Optimize Your Digestion With Plants

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Optimize Your Digestion With Plants

Renowned gastroenterologist & gut health expert, Dr. Will Bulsiwitz, joins me to talk about all things gut health. We discuss his new book Fiber Fueled and why plant diversity is so important for our gut.

He also explains why gut issues are on the rise now more than ever and how to optimize our microbiome to transform our health & wellness.

Dr. Will Bulsiewicz, MD

Dr. Will Bulsiewicz, MD

Gastroenterologist

Dr. Will Bulsiewicz, M.D., MSCI is a gastroenterologist, gut health expert, and author of Fiber Fueled, about plant-based gut health. He completed a bachelor’s degree from Vanderbilt University, a medical degree from Georgetown University, and a master's in clinical investigation from Northwestern University. Dr. B. was also the chief medical resident at Northwestern and the chief gastroenterology fellow at UNC, and received the highest award given by both his residency and fellowship.

Transcript

Maria Marlowe: [00:00:34] Welcome back to the Happier and Healthier podcast. Today I’m joined by Dr. Will Bulsiewicz, more more commonly known as Dr. B. He is a gastroenterologist, gut health expert and the author of the book Fiber Fueled, which was just released this week. Today, we’re going to discuss his book and why plant-based foods are so important for our gut and overall health and how we can optimize our microbiome for overall wellness. We’re also giving away a copy of his book this week. So to enter, head over to my Instagram @mariamarlowe and Marlowe has a w e at the end to enter.

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Maria Marlowe: [00:04:16] Dr. B, thanks so much for being here.

Dr. Will Bulsiewicz: [00:04:18] Maria, thank you for having me on the show. Happier and healthier. It’s pretty cool to be on with you. And, you know, the Internet kind of drives me crazy sometimes. But one of the beautiful things is that you’re in Dubai and I am in Charleston, South Carolina. And we’re able to connect and talk about all things gut health.

Maria Marlowe: [00:04:35] I know. And this is one of my favorite topics. And it’s one of the most popular topics on the podcast as well. So I’m very excited to talk more about Gut Health with you. Let’s start at the beginning. I know you have a book that just came out. It’s called Fiber Fueled. Let’s talk about fiber. What is the importance of fiber for our health?

Dr. Will Bulsiewicz: [00:04:58] All right. I like to take it from the top. And so let’s start by erasing from our databank, from our memory, the image of our grandmother stirring the orange drink so that she could so she could poo, you know. And let’s talk about what fiber is, because it’s been so vastly underrated. I think it’s ridiculous. And that’s why I had to write a book about it. Fiber is a part of plants. It’s in all plants. All plants have fiber. And we have been taught to count grams. Like how many grams of fiber do you have in a day? Rhea? I have no clue how many grams of fiber right in day and ask you don’t care because we’re gonna get to some of the more important points during this episode of how you should be thinking about your fiber. But the key is that there are we have no clue. Like millions of types of fiber, potentially billions. We honestly don’t know.

Dr. Will Bulsiewicz: [00:05:50] It’s very hard for scientists to agree on how to even name fiber or define its chemical structure. So to keep it simple, we just kind of break it into two main categories soluble insoluble fiber. But not all fiber is the same. The fiber that you find in a piece of kale is not going to be the same fiber that you find in spinach. And it’s not going to be the same fiber that you would find in Quinoa. So all plants have fiber. All plants have unique wins of fiber. Different types of fiber do different things in the body. And what we want to talk about today is the way the fiber affects our gut, which is really the critical piece.

Maria Marlowe: [00:06:30] So I’m always interested, actually. Let’s take a step back even further. I’m always interested in how people get interested in their passion. Right. Your passion is obviously and your purpose is gut health and educating people about fiber and gut help. How did you get to this point?

Dr. Will Bulsiewicz: [00:06:45] Because I’m a normal human being who was susceptible to the same mistakes that any other person is. I mean, you know, ignore for a moment my education and the fact that I’m a medical doctor, a gastroenterologist. And, you know, it’s just talk about me, Will, the guy. And so I was a good athlete in high school. I come from a family who’s always been skinny. I always thought that I could eat whatever I wanted and get away with it. And that was true for a long period of my life. And as I progressed through my 20s and approached 30, I was working my tail off. I was in my residency 16 hour shifts, six days a week, not sleeping and eating on the go and kind of eating whatever was available and easy and tasted good. And that basically meant a lot of fast food. And my health got away from me. I didn’t like the way I felt my energy levels were gone. I basically was like, I should have been sponsored by Red Bull because I was like smashing those things three times a day, plus coffee a couple times, gained weight. So I was up 50 pounds relative to what I weighed in high school, which is hard for a guy to stomach when you think of yourself as being an athlete. And it’s hard to stomach when you have younger brothers that are calling you out on it. So, like, I had this gut and it was not a beer gut, because I didn’t have enough time to drink beer.It was a food gut.

Dr. Will Bulsiewicz: [00:08:06] I had high blood pressure, had anxiety. I was accomplishing my professional goals, but feeling unwell in doing it. And something had to give. And, you know, I thought that I could outwork it. I’m a hard working person. That’s just who I am. So I thought I could outwork it in the gym. And so I started going in the gym. So we’re talking about, you know, I’m in my early 30s at this point, and I am a single male in my early 30s. I will do literally anything within my power to try to impress women at this point in my life. And so I’m in the gym for 30 to 45 minutes, lifting weights six times a week. And then after I’m done lifting weights, jumping on the treadmill for a five to 10K or jumping in the pool for 50 to 100 laps if it’s the summertime. And like I could put on muscle mass, I couldn’t lose the gut. And I never really connected that like this food that I eat my entire life. Like, it’s not that I sat there and thought, this food is healthy. I just never really connected that the food that I had consumed my entire life that I could get away with that when I was younger. I couldn’t get away with it anymore.

Maria Marlowe: [00:09:14] Well, I think there’s also this idea. I remember when I was growing up that you can outrun a bad diet so that it doesn’t matter what you eat, as long as you exercise and you burn off the equal amount of calories, you’re fine, which is not is not actually the case. Yeah.

Dr. Will Bulsiewicz: [00:09:29] I heard a lot of my friends when I was this age, a lot of my friends would say, you know, I workout so that I can eat what I want. But the problem is that philosophy wasn’t working for me and I couldn’t get anywhere. And so what really changed things for me was that I met and started dating the person who is now my wife. And I had literally, Maria, never been around someone who was, like, even vegetarian. And my wife ate that way. And we were go a day and we’d be at this beautiful restaurant and you can get whatever you wanted. And I would be looking at the chops and the rib eyes and stuff. And she would get a plant plate and she would ask the waiter. It’s not on the menu because you have the chef put together a bunch of plants on a plate for me and my wife could control her weight. She looked amazing. She was not working out the way that I was working out. So you really started the gears turning in my mind that like. What’s the deal with this? And you got to understand, like, so there’s this guy, the normal person. I’m a normal guy. I’m vulnerable to the same things that anyone else’s. But I also have this education.

Dr. Will Bulsiewicz: [00:10:33] I am a board certified urologist, board certified internist, at one point considered myself a biologist. Like, I really was planning to be a clinical researcher. And then I met a point in my life where I had to make a choice, one or the other, clinical research or being in a room with patients taking care of them. And I just I had to do the patients. But my point is that I’m a scientist. I need the science to be there. If the science is not there, I’m not on board. And so when I saw this person, I was dating, eating this way. They opened up my mind to the possibility. But I was like, why haven’t I heard about this? What have I heard about this med school or any of my training? And I started looking and what I discovered shocked me. It wasn’t like a couple hundred studies. It was, you know, more than 10000. It wasn’t bad research or wimpy research. It was like really, really high quality research. And I found enough for me to believe that there was this path. I started making changes in my life, starting with simple stuff like super small stuff. I would drop the fast food for dinner and go home and make a big old smoothie, like a big one.

Dr. Will Bulsiewicz: [00:11:48] And when I did that, I instantly felt better. My energy levels were much higher. I could get more work done. I could be more focused. I started losing weight naturally, my hair was thicker. My my nails were better. My skin looked healthier. I feel like I reversed aging. Over the following years, I was pescatarian, and for several years I dropped about thirty five pounds. And then I got to a place where I was one day, and I can’t even have, honestly, a date for this because it was something where I was like marking a date or wasn’t some, you know, come to Jesus moment or something. But I had this day where I was like you know what? I’m just gonna, like, try and see what happens if I if I go all the way. And I dropped the dairy, the eggs and the fish, and I lost another 15 pounds since then and got back to my high school weight. And here I am now. I’m a dad. We got two kids. My son is three. My daughter is almost six. And I am working super hard. But I feel younger. I feel more energetic. I think I look younger. I definitely have more people asking me in the clinic if I’m old enough to be a doctor. It’s like I’m 40.

Maria Marlowe: [00:12:56] That’s a nice compliment.

Dr. Will Bulsiewicz: [00:12:57] So I’ll take it.

Maria Marlowe: [00:12:58] Yeah. That’s incredible. And I love that because you have been on both sides. Right. So you know what it feels like to feel unhealthy, even though as a doctor you would think, OK, doctors know everything. They’re the healthiest people. But unfortunately, in medical school, you’re not really taught about nutrition and diet and what to eat. And because of the hectic hours and just the crazy schedule, you end up having a lot of unhealthy habits. I’ve heard this story a lot of times from a lot of doctors. So that’s amazing that your wife is a wonderful person and introduce you to this plant based lifestyle and was able to help you out and turn your health around. That’s amazing. So let’s just dive into some gut health questions. What are some of the biggest misconceptions you think people have when it comes to gut health or the microbiome?

Dr. Will Bulsiewicz: [00:13:48] Oh, gosh. All right.

So I started my Instagram account. The guthealthmd a few years ago and really right up to writing this book because I felt like what was being shared when it comes to gut health was really evidence based. And I get some of the ideas that are out there and I get the idea of an intuitive approach where if you feel better when you do something, then you should continue to do that. I get that. But the problem is that we need to allow the science to be our compass at the end of the day, if there’s no science, then, OK, let’s use the best information we have. But if the science is leading us one way, we have to follow it. And what I worry about the worst, the most, Maria, honestly, when it comes to gut health is the idea, and this is something I detail in fiber fueled, the book quite a bit. I’m worried about the idea that if it makes your stomach hurt, it must be inflammation. I see this a lot. And it’s been kind of the prevailing theme of diets for the last 20 years. And I get the idea. Like 20 years ago, we didn’t really have the data.

Dr. Will Bulsiewicz: [00:14:53] When the paleo diet rose up in the early 2000s, we didn’t really have the data to understand why people were feeling the way that they did. Then there were food sensitivities. I mean, there’s no denying that. You know, including with legumes and grains. The question is, is it inflammation? And the science would say otherwise. The science would say that it’s not, it’s not inflammation. It’s sloppy digestion. It’s sloppy processing. And so what I worry about is let me say this like I have a feel for the way that you eat, Maria. And I think you eat an incredibly healthy diet. And this not just one size fits all right. But I think that a pill, your diet in many cases is they help your diet than a vegan diet. When people are eating vegan junk food. OK. But I think the part that I would love to have a conversation about or that I worry about is the restrictions and the eliminations. Go ahead.

Maria Marlowe: [00:15:46] Yes. No, no. This is really interesting. First of all, I love having all differing opinions on here. And so, for example, I just had Dr. Terry Wahls on, who healed herself from M.S. using paleo principles. And she was originally vegan, vegetarian and felt that the way that she was eating may have contributed to certain nutrition deficiencies for her and may have contributed to her issue. And I can tell you personally, you know, I was actually vegan for a period of time and I’m still very heavily plant-based. I mean, I eat probably 90 percent of what I eat is plant based cruciferous vegetables, dark leafy greens like nutrition, dense. You know, I’m not eating like Oreos and French fries, that kind of stuff. I also had our have an autoimmune condition. And for me, I felt better adding and a little bit of high quality organic grass fed meat and animal products. Not a ton.

Maria Marlowe: [00:16:42] I think when people think of paleo diet, generally, they’re thinking, you know, eating big slabs of meat all day long. And that couldn’t be further from the truth for me anyway. So. And then in terms of the elimination, like for me, gluten, talk about digestive issues, like instantaneously before I finish the bowl of cereal, I’d have to be in the bathroom, you know.Yeah. Dairy, you know, same thing. I’m Italian. So I grew up eating milk and cheese on everything and like, I love that stuff. So giving our dairy up was like a sad, sad period for me. But I felt so much better and I had a really bad acne. And that was one of the key things that I think contributed to clearing up my acne. So for me, I have those sensitivities. I know a lot of people have sensitivities. Well talking of gut health, leaky gut. Let’s talk a little bit about that. On a vegan diet. So I assume you’re still eating, obviously grains and beans and things like that, foods that tend to contribute to leaky gut. He got so let’s talk a little bit about that, why there’s, you know, cultures all over the world that do eat grains and that do eat beans and they seem to be doing fine. But then there’s a subset of people that they eat them and they have problems. So let’s unpack that a little bit.

Dr. Will Bulsiewicz: [00:17:55] Oh, totally. Thank you. By the way, for allowing me to have this conversation about this. And let me just say, first of all, I have great respect for Terry Wahls. We have the same publisher for our books. And I think that there’s different ways that you can approach diet. And my point, you know, if you read my book for the people who are listening at home, what you’re going to find is that this is not trying to force you into a one size fits all approach. This is about a personalized approach. And actually, really, you are eating exactly the way that I describe in the book. 90 percent plant-based. So from the gluten issue, we can unpack, too, if you want to. That’s a bigger. That’s it. There’s some complexity there. Yeah. But let’s start with ignoring the gluten for a moment. Let’s talk about beans and whole grains. OK. So you know that the blue zones, the five blue zones for around the world are the, you know, from what we can tell it the longest lived populations that exist. Now, they are not predominantly vegan. They are predominantly plant based.

Dr. Will Bulsiewicz: [00:18:57] And I think that the path to health is, you know, particularly when I live in the United States and it’s a country where the average person’s 10 percent plant-based. I think the path is through plants. We can’t be 10 percent plant based and be healthy, I just don’t see how that’s possible. So when it comes to grains and legumes, when we start with legumes, you know, beans, lentils, stuff like that. People feel unwell when they eat these foods sometimes. And I totally get it. I see in my clinic every single day, I’m a gastroenterologist, this is what I’m taking care of. The person who feels unwell is not the person who has a fully healthy gut, the person who feels unwell as the person who’s had damage to the gut. And the question is, and you described it as leaky gut. And that’s a fair way to describe it. I would use the expression dysbiosis, which is essentially the same thing. A person who has this biosensors had damage to their gut. You see changes in the microbes, less good guys or bad guys, loss of diversity. You see increased intestinal permeability, the leaky gut. All right. That’s dysbiosis. And so when a person has dysbiosis, let’s say they have irritable bowel syndrome, where almost 100 percent have food sensitivities.

Dr. Will Bulsiewicz: [00:20:12] What happens when they eat the bean? Is that being is a very, very, very rich source of many different types of fiber and resistant starch. Now, the problem is that we as humans, we’re not built to process fiber ourselves. If we were 100 percent sterile, which none of us are pure, if you were a half percent sterile, you would not have the ability to unpack and digest fiber. We outsource that to our microbes. We outsource it. And the reason why is because we think about human evolution and sort of human history. We fanned out from Africa to different parts of the world. There is there is no one size fits all ancestral diet either. Wherever people lived, they eat off the land. And it had to be whatever was available within their ecosystem. They were living in famine. You needed a gut that was adaptable to all the different types of plants that exist on this planet. How many plants are there that are edible? We think three hundred thousand. 300,000. So you can’t have a gut that’s just good at a processing, you know, 50 of them like we have in the United States, you need something that could adapt. So there are these enzymes. By the way, I apologize for being a science nerd here. I’m going a little bit nerdy.

Maria Marlowe: [00:21:26] You know, we love. We love this stuff. So please be a science nerd.

Dr. Will Bulsiewicz: [00:21:29] So there are these enzymes called Glycoside hydrolases. All right. And that’s what we used to unpack our carbohydrates like fiber. And we big, strong humans have 17 of them total. And you can take a single cellular bacteria in it could have over 200 of them. There are estimates that our microbiome has 60 thousand unique enzymes to unpack our fiber. And that goes back to what I said in the beginning. Every type of fibers different. And we don’t know how many types there are. There’s tons. When you damaged the gut, you lose diversity in the gut, when you lose diversity in the gut. Who knows where you go from 60 thousand. But it’s not going up. It’s going down. You’re losing the enzymes that you need in order to process and digest your food. And what you result in is people who test themselves with the higher fiber foods or the higher FODMAP foods are the people who struggle to process and digest the food. And that’s what you see happening when they consume all of you.

Dr. Will Bulsiewicz: [00:22:30] So when they do the studies looking at the effect of legumes on the microbiome, I mean, I understand as these conversations about lecterns and stuff like that. I want your listeners to realize that there is a hierarchy to research. The hierarchy is that at the bottom, are test tube studies. That’s the weakest quality research that we have. We actually consider that less than a single human anecdote, like your uncle saying that they drink a 12 pack every day and still live to 90. Right. Test tube research is the lowest research. Animal research is just above that. The highest quality research is a systematic review and meta analysis. We are compiling data from multiple studies, systematic reviews and meta analysis of legumes consistently show that they are beneficial to us as humans, that people live longer.

Dr. Will Bulsiewicz: [00:23:17] There was one study where they took a number of different plants foods. And when they analyzed that and they controlled for confounding factors, there was one, only one food that jumped out as being promoting longevity. That was legumes. And it verifies what you see in the blue zones populations. They all eat legumes, but does do legumes actually damage our gut and cause inflammation? As I lay out in the book and in more detail than what we can get into in this podcast, the answer is no. The answer is no. It actually shows that because it’s becoming healthier when you consume legumes. But the problem is this. This is how I want everyone to think about the gut. The gut is a muscle. What it means is it can get stronger. What that also means is it has a breaking point. So if you go to the gym and you lift three times what you normally lift, what are you going to do? You’re going to hurt yourself? If you have an injured gut that struggles with legumes and you go and you do the four bean chili, you’re going to hurt yourself. And it’s not that you’re actually inducing dysbiosis or you’re inducing leaky gut. It’s that you have spouses. You have we got. And as a result of that, you struggle to process this food. And so it hurts. But if you go to the gym with the right amount of weight, which in some cases after you’ve had an injury, it’s a rehab liberal weight. It’s not like trying to show off at the beach. It’s more like you’re grabbing two and a half pounds. That’s the way that you need to approach this.

Dr. Will Bulsiewicz: [00:24:47] If you have damaged your gut, you need to introduce legumes in a slow way and increase slowly over time and your gut will adapt to it. But if you overdo it all at once because of the damage to your gut, you’re going to struggle with it and you’re going to feel, you know, you’re going to get those feelings that no one likes, dysbiosis.

Maria Marlowe: [00:25:04] Well, my question for you is, you know, I grew up in New York, Italian American family eating a very standard American diet. I was eating a ton of fast food, no vegetables. I probably had actually an exceptionally bad standard American diet. And just in talking with people, whether it’s clients, friends, family and even doctors on this podcast, I feel like in the US there are so many things in our daily life that are working against our gut. Growing up, I was on I don’t know how many rounds of antibiotics for every cold flu virus that I was, you know, ever had. The water is chlorinated, stress. Everyone is super, super stressed and we know that can negatively affect the gut. There’s just so… Sugar, refined carbohydrates, junk food, all this stuff. So how do we get ahead of that? You know what I’m saying?

Maria Marlowe: [00:25:56] It’s it just seems like everything’s working against our gut. And I’ll give you another example. So my husband is Indian and his grandfather is such an amazing man. Grew up in India. Still lives in India. And this guy can eat anything, you know, drink anything, anything. He’s got an iron stomach. He’s completely fine. Whereas his grandson, my husband or me growing up in a more Western society, you know, we have to be extremely careful what we’re eating because, like, our gut is not as strong as his is, because, again, we grew up with very different sterile environment, said at all of this stuff. So how do we get ahead of that?

Dr. Will Bulsiewicz: [00:26:36] So I think that you bring up a lot of great points. OK. One is a generational difference. And there actually are studies that you can’t do this study any human because it takes us too long to look at what happens over the course of, you know, three generations. Cumulous right. But they do these studies in mice where they look at the microbiome that that changes over time. And there’s this guy, Peter Turba, who’s one of the top microbiome researchers on the planet. And what he showed is that if you take a mouse and you put on a low fiber diet and it starts off with let’s just give it a number to make it simple, a thousand species. OK. So grandma has a thousand species. But you put her on a low fiber diet. By the time she has mom, she’s done 700 species. So mom inherits 700. And then mom’s on a low fiber diet. And by the time mom has you, she’s gone to 400 species. You starting off at a 60 percent deficit compared to your relative from two generations ago in this study. If they reintroduce fiber early enough, that entire process is reversible. And so what that means is that some of the issues that you struggle with now, if we can get back on the right types of fiber, we can reverse that issue, is not that you’re permanently lost.

Dr. Will Bulsiewicz: [00:27:56] But you’re bringing up a lot of great points, Maria, about our lifestyle. So let’s go beyond the food. Let’s go beyond the fork for a moment and talk about some of these things. So you mentioned some of them. You know, stress, stress damages the gut. Stress induces dysbiosis by itself. Some of the most challenging patients that I take care of are people with trauma or people with an eating disorder. Both of those things severely affect the gut and when I take care of those patients, I know in order for me to get them better, we have to address those underlying issues or they’re just not going to get better. Sleep. There are studies that literally changing your sleep by 30 minutes per night can have detrimental effects on your health. And the reason why is it affects your gut. When I was that guy who was in his late 20s and not sleeping, I was what science has proven in the sense that. Sleep deprivation changes or in a way that makes it resemble a person who is obese. You crave carbs. You crave fast food. That’s the guy that I was, that’s why I put on 50 pounds, you know, so key in biology. So like our bio rhythm, we you know, you we will eat dinner at eleven o’clock at night sometimes where we do eat night snacks.

Dr. Will Bulsiewicz: [00:29:21] Every single living creature on our planet has a biorhythm, and that includes the microbes in our gut, of which there’s 39 trillion. And if you take the exact same meal, Maria, and you feed it to a person at breakfast or you feed them late in the day, you can be literally the exact same meal with no difference. You will have a different biologic effect and they will have higher sugar spike, higher blood glucose levels later in the day. And it has to do with their circadian biology. Blue light, blue light throws off melatonin. So looking at your phone, looking at your TV, what can your computer late at night. It’s not only affecting your sleep, it’s affecting your gut. Absence of exercise. I mean, I don’t think I need to cover, like, how sedentary we are relative to what we were one hundred years ago when cars didn’t exist, you know? And then just like our sterile environment, we have built these human edifices thinking that it’s provided us with safety. And it’s like a microbial beduins. It’s like we devoid of microbes and we’re spraying it with chemicals. And I think this is even more applicable right now, Covid 19, where we’re trying to be as clean as we can. But there’s a consequence that we pay. That’s the flip side, which is destroying our microbes. And then, you know, coming back to our food just for a moment, 60 percent of the American diet is processed food, whether it’s my diet or it’s your diet, which I mean, unless you were effectively on the same page by.

Dr. Will Bulsiewicz: [00:30:55] Those foods contain preservatives that didn’t exist 100 years ago. Our grandparents didn’t grow up eating those foods. We did. And how do you create a food that can sit in a box on the shelf and not change for months on end? People need to understand that, that the breakdown of our food is done by bacteria. And so if you have, you know, cold cuts that sit in the refrigerator for six months, you slice off a couple pieces every once in a while. The reason why it doesn’t rot is because it’s killing bacteria. The bacteria can’t get to it. So what do you think happens when you take that food that’s designed to destroy bacteria and you drop it in with thirty nine trillion microbes that are focused and centered and you call it? So you see all of these things. And how do we correct that?

Dr. Will Bulsiewicz: [00:31:46] This is where I actually think that a lot of the concepts direct the core philosophy of the Paleolithic diet. There’s a lot to love there. There’s a lot of love, which is that there needs to be a return to centering ourself in a way that is human biology. And that means like actually getting a good night’s rest. Going to bed early, getting your eight hours of sleep, having dinner early, ideally, and then not eating any food after dinner. Like water fasting from that point forward. I’m a believer in water fasting into the next morning and extending it a little bit. Getting our routine exercise and then ideally exercising outside, spending time in nature, potentially planting a garden and then returning to food that is natural.

Maria Marlowe: [00:32:32] And what about a lot of people turned to supplements like probiotics and prebiotic fiber? People are adding to smoothies. So what are your thoughts on that? Do we need those to repair the gut or do you think primarily through the diet is enough?

Dr. Will Bulsiewicz: [00:32:46] Let me start here and say that I think that there is a hierarchy and you can’t take a C minus guy and turn it into an A plus with the supplement. That’s not possible. All right. If your diet is not in line, then you’re not going to get there. And so from a dietary perspective, there’s one key philosophy. I said in the beginning, it’s not about grams of fiber. Let me tell you what it is about in the biggest study to date to connect our diet and lifestyle to the health of our gut, which is called the American Gut Project. When they performed their analysis, there was one thing that jumped out as the clear cut number one predictor of a healthy got microbiome. This one thing, and that was the diversity of plants in your diet. When you have a wide, broad mix of plants, you get a wide, broad mix of fiber that supports a wide, broad mix of microbes. Diversity in your plant diet translates into diversity in your microbiome. And that is a measure of health. So if you’re not doing that, you can’t reverse your gut with a fiber supplement or a probiotic by itself. But with that being said in my guest, urology practice, what I think your patients.

Dr. Will Bulsiewicz: [00:33:59] I mean, almost all of them are put onto a prebiotic supplement, almost 100 percent. I actually take a prebiotic myself. What is a prebiotic? It’s basically just concentrated fiber, concentrated soluble fiber that has been demonstrated in studies to eat and nurse the healthy microbes inside of us. A probiotic is the living bacteria that we’ve heard about. And, you know, I could break them probiotics in far more detail. But I think the bottom line and just to shorten it is say that they do have value and benefits to some patients. It’s not that I’m opposed, but right now there’s more hype than signs. You shouldn’t believe that the probiotic is going to radically transform your health. That may give you some benefit and it will only give you a benefit for the time that you’re taking it. And then the minute you stop, that benefit is gone. So at the end of the day, it’s me. You have to make that dietary adjustment. I really think that the core philosophy needs to be about diversity of plants within your diet. Starting to get that ramped up. And then to get you there, there is benefit to potentially prebiotics and probiotics.

Maria Marlowe: [00:35:02] Yeah. I think when it comes to any sort of supplement, there’s always a wide range in terms of what’s actually in the supplement, which strains of bacteria or probiotics are in there. I feel like that also adds to the complexity and sometimes confusion, because someone might be like, oh, I took a probiotic and it didn’t work, but maybe the one that you took wasn’t great or wasn’t great for you. So I think it’s always we can’t do what our sister is doing. Our best friend’s doing what they say on the news. We need to figure out what works best for our individual body.

Dr. Will Bulsiewicz: [00:35:32] Because it comes back to bio-individuality. So you have a completely unique microbiome. There’s literally no one on the planet that has a microbiome like you. It’s like your fingerprint. And when you take a probiotic, what you’re doing is you’re taking a generic formula that is being applied just universally to everyone. When you take that generic formula, the hope is that those bacteria will drop down into your colon and lead to good biochemistry, which gives you a health benefit and you’ll know if you feel better and you feel different. And when people feel better and they feel different than to me, if you comfortable with the costs, then it’s worth it. But if you don’t notice the difference, then that probiotic is not for you. And it doesn’t mean all probiotics are a failure. It just means that particular one is just not working with your biochemistry.

Maria Marlowe: [00:36:19] Exactly. So you keep mentioning the diversity of plant-based food. So I’m curious, how do you in your daily life, how are you making sure you’re getting that wide diversity? Because sometimes I feel like in the grocery store I see the same 50 vegetables and fruit, you know, and that’s why I love to shop at the farmer’s market. But I’m curious, how do you incorporate that variety?

Dr. Will Bulsiewicz: [00:36:41] Let me ask you a question. I’m just curious, like not to jump tables, but just give me whatever number comes to mind. How many different plants do you think you consume on a weekly basis and herbs count if they’re fresh. Again, you’re 90 percent plant-based. So you are predominantly a plant-based person.

Maria Marlowe: [00:37:01] Yeah, I would say at least 30.

Dr. Will Bulsiewicz: [00:37:05] Yeah, that’s fantastic. And that was actually in the study. That was the threshold, was if you got more than 30, you have to understand a little bit of the statistics of it that, you know, more would still be better. Thirty five is better than 30. But 30 is fantastic. They have studied native tribal people in Tanzania called the Hadza. They are one of the few modern day hunters and gatherers that exist. They don’t have organized agriculture. They just live off the land. And what they found is quite fascinating. You know, I said diversity is the key of your microbiome, meaning when you have more diversity, it’s a healthier microbiome. When they look at an American’s microbiome, we have 40 percent less diversity than they do. And they ask the question, so what are they eating? And they’re not vegan. They’re again, they’re hunters and gatherers, but they are eating more than one hundred grams of fiber per day. And when they look at the diversity of plants in their diet because they’re foraging and they’re not like just eating whatever the same routine, like iceberg lettuce with a tomato cut four ways and blue cheese dressing on top, which, by the way, was my favorite salad back in the day. They are eating literally 600 varieties of plants.And most Americans are less than 30. Most Americans are more like on the 10 to 20 range.

Dr. Will Bulsiewicz: [00:38:29] So to answer your question, how do I get more diversity in my diet? It’s very simple. It’s a core foundational philosophy for me. All right. I’m not thinking about superfoods. I’m happy to talk about superfoods and how they how they weigh in. But I’m thinking about diversity. So when I go to the salad bar. To me, if it’s a plant. It goes on my salad. It’s just a question of how much. When I go to the supermarket, the diversity of plants, when I make recipes at home. Can I spice this up with more plants? So like a simple meal that we have. I mean, we’re not like cooking. You know, we’re a normal family. We are not cooking lavish gourmet meals that are like, you know, from Forks Over Knives. We do sometimes, but most nights it’s the routine stuff. And so we’ll have, like, you know, a penne. It’ll be like an organic whole wheat penne for us and add tomato sauce and you could end it at that. And that would be diversity of two. Or you can add onions, garlic, mushrooms. You’re Italian. So I imagine you probably like this kind of stuff.

Maria Marlowe: [00:39:38] I put garlic on everything.

Dr. Will Bulsiewicz: [00:39:41] Garlic, onions, mushrooms, you know, throw some some squash or zucchini in there. Throw some fresh parsley on top. Right. And now all of a sudden, you’ve gone from diversity of to up to diversity of like seven or eight. And it’s it’s even more delicious. Yeah. So it’s just having that simple approach of saying when I have a chance to add more, I do.

Maria Marlowe: [00:40:05] Yeah, now that’s great, and I love adding fresh herbs when you put it that way. I can see how it’s actually quite easy to get diversity. Luckily here in Dubai, there’s this incredible farm here started by a woman who wanted more organic produce here, and she grows over one hundred and forty different heirloom varieties of vegetables. Well, I feel like the luckiest person to be able to order it online. And it’s delivered right to my house. And every every week I could have a different type of tomato and a different type of cucumber. And so if you guys have a farmer’s market nearby, I definitely recommend shopping your farmer’s market, because there you can find these heirloom varieties, which are typically more flavorful even than the stuff that you’ll you’ll get at the grocery store.

Dr. Will Bulsiewicz: [00:40:51] Because there’s been such pressure and this is one of things I talk about a little bit in the book is there’s been such pressure on the farmers to conform. And so they are they are being forced to choose the varietals that produce more at a lower cost and that are heavy, that are water dense.

Maria Marlowe: [00:41:07] Right. Yes. A lot of it’s sold by the pound. So what happens is they grow these massive cucumbers that are huge and the cost you two dollars a cucumber, but it has no flavor because all the water just basically dispersed the flavor of it.

Dr. Will Bulsiewicz: [00:41:22] 100 percent. And then the other issue is, I’m sure you share the same concerns with the soil. Yeah. So, you know, soil is like a marker of human health. Maybe maybe people don’t think of that. But like, the soil prepares our food supply and you can only be as healthy as your food supply. And I worry, you know, this is where I get worried about glyphosate and roundup, which is that some of the claims with glyphosate maybe go a little bit too far beyond what the science is literally showing us. But I will stand here and tell you that by everything that I’ve seen, there’s no way that glyphosate is good for your gut. It’s just a question of how bad. And I am highly confident that it’s not good for our soil and we’re dropping it by the time. And so I really hope that, like when we come out of Covid 19 phase, I really hope people wake up. And understands that, you know, we can all have our conspiracy theories and they’re kind of fun and entertaining sometimes to talk about. But at the end of day, what this really boiled down to is is we’ve been lashing this planet. We’ve been lashing this planet and we’ve got seven billion people. And, you know, it was two billion in nineteen hundred and it was one billion and eighteen hundred. And it’s going to be 10 billion in 30 years. And we’re pushing it to the brink. And this is the kind of thing that happens when you push it too far.

Maria Marlowe: [00:42:41] Yeah, we can just hope everyone wakes up. I think now everyone realizes also just how interconnected everything is from our health to just different countries like the entire planet. Like everything is connected. There’s there’s just no way around it. So I think I think hopefully people will start to think about these things like the environment and the chemicals that we’re spraying and all of these things a little bit more deeply.

Dr. Will Bulsiewicz: [00:43:08] Yeah. It’s so, so interesting to think about, you know, like, for example, think about ecosystems. So, I mean, you talk all day about this kind of stuff. I just I’m like, nerding out here. But you don’t think about the Amazon rainforest and what we’ve seen happening to that. Right. And it’s it’s kind of depressing to know, like the loss of species that exists in what is a measure of health within the Amazon rainforest. It’s actually the diversity of species. So there’s this balance that exists, and I don’t love mosquitos or snakes, actually. I’m like terrified of snakes, but I don’t want them gone because they serve a purpose. And when you remove things from the ecosystem, that’s when failure occurs. And that is literally the exact same thing that happens in your gut. Your gut is an ecosystem to. And diversity of species is the same rule the way. Whatever ecosystem you’re talking about, whether it’s your gut on a small scale or it’s like the Amazon rainforest on large scale, diversity of the species becomes key and that leads to balance and strength.

Maria Marlowe: [00:44:10] Yeah. So I’d love to switch gears a little bit and ask a question that I feel like as a gastroenterologist, you probably talk about this kind of stuff all day long. But let’s talk about poop for a second.

Dr. Will Bulsiewicz: [00:44:22] This is my favorite topic.

Maria Marlowe: [00:44:24] Yeah. Nobody nobody wants to ask or talk about this in public, but I feel like we need to talk about it because you can tell a lot from your poop. So can you can you share, when should people be concerned? Like, how can you use it as well as a diagnostic tool to kind of figure out what’s going on and maybe what you need to do to remedy that, for example? I mean, you could kind of even see whether you have enough fiber or not. Right.

Dr. Will Bulsiewicz: [00:44:49] Yeah, you can. Yeah. No, it’s it’s it’s a fascinating topic. And I kind of I don’t want to admit this in front of my mother in law, but I’m kind of obsessed with this. So I feel like poop should be a vital sign. Then like I’m not exaggerating temperature. I agree with your husband rate blood pressure. And then, like, what’s going on with your poop? All right. And for the listeners at home, you can pull this up. No, I feel bad for the person whose name is attached to this. But there’s this thing called the Bristol stool scale. Have you ever heard of that?

Maria Marlowe: [00:45:20] Of course, yes. I love that thing.

Dr. Will Bulsiewicz: [00:45:23] Yeah. Nice. So. And the Bristol stool scale actually gives you visual images of different types of poop. And there’s seven different types with four being completely normal. And no, they’re ones that are specific to constipation. There’s ones that are specific to diarrhea. I actually think that’s quite helpful to understand what’s going on with your body that we should normally be having these sausage shaped, soft performed bowel movement. And that’s what a Type four is. And when you have a lumpy, bumpy stool or when you have to string had a little turd. Those are signs of constipation. And that, to me is information I’m searching for when I see my patients as a GI doctor. The same is true with a loose stool or a cow pie or any of those types of things. OK.

Dr. Will Bulsiewicz: [00:46:06] I also look at stool frequency, so the form is probably the most helpful thing but the frequency is important, too. And you know, what we hear is that there’s this normal range with normal being one down movement per day. Maria, we have normalized that normal. We’re seeing one bowel movement today is normal, but that’s never been normal in human history until us. So that maybe be the average for us. But, you know, if we were consuming fiber the way that the hoods were in chains that are in chains and, you know, 100 grams of fiber per day, you would have three bowel movements a day because you would you would have about movement every time you eat. And those bowel movements are reflective of the health of your microbiome.

Dr. Will Bulsiewicz: [00:46:45] 60 percent of the weight of your stool is from your microbes. So it is not like the excrement or the waste that’s left over from your food. Most of the weight is the microbes. And if you take soluble fiber, which is the prebiotic kind, prebiotic is the kind of feeds the microbes. If you take cyber fiber, it actually dissolves completely. There’s no grid. Right. So you can’t make an argument that that like it literally is like it can be you just like regular water. You can’t make an argument that that is the roughage that’s making your poop big. It’s not. But you can try this experiment at home. If you take soluble fiber, you will find that you’ll have a larger bamboozlement. Why? Because you have just promoted the growth of bacteria in your colon. And that’s a good. And that leads to a bigger bowel movement. So I think and there’s so many other things that we could talk about. It’s kind of interesting. I actually have a course that I’m beta testing right now, and it’s going to be like a full launch probably this summer, depending on when we could actually do the videos. But in my beta testing, I’m in my second round of beta testing. And this is one of the lectures that people have enjoyed the most. What does your poo say about you?

Maria Marlowe: [00:47:56] Yeah, I bet. Because it’s really interesting and it does give you so much information that you can work with. Right. So if you see it’s the one or two on the chart or you’re constipated, you know, OK, I’m constipated here in a couple of things that I could do. I could have more water, I could have more fiber. I could do this. I could do the same thing on the other side. So you can use it to figure out, you know, to experiment and to figure out how to fix it.

Dr. Will Bulsiewicz: [00:48:22] Yeah. One hundred percent. And that’s and that’s one of the critical pieces as a GI doctor, when I see my patients for sure.

Maria Marlowe: [00:48:27] Yeah. And I’d love to ask you about parasites. Is that something that you see often in your practice? Because I feel like sort of in this holistic wellness world, we hear a lot about parasites. So I’m just curious, in your practice, do you see that with some frequency and how would people know or when they should go check for that?

Dr. Will Bulsiewicz: [00:48:48] So I don’t see a lot of parasites. I run a lot of tests looking for parasites. They can be hard to diagnose. To be fair, and there are certain types of viruses, parasites of a wide variety. And some of them are terrifying. And some of them are, you know, I mean, honestly could be thought of as very much on the spectrum of bacteria. So but I don’t see a ton of them in my practice with the testing that we use. I do occasionally come across them. I’m just in for them all the time. But I think that is within reason to be looking for these things. But I do want people to know one thing. There’s a harmony and a balance that exists in the gut. And when we disrupt that harmony and balance. Sometimes we have undue consequences. And what I worry about is when we try to destroy things. Strategy is to destroy microbes like bacteria oftentimes lead to people having worsening gut issues. Maybe a better short term and you get worse in the long term.

Dr. Will Bulsiewicz: [00:49:55] When it comes to parasites, I would want to make sure that there’s a good reason that we’re trying to make to do the treatment. And part of the reason that I would say that is, you know, it’s easy to sort of vilify them and make it sound like all parasites are bad. There’s actual treatment that’s been done, Crohn’s disease using worms. You can actually treat Crohn’s disease with worms? Because the worm is not necessarily trying to kill you. The worm is actually contributing to a balance that exists in our microbiome. Our microbiome has bacteria, fungi, parasites, archaea and viruses. And they all live in harmony and sometimes they’re meant to be there. And so I guess the broader point that I would like to make on this topic is that the way that we win with our gut is by empowering the good guys. I don’t really think that our best strategy is typically to try to destroy the bad guys.

Maria Marlowe: [00:50:51] Yeah, well said. Well, this has been very, very insightful, so much amazing information. I’d love to ask you one last question. If there is just one tip you can leave our listeners with on how they can live a happier and healthier life, what would that be?

Dr. Will Bulsiewicz: [00:51:07] I think you probably know where I’m going here, and that is that I truly believe and I talk about it in my book, Fiber Fueled. But one of the main things that we’re missing is this concept of diversity of plants and the book is very much about meeting you where you are. So I’m not trying to turn you into one hundred percent plant based, if that’s not what’s right for you. But what I am trying to do is show you the science based approach to optimizing your gut microbiome and making this a part of your dietary philosophy. No matter what diet you follow, the diversity of plants, no matter who you are, you can do this. You can do this. And you will reap the reward as a result of that.

Maria Marlowe: [00:51:50] I love it. Well, thank you so much, Dr. B. And for more from Dr. B, you can head to theplantfedgut.com. And of course, you can check out his book. You can find the book wherever books are sold. It’s called Fiber Fueled. And if you head over to my Instagram @mariamarlowe, we’re doing a book giveaway this week. Well, thank you so much for being here, Dr. B.

Dr. Will Bulsiewicz: [00:52:12] Maria, thank you so much. It’s been a pleasure hanging out. And, you know, honestly, you keep talking forever, I’m sure. But thank you for everyone listening and hanging out with us.



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