Dr Jason Hawrelak: Decoding the gut Microbiome

There's been some research they looked at is a mouse study, you know, so there's some limitation there. But what I thought was interesting is they had mice eating like really healthy microbiome diet, mice eating junk food seven days a week and then mice eating junk food on the weekends. And it turns out that the weekend was almost as bad as eating junk food seven days a week, which, which blew their mind because I thought, okay, you know, eating healthy food five days a week, surely that's going to count. So it's just like no more than half is as bad as having it daily, which is like w.

Hello and.

Welcome back to the Year Great Podcast with your host Unique. I created this podcast to inspire, support this wonderful community of health seekers. It's also just my passion project. I don't get paid to do it. If you want to make a donation, hit me up for my Venmo. But I just do this, you know, I, I set aside time to do this when I have a healing story or I am excited about a health professional and today is just that. Dr. Jason Harolak is a researcher, educator, western herbalist and naturopathic physician with over 25 years experience, clinical experience. His primary expertise is gastrointestinal health and the gut microbiome. Yes, please, all of that. The key aspects of his professional background. He holds a PhD that focused on the capacity of probiotics, prebiotics and herbal medications to modify the gastrointestinal tract microbiota. He is considered one of the leading experts in the treatment of gastrointestinal conditions with natural remedies. Herbal remedies, I would imagine. He is the Chief Researcher@ProbioticAdvisor.com if you are interested in an incredible education, I suggest that you go there can become a member and anytime you take a antibiotic he can tell you what probiotic strains are appropriate to repopulate your incredible gut microbiome. He is considered one of the leading experts in the treatment of gastrointestinal conditions. He has taught health professionals at both the undergraduate and postgraduate levels for over 20 years and currently is a senior lecturer in the complementary and alternative medicines at the University of Tasmania College of Health and Medicine. He is a fellow of both the American College of Nutrition and Natural Paths and Herbalist association of Australia. He's pretty much a badass. He has been studying the gut microbiome, looking at gut tests and really I couldn't have been more excited to pick his beautiful and really kind brain. I had a lot of questions, a lot of them very personal about Crohn's disease and gut health in general. As you know, he spends a lot of time looking at IBD guts sibo, which he definitely mentioned that sugar is no bueno for the sibo. Just in case you were wondering, a lot of people with SIBO often end up with reoccurring SIBO symptoms because they just never change their diet and lifestyle long term and often go back to the very foods that that recede the situation, which I thought was interesting as well. I learned so much and I really learned that the protocol I'm on is awesome. Awesome for the gut microbiome, awesome for overall health, and that's really exciting. I love it when, unbeknownst to me, I get these kind of affirmations and confirmations of where I am. I would trust it anyway because I feel so good. But you know, it's always nice when somebody who's studying the gut microbiome is like, yeah, your high fiber diet for the win. Anyway, I hope you enjoy this conversation and I'll see you on the other side.

Hey, good morning for me, but I don't know what time it is for you.

Unique afternoon in Los Angeles.

I was looking at your bio. You're in Tasmania?

I used to be. I live just north of Byron Bay where I first came in. Byron Bay. I was a backpacker 1992 and it was low scale hippie. Whereas now it's different. But the beaches are still beautiful and the rainforest around it is amazing. There's so much culture of wellness that eating well and healthily is so easy in this part of Australia. That's one reason why I live here is because it's so easy to get amazingly good food 12 months of the year. That's a big thing, as I'm sure you'd agree. It's like if you don't have access to good food 12 months of the year, your health long term suffers for that.

I think about that a lot because I take morning walks watching the sunrise come up and I think about how health is a verb. It's not something you do once, it's something you get up and you do every day. It's an active state. I think in modern culture, so many people have become complacent thinking, oh, I can be healthy during the week and then I can do whatever I want on the weekends. There's a lot of people doing things that they think are right. But you've had 20 years experience of working with the gut microbiome and studying the gut microbiome and making you an expert, hopefully clear up some confusion. But health is not static. Yeah, health is not static. It's not a static thing. I see clients who will be working together and they feel good and they're having good bowel movements and then they go away on a trip and they eat all of this stuff and they come back and they go, oh, I don't feel good and I'm constipated. I'm like, yeah. Because everything we do shifts our gut microbiome. This idea that we can kind of just do whatever we want and it's not going to have any consequences is, I feel like a bit disconnected.

Yeah. And I think it's something that maybe it's relatively common in our 20s or something. A lot of people have got that idea that we can just put garbage, as much garbage in as possible and there'll be no consequence. And for a while, some people seem to get away with it. I mean, some people don't and they feel it right away and they feel bad right away. But other people seem to get away with it for years before it catches up with them. It's never too late. Yeah, 50, 60, you can still change things out, it'll still make a big difference. But it's just like the earlier you make the changes and stick with them, obviously the better the long term outcome is going to be.

And it is sticking with the changes. Right. You can't think that you can eat a couple good meals and you're back. And.

Yeah. And even from a microbiome lens like there, there's been some research they looked at, there's a mouse study, you know, so there's some limitation there. But what I thought was interesting is they had mice eating like really healthy microbiome diet, mice eating junk food seven days a week and then mice eating junk food on the weekends. And it turns out that the weekend was almost as bad as eating junk food seven days a week. So I thought, okay, you know, eating healthy food five days a week, surely that's gonna count. This is like, wow, that's intriguing and also illustrates the importance of sticking, you know, so, I mean, I don't think the occasional treat is not gonna be an issue at all in the context of a really healthy diet. But I do think that having, you know, two days a week where you eat absolute crap will have consequences for your system. Yeah.

So then that leads me to good question, which is how does sugar and does fruit and table sugar affect the gut microbiome in the same way?

This is an interesting area as A microbiome. I always hasn't used the word expert. I've been doing it for, I've been researching for 25 years. One of the biggest issues with the western diet that's high in processed food and high in sugars is not from a colon perspective and the microbiome perspective, it's not the negative impact of sugar on the microbiome, but it's the fact that nothing's reaching the biome. There's no fiber, there's no polyphenols, there's no what we call microbiotic accessible carbohydrates. But you do get protein being putrefied, you get bile, that sort of comes down there. So you're kind of feeding more pathogenic pro inflammatory microbes and not feeding the good guys because you're just absorbing everything from that processed sugary thing, you know, and then we always get the blood sugar spikes and dysregulation that occurs from that in a pretty direct way. And the microbes start eating away your protective mucus layer. You know, I just had a microbiome commerce in Rome the last two weeks ago and they were talking about, okay, we should be aiming for 50 grams of fiber per day. Is that better than 15 or 10? Yes. If we look at traditionally what societies were consuming across the world, some were 100, 150 grams of fiber per day. But 50 is kind of the minimum we're going to work with. They did do this human study where they had people eat 40 grams of fiber per day, or 14, just for a week, and they looked at the composition of the microbiome and essentially it's one week on that low fiber diet meant they had these massive blooms in mucus degrading bacteria. So keeping in mind that you've got this, you've got your cells here, then you've got a layer of mucus, and then you've got your bacteria here. And the mucus layer plays a really important role in preventing microbes and micro byproducts and inflammatory compounds from interacting with gut cells. But it turns out when we stop feeding the microbes fiber, they eat away at that protective mucus layer and make it thinner and thinner and thinner. And then we essentially get leaky gut kind of consequences that we see around us. And that can be seen in just one week of eating a lo fiber diet.

Yeah, that is intense. One week of eating a low fiber diet, you can start degrading that layer, that mucosa for sure.

I don't eat sugary processed foods, haven't for like since I was 19. So like a long time. The main problem with the sugar isn't the direct negative impacts on the microbiome, it's the indirect consequences of having a non fibrous diet that doesn't feed your good bugs. That is the main concern because I treat lots of patients with small overgrowth. Yeah. Yes, direct. You can hang it directly recognizing impacts from, from sucrose and directly in that case and table sugar. But for when we're generally saying microbiome, we're talking about colonic microbiome. So it's a different situation because those things just don't reach there, you know, because they get absorbed in your small intestines. So even though some of your best bacteria, bifid bacteria and faecalobacterium, they would love to eat sugar, they just don't get to because it doesn't, doesn't reach.

Come on guys, come on.

They get fiber. Yeah, they get the fiber, you know, so we like, you know, sugar process in a way that we can't broke it down, which is what fiber is. Yeah, essentially it just, that's what feeds those, those particular microbes and then they don't have to eat it by us, our protective gut layer, you know, and they actually encourage a thickening of the mucus layer when we're feeding that fiber. It's an interesting scenario, I think. You know, soft drinks are horrific things that shouldn't really be sold, you know, like they're. Nothing good comes from those things. But we can't extrapolate research from a Coke or, you know, soft drinks. And it was the same as an apple because it contains a certain amount of fructose. It's like totally not. You cannot do that. It's like in that apple you're getting hundreds of millions of bacteria for one thing, and you're getting polyphenols in the skin, you're getting pectins and soluble fibers as well as some fructose. You know, it's completely different package. And in that apple you're getting all these health enriching properties that feed beneficial bacteria. You don't get that from a dose of fructose from a soft drink. And I think that has been skewed so that everyone thinks that fruit is evil because fructose isolated fructose is evil. And I think that's a huge concern too from my perspective. Perspective.

Well, a lot of people also get their microbiome is so degraded that even eating fruit is bothersome to them where they're getting bloated and they're not digesting properly. And so what it sounds like you're saying is that that's really the outcome of potentially a lot of antibiotics. Drinking alcohol, like what is the main thing Eating a high processed food sugar diet that's really degrading.

Key, but not the only thing. But the western diet is obvious, is definitively problematic from microbiome perspective. But we're also in a situation where antibiotic use causes massive changes to the microbiome. C section birth has got long term repercussions. Formula feeding, long term microbiome repercussions, the toxic soup that we're constantly surrounded in have negative impacts on the microbiome. Pesticides again harm our beneficial microbes. Glyphosate's the case in point. But others do too. It's pretty consistent across the board. And so we have a reduction of bacteria with pesticide exposure and increase sometimes pathogenic or pro inflammatory species as a consequence of that too. We have this sort of almost perfect storm of scenarios in the west that we had very high increasing rates of C section birth, increasing rates of formula use, lots of antibiotic use, particularly in early childhood, which we know causes essentially you can argue lifelong alterations.

Lifelong. Let's just say this child was a C section baby. They breastfed and they go on to eat a really healthy diet, high fiber, good variety. If they never go through their 20s of alcohol and eating a lot of processed foods or fast foods or hangover foods, let's just say do you still see a problem like if they have a really good diet after that?

Yeah. No. I think the breastfeeding thing is huge. Okay, so let's say if you have C section and then completely formula fed, their microbiome is always different. Like you can still make it better by eating the right foods. Don't get me wrong, I'm not saying that has no impact. It's just that some of the early immune system training, and we would even argue nervous system or brain training that comes from the gut brain connection and gut immune system connection occurs in the first couple years of life. We know that if the ecosystem is different at that point, and it is different in kids born via C section and formula fed than kids born vaginally breastfeeding, they have increased risk. This manifests as increased risk of allergic disease, depression or anxiety. There's a whole range of different conditions that we know are associated with some sort of altered birth protocols. But it's through sort of the change in the microbiome composition is it is.

Different always no matter what you eat for the rest of your life. If you never take a antibiotic, it's always altered. Is it always altered for the worst?

Arguably, based on data, we'd say yes. I mean you might find the, I mean I always say all these hard, hard, you know, different advances. Like there might be the exceptional rare case where someone's microbiome is so deranged that you might go, okay, well having that passed on to the next generation may not be the best scenario, but I would say it's general rule. Yeah, interesting.

I was looking here at your main focus are acute GI conditions. You're looking at a lot of irritable bowel gut microbiomes. You're looking at a lot of small intestinal bacteria overgrowth. You're looking at inflammatory bowel disease. I was vaginally born, breastfed for three months and then my mom made some sort of concoction of like raw milk, eggs, molasses, some hippie thing. Because my mom was like a baby making machine. So she was on to the next kid. So she was weaning us and getting us on these bottles. At 34, I was diagnosed with Crohn's disease. And so I'm very fascinated about your thoughts because I was having gut issues, but I was still drinking alcohol and taking clients out and working. I was a working mom. And you know, I could tell that alcohol didn't do right my b but I couldn't tell why. And everybody seemed to be doing it and seemed to be fine when I was diagnosed. I rem saying to the doctor when I woke up from the colonoscopy and they said, well, what can I do diet and lifestyle wise? And he goes, nothing, there's nothing you can do. And you are going to get on these biologics and you're going to have all these surgeries. And I just remember the minute he said, I was like, I'm going to heal this naturally. I don't know how, but I'm going to go searching for the answers. And so I'm really curious. Dysbiosis, gluten related disorders. Like you really study this stuff. If two people come in with Crohn's disease to see you do you see the same issues in the gut microbiome present?

We often see similar patterns. You don't always see the exact same picture, but there'll be some commonalities. Like I mean, broadly speaking, we go too, too little good bacteria, too much pro inflammatory species. That's very broad. But you can go into six. Like there's One bug species called faecali bacterium that very few people have heard of. But it's like one of our most amazing, important keystone species in our gut. And we know that people with Crohn's tend to have low levels of faecalibacterium and they have higher levels of, let's just say E. Coli and more traumatic sort of E. Coli. So that pattern is not uncommon to see and we can address that. And research even shows that people with Crohn's who have higher amounts of Kalibakturuna respond better to every intervention, whether that be biologics or dietary changes or lifestyle, whatever, you know, and that's certainly something I see in my practice too. So we focus on let's increase Faecalobacterium, you know, as well as other anti inflammatory species. And I always find it amazing. Yes, there's a genetic component with Crohn's, no doubt, but it's increased like tenfold in the last 40 years. Tenfold.

What's changed?

Our microbiome has changed, our diet, lifestyle has changed, but the microbiome is huge.

Yeah.

With this condition, and to me it's one that actually responds really well to treatment. When we were able to change diet and lifestyle and optimize in the microbiome, it's like we can put the disease in remission long term. You know, people that like using the word cure, so I don't use it in this instance, but it's like you get them into long term remission and they're fantastic. Life again. You know, sometimes we have to, we use herbs and we're using pharmaceuticals and herbs and microbiometrification, depending on the case and how severe it is, etc. How long it's been going on for and how much degree of damage Crohn's can be from very small, little isolated ulcerations to like your entire gut being inflamed. So, you know, they can vary in severity, but irrespective of that, people get better. If you work on diet and lifestyle, which is not surprising in any way when we consider that that's like with interfacing with the gut too. Antibiotic use has definitely been a risk factor for Crohn's too. We know that even early child antibodies increase the risk of inflammatory bowel disease development later in life. And in people that are in remission for their inflammatory bowel disease, taking course antibiotics increases the risk of a flare developing too, because you're just disrupting that ecosystem, causing that imbalance and then that.

Flows off the story ends well. I went into remission naturally, but I couldn't find anybody who really understood the gut microbiome. Which is why when I found you, I was like, oh, you're gold. Because you actually understand the gut microbiome and disease. And I went to a lot of people who really did not understand it. And I ended up fasting to kill off the gut microbiome because I guess after a certain amount of hours, the gut microbiome dies off. Majority of it, some of it does.

A lot of the research on fasting has been done during Ramadan, which is like an easy population to work with because you've got. There's millions of people and you don't eat for long stretches of time during the day. But it's not the same as completely water fasting.

I didn't water fast. I ate white rice for four days, six days, and white rice and salt, and that was it. Because it digests in the mouth and in the stomach, so.

Got it. So you took like your own sort of elemental diet, essentially, is what you put yourself on in that way. Yeah, yeah. And we will see changes in the microbiome. Some bugs will go down, some bugs will stay more stable. The ones that eat mucus will interest, you know, probably stay more stable because their supply is still to consume. Yeah, some are beneficial. Akkermansia is one of those microbes that many people. More people have heard of these days in the last few years. You can't definitively say yes for every single person. In general, we say, yeah, that's not a great scenario. But we know the main risk of having, you know, based on a current understanding of what Akamanzi does, is we have metabolic dysfunction, obesity, type 2 diabetes, et cetera, as it's higher risk. And I don't think you necessarily look to me like you're in that category.

My genetics, all over my genetics is type 2 diabetes, obesity. Like, when I've done genetic testing and I say I'm 57 and I weigh 125 pounds, it's like, what are you doing? You know, because every one of your genetics points towards multiple disease states. And so I've been in remission, naturally, without intervention, but I always think, is there more I should be doing? I don't take a probiotic. So I watch a lot of your stuff because it really validates what I've been doing for the past 13 years. So I've been in remission for almost 11 years. Which is diet.

Yeah. Which is almost just like, from a goal perspective. That's amazingly good. Yeah.

Right.

They get someone getting 12 months in remission without a flare, they're pretty content, you know.

So I have and I wrote a book about my journey of getting on a high fiber diet where I eat protein. I'm an omnivore, but I eat a high fiber, low saturated fat diet. A lot of legumes, a lot of vegetables, some protein. I cannot do saturated fat. Like my body wants to gain weight as soon as I start with any kind of saturated fat, whatever my genetics are, it wants to go towards type 2 diabetes. I don't eat, I don't drink alcohol. And that's how I've maintained remission. And a lot of people are like, oh, that's so restrictive. And I'm like, no, you don't understand. When you have Crohn's disease, it's like your body is always gearing towards disease in a weird way is what it feels like.

Yeah. And it's like you've worked out how to keep your body happy.

Yeah.

And you kind of tuned in. And I think maybe it's important for all of us to do that actually. And sometimes to requires a disease to encourage us to go down that, that particular path and become more in tune with like how what works or not. You know, I think often when you get used to eating really well and you can tell when you eat something that isn't because your body just feels off and you're like, I don't want to do that. You know, like in my taste buds, like the almond croissant, I feel like crap afterwards. It's like worth feeling an hour and a half, like bad for that sort of 30 seconds of taste, but taste bud, enjoy.

I call it the mouth party. But if I am going to have something, it will be a croissant. But after I have like a big fibrous meal if I'm going to have it.

But it's totally different than if you just completely do it without the fiber bit. I think that's where I kind of, maybe I've mentioned before that I don't mind people having the occasional snacky thing that's less healthy. After a whole food, high fiber kind of meal, the impact is really much more minimal. You recommend having an almond croissant every day after, after a good meal, that's going to be problematic. But as an occasional thing, it's not. Not going to be a concern in that context for the vast, vast majority of people.

I was watching your Instagram recently and you were talking about how The Mediterranean diet is probably one of the best diets for a healthy diverse gut microbiome. And do you feel like. Because I actually probably eat quite a bit of animal protein, lean chicken, no fatty eat meat. But I eat a fair amount because I feel like my body, if I don't, I feel broken down, I'm not energized and my brain doesn't work as well. So I've really played with protein over the years. And do you feel like if you have a high fiber diet and you're eating protein. Because I also watched the reel that you put out about these people who are carnivore and keto. Like that's really detrimental for the gut microbiome. But is is an omnivore diet, lean proteins amongst a lot of fiber and diverse vegetables. Would you say that that would still produce a healthy microbiome?

For sure. I mean I always tell my patients it's predominantly plant based is what we're going for. Doesn't have to be all plant based. It can be, but it doesn't have to be. And in fact probably the diet I recommend most is a pescatarian diet where they're having and plant based. To me that is probably you get the ideal from everything in that scenario in terms of the omega 3 content, et cetera. And the better zinc absorbed in the fish component. Yeah. And so there'll be certain times where I'm chinks ulcerative colitis will go generally initially when they're in a flavor we'll cut out red meat completely and just focus on plant based sources of protein, fish. But then that will change that maybe after. Again this is also. So there might be a red meat once every week or two weeks.

Might be a little bit because of the opportunistic bacteria that feeds off a red meat. Say more about that. That's interesting.

Yeah. I mean do I think like having a little steak like this daily while you're resting your meal is high fiber or low plant foods can be an issue? No, as a general rule. But we know with ulcera colitis it's just trying to get the balance right. And initially we're really trying to suppress hydrogen sulfide gas producing microbes. And there's some hydrogen sulfide gas producers that eat animal protein. Yeah. So and don't eat plant protein. So it's pretty easy just to switch them over or I don't seem to go. They go fine with fish too. It's very clear in the research and in my clinical reality is that okay, we need More fish. Those bugs don't go up, up but you eat more pork or beef, they go up. You know, so we'll just not eat those things and just stick with, with fish. We don't have to have that, that concern. And also because there was a dietary protocol called the semi vegetarian diet was, that was clinically studied, you could put out for Crohn's disease where they red meat once every two weeks and it was mostly like, you know, they fish a couple times a week and yeah, and they had great results in Crohn's this is speaker study in it and it got people in admission for very long periods of time following that sort of dietary approach. So in my, my approach to IBD has been initially it was, you know, because I've been teaching and working with patients for 20 some years before the study was done on the semi vegetarian diet where I was working in the same area going okay, well how do we, you can look at population based research. If it lasts for 20 years, we can kind of go okay, what foods if people eat more of increases the risk of inflammatory bowel disease. What foods can be protective? Because there's been research like that done since the 1980s and 90s, early 2000s. And even from that we could work out that the western dietary pattern was a risk factor for inflamed balance. That was clear. And that we're not getting enough omega 3 fats, we're getting enough fiber, we're getting enough antioxidants in the diet. So you know, I've been using a probably plant based dietary approach to IBD for 20 some years. It's just that more recently it's been more clinical studies looking at, oh let's look at, let's study it in people in a more rigorous way and getting good results. So it's kind of based on the pattern that came through with the literature. And I don't think a little bit of red meat is again, and this is for phytobal disease where you have, you would argue that genetics are there for the right for the disease to manifest in the right conditions. Just really focus on making sure the conditions don't manifest and keep people remission long term. But I'm less concerned necessary people who don't have inflammatory bowel disease. I'm not anti free range cow, you know, eating this wild grass. It's like, you know, they're really, really cutting out the fat aspects. I think that I'm not really concerned about that being a component of people's diet versus if the mainstay of their diet. Yeah, you're gonna, you see microbiome hard from, from that for sure. You know, irrespective of whether that cow had a really great life in the paddock or you know, eating a great fit lot, there's gonna be some differences there for sure. But in terms of microbiome changes, it's the same regardless of where that cow grew up.

Yeah, that is interesting mostly because I tend to have a high iron, so I just don't have a need for it. That's really interesting because I have met people on my travels that have gone into remission on a total plant based diet. I just find for my genetics that if I don't get enough protein, so I figured out like chicken, some eggs, like tend to be my sweet spot. But honestly I think yeah, like no sugar.

And when you're cutting out processed sugar, you're also cutting out the ultra processed foods contain the emulsifiers. And this is. You were doing this before. People are talking about emulsifiers, but they're huge from a family bowel disease perspective. There was this diet one of my colleagues published in UK recently where they put people in Crohn's on a low processed food diet and good chunk of desert remission. As for doing that simple thing of cutting out dietary emulsifiers like carrageenan polysorbate 80 and carboxymethyl cellulose were the three that we're really, really worried about. And they cut those out and these people went on remission. So you know, these things strip away your protective gut lining, you know we talked about before. But there's bugs that eat away your protective gut lining. While these compounds that are added to bind together cheap ingredients to make the mouth feel better strip away our protective gut lining too and just thin that out. They also incurred the growth of bad bacteria in your gut. So that's a bad combination of more pro inflammatory bacteria. Thinner mucus layer means your immune system starts interacting with the microbes. And if you have the right genetics, that can manifest into Crohn's disease and other people, if it's manifest in the leaky gut and maybe autoimmune disease or increased cardiovascular disease rates or even cancer too. Like there's so much stuff now and Alzheimer's and cognitive decline. All these diseases that are around us in western nations are now being linked into microbiome composition and dysbotic states. There's differences in the microbiome picture that runs between the different conditions in some respects, but it's also similarity that we have too low beneficial anti inflammatory species and too high pro inflammatory species.

So avoid emulsifiers I would imagine. Avoid pesticides, herbicides.

Yeah, yeah. I mean as much as you can the organic. And listen, I've had different times in my life where I'm just scraping by on funds. My student studying to be a naturopath and it's like I could buy some things organic but geez, I couldn't buy all my diet organic. So you choose according to what you can afford and you afford the ones that you know are going to be really well sprayed with the dirty dozen, so to speak. If you can afford it, definitely eat as much as you can.

Health should be avoided. Besides the emulsifiers and those things.

I think you're right about alcohol too. I think there's a dose related thing here for most people. Again, I'm very cautious with inflammatory bowel disease and alcohol as you have already noted for yourself, there's this very clear risk factor there for causing flares on people in remission and for you know, perhaps being a driver. And alcohol is interesting because in large amounts can it cause leaky gut. It stops at a motility in the gut, slows things down and again changes the microbiome for more pro inflammatory pathogenic species and less good bacteria. Now do you get that from one red wine once a week? No. But do you get that from four red wines, you know, four nights a week? Yeah, you do. So there's definitely a cut off there. And it usually is right about two to three drinks. Mark is where we start getting the harm. And you might be okay when it's under that sort of two drink. I don't drink. So put that out there too. As one of those people that realized early I want to focus on optimizing my health and living a long life and obviously balance it out with doing things you think are fun too. But I don't necessarily think that has to include alcohol personally. But you know, I might go bushwalking, living on the edge from where I'm going hiking or something. There's different ways of getting you thrilled than alcohol.

But if you have a genetic disposition, would you still say that that would be a safe amount? Because I think most people are walking around having no idea what their genetics are.

So I mean I think there's some more recent research that suggests there's no safe amount about any is is problematic. But I'm also trying to with patients are often trying to walk this middle path of okay, you know, with a history of infamy, bowel disease, or when I'm treating some with sibo, it's like very easy for me to say, say nut. Whereas, you know, your general person just wants to. To fund the right middle path for them that's going to reduce their disease risk and improve the quality of life, et cetera. Then, you know, do I think winner two glasses of red wine once or twice a week is going to be an issue? Probably not.

I don't think, especially if your diet's really good, if you have a really.

Great diet, you're feeding, then again, if you feel bad from it, then no, it's not a good fit. So this is tuning into your body and what works for you. And this can be tricky when you are constantly feeding your body toxic stuff. And so that with me in my teens, you know, I grew up in a typical Australia Canadian diet, which was like the American diet or like Fruit Loops and Lucky Lucky charms and, you know, horrible pseudo foods. So I had no idea what my body was supposed to feel like until I essentially changed. And for me, it's when I came to Australia as a backpacker and just arrived in a place where everyone else was healthy and I was like, oh, okay. I didn't know I was unhealthy even, you know, based on what I was eating. Then you eat really healthy, you know, and start living a different lifestyle. Like, oh, my God, I feel completely different. I'm not sick all the time. I've got more energy and my brain's clicking better. And then it's easy. When you do that for a while, you can work out what things are causing you harm or what things make you feel poorly after eating it. And those things are easier to avoid from that do.

So alcohol, emulsifiers, processed foods, ultra processed foods. These are all going to feed kind of the. Would you say more pathogenic or how would you describe.

Yeah, I think that would be a good way because, I mean, they're damaging the gut lining and feeding problematic species.

Yeah. I think one of the biggest misconceptions are around the gut microbiome like that you see popping up in the social space.

Yeah. That you can fix it all by taking a probiotic or by eating fermented foods that you could just take a number of courses of antibiotics and, you know, she'll be right. I'll just take a probiotic afterwards and replenish my gut. It's just that does not happen.

Did you read that study where they tracked. I remember seeing this years ago and I thought it was really interesting where they, they took two groups and they put both groups on antibiotic and then afterwards they put one group on a probiotic and the other one on nothing. And they saw that the innate microbiome came back quicker in the group that they didn't give them a probiotic.

And that study made like headlines because of its results. Now, it's really important for context here, number one, context. There's been like, you know, 15 or 20 other studies on probiotics showing the opposite. So just because one study found one thing, we can't, we have to always try to put in context. Context of like what the other 20 studies in this area have they found similar in age and we haven't.

So you see a probiotic definitely always after an antibiotic.

Yeah, totally. But you just have to choose the right one. To my mind, from this study, that was an Israeli research study, very, very cool in many, many respects. But essentially it was the lactobacilli found in this particular product sold in the markets in Israel. Okay. That produces a compound that killed your beneficial bacteria. All right, so you, all you could say is that this particular probiotic from Israel shouldn't be taken post antibiotics because it could ca. Does slow the restoration of the ecosystem. Yeah, but we have other probiotics in so other parts of the world who actually do the opposite. And we've got clinical studies showing that. So I think that the findings of the study were way over extrapolated from what the study actually found, because it should have been, okay, this is a problem. Don't take this supplement. And this could be a broader problem. If you just take a random supplement, you take antibiotics because you could end up with this.

But how do you know what you take? Like the random person is just rolling into a healthcare store and grabbing a probiotic and taking it after antibiotics.

Well, this makes it tricky for me as a clinician who spent years researching. We have clinical studies showing exactly what ones to take, who will minimize the damage, help restore the use of more quickly and actually make the side effects less from the antibiotics too.

Where do you find that? Where do you find that information?

Well, I mean, I've said gold.

That is gold.

I've set up a database called Probiotic Advisor database and it has exactly that. Yes. So you can, it's a subscription database, but it's only like 50 bucks a year and you can go in there, you can just type in antibiotics and it'll tell you, tell you what one to take, what's going to be named in your country and See, you can make sure you're taking the right one. It's also got, you know, ones for depression or anxiety or a whole range of different things you might you want.

To take probiotics for. I love promoting great information so I'm going to definitely promote that big time. I run women's groups where I work with their diet and lifestyle to a high fiber diet to really help them rebalance their bodies. Because you really see the gnarly effects of modern food and diet on women's bodies with our complex hormone system. I don't dabble in probiotics quite honestly because I just don't know enough to make sure I'm doing something beneficial. So I tend to just work with the prebiotic and probiotic foods.

It's a safer bet. And also you're going to get more leverage from microbiome perspective. Despite what they're sold as aren't necessarily great for restoring a healthy microbiome. You're going to get far more traction eating a high fiber diet and taking prebiotics after the antibiotic than you will with a probiotic in terms of restoring the ecosystem more quickly. What probiotics can do in that instance is they can reduce the side effects, they can reduce the overgrowth of pathogens, they kind of slot in and take up territory. Yeah, because when you take in the course antibiotics you've created a bit of a ecological desert. Like you've come down and cut down lots of big rainforest trees and there's all these gaps in the environment now where weeds could grow and the product was come and take up those spaces to suppress the weed growing growth while we wait to feed the trees back up. And luckily they don't take 150 years to grow back to a forest ecosystem. It can take like four weeks for them to restore to fairly similar states after course antibiotics. But then probiotics are really important in that initial phase just to suppress weed growth and to decrease the side effects you might otherwise get from the antibiotics, including things like C. Diff infections or candida infections. You know, we can kind of prevent that from occurring. So the right prevention, it's very useful there. But I think sometimes we people are expecting too much and not realizing that the best way of nurturing your microbiome is feeding the species you want to feed.

Yeah.

And you do that is lots of fiber, lots of plant foods, lots of colors. You want to have blues and purples and reds and oranges. My plate is a rainbow as much as I can when I try to grow purple Tomatoes and orange watermelons. I try to grow as many varieties of different colors as possible so that you're feeding microbes different compounds, because the color compounds in those fruits and veggies and black rice and red rice, for example, we don't necessarily digest, but they reach the colon and interact with microbiome components there. And they actually break these really big compounds into these small things which we then absorb. So we get this win, win situation that we feed the good bugs, and they potentially change a big unobable compound to a small anti inflammatory, antioxidant, anti cancer compound, which you then absorb. So this great scenario, but it's important, the diversity of plant foods, diversity, plant fibers as the best way of establishing and maintaining a healthier inner garden. Essentially.

I'm just smiling because I just. I feel so happy to have found you after. I mean, you've been around doing your work for 20 something years and never heard of you until recently. A client of mine, your company, analyzed her son's gut microbiome. And so I started researching you, and I was like, where were you 15 years ago when I was diagnosed with Crohn's?

Because in the small island off of Australia, very focused on just working with pain and publishing research studies, you know.

Yeah. I have so many people as a nutritionist. I basically spend my days helping people rebalance their gut microbiome with diet. And we often do an elimination phase for a couple of weeks, because in my understanding is that every three to five days, the gut microbiome has a new layer of the epithelial cells. Is that correct?

Well, I mean, the epithelial cells do turn around that span.

And so, you know, we look at for. Especially for leaky gut. So diet shifts. Simplifying the diet. I get a lot of histamine. I'm a high histamine person as well, which was part of my disease disease compilation in my gut was the high histamine. The microbes, I guess, that block the breakdown of histamines or something is that.

There'S microbes that make histamine in the colon too. And so how much that occurs varies dramatically between patients as to whether they've got any histamine producers or not in there.

It says, genetically, I'm a high histamine maker. I don't know what that means, but.

Maybe, yeah, because you could have. Your genes might lead to a propensity to produce it or a slower capacity to break it down once it's produced, for sure. But from the microbiome perspective, it would be the bacteria that are present and what ratio they're at and what the environment is like in terms of ph that creates will determine how much histamine they produce.

Yeah.

And then whether you have other, other amines being produced too, like cadaverine or spermidine or spermine, they, they can kind of compete with the same sort of degradation pathway in the colon. And then you can get more histamine coming through that way. So there's, you could definitely have histamine as a driver from, from the gut for sure. Sure.

So how does dairy play a role like fermentable, like kefir and stuff like that in your world?

My patients avoid dairy.

All dairy.

Yeah. It's interesting. And that does react and behave differently in the gut compared to other, other fat in terms of the consequences. Saturated fat binds, for example, to bacterial toxin called endotoxin and increases its absorption. And we don't get that from olive oil or avocados or nuts or seeds. Seeds. But we do get it from all saturated fats, whether that be coconut palm or dairy. Saturated fat also encourages the growth of some pathogenic bacteria in the gut specifically too. And again, we don't get that with fish oil. You don't get that with, with avocado or olive oil or nuts or seeds. But we do see it with saturated fats. And that's a bug called Bilophylla and its name means bile loving. And it loves the bile that our liver makes. When we eat saturated fat. That's, that's when we deal with a saturated fat meal. Our bile sulfur level goes up and then this bug is like, woohoo, I got more sulfur and eats that in, produces hydrogen sulfide gas. And that hydrogen sulfide gas has been linked to inflammatory bowel disease, risk to mitochondrial dysfunction, to visceral hypersensitivity, where the nerves in your gut are hypersensitive. And I see this very commonly in my irritable bowel syndrome patients. And they've got high levels of bilopila.

What if it's fat free, like kefir? Because everybody's into kefir right now for the gut microbiome. As a gut expert, what do you, what are your thoughts?

Yeah, I mean, I do have concerns again about just the saturated fat component that might be there. But let's say if you did skim milk or something like that, which, like.

Fat free, like no fat.

Yeah. That would take the saturated fat out of the equation completely. I don't want to come across as like anti home.

It's okay.

If you do, I'm not. But. But some like I just had one patient who, who bought a kefir seed kit from some place on Amazon. He started growing his own kefir and you know, made little grains, everything beautifully. He was drinking it and he was checking his gut microbiome every single week. All right. So for years. So we had this very standard data and two weeks after having the kefir, all these pathogens spiked in his ecosystem and we're like, what the hell? So he sent his culture away to get sampled and this culture was full of these horrible pathogens. He still can't get rid of these bloody bugs that he. Pathogenic bugs that were picked up accidentally. And this game, it wasn't his fermenting that was a problem. The company who sold it to him ended up having had the kefir bugs in it. But it had a range of these klebsiella, some really nasty E. Coli strains, and enterobacteria, these really nasty bugs in there too. He's been unwell since that moment. So I can't help but remember that experience when people talk about their experience because that, you know, not homemade. It's a wild one. Okay. Not homemade where it's like this. The cultures are all really kind of standardized by manufacturing practices, etc. I wouldn't have concerns about that outcome but, but I still think I prefer working with sauerkraut or kimchi.

You're okay with sauerkraut and kimchi?

Yeah, totally. Like I sauerkraut kimchi leaves twice, twice daily in like large, large quantities.

And do you buy it from somebody or do you make your own?

I used to make a beautiful cauliflower, chili, garlic kind of combination. Now I just buy it from some local. Luckily where I live there's like five different people who make amazing sauerkrauts and kimchi and different prodies. So I'm happy playing around with that. And there's some. Something we're at low risk of those weird microbes growing in our homemade plant cultures because it's something about the milk media that disallows pathogens to grow in a way we don't have with crush up salted cabbage.

So what I hear you saying is you'd prefer for a healthy gut microbiome that people don't do dairy because of the saturated fat that feeds pathogens in the gut. So the saturated fat component is the big one for you. If it's a fat free controlled company.

Made kefir or, or some Minnesota yogurt that's Fine.

Yeah.

So there are some companies in Australia, for example, that what I make what I call medicinal yogurts, that they are, let's say that they're low and they contain. They've been spiked with a therapeutic probiotic strain. So we know it's there in a medicinal amount and it has medicinal effects. It's just often just because they add the bugs that make it yogurt, which makes the milk go sour, it doesn't necessarily have a huge range of health benefits beyond that. Whereas some companies make a medicinal yogurt where they actually spike in medicinally active probiotic strains. And then I use them frequently in clinical practice and very much like using them. And that has inspired some people to make their own home ferments where they actually will use a probiotic as a starter. And again, there are ways of doing this well and ways of not doing it well, but when they do it well, you can actually make yourself a really potent medicinal home probiotic ferment. Yeah.

Yeah. I am on my journey, I tried many things and I found this place in Texas that was making goat kefir. And because I was at that point going through my kefir era in my autoimmune condition, I was shipping kefir to my house from this company in Texas. And my whole fridge, you open it and it was just lined with goat kefir and I was drinking it and it was just going through me like hot lava. So I have a feeling it wasn't. What ultimately ended up healing me was doing the white rice fast for three to six days and then slowly adding in nutrients one at a time, kind of like.

Yeah. And longer term, I would say it's avoidance of the ultra processed food and it's the high fiber and polyphenols, antioxidants and all the things that go with that.

Yeah. And I was just eating like baby food. It took me 18 months to go into remission, but I've been in remission ever since.

Wow. Okay.

I've never looked back. I just have been eating so well and I just recently did a gut test and they didn't find any pathogens. And I was like, is that okay? Like, what is a good health, healthy microbiome look like?

Totally, totally good not to have pathogens there. No concerns there. I don't take a probiotic daily. Listen, I recommend them to lots of my patients, but I don't take one daily. Now, if my youngest comes home with viral gastroenteritis from school. Yeah, I'll take a probiotic. That protects me against viral gastro or if there's a cold or flu going around and I want to uplift my immunity. Yes, I will take one for those things. So I do take probiotics for uses, not just as a general thing, whereas for me, it's like, yeah, eat fermented foods daily, but I eat 50 grams of fiber per day and lots of legumes and extra virgin olive oil and lots of, you know, brightly colored rainbow type things. And I buy from an organic farmer's market, grow lots of my own food. I do my best to nurture my microbiome in the ways we know spend time in nature. There's always that actually nurture your microbiome as well as what we're putting in. But where we spend time, because we can, it turns out we're passing when we're in our garden and we're there like smelling and weeding and sniffing. I've got a herbal garden, so I'm constantly engaging with and things different, different ways. But we're sharing microbes. Yeah, I'm probably passing on microbes to them, but they're sharing their microbes when they were weeding. Even ornamental gardens, we pick up microbes and if we're pruning, we pick up microbes. People who have more diverse gardens, not even just edible gardens, but just ornamental gardens, have more diverse microbiomes. But then if you're actually growing some of your own food on top of that, where you're able to pick up those microbes, that's great. And we know people who buy. When you buy food from a farmer's market, it's a much more diverse ecosystem on that than if you buy the same food from a supermarket market. Yeah, like an apple from the supermarket has the same number of microbes on it, but completely different ecosystem than one that's from the farmer's market.

That's a great tip. Yeah, I like that.

Take a prebiotic daily. Prebiotics are your selective fertilizers that particularly encourage some specific beneficial bacteria to grow.

So what's the product that you take daily?

For prebiotics, I would take fructooligosaccharides daily and galactooligosaccharides daily. And also partially hydrolyzed guar gum. So there's three different precision prebiotics I take daily and they feed different microbes, like the partially hydrolyzed guar gum. I know it's lots of syllables. You might think it's a horrific compound. It's not. It's just partially Hydrolyzed means it's been chopped up fiber. So it's just a different type of guar gum where they just chop up the fiber a bit. But it feeds butyrate producing microbes. And butyrate is something that that many westerners need more of and I definitely want more of even if I eat a diet that's very rich in, you know, petrogenic substances. But then inulin phosphorus feeds your bifidobacteria and your faecali bacterium and your akkermansia. And then I take galactic oligosaccharides also because it feeds your faecalibacterium and bifid bacteria.

Are there certain brands that you're talking.

About for these brands matter less when it comes to prebiotics. Yeah. With probiotics brand can make the difference between something working or not. With prebiotics it's like inulin phos is. Inulin phos is inland floss with different brands. So in the US for example, I was using Jarrow as my inulin phos supplier but Jaro just stopped doing it. So I'm still trying to find an alternate option. In Australia I use Araya. You can see this is just to my desk and just take a scoop, scoop after breakfast and scoop it the other one after, after dinner. So Araya does partial hydrolyzed Gorgo England, FOSS and Goss in Australia for example. Whereas GOS is hard to come by. In the US there's a company called Lift Mode L I F T M O D E that does Goss there but partially hydro.

It's easy to find gos.

Yeah, G O S. Yeah. And not everyone needs those things. I'm trying to optimize my aging process and make sure because often when, you know, I'm early 50s now so you start thinking about, you know, how functional I want to be when I'm 80 or 90. I'm still going to be hiking mountains really into my brain, sharp as attacks. Because often what we see with westerners is a deterioration of our good bacterial populations as we age. And the quicker that occurs, the quicker we age, the slower that occurs. The slower we age would be a good way of describing it. And there's places where people live to 100 and some years and live well. They've got great health span, you know, not decrepit in a wheelchair for 20 years. They're actually living life and great, then they boom, they just die. That's what we want. They have this ecosystem that, that those same changes occur, but they occur when they're like 95 or 100 instead of occurring when you're 60. In Western nations like Australia, America, Canada, most people have these microbiome changes that occur in your 60s that speed up that aging process. So taking prebiotics, eating really well. I think we've already touched on mostly plant based, lots of legumes, all those things will help to prevent that from occurring. But these things work as a bit extra. Just one scoop a day is a minimum therapeutic dose. So it's, they're inexpensive as well. Improved absorption of calcium, magnesium, improved immune response. Less wrinkles to the recent study show less wrinkles.

How old are you?

52.

You're 52. Okay. We're a couple years apart. And you, you look like you're aging well, so I want in on that.

As to you, I do like the people I've consistently see eating high fiber fiber. It doesn't have to be all plant food. I've seen generally when you look around at the community, they age slower. And I think that makes sense for microbiome.

Well, less inflammatory. Inflammatory, yeah, yeah.

Because whenever you eat the plant foods you're getting antioxidants too and anti inflammatory compounds as well as the microbiome changes too. And they. Because the microbiome can either drive inflammation in your system or it can decrease inflammation in your system. And what determines that is that's mostly what you eat for your day to day. Stuff you have most control over is like what you eat can really dictate whether that's an anti inflammatory great driver or it's something that's actually driving inflammation and disease. And for many people in western nations, because of what we're eating, as well as the high stress levels and the inadequate sleep and no exercise, these things impact the microbiome negatively too. The microbiome essentially is a disease driver rather than something that we're leveraging to slow down aging, prevent the sort of disease processes which it has historically been, I would argue, you know, before westernization, urbanization, et cetera, where we now have these sort of generally despotic ecosystems in, in western populations.

Well, if you think about it, people are doing a lot of inflammatory things and then not feeding their gut microbiome. So then they're left with this kind of crippled situation from within and aging rapidly on the skin because of it. Not realizing that it's such a driver of the aging process. People say to me like oh, are you doing Botox and all this stuff? I'm like no. For like I can't imagine that'd be Good for the gut microbiome. Anyways, as long as we're on topic like how, how does stuff like that do? Would it have.

Well, I don't think that's been researched yet. So I don't know.

Can anything stay locally though? Isn't it ultimately things systematic, like the body isn't compartmentalized?

Yeah, no, great question. And I don't know, I haven't looked into it. I worry about the same thing with tattoos too. It's just like the, the ink is there but truly it's like must move around a certain degree, you know. So I've got some cautions around, around. Yeah, packs of these, some of these things that are supposed to be local.

So you do the guar gum two times a day, the G or the.

Partially hydrolyzed guar gum once a day. And I would do, you know, three, three grams of gauss a day. I would eat three grams of inulin phos per day and I would do 6 grams of phg per day.

From my experience of illness to health, there is nothing more important than the gut microbiome, period.

And I would. I obviously agree with you because I've been researching for 25 years. Years. The research of the last 20 years has shown me, I actually had no idea how important it was even 20 years ago. Now it's like there's things like Alzheimer's disease, high blood pressure. Is microbiome related? Alzheimer's, Parkinson's, osteoporosis. I would never have considered 20 years ago that osteoporosis was a microbiome driven condition. We can do a poo transplant from women with osteoporosis, put it into rats and they will develop bone loss.

What else do we not think about is gut microbiome related disease wise? Like that's crazy.

Yeah, yeah. I mean, I think, you know, recurrent infections, obesity, type 2 diabetes, those are getting a bit more airtime these days. But depression, anxiety, definitely, you know, Parkinson's, multiple sclerosis, Alzheimer's, cognitive decline for sure. You know, and these are just gestational diabetes. Even recurrent urinary tract infections often have a gut microbiome factor.

Well, can the UTIs be also from partners with bad microbiomes infecting a female partner?

Potentially from a penis microbiome perspective. Yes. For women, if you have a high level of E. Coli in your gut microbiome, they actually migrate from anus to vagina to urethra if you get a one off UTI very rarely. This isn't a concern, but if you have recurrent like you can't get rid of them. Often we have a reservoir of E. Coli in the gut and we need to fix the gut imbalance before you.

Have to do a micro antimicrobial to get rid of E. Coli in the gut or.

No, not necessarily. It depends on how high it is and what choice I might make for intervention wise. But we know that taking prebiotics, which is E. Coli counts in the gut. Having a high fiber diet, which is E. Coli counts. Some microbes in the gut are very PH sensitive. So if we make it more acidic or alkaline, we can change their growth. When we have lots of fiber, we're essentially creating an acidic environment in the colon. And that's because the bacteria eat the fiber and they produce things called short chain fatty acids. And the acids is a ported there because it lowers the pH. Yeah. And that's like butyrate and acetate propionate. But the key thing is this thing, more fiber makes a more acidic environment in the colon. And this is great because this acidity actually suppresses the growth of most pathogens, suppresses the release of cancer genic compounds. It's really important to keep that environment acidic. And this is another reason why fiber is so key. And when we essentially take the fiber out, we end up with a neutral or alkaline colon. And this is where the risk factor of colorectal cancer, for example, and we are allowing the growth of protein pathogens who like growing in that environment, who don't grow when it's nice and acidic.

So would you say ketogenic and carnivore diet are maybe the worst diets you.

Can possibly get on from microbiome perspective? I mean it's always hard because it's like in the typical western diet's pretty bad. But yes, because it's like you're just feeding, you're feeding pathogens and not feeding any good bacteria. Yeah, with a carnivore diet it's as simple as that. And you see that those changes now keto diets, they depend because you can do plant based keto where it's olive oil and lots of fibrous things and nuts and seeds, or you can do just eggs, bacon and butter. That's bad news from microbiome perspective. The plant based variant, it actually mitigates most, but not all the impacts that could occur.

You miss out on a lot of nutrients when you're not eating vegetables. There's certain things that happen in health trends that I just scratch my head about and Demonizing plants because they have chemicals in them, to me was one of the most asinine things that's happened in the last 20 years.

I hear you. I mean, I'm a herbalist too. These chemicals are like, they make the plants work, you know, like, are you suggesting that we shouldn't be using plants as medicines and people just take pharmaceuticals instead? It's just like, I just can't get my head around the plants being these horrific beings here to kill us.

No, it's. It's clickbait. And then because I think human nature is a little driven by fear, a fear of doing the wrong thing. If somebody says that you respect, this is bad. And then all of a sudden, you know, I think it was Gundry who was like, beans are bad. And I'm sitting over here eating beans and getting better and have a healthier microbiome and go into remission naturally. And he's scaring people off of foods that could keep them alive not just longer, but better. And you're just like, how, how do you sleep at night scaring people off of. Of plants?

The legumes and lectin ones drives me mad because it's like, do you eat your. Your kidney beans raw? Yeah.

No.

No we don't. So raw kidney bean compound is completely irrelevant because if we just boil them or pressure cook them, there's no lectins. So it's completely, you know, valid argument. Yeah, well, totally. It's like talking about something that's completely irrelevant when no one eats bloody raw legumes. You know, they're quoting studies where they give them raw legumes and they get gut damage going, oh, these bls like, geez, put some context on this. I get really frustrated by this because this is. Because it's like, you're surely not that stupid that you think people eat 70 of the diet is raw leg games. So you're just kind of. Yeah, you're clickbaiting or whatever to. To make money from the process, which is frustrating.

And I'm just over here. Literally, I spent the last decade getting people to eat a well balanced, high fiber diet. And, and. And people are so scared to eat a well balanced diet that when clients of mine get pregnant, they're like, is this safe to stay on? And I'm like, yeah, why wouldn't it be? It's literally all whole foods. Like, you're literally nourishing yourself from the inside out. Why is this. Why are we living in a world where this is scary? Coffee enemas.

Yeah, you know they first gained notoriety from the Cant Cure from a book in the 1980s 90s. If you're relying on it to empty your bowels, that's a problem. And it will mean that you kind of lose the natural flow of it in that situation. And that's the issue I've always had with or I've seen to occur with colonics too. Is that where you kind of washing the entire colon out if you're full of poo for like you got two weeks worth of poo in you and you wash that poo? I do feel better. Yes, you definitely feel better. But if you want to get better long term, you can't keep doing it because you're essentially stopping the normal flow is. Is stuff moving from one end to the other. And if you empty the entire colon out, you're kind of like, it's just unnatural. So it's virtually impossible to establish a natural rhythm to your bowels if you're using something to empty them.

Constantly emptying them. Yeah. I feel like there's something about peristalsis, something about your brain and your gut and this communication system where it's like, I've never met an angrier woman than a constipated woman. So I get the desperation. What I hear you saying is it's speaking to a bigger issue that needs to be resolved to bring back online. A natural elimination process versus going in there and roto rootering yourself all the time.

I totally agree. That slow transit time absorption of biotoxicity, these are huge issues for a large portion of our population. And I spent a lot of time working on fixing that and establishing natural rhythm. But I can just say that using colonics prevents the re establishment of a natural rhythm. That's my main concern. I'm glad you feel good for a couple days afterwards, great. But it's just not going to get you fixed in the longer term if you keep using it.

In parting wisdom for people, what I heard you say is eating a plant forward diet, high fiber up into the 40s and 50s, depending on the size of the person and variety, and that that is your biggest driver for great gut health and diversity when needed with a skilled professional for SIBO and things like that. Do you typically see having to use interventions to get that overgrowth out of the small intestine?

I think you've mentioned this before too, but if you've been unknowingly for long periods of time, stuff happened to you when you're a kid that you didn't really have control over and you've got visceral hyper sensitivity. The nerves in your colon are really sensitive and any intestinal gas production causes you severe pain and discomfort and you blow up like a balloon. You know, it's like, we need to do work. You can't just go, hey, let's put you on 40 grams of fiber per day because your colon microbiome will be better for it. It will, but geez, you're gonna have a horrible life for a period of time until your gut adapts and, or if it will. So we don't do that. Like you've gotta treat the sibo first. You have to address the visceral hypersensitivity. You have to address the slow motility too, too, because for some people, you know, if you have your fiber diet, your fiber intake is very low, your bowels work slowly, you increase the fiber, the biles start working better. Great, all good. But there's some people where that's not what occurs. You give them more fiber and they get more backed up and they just blow up like balloons and they get far worse. And it's like, no, because we've got to fix the motility first. And we might slowly build up the fiber. We just don't go from here to here. And other people, you can go from here to here depending on the situation. Situation. But you know, I think just keeping that all in context is that so for some people we have to do the preliminary work, whether it's treating the sibo and excess methane production in the colon, which is slowing your transit times, we have to address that, you know, and then it makes it so much easier to make the requisites or dietary interventions that we see with optimal microbiome health.

Do you have a lot of practitioners? Is there a way to work directly with you? I mean, I personally would love to work with, I'd love for you to analyze my gut microbiome at this point point, having been in remission so long to see what would be an ideal long term plan for me. I finally found a medical and holistic doctor, Eastern and western trained. And he, as I started to get better from my diet, he actually was the one who was like, stop doing all the testing and just trust the healing process that you're on. Because if you test too soon and you see poor results, you're going to get discouraged. He goes, but I believe you're on the right path. And so I just kind of like took that and ran for a while while I got CAT scans later to kind of look at If I still had narrowing and things had all cleared up. There's a company, Tiny Health, that I just ordered.

Their Tiny Health is good.

Okay, great.

Yes. Okay. Shotgun metadrophic sequencing and which gives a lovely snapshot from a DNA perspective. We can see all the bacteria, fungi, if they're high enough amount. And we get to get a lovely snapshot of the ecosystem in great detail. So, yes, it's a good.

Okay, so that's the one I'm about to do. I did this other one, but I wanted to do more in depth and I'd love to have it analyzed by you because I really want to stay in remission and I want to do right by my gut microbiome long term, especially knowing my disposition towards all of the bad things from my history and genetics and everything.

Yeah, I mean, obviously you found the right diet, but yeah, you could look at that and go, okay, are there tweaks that could be made, some population that could be increased a little bit? Obviously vaccrame.

I had zero of that. It was like, you have none. I have another Crohn's client who has none as well. And she tried to enter it back in and got really sick trying to enter it in.

To date, I haven't seen the. The current generation Akkermansia supplements engraft and permanently restore populations like, like they can help replace functionality. If you're missing Akkermansia and. And your metabolic health is suffering, then we can give you the Akkermansia supplement and that can help improve vital health. Yes, I think we've got data around that and I've in practice, but I haven't seen it go, hey, you got no Ackermansia. Take this Acremania pill and we'll restart growing in your gut.

Does, does a healthy microbiome have a teaming good guys, bad guys, fun guys, parasites? Like is it. Is. Should it be kind of like this teeming ecosystem in balance with each other teaming?

Yes, I would say that we don't necessarily have to have bad guys there. Like we might analyze things. We've got those which are clearly beneficial. We have pathogens which are very much disease causing, which we don't really need. Then you've got pathobionts. And pathobionts are species that in the right amount do healthful good things for us, but when they're out of balance, cause us harm. So having the right amount of them is important. Whereas I'm not worried about, okay, you don't have a pathogen. I'm like, I'm not gonna Go. You need to get a pathogen in there, that's fine, but it's often trying to get the right balance of the pathobionts and, and good bacteria and then reducing or eliminating the pathogen, depending on what microbe it is and how low, it's problematic. But you are right in that we will have a range of protozoa microbes, a range of fungi, and a range of bacteria and viruses all living in there, all contributing to our health. And some of that ecosystem we just don't know much about as yet. Like the viruses, we don't know much about, the fungi, we don't know much about, the protozoa, we don't know much about. And I get that. But as someone who's been researching this for 25 years, it's like, yeah, we do. You know, there's still stuff we don't know, granted. And I look at the microbiome report and might be 250 species that show up in someone's pretty diverse ecosystem. We have no idea what they do. Still, a lot we don't know. But we do know what a range of good ones are and how important they are. And we know that when we increase them, people's health improve. We know that we could decrease the ones that are pathogenic people's health improve. If we bring the ones that are out of balance in the path of bond category down, their health improve. So we've got data around that and that's certainly the way that I'm viewing it. And we know that diversity is key too, that we want essentially as diverse as soon as we as possible. But you know, there are exceptions to that too. Like, I remember reading a post on Facebook of someone who just went keto, but the egg bacon type keto, and they were like, oh my God, my diversity has gone up in their ecosystem. That's a good thing. And it's like, generally we say that is, but everything that grew was just pathogenic bacteria. You've got another 15 pathogens present that weren't there beforehand. So, yeah, your diversity is increasing, increased, but the exam is actually worse condition than it was before. So.

Oh, that's nice. Is the, do you see like the, what is the main driver of Candida then? Like, why do women. Why is there such a bloom of Candida everywhere where women are like being diagnosed with Candida?

Yeah, I mean, obviously there's vaginal candidiasis issues and that can be, you know, the range of potential different drivers locally in that area, including different sort of control products that might be Playing a role there. Antibiotic use which causes fungal overgrowth in the gut as well as elsewhere that are pretty widespread. You know, like most women take you know, one or two courses. Most people take one or two courses of an arts a year, believe it or not. Not in my sphere but in the general sphere of who we're working with that's not uncommon. You know, some kids you see will take 10, 10 courses a year, you know, and some years it's like I'm guessing a three year old who took 30 courses by the time they were three. And I'm like, oh my God. And we just took him off of dairy, which he was clearly allergic to and giving a prebiotic, something called England Foss. We completely broke the infection cycle completely just by those two simple actions that you know, cost them, you know, $5 a month in terms of interventional costs. It was like so inexpensive to sort. It's just that they had gone through conditions who didn't know quite was going on. Yeah.

Do you work a lot with kids?

I have historically and, and I do work with a lot of kids on the spectrum as well. Make up a decent portion of my client loading my microbiome biome work in that population too often there's rich rewards from optimizing microbiome composition and decreasing, you know, the, the correlated between microbiome composition and brain inflammation. Some people will be more prone to getting that in the brain, other people getting it elsewhere. But we can just again reduce the drivers inflammation that are coming from the gut into the brain and things improve.

You are a gem. I am so glad that you are doing the work you're doing doing. I really am and I hope it.

Yeah, I love it too. You know, I've been lucky enough to choose as a PhD topic 25 years ago was the gut microbiome before it was remotely discussed outside sort of natural medicine circles. But it's still one of those things that I, you know, went to Rome just for three days of microbiome conferences soaking up the information. But I still find it immensely fascinating. And I like having this role where I can take in complex stuff and try to simplify it and get the message out there. That's one of my key things too. That's the thing about being a clinician, researcher, educator and doing it for this period of time is you kind of have this skill set that you can take those more complex things and try to simplify and get it out there too. So people can rather wait five years for things to change. We don't like medicine's a slow moving thing to change from when something is first published and researched to when it actually changes clinical practice where I'm trying to speed up that process and get things moving along.

Thank you so much for coming and chatting with me today. Really, thank you so much. And I'm I'll link all of your information.

I hope you enjoyed my conversation with the wonderful, soft spoken, intelligent Dr. Harlak. I hope to have him back many times on the podcast to discuss many things. I've put all of the resources that he spoke about, the prebiotic products that he takes in the show notes and also how to take them because offline I asked him about that as well. And I also wanted to let you know that I currently have the wait list open for my next 12 week course. I have recently revamped and changed whether it's live at the moment or not. May not be because I've been working on it, but I will have a whole new eight week course that I'm offering and consolidating rating from the one I've had for the last six years. So that's really exciting. If it's not live yet, now is your time to buy my course at a cheaper rate because everybody will be moved over and have access to, you know, the new course at no additional cost if you've signed up in the last two years. Anyway, that's it from me. Thank you so much for being here for following the podcast. You can also find this if you want to watch us talk. Kind of creepy, right? But cool. You can check us out on YouTube. All right, thank you. Take care of yourself wherever you are in this beautiful world.