treatment for a period of time, sometimes a month, sometimes if it's certainly been six months and you've been taking certain things and you have not received any improvement or benefit, or even just mild improvement, then that's probably not the right treatment for you. You probably need to be pivoting, maybe talking with a new clinician. And I see this most often in the people that have had this extensive kind of microbiome testing. They are following this protocol. So just be mindful of this. Be mindful that the science has not caught up with what those kind of direct-to-consumer tests are showing us. And I think it just provokes more anxiety than it offers benefit at this particular time of research. So I'm a hard no. Hard no.

Kate Scarlata, MPH, RDN 30:59

I'm a hard no. Hard no. Yes. Hard no. Save your money. Save your money, save your anxiety, save your hypervigilance on these crazy diets that are recommended. Okay. So what

Lactose Intolerance Patches Are A No

Kate Scarlata, MPH, RDN 31:12

I wanted to talk about is what I've been seeing on my Instagram feed. And that is these transdermal patches for lactose intolerances. So this is a skin patch that's marketed to people that have lactose intolerance, and they put a patch on their skin so they can eat dairy as they desire. And, you know, it's convenient. There's no pills. They don't have to down a bunch of pills before they have their ice cream. It's sort of this new innovation. The patches are kind of cute. It's effortless, right? Put a patch on and go about your day. But I find it really interesting because if you know the physiology of lactose intolerance, which is malabsorption of lactose in your intestine, that requires an enzyme called lactase in your gut to break down the lactose that's in many dairy-rich foods in your intestine, so then it can then go into the bloodstream digested, into its digestible components, and you don't have it not being digested and going following into your colon, dragging water and causing diarrhea. So I don't understand how a transdermal patch that goes right into your bloodstream is going to help with that when lactose itself needs to be broken down and is found in the intestine. I don't get it. People get to report what they want to report. That's right.

Dr. Megan Riehl 32:47

I'm using this patch. There's going to be bias, there's going to be some placebo effect. Absolutely. Sometimes it's really bad, dependent on dose. So yeah, this is one of those things, especially from a trend perspective, where you get people that are influencing, right? Like that's the other thing here that it worked for me, and I happen to have a following of 50,000 people. And so if out of those, we know that a lot of people have GI problems. They're looking for solutions. This is one of those snake oil things where people that don't have the right credentials to be making these suggestions widely are probably putting some people at risk. And or again, maybe again, it's it's a financial risk of just you're spending your money on the market. Totally.

Kate Scarlata, MPH, RDN 33:46

And these are companies, right? That are going, hey, how many people are lactose intolerant out there? Quite a bit. Quite a few. Yeah. Yeah. So this is a great way to make some money. So no science to support this. The only evidence-based options remain those oral lactase supplements using lactose-free products and you know, following a modified lactose-containing diet. So patches lack validation. Hard no. Hard no. If it doesn't reach the gut, it can't treat the gut, right?

Dr. Megan Riehl 34:19

That's right. That's right. All right. One

Castor Oil Packs And The Ritual Effect

Dr. Megan Riehl 34:22

final trend that we're going to cover, and then we're going to dive into a quick speed round here. But this last one that I see again, some influencers where they do these beautiful, you know, morning rituals or whenever they want to do this abdominal castor oil packs. And they're kind of touted as topically with some heat. Again, that word detox the gut, reduce bloating, improve your digestion. And I think what's interesting here is that oral castor oil actually is a laxative, but it's not used as often because of the side effects that can be bloating, vomiting, abdominal cramping, some dizziness. So it doesn't tend to be a go-to strategy from an oral ingestion remedy perspective. Nope. And so it is a real drug if you drink it, but activating and it kind of works on the specific receptors inside your intestinal wall. But again, putting it on the outside of your belly is, I think of it kind of like you're taping an aspirin to your forehead for a headache.

Kate Scarlata, MPH, RDN 35:29

Yeah.

Dr. Megan Riehl 35:29

You might get some relaxation out of the ritual of creating a nice environment to do this. And sometimes putting something warm on your belly feels good, but your gut is not improving because of the oil doing anything. So no clinical evidence to support these topical castor oil packs. I would focus your attention again on creating using your time wisely. Your time is precious. So don't stress yourself out trying to do a detox trend. Instead, spend your time, you know, doing some mindfulness work, being present. If you love, you know, taking a bath, then try to carve out 15 minutes to give yourself a nice bath or a warm shower. Put some essential oils in the shower with you. If you love a face mask situation, do that. Self-care is amazing. It's great for us and it helps reduce stress. So stick with, you know, finding what really relaxes you. Don't worry about detoxing yourself.

Kate Scarlata, MPH, RDN 36:37

Absolutely. And I really do think it's that I think of heating pads, warm baths are really therapeutic for people with sensitive guts. They're not detoxifying the gut, but they're relaxing the gut. And you know, that gut brain connection, Dr. Riehl. It's real. If you relax, it's real. And so I think anything that's going to relax you is going to have some benefit. And if that castor oil pack is warm, certainly going to make that gut relax maybe a little bit, but I'm not sure it's the castor oil itself. So I'm a hard no. Hard no.

Dr. Megan Riehl 37:13

All right.

Speed Round Favorites And Simple Joys

Dr. Megan Riehl 37:14

We've given our take on the trends. And this episode, you get to get a speed round with the both of us. So I'm going to start with you, Kate. All right. And we will run through these. What is your favorite colonoscopy prep survival strategy?

Kate Scarlata, MPH, RDN 37:32

I love like slushy things like an ice or a popsicle. So making that out of Gatorade, like a clear, suitable, liquid Gatorade flavor, rather than just constantly drinking. It's just nice to kind of take it a little bit slower. So that's one of my faves. I like Jell-O, you know?

Dr. Megan Riehl 37:53

And so I just had at it with the Jell- O. You either like it or you don't. And so thank goodness I'm a Jell-O girl. It reminds me of my childhood. And so I just ate a ton of, I think it was pineapple. That was delicious to me after not having any So I stuck with Jell-O.

Kate Scarlata, MPH, RDN 38:12

That's a good one. I uh didn't even know they had pineapple Jell-o. I'm not really a Jell-o person, but maybe I'll look that up on my next colonoscopy prep. So let me ask you what's your easy go-to dinner when you don't have anything planned?

Dr. Megan Riehl 38:27

So I do chicken breast, 350 degrees in the oven for 30 minutes, and I throw in veggies with it. Whatever veggies I have. If I've got little cherry tomatoes around broccoli, mushrooms, whatever, onion. Sometimes it's just, you know, onion and one vegetable. The real family has been doing sheet pan dinners this summer, and it is just such an easy go-to. So I always will have frozen chicken breast, you know, around and we just add to it whatever I have.

Kate Scarlata, MPH, RDN 39:00

I love that. And I'll say so the two, there's two versions for me, right? So I have the mom version years ago when I was raising my family, and that would be a crock pot meal all the time. My kids used to snack on it at three after school sometimes and then have it again for dinner. But now that I have no children in the house, my husband and I, if we're really not that hungry, we will get a very large Greek yogurt parfait and just layer it with granola and nuts and seeds and fruits. And I kind of hit on all cylinders for all the things protein, produce, healthy fats, etc. So that can be a go-to sometimes on a just low-key evening. Okay. And so what's your favorite fiber source? I'm a seed queen, as I mentioned. I really love them. I add them to salads and pasta dishes and over yogurt and oatmeal. And I really am in a committed relationship with pumpkin seeds. I have them all the time. They're a great source of magnesium. So if you're looking to up your magnesium, pumpkin seeds can be your friend.

Dr. Megan Riehl 40:03

Okay. Well, I'm still like just I try to get some fruits and veggies, just regular fruits and veggies. That's any fiber I can get in. My recent go-to is frozen fruits that I just pour some on some Greek yogurt with some honey. And I know that I'm getting both protein and some fiber there.

Kate Scarlata, MPH, RDN 40:22

I love that. So, what about you? What is your summer habit that brings you happiness?

Dr. Megan Riehl 40:28

So a family walk in the evening, pushing bedtime. You know, like I'm in the busy stage of life. So my kids can't understand that they're on summer break and mommy still has to go to work. So I still am getting home at five o'clock sometimes later. And so then we eat dinner and like we're just, you know, the habit of let's go for a nice long walk. It's still sunny, it's still warm. We're pushing bedtime a little bit, but that's okay. It's like a summer treat.

Kate Scarlata, MPH, RDN 40:56

I love that. So I'm by the beach in the summer up here in Maine. And so walking the beach is really my favorite summer habit with or without the dog. And then if I have a little extra time, I like to sit on the jetty and just listen to the water kind of coming in, hitting the rocks, and watching the birds. And that's like a very like calm zen time for me.

Dr. Megan Riehl 41:17

You go. I'm so proud of you.

Kate Scarlata, MPH, RDN 41:20

I'm working on it, Dr. Real. I'm working on it.

Dr. Megan Riehl 41:25

I love that for you. And man, anytime I I can uh go and visit you and join you on that jetty. You're welcome anytime. I'm welcome anytime. Thank you. Thank you. All right, final one simple indulgence that sparks joy.

Kate Scarlata, MPH, RDN 41:40

Yeah. So for me, I really love a special chai tea latte and I froth my milk. I have a little frother. I usually do a mix of regular lactose-free milk and then oat milk or almond milk. I like that little blend. And then I put a little maple sugar, which is very common up here in Maine, and a little cinnamon on top. And I just savor that so much all times, all year round. How about you?

Dr. Megan Riehl 42:07

Yeah, I also it has to do with caffeine. So I give myself the indulgence of stopping by a local coffee shop most mornings. And, you know, I know the baristas. We have a little friendly banter. Shout out to Dozer Coffee in Ann Arbor, Michigan. That's probably the one I frequent the most. And, you know, it's just, it's a really good cup of coffee. I don't make it at home very often anymore. And, you know, it's my go-to. You know, the financial advisors have come to the conclusion that your morning coffee is not going to be the reason you can't retire. So I'm going with I spend a little bit of money in the morning on my coffee.

Kate Scarlata, MPH, RDN 42:49

Yeah, I totally, especially being a young, you know, having the young kids at home. I can see that having that coffee by yourself on the way to work. I mean, I definitely did that. And now again, I'm on the other side of it. So I have a little nook here in Maine, and I just have my little chai, and it's very quiet and peaceful. So less money spent on my coffee and teas up. That's right. But nonetheless, there'll come a time. There will come a time. Enjoy it while you're there. That's right. That's right.

Final Takeaways And How To Connect

Dr. Megan Riehl 43:21

Well, we hope that you've enjoyed our take on the trends. And as always, we appreciate all of you for listening and sharing with both your friends and colleagues and patients. And we will see you next month on The Gut Health Podcast.

Kate Scarlata, MPH, RDN 43:35

Yes, we will. Thanks for listening.

Dr. Megan Riehl 43:38

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 @The GutHealthPodcast, where we'd love for you to share your thoughts, questions, and experiences. Thanks for tuning in, friends.