0:00

Coming up on today's show. Dr.

0:30

B, I

0:58

have quite a few people in my

1:00

audience who are carnivore animal based, low

1:04

carb, somewhere in that territory with

1:06

diet and the way they eat. A

1:09

lot of them are going to be quickly dismissive

1:11

of a lot of the things we're going to

1:13

talk about today such as fiber and eating more

1:16

plants. Before they

1:18

click away, explain to

1:20

them why they need to

1:22

come into this with an open mind and

1:25

that they can still get value from what we're about to

1:27

share. Well, I

1:29

think the way that I would start

1:31

that conversation is by first saying that

1:33

I'm quite sure that when they actually

1:36

pursue their own dietary approach, they're

1:38

asking others to be open minded to

1:40

what they're doing. And

1:43

that to me is a grace that should be extended

1:45

both ways. In today's world,

1:48

we need to have these conversations and

1:50

find common ground and find ways

1:52

to understand and appreciate one another and

1:55

also learn from one another. So

2:00

the thing about it, Jesse, from my perspective is

2:02

that anyone

2:05

who makes dietary change in the interest of

2:07

better health is a person that has

2:09

my respect because the vast majority

2:12

of people are not willing to do that. And

2:15

while I may not wholeheartedly agree with some

2:17

of the choices that people make, that's okay

2:19

because there are people that exist in my

2:21

own space that I don't wholeheartedly agree with

2:23

everything that they do either. And

2:27

I also don't think that I'm always right. But

2:30

I do think that the microbiome science is

2:32

pretty transparent and clear. And

2:34

so that's my job is to stand here, present

2:37

what I see as the transparent and clear microbiome science,

2:39

and then we can talk about it. And

2:42

Dr. B, it's been a year or

2:44

two since we last chatted. Anything

2:46

in that period of time that you've changed your mind

2:48

on or any new science

2:50

that is really flipping

2:52

the paradigm? Well,

2:54

I mean, I think if we're going to talk

2:57

or bring up the carnivore approach, I

2:59

mean, clearly this is a highly popular

3:01

diet right now. Popularity

3:05

is not the same as our biology. But

3:09

I think that from my perspective, there is an

3:13

increasing acknowledgement that there are definitely people

3:15

who follow these dietary patterns and they

3:17

feel better. And

3:20

there's just no denying this, nor would I say

3:22

that your body is lying to you or the way

3:24

that you feel is not real. That's

3:27

ridiculous. So I think that

3:30

building an enhanced understanding of these things

3:32

is necessary and important. But I also

3:34

think that part of

3:36

my responsibility with

3:38

that is not so much to attack or

3:40

make it sound like you're

3:42

a horrible person because you made that choice when

3:45

you're just trying to improve yourself. My

3:49

responsibility is to point out ways in which

3:51

we can tweak things and

3:53

perhaps start to move in

3:55

a direction that can enhance your health even

3:57

further. One

4:00

of the things that I find to be interesting, Jesse,

4:02

with respect to Paul Celadino, is

4:05

that he himself has

4:09

adapted and changed his diet. And

4:13

he's been quite open and transparent with that,

4:15

which I respect that, I think that's great.

4:18

So, and I think that that's ultimately

4:21

what we want. Like none of us,

4:23

none of us should be overly dogmatic

4:25

about our approach. We should all be

4:27

just kind of striving to be better.

4:30

And one thing I've noticed over the years,

4:32

having these conversations every week is that there

4:36

is good arguments on both

4:38

sides. And what I'm preparing

4:41

for and chatting with somebody more in

4:43

the plant-based world like yourself, it's

4:46

easy for my own paradigm to

4:48

slightly be deviated that way. And

4:50

then again, when I'm talking to somebody more

4:52

on the meat-based spectrum. So it's, none

4:55

of us are immune to this. And

4:57

I think all of us need to continue

4:59

to be open-minded and learn. I

5:02

love that. And I think that's

5:04

wholeheartedly so what we need right now

5:08

on multiple levels as humans is we

5:10

just need to open our hearts and

5:12

learn from one another and see

5:16

the humanity in one another. So

5:18

in that last year or two, since we

5:20

chatted, has there been any

5:22

big breakthroughs in the science? Well,

5:24

we are moving forward. So

5:27

I will tell you that,

5:29

for example, with myself, I've been involved

5:31

in a number of different research studies

5:34

that I see as

5:37

potential game changers. I think we'll talk about some

5:39

of them. I don't wanna necessarily dig right into

5:41

them right now, but I've been involved in a

5:43

number of different studies that are game changers involving

5:46

intermittent fasting, involving bowel

5:48

movements, involving

5:50

our gut microbiome. There's new

5:53

research that's emerging in terms of

5:55

how we manipulate the microbiome. we

6:00

are now seeing like, I guess the

6:02

area that has my attention is

6:06

the way in which we treat cancer

6:09

is shifting towards an

6:11

approach called immunotherapy. And

6:15

immunotherapy is where rather than

6:17

using chemotherapy that our traditional

6:19

approach, which is

6:21

intended to kill and destroy tumor cells,

6:25

but unfortunately is not so

6:28

perfectly targeted. So it

6:30

kills and destroys many cells. And this

6:32

is why people feel miserable when they

6:34

do chemotherapy. The new

6:36

approach is to empower our

6:38

own immune system. And

6:42

so that's what immunotherapy does. And

6:44

it turns out that when you empower our

6:46

own immune system, it's highly

6:49

capable of eliminating tumor cells. And

6:52

so what's fascinating and interesting is the

6:55

increasing evidence that exists that is showing

6:57

us that the gut microbiome plays a

6:59

central role in this process. And

7:03

so there are a combination

7:05

of studies showing,

7:07

for example, that fecal transplants may

7:10

provide benefit to people who have

7:12

a damaged gut in the context

7:15

of receiving immunotherapy for specific cancers

7:17

such as melanoma. By

7:19

the way, I should say with that, this

7:22

is for early phases

7:24

in terms of understanding this. So I wouldn't describe

7:26

this as being like set in stone in the

7:28

way that it may be in 10 years. But

7:32

we're starting to see this signal that emerges

7:34

in the evidence. Or

7:37

alternatively, that if

7:39

you modify a person's diet

7:41

and by modifying their diet, you modify

7:43

their microbiome, that that

7:46

may in itself also provide benefit

7:48

in terms of cancer outcomes with

7:50

immunotherapy. So it's

7:52

an exciting time because we

7:55

went through a period where all we did

7:57

was describe what we were seeing in the

7:59

microbiome. And now we're

8:01

in a place where it's not a

8:03

matter of just sort of observation, it's

8:06

actually manipulation and looking at how we

8:08

can take

8:11

advantage of the power that exists within

8:13

these gut microbes. And

8:16

if we're going to get in and talk about,

8:19

which we will, how to optimize

8:21

the microbiome and things that are destroying

8:23

it, I think a good

8:25

benchmark to start with is what we're aiming

8:27

for. So let's talk about

8:29

what the optimal gut

8:32

microbiome looks like, and

8:34

then we can talk about how to protect it and how to

8:36

build it up. Yeah.

8:39

Looking at the gut microbiome, I think we

8:41

need to first sort of zoom out and

8:43

look at this holistically. Imagine

8:45

that you had sort of a high

8:49

view looking down on this community,

8:51

this ecosystem. And

8:54

the problem is that many times in research,

8:56

because we are simple, we're

8:59

much more happy when

9:03

we have linear thoughts. If

9:05

you do this, you get this and therefore you

9:07

are better. And so many

9:09

times we reduce the microbiome down to

9:11

like single strains, hey, this

9:13

is a good bacteria, this is a bad

9:15

bacteria. But yet it's

9:18

the entirety of the ecosystem that really matters.

9:20

It's the health of the overall picture. And

9:23

within that sort of big picture

9:25

view, there will be

9:28

the rise and fall of specific families of

9:30

microbes. And I would

9:32

make this a comparison, Jesse, to like, I

9:34

would love for the people who are at

9:36

home listening to us to

9:39

in their mind conjure a picture of

9:41

an ecosystem that exists within

9:44

their space, within their world. So

9:46

I'm here in Charleston, South Carolina. We're

9:49

a coastal city in the southeast United States

9:51

on the Atlantic Ocean. And

9:54

as I look out right now

9:56

through this window, this is my

9:58

yard and we have all kinds

10:00

of buried trees. There are

10:02

squirrels, there are birds, and I know that there

10:04

are bugs. Lots of

10:07

mosquitoes. And

10:09

within that, we could

10:11

zero in on one, the mosquitoes

10:13

and say the mosquitoes are bad, and

10:15

we want less of those. But

10:18

the problem is, if we have less of those and we start

10:20

killing them off by spraying them or whatever we might do, that

10:23

affects the birds. Or that

10:25

affects other animals. And

10:27

so there are ripple effects that start to

10:29

take place. The health of this ecosystem is

10:31

the fact that there is a wide variety

10:33

of different plants, a wide variety

10:36

of different animals and bugs and whatever

10:38

it may be. So

10:40

it's that biological diversity that is

10:42

essential and key. And if we want

10:44

to simplify the microbiome, we

10:47

should look at the diversity within

10:49

the microbiome. Because much like

10:51

looking at this ecosystem that is surrounding

10:53

me, if you were to zoom in on

10:55

your gut, it would be that diversity

10:58

that's key. And within that diversity, yes, there

11:00

are bad guys, but the bad

11:02

guys play a role too, much like the mosquitoes

11:04

play an important role in the ecosystem around my

11:06

house. And one thing we

11:08

tend to do in the natural health world is

11:10

just focus on the bacteria within the gut. And

11:13

there's also viruses, fungi,

11:15

parasites, all kinds of different

11:17

things going on down there. So

11:20

talk about that integration. Yeah,

11:22

there's actually a historical reason for this. We

11:25

like to talk about the things that we can test. And

11:29

if we can't test it, then like,

11:31

how do we measure it? How

11:33

do you measure happiness? Like I can tell you how

11:35

much money I have, but how do you measure happiness?

11:38

It's a much more complicated thing. And when it comes to

11:40

our body, the same is also true. And

11:43

in the beginning, Jesse, all that we could test

11:45

for really were the bacteria. That

11:47

was the test that we had when it came to

11:49

the microbiome for a very long time, until very recently.

11:53

And now we have

11:55

an improvement of the test called shotgun metagenomic

11:57

sequencing, which allows us to have a more holistic

11:59

view. that includes the

12:01

bacteria and also the fungi and

12:03

yeasts and the parasites.

12:06

And in some cases, you can actually test

12:08

and see the viruses as well. And

12:11

so now the bacteria are from a

12:14

numbers perspective, the dominant ones.

12:16

The vast majority of the

12:18

microbes are bacteria. But

12:21

clearly there's an important role that fungi

12:23

and yeasts play. And we all know

12:25

this because there are many people who

12:28

deal with yeast related

12:30

issues, such as the athlete's foot, or

12:33

jock itch, or female

12:36

yeast infection, or you

12:38

take antibiotics and you get thrush, right?

12:40

This is all yeast

12:42

related. So

12:45

these microbes play

12:47

an important role as well. And the one thing

12:50

that I would say is that one of the

12:52

lessons that we have is, you

12:55

know, there's sort of just this general idea that

12:58

if something is bad, like in the microbiome,

13:00

if something is bad, then we should kill

13:02

it. And

13:05

every single time we do this, we discover that actually

13:07

that was not the right approach. And

13:09

with antibiotics, for example, like, is there a

13:11

role for antibiotics? Yes, of course. They're so

13:14

important when we need them. But

13:16

should we use them liberally? No, because there's

13:18

consequences and we're causing harm. And I think

13:20

that the same is also true when it

13:22

comes to some of these things. Because one

13:24

of the things that we've discovered

13:26

is that, for example, there are like,

13:29

perhaps the most studied

13:31

probiotic is Saccharomyces buardii, which

13:34

is, let's say yeast.

13:36

It's a probiotic, it's good for you. And

13:39

there's actually research that we've done

13:41

that has discovered that there's a

13:43

parasite that actually

13:46

is good for us. And

13:49

it helps to control our blood

13:51

sugar, it reduces visceral fat, and

13:54

it's a parasite. So normally we would be under the impression

13:56

that we should kill it, but in fact, it's not

13:58

something we want to do that. And

14:01

when it comes to all these different

14:03

integrations, again, of viruses, bacteria, different things

14:05

that are going on in the gut,

14:08

when it comes to maintaining a healthy

14:10

gut, at this point

14:13

with what we know and where the science

14:15

is, is it all

14:17

about manipulating the bacteria and

14:19

then in turn that impacts things like

14:22

viruses and fungi? You mentioned that one

14:24

specific Saccharomyces boulardii,

14:27

but in general, when it comes

14:30

to probiotics we're taking, it's traditionally

14:32

bacteria. We don't focus a lot

14:35

on these other organisms. So

14:39

when it comes to maintaining that ecosystem

14:41

and that balance with all these different

14:44

organisms, where the science is now, is

14:47

it about focusing on the bacteria and

14:49

then letting everything else balance? Well,

14:52

we know so much more about the bacteria.

14:55

So it's a lot easier for us to

14:57

create strategies that are intended to manipulate them

14:59

because that's where we have 15, 20

15:02

years of data. And

15:04

when it comes to the mycobion,

15:07

M-Y-C-O, which is

15:09

the fungi and

15:11

yeast, we don't have nearly as

15:14

much information available on that. But

15:16

what we do know is they live in harmony and

15:19

that there's a balance that

15:21

naturally exists and we want

15:23

to support that balance

15:25

within the microbiome. So

15:28

it's not so much from my perspective

15:30

that we should focus on how to

15:32

manipulate the bacteria specifically. It's

15:34

more so how can we make choices that

15:37

frankly tend to be common sense and the same stuff that

15:39

our grandma was teaching us 30, 40 years ago. How

15:43

can we make common sense choices that will

15:46

help to build a healthy ecosystem that includes

15:48

a wide mix of all of these different

15:50

things that include bacteria, fungi, archaea,

15:53

parasites possibly. I mean, again,

15:56

parasites, they're ones that are good. I

16:00

don't particularly want us to vilify them, I want us

16:02

to understand them. CB. And

16:04

I think part of where this narrow approach

16:07

focusing on bacteria comes from, again, coming

16:10

to the fact that when we're going

16:12

to manipulate what's going on down there

16:14

and take a probiotic, we're

16:16

focused again mostly on bacteria and

16:19

often only a handful of bacteria. It might

16:21

be five different

16:23

species within a probiotic, which

16:26

is such a

16:28

minimalistic, narrow-minded

16:31

approach to manipulating the intricacies that

16:33

are happening down in the gut.

16:35

CB. I wholeheartedly

16:37

agree. Now, I guess

16:41

let me say

16:44

from my perspective as a gastroenterologist, that

16:47

there are tons of people,

16:49

plenty of people that I have taken

16:51

care of through the years that have

16:53

used probiotics with benefit. But

16:56

the problem is that I think that

16:58

the marketing machine wants us to believe

17:01

that the solution to our problems is

17:03

in that capsule. And

17:05

that's not the way that I would personally

17:07

describe that. And

17:10

the other issue is that if we were to talk about,

17:12

if we were to do Probiotics 101 and

17:14

I were allowed to teach for the next two

17:17

minutes about how do you approach this issue with

17:19

probiotics for the listeners who are curious about this,

17:21

because again, for people who have gut issues, there

17:24

may be a role. But

17:27

the issue with this, Jesse, is that let's just

17:29

use you as a quick example. You

17:32

have an entirely unique microbiome. There's

17:35

literally no one on the planet that has the exact same

17:38

microbiome as you. I don't

17:41

recall you having an identical twin, but if we pretend

17:43

for a moment that you did, you would

17:47

share the exact same genetic code, 100% the

17:50

same DNA as that identical twin.

17:54

And in the vast majority cases, you would

17:56

be raised in the same home, eating some

17:58

more food, similar sort of way. lifestyle. And

18:01

yet despite all that, you would only share 30 to 35% of the same

18:03

microbes. Your microbiome

18:07

would be more different than it would be

18:09

the same from your identical twin that you

18:11

can't get more somewhere to than that. So

18:16

that uniqueness of

18:18

your microbiome, we

18:21

don't know what's going to happen until

18:23

we try. And this is true of probiotics, and this

18:26

is true of other supplements. And this is also true

18:28

of medications. This is

18:30

the reason why one medication can

18:32

have amazing effects for one person

18:34

and have catastrophic adverse effects for

18:36

another. So

18:38

with the probiotic, the way

18:40

that we approach this is you should

18:42

have a goal in mind. It shouldn't just be,

18:44

hey, I want better gut health. It should be,

18:46

this is what I'm hoping to accomplish with this

18:48

particular probiotic. And

18:51

you should choose a probiotic that has the science

18:53

and the evidence to back up that

18:56

it will actually work for that specific health issue.

18:59

But that doesn't mean that it's going to work for

19:02

you. So ultimately,

19:04

you have to be your own scientist for

19:06

your own body. You could

19:08

apply this to many things, not just probiotics, where

19:12

you start taking that

19:14

probiotic with your specific

19:16

health goal in mind. You

19:18

see where it takes you. And

19:20

if it provides benefit in

19:22

your health goal, and you're comfortable with the

19:25

price, then that's great. But

19:27

if it does not, you stop wasting

19:29

your money. And either you move on to another

19:31

probiotic or you move on to something different. And

19:34

I think the last thing is there

19:37

are more surefire ways to

19:40

manipulate our microbiome. And

19:42

really, this is, I think, where the

19:45

conversation exists with diet, with lifestyle, with

19:47

fiber. These are

19:49

the ways in which we can really start to

19:51

shape the microbiome in a more powerful way. And

19:55

again, coming back to the different organisms

19:57

within the gut, is there good

19:59

news within the gut? this, the fact that

20:01

when we take on the practices we're

20:03

going to get into today, that it

20:05

does help rebalance

20:08

all of them. Because say we're talking about

20:10

putting in more fiber for the bacteria, hypothetically,

20:13

that could have a negative impact

20:16

on viruses or fungi. Is

20:20

there good news that there is

20:22

an approach that brings harmony

20:24

to all the different species? Yeah,

20:27

there is. And it's not exclusive

20:29

to fiber. There are other things

20:31

beyond just fiber. I tend to

20:33

focus on fiber because I think

20:36

about things on a public health level as a

20:38

public speaker. And 95% of

20:42

people in the United States and quite somewhere in Canada

20:45

are deficient in fiber. So to me, I see

20:47

this as a tremendous opportunity not to put people

20:49

on a high fiber diet, just

20:51

to normalize fiber. But

20:54

yes, there's more that exists beyond

20:56

just that. And the answer to

20:58

this question, Jesse, is

21:01

when we look at gut diversity, that

21:04

is our measure of health. Then

21:06

gut diversity is not exclusive to

21:09

the bacteria or the fungi that

21:11

are beneficial to human health and are probiotic in

21:14

their nature. But diversity

21:16

still includes things that we may consider

21:19

to be pathologic. And

21:22

yet, within that harmony imbalance,

21:25

it's okay for E. coli and

21:27

salmonella and these other microbes

21:30

to exist because when

21:32

they are harmonized and in balance, they're actually

21:34

not causing trouble. You know this because you're

21:36

not sick. And

21:38

in some cases, believe it or not, they

21:41

may be more complicated. And in some cases, they

21:43

can be beneficial and helpful. I

21:48

hate to make it about a TV show that maybe people

21:50

haven't seen, but this is perhaps the most popular TV show

21:52

of the last 15 years, Game

21:54

of Thrones. And the

21:56

cool thing about Game of Thrones to me was the depth

21:59

of the characters. and you have people like

22:01

Jamie Lannister who like one season he's

22:03

a bad guy, another season he's a good guy,

22:06

many of these microbes can

22:08

be like that. It's contextual. So we

22:10

can't necessarily just apply a label of good versus

22:13

bad. So for somebody coming

22:15

into this wanting to optimize their gut health

22:17

from wherever they're at today, is the

22:21

first step to look at symptoms

22:23

that they're experiencing, to have

22:26

some sort of objective testing done.

22:29

You talked about how diversity is what we're

22:31

looking for here. How

22:33

do we assess where we're at right now? Well,

22:37

we live in a world right now

22:40

where we have more access

22:42

to testing than

22:44

we've ever had. And

22:46

I think it's cool, but

22:50

I'm a little bit of an old school doctor in

22:52

this regard. At

22:55

the end of the day, the most

22:57

important question from my perspective is

22:59

how do you feel? Let's

23:03

get back to a very basic thing because

23:06

if you use, for example, your Apple Watch and

23:11

your heart rate variability went down, but

23:14

you had a great night's rest and you

23:16

feel fantastic. That heart

23:18

rate variability is actually causing you stress,

23:20

raising your blood pressure, increasing

23:23

cortisol levels, activating your

23:25

sympathetic nervous system, and actually having a negative

23:27

effect on your gut microbiome, not a beneficial

23:29

effect. So I

23:32

think that data is good, but

23:34

let's start with the basics. And

23:37

when I'm measuring a person's gut

23:39

health, do I think that

23:41

there's a role for tests? Yes. But

23:43

before I even entertain those tests, I

23:46

want to start with this. If it

23:48

was a patient that I were talking to in

23:50

the clinic, the first question, how do you feel?

23:54

The second thing that I look at, what

23:56

is their health history? All

23:59

right. So when a person... has, and this is

24:01

often the case, when

24:04

a person has a history of something

24:06

that is a microbiome-mediated health condition, which

24:10

many of the listeners may say, oh, well, Dr. B,

24:13

you're talking about your old bowel syndrome. Yes.

24:16

And other digestive health problems like

24:18

ulcerative colitis, Crohn's disease, acid reflux,

24:20

et cetera. But

24:22

I would expand that so much further because

24:25

metabolic issues, obesity, type 2 diabetes,

24:28

high blood pressure, high cholesterol, and

24:31

immune-related issues, allergic diseases, autoimmune

24:34

diseases, and

24:36

cognitive issues, which

24:40

may include mood disorders, depression, anxiety,

24:44

Alzheimer's disease, Parkinson's

24:47

disease, hormonal issues.

24:50

So in men, erectile dysfunction,

24:54

in women, fertility,

24:57

endometriosis, polycystic ovary

24:59

syndrome, menopausal

25:01

symptoms, all

25:04

of these things are

25:06

connected back to our gut. So

25:09

in addition to asking a person, how do

25:11

you feel, I'm looking at the list of

25:13

their health history. And when I see multiple

25:15

different ones that are lighting up as being

25:17

connected back to the gut microbiome, I

25:20

already know. And

25:23

the last thing that I would add,

25:25

and again, all of this is free. I would

25:29

encourage the listeners to take a quick moment

25:31

of a look in the mirror to

25:34

say, is this me? And where

25:36

does this fit for me? Let me think about that. The

25:40

third thing is our bowel movements. As

25:44

you know, Jesse, I am far

25:46

too comfortable talking about this topic. But

25:49

for most of us, we're not.

25:51

Most people, this is sort of a stigmatized

25:53

thing. We can't talk about our bowel movements.

25:57

Yet this is so direct.

25:59

relevant to our health, specifically

26:01

our gut health. You

26:05

can literally tell the difference in

26:07

a person's microbiome based

26:09

upon their bowel movements because

26:11

the majority of the weight of

26:13

our stool is not

26:15

actually the excrement of your food. It's

26:18

not the food waste. The

26:20

majority of the weight of your stool

26:23

is actually from

26:25

your microbiome.

26:28

So what you have there is the gut

26:32

health equivalent of a cardiologist listening to

26:34

your heart with a stethoscope. And

26:37

so for each of us, we should look at the

26:41

shape. So you could pull up

26:43

the Bristol stool scale, the shape, the

26:46

frequency, but also importantly,

26:49

the experience in the

26:51

bathroom. Do

26:54

you have a good, complete evacuation? Is

26:56

it satisfying? Because it should be. Do

26:58

you feel good afterwards? Because you should.

27:01

Or is it effort? Do

27:05

you have to work hard and strain? Do you

27:08

still feel like you have to go? Do you

27:10

feel like you didn't really fully poop? Because

27:14

if the answer is yes to

27:16

any of those things, then it's not where we want it to

27:18

be. So those are the main things

27:20

that I look at. And then after that, we

27:22

can dig into tests. There's all kinds of tests.

27:25

I'm involved with a company. I'm

27:28

the US medical director of a company called Zoe.

27:31

And unfortunately, we're not available in Canada at

27:33

the moment, but in the US and the

27:35

UK, we have a test

27:37

kit where we measure a person's

27:39

microbiome, provide them with a score

27:41

and provide them with a personalized

27:43

nutrition plan to improve their microbiome.

27:46

So and I do think that there's a place where that could be helpful.

27:48

All right, so the three

27:50

big areas you look at, how's

27:53

the person feeling? Their history,

27:55

specifically, well, no, actually, beyond that, I was

27:57

going to say related to the gap. but

27:59

you're looking at whole health history and

28:02

then trying to see what you could

28:04

connect back to the gut. And

28:06

then third is what's going

28:08

on with the bowel movements. And

28:11

I wanna stick on that third piece for a bit. You

28:14

talked a lot about the fact that we should

28:16

feel satisfied after

28:19

we poop. What

28:21

is it we're looking for when we look

28:23

down into the toilet? Assuming we do, we

28:26

should. But what is it

28:28

we're looking for in an

28:30

ideal poop, shape-wise, size, and

28:32

then we can go from there? Yeah.

28:37

There was a famous

28:39

British scientist

28:43

who studied poop in Africa, believe

28:45

it or not. And

28:47

he came back, he had a sense of humor, like

28:51

many Irish people do. And he said, when

28:54

you have big poops, you need small hospitals, and when

28:56

you have small poops, you need big hospitals. And

28:59

so in a perfect world, we

29:01

want big poops. Those are

29:04

healthy ones. And the way

29:06

that they would appear is, and

29:08

again, my wife always tells me, you need

29:10

to not talk about poop so much in

29:12

public, but since we're on a

29:14

health-related podcast, I have the freedom to do this

29:17

right now. A

29:20

good healthy bowel movement is like a

29:22

sausage. So it

29:24

is soft. It is

29:26

formed. It has that

29:28

sausage-like shape. And

29:33

because we are pooping with

29:35

good pelvic floor relaxation, and

29:38

it is effortlessly leaving our body, then

29:41

it's long as a result of that.

29:43

It's not broken up into little chicken nuggets. It's

29:46

nice one long sausage or snake, whatever you

29:48

wanna call it. I'm kinda scared of snakes,

29:50

so I avoid that

29:52

one. But that's what

29:54

we want, and that's what we call Bristol 4. All

29:58

right, so the Bristol stool scale. Actually,

30:00

there's a historical reason for this. It

30:03

goes back to the 1990s and

30:05

they were in Bristol in the UK and they studied

30:07

about 2,000 people. And they

30:09

came up with this sort of concept

30:13

of there's seven types of bowel movements. So

30:17

the sausage one is our normal healthy bowel

30:19

movement. That's number four. And

30:22

as we move three, two, one,

30:25

we are moving into a constipation space.

30:29

So three is hard and lumpy bumpy. And

30:32

two is actually turning

30:35

into like hard, lumpy,

30:37

bumpy, almost like nuggets. And

30:41

number one is rabbit pellets,

30:43

like hard balls. All

30:45

right. So that's one, two, three. And then we can go

30:47

to the other side, five, six, and seven are diarrhea. Five

30:52

is like a Cal Patty. So

30:55

just losing its shape. Six

30:59

is rather loose and

31:02

seven is straight water. So

31:06

three and four are our normal

31:10

healthy bowel movements. One and

31:12

two constipation, five, six, and seven diarrhea. That's

31:15

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33:37

All right, so we want to hit that three and four, at

33:40

least the majority of the time. How

33:43

often should we be pooping?

33:46

All right. I

33:49

want to start by saying this, that there

33:51

are tons of people

33:54

who poop every single day and

33:57

they are constipated. The

34:00

frequency is not the principal determinant

34:02

of these things. This

34:05

is why we need this whole picture of

34:08

what a healthy bowel movement is as you're asking

34:10

me about this. The

34:12

average bowel movement frequency for people right now

34:14

is one poop a day. That

34:18

doesn't mean that you're unhealthy if you go every other

34:20

day. We

34:22

should be pooping at least, at least twice

34:24

per week. There

34:27

are people though

34:29

who will poop more frequently and

34:33

it's not a complete bowel movement. So

34:36

they go and it just doesn't feel

34:38

right when it's coming out. Again, not

34:40

complete, not effortless. And

34:43

then they feel like they have to go again. They

34:45

come back 45 minutes later and it's another little nugget.

34:49

Those small poops don't count. That's not a full

34:51

poop. Those are

34:53

partials. And those

34:55

often are people who are suffering with bloating

34:57

and gas, they're constipated. And

35:00

what they need is they need more complete

35:02

regular bowel movements because if they had that,

35:04

if they were to really start to mobilize

35:06

their bowels, their symptoms

35:09

would go away. How

35:12

do you feel about using a stool to

35:15

put the feed up on when pooping?

35:19

There's a brand out there called Squatty Potty.

35:21

I think they got everything started and now

35:23

people use all sorts of things. Is

35:26

that a good practice? It's a phenomenal

35:28

practice and it makes complete sense just anatomically.

35:30

It's like a very simple idea here, which

35:33

is that if you were out in nature camping

35:37

and you had to go number two, I

35:40

don't think that you would actually prop yourself down on

35:42

a log and try to figure out how to sit

35:44

the way that you sit on a toilet. What

35:47

you would do is you would just squat down, deep

35:51

squat and you would poop. And

35:55

anatomically, we're actually set up to do

35:57

that. So there

35:59

are muscles that... exist within the bowl

36:01

of our pelvis, our pelvic floor that

36:04

are designed to actually make it

36:07

difficult for us to poop unless

36:09

we're in a squat. And

36:11

when we are in a squat, then actually

36:14

it creates a straight rectum which

36:16

allows us to then have that clean, effortless,

36:19

and complete bowel movement. So

36:22

squatting is the preferred position for pooping.

36:24

And the person, John J. Crapper or

36:26

whatever his name was who

36:28

invented the toilet, he did not know

36:31

this. And so they invented

36:33

a toilet that was more like a throne or a chair.

36:36

And we sit there with a 90 degree

36:38

knee and a 90 degree hips, like the

36:40

way in which our legs

36:42

connect to our back, it's like 90 degrees.

36:45

And that's not the way it should be. The

36:47

angles should be more cute. And

36:50

it doesn't have to be necessarily the brand Squatty

36:52

Potty. If you like their brands, I'm all for

36:54

it. But it's more so

36:56

just getting your feet elevated. When

36:59

you elevate your feet, you get

37:01

your hips up. And when you get

37:03

your, I'm sorry, you get your knees up and

37:05

you get your knees actually above your hips. So

37:08

when the knees go above the hips, that's

37:10

when you know that you're in a better

37:13

pooping position. So it could be

37:15

anything. You could be anything. We have a little in

37:17

our bathroom at home, I have

37:20

little kids. So I have two kids who

37:22

are under two. I have

37:24

two older kids as well, four total children. So, but

37:27

with the two little ones, we need

37:29

a little stepping stool for them to be able to

37:31

get up to the sink and wash their hands and

37:33

things like this. So the stepping stool

37:35

makes for a nice Squatty Potty. Any

37:38

hacks if you're in public and you have to poop? Like

37:41

when I'm traveling, if I'm in

37:43

O'Hare in a

37:47

major airport and I have to go, I'll

37:51

put my bag down and I'll use that for

37:53

my feet. So that would be one

37:55

of the things that you could do. I mean,

37:57

just finding something basically that you can put your feet on. All

38:01

right, so hydration, diet, I decide I want to

38:03

get into those later. Any

38:05

other hacks when we're

38:07

in the bathroom specifically, position, things

38:10

in that realm that

38:12

can improve our pooping? Taking

38:15

a nice breath in and then letting

38:17

it out through our lips slowly and

38:19

you might even make like a humming

38:21

noise and that helps to actually relax

38:24

our pelvic floor in that

38:26

moment. So that's one of the things that we

38:28

can definitely do. I'm just

38:32

somebody walking in while the legs are up

38:34

and humming and the

38:36

scene that would make. This happened the other

38:38

day with our nanny. I told our nanny, I was

38:40

like, you're officially a part of the family now that

38:42

you walked in the bathroom on me. So

38:46

yeah, so

38:48

just our breathing patterns and nice deep breaths

38:50

in through the nose and then releasing through

38:52

the mouth. You don't have to do the

38:55

humming noise if you don't want to, but

38:57

that's one of the ways that you can help

39:01

to relax the pelvic floor. A few

39:04

other things. So hemorrhoids get worse if we spend too

39:06

much time on the toilet. So

39:09

don't make it a habit or

39:11

try to avoid the habit. This is actually, by the

39:14

way, mostly a message for men because men are the

39:16

ones who do this the most. Try

39:19

not to make it a habit of sitting on the

39:21

toilet for 20 minutes and reading your phone or whatever

39:24

it is that you're doing. Five

39:27

minutes. You feel the

39:29

urge, you go, you

39:32

release your bowel movement, and then you get up and you

39:35

move on with your day. The

39:37

other hack that's interesting, if

39:40

you are a person who's your regular in

39:42

your bowel movements, one

39:45

of the things is that our entire body thrives

39:49

on consistency. Our

39:52

entire body has a circadian rhythm. This

39:55

is the reason why the most common time of day

39:57

for people to poop is in the morning. fairly

40:00

consistently, but some people are not like that. And

40:03

that may be because their circadian rhythm

40:06

is not actually optimized and not in

40:08

balance. There are

40:10

many things that you can do to optimize your circadian

40:12

rhythm, which by the way, and we could talk about

40:14

this more, are good for the gut. And

40:17

this includes, for example, early morning light exposure

40:21

to help to start the day. But

40:24

when it comes to creating a

40:26

regular pooping

40:28

schedule, believe it or not,

40:31

you can do this yourself. The

40:34

way that you do it is by simply

40:36

establishing a time, many times

40:38

after coffee, perhaps after breakfast if you're

40:40

a breakfast eater. After

40:43

that, you go and you sit on the toilet for

40:45

five minutes. Even if you don't feel

40:47

like you have to go, you just do that, five minutes. Don't

40:51

force anything, don't strain. Only

40:53

five minutes pass and you haven't pooped, get up and leave. But

40:57

I promise you that if you do this for three or four days

40:59

in a row, your body will pick up

41:01

on what you're trying to do and you will start to

41:03

have bowel movements at that time. And

41:05

then you can get yourself into a rhythm of having

41:08

a good, regular, healthy morning bowel movement, which by

41:10

the way, to me is just as

41:12

good as a great cup of coffee. You

41:15

mentioned the fact that we could

41:17

do this after coffee or breakfast. What

41:20

is it about those two specific

41:22

inputs that seem

41:25

to facilitate pooping? Okay.

41:29

This is going to perhaps move us into a broader

41:31

conversation. I'll be curious to see where you take this.

41:35

But I think actually the serotonin is

41:37

the key. Serotonin,

41:41

most of us think of serotonin as the

41:43

happy hormone. When a

41:45

person uses drugs to treat depression, those

41:48

are serotonin reuptake inhibitors. They boost serotonin levels

41:50

in the brain and that helps to address

41:53

depression. It turns out that 90 to

41:55

95% of serotonin is produced

41:57

in the gut. And

42:00

the reason why is because

42:02

it's a motility agent. Serotonin

42:05

helps to stimulate gut motility. And

42:08

when we wake up in the morning, particularly

42:12

with light exposure, actually

42:15

that helps our gut to produce

42:18

serotonin. And

42:20

then that serotonin turns on, activates the gut,

42:22

things start to move, and this is part

42:24

of the reason why. You

42:26

can enhance that even more with

42:29

morning coffee or with

42:31

fiber. You can boost those

42:33

things even more resulting in that morning

42:35

bowel movement. Interesting.

42:38

I've never heard that connection between

42:40

motility and serotonin. I've

42:42

heard that statistic or something in that

42:44

range, but it's always

42:46

assumed that we're talking about serotonin that's going to

42:49

end up in the brain. Does

42:52

any of that serotonin end up going to the

42:54

brain and facilitating mood? That

42:57

serotonin is affecting our brain. It's

42:59

not directly, directly crossing the blood

43:02

brain barrier to

43:04

have a direct effect on the brain, but many

43:06

of these systems run in parallel. And

43:09

there are connections between our gut and

43:12

our brain through the vagus nerve. And

43:16

so the serotonin in the gut can signal the

43:18

brain to impact our mood

43:21

and our cognitive function.

43:26

And these are the reasons why

43:28

I should mention that we

43:31

believe that through the gut brain axis that our gut

43:33

microbes do play a role in our mood. This

43:38

is also the reason why there are nutrition studies where

43:43

the intervention is a change in diet

43:45

with the enhancement of mood. And

43:50

if we broaden this out, this is again,

43:53

I find this to be so fascinating. And some of these

43:55

things, by the way, I haven't really talked about on many

43:57

podcasts. In fact, I don't even know if I've talked about

43:59

it on any podcast. because this is

44:03

sort of new stuff. But what's

44:06

fascinating is that the exposure to morning

44:09

light enhances serotonin

44:11

production in the gut. It

44:13

also enhances serotonin production in the brain. And

44:18

if we take a step back and think about what I just said, light

44:21

exposure enhances serotonin production.

44:25

We all know this to be true because

44:27

that is seasonal affective disorder. Seasonal

44:30

affective disorder is when people in winter

44:33

don't get outside as much, don't get

44:35

exposure to natural sunlight. And

44:37

as a result of this, it adversely affects their

44:39

mood. All right, so,

44:42

but the, now here's the

44:45

extra interesting part. Serotonin

44:47

is part of a pathway. So

44:50

serotonin isn't just affecting our

44:52

cognition, our mood, our energy

44:54

levels, our gut motility. It's

44:57

not just that. Serotonin

44:59

actually gets converted by enzymes in

45:01

the body to produce

45:03

melatonin. And

45:06

melatonin actually is focused

45:09

in the gut. Believe

45:11

it or not, so I said 90 to 95% of serotonin is

45:15

produced in the gut. That serotonin gets

45:17

converted into melatonin. We

45:19

have 400 times, 400 times

45:22

more melatonin in our gut than

45:25

we have in our brain. All

45:28

right, so that's a staggering amount of melatonin.

45:31

And why is it there? And

45:34

the reason why is because actually

45:37

melatonin produced

45:39

from serotonin actually

45:42

helps to change the microbiome, enhance

45:45

the good guys, suppress

45:47

the bad guys, and repair

45:50

and restore the gut barrier. So

45:53

within the gut, there is this

45:55

thing that exists where

45:57

when we get serotonin, we can produce more

45:59

melatonin. which actually helps to restore

46:01

a healthy gut. But in the brain, melatonin

46:05

also is produced from

46:07

serotonin as a part of our

46:09

pineal gland. And our pineal gland

46:11

is what releases melatonin in the evening when

46:13

we turn our lights down. And

46:16

it helps us to sleep. So

46:20

all of these things, light exposure

46:22

in the morning, darkness in the evening, and

46:25

our gut microbes, they're

46:28

all interconnected. So

46:30

this melatonin made from serotonin in the

46:32

gut, does any of that

46:34

have an impact on the brain? So

46:37

we think that it actually it does, in

46:39

fact, cross the blood-brain barrier, the gut melatonin.

46:43

One of the fascinating things to me is

46:45

it appears that melatonin also is able to

46:48

enhance the gut barrier,

46:54

meaning like basically using layman's

46:56

terms, prevention or reversal of leaky

46:58

gut. But we

47:00

also have a blood-brain barrier. And

47:03

the expectation would be that the melatonin,

47:05

that blood-brain barrier is actually the exact

47:07

same setup, the exact

47:09

same build as our gut

47:11

barrier. It's epithelial cells held

47:13

together by tight junctions. So

47:16

the expectation is that melatonin, whether it be

47:18

in the bloodstream or in the brain, and

47:20

coming into contact with the blood-brain barrier, has

47:23

the capacity and ability to enhance and

47:25

restore the blood-brain barrier as well. And

47:28

now to be totally clear, I

47:32

just wanna explain one thing, because I'm sure there's

47:34

gonna be someone at home who's gonna be curious

47:36

about this. I

47:38

said there's 400 times more melatonin in the gut. All

47:43

right, but when it comes to

47:45

our circadian rhythm and

47:48

our sleep, it's the

47:50

melatonin produced by our pineal gland in

47:52

our brain, that is the key. And

47:55

so it's not just about healthy gut, healthy

47:58

gut means good sleep. Yes, healthy gut does mean good sleep. But

48:01

just as important is as we get

48:03

into the evening late in the day,

48:06

having a routine that allows us to

48:08

actually support the release of that melatonin

48:10

into our bloodstream so that we can

48:13

prepare ourselves for restful sleep. And

48:15

then that nighttime melatonin is having healing, as

48:17

I think the listeners I'm sure are taking

48:20

away, that nighttime melatonin is having healing effects

48:22

throughout the entire body. What

48:25

are your thoughts on supplementing with melatonin?

48:27

And how does that impact the gut microbiome? Yeah.

48:30

Well, so some of these melatonin

48:33

studies, some of the effects

48:35

of melatonin on the gut microbiome are

48:37

based upon melatonin supplement studies. And

48:41

so if you look

48:43

at the big picture of melatonin in

48:47

a world where there are a lot of people

48:50

who are using sleep

48:52

aids at night, many

48:54

of which have side effects that are

48:57

not desired. Melatonin

49:00

supplementation has an extremely,

49:02

extremely safe profile. If

49:06

you take too much of it, it will

49:08

make you groggy the next day. And this

49:10

is easily addressed by simply starting with a

49:12

small dose and easing into it to see

49:14

how it affects you. So

49:17

it's not to say that it's for everyone, but I

49:19

do believe that there are benefits to melatonin for people.

49:22

That being said, to be totally clear, my

49:25

recommendation would not be that you have

49:27

a rambunctious evening with a lot of

49:30

bright light and alcohol and

49:32

whatever it may be, which is going

49:34

to suppress your melatonin, and then take

49:36

a melatonin supplement. My recommendation actually

49:39

is that after 8 PM, we

49:44

wind down and that

49:46

includes our light exposure. And

49:49

that allows your body's natural melatonin

49:52

stores to get released. And

49:54

then if there's a place where a melatonin

49:56

supplement enhances that for you, then I think

49:58

that that's going to be a good thing.

50:00

completely reasonable. All right, I'm gonna

50:03

try and piece some of this together. 90 to 95% of

50:07

serotonin is being the gut. It

50:09

doesn't directly act on the brain. The

50:12

brain makes its own serotonin. Some

50:15

of that serotonin in the gut

50:17

gets converted to melatonin, can

50:19

repair the gut, can repair the blood-brain

50:21

barrier, can actually get into the

50:23

brain, but the brain also

50:25

makes its own melatonin. Does

50:28

that summarize

50:31

some of the high level points there?

50:33

Yeah, and then the part that is

50:35

the actionable lever that we can

50:37

pull for the people at home who

50:42

are like, okay, well, how do I use this information? The

50:44

answer is morning light. Because

50:46

when you step outside and

50:48

you get exposure to, even on a

50:51

cloudy day, by the way, even

50:53

when the weather is not good, you

50:55

still are getting a spectrum of light that

50:57

comes from the sun and it's

50:59

profoundly more bright than what we get if

51:01

we stay inside even with lights on. So

51:06

you step outside for ideally 30 minutes, but even if

51:08

you have less, even in 5, 10, 15

51:11

minutes, I'll take it. And what

51:13

ends up happening is in that moment, through

51:16

that light exposure, you are producing serotonin in

51:18

the gut, which helps to stimulate your gut

51:21

motility, which is a healthy gut, is

51:24

going to ultimately shape your gut microbiome and

51:27

provide potential benefits throughout the body. But

51:30

simultaneously, there's serotonin being produced in

51:32

your brain. That serotonin is creating

51:34

energy and an uplifted mood for

51:36

the day, which are the things

51:38

that you want so that you

51:40

can have a highly productive, focused

51:42

day. But 12 to

51:46

16 hours from now, because you

51:48

got that morning light exposure, the

51:50

gifts will continue because

51:53

of the production of that melatonin, which

51:56

will result in a good night's rest. So, and I, this

51:58

has been, I'm just going to say, a

52:00

game changer for me. I didn't do this

52:02

the last time you and I were on a call together two

52:04

years ago. And

52:06

now I have a morning routine

52:08

that includes me making sure to

52:10

get time outside. And

52:12

one of the things that I've done to kind of piggyback

52:15

this and sort of squeeze as much

52:17

value as I can out of my 30 minutes

52:19

in the morning is

52:21

that I also wear Rock Fest. And

52:24

so I'm also of the belief that gentle

52:27

exercise in the morning actually

52:30

helps us to have better days.

52:33

So, so I'll wear this Rock

52:36

Fest. I started off with 20 pounds, which is

52:38

about 10% body weight for me. I

52:40

moved up to 40 pounds, which is about 20%

52:42

body weight for me. And

52:45

a lot of times I'm like walking with my kids, you

52:47

know, and I have a

52:49

stroller that I'm pushing. I got this military

52:52

grade Rock Fest on as I walked through

52:54

this neighborhood in Charleston, South Carolina, but

52:57

I come back, I'm a

52:59

little bit tired. I feel

53:01

amazing. And I have

53:03

far more productive days and I have much better

53:05

rest that night. All right.

53:07

Well, now that we're into the morning routine, let's get

53:10

into the nuances here. We

53:12

know you're walking with the Rock Fest, getting

53:14

that morning light, you're with the kids

53:16

out for a walk. Let's go

53:18

all the way back to when you wake up, what

53:20

time is it? And

53:23

then we can piece together, you

53:25

know, we talked about food before

53:27

coffee, bowel movement. Let's

53:29

get into the details. What does it look like right

53:32

through that morning for you? So what

53:34

I do is, first of all, let me say I, as

53:38

an author, I

53:40

have found that my best work is done in the morning.

53:43

And that may be specific to me, that may not

53:46

be everyone. But for me,

53:48

my time of intense focus and

53:50

productivity is starting early and

53:53

trying to get as much done by nine o'clock in the morning. So

53:57

I typically wake up somewhere in

53:59

the range of... between 5.30 and 6.30, somewhere

54:01

in there. Kind

54:05

of depends. Like if I'm watching football the night before, then it's

54:07

closer to 6.30. I

54:09

get up and I roll

54:12

downstairs and I've actually changed

54:14

my routine. I used to be immediately

54:16

coffee, boom. I've

54:19

now switched. I do two mugs

54:21

of warm water. And

54:24

the first one, I will

54:26

actually add a splash of apple cider vinegar too.

54:31

All right. The second one, less

54:34

warm, closer to broom temperature. I

54:37

actually add my pre-biotic too. So,

54:41

and you know this

54:43

Jesse, but the listeners may not. I started

54:45

a company called 38 Terra. We

54:47

launched in January, but this is a project that I've been

54:49

working on since 2021. And

54:53

I developed basically the pre-biotic supplement

54:57

that I always wished that I could have had

54:59

for my patients. So

55:01

going back 10 years, I've

55:03

treated thousands of people with fiber supplements,

55:07

but I always felt like they could be

55:09

better. I also was frustrated because they were

55:11

not transparent. Like, you know, who knows what's

55:13

in these things. No one's testing it and

55:15

showing you the report. So

55:18

basically that's what motivated me to start this company.

55:21

And so our first product is called

55:23

Daily Microbiome Nutrition or DMN. And

55:25

it includes a mix of fiber resistant

55:27

starch and multiple polyphenols from

55:30

seven different plant-based ingredients. And

55:33

this is sort of like a multivitamin for my gut.

55:37

So, and I do that to start my day. Because

55:39

if you think about some of these things that we're talking

55:41

about, I'm of the belief that

55:44

our gut microbes are central to

55:46

us having good days, central

55:49

to that healthy morning bowel movement, central

55:51

to serotonin production. And

55:54

so from my perspective, then it makes sense to

55:56

start the day by feeding them. So

55:59

my first is... I use a warm glass of water with

56:01

some apple cider vinegar, which by the way, I count that

56:03

as a fermented food. My second

56:05

is my another large glass of water,

56:07

more room temperature with my pre-biotic in

56:09

it. And then from that point forward,

56:11

it's been about a half hour, I'm ready

56:14

to move into coffee. So

56:16

I typically will wait about 30 minutes in

56:18

terms of my coffee. Now, in

56:20

terms of getting my walk in, it depends a

56:23

little bit. Sometimes I go straight to work and

56:25

I start writing because it's dark outside. I

56:29

always get my morning sunlight by nine o'clock. But

56:35

on other days, I will like basically

56:37

wake up, have my two mugs of

56:40

water, and then I'll go and do my family thing,

56:43

take my walk outside with

56:45

a ruck vest, or, and I could go grab it

56:47

if you want me to, because right

56:49

over there, I have a, what's

56:54

the proper language for it? It's like

56:56

a weighted baton or a weighted mallet. All

57:00

right. Why don't you grab it if it's right there for the

57:02

viewers? Yeah, yeah, let me grab it, huh? I'll be right back. All

57:05

right, so I'm of the belief, and I mentioned

57:07

this, that I think that a little bit of

57:09

morning exercise is really good for us. And

57:13

when I say this, I don't mean a,

57:16

like you could do a vigorous workout, and I don't think

57:19

there's anything wrong with that. But I'm

57:21

just talking about light exercise kind of to get myself,

57:23

to turn my brain on, turn my muscles on, get

57:25

my heart rate up a little bit. And

57:29

if you do that, you will definitely find that

57:31

your energy levels increase. So

57:33

I have this, now this

57:35

right here weighs 10 pounds, and

57:38

it's made of steel, and it's got, what I'm describing here

57:40

for people who are not seeing us on YouTube, you should

57:42

just go to the YouTube video, it's a lot easier. But

57:46

basically, it's like a

57:48

weighted baton. It's

57:51

something on the order of like, maybe

57:53

16 inches. So

57:56

I'm trying to think in terms of centimeters, maybe 30 centimeters.

57:59

Kind of like a. Yeah, like

58:02

a small baseball bat. It weighs 10 pounds.

58:04

All right, so this is four kilos, roughly,

58:06

maybe a little bit more, four and a

58:09

half kilos. And

58:11

so the thing about it has this grip.

58:13

So you can actually grip it pretty good.

58:16

And what I do with this is I'll

58:18

go for a walk and

58:20

I just swing this thing all over the place. My

58:22

neighbors probably think I'm a weirdo and

58:25

I don't care. Okay. You

58:27

totally see you in the bathroom humming later. Exactly.

58:30

Or squatting in the woods.

58:33

Exactly. They haven't seen anything

58:35

yet. Yeah, exactly.

58:37

So anyway, but I just, I

58:40

take this thing and the

58:42

beauty of it is that it's not

58:45

10 pounds. Again, I'm a

58:47

big guy. I weigh about 200 pounds. It's

58:51

not like pushing my muscles to an extreme.

58:54

But when I take a walk for a

58:56

half hour and I

58:58

swing this all over the place, including

59:00

over my head, or

59:02

just doing curls with it or

59:05

doing funny, turning torso

59:07

type exercises with it as I walk, I

59:12

come back. I feel fantastic. And then

59:15

hop in the

59:17

shower and I'm ready to start my

59:19

day. So this is an

59:21

alternative. I don't typically do this at the same time as

59:23

my Ruck Fest, but it's

59:25

like one or the other. But I'll just

59:28

work this in. So this is part of my

59:30

morning routine as well. Show

59:33

and tell. All right. So you get back from

59:35

the walk. What happens at

59:37

that point? If you're still in the work mode, you'll

59:39

get back to doing writing? Yeah.

59:42

So I try to do my writing from

59:44

somewhere in the range of six to nine in the

59:46

morning. And

59:49

then a lot of times during the week, I'll

59:51

do that and then I'll do a family walk at nine

59:53

o'clock. And now

59:55

I realize because I'm self-employed, my hours

59:58

are quite different than most people who

1:00:00

work at nine to five. But, and

1:00:03

then I may get

1:00:06

back to work, but I think that the question

1:00:08

that you may be curious about is like, so

1:00:10

I haven't mentioned any food yet. All

1:00:13

right, so how do I

1:00:15

approach that? And the answer to

1:00:18

that is that I enjoy

1:00:20

following a time restricted eating lifestyle.

1:00:25

And some people, and I don't

1:00:27

know how you feel about this, I

1:00:29

feel like maybe I need to let this go,

1:00:31

but it's

1:00:34

a little bit of a pet peeve to me

1:00:36

to call intermittent fasting the same thing as time restricted

1:00:38

eating, because it's not intermittent,

1:00:40

it's a lifestyle, it's every day. Whereas

1:00:44

to me, intermittent fasting is more like, hey,

1:00:47

like two days a week, I'm gonna fast

1:00:49

completely. So,

1:00:51

and the way that

1:00:53

I approach this is that if

1:00:55

I had one, like we've been

1:00:57

talking about the morning, okay? But

1:01:00

when it comes to actually timing of our meals, if

1:01:03

I had one request to the listeners at home

1:01:05

as a foundation to start with, it

1:01:08

would be please just eat your food during

1:01:10

daylight hours. Try

1:01:13

to avoid eating at night. I understand the Northern latitudes

1:01:15

in the wintertime, like up where you live, Jesse, it

1:01:18

gets, I know, it gets cold, it

1:01:20

gets dark around four o'clock during some of

1:01:22

those days in December. But try

1:01:26

to eat during daylight hours, try to

1:01:29

avoid eating after 8 p.m. if you

1:01:31

can, try to avoid evening alcohol, evening

1:01:33

snacks, things like this. Our

1:01:36

body actually, it's interesting, you can eat the exact

1:01:38

same food at different times of the day and

1:01:40

get different results. So

1:01:43

even though I'm sitting here and talking about how

1:01:45

I basically don't eat breakfast most days, let

1:01:48

me be completely honest, the science actually doesn't support

1:01:50

that. We're

1:01:53

actually better shifting our food and

1:01:56

front loading it in the day. So

1:01:58

that means eating earlier in the day. day and then

1:02:01

ending our eating later in the

1:02:03

day. But

1:02:06

for me and just sort of the cadence

1:02:08

of our family, we don't have breakfast together,

1:02:10

but we have dinner together every night. It's

1:02:12

our family tradition. So

1:02:15

because I want to enjoy that family dinner at

1:02:17

around 6 p.m. every night, what

1:02:19

I do is I typically have

1:02:21

this eating window that exists between

1:02:24

on most days, 12 noon

1:02:26

or 1 in the afternoon and

1:02:28

then dinner time, which is at 6 p.m. And

1:02:32

that's my eating window for time

1:02:34

restricted eating. That's quite tight. Is

1:02:36

that new for you? Well,

1:02:38

I'm not religiously or emotionally attached

1:02:40

to it. I mean, I certainly

1:02:42

have times where I have avocado

1:02:44

toast on the weekend or something

1:02:46

like that. It's

1:02:50

probably a little bit tighter than I did the last time

1:02:53

that you and I got together. And

1:02:55

let me say

1:02:58

a few quick things on time restricted eating. So

1:03:00

I feel like it's controversial sometimes.

1:03:04

People are like, well, it's not everything it's hyped up to be.

1:03:06

Okay, let me tell you what it is. Let

1:03:08

me tell you what it is. Number one,

1:03:10

it's a way for you to control the time of

1:03:12

day that you actually eat. And

1:03:15

that does make a difference. So again,

1:03:17

that you could eat the exact same meal earlier in

1:03:19

the day and it would give

1:03:21

you better butcher control. And the

1:03:23

worst time is late at night. All

1:03:25

right, number two, it's a

1:03:27

way for us to have better control over how many

1:03:30

calories we take in. There

1:03:34

actually is clear cut science at

1:03:37

this point to show that for

1:03:39

people who are overweight, which let's

1:03:41

just be honest in North America, this is

1:03:44

a huge percentage of people. For

1:03:47

people who are overweight, calorie

1:03:49

restriction actually results

1:03:52

in longevity. There

1:03:56

are benefits to this and we need

1:03:58

to figure out. ways

1:04:01

to make it work for ourselves. This

1:04:05

is why the GLP-1 drugs are so popular right

1:04:07

now because it helps people to reduce

1:04:09

how much they eat. But

1:04:12

for many people, a time

1:04:14

restricted eating approach actually can help them to

1:04:16

facilitate that as well. And

1:04:19

there have been studies that show that in the

1:04:21

real world when people follow a time restricted eating

1:04:24

approach, they reduce their caloric intake. The

1:04:27

last thing, I do think that there's value

1:04:29

to resting the gut for a period of

1:04:31

time and time restricted eating helps to facilitate

1:04:33

that. There are

1:04:35

studies with 12 hours of gut rest.

1:04:37

So 12 hours would be like, if

1:04:39

hypothetically you stopped eating at 7pm, then

1:04:42

you don't eat again until at least 7am. That

1:04:46

is the starting point. And

1:04:49

if we go beyond 12 hours of gut rest,

1:04:51

and we get into 14 hours of gut rest,

1:04:53

we start to actually see an intensification of some

1:04:56

of those benefits. There was

1:04:58

a study where people had increased gut

1:05:00

diversity through this

1:05:03

time restricted eating pattern and

1:05:06

less markers of inflammation. So

1:05:10

is this the solution to all of our problems?

1:05:12

Is this the one thing

1:05:14

that we need to do? No, it's

1:05:16

not. But it can be inserted into

1:05:18

a healthy lifestyle pattern and I think

1:05:20

provide some benefit for people. Hey

1:05:23

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up on the latest episodes

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without the ads. Okay,

1:05:52

it's official, we are very much

1:05:54

in the final sprint to election

1:05:57

day and face it between debates

1:05:59

polling releases even court appearances, it

1:06:01

can feel exhausting, even impossible, to

1:06:03

keep up with. I'm Brad

1:06:05

Milkey. I'm the host of Start Here,

1:06:08

the daily podcast from ABC News. Every

1:06:10

morning, my team and I get you caught

1:06:12

up on the day's news in a quick,

1:06:14

straightforward way that's easy to understand, with just

1:06:16

enough context so you can listen, get it,

1:06:19

and go on with your day. So,

1:06:21

kickstart your morning. Start smart

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with Start Here and ABC

1:06:26

News, because staying informed shouldn't

1:06:28

feel overwhelming. You

1:06:31

mentioned maybe having avocado toast on

1:06:34

the weekend. I want to get

1:06:36

to what you break your fast during the week with,

1:06:38

but first, let's come back to

1:06:41

those two cups of water in the morning. First

1:06:44

one with apple cider vinegar, you mentioned it's

1:06:46

a fermented food. What

1:06:48

other benefits or are there other benefits you're trying

1:06:50

to get with that? Well,

1:06:53

hydration is a big one. So,

1:06:57

I want to

1:06:59

challenge the listeners to

1:07:03

pay closer attention to

1:07:05

their own signs of dehydration in the

1:07:07

morning. One

1:07:10

of them is the color of your urine. So

1:07:12

I've already got you looking in the toilet bowl at your

1:07:14

poop. Now I'm going to have you take a look

1:07:16

at your urine as well. And

1:07:18

when it's a deep, dark yellow, you

1:07:21

know that your body is trying to

1:07:23

hold onto water and it's

1:07:25

concentrating urine because it's

1:07:27

basically in dehydration mode.

1:07:30

Not that you are dehydrated per se,

1:07:32

but it is in dehydration mode, meaning that it's

1:07:34

protecting its water supply. But

1:07:39

also, pay attention to your

1:07:41

lips. So

1:07:43

I find that this is where it shows up the quickest.

1:07:46

When people are dehydrated, their lips start to

1:07:48

get chapped real quick. And

1:07:51

when they're adequately hydrated, you have nice, lush,

1:07:53

juicy lips. When

1:07:55

you wake up in the morning, pay attention to where that's at. Have

1:07:58

a couple glasses of water and see how changes. You

1:08:01

will see the difference. The

1:08:03

problem is that all

1:08:06

of us go through a period of time where

1:08:08

not only are we fasting, we're also not drinking

1:08:10

any water at night. We

1:08:12

get up most people a couple of times to

1:08:14

go to the bathroom, go number one, and

1:08:18

then you wake up in the morning in a dehydrated state

1:08:20

and you

1:08:22

don't drink water. You

1:08:25

do other stuff or you drink coffee

1:08:27

and coffee has a diuretic effect and

1:08:29

makes you pee even more. So

1:08:32

I think that there is value

1:08:34

to starting our day

1:08:37

with water. I think that there's value to

1:08:39

continuing to consume water throughout the day and

1:08:42

the value includes it turning on your

1:08:45

brain, getting more sharp and focused, more

1:08:47

energized, turning on your

1:08:49

kidneys. Kidneys,

1:08:52

by the way, allow your body to

1:08:54

excrete toxins and

1:08:56

turning on your gut so that you can

1:08:58

have not only a healthy gut but

1:09:00

a good, healthy morning bowel movement. So

1:09:03

these are some of the benefits that I personally have

1:09:05

found with morning hydration. Honing in

1:09:07

on the apple cider vinegar piece though,

1:09:09

other than the fact that it's a

1:09:11

fermented food, is

1:09:14

there certain other benefits you're trying to get

1:09:16

from that? Because obviously, it's

1:09:18

important to you if that's the first thing you're

1:09:20

having in the morning and you only have two

1:09:22

drinks before your coffee and one of them includes

1:09:24

the ACV. It's one

1:09:26

of those things online, you hear all these different

1:09:29

wives' tales, just like coconut oil, that

1:09:32

it's like a miracle cure for everything

1:09:34

ACV. Is there anything

1:09:36

specific with that other than the fact that

1:09:38

it's a fermented food that you're trying to

1:09:40

get? I'm most,

1:09:42

from a purely scientific perspective,

1:09:46

I am most attached to the fact that it's

1:09:48

a fermented food. And of course, I'm talking about

1:09:50

raw apple cider vinegar with the mother. The mother

1:09:52

is basically the fact that

1:09:54

there's the presence of life microbes. We

1:09:58

consume a far too sterile diet, far

1:10:00

too sterile. We think about

1:10:02

the foods that exist in our supermarket that can

1:10:04

sit on a shelf for

1:10:07

12 to 24 months before

1:10:09

we even purchase them to bring them home. And

1:10:12

they're completely unchanged. How

1:10:15

is it possible that they don't get

1:10:17

moldy? And nothing goes wrong

1:10:19

with them. The reason why

1:10:21

is because what the food industry calls

1:10:23

preservatives, I would call antibiotics. It's

1:10:27

designed to kill microbes. And

1:10:29

that's the reason why something is able to

1:10:31

stay in that sort of shape over

1:10:35

time. So with

1:10:37

60% of the American diet being ultra processed

1:10:40

foods and sadly in our children, 70%,

1:10:43

we're on a far too sterile diet. And if we

1:10:45

look back at food traditions from not that long ago,

1:10:49

every culture from across the world had,

1:10:51

as a celebrated part of their food

1:10:53

traditions, fermented foods. So

1:10:55

I really think that we need to bring them back. There

1:10:57

was a study out of Stanford that

1:11:01

was published, I think two years ago. And

1:11:03

we may have talked about the last time that you and I

1:11:05

were together because I think it came out around that time. And

1:11:09

basically what they did, and this was to me

1:11:11

a fascinating study. They

1:11:13

had people ramp up their fermented food intake. And

1:11:16

eight weeks later, their

1:11:18

gut microbiome was more diverse and

1:11:22

measures of inflammation were reduced. That's

1:11:25

the effect that we want. And

1:11:29

this is something that again, our food

1:11:31

system will not feed us this type

1:11:33

of food unless we

1:11:35

make an intentional play to

1:11:38

introduce fermented foods into our diet. So

1:11:41

the ACV is

1:11:44

a very small, but

1:11:46

yet quite clear example of

1:11:49

me introducing fermented foods into their diet. Now

1:11:51

going beyond this, just intuitively,

1:11:54

what I come back to again for a moment is

1:11:56

this approach of how do you feel? When

1:12:00

I drink water that

1:12:02

has a splash of ACV or

1:12:06

a squeeze of lemon, I

1:12:09

like the way I feel. And

1:12:11

it does feel a little bit different than when

1:12:13

I drink water in isolation. And I'm a big

1:12:15

believer in water and isolation. But

1:12:18

if you feel better with a splash of ACV or

1:12:21

a squeeze of lemon, I'm here to tell

1:12:23

you that don't ignore the way that you feel. I

1:12:25

think that's important. Is this

1:12:27

water filtered or? So we are

1:12:30

in some ways blessed that we have

1:12:32

clean water. Yet

1:12:35

simultaneously, there's not a

1:12:37

requirement that our water

1:12:40

needs to contain not just

1:12:43

contaminants, but also the things that are intentionally

1:12:45

put into the water to, you

1:12:48

know, chlorine and fluoride and

1:12:50

things like this. So

1:12:55

we use a reverse osmosis filter in

1:12:57

our home. And

1:13:00

the reverse osmosis filter from my

1:13:02

perspective is number one

1:13:04

worth every penny. And

1:13:07

I would encourage people to think about

1:13:09

it this way. Is there

1:13:11

a large upfront investment? Yes. And

1:13:15

if you use it and you replace

1:13:18

other beverages with

1:13:20

clean water that comes from the RO filter,

1:13:24

you will save money for sure. And

1:13:26

it probably won't take you too long to do that. So,

1:13:30

and then our filter has a special thing where

1:13:32

it basically, the one downside of RO is

1:13:35

that it is so effective at

1:13:37

removing everything from the

1:13:39

water that there's literally nothing in

1:13:42

there, including the minerals. So

1:13:44

we have a special filter that actually replaces those

1:13:46

minerals. So like magnesium and zinc and things like

1:13:48

this get placed back into the water. Potassium.

1:13:52

Cool. I'm a big fan of RO and that's what

1:13:54

we used to. Amazing. So

1:13:57

second beverage, your...

1:14:00

supplement goes in water. I'm

1:14:02

curious why you take that on

1:14:05

basically an empty stomach versus

1:14:07

waiting till when you break your fast, including

1:14:10

it then. Is there any specific advantages

1:14:13

while your stomach's empty having that food go

1:14:15

to the microbiome? Okay,

1:14:17

so let

1:14:20

me be the first to say there's no

1:14:23

study on the timing from a circadian

1:14:25

rhythm perspective of fiber supplements, which is

1:14:28

kind of what we're talking about here.

1:14:30

I mean, our daily

1:14:32

microbiome nutrition includes fiber and resistant starch

1:14:34

and polyphenols, and that's what makes it

1:14:36

unique. But there's no study

1:14:39

that shows us what is the perfect ideal time

1:14:41

to use it. Here's what I

1:14:43

know. I know that,

1:14:45

number one, I want to activate

1:14:47

my gut in the morning. I

1:14:50

want my gut to be functional. I

1:14:53

want to have a healthy bowel movement, and

1:14:56

I want it to be producing the serotonin we've

1:14:58

talked about. And

1:15:00

so this is the reason

1:15:02

why I choose to time my supplement for

1:15:05

the morning, because basically as

1:15:07

I'm starting my day, I'm turning on my

1:15:09

gut at the exact same time. Now

1:15:12

I can stay in a fasted state

1:15:15

while using the supplement, because

1:15:18

it doesn't contain sugar or

1:15:20

the amount of natural sugar that comes

1:15:22

from, for example, kiwi and mango, is

1:15:25

so small that you will not

1:15:27

be breaking your fast. So it basically supports

1:15:29

a ketogenic or a low carb lifestyle. But

1:15:33

it also simultaneously supports the

1:15:35

gut microbes. That's

1:15:37

the reason why I choose that time. The

1:15:40

second thing is, to me,

1:15:42

it's about consistency. So

1:15:46

there's research that's been coming

1:15:48

out, Jesse, that indicates that, interestingly,

1:15:52

coffee, of

1:15:54

all the foods in the Western diet,

1:15:58

is the food that seems to have the strongest impact. and

1:16:00

pack it on the microbiome. Now,

1:16:02

is this because coffee is the

1:16:04

healthiest beverage or even healthiest food

1:16:07

that exists? No,

1:16:10

absolutely not. It's good, it's good. Don't

1:16:12

get me wrong. It has polyphenols. It

1:16:15

actually has some soluble fiber. But

1:16:19

the thing about coffee is it's the one thing

1:16:21

that when you're a coffee drinker, you

1:16:23

do it every day. You're consistent.

1:16:27

And it's a snowball effect. The

1:16:29

thing that you do with the microbiome consistently,

1:16:32

it will start with a small effect on that

1:16:34

snowball. That snowball is a pebble and

1:16:36

then a marble and then a tennis

1:16:38

ball and then a softball and then

1:16:41

a basketball. And eventually it's that big

1:16:43

snowball careening powerfully down the side of

1:16:45

a mountain. This is how

1:16:47

small choices can have big

1:16:49

profound effects on our health. And

1:16:53

it's true within the microbiome. The

1:16:55

microbiome thrives off of

1:16:57

consistency because of the momentum that

1:17:00

you can build. So because

1:17:03

this supplement is, and a person could in

1:17:05

theory replace this with a different supplement, it

1:17:07

just wouldn't be the same. But because

1:17:11

the supplement includes the things that our

1:17:13

gut basically needs, the fiber, the resistance

1:17:15

starches and the polyphenols, by

1:17:18

taking it at that time on a

1:17:20

consistent daily basis, it's helping

1:17:22

me to basically get that momentum that I'm looking

1:17:24

for with the microbiome. That makes

1:17:26

sense. And you've

1:17:28

mentioned a couple of times now the fact that there's a few different

1:17:31

foods in there, polyphenols, resistance

1:17:33

starch and fiber, which

1:17:36

we could further break down into soluble,

1:17:38

insoluble. Talk

1:17:40

about the differences there.

1:17:43

And if there's any overlap as

1:17:46

foods for

1:17:48

the microbiome. And why I wanna

1:17:50

get into that, if somebody's missing one of those, can they

1:17:52

make up for it in a different area? Or

1:17:54

do they need all those every day? Okay,

1:17:57

so I would start and

1:17:59

explain. Thank you for that question by

1:18:02

talking about my mindset as I was

1:18:05

formulating the supplement and the scientific justification

1:18:07

for this product. And then I want

1:18:09

to expand that to include nutrition because

1:18:11

to me, the main source

1:18:13

of these things actually should be our diet. It should

1:18:15

not be a supplement. So

1:18:20

what we know is that each

1:18:22

of these is a different class of

1:18:24

prebiotic. Prebiotic,

1:18:27

P-R-E, is food

1:18:29

for the microbiome. The

1:18:31

microbes actually metabolize it. They

1:18:34

break it down, transform it, it

1:18:37

becomes different. And then

1:18:39

the microbes grow as a result of

1:18:41

this. And they

1:18:43

typically will release something called postbiotics.

1:18:46

So in the postbiotics are

1:18:50

the chemicals produced by the microbiome that

1:18:52

have beneficial effects on our body. The

1:18:56

absolute classic postbiotic are

1:18:59

the short chain fatty acids, butyrate,

1:19:02

acetate, and propionate. And

1:19:05

we get those when the microbiome consumes

1:19:08

fiber, specifically and

1:19:10

typically soluble fiber.

1:19:14

Soluble fiber stops being

1:19:16

soluble fiber, microbes

1:19:18

grow, and they release these short

1:19:20

chain fatty acids that have effects right there on

1:19:22

the gut and also throughout the entire body, literally

1:19:24

all the way into our brain. Okay,

1:19:28

well, it turns out that fiber isn't

1:19:30

the only way to produce these short

1:19:32

chain fatty acids. It

1:19:35

turns out that resistant starch actually

1:19:38

allows us to produce as much or even

1:19:40

more. And

1:19:42

resistant starch is conceptually similar to soluble

1:19:45

fiber, but it's not fiber, it's starch.

1:19:48

But we call it resistant starch because we

1:19:50

don't have the enzymes to digest it. So

1:19:55

it arrives to the colon intact,

1:19:57

and then the microbes digest.

1:20:00

to produce short-chain fatty acids. The

1:20:04

third form of prebiotic are the

1:20:06

polyphenols. Polyphenols are

1:20:08

quite different than fiber and resistant

1:20:11

starch, and they don't

1:20:13

get directly turned into short-chain fatty acids. Instead,

1:20:17

polyphenols are these, you may hear

1:20:19

them described as antioxidant compounds. People

1:20:23

who talk about the benefits of wine, they're

1:20:25

talking about resveratrol. resveratrol is a

1:20:28

polyphenol. The colors in

1:20:30

our food, the reason why blueberries

1:20:32

are blue and cherries are red, and

1:20:36

orange is orange, is

1:20:39

because of polyphenols. They're responsible

1:20:41

for those colors. And

1:20:44

there are at least 8,000 unique

1:20:46

polyphenols that exist. They're

1:20:49

found in plant-based foods. And

1:20:51

the fascinating thing is that

1:20:54

our body does not absorb them, for the

1:20:56

most part. 90

1:20:58

to 95% of polyphenols will actually make

1:21:00

their way to the microbiome. And

1:21:04

then our microbes activate them.

1:21:08

And in activating, we get the benefits.

1:21:10

So when people talk about how great

1:21:12

resveratrol is, or cursitin,

1:21:14

or any other of these

1:21:16

class of chemicals, I

1:21:20

just want people to hear and understand the

1:21:23

reason why they're good is because

1:21:25

of the microbiome. So

1:21:29

what happens with polyphenols though, is

1:21:31

that they actually prime the microbiome.

1:21:34

The microbiome becomes shaped in a way,

1:21:36

because it does change the microbiome. The

1:21:39

microbiome in response to the polyphenols

1:21:41

gets shaped in a way where

1:21:43

it is designed to efficiently produce

1:21:46

short-chain fatty acids. So

1:21:48

when you combine these things, you're creating a

1:21:50

synergistic effect. The fiber

1:21:53

and the resistant starches will ultimately turn

1:21:55

into short-chain fatty acids. And

1:21:57

the polyphenols are priming the microbiome.

1:22:00

to basically efficiently do

1:22:04

that process and manufacture those short-chain fatty

1:22:06

acids. All right, so that's

1:22:08

the concept behind the supplement daily microbiome nutrition,

1:22:10

but let me zoom out. We

1:22:14

should not be getting most of our

1:22:16

fiber or resistant starch or polyphenols

1:22:18

from supplements. We should

1:22:20

get them in our diet. And

1:22:23

the way in which we do this is

1:22:25

quite simply, these are all plant-based nutrients. So

1:22:28

we get them by eating a diverse

1:22:30

range of plant-based foods, fruits,

1:22:32

vegetables, whole grains, seeds, nuts, and legumes.

1:22:35

And the variety is the key because,

1:22:38

and I believe that you and I discussed this

1:22:40

back in our original episode, but I wanna bring

1:22:42

it forward again, because it's so important. We

1:22:45

talked about the power of fermented

1:22:47

food, and now I'm gonna add

1:22:49

another concept for nutrition, which

1:22:51

is the power of variety in our diet.

1:22:55

Different foods have different nutrients

1:22:57

that can support and nurture

1:22:59

a healthier gut microbiome. So

1:23:02

we need to add more variety to our diet. So

1:23:04

I think the way that I

1:23:06

approach these general issues, Jesse, is I

1:23:08

want to optimize my diet. I'm

1:23:10

teaching some of the concepts that I personally follow

1:23:12

in my life, some of the concepts that

1:23:14

I have shared with patients through the

1:23:17

years. I support that

1:23:19

with a healthy lifestyle that includes

1:23:21

these circadian things and good sleep

1:23:23

and exercise and human

1:23:26

connection. And then

1:23:28

there's this place where, to me, there's

1:23:30

a role where supplements allow me to achieve things that

1:23:32

I would not be able to achieve with my diet

1:23:35

and my lifestyle alone. I can take it to a

1:23:37

higher level. Sticking

1:23:39

with the diet piece, we know

1:23:41

there's these three different categories now of

1:23:43

food for the microbiome. You

1:23:46

mentioned the key is diversity, which is

1:23:49

your golden rule, eating diverse. In

1:23:54

a practical sense, though, if somebody, because

1:23:57

left there, that's pretty arbitrary. how

1:24:01

do we make sure on a

1:24:03

regular basis we're getting enough diversity

1:24:05

to get enough of each of

1:24:08

these three nutrients to

1:24:10

facilitate an optimal microbiome? Okay,

1:24:14

if you go

1:24:16

to your store and

1:24:18

you eat things that come in a package

1:24:22

from the middle of the store and it

1:24:24

says plant-based, that's

1:24:29

not the type of food that we're here talking about. That

1:24:32

is an ultra processed food and

1:24:34

they're just playing you with

1:24:37

their marketing strategy. What

1:24:40

I'm talking about is

1:24:42

a food where you don't need

1:24:44

an ingredient list. It's

1:24:47

just real and

1:24:49

I'm a big believer that there are many

1:24:51

forms of a healthy diet, not

1:24:53

just one. Much like you have

1:24:55

a unique microbiome and so do I and so does the

1:24:58

listener at home. There are many forms of a healthy diet

1:25:01

but I'm also of the belief that eating plants is

1:25:04

one of the core strategies

1:25:07

for supporting the microbiome and then

1:25:09

achieving optimal health. We

1:25:14

think about varieties of different plants within the

1:25:16

diet and to benchmark

1:25:18

this, in the

1:25:20

study that brought this concept forward for the first

1:25:22

time it was called the American Gut Project but

1:25:24

by the way it wasn't just Americans, it was

1:25:27

an international study. In

1:25:29

that study the researchers they asked the

1:25:31

question what is the most powerful thing

1:25:34

that a person can do in order to have a

1:25:36

healthier gut and by healthier gut I mean more diversity

1:25:41

within the gut and

1:25:43

the answer to the question was eat

1:25:45

30 different plants per week. That

1:25:49

was the key, 30 different plants per week.

1:25:52

Now what counts as a plan? All

1:25:55

fruit, all vegetables.

1:25:58

I want people to hear me. if

1:26:01

you're eating this way, your diet should not just

1:26:03

be those two things. And

1:26:05

it should not just be salads, all right?

1:26:08

Because whole grains and

1:26:11

legumes and seeds and nuts.

1:26:15

And I'm gonna throw mushrooms in there and

1:26:18

herbs and spices,

1:26:21

these all count. Now

1:26:23

our food system does not want you to

1:26:25

eat this way. Our

1:26:28

food system wants to consolidate into

1:26:30

monocrops. Wheat,

1:26:32

corn and soy, if they had their way, that's all

1:26:34

you would eat. If

1:26:37

I have my way, can

1:26:40

you consume some wheat, corn and soy? Sure, the healthy

1:26:42

kinds. But what I want you to

1:26:44

eat is I want you to walk

1:26:46

into your supermarket and think about, hey, what

1:26:49

am I gonna put into that pasta sauce? So it's

1:26:51

not just sauce. Hey,

1:26:53

if I'm making a bowl of soup or chili,

1:26:56

what can I throw in there? That's gonna add

1:26:58

more variety, right? If

1:27:01

I'm making a salad, what are

1:27:03

the things that I can throw in there? I

1:27:05

just want you to think about this when you're in the supermarket.

1:27:07

And then I want that to carry into the kitchen. And

1:27:11

then ultimately when you're at the plate, when you're

1:27:13

at the dinner table and you're building your plate,

1:27:17

diversity of plants, varieties of plants, how many can

1:27:19

you get in there? And a simple way to

1:27:21

do this, Jesse, from my perspective, and

1:27:24

this is something that I'll do with my kids is fun,

1:27:26

is we play a game and

1:27:29

we count plant points and

1:27:31

we'll throw a sheet of paper up on the refrigerator and

1:27:34

you get one point for every single plant in

1:27:36

your meal and you see who can

1:27:38

get the most. So this is

1:27:40

the way that you approach this. And I don't want anyone

1:27:43

to feel bad if they're less than 30. I

1:27:46

probably started off 10 years ago eating six.

1:27:50

So I just want you to

1:27:52

see this direction and start to walk in this

1:27:54

direction. All right, so

1:27:56

it's obvious your enthusiasm for plants and

1:27:58

getting the diversity. on a regular basis.

1:28:02

From the other end of the spectrum, how

1:28:05

do you look at plant toxins? Oxalates,

1:28:08

phytates, lectins like

1:28:10

gluten, are you

1:28:12

mindful of those and limiting

1:28:15

them, or are there certain ones that you don't

1:28:17

consume? It's

1:28:20

a good question. I

1:28:23

tend to not share a tremendous

1:28:25

concern with those things. I

1:28:30

think that sometimes the way that

1:28:32

our body feels is misunderstood.

1:28:36

Let me unpack that for a

1:28:38

quick moment. When

1:28:40

people eat beans,

1:28:46

if you have underlying gut issues, especially

1:28:48

if you have constipation, you

1:28:51

may not feel well. There's

1:28:54

a clear-cut reason for this, which

1:28:57

is that when you start

1:28:59

increasing these high fiber, high

1:29:02

resistance starch, high polyphenol foods, which by the

1:29:04

way, beans and whole grains, those are the

1:29:06

most dense when it comes to fiber and

1:29:08

resistance starches, when you

1:29:11

start increasing them, you don't

1:29:13

have the ability to digest that

1:29:15

yourself. You

1:29:18

are 100% reliant on your microbiome to do

1:29:20

that for you. People

1:29:22

that have not been eating those foods,

1:29:24

it is hard to change and start

1:29:26

eating them. It is hard. The

1:29:30

reason why is because your gut microbes

1:29:33

are not designed to do this implicitly.

1:29:35

They have to be taught. You

1:29:39

have to make the decision that you want to

1:29:41

train your gut in

1:29:43

order to process and digest these foods

1:29:45

that perhaps you have not been eating.

1:29:47

If you haven't been eating them, you

1:29:50

shouldn't feel bad. That's 95% of

1:29:52

people out there. It's the vast

1:29:54

majority of people. But

1:29:57

if you make the decision after listening to this podcast, you

1:29:59

know what? I want to give this a try

1:30:02

and I want to just see

1:30:04

where it goes and follow these ideas that Dr. B

1:30:06

has. I

1:30:08

would encourage you please don't make a

1:30:10

radical change. Please

1:30:13

don't go and eat five bean chili

1:30:15

because I said that it was healthy.

1:30:18

I want you to start low and go slow.

1:30:21

That's the key. So when you

1:30:23

introduce these foods, I want to use a

1:30:25

framework that's conceptually similar to exercise, which

1:30:28

is that your gut is capable of doing whatever it

1:30:31

is that you've been training it to do. And

1:30:34

if you haven't been

1:30:36

eating beans, then that is

1:30:39

conceptually similar to not

1:30:42

being a runner and getting

1:30:44

started on a training program. And

1:30:47

when you do that and you try to make

1:30:49

yourself into a runner, you can do this, but

1:30:53

you have to start with short runs

1:30:55

and the amount that your body can handle. And then you have

1:30:57

to recover from that. And then when you're recovered, you run a little bit

1:31:00

further. The

1:31:05

same is true with our diet. If we have food like these plant-based foods

1:31:09

that people may struggle to process and digest, it's

1:31:12

because your gut microbiome is not adapted to

1:31:14

them because you haven't been eating this way. And so when

1:31:16

you introduce them, you have to, much

1:31:19

like exercise, much like going to the gym, start

1:31:21

with an amount that you can handle, which may not be

1:31:23

much, and then

1:31:25

allow your body to adapt. And then

1:31:28

you can slowly increase over time. That's the

1:31:30

way that I would approach that. One

1:31:32

of the challenges with including more plants in

1:31:34

the diet is generally a

1:31:37

lot of plant foods are higher in carbohydrates.

1:31:41

And in today's world in the

1:31:43

West, there is

1:31:45

a great majority of people that are metabolically

1:31:48

unhealthy. I think the number is up to

1:31:50

93%. Yeah. Disturbingly

1:31:53

high. Yeah. For people that are in

1:31:56

that boat or somewhere

1:31:58

along the continuum of heading that way

1:32:00

to being metabolically

1:32:02

unhealthy, insulin resistance, prediabetic, whatever you

1:32:04

want to call it, I

1:32:08

could see how including more carbs,

1:32:11

spiking blood glucose, spiking

1:32:13

insulin, and

1:32:16

continuing to push people down that

1:32:18

path towards metabolic dysfunction could be

1:32:21

problematic. So I'm just

1:32:23

curious your thoughts looking at

1:32:25

including more plants, which is

1:32:28

going to lead to more carbs from

1:32:30

that lens. Yeah. Well,

1:32:33

first of all, I appreciate the opportunity to talk

1:32:35

about that. There's

1:32:38

nuance to this topic. And

1:32:40

so it's not so simple. And I think that the

1:32:44

challenge is that

1:32:46

there are many people. This

1:32:48

is not just you. This is

1:32:51

not just the listeners at home. This

1:32:53

is also many nutritional scientists who

1:32:56

like to focus on macronutrients, carbs,

1:32:58

protein, and

1:33:01

fat. But the truth of how

1:33:03

our body responds to our diet

1:33:05

is far more complicated than those

1:33:07

specific cylinders of nutrients.

1:33:10

And there are good versions and bad versions

1:33:13

of each. And

1:33:15

I think that we would all agree there's good fats

1:33:18

and there's bad fats. And if I

1:33:20

were to sit here and say that fat is bad,

1:33:22

I would be a bad nutritionist or I would be

1:33:24

a bad doctor. And

1:33:26

if I were to say that protein is inherently bad,

1:33:29

again, the same would be true. Nor

1:33:32

would I say that carbs are inherently good. So

1:33:35

allow me to make a distinction because

1:33:38

there's good carbs and bad carbs. And

1:33:40

the good carbs are fiber and

1:33:43

resistant starches. Those

1:33:45

are carbs. And they're

1:33:47

not so quite easily spiking our blood sugar. In

1:33:51

fact, they're quite the opposite. And

1:33:53

if we look at metabolic health, those

1:33:57

particular carbs actually are

1:34:00

the dominant drivers towards metabolic

1:34:02

health. And

1:34:05

I would actually classify that they are more

1:34:07

powerful than fat

1:34:09

or the absence of carbs in

1:34:12

terms of how much they can

1:34:15

do to improve metabolic health. But

1:34:18

refined carbohydrates are a different story. And

1:34:22

specifically sugar, but

1:34:25

I think that it's also fair to hold flour

1:34:28

accountable. And

1:34:31

there is no doubt that when

1:34:33

we consume foods that include a

1:34:35

lot of refined sugar and flour,

1:34:38

we're gonna spike our blood sugar. And

1:34:41

you can add fiber to

1:34:43

the formulation. And again, like

1:34:45

there are ultra processed foods where they are doing

1:34:47

this. And I still would

1:34:49

not advocate for that food. It

1:34:51

might even have five grams of fiber. I still

1:34:53

would not advocate for that food because it's an

1:34:55

ultra processed food that's filled up with these refined

1:34:57

carbohydrates. When

1:34:59

we eat real food, real

1:35:01

food, just

1:35:04

to take this sort of complex nuance topic and try

1:35:06

to distill it down to something that's much more simple.

1:35:09

Real food contains a combination of carbohydrates,

1:35:11

proteins, and fat. Yes,

1:35:14

plant-based foods definitely have more carbohydrates.

1:35:19

If you have insulin resistance, you

1:35:21

can avoid if you have type two diabetes

1:35:23

or insulin resistance, non-alcoholic fatty liver disease, you

1:35:27

can lower your blood sugar by avoiding

1:35:29

carbs in general. But

1:35:32

are you actually reversing the metabolic

1:35:34

problem? Or are you just lowering

1:35:36

your blood sugar by avoiding the carbs? To

1:35:40

me, it's a bit similar to if

1:35:42

I hurt my knee, if

1:35:45

I lay on the couch, I don't feel pain in my

1:35:47

knee. But

1:35:50

ultimately, I have to heal the knee. And

1:35:53

I would prefer to heal the knee and

1:35:55

get back to a functional state where

1:35:57

I can run and jump and play basketball and do the

1:35:59

thing. that I love. And

1:36:02

when it comes to our nutrition, I would rather

1:36:04

help the people heal

1:36:07

their metabolic disease so

1:36:10

they can consume healthy food and

1:36:13

not have to worry that whether blood sugar is

1:36:15

going to do this or do that. Again,

1:36:18

not to say that there should be no concern about

1:36:20

our blood sugar. It's more so

1:36:22

to say, let's heal the root of the issue. Let's

1:36:24

make the engine run the way

1:36:26

it's supposed to. And I think

1:36:29

that fiber and resistant starch

1:36:31

are an important part of that. Even

1:36:34

in high glycemic foods, Jesse, like

1:36:36

berries, people

1:36:39

who consume more berries actually

1:36:42

reduce their likelihood of developing type 2

1:36:44

diabetes. And

1:36:46

the reason why is because even though there's some

1:36:48

natural sugar in there, you have

1:36:50

the fiber and you have the polyphenols which

1:36:53

have beneficial effects. Let

1:36:57

me say this just to be totally

1:36:59

clear. I do think that you can be

1:37:01

completely healthy on a low carb ketogenic diet

1:37:04

as to be properly formulated. I

1:37:06

also think you can be completely healthy on

1:37:09

a high carb plant-based diet,

1:37:12

high carb not meaning 70%. High

1:37:15

carb meaning 55% because that's what

1:37:17

exists in nature when we

1:37:19

eat real food. So I'm here

1:37:21

to advocate for people eating real food and finding

1:37:24

what works. You

1:37:26

touched on the fact that when we're

1:37:28

having certain fiber,

1:37:30

resistant starch, polyphenols,

1:37:34

that the gut microbiome is going

1:37:36

to take those. And

1:37:38

it sounded like, and here's where I want you to come in,

1:37:41

form certain chemicals that

1:37:45

are going to help us regain metabolic health.

1:37:48

So what's the physiology there? Let's talk

1:37:50

about what's

1:37:52

getting fed, what's getting produced,

1:37:55

and how that contributes to metabolic health.

1:37:58

All right. Well, let's start with something very

1:38:00

basic and I think quite timely

1:38:02

right now with everything happening in health and

1:38:05

wellness, which

1:38:07

is our body's natural satiety

1:38:10

mechanisms, our

1:38:12

body's natural hunger mechanisms. When

1:38:15

we existed in nature for

1:38:18

millions of years, there

1:38:21

was no way to hack that. You

1:38:24

lived in famine and

1:38:27

you got hungry and that hunger motivated

1:38:29

you to find a source of energy

1:38:31

for your body and

1:38:34

you ate until you satiated yourself

1:38:36

and then you stopped. The

1:38:39

problem that we now have is

1:38:41

that we have workarounds that

1:38:43

create hunger confusion. I

1:38:46

would challenge people and I'd be curious, Jesse, I

1:38:48

want to hear from you. Have you ever had

1:38:50

a moment where

1:38:53

you found yourself eating and you

1:38:55

didn't even understand why? You're just

1:38:57

eating. I'm

1:39:01

sure I've at least been enjoying

1:39:04

something, feel full, because of the

1:39:06

flavor and crunch

1:39:10

and whatnot, continue eating it beyond

1:39:12

what I need. Yeah. They've

1:39:14

actually shown that with ultra processed foods,

1:39:17

it actually creates hunger confusion. You

1:39:20

don't know whether you're hungry or you're not hungry.

1:39:22

Yeah, like chimneys and ice cream come to mind,

1:39:24

things like that. Yeah. You

1:39:26

don't naturally have, there's not necessarily

1:39:29

that burning in your

1:39:31

stomach to say, I need food. You're

1:39:33

just like, oh, I'm just eating this and I

1:39:35

don't even know why I'm eating this. I'm not even hungry, but

1:39:37

I'm eating it anyway. We

1:39:40

do know that the ultra processed foods result

1:39:42

in overeating. All right, let's

1:39:44

get back to the basics here. So

1:39:46

the question was about metabolic health. The hottest thing

1:39:49

in metabolic health right now are the GOP one

1:39:51

agonists, like

1:39:54

Ozempic, Wagovie. There's

1:39:57

a place where these drugs

1:39:59

are important and helpful to some people who really

1:40:01

need them. Don't get me wrong. But

1:40:05

what are we doing from a

1:40:07

cultural perspective? When

1:40:09

we don't have any form

1:40:12

of dietary or lifestyle intervention

1:40:14

on any level, we

1:40:17

allow our food system to dominate us,

1:40:20

creating addictive foods that make us confused

1:40:22

about whether we're hungry or not hungry

1:40:24

that result in us overeating, resulting

1:40:27

in metabolic problems because of the

1:40:29

calorie excess that we consume. And

1:40:33

then we solve that issue with

1:40:35

a drug that basically bypasses

1:40:38

our normal hormonal mechanisms for

1:40:40

satiety and instead is

1:40:42

designed to make us feel perpetually full. That's what

1:40:44

we're doing right now. If

1:40:48

we got back to a simpler

1:40:50

approach of eating real food through

1:40:52

our gut microbiome, fiber

1:40:55

results in the production of short chain fatty

1:40:57

acids. Short chain

1:40:59

fatty acids stimulate the cells

1:41:01

lining the intestines to release

1:41:03

the incretin hormones, including

1:41:06

GLP1 and peptide YY.

1:41:10

Those hormones naturally exist and

1:41:12

we're just not eating food that basically

1:41:14

activates them. Now,

1:41:17

when it comes to other aspects of metabolic

1:41:19

health, the metabolism to me is

1:41:21

like this, how do you describe the metabolism? It's

1:41:24

a little tricky. It's

1:41:26

the engine of the car. Energy

1:41:29

goes in and the energy gets

1:41:31

transformed into something else and

1:41:34

the car gasoline becomes movement.

1:41:36

And we want an efficient

1:41:39

engine that's running

1:41:41

clean. And

1:41:44

in order to do that, we really need our

1:41:46

gut microbiome to support us. And

1:41:49

this has become clear through a number

1:41:51

of different studies that include some of the work

1:41:53

that I've done and also things like people transplant

1:41:55

studies where they, for

1:41:57

example, Jesse took a group of young men. and

1:42:00

gave them, these young men, by the way,

1:42:02

had insulin resistance, metabolic

1:42:05

disease, and they gave

1:42:07

these young men a new microbiome. And

1:42:10

for a period of weeks, those

1:42:13

men experienced improvement in their blood sugar, even

1:42:15

though they did not change their diet. Based

1:42:19

upon the fecal transplant, the problem was

1:42:21

they didn't change their diet so that

1:42:24

microbiome that they received only lasted a

1:42:26

few weeks and

1:42:28

ultimately got replaced by their original microbiome because

1:42:30

they maintain the same diet and lifestyle. They

1:42:32

didn't make any changes. So

1:42:37

I can tell you that in the work that

1:42:39

we've done at ZOE, I mentioned earlier that ZOE

1:42:41

is the science and nutrition company that I'm the

1:42:43

US Medical Director. I

1:42:45

can tell you that in the work that we've done at

1:42:48

ZOE, we have research where we look at what

1:42:50

is the dominant predictor of your blood

1:42:52

sugar. And

1:42:55

in the top five is the microbiome. What

1:42:58

is the dominant predictor of your blood fat?

1:43:02

Once again, microbiome is there. What

1:43:05

is the dominant predictor of insulin release

1:43:08

after a meal? Microbiome

1:43:11

is right at the top. Like

1:43:13

I think number two. So

1:43:18

all of these things, our

1:43:20

metabolic health, ultimately

1:43:23

are connected back to

1:43:25

our microbiome. And one

1:43:27

of the keys to maintaining a healthy

1:43:30

metabolism includes energy

1:43:33

balance, which we get from satiety

1:43:35

hormones like GOP1 and peptide YY

1:43:38

and blood sugar and blood fat

1:43:40

balance, which is facilitated in

1:43:42

part by our gut microbiome and the

1:43:44

release of short-chain fatty acids. For

1:43:47

completeness, we've talked about extensively

1:43:51

the power plants to feed the microbiome.

1:43:54

What happens on a meat-only diet

1:43:56

or predominantly meat? Can

1:43:58

the microbiome feed on that? And

1:44:01

then because basically by going on a

1:44:03

diet like that, it's a type of

1:44:05

elimination diet, the next step would be

1:44:07

fasting. So what I

1:44:09

want to do is look at a couple of these more

1:44:11

extreme quote-unquote

1:44:14

metabolic states and

1:44:17

talk about what the

1:44:19

microbiome feeds on. Obviously, there's still a

1:44:21

microbiome there and

1:44:24

changes that happen. Yeah,

1:44:26

so these diets, I think that anytime, let

1:44:28

me start by saying this, and this is

1:44:30

not just exclusively talking about a meat only

1:44:33

diet. I would talk about extremes on both

1:44:35

ends, which is that

1:44:37

when we go on extreme elimination diets

1:44:39

of any variety, there's complexity

1:44:41

to that and there can be nutrients and

1:44:43

micronutrients that we miss as a result of

1:44:45

that. And that includes whether it's a vegan

1:44:48

diet or variations on a vegan

1:44:50

diet. Even if a person

1:44:52

were to go vegan, I am not a fan

1:44:54

of some of the vegan diets like a fruit

1:44:56

only, things like this. And the alternative would be

1:44:58

a meat only diet. And

1:45:00

clearly there are some limitations to that from

1:45:02

a nutritional perspective. So if

1:45:04

we're going to go in these directions, I definitely think that the

1:45:07

layperson should have the support of someone who

1:45:09

can give them guidance on

1:45:12

how to maintain the balance that they need acknowledging

1:45:15

that extreme eliminations reduce diversity within

1:45:17

our diet and as a result,

1:45:19

put us in a vulnerable position

1:45:22

for nutritional deficiencies. What

1:45:25

happens with the microbiome? We don't know. We don't

1:45:28

have a good study. I can provide

1:45:30

different theories and some of them are more supportive

1:45:32

and some of them are less supportive. I

1:45:35

will say this, beta hydroxybutyrate,

1:45:37

which is of course

1:45:39

of ketone, beta

1:45:43

hydroxybutyrate. These

1:45:45

are very similar actually from a chemical perspective.

1:45:49

So our body is actually designed, if

1:45:52

you think about this, our

1:45:55

body is designed to provide some very

1:45:57

good food. version

1:46:01

of short chain fatty acids or

1:46:04

something that activates those short

1:46:06

chain fatty acid receptors, whether

1:46:08

we are feasting or

1:46:11

in famine. This

1:46:13

is the reason why our metabolism flips into

1:46:16

burning fat to create ketones

1:46:18

and ketones include beta hydroxybutyrate.

1:46:22

Now the evidence indicates that beta

1:46:24

hydroxybutyrate is not a one-to-one substitute

1:46:26

for butyrate. Butyrate

1:46:28

is definitely more powerful than the beta

1:46:30

hydroxybutyrate, the ketone. But

1:46:34

I think that the ketones are

1:46:36

essential, not just for protecting

1:46:38

our brain, but the

1:46:40

ketones are also simultaneously essential for

1:46:43

protecting our gut within

1:46:45

fasted states, low-carb states.

1:46:48

So that to me is the part

1:46:51

of the potential benefit that exists. I

1:46:54

do believe that, so let me be

1:46:57

clear on one thing, these topics, they

1:47:00

can be quite nuanced. And

1:47:03

I present them in a way that's my best

1:47:05

way of trying to take complex topics and simplify.

1:47:09

But don't get me wrong, there

1:47:12

are people who their gut

1:47:15

needs a break. And

1:47:19

they rest the gut. And

1:47:21

during that time, the gut actually gets stronger. And

1:47:24

that actually puts them into a better position in

1:47:27

terms of their ability to then move forward. I've

1:47:32

never been one to advocate for

1:47:34

permanent dietary elimination. I've

1:47:38

always been of the belief that if you

1:47:40

eliminate, it should be on a temporary basis

1:47:42

with subsequent reintroduction. But

1:47:45

I am of the belief, I made the knee analogy

1:47:47

a moment ago. If you

1:47:49

hurt your knee and you lay on the couch

1:47:51

all day, you won't feel pain, but

1:47:53

you also won't be completely healing that knee. That's

1:47:57

true, but also some people when