Gut Health Unveiled: How Your Digestive System Shapes Well-Being

Episode Transcript
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Erin Brinker (00:00):
Aaron, welcome to the hope table. I'm Erin

(00:08):
Brinker, and I am absolutelythrilled to welcome back to the
show. Dr Timothy Jenkins. He isa board certified
gastroenterologist with KaiserPermanente here in San
Bernardino County, and he's hereto talk about gut health and how
it impacts the body overall. DrJenkins, welcome back to the
show.

Dr. Timothy Jenkins (00:25):
Thank you so much, Erin. I really
appreciate the invite back. Ihad such a wonderful time last
time, so I'm looking forward tospending some more time with
you.

Outstanding.
Outstanding. I am too. So let'sget to the like. First things
first. What does gut healthmean.

So what does gut health mean? I mean,
really, if you think about it,one of the most important
systems in our body is our gut.
And when we talk about that, youknow, in medical terms, we talk
about our gastrointestinalsystem, but it really involves
everything that goes in ourmouths and that comes out at our
bottom and everything inbetween, and there's a long
pathway that that follows, andwhen that's healthy, we're

(01:04):
healthy, and we feel better, andwe feel feel good. And when
that's not healthy, it leads toa whole host of different
problems. And so those are someof the things we'll talk about.
But, but really, gut healthmeans that your intestinal
systems healthy, and as aresult, you feel good about
yourself.

So what is a healthy gut? What is that? What
does that look like when?
Because when we've all had timeswhere we've had an upset
stomach, maybe something didn'tagree with us, but it's so much
more than that.

Yeah, no.
Thank you. So there's, there'sseveral different parts of the
of the gut, and I could talk alittle bit about that, just so
everyone knows, you know, kindof the road map of what we're
talking about. And so you startwith your mouth, and so you're
that's where you take the foodin and you chew. And what that
accomplishes is it breaks thefood into smaller pieces, and
that enables you to swallow thatfood down. Once you've swallowed

(01:57):
and it's past your throat, itgoes into something called the
esophagus, and that that lookslike a tube. It's a straight
tube. It's 12 to 16 inches long,and it connects your mouth down
to your stomach, which sits inyour midsection of your body, so
in your torso, in your body, andso the esophagus connects those
two parts. The food travelsthrough the esophagus. It ends

(02:20):
up in the stomach. And thestomach is an organ that churns
and starts the digestion processof your food. And so it does
that in two different ways. Itdoes that through acid that it
produces. So acid breaks downfood and it and it helps to
start that digestive process.

(02:41):
And it also the stomach alsocontracts, and it squeezes, and
so it churns the food, and thatalso helps break it into much
smaller pieces and actually intokind of a liquid form. After it
leaves the stomach, it enterswhat's called the small
intestine. The small intestineis about 20 feet long, and it
winds around. It looks like acircle, kind of curlicue circle

(03:03):
that goes in your in yourmidsection, and it's twisted and
turned. But if you took it outand stretched it out, it's about
20 feet long, if you couldimagine you got it. You got a 20
foot long intestine leaving yourstomach, and that is where the
absorption of all the nutrientshappens. It happens in the small
intestine, and it travels atlong distance, because humans

(03:26):
need that much distance toreally get all the maximum
nutrition out of the food theyeat. All the stomach does is
just breaks it into smallerpieces and moves it along. But
the stomach is really notabsorbing in you know, the
nutrition that you get thathappens in the small intestine,
and that process can takeseveral hours. So when you eat a
meal, you swallow, it goes downthe esophagus. It's in your

(03:48):
stomach within a matter ofseconds. It stays in the stomach
an hour or two to churn and getthe acid and grind everything
up. And then it gets in yourintestine, and it stays there
for several hours to pass allthe way through there to get
that nutrition. Then it exitsthe small intestine. There's a
little valve at the very endthat kind of regulates the

(04:09):
materials leaving the smallintestine, and it goes into the
large intestine, which is alsocalled the colon. And the colon
is about six feet long, and soit wraps around, also down in
your abdomen, and the food therethat's already been processed is
now reduced all the way down towaste products and bacteria, and

(04:30):
that passes through the colonuntil it passes out with a bowel
movement. And so that's a that'sjust the long and the short of
the whole process of whathappens with your gut. But when
we talk about gut health, we'retalking about that whole system
being healthy, and that leads toa huge impact of how you feel,
in your mind, in your body, andyour own personal wellness.

So gut health is a huge topic, and it has been for
the last couple of years, asmore research has been done
about. The impact of a healthygut on every system in the body.
Now, we've heard terms from fromthe homeopathic community, like
leaky gut, or, you know, thatsort of thing. What? What does

(05:13):
all of that mean?

Yeah, yeah.
So, so what are the what arethose key components that make
it a healthy gut? And the firstthing I would start with is
what's called the the gutmicrobiome. And the microbiome
biome is kind of like anenvironment. If you go out into
the world and you're in a jungleor in a forest, that's the type
of a biome, but you've actuallygot a biome inside your body,

(05:35):
and those are bacteria, there'sthere's viruses, there's
funguses, there's a whole lot ofdifferent organisms that are not
you, but they're inside of you.
And all of that together formsthe gut microbiome, and it's an
it's like an ecosystem thathelps you with your digestion,
and it also protects you againstother harmful, harmful bacteria,

(06:01):
for example, that could causesomething like food poisoning.
So that's one very, veryimportant component. The other
part is how everything movesthrough there. So your gut has
to be very coordinated. I talkeda little bit about the stomach,
but there's also contractionsand movements that are happening
through your small intestine,where it's absorbed in your
colon to have a bowel movement,and also your esophagus, when

(06:24):
you swallow for food to go down.
And there's a very it's kind oflike a dance, like it's a very
careful dance that has to happento make sure you know
something's not running intosomething, it's not getting
clogged, it's not getting stuck,and so that all has to work
properly. And then the last partof it is symptoms that you could
have. And so if you're gettingbloated or you're getting
cramping or pain or things likethat, it can be an indication

(06:46):
that there's something happeningthere that may not be as healthy
as it could be. So those are thedifferent parts of that. So then
your question about, you know,the different parts of the gut
health relate to those threeareas. So we could, we could get
into talking a little bit aboutthat, but those are the key
components to having a healthygut, your microbiome, your
bacteria and all that, your yourcoordinated function of the GI

(07:08):
tract, and also the symptomsyou're having.

So how does the digestive system impact other
parts of the body? So immunity,mental health, energy levels,
cognitive function, etcetera.
Yeah.

So, So, great question. So the the gut
is actually an immune systemorgan itself. So we think about,
we think about the gut beingyour digestive organ, but it has
a huge component of immunesystem function that's in the GI
tract and if you think about it,it really makes sense why it has

(07:44):
that. Because I just mentionedbefore that you have all these
bacteria that reside in yourgut, and so what keeps those
bacteria in the right place,helping you with digestion and
not causing harm to you? Well,that requires a very, very
active immune system in your gutto really regulate everything

(08:05):
that's happening that goesthrough the gut, including those
bacteria. And so that immunesystem is not just like a fixed
it's, you know, it's not like atree stump just sitting there.
It's moving around. And so thosethose cells that make up your
immune system travel between thebloodstream and the gut and
other parts of your body. Sowhatever's happening in your gut

(08:29):
gets communicated to other partsof your body, your mind, your
extremities, you know, all thosedifferent areas. So the gut is a
very, very important part ofyour of your immune system, no
question, and that is importantto keep you healthy. Now, if
your immune system in your gutis not functioning properly, it
can cause many, many differentsymptoms, diseases. There's

(08:50):
other conditions that can happenwith that. So that is a very,
very important part of thiswhole gut, brain connection and
other parts of your body.

So you know, I, and I, it would seem to me that
your gut then would because ofthe signals it's getting from
the body. It would, it woulddrive your cravings. So the
bacteria in your gut would drivethe cravings because of what it
needs to do its job. And ifthings were out of whack, then
you're craving out of whack,like you're craving too much
sugar, I'm guessing, and you'regoing to disabuse me of this

(09:23):
idea, because it's just cominginto my head right now. If you
are, if you need vitamin D,you're going to you're going,
well, like vitamin D you getfrom the sun. If you need other
things that you get from food,folic acid, your body's going to
crave that based on what thatbacteria needs. Is that true?

Yeah, it's very interesting. And that's,
that's a great way of thinkingabout it, it actually the gut, I
guess I would say the gut is nottuned so much to make sure the
bacteria are healthy, in thatthe gut works in teamwork with
the bacteria to help your body.
If I could put it that way. Sofor example, if you're
deficient. In a certainnutrient, your body can sense

(10:00):
that you have different sensorsin your brain and your different
organs, that can tell there's athere's a deficit of something,
and it caught it can cause somecravings. So for example, if
you're if you're deficient iniron, and iron gets absorbed in
the first part of the smallintestine when food just leaves
the stomach. That's where theiron gets, gets absorbed. You

(10:21):
start having cravings, andpeople start thinking, Gee, I
can sure you chew on an ice cuberight now, because I'm they
don't even know why they want todo it, but their body is telling
them you've got a your theiryour iron deficient. And that is
one of the responses thathappens with that not so
effective for iron, becausethere's not a lot of iron and
ice, but that's

just better with a steak.

So, so it's so I guess my point would be,
the bacteria are doing fine.
They're not deficient. They'rethey. They figured out ways to
subsist on just about anythingit. It really is your body that
can sense that, and when thatgets out of balance, it sends
signals to your brain that youneed to do something, change
something, eat something likethat. And there's a whole
there's a whole set of hormones,and there's things like insulin.

(11:11):
You people know about insulin,and they know if someone has
diabetes, they don't have theright amount of insulin, or
their body doesn't respond toinsulin, and those, those are
some examples of things that areconnected to the gut that have
effects on your whole body, thattell you you need to eat, or
you're you're full and youshould stop eating. All those

(11:32):
kind of things are justtransmitted from the nerves and
the hormones that are connectedto your gut.

So what does the use of antibiotics do to that
bio right?

And so antibiotics are antibacterial
medicines. And so if someone hasa pneumonia from a bacteria that
got in their lungs, we give themanti but we give them certain
antibiotics for a bacterialpneumonia, we don't give it for
virus because, back, becauseantibiotics don't work against
viruses, but for a bacteria,it's very toxic to the bacteria.

(12:07):
And so what happens? You canimagine, if you're taking an
antibiotic for a pneumonia, forbacteria in your lungs, and you
swallow a pill of amoxicillin oror something like that, that not
only gets into the lung, becausethe blood flows there, and so it
carries the antibiotic to thelung. It also goes throughout
your gut, because you swallowedit, and this goes through your

(12:27):
GI tract. Well, guess what?
You've got all these bacteriathat normally live in the gut,
and it also affects them aswell. So you take the
antibiotic, and now you'reyou're causing damage to those
bacteria that live in the GItract, and that can set set up
for some other problems that canhappen. Now, why do we do there?
Say, Well, why do we takeantibiotics that doesn't sound

(12:49):
good, that sounds evenpotentially dangerous? We're
willing to accept that there aresome risks to antibiotics, but
we but we think the risk of thepneumonia that you've got is an
even greater risk, and so we'lltake the antibiotics, we'll let
it have that effect on thebacteria. You don't keep taking
antibiotics for pneumonia. Youfinish it, you go off the

(13:10):
antibiotic, and the bacteriagrow back, and they come back
from that. But it is, it doeshave that effect on your GI
tract. Now there's some, and Iwas gonna say, and I'm so sorry,
what I was gonna add? No, you'regood. You're good, yeah, yeah.
So there's some pretty there'ssome dangerous bacteria that are
out there. And there may even,we may even carry them around

(13:30):
ourselves. For example,something called Clostridium
difficile, which is a hazardousbacteria that can live in our in
people's track GI tract, andthey don't have any symptoms of
it, but if they take anantibiotic, it kills off those
other bacteria that are keepingthe Clostridium difficile in

(13:51):
check. So your bacteria, thereare kind of a defense against
that they they don't allow the,you know, the C difficile to
grow. It's kind of like a treethat's over the grass and
there's shade, so the weedscan't grow underneath that, but
you chop down the tree, and allof a sudden the weeds take off.
Well, that's kind of whathappens here. And so people can

(14:12):
get very sick after they take anantibiotic, and especially if
they never needed theantibiotic. They said they took
a risk. They didn't need to, andthe C difficile takes off, and
now they're sick from thatbacteria which needs a whole
different kind of treatment.
Wow.

And so that's really a balancing act. It's
like a tightrope, yeah, if youend up with a with a antibiotic
resistant bacteria, you know,then you you are, you really got
to weigh the risk, obviously,the pneumonia is going to kill
you quicker. Yeah, yeah. And so,you know, you have to work with
your doctor to make sure thatthat you're handling it

(14:51):
correctly,

exactly, yeah. I mean, and if you've gone
to an urgent care and you comein with a cough and cold and a
runny nose, and the doctor said,you know. I think you've got a
virus, I don't think you have abacterial infection. And and you
may ask, you say, Well,shouldn't I start some
antibiotics? And the doctorsays, No, this is one of the
reasons why we don't. You don'tjust usually buy antibiotics

(15:15):
over the counter, because theydo have some risk to them. If we
want to be sure they'reabsolutely need to be used. We
use them at the right time. It'sappropriate, it's necessary, but
we also there is some risk, andwe don't want to take them if we
don't

need them very good. So what are some Oh,
before I get on to what are somegood habits? What does poor gut
health? How does it affectweight loss or weight gain? You
know, this is, this is thebeginning of the year. This is
New Year's resolution time. SoCan, can poor gut health
actually affect weight loss orweight gain? And, if so, how?

Yeah, so it can do both. And it really has
to do, like you were saying, Ithink you put it really well,
Erin, it has to do with thatbalance. And so, you know, too
much or too little of somethingis is often that's a problem for
the for the gut. And so ifsomeone is malnourished and

(16:12):
they're just not getting enoughcalories, and that they lose
weight, and their gut health ispoor because they're just not
getting the nutrition they need.
And and tragically, there'speople out there in this country
where there's food insecurity,people aren't getting enough
food, and they need the food,and they can become malnourished
from that. We see that in otherparts of the world. So that's
one example. The other exampleis when the body systems for

(16:33):
control of appetite and ofmetabolism, of how the food is
is burned, how the fuel in yourbody gets burned? If those get
out of sorts, and diabetes is agood example of that, then the
food can actually be associatedwith a lot of weight gain, and
so the gut is not healthy inthat situation either, because

(16:55):
the person continues to feel theneed to continue to taking in,
to take food in, but theircalories are actually okay, and
they really don't need the food,but they keep taking it, and so
they gain weight, and they havepoor health on that basis. So it
really can be either directionfor that. And there's disease
conditions that that can developin the gut that can lead to

(17:19):
either weight loss or weightgain, depending on that
condition.

You know, you talked about poverty and and how
not enough calories are consumedby many people around the world,
but in the United States, veryoften, poverty and malnutrition
comes with an obese person. Itcomes in an obese body because
they are eating enough calories,they're not eating enough
nutrition, and the food is notgiving their body what they

(17:47):
need, and so it tries tocompensate for too many
carbohydrates, or whatever, andand they people crave junk food.
I read an article recently, andI'm going to be super
transparent. I am on ozempic,and it has been, it has been
such a game changer. And what Iwhat I read, is that some junk
food, and again, you'll disabuseme if I'm incorrect, some junk

(18:09):
food can suppress the body'sability to create GLP one. And
so your body's natural way ofsaying, hey, you've eaten
enough, stop eating is has beenhijacked. And now that I'm
taking a GLP one. It's like, oh,that's what this is supposed to
feel like. And the the thenoise, the hunger, noise for my
body is gone. And it's beengreat. It's been fantastic. I

(18:31):
feel, Oh, this is what I'msupposed to feel like. And what
are you seeing in your patients?

Yeah, no.
And I really am glad you broughtup that topic, Erin, and I'm and
I'm also very glad to hearyou're, you're having a good
result with that medication. Itturns out that these medications
are very widespread, and there'sestimates that about one in
every eight people in the wholecountry have have used them at
some time. And I think it'sabout one in 16 that's actually

(18:57):
on it right now. So if you thinkabout, you think about like a
room full of people, most likelythere's going to be other people
like yourself, Erin, that aretaking the GLP one and and for
those in the audience who aren'tfamiliar with it, it's it stands
for a glucagon like peptide. Andwhat it does is it blocks one of
your hormones in the in thebody's system, which increases

(19:20):
blood sugar, increases insulinand things like that. And so it
it gets that it gets involved inthat step in the body that then
decreases appetite, and it canactually help with diabetes as
well. So it's

and I'm a diabetic, which is why I started
taking of God sent,

right, right? So it's indicated for
diabetes, for certain kinds ofobesity, and it's very, very
effective. There's risk to it,just like there is with
everything. But theeffectiveness has been really
dramatic, and people have saidit's a it's a life changer for
them, but it but it's what. Awas an innovation. It came
through research. And I canremember back in medical school,

(20:05):
I was in medical school in 1990learning about glucagon, but I
never thought there'd besomething that could actually
get in there and work throughthat system to to affect the
whole body in a positive waylike it does. So so I'm glad you
brought that up.

It's been, it's been great. And I, I it really,
we know we are what we eat. AndI find even on the medication,
if I, if I slip into old habitsand start eating junk food,
which I really try to stay awayfrom, and have been staying away
from, the cravings come back inthe you know, I feel lousy and
I'm fuzzy headed, and I've askedmyself, What in the world just I

(20:44):
did? I just do to myself. Itjust makes you feel lousy.

Yeah, well, and you mentioned fuzzy headed
and so, and that gets to thebrain connection and, and
there's, you know, they talkabout the GI detract or the gut
being almost like a secondbrain. And and if you think
about it, it really is, there's,there's not as many nerve cells
in the gut as there are in thebrain, but there's almost as

(21:09):
many. I would say it's, it's,it's, you know, it there's so
many, and all those areconnected. They connect up
through the nerves, up throughthe spinal cord, up to the
brain, and they talk back andforth. So if you're feeling
fuzzy headed, there's a reasonfor that, because there's a
direct connection of the nervesin the brain down to the gut,
and they talk back and forth.
And so if you, if you, if youdon't feel good, it's can start

(21:31):
in the gut, it's transmitted upto the brain, and that causes
you to feel the way you do. Andit can cause you, like you said,
you can feel fuzzy, cloudy,thinking, like a little off
balance. Things like that canhappen. And so this, this GLP,
one agonist, can really kind ofrestore some of the balance for
patients with various, you know,conditions like you mentioned,

(21:53):
and really help them feelbetter.

So many people are set resolutions about losing
weight. And you know, often theexpectation is you lose it fast
in bikini seasons coming up. Andyou know, of course, here in
Southern California, it comesmuch sooner than in other
states, but, but nobody wants tofeel like they're white
knuckling it through their diet.
So if somebody is making aresolution this year, what is

(22:17):
your advice for them?

Sure. No.
So, what are some of the, whatare some of the good health
habits for good for gut health?
And there's, there's a few ofthem, so I'll just go through
them. And of course, a lot ofthis is imbalance, and it's,
it's kind of looking at, youknow, it's not always an all or
none. It's an amount of it. Butwhen you look at what's bad for
gut health, it's really foodsthat are high in sugar, high in

(22:43):
certain types of unhealthy fats,high in certain kinds of
additives, like processed food,fried food, red meat, sugary
drinks. You're also talkingabout alcohol, which can be
unhealthy for gut health,artificial sweeteners and too
much caffeine. And so when youlook at the new year's
resolution and say, I'm going towake up on January 1 and I'm

(23:06):
going to change my diet, and Iwant to I'm going to change for
the better, because I'm just Iwent through 2025 I'm not
feeling so good. I maybe I'vegained weight, you know, and
maybe some health conditionscame up. What can you do? Well,
what are some of the things tolimit, and I'm not saying
completely exclude, but I'msaying to limit. These would be
processed and ultra processedfoods. So you're talking about

(23:29):
like chips, pastry, sugarycereal, frozen food that has our
additives into it. The next oneis refined sugar and high
fructose corn syrup. So you seea lot of that in things like
soft drinks, for example, theyhave that. But also sports
drinks and even some things thatare considered health drinks can

(23:49):
have refined sugar and highfructose corn syrup. You also
include fried foods, which arehigh in unhealthy fats, which
can increase inflammation inyour gut. We talked about that
earlier, and they can alsoaffect the speed of the
digestion of your food. And youcan have either too fast and
that can lead to too many bowelmovements and cramps and

(24:12):
problems, or it can go the otherdirection, cause constipation
and bloating, excessive redmeat, alcohol and then
artificial sweeteners, which cancause can also cause diarrhea,
too much caffeine. Now I know Ilike my coffee, and I'm people
see me. They see I don't want topromote any brand, but they'll

(24:32):
see me at the Starbucks andranch group market, like, Oh
hey, hey, Doctor Jenkins, howyou doing? But I get my
caffeine, but I do have to watchit, because I do watch if I have
more than a cup or so, I dostart feeling jittery, and I do
feel it in my gut, so I so I dohave to watch that. But so
excessive caffeine, I'm notsaying a little bit's not okay,
but, but too much. And thenthere's also some types of foods

(24:56):
we call FODMAP, F, O, D, M, a,p. And it's I've seen that. What
is that? Yeah, so FODMAP reallyhas to do with foods that are
fermented in a certain way. Theyproduce different types of gas
and fermentation. And for somepeople, especially with a
condition called irritable bowelsyndrome, which is where you can

(25:16):
have abdominal cramps and youcan have diarrhea, constipation,
or back and forth post or justthe cramps alone, and the bowels
are okay. Foods like onions,garlic, beans, cabbage and some
types of fruits can cause excessgas and cramping, but especially
people with irritable bowelsyndrome. Now, some of those are

(25:39):
going to be good for you too. Wetalked about fiber and fruits
are good for that. So we're notsaying avoid that, but if the
person has irritable bowelsyndrome like I just described,
their doctor may say you need togo on a, you know, kind of
different, different FODMAP,kind of diet to try to help.

That just makes me sad. I love beans. I love onions
well.

And I think if you don't know now, Erin, if
you don't have irritable bowelsyndrome, if you haven't been
diagnosed with that, that can beperfectly good for you. So I'm
not

okay. I have not.
Thank you guys,

you can, then you need to get your beans.
Then that's okay. But if youdon't, so that. So that would be
like, if I'm making new year'sresolution, I gave you a list of
things, and it would be cuttingback on that. That would be one
area. But I also want to talkabout non things that you're not
eating but that do affect yourgut health, and could also be

(26:35):
part of New New Year'sresolution, and one of those is
stress. And so, you know, if wethink about stress, and I mean,
the one that always resonateswith me has to do with, you
know, getting up, like doingpublic speaking. And I can
remember before I had done it,and I was a kid, and I was in
school, and say, Oh, Tim, you'regoing to be the lead in this

(26:56):
play. I can remember gettingthis kind of like a cramping
feeling in my stomach, and as akid and thinking, What is that
all about? And I hadn't eatenanything, and I wasn't sick, but
it turns out that that I wasstressed thinking about, Oh my
gosh, I got to remember mylines, and I'm going to get up
in front of a bunch of people,and I'm getting what's called
butterflies in the stomach, andit's, and what is that? Well,

(27:20):
that's it's not in my stomach,it's in my brain. I'm thinking
about it, but because of thoseconnections we're talking about,
it transmits to the intestine,and that's what you feel. You
get the butterflies in thestomach from the stress coming
down from the brain. And so ifyou got a New Year's resolution
saying, I'm going to do thingsto lower my stress, and that's

(27:40):
easier said than done. We knowworld's a stressful place. Work
can be stressful. Finances, allthe things family, I mean,
there's a lot of things that arestressful, but that can affect
their gut health, so to thedegree that you can do
activities to lower stress, thatcan help sleep also, I'll stop
there, but there's a coupleothers I did want to mention
about sleep and exercise thatare very, very important, that

(28:04):
are great parts of New Year'sresolution as well.

Well, you know?
And I was going to bring up theexercise question. I watched a
video recently talking aboutblood sugar, and what a dramatic
difference just taking a walkafter you eat can do to
digestion and keeping bloodsugar at a good level, even for
those who are not diabetic. Somany Americans are pre diabetic,
and they may not even know it,that this is something that

(28:27):
could really make a difference.
I assume it also impacts guthealth.

It really does. And so when someone is
sedentary and they're notexercising, and they really and,
you know, and a lot of us havejobs that involve that we're at
an office, or we're at a desk orsomething, and we're just, you
know, we just, by nature of whatwe do is it's more sedentary, it
can affect the digestion. Andso, you know, I'll see patients

(28:53):
who may be like a cab driver orUber driver or truck driver
things like that, where they'resitting a lot of the day and
they're seeing me, and theysaid, Doctor Jenkins, I'm
constipated. I can't have abowel movement, and I feel
bloated. And that is because asedentary lifestyle can slow
down someone's digestion. And sothe antidote to that is, is, is

(29:16):
activity. So just like you said,you have a meal, go out and take
a walk. And you know, in theinteraction of the exercise,
even if it's just mild exercise,we're not talking about running
a marathon. We're just talkingabout, you know, walking for
1020, minutes, getting yoursteps that can really aid the
digestion and and I'll noticethat, like if I go on a plane

(29:36):
flight and I'm travelingsomewhere, and I've been on the
plane the whole day to fly, say,back to the East Coast. I It
does throw me off a little biton my digestion, and I'm not as
hungry, and things kind of slowdown. And then once I get active
again, it picks up again. Soyes, so physical activity is
totally connected to gut health.

So is gut health tied to sleep hygiene? Because
you started to talk about sleep.
The two of those related,

it is related. And so that is also
connected. So one of those NewYear's resolution can be, I'm
going to get, you know, a good,good quality sleep. And there's
several things you can do tolead to that. I know that's not
the topic of this, of thisconversation in terms of sleep,
but it is connected. And I wouldjust say that if someone eats a

(30:23):
meal right before they lay downto sleep, there's a whole lot of
things happening in your body todigest that meal, and it throws
off the hormones that also helpregulate sleep, things like
melatonin, for example. And soit's better to, you know, really
better to sleep on an emptystomach. So have a meal a little
bit earlier, have some time forthat food to digest and then

(30:44):
sleep, and then really get agood, you know, seven, eight
hours of uninterrupted sleep ina comfortable environment and a
comfortable place to sleep andall that, and that, in turn,
then Improves Your Immune Systemand improves your gut function,
improves how you feel. So thoseare directly connected.

You know, I think of, we think of people eating
dinner early, and we tend tothink of older people. Sounds
like they're onto something.

Yeah, you know, I've noticed myself. I'm
getting close to 60, and I lovethose senior specials. And I
would when I was a kid, Ithought that's, that's the
goofiest thing. I would never dothat. And now I'm like, You know
what? So my wife and I will makea reservation if we go out at
five, five o'clock, or even,like, 430 and I'm like, well, we

(31:29):
beat the lines, and we feelbetter too. So exactly, it's win
win. It's a win, win, it's awin, win. So I and you get the
special too. So that's a goodthing.

So there are, there are 1000 fad diets, and
there's always, there's one bookafter the other comes out, and
there have been for as long as Ican remember. This is the key to
weight loss. You should eat onlysteak. You should eat. You
should never eat any animalproducts. You should you know,
keto and paleo and Atkins andvegan and all of the diets, you

(32:04):
know, and so I personally reallylike I used to be a vegan.
Turned out it was, it was murderon my blood sugar, because rice.
But I really like that diet,like a plant based diet. My
brother, on the other hand, heis Mr. Keto, meat and vegetables
and non starchy vegetables.
That's all he eats. And he has,he's begged me to switch. I've

(32:24):
tried to switch. It was murderon my stomach. I just didn't
like it at all. Are we alldifferent? Or does it take time
to for your gut to get used tothe new diet? What? What is your
approach? What do you think?

Yeah, and so there's really, there's
benefits to these diets, andthere's, there's risk to it, and
I think that no one's found themagic solution to it. I think if
they had, we wouldn't havedeveloped areas like GLP, you
know, and so forth. And because,because it, there's so many
different factors that go intogut health that there's really

(32:56):
not one kind of magic solutionto it. And so you mentioned, you
know, the Keto, keto diet, andsome people really believe in
that. But you know, there arealso some things where it can
throw some things out ofbalance, if it's too excessive
on that, because you really doneed a good balance of healthy
fats, carbohydrate, protein andall of that for good nutrition,

(33:19):
plus your vitamins, and for allthat to be in balance. And so if
it's too out of balance, it canreally, you know, it could have
some adverse impacts. Anotherexample would be intermittent
fasting. And you know, someoneyou know, would say, Well, I'm
going to eat one meal, but thennot have any any nutrition for a
certain number of hours. And youknow, that's another example,

(33:42):
and it can be helpful, but forsome individuals, they can
become hypoglycemic, and it cancause them symptoms and problems
if they do that. So especiallyif they get older, it's more
difficult to do the fasting withage, the body's kind of
resiliency is is not the same asit is when they're 20 years old
versus they're 80 years old. Sothat's, that's another different

(34:05):
so I think there's, you know,there are different diets.
There's some benefits to them.
But I would say, you know,overall, some of the things I've
just talked about already, aboutan overall healthy diet, those
New Year's resolution, I thinkthat's really something that can
be put into practice by mostpeople.

It sounds like you're telling people to really
listen to their body.

Yeah, absolutely right. Listen to how
you feel. One of the when I seea patient and I'm evaluating
them and they are coming to mewith GI symptoms, one of the
questions is, well, well, whatcauses the symptoms? What are
the types of foods you'reeating? And we go through the
list of that, and that helps mezero in on what might be the
condition that's causing theirsymptoms. And so you do listen

(34:48):
to your body and say, You knowwhat, what works for you, what
doesn't and and my wife, I mean,she there's certain things, she
says, If I have certain type ofspicy food or something, I.
Really feel it, so I have towatch out for that and and
whereas, for me, that doesn'tmake as much of a difference. So
so people can be different inthat regard.

So let's talk about when, when there's trouble
with the gastrointestinal tract.
And last time you were on, wetalked a lot about colon health
and colon cancer, so we justkind of revisit that a little
bit. So how do you know when thecramping that you're getting or
the upset that you're gettingmight be a problem, right?

And so there's so, of course, with any
symptoms, and in this programwe're doing is these are general
terms, and so you always need tosee your doctor and have a
conversation with them and andhave an evaluation. But there
are certain symptoms we call redflag symptoms that are that are
not normal, and they're alsopotentially more indicative of

(35:48):
something more significant inthe GI system. So, you know? So
I go through a list of questionswhen I see a patient, and one of
the things is unexplained weightloss, for example. So if I have
a patient who says, you know,Doc, I'm just not feeling so
good. I'm having stomach cramps,and I've lost 20 pounds, and I
used to weigh 150 and now I'llweigh 133 months later, and I'm

(36:11):
and I don't really know why I'meating, you know, normally, and
all that that would lead me todo further evaluation, blood
test and maybe other types oftests, a scope or an imaging
test, or thing like that, toevaluate that. So that's one
example, is unexplained weightloss. Another symptom that is

(36:32):
potentially concerning andsomething we need to look at
more would be vomiting. And soif someone is describing, you
know, I just get vomiting. Andyou know, that's not a normal
part of digestion. It can be ifsomeone has something that's
highly irritating to the stomachand they need in the body reacts

(36:52):
and wants to get that out of thesystem. But if they're having
recurrent vomiting, there can beother situations going on with
their gut or with other parts oftheir body that could lead to
that, vomiting is also triggeredout of the brain, and so there's
things in the brain that canlead to that. So that would lead
to further testing. Bleeding isanother example. So if someone's

(37:13):
having bleeding with their bowelmovements, that's not normal,
and so there needs to be someevaluation for that, and so I
asked about that when I youknow, when I see a patient. So
those are just three differentsymptoms, and there's more, but
those are some that would tellyou there's something that could
be more serious. On the otherhand, symptoms such as bloating,

(37:37):
such as cramping, alternatingdiarrhea, constipation, without
any of those other symptoms maynot be as serious of an issue
than some of the other ones thatI talked about. It still could
be, and you should see yourdoctor and have it evaluated,
because there's potential forthings that are serious. But

(37:58):
those are those, to me when Ihear those symptoms are, they're
not the same as someone who'svomiting, bleeding, unexplained
weight loss, things like that.
So, so those are some of the,some of the things we look at.
You know, just a quick thingabout diarrhea, constipation. So
how often should we have bowelmovements? We always hear about,
oh, it should be once a day, andat this time of day and all

(38:19):
that. And there's some peoplelike clockwork, and that's the
way it is, but there's a range.
And so it's really up to threetimes a day bowel movements, or
three times a week, andeverything in between that is
considered kind of the range ofnormal. And people are
different. So some people tendto one side of that or another,
or they kind of go back andforth

between that. Now that is greatly impacted from
from what I've read andunderstood, and may not be true,
but by the amount of fiber andthe amount of water that you
consume. Is that correct? Andwhat role do both of those play?

Yeah, it is. So fiber is super important.
And one of those New Year'sresolutions to be I'm going to
have more fiber this year, and Inotice it myself. If I, if I
don't have some fiber, and I'll,I'll buy some bananas at the
store, or I'll have salads orbeans or things like that. If I,
if I travel and I'm just notkind of eating my routine, I

(39:13):
notice it, and it can make adifference in my digestion. So
in general, the more fiber, thebetter, because it really
assists your body and digestionin it, and it is a food source
for those bacteria that are inyour in your gut. So it helps,
it actually helps them stayhealthy. It helps you stay

(39:34):
healthy. It helps everythingmove through the system. And
kind of, kind of lubricates thesystem and helps things move
properly and leads to betterfeeling of abdominal symptoms,
reduces that and more regularbowel movements.

So should we be getting fiber just from our
food? Because you talked aboutbeans and leafy greens, and I
know apples, for example, arehigh in fiber. Or should we be
taking madame? Was sold everyday. What do you what do you
suggest?

Yeah, I think it has to do with the
amount that you take in yourregular diet. And so there's
guidelines in terms of how muchfiber we should take per day.
Like, for example, like 25 gramsof fiber a day. And there's
different tables, like, Okay, Ihave a salad, an apple and a,
you know, banana and some brandcereal, and you can kind of
figure out about how much you'retaking per day. For individuals

(40:25):
who are not where it'sirregular, like they may be
traveling a lot, they don't havea more regular diet, and they
need to supplement that. That'sokay, but if someone is able to
just have that intake of dailyfiber through their diet, they
really don't need to take asupplement, because they're
going to get it there. So Ithink it just depends on the
individual and what theirlifestyle is. You know, I've

(40:49):
taken it off and on. I wouldhave taken Metamucil in the
past, or take it. I didn't takeit. And I seem to remember maybe
Erin residency when I was intraining, and I used to work 36
hour shifts, and like, eating

out of vending machines.

Like I was, my best friend was the vending
machine. And you kind of justget food when you can not, not
you know, is good for learningabout medicine, not so good for
your gut. So, so I think I didtake, like, some Metamucil or
something like, I got it, I'mnot going to get a salad today.
I got chips and a, you know,soda, which is not healthy for

(41:26):
me to do all the time, but, but,yeah, so I, so that's what I
would do. Look at your diet, ifyou're not getting that good
intake of fiber, you may want tosupplement it with, like, a, you
know, a fiber supplement. Andthere's plenty. There's also
fiber supplements that havesugars and additives and all
sorts of stuff. So you do haveto look at, look at what you're
buying, but that's what I woulddo.

Chia seeds are a great addition to to your food,
if you want to get lots offiber, and they don't take up a
lot

of space.
Yeah, that's a great example.
That's a great example. So let's

talk about probiotics and supplements.
Because, you know, some I hearsupplements are a big fat, hairy
waste of money, and then I hearother people swear by them that
they feel so much better whenthey're taking supplements. What
does your body do with them? Andcan they absorb them?

Yeah, so the probiotics are something
that really kind of goes, goeshand in hand with the, you know,
with the gut bacteria that youhave so and they can be things
like lactobacillus, for example,is a type of probiotic that can
be in yogurt and some types offood products, and it really

(42:32):
helps keep that balance of thegood bacteria in your gut that
helps you with your digestion.
And so what we have found is forcertain people that have gi
conditions like irritable bowelsyndrome, which I talked about
earlier, and they takeprobiotics. Some of them really
can benefit from that, and theyfeel better because of that. And
the reason that happens is thoseprobiotics help to restore the

(42:54):
balance of the bacteria in yourgut.

So which, which makes a lot of sense. So if you
go through, I went through aperiod years and years ago where
I had sinus infections that werereally hard, hard to clear up,
and I took antibiotics for waytoo long, ended up clearing up
the problem. But then, you know,needed probiotics, and so I ate
the yogurt, I had the kefir. Idid, you know, I did. I took

(43:21):
probiotic supplements, and iteventually evened out. The
challenge, though it was, it'snot a quick fix. It takes a
minute for it to for you,everything to become, to go back
to normal,

right, right? Yeah, we've had patients,
and I'll talk about something.
This is a little little queasyfor some people, but we've
actually, we've actually gone asfar is something called a stool
transplant for a patient whohas, for example, one of those
conditions with the bad bacteriaand the good bacteria, we just
can't get them restored back,and so they continue to have

(43:53):
symptoms. They continue to haveproblems with the bad bacteria.
They've taken probiotics, it'snot working and so forth, and
they still have an illness.
They've actually gone to theextent of having a stool sample
from a close family member, andof course, we test it and make
sure there's nothing harmful inthere. And they go in, you know,

(44:14):
and I go with the scope intotheir colon and plant the stool
sample in there to restore thebacteria in their culture. So
that's crazy, not, not exactlydinnertime conversation, but,
but it's but it is. It makessense when you think about it,
because really, their familymember, who has a normal gut is

(44:35):
good health, has normal bowelmovements. They have a normal
mix of bacteria. Can donate thatto their other family member,
and can do that. Now, this hasto be done under medical
conditions, lots of testinginvolved. We don't do this. This
is pretty rare for this tohappen, and it's not done that
often, but it just, it justshows the reality of. Of the gut

(45:00):
health and the gut flora, thebacteria that are in there. How
important that is, that we wouldgo to that extent, and I can
remember, and that didn't existback when I was in medical
school. We hadn't tried this,and it's been in the last 30
years. But someone had I saidthat 30 years ago, they would
have looked at me like I was.

But it makes sense, right? I mean, the biome
is like a garden, and if yourgarden's out of whack, you have
to give it the nutrients that itneeds, or give it the fertilizer
that it needs, or give it thewhatever that it needs, so that
your garden is restored.
Absolutely.

It's like you've gone over to your
neighbor's garden and they'vegot all the great things growing
and say, Hey, give me some ofthat soil, and you bring it back
to your garden, and lo andbehold, it works. It works.

Yeah. So, so for the person who's starting out
new year's resolution and theywant to make gut health, health
a priority, what first step doyou recommend?

So I would say the first step really, would
be to look at those foods andfoods and drinks to live it,
because that's really, that'swhat you're taking into your
body. And I gave that listearlier in the show, but that
would be the first thing. Andthen I would say number two,
three and four would be to workon the stress. So, you know,

(46:15):
whatever that is for that foryou, in terms of the things that
cause stress, the sleep and thephysical activity. Those are the
three. Those are three otherthings. So the foods are taken
in, limiting those areas. Italked about stress, sleep and
activity, and I think that'sreally, you know the going to be
the best thing. Now, ifsomeone's smoking cigarettes to

(46:37):
about using tobacco, that'sdetrimental for many reasons. If
they're using antibiotics andthey shouldn't be, they, you
know, that should be avoided. Sothere's other individual things
that can be done, but foreverybody, it's really the diet,
the sleep, the exercise and thestress management.

You know, we you talked about alcohol a little
bit, and the more research thatcomes out, it used to be they
having thought having a glass ofwine a day was considered
beneficial and and now theresearch is showing that it's
actually could be quite harmfulfor the body. Should people just
avoid alcohol, or is there asafe level of drinking alcohol?
What do you think?

Yeah, and it's and it's kind of we're in
dry January, so one of my one ofthe doctors I work with, I did
it last year. I did the dryJanuary. Didn't drink any
alcohol for the month ofJanuary, and I think it's become
more popular, but we're in thatmonth, it's been difficult for
research to really conclusivelyprove what level is it of

(47:37):
alcohol that you know that doescause more and more problems.
What we do know is that the morewe drink, the greater risk there
is to that. And so less isbetter. Avoiding it completely
means there's no risk from that.
And so I would say it should beminimal. And the whole idea that
if you drink a glass of wine aday, like you're saying, and I
can remember when that used tobe the talk of the town, really,

(47:59):
really, that's been debunked.
And what I find interesting, Ihave a son and my daughter.
They're in their mid 20s now,and what I'm seeing with their
generation is there does seem tobe less alcohol. When I was in
college in the 80s, and I wentto and I went to Harvard

(48:20):
College. I went to a pretty goodschool, but the students we
would they would wander frombuilding to from dorm to dorm,
and there would be the alcoholparties going on, and that's
what happened. And in this inthe kids this day, I call them
kids, minor, mid 20s or adults,but they don't seem to be as
interested in alcohol as beingpart of that. And I think that's

(48:40):
a healthy trend that's betternow than it was when I was in
college back in the 80s. And soI think the next generation
probably, you know, eachgeneration gets smarter. Each
generation learns from theprevious one. I think there's
some benefit to that. And and Ijust find my kids and their
their friends and all that don'tseem to be as interested in, so

(49:01):
that, I think that's a goodthing

well, and I think they're, I think they're
interested in cannabis, and Ithink that's that alcohol has
been displaced.

Well, that's another that's an
interesting one. And, you know,and there's become more social
acceptance of it. And what Iwould say about that gets to,
you know, kind of how much ofsomething people use, but we do
see something where if someoneuses cannabis on a regular
basis, or something calledcannabis vomiting syndrome, and

(49:29):
so that's that red flag symptomI was telling you about earlier,
someone says, you know, I'm justI get up. I'm throwing up every
day, and I don't know why. Oneof the first questions I ask
them is, well, do you usecannabis? And if they say, Well,
you know what I do? I use it forvarious reasons, and I do it
every day and and in Sureenough, I'll make the

(49:49):
connection. I'll say, well,there is this vomiting syndrome
that happens with that, and it'sthought to trigger from the
brain. And the effect ofcannabis on that, that can, that
can cause vomiting when it'sused on a regular basis. Is so
they discontinue it. And I'veseen some very dramatic I've
seen patients who we've doneevery test we've scoped up and
down and done all kinds ofscans, blood tests, everything's

(50:11):
normal, and they're stillvomiting. And we ask one
question, are you usingcannabis? We find out they are,
and they're honest with us, andwe appreciate that, and then
they stop and they feel better.
So that's just an example ofwhat it can do. Wow.

Okay, so what does the future of gut health
research look like? So what's onthe horizon?

Yeah, so there's, there's a lot of
interest right now in theconnection between the brain,
gut connections and mentalhealth, and there's so much more
awareness of mental health, andthat's another topic that's not,
you know, not part of thisconversation today, but there's
so much more awareness of theimportance of mental health and

(50:54):
the impact of mental healthcompared to what it used to be
many years ago. And so there's alot of interest in research to
look at the different types ofbacteria that are in the gut and
the hormones that that connectswith in terms of what the body's
producing, the signals thathappen from the gut up to the

(51:15):
brain, and how that influencesnot only things like sleep, but
also someone's mood, someone'sfeeling of anxiety, depression,
and so there's a lot ofinterest. So there's, there's a
lot of research happening nowtrying to identify types of
bacteria, types of themicrobiome in the gut, that

(51:36):
could be associated with, youknow, with with mental health.
So that's one area. The secondarea is that what we're finding
is that certain conditions suchas inflammatory bowel disease,
so that's Crohn's disease,ulcerative colitis, diabetes,
heart disease, various types ofcancers, even things like

(51:59):
multiple sclerosis. There may besome connection to imbalances in
gut health that can be connectedto that. So there's research
happening in that area as well.
And so those are a coupleexamples of what the future is
holding. So there's a lot ofresearch happening. It's very
exciting. That is exciting, andthat's how GLP happened. It's
where we understand it, we seethe mechanisms, and then

(52:21):
targeted therapies are developedbased on that science. So so
just to put in a plug, I used todo a lot of research many years
ago, and did cancer research inthat and I think it's, you know,
important to me, and I recommendthat our, you know,
collectively, we as a country,we as a society, continue to
prioritize research, becausethat's really how we improve our

(52:45):
health and learn about thethings that are going to be
important in the future.

You know, I It's a couple of the diseases that you
talked about are autoimmune, andI there has to be a connection.
I mean, logically, in my mind,there has to be a connection
between gut health andautoimmune disorders where the
body gets hijacked and startsattacking itself, whether it's
rheumatoid arthritis or lupus orHashimotos or, you know,
sarcoidosis or whatever. And isthere research being done in

(53:13):
that area?

There is actually the researchers have
gone to the extent in animalmodels, and we don't use as much
of that today, because we'revery mindful of animals and for
that role in society that theyhave. But in the past, we've had
animal models where they've beenraised in an environment that's

(53:35):
sterile, that has no bacteria.
And what's interesting, we findthat the animal may not develop
those auto immune conditions,but as soon as you introduce
bacteria that they normallywould have, and in the food that
they eat, in the activities theyhave, they develop those
conditions and so and so we findthat these you know that there's
a direct connection in that, andit makes sense, because once the

(53:59):
immune system interacts withthose bacteria in the gut, then
the immune system has certainreactions, and sometimes those
reactions lead to disease, likeyou said, like rheumatoid
arthritis or inflammatory boweldisease.

So I could talk to you all day long. Dr Timothy
Jenkins, this has been so great.
How do people find you? I knowthat you're at Kaiser Permanente
here in Southern California.
What's the best way to reach outto plug in with a Kaiser doctor
to get more information?

Sure. Well, I'm proud to be part of Kaiser
Permanente. Thank you for sayingthat. I work in San Bernardino
County. I'm the medical directorfor the Kaiser Permanente San
Bernardino County. So I'm a GIphysician of also a physician
leader in this area, supportingall of our 1000 plus physicians.
And so if you're a KaiserPermanente member and you have

(54:54):
then you're, you know, you'repart of our plan, and we're
happy to take care of you. Andso that. Yes, that's what we do.

Well. Dr Timothy Jenkins, thank you so much for
joining us, and thank you foreverything that you do to spread
awareness, to offer directservices, to lead the Kaiser
Permanente team here in SanBernardino County as a proud
Kaiser member. I appreciate you.

Oh, well, thank you Erin, and thank you
for doing such a great serviceto the public. This is just
awesome that you have thisprogram. You do such a great job
at it, and I appreciate you.
Thank you happy new year too.

Thank you. Happy New Year to you. Well, that is
all we have time for today.
Thank you so much for spendingthis time with me. I'm Erin
Brinker. You've been listeningto the hope table, and as you
work your way through this brandnew year 2026 make a commitment
to yourself, to your health andto your heart. Have a great

(55:49):
week. Everyone. You.

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