Diet to Improve Gut Health - with Brenda Watson | The Empowering Neurologist EP. 22

Hello everyone, I'm Dr. David Perlmutter and welcome to The Empowering Neurologist. Today we're going to speak with Brenda Watson, and that's a probably a household name for many of you. Brenda's new book is The Skinny Gut Diet, terrific book. She has a wonderful public television program that goes along with it. She's really dedicated her career to helping people achieve long-lasting health, to live a vibrant life through improving digestive function. Who knew how important digestion is? She's a dynamic health advocate and among the foremost authorities in America today in terms of optimizing nutrition and the all-important digestion extraction of nutrients from the food that we eat. She also focuses on, on natural detoxification and in various approaches to internal cleansing. She's a New York Times bestselling author and has written 7 books. She has been called the diva of digestion and continues to educate people in terms of digestive health, how having good digestive health is the foundation upon which the general health throughout the rest of the body is built. Her high-energy, no-nonsense approach to bodily functions has made her a very A popular presenter on public television. So let's jump right into the interview. So, Brenda Watson, so nice to talk to you. How are you doing today?

I'm doing great today.

And the reason we're together is you've written this phenomenal book, Skinny Gut Diet, that I talked about in the introduction. And, you know, there are a lot of people, yourself included, who are really focused on this revolution in understanding metabolism, As it relates to weight loss and weight gain and how intimate that relationship is with this 100 trillion microbes that live within us. How did this dawn on you? What was your epiphany here?

Well, I think, David, the epiphany for me— I've been in gut health for 25 years before it was ever popular. You know, I was in working in colon therapy and detoxification programs in clinics back in the early '90s when it was weird. So no one was thinking about gut health, as a matter of fact. But I began back then doing stool analysis right when the first laboratories began to come out with those and more of the functional medicine side of things. And so I really knew the impact that gut health had on all of our health, you know, our immune system and all the things we both talk about. But I didn't have any idea about it in terms of weight management. In about 2012, I went to the New York Academy of the Sciences for a probiotic symposium, and I really didn't want to go. My husband Stan drug me there, and I'm like, I don't really want to go to that because it's a lot of microbiologists, and, you know, I just don't want to go. But I heard a couple of very important people present, doctors present. Martin Blaser was one whom you know, and another gentleman from the UK, a doctor from the UK. And they were talking about the relationship between bacteria and weight management. And that kind of made the lights come on for me because I had never looked at it from that perspective before. So as I went back and looked at the research on it, it started in 2004 when Jeff Gordon did the whole, you know, looking at giving obese mice the certain what I call the fat bacteria and they— the skinny mouse got fat. So that's when I guess it really began, the scientists' eyes coming open and going, wow, there is some correlation here between weight and gut bacteria. Well, since I had been doing stool analysis so long, I thought, you know, I look at these stool tests and at the bottom of them, there's always this adiposity index and I never paid much attention to it. I'm looking at good bacteria, bad bacteria, how do they digest their foods, do they have inflammatory issues going on from the test. And as I began to go back over them, I thought, wow, this has been on this test for a long time and I never paid any attention to it. I'll bet—

There you go.

I could go back and recruit 10 people who are overweight, do a stool analysis on them and see if their— it's the Bacteroidetes is I call the B skinny bacteria and the Firmicutes I call the fat bacteria. See if these ratios are out of balance in these people because that's what they're saying, that they're, you know, they have too much of the fat bacteria and not enough of the B. skinny. And in every single case of these people who were anywhere from 20 to 80 pounds overweight, they had this adiposity index that was out of balance. And so then I, then I began to, you know, bring them in as an approach and I worked with them for 6 months. So for 6 months, I put them on a particular plant-based diet with protein, good fats, And then every six weeks, I did another stool test to see if the Firmicutes and the Bacteroidetes came in balance because you're never going to get rid of all of it. You're not like it's not like the fat bacteria is going going to go to nothing. It's just that you want to bring the ratios in a better balance than than having the the fat bacteria be a lot higher than the be skinny bacteria. And so every six weeks for six months, as I change their diet, as you know. Dr. Perlmutter, everything is diet to a great degree, and especially with weight management or weight loss. So as I did this and worked with these people and taught them how to eat, because they didn't know how to eat, I had a weekly class with them, and each week I taught them something different. How to do, you know, what I call blending of juices, not juicing, but blending of juices and keeping the fiber in, and how to eat healthy. They begin to lose weight. And then I began to see these ratios become back into balance.

Let me just— there was a great point that I don't want to be lost. And that is, you said blending of juices as opposed to juicing, because of the fiber. And I really think that's a really important pearl for our viewers. Because, you know, so, so many people are into juicing because of all the nutrients that are found in fresh organic vegetable juice with some fruit added, perhaps. But the problem is, so many times when you juice, many juicing machines take out the fiber. That stuff that you end up throwing away is highly valuable for exactly the reasons that you're talking about right now.

Yes, you do not believe the people I see who are actually becoming pre-diabetic because of this juicing. Because the problem of it is, is the fiber of course manages the blood sugar, and many times people are putting too much fruit in it in the first place. But what I believe is by a viral Vitamix or a Blendtec or one of the blenders, you keep that fiber in there because even though you extract the juice out of it, there's still sugar in there. And so it's very important, and I really want to teach this because I believe many people are just going into stores and purchasing juice and thinking in their head, oh, this is really healthy, when it's just another sugar drink.

Right. And even here in Florida, you know, well, nationwide, everybody thinks, well, I'll start my day with a glass of orange juice. You know, 12-ounce glass of orange juice—that's 36 grams of sugar, 9 teaspoons—and that's you know before the croissant even arrives. So you know you're right, and and here we are having a conversation where we're bashing juice and we're doing it for the right reasons, I believe.

Yes, and so with my group, of course, what you have to do is most people, like we were saying, put fruit in it. Now what I had them do was. In a green— let's say they did celery, you know, cucumber, kale, spinach, ginger, those types of drinks. I always had them add 1/2 of a Granny Smith apple. And with 1/2 of a Granny Smith apple, it's palatable. So they can drink it, it tastes good, they adjust to their taste. You know, they could put 3/4. But because on the Skinny Gut Diet I have them counting their teaspoons of sugar in their daily intake, You know, with the, with the teaspoon tracker that I have.

Right, you did. And I thought that was actually very, very handy. In fact, I dog-eared that where you actually go through and talk about— there it is, chapter 8. You talk about food, but in, in relationship to how many teaspoons of sugar. It's really very handy.

It is. And here's the, here's the, I guess, the sort of the mystery out there. People are looking at a label in a grocery store or a health food store, and they're looking at the grams of sugar on the label. Forget that. Just forget the grams of sugar. Take the carbs minus the fiber and divide it by 5, and that gives you how many teaspoons of sugar is in a serving of that food. So what I had the people I worked with do is keep to 10 teaspoons a day. Now that's in all the food they're eating. That's not like added. That's in all the food they're eating. And so that's the important piece is Be— is that formula right there so that they're looking like if they're going to have— let's say they're going to have a sweet potato or they're going to have— I'm trying to think of something that they would have. Anything, anything that they would have, they would be able to have half a cup of blueberries, for example. They would have to be able to do that formula on the half a cup of blueberries and then add that into their daily intake of 10 teaspoons a day. And with that, Because you have about 7 liters of blood in the body and you need 1 teaspoon of sugar in the blood at any given time to stay balanced. And that's why the 10 teaspoons is important or below. Some, if they needed to lose more weight, I could get them down to 8 teaspoons of sugar a day. But remember, 80% of what they're eating is plant-based, you know, and then they're having protein, animal protein too. And there— and I did a lot of the fermented vegetables. And one of the things that I taught was eating fermented vegetables and making their own, you know, whether it's sour cabbage or carrots or asparagus. I taught all sorts of classes because you can actually ferment any vegetable. So I taught that. So like, for example, a snack, they might have a slice of turkey and in the middle of it, roll it up with a fermented vegetable. And that would— so they're keeping the food going in. About every 3 hours. And so that keeps the blood sugar balanced. So it's— it is eating frequently.

And you mentioned again fermented vegetables. And just to really be clear about that, why is that so important?

Well, fermented vegetables actually have a lot of the lactobacteria. They don't have bifido, which is the main friendly bacteria in the colon. So really, you have to supplement with a probiotic in cases, in this case or in any case, to get the good bacteria in the colon. But in the fermented vegetables, they get a lot of the Lactobacillus bacteria, which is the main friendly bacteria in the small intestine. So as you— if you go into a store and you look in a refrigerated section, anything that's refrigerated like cabbage or carrots, and they have all sorts of different brands now, even pickles, If they're in the refrigerator and they are— have been fermented with salt, they're fermented vegetables. If they're on the shelf in vinegar, they're not. They have no bacteria in those. So those have been pasteurized. But because I wanted to teach this, and it's like simple Simon to do this, you throw some vegetables in a Mason jar with some Celtic sea salt and water, put a lid on it, sit it on a counter for 36 hours, and you have fermented vegetables. And many people think of it as only sauerkraut, but we did everything. We did anything, like I said, from asparagus to green beans. So we have a lot of—

Do you inoculate these with any probiotics? I know I recently spoke with Dr. Mercola and he likes to actually give a little boost to get the bacteria started.

You can. Now there are some out now, some starter cultures, and there is a starter culture, I can't remember the name of it, but they have actually done a study on this particular culture showing that the lacto grows much faster doing the starter culture. So that is another thing that you can also purchase in the store. So if you ask someone in the store for a starter culture, that might help boost the amount of friendly bacteria.

But you can really use a good probiotic supplement as a starter culture, can't you?

Well, yes, you can. You'd have to, you know, make sure that you just— again, it's mostly lacto. I don't know how the bifido would stay stable in it, but the lacto for sure, adding that in there, that might

And Brenda, can you give us some of your tricks for getting good levels of prebiotic fiber and maybe define what that means?

Well, mostly soluble fiber. And this is the way I educate people on what's the difference in insoluble and soluble fiber. Think of a kitchen sponge. Soluble fiber soaks up and it mixes clear in water. Insoluble fiber is like the roughage on the other side of the sponge, the green side. And so that's what gives you in your colon the bulking of like for, for bowel movements. The soluble fiber is your prebiotic. So anything from like acacia fiber, FOS, your inulins. Now FOS and inulins can sometimes be a little bit gassy. That's why I've tended to lean toward the acacia fiber. And so that soluble fiber, when it mixes up clear, has the ability to feed the friendly bacteria, but it does much more. It is what creates you feeling full. So when you have a scoop of that fiber, it actually releases a hormone that tells your brain you're full. And so you have that. It actually— it also helps manage blood sugar levels. So it's a great addition to a probiotic is adding in something like a soluble fiber prebiotic. Now here's the one thing that people get so concerned about. They start saying, oh, well, I feel gassy. Well, in the beginning, when you're taking a probiotic, a prebiotic, or you're changing the bacteria balance from good— from bad to good, you will feel some gassiness for a few days. It's not a bad thing. I tell people that. But it will pass. It will pass. Yes, it will. It'll pass.

I've been through it.

Yeah. So it will pass. It's a war going on in there. And so when it's switching, you know, you have a little bit more fermentation going on, and so you could get a little gassy. But it should go away in a few days.

So your favorite fibers seem to be— you mentioned acacia gum. I guess that would be acacia senegal, the gum that comes from the tree. And

yep,

that is a— it's an excellent— I agree with you, an excellent prebiotic fiber. How about prebiotic-rich foods?

Yes, like artichoke. Different foods like that, you know, are very good foods for, for, you know, prebiotic— as a prebiotic, for sure. Yeah, food is always a good choice.

You know, people talk about eating fiber, but it's, it's beyond eating fiber here. It's specifically prebiotic fiber to nurture the gut bacteria. So, so that said, you also mentioned in your book about certain drugs, and I think you touched upon these proton pump inhibiting acid blocking drugs that everybody thinks they have to eat, they have to take whenever they have a meal. So Why is that such a threat?

Well, the acid-blocking medication disrupts the pH. So you're not allowing the stomach to produce acid. So therefore, you know, you change the pH there. Your stomach being the tank that, you know, sort of churns and mixes and liquefies your food, especially proteins, that's where the predigestion of protein is. So if you stop the production of stomach acid, you will have undigested protein entering into the small intestine. And so the acid-blocking medication is very dangerous long-term, and that is proven over and over and over today. It increases osteoporosis, it increases your risk of pneumonia, and it increases your risk of C. difficile antibiotic-resistant bacteria. Those drugs are only supposed to be taken very short-term. For example, if you had an ulcer and, and it was an— it was an open ulcer, and you needed to take an antibiotic, let's say, while you were doing that, that— and that's a very strong antibiotic that you take for ulcers, you may want to take an acid-blocking drug for a couple of weeks. But I have had people in audiences raise their hand and tell me they've been on them 14 years. And I'm like, seriously? So no, these are dangerous.

A big study came out of Stanford recently showing a about a 14 to 17% increased risk of heart attack, but if you have that heart attack, your risk of dying from it is doubled. So, in people taking these proton pump inhibitors, another report interestingly showed that the way that the bacteria regulate their pH within them is affected by their exposure to the drug. So, it's not just— Okay. The acid-producing cells in the stomach, but the actual bacteria themselves may be directly affected and therefore their internal metabolism can be changed when they're exposed to the proton pump inhibitor.

The problem that people have is if they stop taking them, there's a rebound effect. So they believe that when they have the rebound effect that they're— that they have— they believe they have too much acid anyway when, as you know, many times they don't have enough. And that's a very unclear way people don't understand it. But when they stop taking these drugs very quickly, then they have a rebound effect and it seems like they're worse. One of the things I've always had people do is wean off of them.

Uh-huh.

So you take, you know, you start with, you know, taking half dosage and then half it again. And then as you're doing that, then you take a probiotic, you take some, you know, powdered L-glutamine which helps with, you know, some inflammation in the upper esophageal area, powdered glutamine is wonderful, at least at 5,000 milligrams a scoop. Taking that with a probiotic and then weaning yourself off of them, and I have success after success with people doing that. So that's the key point.

What I really like hearing from you is this notion that there's more going on to obesity and overweight than simply, obviously, calories in versus calories out, or even carbs versus fat, that, you know, the gut bacteria are playing this fundamental role. And I think the empowering part of that notion is that, you know, people are struggling with weight, and it's not necessarily their fault at this point that their bacteria have been challenged by drugs, by previous dietary indiscretions, and that, you know, even though they may be trying really hard now in terms of managing their calories, This missing link may well explain why so many people are struggling with their weight.

Well, I think one of the key factors is when your fat bacteria levels are really high, the fat bacteria really, I guess you'd say, flourish on sugar. So actually, you're craving something and you think that it's psychological with you, but it's probably more likely your bacteria in there going, feed me. Now, when you begin to switch that ratio to the B. skinny bacteria, it likes more of the fiber like we were talking about, the prebiotic. A prebiotic is what makes that particular bacteria proliferate in the digestive tract. So the difference is if you start feeding that B. skinny bacteria and the fat bacteria levels go down, they stop craving so many of the carbs and sugar. And that was the beauty of it with the the people that I worked with on this program for, for the 6 months, they would come over and say, I'm not craving, I'm not craving anymore. I'm like, well, you're also keeping some food going in every few hours and keeping the blood sugar balanced. And as we begin to shift— now, they didn't just have overweight issues, they had GI problems, some of them had headaches, some of them were depressed. I mean, when you're overweight, you have a lot of other things going on in I find in the body. It's not just being overweight. There's a lot of other issues. So as this began to happen and they began to lose weight, balance the bacteria, GI issues went away. I had one lady who was so depressed and she got so much better. She was— she became the happiest person and she didn't even really need to lose but 20 pounds. It wasn't like it was a big deal for her. It was— she was more of a menopausal issue. But as we began to shift that bacteria in her, She said, I have been taking something for nausea from the drugstore for 5 years every night.

Oh my gosh.

And that all went away whenever, you know, she began to balance this bacteria. So the key to it is, you know, you have overweight issues but you have a lot of other problems. And as you know, one of the things that people typically think is if there's something wrong in the GI tract, they have a GI symptom. And that's not necessarily true. As you know, it could be if you're depressed, you might not have a GI symptom. If you have migraine headaches, you might not have a GI symptom. If you have arthritis, you might not have a GI symptom. But the gut, what I call the GPS, the Gut Protection System, is the radar is off. And when that radar is off, then of course we get into the whole leaky gut issue and, and inflammatory conditions around the body that people don't associate back To their digestive tract. And most of the time, they're, you know, even when years ago when I used to, you know, do lectures on constipation, people would come and go, I didn't really realize I was constipated, but they were, you know. So they don't really pay attention to their gut very much.

I think it's a really good point. You know, there was a doc— there is a doctor in England, Dr. Marios Hadjivassiliou, who really calls our attention to the fact that food issues may be related to neurological disease even if there is no gut involvement. And he specifically focuses, for example, on gluten sensitivity. Mm-hmm. And, you know, we call these extraintestinal manifestations where the gut is not involved and yet gluten sensitivity is, which can be brought on actually by imbalance of gut bacteria, can be related to Some of the things you mentioned— cognitive issues, migraine headache, even movement disorders, and even seizures. So it's a, it's a very, very good point. Well, listen, this is a great book. And again, I'll show a picture of it because I really like it. I think the COVID is really cool too. And you'll notice, viewers, that I gave a nice endorsement for Brenda here because it's a terrific book. What is really great about it and all of your work is it's so user-friendly, you know. A lot of times you run into these books that, that are a little bit scientific and you read them, and I think if you're not in the biz, that it can be a little bit challenging to figure out what's the message here now, what am I supposed to do? But you've really done a crackerjack job, and I applaud you for that.

Well, thank you, thank you. You do too. So we have to get the message out as simple as we can, because the way I look at it is if people can't do it, it doesn't help them. They have to be able to be able to do it.

And that is the mission. Well, listen, Brenda, all the best and thanks for joining us today.

Thank you.

Okay, bye-bye.

Bye-bye.

Well, I really enjoyed that interview. Brenda gives such a great presentation. She has so much good information for all of us. And, you know, again, really drives home the point that health derives from good digestion, that, you know, our ability to digest the very food that we eat is the cornerstone For health in the rest of the body. I hope you enjoyed the interview today. Thanks for joining us. I'm Dr. David Perlmutter.