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with the Hello Monday podcast.

0:27

We'll navigate career pivots. We'll

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0:32

Listen to Hello Monday with

0:34

me, Jesse Hemple, on the

0:36

LinkedIn Podcast Network,

0:39

or wherever you get

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your podcasts. LinkedIn

0:43

Presents. What if you

0:46

could improve your mental

0:48

health by improving your

0:50

gut health? I'm Mora

0:52

Arons Mealy and this

0:54

is the anxious achiever,

0:57

the show that looks

0:59

at the intersection

1:02

of mental health, leadership

1:04

and work, and how

1:07

we can do them all

1:09

better. Physical ailments

1:11

are absolutely

1:13

linked to our mental

1:16

health. We all know this.

1:18

But there's one trend in particular.

1:21

I feel like I've been noticing

1:23

anecdotally. It's something we've talked about

1:25

on the show before. But it's the

1:27

idea that a whole lot

1:30

of high achievers out there,

1:32

people I talk to every

1:34

day, seem to not just

1:36

have anxiety, but also digestive

1:38

issues, especially irritable bowel syndrome

1:40

or IBS. Saturday Night Live

1:42

in its 50th anniversary Extravagansa

1:44

even went so far as

1:46

to make a video about

1:48

the fact that, as they

1:50

say, all performers on S&L,

1:52

comedy legends that are household

1:54

names, have anxiety. and IBS.

1:56

According to the American College of

1:58

Gastro... enterology, 10 to 15% of

2:01

Americans might suffer from IBS. And

2:03

our guest today says that number

2:05

is really probably much higher. Dr.

2:08

Will Bolsoitz is a gastroentorologist and

2:10

gut health expert, and he is

2:12

the founder of 38 terra, and

2:15

he's here to shed light on

2:17

all the ways we haven't realized

2:19

that our gut and our mental

2:22

health are connected. This, y'all, it's

2:24

a workplace issue. It's a leadership

2:27

issue. It's an issue that especially.

2:29

If you're in charge of people

2:31

or if you're in HR and

2:33

in charge of people's well-beings, should

2:36

be on your radar. And it

2:38

might be already, because it's really

2:40

common. Enjoy my conversation with

2:42

Dr. Will. Can you just share

2:45

at a very high level how gut

2:47

health and mental health and stress

2:49

are all associated? I would go

2:51

so far as to say that

2:54

throughout my career, my greatest moments

2:56

as a medical doctor have not

2:58

been... changing a person's diet,

3:00

getting them to consume more fiber.

3:02

In fact, I would actually argue

3:05

that my greatest moments as a

3:07

doctor have been when I've brought

3:09

a person's attention to this

3:11

space, because the opportunity for

3:14

healing is intensely powerful.

3:16

And in my mind, the visual that

3:18

I have for like what this

3:20

looks like is I've had many people

3:22

throughout my career that they would

3:24

come to me perhaps after my

3:26

books came out and said, I've done

3:28

everything that you're saying. I followed

3:31

the meal plan, right? I'm exercising,

3:33

I'm sleeping, I'm doing all the stuff,

3:35

and I'm not getting better. And

3:37

that person to me is like a

3:40

rocket that's trying to take off, but

3:42

it's chained to the ground. And if you

3:44

can break that chain, it's unbelievable to

3:46

see what happened. And I think

3:49

that many of us, myself included,

3:51

deal with things that are on

3:53

this issue on some level, and

3:55

it's different for different people. to

3:57

answer your question as sort of

3:59

an interest. introductory explanation, what we're

4:02

really talking about here is the

4:04

gut brain connection. And the realization

4:06

that yes, we may study science

4:08

as realms of specialization, but that's

4:10

not the way that the body

4:12

works. And in the body, everything

4:15

is interconnected. And there's

4:17

the realization that the things that

4:19

are happening in our gut for reasons

4:21

that I'm more than happy to explain

4:24

and unpack are impacting what's

4:26

happening in your brain, which includes

4:28

your mood. and your cognitive function,

4:30

meaning like your ability to

4:32

perform complex neurologic tasks during

4:35

the day, your endurance. Let's

4:37

just pause on that for a

4:39

second, because I think that's huge.

4:41

So you're not only saying it's

4:43

affecting your mood, your emotional health,

4:46

it's actually affecting your performance, your

4:48

cognitive abilities. 100% and the people

4:50

that you're describing, let's put aside

4:52

for the moment the idea of

4:54

some sort of diagnosable illness. And

4:56

let's just talk about high performers.

4:58

which is that if you want your

5:00

brain to perform at optimal

5:03

function, which means smart, fast,

5:05

have a great memory, being able

5:07

to perform multiple different

5:10

tasks, and to sustain that

5:12

with endurance during the course

5:14

of a stressful day, you

5:16

absolutely need to get your gut

5:18

health into alignment as much

5:20

as possible. Because of the ways

5:22

in which the gut is

5:25

influencing those different processes. So

5:27

they may be separate. But they

5:29

are talking to each other literally right

5:31

now. And the things that are happening

5:33

in your gut are affecting what's happening

5:35

in your brain, and the things that

5:37

are happening in your brain are affecting

5:39

what's happening in your gut. To really

5:42

dumb this down for me, when I'm having

5:44

IBS, when things just aren't working,

5:46

what is my gut trying to tell my

5:48

brain? All right, so let's zoom in on

5:50

IBS as an example. It's a fascinating, this

5:52

is a fascinating condition, because

5:55

it's a syndrome. which basically means

5:57

to this day more than 40

5:59

years. since we started to see

6:01

this pattern emerging. We don't have

6:03

a diagnostic test. Like there's no

6:05

blood work, there's no CAT scan.

6:08

No, I've been through it myself.

6:10

Right. I had a colonoscopy though.

6:12

I think that was for my

6:14

insurance company mostly. Well, it's not

6:16

to say that was for my

6:18

insurance company mostly. Well, it's not

6:20

to say that you shouldn't do

6:22

colonoscopy. Like you need to make

6:24

sure. Yeah, that's a separate conversation,

6:26

but you've just exemplified why I'm

6:28

a big believer in cancer screening

6:30

and including colonoscopy as a part

6:33

of that. So we have this

6:35

like basic pattern of symptoms. This

6:37

is how we make the diagnosis

6:39

determined by what's called the Rome

6:41

criteria. Rome, R-O-M-E. And the backstory

6:43

to the Rome criteria is actually

6:45

this is my mentor at the

6:47

University of North Carolina, who's the

6:49

founder. of the Rome Foundation to

6:51

this day and they have I

6:53

think they're on their fourth version

6:55

of the book to bring people

6:58

up to date on how to

7:00

make the diagnosis of multiple different

7:02

digestive health conditions including your role

7:04

bowel syndrome. But basically if we're

7:06

to simplify IBS is this you

7:08

have to have abdominal discomfort and

7:10

you have to have a change

7:12

in your bowel habits. So it's

7:14

not just discomfort, it's not just

7:16

pain, it's also that you're somewhere

7:18

on the spectrum of diarrhea, constipation

7:20

or back and classically, people that

7:22

have IBS, their discomfort is remedied

7:25

by pooping. They feel better when

7:27

they go. All right, so this

7:29

is the classic pattern, and again,

7:31

different things can masquerade as this.

7:33

So you need to rule out,

7:35

you know, celiac disease and inflammatory

7:37

bowel disease and all these different

7:39

things. But at the end of

7:41

the day, this is what's going

7:43

on. Okay, so what's actually happening

7:45

in the body? Well, it's taking

7:47

us a long time to get

7:50

to this, but... Part of what's

7:52

happening here involves the microbiome. The

7:54

microbiome is struggling. And if you

7:56

were to look under the hood,

7:58

every single person that has earral

8:00

bowel syndrome has a damaged gut,

8:02

which we would call dysbiosis. That's

8:04

the language that we would use.

8:06

In part, the microbiome, when it's

8:08

struggling, that affects our health because

8:10

the microbes produce chemicals that affect

8:12

our gut barrier, our immune system,

8:14

the motility of our intestines, like

8:17

how our intestines move and process

8:19

and digest our food. and affect

8:21

nerves. We have this thing that

8:23

people refer to as the second

8:25

brain. By the way, I would

8:27

argue it's the first brain. We

8:29

can talk about that if you

8:31

want to, and we also call

8:33

this the enteric nervous system. So

8:35

the second brain or the enteric

8:37

nervous system. Well, this is the

8:39

nerves that are involved with your

8:42

intestines, which are something on the

8:44

order of 20 to 25 feet

8:46

long, and there's 500 million nerves.

8:48

what you would find in your

8:50

spinal cord. So your brain has

8:52

more nerves, but that's the only

8:54

organ in the body that has

8:56

more nerves than your gut. And

8:58

these 500 million nerves are constantly

9:00

feeling and sensing, and the job

9:02

of a nerve is to receive

9:04

information and transmit. And so it's

9:06

receiving information from deep inside of

9:09

you. And the problem is that

9:11

they can become dysfunctional like any

9:13

other organ in the body. And

9:15

when it's dysfunctional, you develop something

9:17

that we would describe as hypersensitivity.

9:19

Which means that things that should

9:21

not trigger you to feel pain.

9:23

It will trigger you to feel

9:25

pain. And then information gets relayed

9:27

up to the brain and then

9:29

you say. I gotta go. I

9:31

gotta go, right? And in essence,

9:34

here's the package of symptoms. Disfunctional

9:36

gut microbiome, which is affecting gut

9:38

motility because gut motility is affected.

9:40

Now we have either diarrheal constipation

9:42

or both. And simultaneously you have

9:44

developed what we call visceral hypersensitivity,

9:46

which means 500 million nerves are

9:48

not functioning the way that they're

9:50

supposed to, and you're feeling things

9:52

that make you feel unwelcome. And

9:54

that's a real thing, by the

9:56

way. I'm not in any way

9:58

trying to make it sound like

10:01

the body is making this up.

10:03

It's not. It's just that the

10:05

brain and the nerves are not

10:07

functioning the way they're supposed to,

10:09

so you're hypersensitive. In short, like

10:11

this is actually the underpinning, like

10:13

this is, I just basically gave

10:15

you the class on what every

10:17

guest neurologist in America should know

10:19

about the way in which we

10:21

manifest this condition that we don't

10:23

have a diagnostic test for. Why.

10:26

have a diagnostic for 500 million

10:28

nerves and you can't have a

10:30

diagnostic for gut motility, and you

10:32

can't have a diagnostic for the

10:34

gut microbiome, that's reliable enough. So

10:36

this is the issue, but then

10:38

it affects the brain because, and

10:40

we can get into all of

10:42

this, but it affects the brain,

10:44

but it affects the brain, but

10:46

it affects the brain through a

10:48

number of channels, because these things

10:50

are not functioning the way they're

10:53

supposed to. I got my copy

10:55

of the health beat from Harvard

10:57

Medical School yesterday, which can contribute.

10:59

to chronic inflammation, and I'm

11:02

assuming a lot of these

11:04

features. So they're saying that

11:06

your psychosocial life might actually

11:08

affect your bacteria? A hundred

11:10

percent. There's no doubt about

11:12

this in my mind, yet

11:15

the science emerges and over

11:17

time catches up with observations

11:19

that every single one of

11:21

us has already seen with

11:23

our own eyes, which is

11:25

We need each other. And

11:28

there's a word that I'm

11:30

a bit attached to. And

11:32

that is connection. Because as

11:34

humans, you have to understand

11:36

where we came from, that

11:38

we can't change. It's hardwired

11:41

into us. We came from

11:43

a tribe. And that tribe

11:45

offered us protection and survival.

11:47

So we became very attached

11:49

to having that tribe. if

11:51

we were to go back

11:53

10,000 years. was not money

11:56

in your bank account. It

11:58

was the size of your

12:00

family and the size of

12:02

your tribe and the number

12:04

of connections that you had.

12:06

And you can't knock that

12:09

out of us as much

12:11

as society changes and culture

12:13

changes. We may want to

12:15

knock it out of us.

12:17

We can't. And so we

12:19

may become fixated on new

12:22

things like the size of

12:24

our bank account or our

12:26

home or our car and

12:28

these types of things. And

12:30

that does not actually foster

12:32

connection and make you feel

12:35

safer and supported and comfortable.

12:37

I would also argue that

12:39

there's cultural aspects that we

12:41

have embraced, such as individualism.

12:43

It's not just money, it's

12:45

also individualism to say that

12:48

I was raised with a

12:50

belief, and I would not

12:52

say this was necessarily the

12:54

belief of my parents trying

12:56

to instil this on me.

12:58

I would say that this

13:01

was the culture that I

13:03

was raised in. And I

13:05

assume you were a high

13:07

performer, you were good at

13:09

school, all those things? Yeah,

13:11

I'm the type A that

13:14

you described. And I can't

13:16

change that, that's who I

13:18

am. But I was raised

13:20

within a culture that says

13:22

that success. is not just

13:24

the bank account. Success is

13:27

that you have separated from

13:29

your parents and are independent

13:31

and own a home, and

13:33

within that home you are

13:35

separate. And if you are

13:37

truly successful, then that home

13:40

is so big that everyone

13:42

has their own room. And

13:44

I think I would imagine

13:46

that the listeners can relate

13:48

to what I'm describing. And

13:51

everything that I've just described,

13:53

if you actually think about

13:55

it, is pulling you away

13:57

from human connection. Right? We

13:59

should. be multi-generational. We should

14:02

be sharing tight spaces. We

14:04

should not view ourselves as

14:06

succeeding or failing based upon

14:08

independence because actually the opposite

14:10

is true, that again success

14:12

is defined by your connections.

14:14

So I would make the

14:17

argument that our emotional health

14:19

is highly contingent on these

14:21

particular things that unfortunately we

14:23

actually are not being intentional

14:25

about. I want to share

14:27

something, I think my husband

14:29

would be okay, but I

14:31

will say that this time

14:34

when I went to the

14:36

doctor and I had just

14:38

horrible IBS, it was a

14:40

really confusing time because I

14:42

was so skinny and I

14:44

got all this feedback of

14:46

like, you look great. And

14:48

I was like, I feel

14:51

awful, which is confusing, but

14:53

very true in our society.

14:55

But very true in our

14:57

society. But I think that

14:59

looking back it happened at

15:01

a time that my marriage

15:03

was really in a rocky

15:05

place. That fundamental connection in

15:08

my life, my best friend,

15:10

my husband of almost 20

15:12

years, and I were really

15:14

not in a great place.

15:16

And when we got better,

15:18

I got better. Yeah. First

15:20

of all, I'm very grateful

15:23

that you shared that. and

15:25

want to acknowledge that there's courage

15:27

involved in sharing our own story

15:30

because it's personal and many times

15:32

emotionally charged. And I think that

15:34

what I would say to the

15:36

listeners at home is that how

15:39

does this apply to your own

15:41

life? And ask the question. Is

15:43

there something, by the way, I

15:45

want to preface this by saying

15:47

that life is not defined by

15:50

trauma. We're not passive victims

15:52

on a journey through life that

15:54

there is love and human connection

15:56

and opportunities and a lot of

15:59

beauty that comes in that but

16:01

there can be things along the

16:03

way that can deeply affect our

16:05

soul in places that are not

16:07

necessarily physically visible. It can be

16:09

within our non-conscious minds or sort

16:12

of our core self, but you

16:14

can think of it as bodily

16:16

injury even though I'm not describing

16:18

it in a physical way, I'm

16:20

describing it in a, you know,

16:22

the non-conscious mind alternative place. Yeah,

16:25

it is bodily injury that needs

16:27

to be healed. So not everything.

16:29

that makes us uncomfortable is causing

16:31

this level of injury. But there

16:33

can be things that do exist

16:36

within our life that do cause

16:38

this level of injury. And if

16:40

we ignore them, which most of

16:42

the time that's the path that

16:44

we choose because they're painful, don't

16:46

want to touch an open wound.

16:49

If we ignore them, then they

16:51

fester, and they don't heal. And

16:53

this is getting back to my

16:55

analogy of the rocket ship that's

16:57

chained down, I'm describing the chain.

16:59

And breaking the chain means identifying

17:02

that this exists. So when you

17:04

say I'm not a psychiatrist or

17:06

a psychologist or a mental health

17:08

professional, I'm a gastronorologist, so the

17:10

way that I approach this is

17:12

that I am helping my patients

17:15

to acknowledge that this exists. That's

17:17

my goal. And then the next

17:19

step is to say I want

17:21

to make it better. And to

17:23

find the help that you need

17:26

in order to need in order

17:28

to make it better. accomplish that.

17:30

And I feel like there's many

17:32

dimensions to what help looks like.

17:34

Part of it is helping ourselves

17:36

to forgive on some things, right?

17:39

But it's not always that easy.

17:41

Many times we need outside assistance

17:43

from people that are trained health

17:45

professionals, so we turn to them.

17:47

And there should be no shame

17:49

or stigma with that. We should

17:52

want the people in this world,

17:54

all of them, to heal those

17:56

wounds and to find better health.

17:58

And the amazing thing about it

18:00

is I said that this is

18:02

not a physical thing. manifests in

18:05

a physical way. So when we

18:07

heal the things that are afflicting

18:09

us within the core self or

18:11

the non-conscious mind, when we heal

18:13

those things, we can manifest physical

18:15

health as a result because it's

18:18

no longer holding us back. And

18:20

by the way, I am a

18:22

telepathic medical doctor and I am

18:24

also a very, very big believer

18:26

in science and this may sound

18:29

very woo-woo. And I'm telling you.

18:31

that this is not, and depending

18:33

on how much time you want

18:35

to spend, I could dig into

18:37

the physiology that involves a hormone

18:39

called corticotropin releasing hormone or CRH,

18:42

that explains why this is happening.

18:44

It's our stress hormone. And the

18:46

issue with when someone has something

18:48

like this that's happening, this sort

18:50

of deeper emotional wound, is that

18:52

we're activating our stress response perpetually.

18:56

And therefore we're not able to

18:58

get ourselves into a place of

19:00

comfort and safety, because we never

19:02

actually, we may not be able

19:04

to acknowledge this, because again, it

19:06

may be not in our conscious

19:08

mind, but we're not able to

19:10

feel safe and comfortable, because we

19:12

constantly feel threatened because of this

19:14

thing. Well, and right, there's a

19:16

whole emerging field of chronic pain

19:18

science that is a little bit

19:20

similar, that when we never feel

19:23

safe. our body

19:25

creates pain, right? Yes, and

19:27

actually what you've just described

19:29

we can see in the

19:31

gut because we're talking about

19:33

hypersensitivity of these nerves, 500

19:35

million nerves, and those nerves

19:38

are part of what makes

19:40

them sensitive is inflammation. And

19:42

chronic inflammation affects the functionality

19:44

of many parts of our

19:46

body, including our nerves and

19:48

how we receive that sensory

19:51

information that can include discomfort

19:53

or pain. But it's important

19:55

to see what's happening. there,

19:57

which is that inflammation is

19:59

activation of the immune system.

20:01

If we're going to really

20:03

simplify it, it's just activation

20:06

of the immune system. It's

20:08

a bunch of cells sending

20:10

out the fire truck, right?

20:12

Sending out the fire truck

20:14

and the police and all

20:16

these different things, all these

20:19

different units, and maybe the

20:21

Army and the National Guard,

20:23

in response to a threat.

20:25

And when the threat is

20:27

real, such as an infection,

20:29

or a cancer cell, Absolutely,

20:31

you want to send in

20:34

those units and get it

20:36

cleaned up. Right? That's why

20:38

we developed inflammation. The problem

20:40

that we have in the

20:42

modern world is a threat

20:44

that's not even there. And

20:46

we're just sending them out

20:49

for the sake of sending

20:51

them out. And that has

20:53

consequences. And there's many ways

20:55

in which that inflammation can

20:57

manifest with consequences. That affects

20:59

pain in the way that

21:02

you've described. But I would

21:04

also make the argument that

21:06

it affects our brain and

21:08

brain function, something called neuroinformation.

21:10

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the next big idea. I'm Rufus

22:00

Griskem and every week I sit

22:02

down with the world's leading thinkers

22:04

for in-depth conversations that will help

22:07

you live work and play smarter.

22:09

Follow the next big idea wherever

22:11

you get your podcasts. One of

22:13

the things I love I found

22:15

you through Zoe that I love

22:18

about Zoe and I'll give Zoe

22:20

a free plug here is that

22:22

Zoe applies science. to things that

22:24

we know in our hearts, but

22:26

have often been told, is woo-woo.

22:28

Although I'm very pro-woo, but like,

22:31

I think it's such an, you

22:33

all are such an unusual group

22:35

of scientists in that you give

22:37

us permission to know what we

22:39

know in a way, which I

22:42

love. Well, I think that there

22:44

is a search that we have

22:46

for answers. Why is this happening?

22:48

to claim that it's genetic is

22:50

first of all not true and

22:52

really diminishes it because then it

22:55

turns us into hey you were

22:57

born this way and despite everything

22:59

in your life and no matter

23:01

what you did this was inevitable.

23:03

When you say it's not genetic

23:06

do you mean gut problems? So

23:08

when I say that it's not

23:10

genetic and thank you for allowing

23:12

me to expand on that a

23:14

little bit because they're I mean

23:16

they're clearly are certain conditions like

23:19

don't get me wrong. Cystic fibrosis

23:21

is a genetic health condition. If

23:23

you don't have the gene, you

23:25

can't develop that condition. But the

23:27

vast majority of health conditions, the

23:30

vast majority, there are genes that

23:32

may predispose and they increase the

23:34

risk a very small percentage. And

23:36

that whether or not we develop

23:38

heart disease and cancer and a

23:40

stroke and diabetes, that's not predetermined

23:43

at birth. It's based upon... the

23:45

multiple factors within our life that

23:47

include our diet, our lifestyle, and

23:49

the factors that we're discussing with

23:51

a greater amount of attention here

23:54

today, including mental health and emotional

23:56

health and spiritual health. I think

23:58

that all those things are extremely

24:00

important and not to be diminished.

24:02

With Zoe, I guess let me

24:04

just say real quick more hope

24:07

you don't mind that our founder

24:09

is Professor Tim Specter and he's

24:11

one of the most published scientists

24:13

on the planet. I mean, it's

24:15

staggering to look at his all

24:18

the papers that he's published over

24:20

a thousand in the most elite

24:22

medical journals. But really where this

24:24

comes from is that Tim was

24:26

studying genetics back in the 90s.

24:28

in twins. And far too often

24:31

he found that people would have

24:33

identical genetics and different risks for

24:35

disease. And he was searching for

24:37

an understanding because he's a scientist.

24:39

And where that search led him

24:42

was into the gut microbiome. And

24:44

when you open up, this is

24:46

the same thing, by the way,

24:48

and on some level, I'm just

24:50

a few years younger than Tim,

24:52

but... In the same way, in

24:55

a parallel journey, I didn't know

24:57

who he was back in 2013,

24:59

2014, but I myself was discovering

25:01

and gesterology that gut microbiome is

25:03

an important part of the story

25:06

of these people that are walking

25:08

through these doors. And so when

25:10

you get into this, what you

25:12

discover is, okay, well, what are

25:14

the levers that I can pull?

25:16

And the answer is that there's

25:19

many, but food is perhaps the

25:21

dominant one. I want

25:23

to get into that because, but

25:25

I want to, I want to

25:27

go through for our audience, this

25:30

is a show about work, I

25:32

want to talk about food, I

25:34

want to talk about your plant-based,

25:37

fiber, heavy approach. We've talked a

25:39

lot about emotional, psychosocial, mental, spiritual

25:41

health, which is a huge piece.

25:44

Many people right now and especially

25:46

people who listen to my show

25:48

are unemployed and they're not happily

25:50

unemployed. They've been let go. they

25:53

are looking for jobs, the job

25:55

market is rough. In my anecdotal

25:57

experience, when you are unemployed and

26:00

you don't want to be and

26:02

you have financial insecurity and everything

26:04

that comes along with it, your

26:07

gut becomes a mess. They can't

26:09

get hired tomorrow. What can they

26:11

do? It's a valid question. And

26:13

when we have some specific thing

26:16

that is holding us back, of

26:18

course, of course, we should address

26:20

that specific thing. And I would,

26:23

by the way, say, acknowledging this.

26:25

as you were saying, that something

26:27

in my mind of other examples

26:30

that can be very challenging, that

26:32

you don't necessarily have complete in

26:34

total control over. Like an example

26:36

would be in fertility, right, is

26:39

stressful for a young couple on

26:41

par with cancer therapy. That's what

26:43

research has shown. So we don't

26:46

have complete in total control over

26:48

these things. And so yes, we

26:50

should take steps to address those

26:53

issues. acknowledging that there's not any

26:55

simple and easy resolution. And simultaneously,

26:57

I'm of the belief that our

26:59

health is multifaceted and that taking

27:02

steps to address other aspects of

27:04

our health that are not the

27:06

one thing, rises the tide. I'm

27:09

of the belief that when we

27:11

do things that are going to

27:13

put our body into alignment, we

27:16

receive benefits. that may be the

27:18

result of like the direct goal

27:20

that you have. Hey, I want

27:23

to eat for better gut health.

27:25

What do I eat? Dr. B.

27:27

OK, let me tell you. But

27:29

by the way, this is not

27:32

just going to affect your gut

27:34

health. It's going to affect many

27:36

other aspects. For example, they have

27:39

shown that there are dietary patterns

27:41

that can be followed to improve

27:43

our mental health, that in the

27:46

Smiles trial, by Felice Jaka, from

27:48

Australia, Deacon University, that they put

27:50

people on a plant predominant Mediterranean

27:52

Mediterranean Mediterranean Mediterranean Mediterranean Mediterranean Mediterranean

27:55

Mediterranean that aligns with my views

27:57

and treated major depression. Aions. yes

28:00

we should address these different facets

28:02

of our health that I would

28:04

encourage and recommend and there's a

28:07

place for professional help in addition

28:09

to that these are not mutually

28:11

exclusive things where we do one

28:14

and we ignore the other. I'm

28:16

of the belief this is my

28:18

general approach to health as a

28:20

medical doctor that we should put

28:23

on the table all of the

28:25

things that can benefit us. and

28:28

then make choices about what we

28:31

are willing to do. Right? You're

28:33

not gonna do all of them.

28:35

Where can we start? What's most

28:37

valuable? What for you specifically is

28:40

actually going to stick? Right. Right,

28:42

because stuff isn't easy. No. It's

28:44

not. And we have, you know,

28:46

many different things that can hold

28:49

us back. I don't need to

28:51

create the laundry list here. We

28:53

all know what they are. Last

28:56

night I had a lot of

28:58

wine and ice cream. It's a

29:00

great start to. Sunday night, not

29:03

in a great place, feeling stressed.

29:05

Just a lot of wine and

29:07

ice cream. Yeah, well, and I

29:09

don't think that you should feel

29:12

bad about that. But I feel

29:14

bad in my body. Sure. Because

29:16

you're trying to cope with something

29:18

else that's bothering you. And

29:21

what you've just brought up, it

29:24

by the way, speaks to my

29:26

belief that we have to create

29:28

space to forgive ourselves and accept

29:30

imperfection. I never want to present

29:33

information making it sound like the

29:35

perfect diet exists or that anyone

29:37

eats that way. Because I sure

29:40

don't. You don't? What do you

29:42

eat? Talk us through a week

29:44

in your life. Well, my diet

29:47

has been an evolution. I

29:50

grew up in a family, this

29:52

is kind of, you know, leads

29:55

into some of the things for

29:57

me, personally. My parents were divorced.

30:00

We were poor. My mom

30:03

worked hard to provide for

30:05

us. And I came home

30:08

from school. And we cooked

30:10

hot dogs every day. And

30:12

I had a snack. And

30:15

that's what we ate. And

30:17

we loved them. And it

30:20

tasted great. And so grilled

30:22

hot dogs. And I thought

30:24

I was invincible. And I

30:27

continued to eat this way.

30:30

increasing intensity and rigors of my

30:32

educational and professional life as I

30:34

became pre-bad and went to medical

30:37

school and then was working at

30:39

a hospital in Chicago and then

30:41

was working at the University of

30:43

North Carolina and my gastrology fellowship.

30:46

And it caught up to me

30:48

and kind of reached a point

30:50

of crisis where I was unwell.

30:52

And the ironic thing is that,

30:55

again, joy and happiness are not

30:57

defined by individual accomplishments. You were

30:59

so accomplished, right? Yeah, and don't

31:01

get me wrong. I am, like,

31:04

I can't change who I am.

31:06

I'm a goal-oriented person. I line

31:08

up goals. I go after them.

31:10

The minute I've accomplished them, my

31:13

wife says to me, you should

31:15

celebrate. And I said, well, I'm

31:17

already moving on to the next

31:19

time. What's next? And that's just

31:22

who I am and it's okay

31:24

to embrace like we should love

31:26

and embrace who we are. But

31:29

to put people where I was,

31:31

we're talking about 15 years ago

31:33

and I was around 30 years

31:35

old and I was in a

31:38

dark place and it was weird

31:40

because if you looked at my

31:42

CV, you would think that I

31:44

was thriving because I was accomplishing

31:47

all of my goals and actually

31:49

more than that. Things that were

31:51

far beyond what I expected. I

31:53

won the highest award. at Northwestern

31:56

University among 60 doctors, all of

31:58

whom I thought were more brilliant

32:00

than me. And that's just an

32:02

example, but like these kinds of

32:05

things were happening. And yet, where

32:07

was I? Well, I was by

32:09

myself at home in a dark

32:11

room under a blanket. I wanted

32:14

to be left alone and I

32:16

was watching Bravo. All right. That's

32:18

where I was where I was

32:20

at. And I knew that I

32:23

wasn't well. I was 50 pounds

32:25

overweight. I was anxious. I was

32:27

depressed. I sincerely believe, like to

32:29

me, the world was coming at

32:32

me in shades of different gray.

32:34

And I also had insanely low

32:36

self-esteem, considering. And there were many

32:39

facets that I needed to heal.

32:41

And part of what I needed

32:43

to heal was... diet and lifestyle

32:45

based because I was eating an

32:48

inflammatory diet filled with fast food

32:50

multiple times a day. But I

32:52

don't think that that's just the

32:54

only thing that was going on

32:57

there. I do think that the

32:59

things that happened to me when

33:01

I was seven years old and

33:03

my parents got divorced and the

33:06

complex relationship that I had with

33:08

my dad from that point forward

33:10

that was actually my fault. That

33:12

was catching up to me because

33:15

I was trying to push it

33:17

down. and ignore it and say

33:19

it doesn't matter. And yet here

33:21

I was on this quest to

33:24

prove myself when all I needed

33:26

to do was accept that my

33:28

dad loved me. And so the

33:30

question that you asked me, I

33:33

apologize for getting divergent there, but

33:35

I love it and I can't

33:37

tell you knowing my audience as

33:40

I do, so many of them

33:42

are vibing with you right now.

33:44

But I think that the, you

33:46

know, the question that you asked

33:49

me is how do we cope

33:51

when we're going through tough times.

33:53

And my answer to this question

33:55

is that we should do the

33:58

things that we can control. and

34:00

make the most of them, right?

34:03

And then with the things that

34:05

we can't control, you should do

34:07

our best and make a plan,

34:09

but also create some space with

34:11

grace to understand that we're doing

34:14

our best and we can't control

34:16

everything. So your diet has evolved?

34:18

Yeah, my diet has evolved, yes.

34:20

What does a week look like?

34:22

If I were to put a

34:25

simple concept on the table, like

34:27

where I started was with smoothies.

34:29

Not smoothies in a pouch just

34:31

like literally pulling out I was

34:34

a single guy and I didn't

34:36

want to cook and I was

34:38

tired I was working hard and

34:40

So I pulled out a blender

34:42

and I started throwing stuff in

34:45

there That's it And it worked

34:47

it was a great starting point

34:49

for me and then where I've

34:51

evolved over the course of time

34:53

is that I have Incorporated plant-based

34:56

food into my diet and really

34:58

looked for, and this is like

35:00

by the way, constantly happening, where

35:02

I'm looking for new opportunities to

35:04

continue to tweak and optimize. So

35:07

when I did make these changes,

35:09

by the way, I had like

35:11

really pretty substantial health improvements that

35:13

happened very quickly. So I lost

35:16

50 pounds, blood pressure, high cholesterol

35:18

issues got better, my mood improved,

35:20

my confidence soared, a lot of

35:22

great things happened. By the way

35:24

that does also coincide with me

35:27

meeting my wife. Which happened first?

35:29

Actually I met my wife first.

35:31

Because a lot of what I'm

35:33

describing was me being ignorant to

35:35

my diet, which is bizarre because

35:38

I'm a medical doctor. You would

35:40

think like eating a fast food

35:42

diet. Yeah, like come on, like

35:44

eating a fast food diet isn't

35:46

that obvious? But actually

35:49

me and my wife and then

35:51

seeing the way that she ate,

35:53

which was her own way and

35:55

she never asked me to make

35:57

any changes, she just did her

36:00

thing. But observing that was like,

36:02

wow, that's incredible. So anyway, my

36:04

diet is built around plant-based foods.

36:06

On the weekends, I might have

36:08

avocado toast and cover it up

36:10

like on a sour dough and

36:13

cover it up with like accoutremence

36:15

that I enjoy, put some extra

36:17

virgin olive oil and some nice

36:19

balsamic vinegar on the toast. Delicious,

36:21

right? Or I might do a

36:24

yogurt. I might opt for a

36:26

plant-based yogurt, but to like there's

36:28

certainly nothing wrong with regular yogurt.

36:30

and take a yogurt and add

36:32

seeds and nuts and berries. It's

36:35

a delicious meal. It's very satiating.

36:37

And then lunchtime, I am a

36:39

big fan of like soups and

36:41

sandwiches and salads. So a kick

36:43

that I've been on recently and

36:45

I don't recommend this for people

36:48

that are new to this way

36:50

of eating, right? This is what

36:52

I've evolved into over the course

36:54

of like more than 10 years.

36:56

But I've been on like a

36:59

soup plus beans kick. where I

37:01

will take, for example, a ministrone

37:03

soup and I'll add an entire

37:05

can of chickpeas to it. And

37:07

if I eat that way 10

37:09

years ago, I would have been

37:12

folded over in pain because you

37:14

have to build your gut to

37:16

that point and get used to

37:18

this. I can eat three bunches

37:20

of kale, no problem. Nice. Which

37:23

I'm very proud of. Literally. 20

37:25

years of eating like insane amount

37:27

of fiber. I think once you

37:29

get used to eating a certain

37:31

way, like the one of the

37:34

important messages is that your gut

37:36

microbiome is adaptable. It's adapting. It's

37:38

adapting as we speak. The choices

37:40

that you make today are reflected

37:42

in your gut microbiome by tomorrow.

37:44

But that doesn't mean that you

37:47

should make radical change all at

37:49

once because that's not how you

37:51

allow good adaptation. Right like starting

37:53

low and easing into something. I

37:55

say start low and go slow

37:58

Starting low and easing into something

38:00

is the same thing that you

38:02

would do for exercise. Right? So

38:04

think of your gut as a

38:06

muscle. It can be trained, it

38:08

can be made stronger, it can

38:11

be more resilient, it can be

38:13

more powerful, more functional. And all

38:15

of that is possible, but there

38:17

is a program and a process.

38:19

It doesn't happen in one day.

38:22

You know, so anyway, soup and

38:24

chick peas for lunch, and then

38:26

for dinner, it varies like on

38:28

Tuesdays, we do tacos. And we

38:30

get, and basically the way we

38:32

do as a family is we

38:35

put out all the different accoutrements

38:37

and you choose what works for

38:39

you. Or we'll do like, I'm

38:41

a huge fan of anything in

38:43

a bowl. So like to me,

38:46

a nice foundation is to take

38:48

a bowl and have some sort

38:50

of whole grain like I like

38:52

faro, some sort of bean or

38:54

legume, and then just like, you

38:57

know, similar to doing the tacos.

38:59

Like if you're doing a burrito

39:01

bowl, or you're doing a Thai

39:03

bowl. whatever Korean bowl or Mediterranean

39:05

bowl. It's like get out the

39:07

stuff that goes with that and

39:10

then just throw in whatever it

39:12

is that makes you happy and

39:14

excited to eat. You don't eat

39:16

any meat? I don't eat meat.

39:18

You don't eat meat? You don't

39:21

eat meat? You don't eat meat?

39:23

You don't eat dairy. So from

39:25

a dairy perspective, like I'm not

39:27

super picky. I tend to favor

39:29

non-dary choices. soybeans and water, that's

39:31

it. So there's no like fillers

39:34

or any other stuff. So, but

39:36

like, these are choices that we

39:38

make, and I will fully acknowledge

39:40

that there are ethical motivations that

39:42

exist when it comes to my

39:45

consumption of meat. Like, I haven't

39:47

had red meat in a very

39:49

long time. But do I think

39:51

that you're unhealthy if you eat

39:53

that food? Absolutely not. My approach

39:56

is not. about or nothing. My

39:58

approach is about helping you. to

40:01

fill in the things that are

40:03

missing that will bring you better

40:05

health. And I've built my foundation

40:08

around fiber because fiber is the

40:10

essential nutrient for our gut microbes,

40:12

essential. They can't get by without

40:15

it. And 95% of Americans are

40:17

deficient in fiber. And I'm of

40:19

the belief that if we addressed

40:22

this one issue, that we would

40:24

be so much healthier. as a

40:26

society. But to be clear, I

40:29

actually hate dietary labels. I hate

40:31

them. Like vegan, vegetarian, omnivorebiscitarian, paleo,

40:33

keto, whatever. I hate it. Because

40:35

it distracts us from what really

40:38

matters, which is nutritional quality. Quality

40:40

is what matters. And when I

40:42

say quality, that's across food groups.

40:45

So there's junk beans and there's

40:47

good beans. There's junk dairy. and

40:49

there's good dairy, there's junk, I

40:52

mean, in every single category, junk

40:54

fat, good fat, junk carbs, good

40:56

carbs, fibres, a carb. There's junk

40:59

plant-based. I mean, some of my

41:01

son is a vegetarian and some

41:03

of the frozen meals are like,

41:06

just sodium, basically, you know. This

41:08

is why I don't like these

41:10

labels, because you walk in through

41:13

supermarket and there's a box that

41:15

says plant based on it, and

41:17

if I were there, I would

41:20

shred it, I would shred it.

41:22

Right. Right. Because I go out

41:24

there and I tell you to

41:27

eat more fiber and eat more

41:29

plants, and then what shows up

41:31

in your supermarket is that on

41:34

a box. And it's just a

41:36

manipulation. So really what it is,

41:38

is just get back to whole

41:41

foods. And if you do that,

41:43

whatever they are, you're definitely moving

41:45

in the right direction. I have

41:48

one last question for you, which

41:50

is of personal interest, and I

41:52

think will be of interest. And

41:55

this is just, I don't know

41:57

if this is an area of

41:59

expertise for you, so. I have

42:02

bipolar disorder and it has been

42:04

suggested to me many times to

42:06

try keto. I have tried keto

42:09

and it's really hard. It's to

42:11

me unsustainable and when I do

42:13

it I get so thin and

42:16

it's just like miserable and it's

42:18

expensive but then I feel guilty.

42:20

There does seem to be good

42:23

data also around even things like

42:25

Alzheimer's and I'm just curious how

42:27

you stand on mental health and

42:30

keto. What I care about above

42:32

all else is thriving, happy, healthy

42:34

people. That is my agenda. So

42:37

if a person were to say

42:39

to me, I'm thriving and doing

42:41

really well with whatever dietary pattern,

42:44

that's amazing. There's an interesting explanation

42:46

for what's happening with these types

42:48

of approaches of going keto. And

42:51

part of it is that it's

42:53

an excellent framework to eliminate unhealthy

42:55

refined carbohydrates. Like, sugar and flour,

42:58

right? This is an excellent framework

43:00

that people really quickly understand that

43:02

get it. And if you're successful,

43:05

which, by the way, I don't

43:07

think people are as often successful

43:09

with keto as they think they

43:12

are, unless they're being really serious

43:14

about it. I tried to eat

43:16

less than 30 grams of carbohydrates

43:19

for five weeks, six weeks, and

43:21

it was, I just couldn't anymore.

43:23

Yeah. And there's downsides to this,

43:26

right? Like that's a quite unnatural

43:28

approach, and our body does have,

43:30

like people who do ultra-vocarb diets,

43:32

they run into health issues frequently

43:35

when they continue with this, and

43:37

if you look out into the

43:39

world, you will see this, because

43:42

basically you deplete glycogen stores in

43:44

your liver, and there's a reason

43:46

why the body has this, right?

43:49

The body is designed for balance.

43:51

So the physiology, though, is a

43:53

bit interesting, so I want to

43:56

talk about that for a quick

43:58

moment, which is that. when you

44:00

do successfully achieve ketosis, which again

44:03

I I don't believe the majority

44:05

of people actually do. I think

44:07

the majority of people, what they

44:10

do is they get rid of

44:12

carbs, like sugar. But if you

44:14

do achieve ketosis, the classic ketone

44:17

is beta-hydroxy butyrate. And there's another

44:19

one called acetoacetate. And it turns

44:21

out that these ketones are activating

44:24

the same receptor that butyrate and

44:26

acetate activate. And butyrate and acetate

44:28

are produced. from fiber. Fiber comes

44:31

into contact with our gut microbes.

44:33

The microbes digest the fiber. Fiber

44:35

doesn't, like, some fiber does pass

44:38

through us, don't get me wrong,

44:40

but there's what we call prebiotic

44:42

fiber, that's food for our microbiome.

44:45

And fiber produces these, what we

44:47

call short chain fatty acids, butrate

44:49

and acetate. Well, 95% of America

44:52

is deficient in fiber. So they're

44:54

not actually providing the body with

44:56

what it needs. to produce butyrate

44:59

and acetate. And if in theory

45:01

you were to go on a

45:03

ketogenic diet and achieve ketosis, then

45:06

your body metabolically flips and it

45:08

produces betahydrexibuterate anacetoacetate, which activate the

45:10

same receptors, basically what I'm saying

45:13

is the body is telling you

45:15

that when you're eating that you

45:17

would benefit from the consumption of

45:20

fiber. And when you're starving, the

45:22

body use this as being so

45:24

important that during starvation mode, your

45:27

body will protect this by continuing

45:29

to provide. But the problem is

45:31

that beta hydroxy butery and acetate

45:34

are not as good or as

45:36

strong as the real thing, which

45:38

we get from fiber. So you're

45:41

partially activating it. So here's my

45:43

point. If you take the Western

45:45

diet, the standard American diet, and

45:48

you plug in a ketogenic diet,

45:50

and you actually achieve ketosis. I've

45:52

just defined for you the reason

45:55

why this may be beneficial. on

45:57

a number of different health levels,

45:59

including repairing and restoring the blood-brain

46:02

barrier, which is how we get

46:04

many of the benefits. But we

46:06

don't need to necessarily go that

46:09

route. In fact, we could provide

46:11

even more benefit to our body,

46:13

be healthier, and have a healthier

46:16

gut microbiome if we were to

46:18

actually just normalize our fiber consumption.

46:20

So that's my argument in favor

46:23

of that approach. That's

46:28

it for this episode of The Anxious

46:30

Achiever. The show is produced and edited

46:32

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46:35

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46:37

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