February 5, 2024 • 52 mins
When Kate Scarlata's health teetered during a precarious pregnancy, it was a wake-up call to the importance of nutrition and digestion for gut health and beyond. However, at the time of that pregnancy, very little science-based nutrition support was offered. In today's episode, Kate, along with Dr. Megan Riehl, will guide you through the complex world of the gut microbiome and its fascinating link to not just our physical health, but also, our mental well-being.
Welcome to The Gut Health Podcast. This episode highlights how and why Gut Health Matters!
From the foods that nourish our inner gut microbes to the undeniable brain-gut connection contributing to our emotions, we leave no stone unturned. We're also giving you a peek at the evolution of our own careers in healthcare, revealing how our individual journeys have enhanced our intention and compassion to help those struggling with GI challenges.
With the rise of psychological therapies in the management of GI conditions and the spotlight on diet's role in influencing our inner gut microbes and digestive symptoms, we're here to guide you through the maze of misinformation and provide everyday tips for nurturing your gut ecosystem and digestive well-being.
But it's not all heavy-duty science in this episode; we dive into the day-to-day reality of managing stress and prioritizing overall health. Discover why simple acts like diaphragmatic breathing can be a game-changer for your gut and how embracing regular self-care through nutrition and lifestyle changes could help your health journey.
And as we look ahead to our next episode, we hope you join us as we have the opportunity to ask all the burning questions about something that we all do...poop. We'll explore what your poop reveals about your health with Mayo Clinic Jacksonville gastroenterologist, Dr. Jami Kinnucan.
Join us for the first episode of The Gut Health Podcast as we provide you with practical, real-world strategies to give your gut the love it deserves.
This episode was sponsored by QOL medical and Schar.
Learn more about Kate and Dr. Riehl:
Website: www.katescarlata.com and www.drriehl.com
Instagram: @katescarlata @drriehl and @theguthealthpodcast
Order Kate and Dr. Riehl's book, Mind Your Gut: The Science-Based, Whole-body Guide to Living Well with IBS.
The information included in this podcast is not a substitute for professional medical advice, examination, diagnosis or treatment. Always seek the advice of your physician or other qualified health care provider before starting any new treatment or making changes to existing treatment.
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Transcript
Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Speaker 1 (00:00):
This podcast has been sponsored by QOL Medical and
Schar.
Maintaining a healthy gut iskey for overall physical and
mental well-being.
Whether you're ahealth-conscious advocate, an
individual navigating thecomplexities of living with GI
(00:20):
issues, or a healthcare provider, you are in the right place.
The Gut Health podcast willempower you with a fascinating
scientific connection betweenyour brain, food and the gut.
Come join us.
We welcome you.
Hello friends, and welcome tothe Gut Health podcast, where we
(00:42):
talk about all things relatedto the gut and well-being.
We are your hosts.
Speaker 2 (00:47):
I'm Kate Scarlata, GI Dietitian, and I am Dr.
Megan Riehl, and we are soexcited to be recording this
podcast and be starting thispodcast, and we're going to be
zooming out and talking aboutwhy Gut Health matters.
We feel like it's necessary tohave a safe space to unravel
myths and bring tangibleeveryday tips to our listeners,
(01:12):
and Kate and I are so excited tohave these conversations about
such an important matter thatreally impacts all of us.
Speaker 1 (01:19):
So, Kate, why does Gut Health matter to you?
Well, I'm so glad you asked,Megan.
You know, when I think aboutoverall Gut Health, I think it's
just amazing that these littlemicrobes that we really didn't
pay attention to you know untilrecently that they play such a
crucial role in maintaining ouroverall health and really
preventing a variety of diseases.
(01:40):
And I think, like learning thatthese microbes can get
imbalanced in how that isassociated with things like
heart disease that is like anumber one killer in America in
cancer, and then all these likeneurological conditions like
Alzheimer's and Parkinson'sdisease.
And of course, you and I, beingin GI, you know we definitely
(02:02):
are learning the connectionbetween these alterations in our
gut microbes associated withirritable bowel syndrome,
gastroesophageal reflux diseaseand inflammatory bowel disease.
It's very interesting, I have tosay.
You know we can't jump the gunbecause this is really new.
It's not like we really knowwhat we're doing here.
(02:22):
We're just tapping into thescience really relatively, you
know, in the last probably 20,25 years.
But what do you think, Megan,like what gets you going?
Speaker 2 (02:34):
Well, I think we're lucky right Because on our show
we're going to be bringing someof the scientists and leading
experts in this area.
That is still, like you said,it's new new in medical terms in
the last decades and you know20, 25 years.
So what we know, even in termsof how intricate our brain gut
(02:56):
connection is, and there's somuch interest in how our body is
impacted by our environment,which you know trickles down to
affect the inner workings of ourbody.
So, as a psychologist and we'lltalk a little bit more about
each of our history and ourareas of expertise but from a
(03:17):
psychology perspective, the factthat these microbes can impact
our mood and the regulation ofdifferent neurotransmitters in
our body, one that comes to mindis dopamine, right?
So when we think about dopamine, it's a feel-good
neurotransmitter and themicrobes can be this precursor
(03:38):
to also serotonin.
Serotonin is another one ofthose feel-good
neurotransmitters that caninduce calm, and when we think
about calm, we think about kindof the emotional state of calm.
But these aspects of chemicalswithin our body also produce
calm in our gut and our system.
And so I think that you know, asa psychologist and the work
(04:01):
that you do as a dietitian, thereality is we need all of us to
help people achieve gut health,and we're certainly going to
dive into that in this podcastseries this reality that
approaching gut health isimportant for everyone and a lot
of the tools that we provide toour patients every day.
(04:23):
One of the reasons we came upwith doing this podcast is
because 45 million Americans areaffected by a bowel disorder
IBS and why don't we helpeverybody?
Why don't we start to broadenthe conversation to people that
might not have IBS but arecurious about their overall
health?
Speaker 1 (04:43):
It is remarkable.
I mean, I think it makes sensethat if there's alterations in
our gut microbes that wouldaffect a GI disorder.
But to me, you know, seeing,you know heart disease and all
these other areas being affectedis really exciting because
maybe we will really developsome new therapeutics to really
(05:03):
reduce risk of all these chronicdiseases that many people are
suffering with.
You know, from a dietitianperspective, I think you know it
is interesting because what weeat, we are what we eat.
Well, we are what we eat, forus, I guess.
But then what about thosetrillions of microbes that are
living in our gut that helpregulate our immune system and
(05:24):
help create vitamins for ourbody and keep us from some of
these chronic diseases?
We're feeding them too.
So what we're eating, we'refeeding them and basically it
comes down to what we eat.
What escapes digestion by thehuman body ends up in the colon
and that's where the bulk ofthese microbes are residing.
(05:44):
And they're waiting there Likewhat's for dinner and you know
it might be a lovely salad, youknow residual fiber from salad,
or a beautiful smoothie thatyour body couldn't process all
of the fiber, and then we'refueling them to do good things.
So what?
We feed our gut microbesmatters, and we're learning that
(06:05):
more and more that diet plays abig role in keeping the good
guys going and minimizing somewhat we often call as
potentially pathogenic microbes.
We all have some of thosepotentially pathogenic microbes
in our gut, but it's aboutkeeping the good guys in charge,
and so there's not a lot ofbullies in there, basically, and
(06:26):
so the role of diet here doesreally play a role in fueling
those health-promoting microbes.
So what we eat matters clearly.
Speaker 2 (06:35):
But it's not an end-all be-all and I think
sometimes we can get fixated ontrying to control things.
You know I can control what Iput into my mouth if you have
that luxury right.
We know that food and foodchoices are a privilege, but if
we have some control over whatwe put into our body and yet
(06:56):
maybe we're still notfunctioning as well as we want,
we have to zoom out a littlefurther and recognize that our
mood can impact how we feelphysically, and our mood can be
impacted by a variety of thingsour environment, our physical
activity level.
And so when I'm working with mypatients, I really like to
(07:16):
remind everyone that we all haveour own individual fingerprint
of what's happening inside ofour body through those gut
microbes, and that means that wehave to take a personalized
approach and really do someself-assessment.
And if you're struggling withyour own self-assessment, maybe
that's when you step in and youask for the help of a
(07:38):
psychologist or a dietitian, ormaybe it begins with your
primary care doctor just havinga chat about your overall health
.
And so our goals of talking onthe podcast are going to be
well-being and giving so manyoptions for really optimizing
(07:59):
health from this holisticperspective.
But you are going to kind ofspeak to what really makes you
happy and excited about a healthjourney and I'm going to talk
about what makes me excited andmotivated to engage in a healthy
lifestyle.
And along the way we're goingto give lots of different
opportunities because each of usare individualized and each of
(08:21):
our experience has to really becatered to Absolutely.
So, with that kind of in mind,maybe we should pull back a
little bit and share somepersonal information.
So, Kate, I know you have apersonal experience in the GI
world, so can you share a littlebit more about that and how you
(08:41):
came to be a GI dietitian?
Speaker 1 (08:43):
Absolutely so.
I was about seven years into mycareer as a dietitian at the
Brigham and Women's Hospital andI was pregnant at the time.
And, just backtracking a littlebit, I was a very generalist
dietitian.
I covered a lot of differentclinics.
I did a lot of oncology andcancer treatments.
Aids was really a big thing andat the time when I started and
(09:05):
we didn't really havetherapeutics, that was another
area I was interested in.
So I developed this like colickypain.
I was three months pregnant.
My belly just did not feelright.
It was nothing that I had everexperienced before.
So I went to my OBGYN and justsaid you know, I'm not feeling
right.
So they brought me into thehospital and you know, quite
honestly, it was a littletraumatizing because they didn't
(09:27):
really believe me, you know,and thought I was a little pain
seeking and I'm like I don'twant medication.
Actually I'm pregnant, I wantmy baby to be healthy.
And they kind of sat on me forabout 24 hours just under
observation and I remember myOBGYN came in and just looked at
me and said she does not lookright, take her to the OR right
(09:48):
now.
So they took me down with apresumption that I had an
appendix, you know inflamedappendicitis, you know kind of
thing.
So just a spinal.
Here we go, and I just rememberlike the five minutes into the
surgery they said we need to putyou out.
Then I woke up and realizedthat they had found that I had
(10:09):
eight feet of strangulated andsmall intestine.
It was dying inside of me.
So I lost about a third, alittle more, all of my ilium, a
little bit of my jejunum in thesmall intestine, and so the
surgeon sent me home.
My baby lived, thank God.
It was very, very scary time.
(10:30):
I was in the hospital foralmost two weeks and the surgeon
just said go eat a steak.
Well, I didn't have an ilium, Iwasn't tolerating fat, I was
just a mess, and so it reallycatapulted me into wanting to
learn about GI nutrition andwhat works, because I was gassy,
I was bloated, I felt souncomfortable, I was growing
(10:52):
this baby at the time and I'm,like this got to be a better way
and grateful because I foundthe better way and I've been
able to really utilize what Ilearned for myself, for
thousands and thousands ofpatients, and it's been just
such an incredible journey andjust such a rewarding career.
It's been amazing.
So having that experience wasawful, but it made me a really
(11:17):
empathetic, compassionateprovider and just a thirst to
learn more and more about thisarea personally, but also to
help people.
So that's a long story, butthat's mine.
Speaker 2 (11:29):
It brings up this reality that unforeseen,
unpredictable, uncontrollablehealth issues.
Nobody is immune to them andpregnancy in itself is an
anxious time and every pregnancyis different, and I'm sure that
(11:49):
this experience shaped and hasprobably impacted the way you
communicate with patients andhear them and validate them,
because I know so many of thepeople that I've worked with
have not been believed, and soif you can validate for somebody
their experience and guide themto better health as a
(12:12):
practitioner, that's beneficial,but you know that
single-handedly, so your storyis really powerful.
Speaker 1 (12:19):
Well, thank you.
No, I definitely.
It's like I always say whenlife gives you lemons, make
lemonade.
I know it's a little cliche,but it definitely.
You know, it's like a terriblesituation that created a
beautiful career and really arewarding space for me, meeting
beautiful people like you.
Tell us a little bit about yourstory, megan, because GI
(12:41):
psychology is relatively new,and how did you land in this
area?
Speaker 2 (12:46):
Yeah, I was fortunate to go to graduate school in
Chicago and through my doctoraltraining as a clinical
psychologist I had these diverselearning experiences.
I had the opportunity to workwith people from a variety of
diverse backgrounds.
I got to see and treat manydifferent psychiatric conditions
(13:10):
and I felt as I was graduatingand kind of starting to think
about where I wanted to headwith my career.
I had a strong hold and a goodunderstanding of how to help
people manage their mentalhealth.
But when you help people managetheir mental health, you also
are helping them with theirphysical health, and an
opportunity at Northwesternpresented to join a behavioral
(13:34):
health fellowship that wasreally the only of its kind, and
so I got training ingastroenterology with two of the
leading experts, Drs.
Laurie Keefer and SarahKinsinger, and I fell in love
with being able to work withpatients using evidence-based
psychological therapies toimprove their gastrointestinal
(13:55):
health.
And I treated a lot of upper GIconditions because at
Northwestern there's a lot ofexperts in the area of the
esophagus and I was treatingpatients where this was their
fourth, fifth, sixth doctor'svisit and what really started to
happen in a lot of instanceswere the esophageal MD
(14:17):
specialists would see thepatient, diagnose them or
confirm their diagnosis and thenmake a referral to our GI
behavioral health program toreally approach their issues
from a multidisciplinaryperspective.
And I'm encouraging people thebenefits of stress management on
how their brain and gutcommunicate.
(14:38):
And in a short period of time,when we think about psychology,
you know sometimes people are intherapy for months and years at
a time and there's certainlyroom for that and that can be
important.
But in our area of work we dothings pretty quickly.
We have five to seven sessionsand so being able to offer that
(14:59):
and grow that program here, growthe program at the University
of Michigan, I've just foundsuch joy and such excitement for
the field and you know againgetting the opportunity to kind
of work with my dietitiancolleagues, my gastroenterology
colleagues.
There's no eye and team.
That's really the importantthing here.
Speaker 1 (15:22):
Absolutely cannot agree more.
It is amazing when we thinkabout GI conditions particularly
maybe because we're both ameshed in this area it's the
multidisciplinary approach isjust so therapeutic and shown to
be more effective in treatingpatients.
So it's nice that we're seeingboth fields GI dietitians and in
GI psychologists growing innumbers throughout the US and
(15:47):
being available to help people.
So I thought we wouldtransition a little bit from
ourselves and then into a littlebit about the gut microbiome,
because you know we talk a lotabout gut microbes and the
microbiome and just someclarification and some common
terms and a little understanding, because I think when people
think about gut microbiotathey're just thinking it's
(16:07):
bacteria.
But there's a lot of othermicrobes in there, from viruses
to fungi or yeast archaea, whichis like an ancient, one of the
most ancient microbes a littledifferent from bacteria protozoa
, and these all play a role,like Lee and our gut health.
But we really haven't expandedmuch beyond.
(16:28):
We're starting to tap into therole of viruses and fungi in the
guide, but bacteria definitelymuch more tapped into an
understanding that.
So when we talk about gutmicrobiota, we're talking about
the different types of microbesthat reside there and gut
microbiome is a little bitdifferent because they're
talking really more specificallyabout not only the gut microbes
(16:50):
but also the genetic materialthey contain.
So there's so many moremicrobes than just human cells.
So there's so much more geneticmaterial that is really
impacting our overall health andwell-being.
They're a big player herebecause they might be small but
they have a lot of geneticmaterial that contributes to our
(17:13):
overall health.
The other thing to reallyunderstand and Megan kind of
mentioned this is that diet canaffect who's there and what
they're doing.
But there's so many otherfactors that affect our gut
health and what the gut microbesare doing and who's there,
whether we were breastfed,whether we were born by cesarean
section, whether we had a bunchof antibiotics as a kid like me
(17:35):
or and my kids, my gosh.
Right, like sometimes we can'thelp the things that may alter
the gut microbiome.
But in various things, whetheryou have a pet or not can
favorably which I'm getting apuppy, so I guess I'm going to
get a better gut microbiome.
But lots of factors play a rolehere.
(17:56):
It's not just diet and I thinksometimes people really hone
into the diet and diet'simportant.
I'm a dietitian but it's notthe one all be all.
There's lots of factors thatcan affect these microbes that
live in our gut and what they'redoing and how you know really
they overall affect our health.
Speaker 2 (18:13):
I think that's fascinating and it just reminds
me every time one of my kids isgiven another round of
antibiotics, the more I knowabout GI, I just start to go, oh
gosh, like here we go again.
But we do the best with what wecan, right?
So if I can avoid an antibiotic, then I try.
But if we need one, then wehave to do one.
And you know, if you can try tobreastfeed, great.
(18:36):
If you can't, you know what Afed baby is, a happy baby.
So I think it can be anxietyprovoking when we think about,
you know, especially when wethink about our kids, right.
So we're trying to do the bestwe can for our kids.
But what I'm also hearing islike a little dirt isn't going
to hurt, right?
So if the dog licks the facesometimes, that's, you know,
just increasing the potential ofgut diversity.
(18:59):
So you know, I think here weare, we're going to give you the
facts, but we're also going tobe real with you.
Speaker 1 (19:05):
Absolutely, absolutely.
Speaker 2 (19:07):
All right, let's talk a little bit.
We are in the world of GI, butwe've made this clear that our
gut health is important toeveryone, regardless of whether
you have a GI condition.
However, a lot of people haveGI conditions.
I'm going to give you somenumbers, but these numbers are
probably even bigger because somany people don't even go see a
(19:31):
doctor to talk about theirsymptoms because maybe it's
normalized in the family, maybewe just don't talk about how
often we poop or we don't poop.
So about 40 percent of theglobal population and this was a
big survey study that was veryrecently done is impacted by a
GI condition.
This might be IBS, this couldbe other what we call disorders
(19:57):
of gut-brain interaction, andabout 10 to 15 percent of
Americans are impacted by IBS.
I always like in a large room ofpeople.
So let's say you're a collegestudent and there's 200 people
in your classroom.
If you look around, there's awhole handful of people that are
probably anxious about possiblyneeding to go to the bathroom
(20:21):
in their college room.
So this impacts a lot of people.
You might know IBS is acondition where you have these
alterations in bowel habits andthen you also have frequent
abdominal pain.
Constipation impacts about onein five Americans, and three out
(20:43):
of five have never discussedtheir symptoms with their health
care provider.
I've sat in rooms ofgastroenterologists where they
have highlighted that this statis probably very much
under-reported, because thegastroenterologist was saying I
have IBS and I've never receivedtreatment for it.
There's so much here that westigmatize, we don't talk about
(21:08):
it, we suffer in silence, wedon't know that it's uncommon
and we are going to talk aboutthese issues.
In fact, we have a really greatpodcast coming up because Kate
loves to talk about constipationand poop.
So we're going to give so manydifferent hidden tricks and tips
to keep you regular bloating.
(21:30):
That's one other thing.
I have to bring it up becausehow many times have women and
also men but you get home at theend of the day and you want to
unbutton your pants or you'rewearing the beauty of the
Lululemon legging?
We're all wearing leggings.
They're more comfortablebecause probably we're putting
(21:50):
tight pants on our bodies andour bodies need that room to
pass gas and bloat a little bit.
So we're going to talk aboutall these things and really I
think now would be a great timefor us to introduce some of our
myth-busting, myth-crushing hottopics here, so let's jump into
(22:10):
this right, I love itmyth-busting.
Speaker 1 (22:13):
Let's crush a myth.
Yeah, okay, so everyone needs aprobiotic.
This is one of my favoritetopics because I'm not
anti-probiotics, but I think wereally need to understand what
they are and maybe are theyone-size-fits-all.
So does everyone need aprobiotic?
Dr Reihl, no.
Speaker 2 (22:35):
No, no, they don't.
Speaker 1 (22:38):
That's right.
So let's back up.
What are probiotics?
So probiotics are livemicroorganisms.
So keep in mind they're alive,okay, and they're administered
in a certain amount that we knowoffers health benefits.
So that means they have to bestudied so that we understand
that that certain microbe helpsa certain condition.
(22:58):
So if there's a microbefloating in the sky and you're
making sourdough bread and thatmicrobe lands and contributes to
some of the fermentation inthat bread, that's great,
fermented bread's good.
But that microbe'suncharacterized, you don't know
anything about it.
It doesn't classify, forinstance, as a probiotic.
So there's a couple things thatwe know.
(23:21):
We know that some probiotics arebeneficial.
There's some probiotics thathave been studied for irritable
bowel syndrome that have goodevidence to show some benefit in
certain patients.
But it's important to know thatprobiotics as a general rule
are not regulated.
No one's really checking to seeif they have the amount of live
microbes they say that are inthem, unless they've been third
(23:42):
party tested randomly.
But that's not normally done.
And while they do appear to befairly safe based on the
scientific data, there's certainpatients and individuals where
they actually can increasemortality or lead to negative
effects, and particularlyimmunocompromised, elderly or
(24:02):
premature infants, for instance,may be higher risk for using a
probiotic.
So if you choose a probiotic,you want to always start with
asking your health care provideris it appropriate for you and
which probiotic would theyrecommend?
When we're usually recommendinga probiotic, in my practice I'm
(24:23):
trying to correct a situationso patients experiencing
bloating or constipation or hasIBS I'm selecting a probiotic
with scientific evidence provenfor that particular condition.
It's also important if you havea provider to ask for data.
You're recommending thisprobiotic.
(24:44):
I can buy it in your office.
Do you have a scientific studyon that?
So some people are out there.
They're making money on youbuying their supplements and you
just want to make sure thatthey have science to suggest
that this product is appropriatefor you.
Speaker 2 (24:58):
And the most expensive probiotics out.
There are they the best?
Speaker 1 (25:03):
Absolutely not.
Speaker 2 (25:05):
There we go One other thing when you have a probiotic
that sits right up next to thedesk at the pharmacy.
Should we be doing probioticswhile we're taking antibiotics?
Speaker 1 (25:17):
Oh, good question, should we?
I don't think so.
I don't think so either.
Now there is some data withsome probiotics showing benefit
to antibiotic-induced diarrhea.
So there is some data that'sout there that might help with
diarrhea.
But there's also informationlooking at probiotics
post-antibiotics showing thatthe microbiome took longer to
(25:41):
sort of reassemble itself afterthe antibiotic when an
individual was taking aprobiotic.
And we want our gut microbiometo bounce back to its normal
status after an antibioticquickly.
So if something's impactingthat, that's never going to be
the goal.
Speaker 2 (25:56):
Yeah, so it's important to talk with your
provider about what they thinkand what's probably going to be
best for you.
Speaker 1 (26:02):
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Speaker 1 (27:55):
So I think in the next, you know, 15 minutes or so
we'll see how this all goes.
Why don't we segue into somesome key topics?
So, as a GI dietitian, I wantto just bump into nutrition and
your gut microbes.
Diet does matter here and again, I don't want it to be a one
all be all.
Put all this pressure on you tohave the perfect gut microbiome
(28:17):
, healthy diet.
That's going to add stress andwe know stress alters the
microbiome.
So don't we don't want a dietto be stressful.
But we do know that eating moreplants or more fiber rich foods,
foods that are rich inpolyphenols, which are plant
chemicals that have antioxidantbenefits so an example would be
(28:37):
a flavonoid like olive oil extravirgin olive oil has a lot of
those flavonoids in them andthose extra flavonoids are
health promoting.
They have this antioxidanteffect, which basically means
that they can help sort of helpyour body fight things that are
going to drive inflammation, forexample.
So plants, fiber rich foods,foods that have these
(29:00):
polyphenols which we often seein really brightly colored
fruits, vegetables, those reallydark olive oils, also chocolate
, just throwing it out there.
Speaker 2 (29:10):
I know I'm like I love a good olive oil and I
didn't know about the chocolate,so that makes me feel good too.
Speaker 1 (29:17):
Okay, there we go.
Right.
I wanted to talk a little bitabout science, because we are
science here.
This isn't going to be just,you know, smush, we're just
throwing out stuff at you likewe know what we're talking about
.
So a couple studies I want totalk about briefly.
So, as a study, it was reallygot a lot of media attention and
it was primarily out ofStanford University and they
were looking at healthyindividuals.
(29:37):
These individuals didn't haveIBS or health conditions related
to their gut, just FYI.
They were healthy and there wasabout only 36.
So it was a small study.
But they split them up.
They put one half of the groupon a high fiber diet 40 grams of
fiber per day.
The average American, by theway, has about 15 to 18 grams,
so we're talking lots of fiber.
(29:58):
And the other half of the groupgot fermented foods.
What they had that group do issix servings a day of fermented
foods Again, a lot not normalwhat we do.
That's a lot.
Yeah, a lot of kimchi, a lot ofkimchi and a lot of kombucha.
So anyway, when they looked atthe microbiome and different
(30:23):
factors within the gutmicrobiome similar population
but different diet they foundthat the fermented group did
have greater microbial diversityin their gut microbiome, and
when we have more diversity,that tends to be associated with
a healthier gut.
So that was interesting.
They also found that some ofthese, like inflammatory
(30:46):
proteins that can kind of floataround in our bloodstream, were
reduced, particularly one thisis again is in the fermented
food group interleukin six,which is a particular protein
that's associated withrheumatoid arthritis, type two
diabetes, and so reducing thisseems like a favorable effect.
(31:08):
The other thing that's importantin this group when they used
fermented foods, these weren'tjust anything fermented, like
sourdough bread is a fermentedfood, but then you cook it and
there's no live microbes inthere.
This benefits to sourdoughbread, absolutely, but they were
sticking with fermented foodthat had live and active
cultures.
So if you get yogurt and itsays live and active cultures,
(31:30):
or if you got sauerkraut, forinstance, and you got one
pasteurized and one wasunpasteurized, the unpasteurized
, the unheated, in other words,didn't kill off the microbes,
would have those live and activecultures.
So that was really interesting.
And then, briefly, I wanted totalk about another study.
This is out of the American GutProject.
(31:52):
This is a research initiativeto really better understand the
human microbiome and it's sortof citizen crowdfunded, so
anyone out there can send intheir poop and fill out a
lifestyle and diet history.
Speaker 2 (32:06):
Okay, I've got some people that would love to do
that.
For all those people that arereally paying attention to their
poop.
Think about this project.
Speaker 1 (32:14):
Exactly, the American Gut Project write it down.
So what they found here whenthey looked at the data is that
in individuals that ate 30different types of plants per
week, versus those that only had10 different types of plants so
plant variety here is reallyimportant they had a greater gut
bacterial diversity and thenthey had less genes that helped
(32:36):
bacteria avoid antibiotics.
So less antibiotic resistantgenes, which is good for what
they call antibiotic resistance,so the individual would have
more likely to benefit fromantibiotics they didn't resist
certain ones.
So again, just showing dieteffects on the microbiome
(32:56):
variety, plant variety seems tohave a more favorable effect.
So let's drill this down to aneveryday tip Eat more plants,
eat a lot of diversity of plantsand include fermented foods,
particularly those with live andactive cultures.
This tends to be associatedwith a more diverse group of
microbes in your gut, which isassociated with better gut
(33:20):
health.
Speaker 2 (33:21):
You know I'm not a dietitian but I work with them,
I try to.
When I'm putting together ameal think about eating the
rainbow right.
So, even with my kids, I'llpoint out what colors are on our
plate, knowing that thosedifferent colors all signal
different kind of key benefitsfor our gut.
So I think that that's a simpletakeaway of just variety, color
(33:46):
and knowing that it's good foryour gut and promoting gut
health.
Speaker 1 (33:51):
Totally and I agree with you and I think we're
creatures of habit.
So even if you have variety,but if you're buying the same
vegetables every single week andyou go and just get your
blueberries and strawberries andhit out the store, think about
trying something you've neverhad, or zip in and get a mixture
of vegetables that you can adda little variety to your stir
(34:14):
fry.
So I think again, just gettingthe color of the rainbow, but
also breaking outside of the boxa little bit and trying
something new.
Speaker 2 (34:23):
Okay, I'm adding that to my to-do list here, All
right.
So new topic, but also related,right?
I want to highlight a littlebit about stress in the gut a
little bit more.
So we've talked about howstress can impact our gut
microbiota, and that happens byhow neurotransmitters and the
(34:45):
chemicals that are beingproduced within our brain and
our body interact, and alsorecognizing I think a lot of
times people again think stressas emotional, and really stress
impacts us emotionally, but alsophysically.
We have physical signs ofstress that could be feeling
(35:05):
butterflies in your stomachbefore something that you're
excited about or something thatyou're nervous about.
That's a signal of how yourbrain and your gut are
functioning, and it's also asignal that different chemicals
are being produced in your bodyand even some of our serotonin
the majority of our serotonin isactually produced in our gut.
(35:25):
So we know that stress exposureand none of us are again immune
to it.
We have to think about it whenit comes to our overall health
and how do we manage our stress,and I'm going to provide a lot
of everyday tips on stressmanagement, but I'm going to
start today with something thatwe can all do, and that's
(35:45):
thinking first how am I doingwith my stress management, Thank
you.
Do you feel overly stressed?
Do you feel like you'remanaging your stress well?
Do you even acknowledge andunderstand whether you're
impacted by stress?
So start with that simplequestion.
I really think we could allreflect on that and for those of
us that can acknowledge we canprobably do better at stress
(36:09):
management routine.
So let's start with routine.
Is there something that you'redoing regularly that is of
benefit to reducing your levelsof stress?
And this might be regularimplementation of a deep
diaphragmatic breath.
So we know that when we takedeeper, fuller breaths from the
(36:31):
belly, that's a different breathfrom the normal breathing that
we're doing from our chest, andthat diaphragmatic breath is not
only beneficial from anemotional perspective.
So a lot of people think aboutdeep breaths as helpful for
calming down and for relaxation,but it can also relax our body
physiologically, so helping toreduce muscle tension and even
(36:55):
digestive distress.
So if you don't do diaphragmaticbreaths or just deep calming
breaths a couple of timesthroughout your day, I'd
challenge you to begin to thinkabout how you can incorporate
that and maybe anchor it tosomething that you already do.
So brushing your teeth, eatingbreakfast, brushing your teeth
(37:17):
at the end of the day taking ashower.
So when you do those thingsthat you already do, you might
add in 60 seconds of justslowing your breath down,
getting present in the moment,starting to shift from maybe a
busy day to winding down.
Also, we can implement otheraspects of self-care, and
(37:39):
exercise are so important to ouroverall stress management and,
again, the routine of that.
So if you're only exercising,maybe you're not exercising or
you're doing it once a weekchallenge yourself, schedule it
like you would any otherappointment.
I point this out to my patientswhen somebody is just starting
(38:00):
to get into exercise and I'llsay look, you showed up five
minutes early for ourappointment today, so you got
yourself to someplace.
That meant something to you andwe need to treat ourselves the
exact same way.
So schedule your self-care,your relaxation, your time for
exercise in the same way thatyou would schedule any other
(38:23):
appointment with somebody else.
You deserve it.
Speaker 1 (38:26):
So I just wanna say one thing about the
diaphragmatic breathing, becauseI love this technique.
It does engage thatparasympathetic nervous system,
so that sort of rest and digest.
So do you think it's a goodthing for individuals to try to
do that before a meal?
Speaker 2 (38:42):
It can.
I've made the recommendationbefore or after a meal.
So if you're somebody that isrushing so much to like get in
your lunch and get in yourdinner and you're not stopping
to kind of pause, then I thinkmaybe it's a good idea to, just
before you take that first bite,take a couple deep breaths,
chill, go into your meal with alittle bit of relaxation.
(39:06):
But also, if you're somebodythat maybe does struggle with
some digestive symptoms oryou're gonna transition into
maybe exercise after a meal orgoing for a walk, I think that
diaphragmatic breath afterwards,for even just five
diaphragmatic breaths, is gonnahelp a lot.
I think that that's a nice wayto kind of wrap up a meal.
Speaker 1 (39:28):
I love that, I love that idea.
So last kind of tip for todayis just that gut health is
personal to you.
When I you know, dr Reelmentioned this that you have
your own gut microbialfingerprint.
So diet will be not one sizefits all either because you've
got your own microbes and someof the microbes in your gut can
(39:49):
digest fibers that maybe yourneighbor's gut can't digest, or
you both can digest the samefibers but your gut produces
butyrate, which is a short chainfatty acid.
That's a fuel for the gut, andthen they don't make that.
They can digest that, but theydon't produce butyrate.
It's complicated.
So you know, just a reminder,that same with certain
(40:11):
therapeutic diets they're gonnabenefit, like the low FODMAP
diet which we'll get in on afurther episode, which is a diet
that's out there for irritablebowel syndrome.
It's not gonna work foreveryone.
In fact it only works in about50 to, you know, 75% of people.
So there's up to 50% that willjust not benefit from that diet.
So I think, from an everyday tip, from the fact that gut
(40:32):
microbes are really personal,it's important to really listen
and tune into your body'smessages.
And when I say that I'm notencouraging hypervigilance and
like I feel a gas bubble.
It doesn't hurt, but I couldfeel it, not that kind of thing.
But if you're feeling continued, repeated pain every time you
take the probiotic supplement,maybe ditch the probiotic
(40:55):
supplement.
It might not be for you.
Maybe it works for yourneighbor.
They have a different gutmicrobiome.
So just to remember that dietand lifestyle to really manage
your gut microbiome is gonna bepersonal and just listen to the
messages, gently to your body,to do what feels right on the
inside for you and don't go atit alone, right?
Speaker 2 (41:17):
So if you feel like you know you could use a little
guidance, talk with your medicalproviders and start.
We'll give some resources interms of how to find people like
us dietitians and psychologists, mental health providers.
But a team approach isoftentimes really helpful and,
again, we can personalizestrategies that make sense for
(41:39):
you, love that, so I wanted toyou know as part of our podcast.
Speaker 1 (41:44):
We wanted to do just like status update, right?
So why don't we start with you,Megan, what's going on in your
life, and why don't you share itwith our audience?
Speaker 2 (41:53):
All right.
So I'm a working mom, right.
I've got three little kids,seven, four and two.
I'm a little bit myself agermaphobe, right, like I'm not
phobic, but I like to keepthings clean.
You know, before the pandemic Iwas somebody that was scrubbing
the airplane seat before I satdown, okay.
So we recently traveled.
(42:14):
I had to completely let go ofmy germophobia as my three kids
were basically licking everysurface in the airport and then
you know, every space that wewent from there on forward.
So I let go of control there.
We were having fun.
I think that life is just busyright now.
(42:36):
I'm gonna be traveling nextweek, solo, solo.
So it's gonna be a littledifferent, a little less germy,
I think.
But as a psychologist and youknow I always have my anxiety
management hat on my kiddos arestarting to recognize when I
leave and that's, you know, alittle bit tough on the mama
heart.
So one of the things I'mworking on is kind of talking
(42:59):
ahead of time, because you knowwhen kids get anxious they're
prone to tummy aches my headhurts, my tummy hurts.
So we're starting to just talkopenly, communication with my
partner doing the same thing,talking about what's coming up
for mom with travel, when I'mgonna leave, when I'm gonna come
back, what I'm gonna be doing.
(43:19):
You know giving them detailsbecause they're curious and you
know doing it in anage-appropriate way.
And I think that that's gonnahelp with this trip, because my
seven-year-old has been askingnow for the last two weeks like
when are you going, how long areyou gonna be there?
So we're talking about it and Ican feel, you know, his little
anxiety is getting a little bitbetter.
(43:41):
And then to manage my ownanxiety, you're gonna hear me
talk about Peloton.
Self-care for myself issomething that I try to
prioritize and I do it on thatbike.
Prior to the pandemic I wouldhave said I was never gonna own
a Peloton, but like, here I am.
And so for all the workingparents out there, especially
(44:02):
with littles, come with me onthis journey of relinquishing
the guilt of hopping on a bikeor a yoga mat or heading outside
for a walk.
Give yourself.
You know you probably don'thave a full hour.
Most of the time I aim for 20minutes and that might mean
bedtime gets pushed a little bit.
(44:23):
It might mean that I'mexercising and I know the
kitchen is a disaster, but Ihave really, over the last
several years carved this timeout and I think it's so
important and I need it for myown wellness.
So Alex Toussaint is my guy.
He's my coach.
I am big fan, big fan over here, but that music just pumps me
(44:48):
up.
I'm motivated by him and Idon't have to be the therapist.
Speaker 1 (44:53):
I love that, I love Alex too, and I have a Peloton
and I never thought I would havea Peloton either, but I'm
definitely an outside person.
Like being in a forest orwalking outside is like totally
my jam.
That is where I feel totally atpeace and so I try to get
outside and do the walking.
It's getting a little harder,it's colder here, kids are grown
so I don't have that sort ofstressor, but I definitely, you
(45:15):
know, writing a book, starting apodcast, getting a new puppy,
got some, you know, a little bitof anxiety creeping in and I
have to say that learning fromyou a lot Megan has really
helped with, you know, helpingmanage some of my anxieties and
any like just quick tip foroutside of diaphragmatic
breathing, other ways to justsort of decrease the anxieties
(45:40):
of life.
Speaker 2 (45:41):
Yeah.
So a daily check-in of just howam I doing today and what do I
need?
Because I think you've beenlike preparing for your puppy
and how that's gonna change yourlife a little bit.
You and your husband you get tojet set, you talk around the
world, I mean, and so some ofthat's gonna change a little bit
.
You're gonna have a baby in thehouse again, I know, and it's
(46:03):
really easy to get way up intothe future thinking about things
that are out of our control andyou won't know what it's like
until you get up there.
And so if you can kind of dialback and say you know what,
today I need self-care or todayI need to, you know, only
address the must-dos on theto-do list, or you might find
(46:24):
that your answer is dang, I amlike feeling great today I'm
gonna like bust through a bunchof to-dos.
So I think that when we're ableto scale it back and not get so
caught up in the future, thatcan be really helpful for our
anxiety management and even justdaily stress.
Speaker 1 (46:42):
Absolutely, which all dials it back to stressors, gut
health.
It all is, you know, like a big, big fat web, right, Yep, yep.
So should we like talk aboutwhat's coming up, or you know,
what do you think?
Speaker 2 (46:57):
Well, okay, I could use some help and I'm gonna ask
and use you as my accountabilityperson.
I admit like sometimes mynutrition is not the greatest
and the psychologist in me says,you know, it's can't be perfect
.
You don't have to be perfect,but I think sometimes if I have
like a challenge, the Stick toit Ness of me will go for that.
(47:22):
So, as a busy working mom, whattip can you give me so that I
can feel like I am reallyboosting my nutrition this month
and I'm gonna do it, okay.
So give me one and I'm gonnafeel good about my nutrition
when we record again.
I love it.
Speaker 1 (47:38):
Okay.
So when I talk about nutrition,I one am I.
I really feel like it'simportant to think about what we
can add, not focus oneverything we can take out of
the diet, because I think a lotof people focus on, avoid this,
avoid this, avoid this.
One of the things that I feelmost of us are really falling
short on and the data shows itis vegetables.
There was a survey studylooking at Americans intake and
(48:01):
it was like 10% of Americans areeating the amount of vegetables
they should 10%, okay.
So the goal veggie intake foradult women like you, Megan, is
two to three cups a day.
You know, if you had a largesalad you could be hitting that
easily.
But you know, sometimes peopleare grabbing a bagel for
breakfast and then you know whoknows they're eating some
(48:24):
tortilla chips On the car, chipsand quack, chips and quack, and
who knows right.
So a couple goals and I thinkthis might be fun for the kids
is try to look at the grocerystore, look at pictures online,
pick out one vegetable thatyou've never tried, do it
together and just try thevegetable.
So that's just one thing I wantyou to work on.
(48:46):
Once a week, pick out a newvegetable, all right.
The other piece of this is Iwant you to think about at least
a two meals a day have twodifferent vegetables.
So at breakfast, that could bethat you're adding spinach and
mushrooms to an omelet, oryou're adding spinach and
carrots to one of your you know,veggie smoothie, fruit
(49:07):
smoothies in the morning, or oryou roast a huge pan of
different types of roastedvegetables and you throw that on
top of your rice or throw thatin a stir fry or have that
around.
But I want to make sure thatyou have two different
vegetables At at least twodifferent meals a day.
So you're having, you know,ultimately you're meeting that
(49:28):
two to three cup need, butyou're also getting some variety
of different ones.
How's that sound?
Speaker 2 (49:35):
So that's a challenge , but I think that we are up to
it, and by we, I mean don't makeme do this alone.
Listeners, come on, I know I'mnot the only one.
So yeah, I will report back.
Speaker 1 (49:47):
I love it.
I love it outside of thediaphragmatic breathing.
Any other tips for me for mylittle bit of anxiety with being
a dog mom?
Speaker 2 (49:57):
Yeah, get outside.
I know you like it already, butyou know, bundle up.
If it's cold, don't stay inside, although I think you're pretty
good at this.
But you'll just have me in yourbackground just kind of
reminding you.
We live in the Midwest, or Ilive in the Midwest, and so when
it gets cold we tend to not getoutside as much.
And I think if you have theessentials so you've got a warm
(50:19):
hat, you've got the gloves,you've got the boots Don't be
afraid to get outside if it'scold, because that fresh air is
so good for our brain and ourbody, our mood.
And so I'd say you know, ifyou're feeling anxious, go for a
walk, change the environment,get outside.
Just even if it's a brief walk,give that a try.
Speaker 1 (50:39):
Okay, I love that, so I love that, and I'm gonna do
that and I'm gonna think of you.
I'll hear you in the back of myhead.
So what should we expect on ournext episode?
Speaker 2 (50:50):
We have a very exciting and dynamic guest, Dr.
Jami Kinnucan, and she is agastroenterologist at the Mayo
Clinic in Jacksonville, Florida,and we are gonna be talking all
things poop, what's normal.
I love it.
It's gonna be good.
All those burning questionsthat we're all too embarrassed
(51:12):
or we don't have the opportunityto ask or we don't know where
to ask.
We're gonna be able to ask Dr.
Kinnucan and so we are going tobe in for a very informational
treat and we're all gonna walkaway learning a lot about our
poop so exciting, one of myfavorite topics, so we'll see
(51:32):
you then.
Thank you for tuning in.
If you are enjoying what you'rehearing, give us a subscribe, a
like, a follow.
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So right now, stop do it for us.
That way you won't miss anepisode.
And join us for the poopepisode.
(51:53):
You won't want to miss it.
Thank you for joining us as wegrow this gut health community.
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This podcast has been sponsored by QOL Medical and
Schar.
Maintaining a healthy gut iskey for overall physical and
mental well-being.
Whether you're ahealth-conscious advocate, an
individual navigating thecomplexities of living with GI
(00:20):
issues, or a healthcare provider, you are in the right place.
The Gut Health podcast willempower you with a fascinating
scientific connection betweenyour brain, food and the gut.
Come join us.
We welcome you.
Hello friends, and welcome tothe Gut Health podcast, where we
(00:42):
talk about all things relatedto the gut and well-being.
We are your hosts.
Speaker 2 (00:47):
I'm Kate Scarlata, GI Dietitian, and I am Dr.
Megan Riehl, and we are soexcited to be recording this
podcast and be starting thispodcast, and we're going to be
zooming out and talking aboutwhy Gut Health matters.
We feel like it's necessary tohave a safe space to unravel
myths and bring tangibleeveryday tips to our listeners,
(01:12):
and Kate and I are so excited tohave these conversations about
such an important matter thatreally impacts all of us.
Speaker 1 (01:19):
So, Kate, why does Gut Health matter to you?
Well, I'm so glad you asked,Megan.
You know, when I think aboutoverall Gut Health, I think it's
just amazing that these littlemicrobes that we really didn't
pay attention to you know untilrecently that they play such a
crucial role in maintaining ouroverall health and really
preventing a variety of diseases.
(01:40):
And I think, like learning thatthese microbes can get
imbalanced in how that isassociated with things like
heart disease that is like anumber one killer in America in
cancer, and then all these likeneurological conditions like
Alzheimer's and Parkinson'sdisease.
And of course, you and I, beingin GI, you know we definitely
(02:02):
are learning the connectionbetween these alterations in our
gut microbes associated withirritable bowel syndrome,
gastroesophageal reflux diseaseand inflammatory bowel disease.
It's very interesting, I have tosay.
You know we can't jump the gunbecause this is really new.
It's not like we really knowwhat we're doing here.
(02:22):
We're just tapping into thescience really relatively, you
know, in the last probably 20,25 years.
But what do you think, Megan,like what gets you going?
Speaker 2 (02:34):
Well, I think we're lucky right Because on our show
we're going to be bringing someof the scientists and leading
experts in this area.
That is still, like you said,it's new new in medical terms in
the last decades and you know20, 25 years.
So what we know, even in termsof how intricate our brain gut
(02:56):
connection is, and there's somuch interest in how our body is
impacted by our environment,which you know trickles down to
affect the inner workings of ourbody.
So, as a psychologist and we'lltalk a little bit more about
each of our history and ourareas of expertise but from a
(03:17):
psychology perspective, the factthat these microbes can impact
our mood and the regulation ofdifferent neurotransmitters in
our body, one that comes to mindis dopamine, right?
So when we think about dopamine, it's a feel-good
neurotransmitter and themicrobes can be this precursor
(03:38):
to also serotonin.
Serotonin is another one ofthose feel-good
neurotransmitters that caninduce calm, and when we think
about calm, we think about kindof the emotional state of calm.
But these aspects of chemicalswithin our body also produce
calm in our gut and our system.
And so I think that you know, asa psychologist and the work
(04:01):
that you do as a dietitian, thereality is we need all of us to
help people achieve gut health,and we're certainly going to
dive into that in this podcastseries this reality that
approaching gut health isimportant for everyone and a lot
of the tools that we provide toour patients every day.
(04:23):
One of the reasons we came upwith doing this podcast is
because 45 million Americans areaffected by a bowel disorder
IBS and why don't we helpeverybody?
Why don't we start to broadenthe conversation to people that
might not have IBS but arecurious about their overall
health?
Speaker 1 (04:43):
It is remarkable.
I mean, I think it makes sensethat if there's alterations in
our gut microbes that wouldaffect a GI disorder.
But to me, you know, seeing,you know heart disease and all
these other areas being affectedis really exciting because
maybe we will really developsome new therapeutics to really
(05:03):
reduce risk of all these chronicdiseases that many people are
suffering with.
You know, from a dietitianperspective, I think you know it
is interesting because what weeat, we are what we eat.
Well, we are what we eat, forus, I guess.
But then what about thosetrillions of microbes that are
living in our gut that helpregulate our immune system and
(05:24):
help create vitamins for ourbody and keep us from some of
these chronic diseases?
We're feeding them too.
So what we're eating, we'refeeding them and basically it
comes down to what we eat.
What escapes digestion by thehuman body ends up in the colon
and that's where the bulk ofthese microbes are residing.
(05:44):
And they're waiting there Likewhat's for dinner and you know
it might be a lovely salad, youknow residual fiber from salad,
or a beautiful smoothie thatyour body couldn't process all
of the fiber, and then we'refueling them to do good things.
So what?
We feed our gut microbesmatters, and we're learning that
(06:05):
more and more that diet plays abig role in keeping the good
guys going and minimizing somewhat we often call as
potentially pathogenic microbes.
We all have some of thosepotentially pathogenic microbes
in our gut, but it's aboutkeeping the good guys in charge,
and so there's not a lot ofbullies in there, basically, and
(06:26):
so the role of diet here doesreally play a role in fueling
those health-promoting microbes.
So what we eat matters clearly.
Speaker 2 (06:35):
But it's not an end-all be-all and I think
sometimes we can get fixated ontrying to control things.
You know I can control what Iput into my mouth if you have
that luxury right.
We know that food and foodchoices are a privilege, but if
we have some control over whatwe put into our body and yet
(06:56):
maybe we're still notfunctioning as well as we want,
we have to zoom out a littlefurther and recognize that our
mood can impact how we feelphysically, and our mood can be
impacted by a variety of thingsour environment, our physical
activity level.
And so when I'm working with mypatients, I really like to
(07:16):
remind everyone that we all haveour own individual fingerprint
of what's happening inside ofour body through those gut
microbes, and that means that wehave to take a personalized
approach and really do someself-assessment.
And if you're struggling withyour own self-assessment, maybe
that's when you step in and youask for the help of a
(07:38):
psychologist or a dietitian, ormaybe it begins with your
primary care doctor just havinga chat about your overall health
.
And so our goals of talking onthe podcast are going to be
well-being and giving so manyoptions for really optimizing
(07:59):
health from this holisticperspective.
But you are going to kind ofspeak to what really makes you
happy and excited about a healthjourney and I'm going to talk
about what makes me excited andmotivated to engage in a healthy
lifestyle.
And along the way we're goingto give lots of different
opportunities because each of usare individualized and each of
(08:21):
our experience has to really becatered to Absolutely.
So, with that kind of in mind,maybe we should pull back a
little bit and share somepersonal information.
So, Kate, I know you have apersonal experience in the GI
world, so can you share a littlebit more about that and how you
(08:41):
came to be a GI dietitian?
Speaker 1 (08:43):
Absolutely so.
I was about seven years into mycareer as a dietitian at the
Brigham and Women's Hospital andI was pregnant at the time.
And, just backtracking a littlebit, I was a very generalist
dietitian.
I covered a lot of differentclinics.
I did a lot of oncology andcancer treatments.
Aids was really a big thing andat the time when I started and
(09:05):
we didn't really havetherapeutics, that was another
area I was interested in.
So I developed this like colickypain.
I was three months pregnant.
My belly just did not feelright.
It was nothing that I had everexperienced before.
So I went to my OBGYN and justsaid you know, I'm not feeling
right.
So they brought me into thehospital and you know, quite
honestly, it was a littletraumatizing because they didn't
(09:27):
really believe me, you know,and thought I was a little pain
seeking and I'm like I don'twant medication.
Actually I'm pregnant, I wantmy baby to be healthy.
And they kind of sat on me forabout 24 hours just under
observation and I remember myOBGYN came in and just looked at
me and said she does not lookright, take her to the OR right
(09:48):
now.
So they took me down with apresumption that I had an
appendix, you know inflamedappendicitis, you know kind of
thing.
So just a spinal.
Here we go, and I just rememberlike the five minutes into the
surgery they said we need to putyou out.
Then I woke up and realizedthat they had found that I had
(10:09):
eight feet of strangulated andsmall intestine.
It was dying inside of me.
So I lost about a third, alittle more, all of my ilium, a
little bit of my jejunum in thesmall intestine, and so the
surgeon sent me home.
My baby lived, thank God.
It was very, very scary time.
(10:30):
I was in the hospital foralmost two weeks and the surgeon
just said go eat a steak.
Well, I didn't have an ilium, Iwasn't tolerating fat, I was
just a mess, and so it reallycatapulted me into wanting to
learn about GI nutrition andwhat works, because I was gassy,
I was bloated, I felt souncomfortable, I was growing
(10:52):
this baby at the time and I'm,like this got to be a better way
and grateful because I foundthe better way and I've been
able to really utilize what Ilearned for myself, for
thousands and thousands ofpatients, and it's been just
such an incredible journey andjust such a rewarding career.
It's been amazing.
So having that experience wasawful, but it made me a really
(11:17):
empathetic, compassionateprovider and just a thirst to
learn more and more about thisarea personally, but also to
help people.
So that's a long story, butthat's mine.
Speaker 2 (11:29):
It brings up this reality that unforeseen,
unpredictable, uncontrollablehealth issues.
Nobody is immune to them andpregnancy in itself is an
anxious time and every pregnancyis different, and I'm sure that
(11:49):
this experience shaped and hasprobably impacted the way you
communicate with patients andhear them and validate them,
because I know so many of thepeople that I've worked with
have not been believed, and soif you can validate for somebody
their experience and guide themto better health as a
(12:12):
practitioner, that's beneficial,but you know that
single-handedly, so your storyis really powerful.
Speaker 1 (12:19):
Well, thank you.
No, I definitely.
It's like I always say whenlife gives you lemons, make
lemonade.
I know it's a little cliche,but it definitely.
You know, it's like a terriblesituation that created a
beautiful career and really arewarding space for me, meeting
beautiful people like you.
Tell us a little bit about yourstory, megan, because GI
(12:41):
psychology is relatively new,and how did you land in this
area?
Speaker 2 (12:46):
Yeah, I was fortunate to go to graduate school in
Chicago and through my doctoraltraining as a clinical
psychologist I had these diverselearning experiences.
I had the opportunity to workwith people from a variety of
diverse backgrounds.
I got to see and treat manydifferent psychiatric conditions
(13:10):
and I felt as I was graduatingand kind of starting to think
about where I wanted to headwith my career.
I had a strong hold and a goodunderstanding of how to help
people manage their mentalhealth.
But when you help people managetheir mental health, you also
are helping them with theirphysical health, and an
opportunity at Northwesternpresented to join a behavioral
(13:34):
health fellowship that wasreally the only of its kind, and
so I got training ingastroenterology with two of the
leading experts, Drs.
Laurie Keefer and SarahKinsinger, and I fell in love
with being able to work withpatients using evidence-based
psychological therapies toimprove their gastrointestinal
(13:55):
health.
And I treated a lot of upper GIconditions because at
Northwestern there's a lot ofexperts in the area of the
esophagus and I was treatingpatients where this was their
fourth, fifth, sixth doctor'svisit and what really started to
happen in a lot of instanceswere the esophageal MD
(14:17):
specialists would see thepatient, diagnose them or
confirm their diagnosis and thenmake a referral to our GI
behavioral health program toreally approach their issues
from a multidisciplinaryperspective.
And I'm encouraging people thebenefits of stress management on
how their brain and gutcommunicate.
(14:38):
And in a short period of time,when we think about psychology,
you know sometimes people are intherapy for months and years at
a time and there's certainlyroom for that and that can be
important.
But in our area of work we dothings pretty quickly.
We have five to seven sessionsand so being able to offer that
(14:59):
and grow that program here, growthe program at the University
of Michigan, I've just foundsuch joy and such excitement for
the field and you know againgetting the opportunity to kind
of work with my dietitiancolleagues, my gastroenterology
colleagues.
There's no eye and team.
That's really the importantthing here.
Speaker 1 (15:22):
Absolutely cannot agree more.
It is amazing when we thinkabout GI conditions particularly
maybe because we're both ameshed in this area it's the
multidisciplinary approach isjust so therapeutic and shown to
be more effective in treatingpatients.
So it's nice that we're seeingboth fields GI dietitians and in
GI psychologists growing innumbers throughout the US and
(15:47):
being available to help people.
So I thought we wouldtransition a little bit from
ourselves and then into a littlebit about the gut microbiome,
because you know we talk a lotabout gut microbes and the
microbiome and just someclarification and some common
terms and a little understanding, because I think when people
think about gut microbiotathey're just thinking it's
(16:07):
bacteria.
But there's a lot of othermicrobes in there, from viruses
to fungi or yeast archaea, whichis like an ancient, one of the
most ancient microbes a littledifferent from bacteria protozoa
, and these all play a role,like Lee and our gut health.
But we really haven't expandedmuch beyond.
(16:28):
We're starting to tap into therole of viruses and fungi in the
guide, but bacteria definitelymuch more tapped into an
understanding that.
So when we talk about gutmicrobiota, we're talking about
the different types of microbesthat reside there and gut
microbiome is a little bitdifferent because they're
talking really more specificallyabout not only the gut microbes
(16:50):
but also the genetic materialthey contain.
So there's so many moremicrobes than just human cells.
So there's so much more geneticmaterial that is really
impacting our overall health andwell-being.
They're a big player herebecause they might be small but
they have a lot of geneticmaterial that contributes to our
(17:13):
overall health.
The other thing to reallyunderstand and Megan kind of
mentioned this is that diet canaffect who's there and what
they're doing.
But there's so many otherfactors that affect our gut
health and what the gut microbesare doing and who's there,
whether we were breastfed,whether we were born by cesarean
section, whether we had a bunchof antibiotics as a kid like me
(17:35):
or and my kids, my gosh.
Right, like sometimes we can'thelp the things that may alter
the gut microbiome.
But in various things, whetheryou have a pet or not can
favorably which I'm getting apuppy, so I guess I'm going to
get a better gut microbiome.
But lots of factors play a rolehere.
(17:56):
It's not just diet and I thinksometimes people really hone
into the diet and diet'simportant.
I'm a dietitian but it's notthe one all be all.
There's lots of factors thatcan affect these microbes that
live in our gut and what they'redoing and how you know really
they overall affect our health.
Speaker 2 (18:13):
I think that's fascinating and it just reminds
me every time one of my kids isgiven another round of
antibiotics, the more I knowabout GI, I just start to go, oh
gosh, like here we go again.
But we do the best with what wecan, right?
So if I can avoid an antibiotic, then I try.
But if we need one, then wehave to do one.
And you know, if you can try tobreastfeed, great.
(18:36):
If you can't, you know what Afed baby is, a happy baby.
So I think it can be anxietyprovoking when we think about,
you know, especially when wethink about our kids, right.
So we're trying to do the bestwe can for our kids.
But what I'm also hearing islike a little dirt isn't going
to hurt, right?
So if the dog licks the facesometimes, that's, you know,
just increasing the potential ofgut diversity.
(18:59):
So you know, I think here weare, we're going to give you the
facts, but we're also going tobe real with you.
Speaker 1 (19:05):
Absolutely, absolutely.
Speaker 2 (19:07):
All right, let's talk a little bit.
We are in the world of GI, butwe've made this clear that our
gut health is important toeveryone, regardless of whether
you have a GI condition.
However, a lot of people haveGI conditions.
I'm going to give you somenumbers, but these numbers are
probably even bigger because somany people don't even go see a
(19:31):
doctor to talk about theirsymptoms because maybe it's
normalized in the family, maybewe just don't talk about how
often we poop or we don't poop.
So about 40 percent of theglobal population and this was a
big survey study that was veryrecently done is impacted by a
GI condition.
This might be IBS, this couldbe other what we call disorders
(19:57):
of gut-brain interaction, andabout 10 to 15 percent of
Americans are impacted by IBS.
I always like in a large room ofpeople.
So let's say you're a collegestudent and there's 200 people
in your classroom.
If you look around, there's awhole handful of people that are
probably anxious about possiblyneeding to go to the bathroom
(20:21):
in their college room.
So this impacts a lot of people.
You might know IBS is acondition where you have these
alterations in bowel habits andthen you also have frequent
abdominal pain.
Constipation impacts about onein five Americans, and three out
(20:43):
of five have never discussedtheir symptoms with their health
care provider.
I've sat in rooms ofgastroenterologists where they
have highlighted that this statis probably very much
under-reported, because thegastroenterologist was saying I
have IBS and I've never receivedtreatment for it.
There's so much here that westigmatize, we don't talk about
(21:08):
it, we suffer in silence, wedon't know that it's uncommon
and we are going to talk aboutthese issues.
In fact, we have a really greatpodcast coming up because Kate
loves to talk about constipationand poop.
So we're going to give so manydifferent hidden tricks and tips
to keep you regular bloating.
(21:30):
That's one other thing.
I have to bring it up becausehow many times have women and
also men but you get home at theend of the day and you want to
unbutton your pants or you'rewearing the beauty of the
Lululemon legging?
We're all wearing leggings.
They're more comfortablebecause probably we're putting
(21:50):
tight pants on our bodies andour bodies need that room to
pass gas and bloat a little bit.
So we're going to talk aboutall these things and really I
think now would be a great timefor us to introduce some of our
myth-busting, myth-crushing hottopics here, so let's jump into
(22:10):
this right, I love itmyth-busting.
Speaker 1 (22:13):
Let's crush a myth.
Yeah, okay, so everyone needs aprobiotic.
This is one of my favoritetopics because I'm not
anti-probiotics, but I think wereally need to understand what
they are and maybe are theyone-size-fits-all.
So does everyone need aprobiotic?
Dr Reihl, no.
Speaker 2 (22:35):
No, no, they don't.
Speaker 1 (22:38):
That's right.
So let's back up.
What are probiotics?
So probiotics are livemicroorganisms.
So keep in mind they're alive,okay, and they're administered
in a certain amount that we knowoffers health benefits.
So that means they have to bestudied so that we understand
that that certain microbe helpsa certain condition.
(22:58):
So if there's a microbefloating in the sky and you're
making sourdough bread and thatmicrobe lands and contributes to
some of the fermentation inthat bread, that's great,
fermented bread's good.
But that microbe'suncharacterized, you don't know
anything about it.
It doesn't classify, forinstance, as a probiotic.
So there's a couple things thatwe know.
(23:21):
We know that some probiotics arebeneficial.
There's some probiotics thathave been studied for irritable
bowel syndrome that have goodevidence to show some benefit in
certain patients.
But it's important to know thatprobiotics as a general rule
are not regulated.
No one's really checking to seeif they have the amount of live
microbes they say that are inthem, unless they've been third
(23:42):
party tested randomly.
But that's not normally done.
And while they do appear to befairly safe based on the
scientific data, there's certainpatients and individuals where
they actually can increasemortality or lead to negative
effects, and particularlyimmunocompromised, elderly or
(24:02):
premature infants, for instance,may be higher risk for using a
probiotic.
So if you choose a probiotic,you want to always start with
asking your health care provideris it appropriate for you and
which probiotic would theyrecommend?
When we're usually recommendinga probiotic, in my practice I'm
(24:23):
trying to correct a situationso patients experiencing
bloating or constipation or hasIBS I'm selecting a probiotic
with scientific evidence provenfor that particular condition.
It's also important if you havea provider to ask for data.
You're recommending thisprobiotic.
(24:44):
I can buy it in your office.
Do you have a scientific studyon that?
So some people are out there.
They're making money on youbuying their supplements and you
just want to make sure thatthey have science to suggest
that this product is appropriatefor you.
Speaker 2 (24:58):
And the most expensive probiotics out.
There are they the best?
Speaker 1 (25:03):
Absolutely not.
Speaker 2 (25:05):
There we go One other thing when you have a probiotic
that sits right up next to thedesk at the pharmacy.
Should we be doing probioticswhile we're taking antibiotics?
Speaker 1 (25:17):
Oh, good question, should we?
I don't think so.
I don't think so either.
Now there is some data withsome probiotics showing benefit
to antibiotic-induced diarrhea.
So there is some data that'sout there that might help with
diarrhea.
But there's also informationlooking at probiotics
post-antibiotics showing thatthe microbiome took longer to
(25:41):
sort of reassemble itself afterthe antibiotic when an
individual was taking aprobiotic.
And we want our gut microbiometo bounce back to its normal
status after an antibioticquickly.
So if something's impactingthat, that's never going to be
the goal.
Speaker 2 (25:56):
Yeah, so it's important to talk with your
provider about what they thinkand what's probably going to be
best for you.
Speaker 1 (26:02):
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Speaker 1 (27:55):
So I think in the next, you know, 15 minutes or so
we'll see how this all goes.
Why don't we segue into somesome key topics?
So, as a GI dietitian, I wantto just bump into nutrition and
your gut microbes.
Diet does matter here and again, I don't want it to be a one
all be all.
Put all this pressure on you tohave the perfect gut microbiome
(28:17):
, healthy diet.
That's going to add stress andwe know stress alters the
microbiome.
So don't we don't want a dietto be stressful.
But we do know that eating moreplants or more fiber rich foods,
foods that are rich inpolyphenols, which are plant
chemicals that have antioxidantbenefits so an example would be
(28:37):
a flavonoid like olive oil extravirgin olive oil has a lot of
those flavonoids in them andthose extra flavonoids are
health promoting.
They have this antioxidanteffect, which basically means
that they can help sort of helpyour body fight things that are
going to drive inflammation, forexample.
So plants, fiber rich foods,foods that have these
(29:00):
polyphenols which we often seein really brightly colored
fruits, vegetables, those reallydark olive oils, also chocolate
, just throwing it out there.
Speaker 2 (29:10):
I know I'm like I love a good olive oil and I
didn't know about the chocolate,so that makes me feel good too.
Speaker 1 (29:17):
Okay, there we go.
Right.
I wanted to talk a little bitabout science, because we are
science here.
This isn't going to be just,you know, smush, we're just
throwing out stuff at you likewe know what we're talking about
.
So a couple studies I want totalk about briefly.
So, as a study, it was reallygot a lot of media attention and
it was primarily out ofStanford University and they
were looking at healthyindividuals.
(29:37):
These individuals didn't haveIBS or health conditions related
to their gut, just FYI.
They were healthy and there wasabout only 36.
So it was a small study.
But they split them up.
They put one half of the groupon a high fiber diet 40 grams of
fiber per day.
The average American, by theway, has about 15 to 18 grams,
so we're talking lots of fiber.
(29:58):
And the other half of the groupgot fermented foods.
What they had that group do issix servings a day of fermented
foods Again, a lot not normalwhat we do.
That's a lot.
Yeah, a lot of kimchi, a lot ofkimchi and a lot of kombucha.
So anyway, when they looked atthe microbiome and different
(30:23):
factors within the gutmicrobiome similar population
but different diet they foundthat the fermented group did
have greater microbial diversityin their gut microbiome, and
when we have more diversity,that tends to be associated with
a healthier gut.
So that was interesting.
They also found that some ofthese, like inflammatory
(30:46):
proteins that can kind of floataround in our bloodstream, were
reduced, particularly one thisis again is in the fermented
food group interleukin six,which is a particular protein
that's associated withrheumatoid arthritis, type two
diabetes, and so reducing thisseems like a favorable effect.
(31:08):
The other thing that's importantin this group when they used
fermented foods, these weren'tjust anything fermented, like
sourdough bread is a fermentedfood, but then you cook it and
there's no live microbes inthere.
This benefits to sourdoughbread, absolutely, but they were
sticking with fermented foodthat had live and active
cultures.
So if you get yogurt and itsays live and active cultures,
(31:30):
or if you got sauerkraut, forinstance, and you got one
pasteurized and one wasunpasteurized, the unpasteurized
, the unheated, in other words,didn't kill off the microbes,
would have those live and activecultures.
So that was really interesting.
And then, briefly, I wanted totalk about another study.
This is out of the American GutProject.
(31:52):
This is a research initiativeto really better understand the
human microbiome and it's sortof citizen crowdfunded, so
anyone out there can send intheir poop and fill out a
lifestyle and diet history.
Speaker 2 (32:06):
Okay, I've got some people that would love to do
that.
For all those people that arereally paying attention to their
poop.
Think about this project.
Speaker 1 (32:14):
Exactly, the American Gut Project write it down.
So what they found here whenthey looked at the data is that
in individuals that ate 30different types of plants per
week, versus those that only had10 different types of plants so
plant variety here is reallyimportant they had a greater gut
bacterial diversity and thenthey had less genes that helped
(32:36):
bacteria avoid antibiotics.
So less antibiotic resistantgenes, which is good for what
they call antibiotic resistance,so the individual would have
more likely to benefit fromantibiotics they didn't resist
certain ones.
So again, just showing dieteffects on the microbiome
(32:56):
variety, plant variety seems tohave a more favorable effect.
So let's drill this down to aneveryday tip Eat more plants,
eat a lot of diversity of plantsand include fermented foods,
particularly those with live andactive cultures.
This tends to be associatedwith a more diverse group of
microbes in your gut, which isassociated with better gut
(33:20):
health.
Speaker 2 (33:21):
You know I'm not a dietitian but I work with them,
I try to.
When I'm putting together ameal think about eating the
rainbow right.
So, even with my kids, I'llpoint out what colors are on our
plate, knowing that thosedifferent colors all signal
different kind of key benefitsfor our gut.
So I think that that's a simpletakeaway of just variety, color
(33:46):
and knowing that it's good foryour gut and promoting gut
health.
Speaker 1 (33:51):
Totally and I agree with you and I think we're
creatures of habit.
So even if you have variety,but if you're buying the same
vegetables every single week andyou go and just get your
blueberries and strawberries andhit out the store, think about
trying something you've neverhad, or zip in and get a mixture
of vegetables that you can adda little variety to your stir
(34:14):
fry.
So I think again, just gettingthe color of the rainbow, but
also breaking outside of the boxa little bit and trying
something new.
Speaker 2 (34:23):
Okay, I'm adding that to my to-do list here, All
right.
So new topic, but also related,right?
I want to highlight a littlebit about stress in the gut a
little bit more.
So we've talked about howstress can impact our gut
microbiota, and that happens byhow neurotransmitters and the
(34:45):
chemicals that are beingproduced within our brain and
our body interact, and alsorecognizing I think a lot of
times people again think stressas emotional, and really stress
impacts us emotionally, but alsophysically.
We have physical signs ofstress that could be feeling
(35:05):
butterflies in your stomachbefore something that you're
excited about or something thatyou're nervous about.
That's a signal of how yourbrain and your gut are
functioning, and it's also asignal that different chemicals
are being produced in your bodyand even some of our serotonin
the majority of our serotonin isactually produced in our gut.
(35:25):
So we know that stress exposureand none of us are again immune
to it.
We have to think about it whenit comes to our overall health
and how do we manage our stress,and I'm going to provide a lot
of everyday tips on stressmanagement, but I'm going to
start today with something thatwe can all do, and that's
(35:45):
thinking first how am I doingwith my stress management, Thank
you.
Do you feel overly stressed?
Do you feel like you'remanaging your stress well?
Do you even acknowledge andunderstand whether you're
impacted by stress?
So start with that simplequestion.
I really think we could allreflect on that and for those of
us that can acknowledge we canprobably do better at stress
(36:09):
management routine.
So let's start with routine.
Is there something that you'redoing regularly that is of
benefit to reducing your levelsof stress?
And this might be regularimplementation of a deep
diaphragmatic breath.
So we know that when we takedeeper, fuller breaths from the
(36:31):
belly, that's a different breathfrom the normal breathing that
we're doing from our chest, andthat diaphragmatic breath is not
only beneficial from anemotional perspective.
So a lot of people think aboutdeep breaths as helpful for
calming down and for relaxation,but it can also relax our body
physiologically, so helping toreduce muscle tension and even
(36:55):
digestive distress.
So if you don't do diaphragmaticbreaths or just deep calming
breaths a couple of timesthroughout your day, I'd
challenge you to begin to thinkabout how you can incorporate
that and maybe anchor it tosomething that you already do.
So brushing your teeth, eatingbreakfast, brushing your teeth
(37:17):
at the end of the day taking ashower.
So when you do those thingsthat you already do, you might
add in 60 seconds of justslowing your breath down,
getting present in the moment,starting to shift from maybe a
busy day to winding down.
Also, we can implement otheraspects of self-care, and
(37:39):
exercise are so important to ouroverall stress management and,
again, the routine of that.
So if you're only exercising,maybe you're not exercising or
you're doing it once a weekchallenge yourself, schedule it
like you would any otherappointment.
I point this out to my patientswhen somebody is just starting
(38:00):
to get into exercise and I'llsay look, you showed up five
minutes early for ourappointment today, so you got
yourself to someplace.
That meant something to you andwe need to treat ourselves the
exact same way.
So schedule your self-care,your relaxation, your time for
exercise in the same way thatyou would schedule any other
(38:23):
appointment with somebody else.
You deserve it.
Speaker 1 (38:26):
So I just wanna say one thing about the
diaphragmatic breathing, becauseI love this technique.
It does engage thatparasympathetic nervous system,
so that sort of rest and digest.
So do you think it's a goodthing for individuals to try to
do that before a meal?
Speaker 2 (38:42):
It can.
I've made the recommendationbefore or after a meal.
So if you're somebody that isrushing so much to like get in
your lunch and get in yourdinner and you're not stopping
to kind of pause, then I thinkmaybe it's a good idea to, just
before you take that first bite,take a couple deep breaths,
chill, go into your meal with alittle bit of relaxation.
(39:06):
But also, if you're somebodythat maybe does struggle with
some digestive symptoms oryou're gonna transition into
maybe exercise after a meal orgoing for a walk, I think that
diaphragmatic breath afterwards,for even just five
diaphragmatic breaths, is gonnahelp a lot.
I think that that's a nice wayto kind of wrap up a meal.
Speaker 1 (39:28):
I love that, I love that idea.
So last kind of tip for todayis just that gut health is
personal to you.
When I you know, dr Reelmentioned this that you have
your own gut microbialfingerprint.
So diet will be not one sizefits all either because you've
got your own microbes and someof the microbes in your gut can
(39:49):
digest fibers that maybe yourneighbor's gut can't digest, or
you both can digest the samefibers but your gut produces
butyrate, which is a short chainfatty acid.
That's a fuel for the gut, andthen they don't make that.
They can digest that, but theydon't produce butyrate.
It's complicated.
So you know, just a reminder,that same with certain
(40:11):
therapeutic diets they're gonnabenefit, like the low FODMAP
diet which we'll get in on afurther episode, which is a diet
that's out there for irritablebowel syndrome.
It's not gonna work foreveryone.
In fact it only works in about50 to, you know, 75% of people.
So there's up to 50% that willjust not benefit from that diet.
So I think, from an everyday tip, from the fact that gut
(40:32):
microbes are really personal,it's important to really listen
and tune into your body'smessages.
And when I say that I'm notencouraging hypervigilance and
like I feel a gas bubble.
It doesn't hurt, but I couldfeel it, not that kind of thing.
But if you're feeling continued, repeated pain every time you
take the probiotic supplement,maybe ditch the probiotic
(40:55):
supplement.
It might not be for you.
Maybe it works for yourneighbor.
They have a different gutmicrobiome.
So just to remember that dietand lifestyle to really manage
your gut microbiome is gonna bepersonal and just listen to the
messages, gently to your body,to do what feels right on the
inside for you and don't go atit alone, right?
Speaker 2 (41:17):
So if you feel like you know you could use a little
guidance, talk with your medicalproviders and start.
We'll give some resources interms of how to find people like
us dietitians and psychologists, mental health providers.
But a team approach isoftentimes really helpful and,
again, we can personalizestrategies that make sense for
(41:39):
you, love that, so I wanted toyou know as part of our podcast.
Speaker 1 (41:44):
We wanted to do just like status update, right?
So why don't we start with you,Megan, what's going on in your
life, and why don't you share itwith our audience?
Speaker 2 (41:53):
All right.
So I'm a working mom, right.
I've got three little kids,seven, four and two.
I'm a little bit myself agermaphobe, right, like I'm not
phobic, but I like to keepthings clean.
You know, before the pandemic Iwas somebody that was scrubbing
the airplane seat before I satdown, okay.
So we recently traveled.
(42:14):
I had to completely let go ofmy germophobia as my three kids
were basically licking everysurface in the airport and then
you know, every space that wewent from there on forward.
So I let go of control there.
We were having fun.
I think that life is just busyright now.
(42:36):
I'm gonna be traveling nextweek, solo, solo.
So it's gonna be a littledifferent, a little less germy,
I think.
But as a psychologist and youknow I always have my anxiety
management hat on my kiddos arestarting to recognize when I
leave and that's, you know, alittle bit tough on the mama
heart.
So one of the things I'mworking on is kind of talking
(42:59):
ahead of time, because you knowwhen kids get anxious they're
prone to tummy aches my headhurts, my tummy hurts.
So we're starting to just talkopenly, communication with my
partner doing the same thing,talking about what's coming up
for mom with travel, when I'mgonna leave, when I'm gonna come
back, what I'm gonna be doing.
(43:19):
You know giving them detailsbecause they're curious and you
know doing it in anage-appropriate way.
And I think that that's gonnahelp with this trip, because my
seven-year-old has been askingnow for the last two weeks like
when are you going, how long areyou gonna be there?
So we're talking about it and Ican feel, you know, his little
anxiety is getting a little bitbetter.
(43:41):
And then to manage my ownanxiety, you're gonna hear me
talk about Peloton.
Self-care for myself issomething that I try to
prioritize and I do it on thatbike.
Prior to the pandemic I wouldhave said I was never gonna own
a Peloton, but like, here I am.
And so for all the workingparents out there, especially
(44:02):
with littles, come with me onthis journey of relinquishing
the guilt of hopping on a bikeor a yoga mat or heading outside
for a walk.
Give yourself.
You know you probably don'thave a full hour.
Most of the time I aim for 20minutes and that might mean
bedtime gets pushed a little bit.
(44:23):
It might mean that I'mexercising and I know the
kitchen is a disaster, but Ihave really, over the last
several years carved this timeout and I think it's so
important and I need it for myown wellness.
So Alex Toussaint is my guy.
He's my coach.
I am big fan, big fan over here, but that music just pumps me
(44:48):
up.
I'm motivated by him and Idon't have to be the therapist.
Speaker 1 (44:53):
I love that, I love Alex too, and I have a Peloton
and I never thought I would havea Peloton either, but I'm
definitely an outside person.
Like being in a forest orwalking outside is like totally
my jam.
That is where I feel totally atpeace and so I try to get
outside and do the walking.
It's getting a little harder,it's colder here, kids are grown
so I don't have that sort ofstressor, but I definitely, you
(45:15):
know, writing a book, starting apodcast, getting a new puppy,
got some, you know, a little bitof anxiety creeping in and I
have to say that learning fromyou a lot Megan has really
helped with, you know, helpingmanage some of my anxieties and
any like just quick tip foroutside of diaphragmatic
breathing, other ways to justsort of decrease the anxieties
(45:40):
of life.
Speaker 2 (45:41):
Yeah.
So a daily check-in of just howam I doing today and what do I
need?
Because I think you've beenlike preparing for your puppy
and how that's gonna change yourlife a little bit.
You and your husband you get tojet set, you talk around the
world, I mean, and so some ofthat's gonna change a little bit
.
You're gonna have a baby in thehouse again, I know, and it's
(46:03):
really easy to get way up intothe future thinking about things
that are out of our control andyou won't know what it's like
until you get up there.
And so if you can kind of dialback and say you know what,
today I need self-care or todayI need to, you know, only
address the must-dos on theto-do list, or you might find
(46:24):
that your answer is dang, I amlike feeling great today I'm
gonna like bust through a bunchof to-dos.
So I think that when we're ableto scale it back and not get so
caught up in the future, thatcan be really helpful for our
anxiety management and even justdaily stress.
Speaker 1 (46:42):
Absolutely, which all dials it back to stressors, gut
health.
It all is, you know, like a big, big fat web, right, Yep, yep.
So should we like talk aboutwhat's coming up, or you know,
what do you think?
Speaker 2 (46:57):
Well, okay, I could use some help and I'm gonna ask
and use you as my accountabilityperson.
I admit like sometimes mynutrition is not the greatest
and the psychologist in me says,you know, it's can't be perfect
.
You don't have to be perfect,but I think sometimes if I have
like a challenge, the Stick toit Ness of me will go for that.
(47:22):
So, as a busy working mom, whattip can you give me so that I
can feel like I am reallyboosting my nutrition this month
and I'm gonna do it, okay.
So give me one and I'm gonnafeel good about my nutrition
when we record again.
I love it.
Speaker 1 (47:38):
Okay.
So when I talk about nutrition,I one am I.
I really feel like it'simportant to think about what we
can add, not focus oneverything we can take out of
the diet, because I think a lotof people focus on, avoid this,
avoid this, avoid this.
One of the things that I feelmost of us are really falling
short on and the data shows itis vegetables.
There was a survey studylooking at Americans intake and
(48:01):
it was like 10% of Americans areeating the amount of vegetables
they should 10%, okay.
So the goal veggie intake foradult women like you, Megan, is
two to three cups a day.
You know, if you had a largesalad you could be hitting that
easily.
But you know, sometimes peopleare grabbing a bagel for
breakfast and then you know whoknows they're eating some
(48:24):
tortilla chips On the car, chipsand quack, chips and quack, and
who knows right.
So a couple goals and I thinkthis might be fun for the kids
is try to look at the grocerystore, look at pictures online,
pick out one vegetable thatyou've never tried, do it
together and just try thevegetable.
So that's just one thing I wantyou to work on.
(48:46):
Once a week, pick out a newvegetable, all right.
The other piece of this is Iwant you to think about at least
a two meals a day have twodifferent vegetables.
So at breakfast, that could bethat you're adding spinach and
mushrooms to an omelet, oryou're adding spinach and
carrots to one of your you know,veggie smoothie, fruit
(49:07):
smoothies in the morning, or oryou roast a huge pan of
different types of roastedvegetables and you throw that on
top of your rice or throw thatin a stir fry or have that
around.
But I want to make sure thatyou have two different
vegetables At at least twodifferent meals a day.
So you're having, you know,ultimately you're meeting that
(49:28):
two to three cup need, butyou're also getting some variety
of different ones.
How's that sound?
Speaker 2 (49:35):
So that's a challenge , but I think that we are up to
it, and by we, I mean don't makeme do this alone.
Listeners, come on, I know I'mnot the only one.
So yeah, I will report back.
Speaker 1 (49:47):
I love it.
I love it outside of thediaphragmatic breathing.
Any other tips for me for mylittle bit of anxiety with being
a dog mom?
Speaker 2 (49:57):
Yeah, get outside.
I know you like it already, butyou know, bundle up.
If it's cold, don't stay inside, although I think you're pretty
good at this.
But you'll just have me in yourbackground just kind of
reminding you.
We live in the Midwest, or Ilive in the Midwest, and so when
it gets cold we tend to not getoutside as much.
And I think if you have theessentials so you've got a warm
(50:19):
hat, you've got the gloves,you've got the boots Don't be
afraid to get outside if it'scold, because that fresh air is
so good for our brain and ourbody, our mood.
And so I'd say you know, ifyou're feeling anxious, go for a
walk, change the environment,get outside.
Just even if it's a brief walk,give that a try.
Speaker 1 (50:39):
Okay, I love that, so I love that, and I'm gonna do
that and I'm gonna think of you.
I'll hear you in the back of myhead.
So what should we expect on ournext episode?
Speaker 2 (50:50):
We have a very exciting and dynamic guest, Dr.
Jami Kinnucan, and she is agastroenterologist at the Mayo
Clinic in Jacksonville, Florida,and we are gonna be talking all
things poop, what's normal.
I love it.
It's gonna be good.
All those burning questionsthat we're all too embarrassed
(51:12):
or we don't have the opportunityto ask or we don't know where
to ask.
We're gonna be able to ask Dr.
Kinnucan and so we are going tobe in for a very informational
treat and we're all gonna walkaway learning a lot about our
poop so exciting, one of myfavorite topics, so we'll see
(51:32):
you then.
Thank you for tuning in.
If you are enjoying what you'rehearing, give us a subscribe, a
like, a follow.
It means a lot to us and wereally want to build this
community.
So right now, stop do it for us.
That way you won't miss anepisode.
And join us for the poopepisode.
(51:53):
You won't want to miss it.
Thank you for joining us as wegrow this gut health community.
We hope you enjoyed thisepisode and don't forget to
subscribe, rate and leave us acomment.
You can also follow us onsocial media at the gut health
podcast, where we'd love for youto share your thoughts,
questions and experiences.
Thanks for tuning in, friends.
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