Dr. Willl Bulsiewicz on How to Heal Your Gut to Improve Your Health

This episode is brought to you by Nourish Me Organics, your Gut health superstore. Nourish Me Organics is the premier store online when it comes to home fermentation kits, gut health supplements, probiotics, prebiotics, and so much more. So do head to www.nourishmeorganics.com and use the code Happy Gut for 10% off. Guys, we have a special treat for you today. Dr. Will Bulwit back for round two. I hope you enjoy.

Hey, guys, Crypt and Gab from the Gut Health Gurus podcast. I've got a background in food science, and today we have a returning guest, Dr. Will B. And I really enjoyed our conversation the last time around. It's been a while, but Dr. B, how about we let the people that don't know about you know a bit more? So who is doctor Will be?

Hello, Cribben. It's great to see you again. Well, the answer to that question actually has changed since the last time that I saw you. So there's just been, you know, I think that first of all, the world is evolving and changing so quickly and simultaneously, many of us in our lives, we discover that things are different for us. That is certainly true for me. Hello, everyone. I'm Dr. Will Bolshowitz. Everyone calls me Dr. B. And I come from a background of traditional medical training. I'm a gastroenterologist, and I have worked for many years as a gastroenterologist. And in this journey, so Cribb and you know this, but for the people who are meeting me for the first time, if we were to go back about 10 years ago, I was in my early 30s and had my own health issues. I was 50 pounds overweight, 20 kilos overweight, and high blood pressure, high cholesterol, high anxiety, low self esteem, low energy. And the irony is that I had great training from some of America's best hospitals. Georgetown, Northwestern, the University of North Carolina. Yet the pills and the procedures that I was taught as medicine were not the solution that I needed for myself in a time of need. And ultimately what I discovered was, was that the diet that I had been raised on, the food that I loved, was in fact the source of my problems. And it needed to change. And that discovery transformed my life. And I was able to overcome these health issues and get back to feeling alive and young and vibrant and thriving. And it was so radical that it forced me to not reject what I had been taught. But cribbing, it's almost like when you get old enough that you realize that your parents are not actually perfect and you still love them, but you also see where the flaws are. And that's the way that I felt about healthcare and what I had been trained as a doctor, that I do value my education, but I also see that it's missing this very, very, very important part, which is that we can prevent many of these conditions through diet and lifestyle. It set me off on a mission to try to understand that better. And I would consume nutrition research at night after work, and then I would bring it into my clinic the next day, and I would treat patients again. I am a gastroenterologist. I would treat patients who had. Maybe it's a patient with ibs, that I helped them overcome their food intolerance, or they have acid reflux and I help them to throw their proton pump inhibitors in the trash, or I put someone's ulcerative colitis into remission. These are powerful transformations for individual people that they desperately want that. And so this led to a series of things that just to kind of accelerate how my life changed. In 2016, I started an Instagram account, and frankly, no one really cared for a very long time. And it was quite humbling for a very long time. In 2018, I did a podcast with my friend Simon Hill from Australia, and it went viral. And that created an opportunity for me to write a book. So I did. I got a book deal in 2018, and my book Fiberfields came out in 2020, which was the last time that you and I connected. Fiberfuels made the New York Times bestseller list, and it has sold 200,000 copies.

Wow.

And it's been really fun, but also simultaneously quite overwhelming because throughout all this, I've been a full time doctor, and I take call 24 out of every 72 hours. So as an example, I was on the Rich Roll podcast, and I had to tell rich roll, like, rich, I'm on call and there's a sick patient. I got to go. Anyway, what I have discovered is that there are doors of opportunity that are opening in front of me. And it has forced me to define what is my purpose. And my purpose is to use my education and my experience and my talents to try to help people and empower them. And I was doing that as a doctor, one on one. And then Instagram allowed me to scale that, and then a book allowed me to scale that even more. And now with the things that are happening in my life, I'm trying to go even bigger. I want to get in contact with a million people, millions of people. And so, actually, very recently, I left my medical practice.

Wow.

Which was not an easy choice. And I'm not leaving clinical medicine permanently. But what I am doing is I'm restructuring my professional life so that, number one, I can have time with my family and I'm not just a workaholic. And number two, so that I can continue to take advantage of these opportunities that I have to write books to, you know, do things on social media, to create courses and content and, you know, different avenues to try to get my message out on larger scale and go after this larger purpose that I see.

Wow. What an introduction. That's just absolutely amazing to hear about your successes since we last spoke and this massive shift in your life to focus. Certainly I can resonate with you focusing more on the family, but also changing things around in terms of your career to be able to facilitate that. So a huge Kudos to you, Dr. B. I'm so happy for you and I'm really excited to see what the future holds. And I'm sure the millions and millions and millions of people across the world are going to benefit immensely. So, Fiber Fueled. So Fiberfield was an amazing book. It really broke down some of the sciences and all that kind of stuff when it comes to the importance of fiber, et cetera, et cetera. But now you're moving. You're moving more to the recipe side of it. So I had a quick squeeze through your second book, and that's more focusing on the recipe aspects. But something that I also wanted to discuss further was about the struggles that people have with intolerances. So we're going to cover all that in this conversation, and I'm really interested to also explore your strategies. I think you call it the growth strategy. So it'll be great for us to go through it. Each of those different. It's an acronym, isn't it? So each of those different elements of your growth strategy and really love to explore it. But firstly, let's talk about a term that you talk about in your second book, the fiber Fueled Cookbook, which is the fiber paradox. So as people would know, Dr. B is a huge advocate of fiber and the importance of plant foods. What is the fiber paradox?

The fiber paradox is that I think it's important for us to have very honest discourse or conversations when we're operating in this space of people who have digestive health issues. Because each person cribbing, you, myself, the person listening to us at home right now, we each have a completely unique gut microbiome to the point that there are 8 billion people on this planet, yet I can assure you there is no one with a microbiome exactly like yours. Cribbon.

Absolutely.

If you had an identical twin, this literally could be an identical twin, genetically the same, that comes from the same home. You would still only share 35 to 38% of the same microbes. The majority of your microbes would be different. I come from a place of first acknowledging that bio, individuality, the journey, is not going to be the same for all of us. What works for me is not necessarily going to perfectly fit for others. I wrote this book fiber Fueled. And my intention, coming from a place of passion and enthusiasm, was to try to show people the connection between this new science of the gut and the dietary choices that we make. Because, frankly, in the United States we are deficient in fiber. And I think that this is causing some of our health issues. I'm trying to really narrow that gap. And it's not a matter of being 100% or not being 100%. I don't care about that. I just want to help to move people in the right direction towards being empowered with the right facts to improve their health. But in doing that, there are people who come to me, you know, they were coming to me in my clinic and they reach out to me through the Internet and they say, but doctor, I am sold. I want to eat the way that you're describing, but I don't think that I can. I don't think that it's possible. And the reason that they come from that place is that they suffer symptoms, they try to eat these foods that I'm saying are so good for us, these fiber rich foods, and it makes them miserable. And the fiber paradox is that this food that heals and nourishes and supports a healthy gut microbiome, the plants, the fruits, the vegetables, whole grain seeds, nuts and legumes, these foods are the foods that a person with digestive health issues actually needs the most. We need that to support a healthy gut microbiome. But the paradox is that this is also the food that makes them the most miserable. I think it's a matter of being very upfront and honest about that. I don't want people to think, hey, fiber is easy, just slap down the fiber and crank it up. And if, and if you can't do that, then shame on you, you're a wimp. Like, that's not the case. And I am trying to create a pathway where, you know, let me say this, if so, I actually believe quite largely in an intuitive approach in most cases, I do think that, like, following our instincts and what our body is telling us is actually very important. But there are times where an intuitive approach can misguide us and actually get us into trouble. And this is actually one of those examples, because I completely understand that when a person eats a food that causes digestive distress, it would make too much sense to just reject the food, to say, I can't eat that, so why don't I just stop? And the problem is that it's ignoring the resilience that you have as a part of your gut microbiome. You may struggle with that amount of that food today, but your gut can be healed, it can be made stronger, it can be fortified, you can restore function, you can enhance function. And it's capable of taking these foods that you consider to be your enemy and turning them into your friend. This is an important part of the message, is to say, don't allow those foods to be your enemy, because the enemies will drag you down. Instead, let's take those foods and let me work you through the process, which is this new book, the Fiber Fields Cookbook, to show you how to take those enemies and turn them into your friend. And now you're celebrating one another.

That's amazing. I certainly totally resonate with what you're saying. When it comes to certain types of foods that can create discomforts. And then people tend to throw out the baby with the bathwater and think, I can't have that. I'm never going to recover, so I'm just going to completely avoid it and eliminate it out of the diet. But I'm certainly with you that we're going to talk about all these intolerances in a moment. But I'm certainly with you that once we go through this healing process, which I think you described well in your growth strategy, then foods that perhaps you could not tolerate in the past, maybe you can after that healing process is. Has been addressed. So in terms of your strategy, let's talk about the intolerances first. What are the common intolerances or sensitivities that you have in the past come across in your medical practice?

So defining a food intolerance first. Food intolerance is when you have symptoms that are undesirable after you consume a food in normal quantities. It's not that you went way overboard on some particular food. If any of us drink a gallon of milk, we're all going to have diarrhea. That's not a food intolerance. But if you have a single glass of milk and it causes bloating or cramping, pain or diarrhea. Well, that is a food intolerance. And about 70% of the world is intolerant of lactose, which is the sugar that you will find in dairy products and milk. And that is. It would seem that that is the most common food intolerance that exists in terms of being very specific about food intolerances. But there are actually many different types of food intolerances. One thing that I'll say, Cribben, before we go further, is that food intolerances, generally speaking, are the manifestation of symptoms as a result of sloppy digestion, meaning that your body is struggling to break down and process the food. And that's not actually the immune system. If it were the immune system, that would be actually a food allergy, which is a very different thing. If a person has a food allergy, for example, to dairy, you know, they have a, they have an allergy to dairy. If I put one drop of milk on their tongue, that could be enough to trigger that food allergy. Whereas a person who has lactose intolerance, it's important to understand that there's actually an amount that that person can tolerate. So if you have lactose intolerance, one drop of milk is not going to give you diarrhea. It's just a question of like, how much is it? If an 8 ounce glass is causing diarrhea, then what is the amount that you can tolerate? Is it 4 ounces, is it 3 ounces, is it 6 ounces? That number does exist. And part of empowering yourself and knowing how best to approach these issues is to isolate the specific food that's causing trouble. And just as importantly, to know how much, you need to know the what and the how much. And unfortunately, there is no reliable test to allow us to just shortcut to that information. I wish that there were, but they're not adequately validated for us to just lean on those things in isolation. Instead, what we have to do is we have to ultimately go to the tried and true approach, which is that we will take the food and we will remove it temporarily from our diet, see how we feel, and then bring it back in, and then we can evaluate whether or not we have a food intolerance. One of your questions, Cribbin, was what are the different types of food intolerances? I'll give a few examples. First, are the FODMAPs. FODMAP stands for fermentable oligosaccharides, disaccharides, monosaccharides and polyols, which is a complex way of basically saying the sugars or chains of sugars that exist in your food. So, like, they could be the fructose in fruits, it could be the lactose in dairy. It could be the fructans, which are almost like fiber that you'll find in garlic, onions, or wheat or whole grains. It could be the galactans, which you'll find in legumes, or it could be polyols, which are sugar alcohols, which can be artificial sweeteners, or they can actually be found naturally in food. Now, these FODMAPs, what's interesting about them is that it's easy to make them sound bad, like, oh, they cause gas and bloating. In fact, almost everything that I just described to you, including the lactose, by the way, is actually prebiotic. It has been demonstrated in studies to feed and nourish our gut microbes and make them actually more healthy. So we don't want to, as you said before, throw the baby out with the bathwater, because we all have gut microbes that are starving for our fiber, starving for our prebiotics. And when we remove these foods from our diet, we're actually digging ourselves deeper into a hole. Instead, we want to actually heal these food intolerances so that we can include these foods because they're so nourishing, good for our gut. Now, one other example of a food intolerance is histamine intolerance, Right? And it's a bit different than the fodmaps because what's happening in the body with histamine intolerance is that. So, first of all, histamine is a signaling molecule that's a normal part of our body.

Absolutely.

You have histamine right now, I have histamine right now. And so do the people at home. We all have it. And when it's in balance, that's part of being healthy and it serves good biological functions. But when it falls out of balance, that's when we can manifest symptoms. And those could be, like, the number one symptom of histamine intolerance is gas and bloating. So, like, for the people who are at home right now with gas and bloating, Curious and, like, interested in this conversation. I'm reaching out to you right now. You have to entertain the possibility of histamine intolerance. You have to ask the question, could this be the cause? Gas bloating, other GI symptoms. But what's interesting is when we have histamine intolerance, we are Struggling to process the histamine that's in our diet. So there is an excess of histamine in the body, and it will activate histamine receptors. Like, for example, in our nose. We get a runny nose, congestion, sinus issues. It may give us a sore throat. It could make us a little bit short of breath, rapid heart rate, lightheadedness could give us a rash or have flushing of the skin, like redness. These are all different potential manifestations of a histamine intolerance. The topic is nuanced and can be complicated, but actually the solution is very simple. If we could just hand our patients two weeks worth of recipes that are low in histamine and they eat that way and tell us if they feel better, that then we have just done the appropriate test to evaluate for histamine intolerance. And that's exactly what is happening in my new book. My book was this opportunity for me to do something that I've always wished that I could do as a doctor, which is to actually hand patients a list of recipes and allow them to eat from something that is designed scientifically to evaluate what's going on with their gut. So there's a low histamine protocol and there's a low FODMAP protocol that allows you to basically assess for yourself whether or not you have one of these two issues. Great.

That sounds incredible. So in terms of histamine intolerance, how prevalent is it in the population?

It is so crippling. It is so hard to know. So I sometimes feel. I don't know how you feel about this. I would love to hear from you on this. I sometimes feel like conventional medicine views histamine intolerance as not being a legitimate thing. What do you think?

Yeah, I would tend to agree. It's in the same bucket as something like sibo. It's another one of these conditions that sit in the kind of naturopathic medicine space. I don't have the answer. That's why I'm so fascinated to hear your take in terms of how prevalent these things are, because it's so difficult to. There's no reliable diagnostic tools for these things from a medical perspective, the field that you're in. So I agree with you. It's just a matter of, you know, using intuition, using that kind of elimination. Food diaries, you know, this is very typical of nutritionists and see how it impacts the body.

Yeah. And this is. And this is. This is where, you know, to me, something like this book is an opportunity for me to bring Something that's actually very useful to the people who choose to engage with it, because histamine intolerance. So you kind of mentioned this, but I just want to unpack it a little bit further that there's no blood test for histamine intolerance. The way that you determine whether or not a person has histamine intolerance is by putting them on a low histamine diet. This creates something that is extremely challenging because no doctor is ever doing this. A doctor never puts patients on a low histamine diet. So if they don't have any sort of diagnostic tool in the clinic, then we're going to find that this is under diagnosed and it's also going to be exceedingly difficult for us to study it, because who are the people that have this? Yet there are clearly people that have these symptoms. Gas and bloating is everywhere. There are clearly people who, when they eat a meal, they get a headache or they get a runny nose or eating, they get flushed and they probably have histamine intolerance and they've been floating through the system and receiving other diagnoses, when in fact the answer to their problem is here. And so I think that to answer your question, we don't really know, Cribben, how prevalent this is, and the reason why is because of these diagnostic limitations. But a diagnostic limitation is not a referendum on whether or not this is real and whether or not people are suffering with these problems. Instead, what it is, is that this is real. These people are suffering. But we are struggling to use the tools available to us at this very moment to actually identify who they are. And so this is where I feel that a book on mass scale allowing people the opportunity to like, quite simply, look, I can assure you this. So first of all, I have, I think, 26 recipes that are low histamine in my book. All right? And you are not going to hurt yourself by doing the low histamine diet for two weeks. Sure, I don't see a downside to it. But on the flip side, what if you discover that your symptoms are radically improved? How powerful is that? Right. The diagnosis that has eluded you, we have just discovered, and it's through the power of basically this protocol. So that, to me is one of the things that I'm actually really excited about. I wouldn't put my reputation on the line with histamine intolerance if I didn't really wholeheartedly believe in it. And the chapter has 90 references just to make sure that it's very Clear that this is scientifically based. It's not just making stuff up.

Sure, absolutely. I think that sums up the whole histamine story pretty well. How about we jump into some of the other common conditions or intolerances that you come across? I think in your book, you talk a little bit about constipation, patient, and also sibo. So how about we touch a little bit on those two as well?

Absolutely. So the first step is, you know, if it's okay, I'll just sort of jump into the growth strategy. Is that.

Sure, yeah, absolutely. Let's do it.

Because I think it makes for a good way for us to segue into what you want to get into. So in the book, I bring forward my approach to food intolerances called the Growth strategy. And this is actually an acronym where if you follow through the letters one by one, it will teach you the steps that you need to take to heal your gut. Now, I was really excited when I came up with this because in my first book, Fiber Fueled, I actually talked quite a bit about the growth mindset because it's something that I want to impart on my. My community. I want us to have a growth mindset. It was first described by Carol Dweck. And the idea is that we don't worry about winning or losing, but instead we focus on the process. So we celebrate that we're challenging ourselves. We celebrate perseverance. We celebrate the growth that comes from those things, even when we fall flat on our face. And so it makes it sort of, if you're doing it properly, then you're just always winning. And it's the same attitude that I want my children to have. So, anyway, but in this case, growth is my acronym, and we're going to go through the whole thing, But I'm going to start with the letter G. G stands for Genesis. As a medical doctor, the very first step has to be a root cause, understanding of the genesis of your symptoms. What is the root cause? Because if we know that, then we are empowered to make great choices in terms of how we attack the problem and make it better. And if we don't properly understand the root of the problem, then we are in a position where we are just slinging stuff against the wall and hoping that something will stick. And maybe something does stick, but that's called luck. That's not called being smart. So ultimately, we want to make sure that where we start is we evaluate for things that can explain and identify the root of the issue. And Cribbon, many times, what I've discovered is that if you do this properly, you may come across something where once you fix that, their food intolerances go away entirely. One of those is constipation. Constipation, to me, is the number one cause of gas and bloating. And it's very poorly understood because there are a lot of people who believe that they've been inappropriately taught that constipation is just like, only present if you never poop. It's not true. Constipation, from my perspective, is the manifestation of symptoms that you don't want because you are inadequately evacuating your colon. And inadequate can look like many different things. Sure. Like a person who doesn't poop in seven days, they're clearly constipated. But the more common thing that I saw in my clinic are people that were pooping every day but not completely emptying. And they would feel like, gosh, I don't really feel like I went all the way. And sometimes they would poop again 30 minutes later. And you clearly didn't empty if you poop again 30 minutes later, because that's not new poop. You don't make it that quickly. And so that person could poop every day and still be constipated and manifest gas bloating, perhaps discomfort, nausea, loss of appetite. Fatigue is an extremely common symptom with constipation, even brain fog. So one of the major questions needs to be, are you constipated? Because if you take that person and you get them into a rhythm, our body thrives on rhythm. Take the heart. If I take a great athlete, this could be an Olympic athlete, and I throw them into an abnormal heart rhythm, I can literally make it so that this great athlete can't even walk up a flight of stairs. And the same is true with the gut. Stop, start, stop, start. That's not rhythm. Rhythm is effortless. Rhythm is things just coming when they're ready to come, and you are completely evacuating, and you are very satisfied. So I do think that it's worthwhile to just be upfront. I mean, maybe I'm a little too comfortable talking about poop. But it's very important for people to understand that bowel movements were meant to be satisfactory. They're supposed to be enjoyable. And so when a person doesn't have that, when they feel like it's incomplete or they're struggling or it's not coming well, that's when we're not where we need to be. We're out of rhythm and restoring Rhythm not only fixes these issues, but, like, what I find is that people who are constipated, they get bloated with everything. Whether it's high fodmap, low fodmap, doesn't matter. Everything bloats them. And when you fix the constipation issue, the bloating goes away.

Great. So what's just some basic tools that you use in your practice back in the days to address constipation? Because it's a very, very common issue.

So what we want is we don't want a roller coaster again. We don't want stop, start, stop, start. That's not rhythm. What we want is something that allows us to just stay in that rhythm and keep things moving through. And one of my things that I like to say is that you could think of this as a log that's floating down the river. You got to make sure there's enough water there to float this log down the river. Don't let it get dried up on the rocks, right?

Absolutely. I'm getting this visual picture in my head of a log fleeting down a river in my stomach.

It's a big log, but we don't want it to get dried up on the rocks. And so ultimately, we want is a bowel movement that's like a torpedo, but it's soft and it's formed. How do we accomplish that? Part of how we can accomplish that can be fiber. But I want to warn people that if you have severe or even moderate constipation, cranking up the fiber can actually make you feel worse. This is where I like to add something in first, which is magnesium. Magnesium comes in many forms, so you have to be careful. Magnesium, for example, glycinate. Great for headaches, great for mood, great for sleep. Not so great for constipation. The three forms that I like for constipation are magnesium oxide, magnesium citrate, and magnesium sulfate. Now, I would encourage people who are thinking about doing this to do it under the care of a healthcare provider, and they can check your magnesium level before you even start. But what I have found is that most of us are actually low on magnesium at baseline. Then when we supplement, I typically will start someone at 500 milligrams before bedtime. I choose bedtime because magnesium helps you sleep better. So that's good. We want that. But the second thing is that we're kind of priming the pump so that we can have a great morning bowel movement. Morning is a great time for a healthy BM and so typically 500mg at bedtime and give it at least a couple days to see how you feel. And if you're not quite there and you're not finding that you're in that rhythm and you need more, then you can go up in 250 milligram increments. 750, 1000 milligrams. You could even potentially go up to 1500 milligrams. Again, when you get to 1000 milligrams or more. I want you to be doing this under the care of a healthcare provider. And typically you would want to check your magnesium level and just make sure that it's not too high. Very few people have. I had to actually push north of 1,000 milligrams. Most people. 500, 750 or 1,000 gets the job done. And you repeat a magnesium level and most of the time what you find is that it's right where it's supposed to be once you're on the supplement. That's a beautiful thing.

Right. That's wonderful advice for people who are struggling with constipation. And this is straight from a gastroenterologist's mouth, if I can say the word properly, tongue twister. But it's straight from the practice of a trained medical professional that's used this very effectively in his own practice. So thank you so much for sharing that. Is there anything else on that growth? So what's the next step in terms of the growth strategy?

Well, just to comment real quick on the genesis and the root of our problem. So I do think constipation is huge and important. Bloating and gas. If you're having these issues that I'm describing where you're incompletely evacuating, then I would. I personally feel that it is in your best interest to focus on getting into a rhythm and be. And I think that it's important to be a little bit cautious about chasing sibo in that setting. So if a person is struggling to poop, focus on rhythm first. If you can get yourself into a rhythm and you keep yourself in that rhythm, the gas and bloating are. It's going to go away with sibo. Sibo. To me, I am mainly concerned in people with diabetes or if they've had GI surgery and there is gas and bloating, but typically there would also be diarrhea. And these people do exist. I'm just a little bit cautious. It may be controversial, cribbon, but I'm a little bit cautious to take a person who has What I would describe as a dysbiosis. That's what SIBO is, a damaged, unbalanced gut. And then going after this with an antibiotic. Because what I have found is that most of the time, people are not actually better. They may be temporarily better, but then there's a relapse very soon. I don't think that long term, we're actually making people more healthy with the antibiotic. So instead, I would encourage people with SIBO to approach this the way that I'm describing in the book and slowly increase your fiber intake, slowly, cautiously, to help to rebalance, renormalize the gut microbiome. So, anyway, all right, so once we get past the root of the issue, the G for Genesis, then we move into. I'm going to actually pair the next three letters together, R, O, W. And we almost talked about this earlier in the episode because this stands for restrict, observe, work it back in. When we're trying to isolate a food intolerance, this is the approach that we take. And it's not a permanent restriction, it's a temporary restriction. But by withholding that food and seeing how we feel and then bringing it back on the menu and again, seeing how we feel, going off, on, off on allows us to create the shifts in current where we can then evaluate whether or not. First, is this one of your problems? Like, do you have an intolerance to this food? And no matter what the answer is, whether it's yes or no, you are empowering yourself with valuable information, reliable information. But the second question is, how much? And so in this process of restrict, observe and working it back in, when we work it back in, we start with just a little bit, and then we increase over a couple of days. And by doing that, you can actually find what your threshold is. And once again, this is empowering information. It's not, hey, I'm intolerant of dairy, It's, I'm intolerant of milk. And this is the amount that I'm okay with. And this is the amount that gives me trouble. Again, that's empowering information.

Absolutely.

Once you know that, then once you have this information, you can move on to the next step, which is T. Train your gut. Your gut is a muscle. It can be trained, it can be made stronger, it can be fortified. But when you struggle with food intolerances, we have to first acknowledge that this is indicative of a damaged gut. People don't get food intolerances when their gut is in a good place. So the engine needs to be tuned up and I would make an analogy to Cribbin. What kind of sports do you like?

Well, when I was younger, I used to play cricket. I'm not sure the familiar Aussies would play cricket.

I love cricket. So. All right, so take cricket. Pretend that you're playing cricket and you twist your knee. All right? And now in your recovery, I'm going to give you two choices, and you tell me what you feel most comfortable with. And I want the people at home to think about this, too. Here's your first choice. I can promise you no pain in your knee, but it requires you to stop walking. And we, you know, just to be upfront, you stop walking, and obviously your muscles above the knee and below the knee, they're going to get weaker and you'll be sedentary, and so this will affect your metabolism, and there probably will be some health issues that will show up pretty soon. But then this could potentially lead towards bigger health issues down the road when, like, high blood pressure, high cholesterol, diabetes are sort of perpetually there because you're not moving anymore. Right. But the good news is you don't have any pain. Right. Option number two is I get you hooked up with a great physical therapist. And this physical therapist is supportive and encouraging, and they're going to work you through a process where you will progressively challenge your knee. And with each challenge, the knee gets stronger, and eventually you get to a point where the function is restored. Now, as you're going through this, you may, at some points, we're going to try not. But at some point, you may experience some pain. But when I get you to the other side, not only is the pain gone, but you are actually fully functional again and you can get back out there playing cricket. What would you like?

Well, option two is certainly a better proposition, that's for sure.

Yeah. And this is where I mentioned earlier that sometimes an intuitive approach can be the wrong approach for us, because if the only thing that motivated us was the avoidance of pain, then we would choose the first option. But there is more to healing a knee than the avoidance of pain. We have other goals that we want to accomplish, and the same is true with our gut. Instead of a knee, we're talking about an injured gut. And when you introduce these foods to an injured gut, they can cause pain. Now, you could remove those foods permanently, and your gut will grow weaker. And as a result of that, not only will you be less tolerant of those foods and find it more difficult to introduce them at a later date, like, it'll actually become more difficult but you may actually find that you have other gut health issues that start popping up because the gut has grown weaker. So alternatively, we can rehab your gut. We can take these foods that cause discomfort. And I'm not telling you, just tough it out. That's not what I'm saying. What I am saying is that we can challenge your gut with an appropriate amount of that food, an amount that hopefully doesn't actually cause any symptoms. And then it grows you stronger, and then we come back and we re challenge you at a higher level next time. And we keep repeating this process until you have fully restored function to your gut. And now you're consuming this food that you didn't think that you could tolerate, and you're eating it without restriction. And that is training your gut. And that's ultimately what I want people to do. You start low, you go slow. And by repeatedly challenging your gut in escalation, slowly, at your own pace over time, just like healing your knee, you can heal your gut and you can get back to restoring the function.

Wow, that is a wonderful analogy, Dr. B. I mean, it's. I understand your previous comment when you say it's a nuanced approach, because it's not really a binary choice. It's these layers of fibers or different tools that you use that people can actually try for themselves and work out what that threshold is. So that's wonderful advice. I really appreciate that. So is there anything else in terms of that growth strategy you wanted to talk about before we move on to the next topic?

There's one last part. Sure. Which is the letter H. And it's perhaps my favorite part of the whole thing, because I think it's very important for people to realize you and I are sitting here and we're talking about a very formulaic approach to nutrition. Each is my opportunity to remind everyone that this is not just biochemistry. This is not just carbohydrates, proteins and fats contacting enzymes, and then something happening. You are a complete person. You have a soul. You have a spirit. You have people in your life. You have an environment in which you live. And all of these different factors ultimately are imprinted in your gut microbiome and become a part of you. The people that you spend time with, Your sleep, your exercise, the environment in which you live, and even your emotional state. And one of the things that I've discovered in my career, Craven, is that there are people who. They do everything right, and then they don't understand why they still suffer. It's actually quite common. And so, like Again, they will eat the way I describe in my books, and they will exercise and they will sleep and they will meditate. But Dr. B, I'm not better. And the reason why is because it actually, we are now going full circle on the growth strategy. You have to understand the root of the problem. And if the root of the problem is that you have something unsettled emotionally. And we could use the word trauma, and that could be a big thing with a capital T, but it could be a smaller thing with a lowercase T. You know, it could be a breakup, right? It could be an unhealthy relationship with a parent or a spouse. It could be a medical issue in someone that you love. If it's unsettled, then what it does is it activates your sympathetic nervous system. There's actually things that happen physiologically that become out of your control. Your pituitary glands releases a hormone called crh, corticotropin releasing hormone. This sets off a cascade, like a cascading waterfall of stress throughout the body that ultimately, if you zoom in on the gut, what you will see is dysbiosis. And this is the reason why people, in times of stress, many of us will manifest it in our gut. But what happens if that stress is chronic and low grade and it's 24 hours a day because there is something in your life that is unsettled. So with the growth strategy, I would close out with this mention of holistic healing by sharing a quick case that I had recently. I had a patient of mine who, she has ulcerative colitis and she might have been suffering with chronic diarrhea, waking up in the middle of the night to go, she's young, single, she couldn't fit date because of this. It's like really disrupting her quality of life. And I'm her GI doctor, and I'm trying to do everything that I can with complete humility. I am failing. I have her on the medicine that I think is the right medicine. I'm working on the diet, sleep, the exercise, all of it. She's not getting better. This is going on for two years. And then one day recently, she comes into my clinic. This is like, know, one of my last days in this clinic. I walk into the room and I'm, you know, expecting that this is going to be frustrating and challenging for both of us. And I look and she just looks different. She's got a big smile on her face. And I sit down and ask her what's going on. She says, Dr. B, my life has changed. I'm all the way back to feeling like myself again and I'm not being dominated. And I asked her, so what changed? I was so excited. But what, what is it? What was it? She said? I realized that my job was holding me back. I would wake up every morning and fear having to go to work because when I got there, my boss, like, abused me and he would publicly demean me and embarrass me in front of my peers. And I finally got the gall to walk away and she found a new job and they treat her with respect. And all of a sudden, this chronic inflammatory diarrhea causing condition, medical condition that I could not fix, goes into remission and she gets back to having a normal life again. That's holistic healing. That's the power.

Wow, that's such an important point, Will. Stress is such a big factor when it comes to gut health. And we've spoken about it so many times in this podcast, the link between the gut and the brain. But that just highlights it perfectly that you tried all these different strategies, all scientifically based, couldn't fix it. But a simple thing is changing your job and getting yourself out of a stressful situation was the. That one step that needed to be addressed. And it was addressed. And then happy days. Thank you for that.

And I feel like, you know, this is where I think it's very important for me. This, I need this reminder because it's so easy for me to go bananas talking about nutrition, you know, and because in my life it was nutrition that changed my life. But so it's so easy for me to just go bananas on the nutrition stuff. And, you know, most of us will at least acknowledge the sleep and the exercise and stuff like this, but we're far more complicated than that. And I think it's very important for people to see these paths to healing so that they can apply it in their own life, like I'm encouraging people to in a safe way. Surrounded by the love and support of people who are there for you, that you take a look in the mirror and ask the question, is there something holding me back? If there is, when the time is right and with the right type of support, in many cases, including a health professional, you turn your attention towards it and you take on that challenge and you fix it. And it's amazing the healing that takes place after that.

So true. So true. I'm very conscious of your time. There's just two more topics to quickly cover. Anything else that you wanted to talk about in that realm. So sorted.

No no, no, that's my growth strategy.

Strategy, by the way. It's so simple. And I love how you add all these, these real life examples because I think it really highlights the importance of all these different steps in your strategy. So a couple of things. People are very conscious at the moment when it comes to the immune system and immune health. So what's your take on the importance of fiber and the immune system? So it's a pretty broad question, but what sort of jumps out in your mind when you think fiber immune system?

We've actually seen it during this pandemic cribbing. The data are continuing to emerge, but we actually have quite powerful data already. This is one of the things that has evolved and changed since the last time that I saw you. And then we spoke. There were animal model studies going back to 2018 where they would just to set the stage for where I'm about to go with this, they would infect these mice with a respiratory virus. It was not COVID 19, COVID 19 did not exist, but it was 2018. And they would give these mice the respiratory virus and then put them on either a high fiber or a low fiber diet. The scientists predicted that their hypothesis was that the mice would be more sick on a high fiber diet because they said fiber is anti inflammatory, it's going to reduce the immune system and then these mice will get hurt. It was actually the opposite effect. The mice on the high fiber diet lived longer. They had objectively measured improvements of lung function and they recovered more quickly. The scientists were blown away and they dug into this further to try to understand what was happening. What they discovered was that fiber meets gut microbes. Gut microbes release short chain fatty acids. These short chain fatty acids have healing effects throughout the entire body, including in the lungs, where they actually help to shape the immune system. What happens is you get the right immune cells on the battlefield to basically get the virus taken care of, but you simultaneously prevent the immune system from going nuclear. Because when a person lands in the ICU with for example, COVID 19 and they require a ventilator and life support to sustain their life, that's not actually the virus doing that. It is the result of the virus, but it's the immune system that's doing that. The immune system is overreacting. We call that systemic inflammatory response. Again, that's the immune system going overboard. It was my prediction that we would discover that fiber would be very relevant. I actually wrote an editorial and I submitted it to the New York Times and they declined.

Geez.

Well, and that's okay, because I get it. We were in a period of time where it was like, you know, May of 2020. And I'm not citing hard data, I'm citing an animal model study from 2018. And so I get it like it was, it was more like me hypothesizing. But nonetheless, In January of 2021, in the top gastroenterology journal in Europe called Gut, there was a paper that showed us that when a person has COVID 19, there's a change to their gut microbiome. There's an increase of inflammatory microbes, but also very importantly, there is a loss of the anti inflammatory short chain fatty acid producing microbes. As you ratchet up the intensity of COVID 19, this deficiency of the short chain fatty acid producing microbes becomes more pronounced. Those with the most severe disease have the biggest deficiencies in their microbiome. They went on to do a study of health care providers, six different countries and look at what diet are they eating and what is their health outcome when they contract COVID 19. That's, this is predating the availability of a vaccine. And what they discovered, which was, I think in alignment with what we're talking about right now, is that people who were eating a plant based Diet had a 73% reduction in their likelihood of having moderate to severe COVID 19. People on a pescetarian diet, this is basically a plant based diet, plus seafood or fish. On that diet, they had a 59% reduction in moderate to severe COVID 19. Now on the flip side, the worst health outcomes were actually seen among people eating a low carb diet. If you were low carb relative to being on a plant based diet, you were roughly about four times more likely to get moderate to severe COVID 19. Now this is not like, I'm not here with the intent of bashing a low carb diet. There are ways in which a low carb diet can be a healthy diet. I don't doubt that. But the problem is that those ways involve nutritionists formulating the diet to address the fact that fiber is a carb. So for the majority of us, if we cut carbs, we're actually cutting fiber. In the real world, when people go low carb, they typically are also going low fiber. That's, I think part of what we were seeing in this study is that it was a fiber effect. One last thing, the question was about immunity. Getting sick and landing in the hospital is not the only bad thing that can happen with COVID 19. People can develop long Covid where the symptoms will persist for months. The question has been, what is going on and how can we protect ourselves? There was recently a study where they showed that people with long Covid, if you look under the hood at their gut microbiome, we're actually seeing a pattern very similar to what we saw with severe COVID 19, a loss of the short chain fatty acid producing microbes. We don't have a study to say that fiber is good to prevent long Covid, But I'm here today to say that I'm willing to make a prediction that we will have that study in the next year. Wow. I expect that we'll have a study where they will say, guess what? We just found that with long Covid, you can reduce the likelihood of having this with a insert whatever your fiber rich diet is of choice.

Great. Well, thank you for sharing your insights. Very topical and I'm sure a lot of people's minds, how to improve the immune system, the impacts of the pandemic that we're going through fiber. So you've wrapped it up nicely and you've provided some nice scientific studies in that space as well. One final question before we wrap it up. There's a section in your book called Fermentation nation Rising. Admittedly, I haven't had a chance to go through it in detail, so. So how about you just give us a quick synopsis and a bit of a teaser so people can run out and check it out themselves and what that section of the book actually entails.

I think that one of the big messages in the gut health space that people need to hear is fermented food is supposed to be a part of our diet. And so now this was something that you could just say, look, we've observed this among cultures from around the world, that every major culture, if you look at the food that they sort of distinguish as their most celebrated foods and perhaps the ones that we might look at and be like, I don't know if I could eat that, but they really seem to love it. It's often the fermented foods, you know, the acquired taste, if you will. Right. So. And you know, part of that was by necessity because we didn't have refrigerators up until very recently. We didn't have preservatives or canning or sterilization. And we didn't even know about the microbes less than 200 years ago. You know, it was the 1850s that we started to really learn about these microbes. And so anyway, but these microbes are everywhere. All living creatures on this Planet either have a microbiome or they are a part of the microbiome, or perhaps both. Like, I sometimes think of us as, like, we have a microbiome, but I also sometimes think that we are a very big part of the larger microbiome that is this planet. Right. Sometimes I feel like we're dysbiotic. It makes me sad. So, but nonetheless, these microbes, they've always been there. And these microbes are intensely powerful. We see what they can do within our gut. But what happens if you set up an ecosystem on your kitchen counter? Because that's what fermentation is. You are creating an ecosystem and you're allowing the right microbes to rise up and flourish, and then they use their unique skills because each microbe has unique talents, unique skills to transform your food. And nature is screaming at us, please do this. Like, nature is almost begging us to do this. How can I prove that? Well, like, first of all, if you want to make sauerkraut, all you have to do is chop up the cabbage and submerge it in a, all of the microbes that you need to produce sauerkraut. Which, by the way, many of those microbes are the same ones that you will find in probiotics. They're good for us. All of the microbes that you need are already resident on the leaf of the cabbage. And so nature is asking us to create sauerkraut like they couldn't. Nature could not make it any easier. How about bread? So, like all bread, unless it's unleavened, all bread is created with the help of microbes. Specifically yeast, like baker's yeast is a living yeast that helps to basically leaven the bread. And if you want to create sourdough, it's so easy. Like the grain already has the microbes that you need. So all you have to do is add water. The grain is begging you to make bread and the microbes want to help you accomplish this. But to be a little more scientific about it and less narrative, I mean, I do love, I do believe that this is the truth, everything that I've said. But to be a little more scientific about this, there's a group of researchers at Stanford University, Erica and Justin Sonnenberg, they are microbiome researchers. And Christopher Gardner, who is a large scale nutrition clinical trial expert. They did a study where they had people introduce fermented food for 10 weeks. They ate quite a bit. But it's important to keep bear in mind with fermented food, a serving size is not a bowl, a Couple of bites is a serving size in the fermented food space. They had people introduce though consistent consumption on a daily basis of fermented foods. This is so exciting. In just 10 weeks, they saw improvement of their gut microbiome with increased diversity and inflammatory markers were reduced. They were reducing inflammation. So the messaging that I like to put out there about fiber and all of these types of things, I mean, that's important. This is, to me, the backbone of gut health is eating with broader diversity and getting all these different plants. But don't lose sight of the fermented foods. This is the update. We need to make sure the fermented foods are in there. So that's really the message of this chapter. And as a result of that, I actually then go on to teach people how to make a sourdough starter, how to make sourdough bread, how to make different ferments. An example that, like most many people would never think that this could be a fermented food, but it absolutely can be, and it is glorious is fermented salsa.

Oh, nice.

Fermented salsa. Don't just get the stuff at the store. Chop it up, give it a week and let the microbes do the work for us and you will enjoy it so much more. It's delicious.

Wow. I'm so excited to try out some of your recipes. I'm fully stoked that you've gone down this path and you've actually given people some practical tools and including some of these fermented foods in the diet as well. Will, I don't want to take up any more of your time. I really appreciate you coming on this podcast for around two. Thoroughly enjoy it. Love your energy, love your presence, love that beautiful aura that you have. So thank you so much, sir. So how can people grab a copy of your new book, Fiber Fueled Cookbook?

Well, it's. I have a big smile because it's always a pleasure to connect with you, my friend. And. And so the Fiberfield Cookbook is available on May 17. So depending on when this podcast is released, it's available on May 17th in the United States through all the major book outlets. And actually it's picked up by a publisher in the UK and that's going to be available on May 19th. And so, like, for example, if you are Australian, I have good news for you. I discovered that I wrote a book called Fiber Fueled where I misspelled both words.

I'm sorry, the Aussie versions.

My apologies. I do love you. I do love my friends from down under. And so Actually, the UK version will be updated so that fiber is spelled F, I, B, R, E, and fueled is with two Ls.

Nice.

We're getting that fixed.

Yeah, Aussies are very particular when it comes to spelling, so I think that's a good idea.

Oh, well, that's cool. That's cool. Yeah. So Fiberfield, the Fiberfield Cookbook, as you basically mentioned yourself cribbing, this is, to me, this is a toolkit for health. And it's really meant to be a choose your own adventure. No matter who you are, we all should care about having. Having gut health. We all should. Even if you're super healthy, like, you don't want to wait until the bomb goes off, you instead should be focusing now on optimizing your gut health so that you can keep yourself healthy and you can age well and have a long, healthy life. So. And this book is meant to empower everyone to find what works for them on an individual basis. I encourage you to make it your own to do whatever you want to Enjoy these recipes, but there are 125 recipes, full color photography. There are two protocols for food intolerances. I teach the growth strategy. I teach you how to sprout. I teach you how to ferment. I teach you how to make sourdough. Basically, again, like, this is a toolkit for gut health. And finally, for people who want to continue to support my journey and engage further with it, come to my website, theplantfedgut.com I have a great email newsletter that I would love for you to be a part of and follow me on social media, Instagram and FacebookMD.

Wonderful. I'm sure that the audience are gonna be chomping at the bits to check out your new book and join your beautiful community as well. Will, as we always wrap up the show, if there's one thing you could do for your gut health today, what would that be?

I'm gonna go in a different direction than we've been going this whole time. I'm going to say, give someone that you love a big hug. All right? And here's why I'm saying it. We share microbes. It's actually an expression of affection between us. Believe it or not, when we kiss, we share 100 million microbes. And there's a recent study that came out that I found to be very interesting. And we'll close out with this. They found that people who like spouses, people who live together, they actually share more microbes than you share with your own siblings. Even though you share so much genetic code with your siblings, you share more microbes with your spouse and they discovered that it was not just a food related thing, that there was far more to this than just the food. And one of the most exciting and fascinating things was that they looked at the quality of your relationship with your spouse and the people who were really optimistic and still very happy, they actually were sharing the most microbes together. Meanwhile, the people who were struggling in their relationship and more like sort of down and out, they weren't sharing nearly as many. So let's share microbes with the people that we love. Let's get out there and give a big hug to someone that we care about. And let's remember that Gut Health is not just about food. Gut Health is also about feeling loved and supported by the people who are around you. And it's important to be the one who also makes them feel loved and supported by you. So it goes both ways.

Wonderful. Well, thank you so much. Beautiful words of wisdom.

Love it. Cribbin thanks man.

We hope you enjoyed this episode of the Gut Health Gurus Podcast with the Amazing Doctor Will Be Guys, if you enjoyed this episode, please leave us a kind review in five stars on Apple Podcasts, Spotify, YouTube, or your favorite podcast app. If you want to connect with me Cribbinger, do head to guthealthgurus on Instagram. I'm highly active on Instagram and also on Facebook and check out the Gut Health Gurus Facebook group if you want to continue this Gut Health journey with me. Guys, this episode is sponsored by Nourish Me Organics, the premier Gut health store. So do head to www.nourishmeorganics.com, check out the range and use the code happy gut for 10% off until next time.