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Gut health: Your gut microbiome explained by Dr. Megan Rossi & Gemma Ogston.Credit: The Independent
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00:00Today we're discussing gut health. To help me dive into this perplexing topic, I'm joined by two
00:04experts who truly know their kefir from their kombucha. Dr. Megan Rossi, who goes by the Gut
00:09Health Doctor, is a leading gut health expert with an award-winning PhD in probiotics. She's
00:14a nutritionist and the founder of Bio & Me, a gut-loving food brand and one of my personal
00:19favourites. She's also the founder of SmartStrains, clinically proven, targeted probiotic supplements
00:25that support good gut health. Gemma Ogston is a chef and the author of The Healing Cookbook.
00:30She specialises in helping the public eat good mood food and she's also the founder of
00:34Mama Shrooms, supplements that harness the power of mushrooms for better brain and gut health.
00:39Gut health is such a sexy term, right? So we think about the actual scientific definition,
00:43it is this nine metre long tube that delivers food from entry all the way to exit. So we'll have this
00:49like quill tube and that nine metres is kind of our gut, right? And that is important for three key
00:55reasons. The obvious one is digestion. No, like nothing new and surprising there, right? If you
01:00don't have good gut lining, the food can't get from that hollow tube from your gut into your blood
01:05system to feed your skin, your hair, all the rest of it, right? The second one is that 70% of your
01:11immune system lives along that nine metre digestive tract, right? So certainly why we see people with
01:16better gut health also have more resilient immune systems. But it's really the third one and that's what I
01:21focused my PhD on and it's brought the fame essentially to this whole area of gut health.
01:26And that is those trillions of microbes, such as the bacteria, but not just bacteria, we have like
01:32fungi such as yeast and viruses and even some parasites, which actually all work together to
01:38look after us. And that raises one of those scientific words you said, the gut microbiome.
01:42Yeah. So what is the microbiome? Can you make sense of that for us?
01:45Yeah. So it is this community of these microorganisms, right? And the largest one or the
01:50most well-studied one is those that are living within our gut. We also have a skin microbiome,
01:56like the second skin of like, again, billions of microbes are looking after us. We've got the
02:01women, vaginal microbiome, men, a testicular microbiome, oral microbiome. So there's these
02:05little niches and, you know, what all the science has highlighted is this is a landmark scientific
02:12discovery. Like this is such an exciting area because so many things we thought was down to
02:17human control, a hundred percent, like mental health, hormone regulation, all that sort of
02:21stuff. We're actually realizing a lot of, you know, that power is coming down to those microbes and how
02:27we look after them.
02:29So you say how we look after them, how can we look after them? I'm wondering here, is this all about
02:35food? Because I've been told that there are certain foods that are good for the microbiome and there are
02:39certain foods and drinks that are bad for the microbiome, but is it that simple? We're always
02:44being told to eat healthily, but what's the why behind that?
02:48Yeah, look, so obviously diet has got one really important role, right? Because we dictate what
02:54these microbes get to eat and they typically love fiber. So again, fiber is a word that we've all heard
02:59so much and it's something I think the government's been slamming down our throat, but not that many
03:04people realize that the thing about fiber is that human cells can't digest it. So we eat fiber,
03:10which is from all our plant-based foods, right? It goes through most of that nine meter digestive
03:15tract undigested. So on things like, you know, proteins and different fats, most of that gets
03:20absorbed higher up our gut and feeds our muscles, skin, et cetera. But fiber, humans don't have the
03:26enzymes to break down. But who do have the enzyme is of course our gut microbes. So in that last final
03:331.5 meters in our nine meters, these microbes have the enzymes, they turn the fiber into all of these
03:39quite impressive chemicals. They're doing things like, you know, impacting potentially our mental
03:44health, our appetite, all of that sort of stuff. So we know obviously fiber and diet is really
03:50important, but there's other three pillars. You know, we know stress, if you're stressed up here,
03:55it's going to strangle your gut, sleep and exercise, all independent of each other, impact the health and
04:01happiness of those community of microbes. Amazing. So we need, we really need these little
04:05helpers. Gemma, I wonder if you can maybe expand a little bit on some of these kind of good foods
04:11and bad foods. Is it that simple? And are there things that are just blanket really good for our
04:15gut or maybe not so good for our gut? I know you're a massive fan of kefir. Big time. Fermented foods
04:21are fantastic. And so many plant-based foods are fermented. Things like, yeah, so kefir that you can add
04:26to smoothies. Miso is another great one, which you can add into soups and stocks. Also things that you
04:32can make yourself like sauerkraut, kimchi. Often I think people think of gut healthy foods as
04:37something that's really expensive, but it really doesn't have to be expensive. All of these things
04:41you can make yourself. Processed foods we know are not good for you. You know, it's not something that
04:48you need to feel terrible if you maybe you're out and you have a pizza or a burger. It's not something
04:53you need to be obsessive about. Social media is just every time you turn on your phone, you're
04:58getting rammed down what to do and what not to do. And it's very easy to be obsessive and think you
05:03can only eat this. But I think having a diet rich in fermented foods and whole grains and whole foods
05:10is the way to go. And there's an amazing phenomenon just to pick up on that, that we see in our clinical
05:15trials at King. So I work as a researcher there, where actually they have this experience of the
05:21nacebo effect. So it's the opposite of the placebo effect. So placebo, if you think you're having
05:24something good for you, often you can feel better, right? Because subconsciously you change your
05:29practices and that sort of thing. So the nacebo effect is when you think something is bad for you
05:33and you eat it, you can physically give yourself symptoms. And it's not because you're crazy, right?
05:38It's because like, you know, if you get food poisoning, you know, and you have a dodgy Indian or
05:43something like that, often you can never go back to the Indian, even though you know the next Indian
05:47could be super safe, if you have this like protective mechanism. So that's the same with
05:51the nacebo effect. So often on social media, people are being like, all grains are the evil,
05:56the devil. And then in clinic, when I see people, they're having them and they instantly get bloated
06:01and like, oh my God, clearly this is not agreeing with me. And obviously some people, yes, if they
06:05got celiac disease, et cetera. But the vast majority of people are experiencing what I often see is the
06:10nacebo effect from social media, this fear and that physically, you know, creates symptoms in their
06:14body. It's almost like the final boss of health anxiety, isn't it? The idea that I've been really
06:21good this week. So if I have this, I know I'm going to feel bad. But actually, if you just have
06:26the pizza, you might enjoy it. You might actually enjoy that meal. It's really interesting. And I
06:32wonder if you can maybe touch on fermented foods again. Gemma was mentioning fermented foods as being
06:38really good for the gut. But why is that? Why are pickled things so good for us?
06:42Yeah. So if we think of fermented foods like kefir, right, we've spoken about that. Essentially,
06:46what's happened is you get standard milk, right? And you add specific types of microbes to it.
06:51And what happens in that milk is those microbes start to break down the milk sugar called lactose,
06:56right? And they produce all these different organic acids. So they, you know, break down some of that
07:01sugar, which actually interesting, a lot of people, you know, struggle with lactose intolerance,
07:05right? So they find that fermented foods might be better tolerated for them. But the other thing is
07:09those microbes, you know, change the structure of some of the fats and the proteins to make them
07:14more bioactive. So actually, in things like fermented dairy, there's been some research
07:18showing that some of the chemicals are thought to have blood pressure lowering effects similar to
07:23medication. So there's all of these different mechanisms. And I think there was a really great
07:27study from Stanford University looking at fermented foods. And they put people on a high fermented food
07:31diet. And they showed not only did it increase their microbial diversity, which essentially means
07:36they've got more different types of microbes in their gut to look after them. Because ultimately
07:40what we want with this like community, right? The more skills that they can, you know, possess means
07:46that we're going to be healthier and happier. So that's kind of a marker of good gut health.
07:51And they also showed that had lower markers of inflammation on this higher fermented food diet.
07:57So yeah, it's a really interesting space. But what I would say, a lot of people like,
08:01oh, fermented food smells funky, and it's off and everything like that. So if you are
08:05freaking out about the fermented food space, you know, I love it, like kimchi with eggs is like
08:11the dream flavor combination. But if you're not ready for that, like, you can still have great gut
08:16health, right? So yes, the fermented food might have those additional chemicals in it and some
08:20extra microbes, which can add to your diversity. But you know, start with the super six as we spoke
08:26about. So I'm not going to put you on the spot of the super six, or should I? Should we put her on the
08:30spot? Ask me what the super six foods are. Should I get? Yeah, let's do it. Six different plants or
08:37six different foods? No, six different plant categories. Oh, plant categories. I wouldn't
08:41even know where to start with that. I thought you were going to ask me for six foods. I could name
08:44six foods. I bet you know it. I bet you know it. Yeah, once I say it, everyone's like, oh, yeah. But
08:49the thing is, what we're seeing is that each different type of like plant category provides our
08:54body and our microbes with different types of fibers. So everyone thinks fiber is just this one
08:59thing. There's many different types of fiber, as well as these different chemicals, like phytochemicals,
09:05which is a science you word again, just for these chemicals that are associated with health benefits.
09:08So the super six, drum roll, are the whole grains. So things like your oats and your quinoa,
09:14your legumes, your chickpeas, butter beans, your fruit, your veggies, your nuts and your seeds,
09:18and your herbs and your spices. I could have told you that. Yeah. And I think often people forget
09:22about the herbs and spices, right? Which is, you know, something that can make anything taste good as
09:27well, you know, as a chef, being able to jazz up a vegetable by using herbs and spices, but also,
09:33you know, getting an extra one of those six into your daily diet is great. And often people don't
09:38associate, you know, herbs and spices as something that, you know, is nutritionally good for you.
09:43Yeah, absolutely. I couldn't agree more. Like there's the flavor side of things. And that's like
09:47what you're alluding to before. It's not just about the fixation on health. Yes, these foods are,
09:52you know, really healthy and will make you ultimately, you know, feel better. But actually
09:56you want to enjoy food. Exactly. And I think that's what's happening. And what I feel is
10:02happening a lot, especially with the negative social media kind of toxic toxicity push at the
10:07moment, you know, the enjoyment of eating and cooking and, you know, yeah, sharing a meal with
10:15your loved ones is so important as well for your mental health. And that is going to make you
10:19happier and healthier cooking food for the people that you love and sitting down and sharing a meal
10:24and making it colorful and bright and tasty. It's so important. It's like right up there for me being
10:28kind of key. I've seen I've seen a lot of posts recently about the fact that spending time with
10:34friends and family is much better for longevity than broccoli, chicken and rice in a little plastic
10:39container every day. So because it gives you happy hormones, it gives you joy, right? And you're
10:44probably likely to live longer if you are having that enjoyable aspect of life as opposed to
10:49very rigid, very structured, and quite joyless. No love in that plastic pot. But I want to go back to
10:56what you were saying about the the big six different types of fruits, vegetables, etc. Because there is
11:02this piece of research from the American Gut Project Society that shows that eating 30 plants a week is the
11:10gold standard for gut health. Is this true? Can you tell us a bit more about this? Because I see 30 plants a
11:15week everywhere. And also, is it possible to do it? The study is actually quite an old study from
11:20from many years ago. And what they showed is people who had more than 30 different plants a week had
11:26more diverse microbes than those who ate the same kind of 10 or less on repeat, right? So this was this
11:33whole new concept, because we always thought that doesn't really matter if you just eat apples every day,
11:39or, you know, bananas every day, as long as you're eating plants, that's the goal, right? So it's a
11:43first study, it was an observational study, which essentially means it just looked at what people
11:48were doing, and then looked at the microbiome and showed, oh, yeah, great, more microbial diversity,
11:53as we mentioned, it's kind of a marker of gut health, you know, people with more diverse microbes,
11:57more skills, seem to have a lower risk of chronic conditions. But that was an observational study. And it was
12:03something that I, you know, I saw and I was like, I know this is going to help people in clinic to,
12:08you know, give them motivation, because people love calorie counting, right? So I was like,
12:11I came up with this plant system where I was like, you know, let's just get people counting their
12:16plants is a fun thing. But actually, we still haven't done a randomized control trial, which is
12:22like the gold standard, right? So fortunately, our team at King's has just received a grant to look at
12:28this. So it's going to be the first kind of world study to look at the importance of diversity,
12:34because, you know, as we kind of alluded to, the government guidelines are still go for your
12:38fruit and veg. They don't talk about the legumes, the whole grains, where it's quite convincing
12:44clinical evidence that like, for example, legumes are associated with many different health benefits
12:48from, you know, heart disease, type two diabetes, etc. It's kind of interesting how, you know,
12:53from an observational study, which is quite low level, mechanisms support it, and it kind of has
12:58kind of taken on a world of its own. But that's what happens is now on social media. But at the moment,
13:04absolutely, I'm still a huge advocate has many different types of plants. And that's kind of
13:09the plant point system. Yeah, I mean, legumes and grains are two of the big subjects that I see a lot
13:15of mad videos about. So that research is going to be really, really important, because finally,
13:21it will give us answers and will mean that a lot of mad wellness influencers won't be able to tell us
13:26to avoid foods or tell us that, you know, they weren't necessarily part of a primal diet, etc.
13:32There's a lot of that kind of thing on the internet. And I do think, you know, if something feels good
13:36to you, great, do it. But I wouldn't necessarily turn to people without qualification for information
13:44on how to eat. But I also think sometimes people can be intimidated by the idea of eating something
13:50like 30 plants a week, or they might not know where to start, or how to even maybe put something
13:55like a lentil in a dish if they're not used to eating lentils. Gemma, have you got any advice on
13:59how to incorporate maybe 30 plants a week into your diet if you're not already doing it?
14:04Yeah, because it can really feel, it sounds overwhelming, actually, 30 plants, but it really
14:08isn't that many. If we're breaking it up over a week, actually, that's what, like four or five a day.
14:13And I think, you know, including legumes and grains, and also, people do panic, and they think
14:20that this is going to cost so much money. And actually, you know, legumes are a really low budget
14:25way to eat. You know, beans, lentils are so cheap to buy, and you can do so much with them. And I am
14:32the queen of hiding vegetables and lentils and beans into my kids' food. I've always done it.
14:39I've got one kid who is, in fact, he's autistic, so he struggles with certain, like, textures. And then
14:47I've got another kid who will eat everything. But I, from when they were little, I've always kind of
14:52added extra veggies. Things like, if I'm making a bolognese, for instance, there's so many things
14:56that you can put, do to put in extra, you know, veggies, like great courgette, sweet potato,
15:03carrot. We've got three already in a bolognese. Maybe crunch up some walnuts. I always do that
15:07in a bolognese, and it tastes amazing. I also grate mushrooms, because kids in particular might find
15:13big bits and, you know, textures horrible. So, you know, that's five, that's five of those already
15:19in a bolognese. Chili, for instance, is another great one. If you're making a chili, you can,
15:24you know, instead of just using kidney beans, put in some chickpeas, put in some butter beans,
15:28even put in a tablespoon of lentils. And then, you know, you can use frozen veggies as well,
15:33like sweet corn. Always think, how can I, you know, boost up this normal dish that I've been doing?
15:40Pesto is a good one as well, because, I mean, I think every kid likes pasta pesto.
15:44So, make your own pesto, add some broccoli, add some frozen peas, add, what else do I put in my,
15:52yeah, frozen peas, courgette, broccoli, maybe some pumpkin seeds. And then, if you're making
15:56your pesto with the basil and the pine nuts and the parmesan, it's going to taste amazing. But you've
16:00just, just putting extra things into pretty much everything. That's what I've always done.
16:04And it not only bulks out the food, so it will make your dish cost less, it will make it go further.
16:10Um, but you don't need to be afraid. And also, don't worry about using tinned pulses. They're
16:16just as good, you know, and that also they're already done because with pulses, often you think,
16:20oh no, I've got to like soak them and boil them for 48 hours. But, you know, it doesn't need to be a
16:26big, a big drama. And I think starting small, do one thing extra every, each week. And, you know,
16:33you don't need to change what you're doing, just add things into what you already do.
16:40That's really good advice. And also quite sneaky. It's good.
16:42I know, I'm very sneaky. Yeah. I still do it now, even though my kids are teenagers.
16:46I'm just going to buck a little bit of that in there.
16:47I love it. I think it sounds great. But what about if your diet is primarily plants? So,
16:52on the flip side, if you are vegan or you're plant-based and you only eat plants,
16:56is it still possible to maintain that healthy gut microbiome?
16:59Yeah, look, absolutely. I think where we look at people's gut health, you can have brewing gut
17:04health if you are on, you know, the spectrum of, you know, vegan, so no animal products at all,
17:09or flexitarian. So you're having a lot of plants, but also animal products, right? So I think goodbye
17:14to the whole fixation, you have to eat this way. It's only plants, that sort of thing. What I would
17:19say, if you are vegan, so 100% plant-based, you know, there are certain nutrients that you need to be,
17:25you know, aware of like B12. And oily fish, we know, is actually associated with health benefits
17:31for our gut. So having things like algae oil supplements to get your omega-3 might be a good
17:37idea as well. Great. I mean, I think on the era of strange diets, we've kind of gone from one extreme
17:45to the other, haven't we? A few years ago, everyone was plant-based. Now we're seeing the rise of things
17:51like carnivore diets. And I write about this quite a lot. And I'm quite interested in the idea that
17:58people are really into restrictive eating at the moment. And to me, that's quite alarming. But I
18:04wonder, is the carnivore diet possibly good for gut health? Or again, is it just one of these
18:09examples of where restriction means lack of diversity and possibly not great gut health?
18:15Yeah, look, we know that carnivore diets, which is very heavily meat, is not going to be getting
18:21your super six of your plants, right? So it's going to be very low in fiber, particularly diverse
18:25fibers. So it's essentially starving certain types of microbes. Because, you know, a lot of people like
18:31say broccoli is a superfood or blueberries a superfood. But if you just ate broccoli, you'd only
18:36be feeding the microbes that love broccoli. And then they might not have the skills that the
18:40microbes that love oats or quinoa have, right? So it really narrows down your microbial diversity.
18:46But I think it's important to kind of broach why some people feel so passionate about like the
18:51carnivore diet. And why you see these wild claims on social media where like anecdotal evidence,
18:57so it's more of just, I've experienced this, but can be really convincing when you hear someone's
19:00story and you're like, whoa. So I hear it, you know, often in clinic. And I think there's two main
19:05reasons why someone on a carnivore diet says, oh my God, I feel the best I've ever felt.
19:09And just to, I guess, reinforce it, typically it's short-term feelings of good. But often these
19:17people might've come from background of a very heavy ultra processed food diet, right? So they're
19:21cutting out a lot of these ultra processed foods and therefore, you know, they might be losing body
19:26weight. They might be getting into a healthier kind of weight category and therefore there might
19:30be less inflammation because of that, right? So it could be because of what they're cutting out.
19:35So it's not just eating meat, it's that they're not eating any of the terrible stuff they
19:39were eating before. Yeah. I'm like, if you were doing Mediterranean, then you would feel even
19:43better than what you're experiencing there. So that's the first one. The second one is often
19:48people can experience like very sensitive guts for, you know, it could be, there's two main reasons.
19:54One, if you get a gut infection, you know, you go to Bali, get Bali, Bali, you've got a threefold
19:59increased risk of getting something like IBS, irritable bowel syndrome in the subsequent year.
20:04But similarly, if you have chronic stress, you know, for, you know, ongoing periods,
20:09then that can also increase your risk of IBS. So essentially IBS is this dysfunction between the
20:14gut and the brain where you've just got essentially a very sensitive gut. So what happens with a
20:19sensitive gut is when you have fiber, which we spoke about as feeding those microbes, the microbes
20:24produce all these amazing chemicals. People start to hear words like short chain fatty acids,
20:28et cetera. And when they produce them, they also produce a little bit of gas. Okay. And that's
20:34why people go on a really high fiber diet from zero to high, we'll get a bit bloated, a little bit
20:39of flexions. And, you know, some people like, who cares? I know it's just feeding my microbiome,
20:43which is the right attitude. Like you should, you know, a little bit of gas is a normal thing.
20:48It's sign of a welfare commutative bacteria, right?
20:50But people hate bloating, don't they? They go on about it on social media a lot.
20:53So these people with sensitive guts, you know, they find that if they go and have a high fiber
21:00meal without any sort of gut training, that increased gas production can get trapped in
21:06because they've got a very sense, like these live wires are strangling the gut. So it can make them
21:11feel bad. But cutting out all the plants is like this bandaid effect. Yes, in the short term,
21:16you'll feel good. But we have so much research showing that, you know, people who eat more fiber
21:21have much lower risk of, you know, death from all causes, right? There's so many mechanisms there.
21:28So I would, I think it's important that people realize that that's kind of the underlying often
21:33of why people in the short term experience benefits. But, you know, it's this bandaid effect,
21:37right? And we know that yes, you know, short term, you know, gain is, you know, often not going to be
21:44good for long term. So you need to train, if you have a sense of gut, I can confirm, you can train
21:50your gut to get the benefits of the fiber without the symptoms. It just, it's kind of like training
21:56for a marathon, your muscles at the gym, it's slow and steady. You know, it might be like one tablespoon
22:01of chickpeas each day for the first week, second week, two tablespoons, and it trains your microbes
22:08to be able to digest that fiber more effectively. So you get the benefits without the bloating or the
22:14altered stools.
22:15Really interesting. And when we were talking about benefits, you also mentioned the gut-brain axis.
22:21So we're talking long term benefits. Can we dig into the gut-brain axis and what that means? Because
22:27this is one of the things that I have found people are most interested in when we talk about gut health
22:33on The Independent. It is this idea that good gut health equals good mood. And that's huge, if it's
22:40true. Yeah, yeah. Well, I mean, you know, you've seen the stats, you write about the stats all the
22:44time, isn't it one in four of us likely to have a mental health event each and every year, right? So
22:48mental health is such a big issue, right? And there is some really fascinating research coming out
22:54around this gut-brain connection, which essentially is just this two-way connection that occurs between
22:59your gut and your brain. So I alluded to it before, you know, your thoughts up here, your mental health
23:05can impact your gut because there's literally hundreds of millions of nerves that innervate it
23:10called the enteric nervous system. But also the more early research is highlighting the microbes
23:15also can impact the brain. So again, for the skeptics out there, I like to describe the mechanisms just so
23:21you kind of have it in your head. So there's three kind of ways which our microbes are thought to
23:26impact our mental health. One is via what I call the alarm system. So remember 70% of our immune system
23:33lives along that 9-meter digestive tract. So they sense that what's going on, they, the microbes
23:39activate the immune system, they produce inflammatory markers, which, you know, talk to our brain, right?
23:43So the alarm system. The second one is via, people have heard of the vagus nerve, this kind of
23:48communication highway, part of the enteric nervous system where the microbes, again, want to have an
23:53instant message up to the rest of the body, including the brain. They activate that, call the brain,
23:58tell it something, you know, activate this hormone or, you know, do this. So that's the second one.
24:04And then the third one is where those microbes actually produce chemicals. So when they break
24:09down the fiber, they produce those special chemicals and some of them get into the blood
24:14system and some of them can pass or thought to pass that blood brain barrier. So that's the science
24:18of how it's all working. But yeah, there is a really convincing clinical evidence out there
24:24highlighting that if you follow a gut nourishing diet, you can significantly improve your mental
24:30health.
24:30Incredible. And Gemma, you talk a lot about good mood food, don't you? The idea that there is this
24:35really strong connection between how we eat and how we feel. I wonder if you can pull on that thread
24:39a little.
24:40Yeah. I mean, before I was working as a chef, I worked in mental health. I was an addiction
24:44counselor. So I spent years and years, you know, talking to people with trauma, anxiety, addiction
24:51problems. And, you know, that was kind of, and I actually started doing a lot of cooking
24:56in some of the projects that I was working. And I really saw, this is where I saw the first
25:00connection between food and mood. And it's not even just the eating the food, but like
25:06we were talking about before, actually that connection with food and being able to maybe
25:11give someone a nice bowl of soup when they're really feeling terrible and upset and traumatized,
25:17how that can make them feel. I mean, that's just a, you know, that's not scientific, but
25:24it's something that I spent a lot of time actually witnessing. And also that it can really kind
25:31of build up a connection between, you know, one person, another. Anyway, I moved into sort
25:36of cooking and my own personal experience when I was going through difficulties and having
25:42a baby, you know, I had lots of miscarriages. And it's when I started looking at what I was
25:46eating. I was incredibly anxious. My, you know, I've never felt so low. I did, you know,
25:51obviously I was getting tested. They, they found out I had a blood disorder, but I was going to,
25:56when I was finally pregnant, I had to go and have scans every week. And I had started changing my
26:01diet and I really saw that personal difference in how I was feeling. You know, I, I, I made swaps to
26:09kind of be predominantly plant-based and whole food. And it just, I felt like I could get a grip on my,
26:15on my mood. My anxiety was just not, it was just kind of, I don't know, it was less. It was like
26:22I was controlling my mood in a much better way. I was sleeping better. You know, sleep is probably
26:27like number one thing if you're not sleeping well, you know, your anxiety and your mood's all over the
26:33place. And of course, if you're not eating well, you're not sleeping well. So the fact that my diet
26:37was better meant that I was eating, that I was sleeping better. Um, I think there's so many
26:42things attached to, you know, your mood and food, but, um, whole food, digestion, going to the toilet
26:51regularly, you know, it makes you feel lighter, makes you feel more energized. Also going back to
26:55that simple thing of like eating a varied diet that's colorful and enjoy, you know, enjoyable and
27:01being excited about what you're eating, you know, it improves your mood, you know, there's nothing
27:05better than having a nice like sunshine breakfast to make you feel good in the morning rather than
27:10grabbing a Mars bar on the way to work, you know, so. I mean, I can really relate to that because I
27:16also had quite a similar experience where I changed my, my eating habits and I slowed down and I decided
27:22to be more intentional with the way that I ate, changed the foods that I ate. And I noticed that
27:27my hair started growing back thicker and I was sleeping better and I wasn't feeling really anxious
27:32all the time. It really, really can make a difference, can't it? Absolutely. And I feel
27:37like we can't necessarily talk about gut and mood without talking a little bit about diets,
27:42about drugs like Manjaro, Zempic and Wegovi and appetite suppressants. And while these drugs can be
27:50very life-saving for people with certain health conditions like diabetes, there's also some adverse
27:56effects, aren't there? We're looking at things like bone and muscle loss. We're maybe looking
28:00at gut issues. Dr. Megan, I wonder if you can explain a little bit more about how a GLP-1
28:06can perhaps affect the gut. Yeah, look, it's a whole interesting area of debate, right? And like you
28:13said, there's definitely pros and then there are the cons, right? And I think with any sort of
28:18intervention that impacts what people eat, because essentially that's, you know, how the drug is
28:24working where essentially people just don't feel hungry, right? You can do it really healthily and
28:29you can do it really unhealthily, right? So if someone, and I've seen this where it's been really
28:34motivating for people who've really struggled, you know, they're quite in a big body, all their
28:39doctors are saying you need to lose weight for your health. And it's actually reversed their type 2
28:44diabetes. It's really allowed them to get that initial kickstart. They feel more confident in the
28:49gym. They get more excited around, you know, their control around fruit, all of that sort of stuff.
28:53So it can be really beneficial. And for those people, if you are also going, okay, well, I don't
28:59feel very hungry, but so I've got just a small amount of room in my stomach, but instead of having
29:04half a croissant for lunch and half a croissant or half a Mars bar for lunch, which is what the
29:10unhealthy version is, they're like, okay, well, I'm going to have, you know, some fruit and some
29:14kefir as a snack. And then I'm going to have a handful of nuts and maybe some salmon. So really
29:20nutritious foods, right? Because even if you don't have a big appetite, if you're getting these
29:24nutrition foods in more regularly, then actually that's going to ensure that your body's adequately,
29:30as well as your microbes adequately nourished. And then we, you know, haven't spoken about and
29:34probably won't have time, but there's this whole gut metabolism axis, right? So we see people who eat
29:40more plants, have more fiber, actually seem to be of a healthier body weight. And one of the mechanisms
29:45around that is to do with the GLP-1 hormone, where essentially when we eat fiber, it's broken down
29:52by our microbes. And some of the chemicals are thought to activate the production of that hormone
29:57in our gut. And therefore, you know, we feel more satisfied and that sort of thing. So in terms of,
30:04I guess, you know, those medications, yes, they've got their role. We need to be careful of what people
30:09are still eating because you can be of a big body weight and still be malnourished inside, i.e. not
30:15getting enough calcium, therefore getting the bone loss, you know, the muscle loss, not eating enough
30:20protein and those sorts of things, which is kind of the half a croissant, half a Mars bar diet of like,
30:26you know, you're still losing weight, but you're not feeding your body and your microbes that way.
30:30Sure. I guess the idea of eating less, almost starving yourself and then eating high sugar foods or
30:37processed foods, you know, it's kind of a recipe for disaster if we're thinking about health.
30:42And I know lots of people are these days very concerned with weight loss because it's all around
30:48us. It's everywhere. Gemma, you and I were talking before the record about how we see a lot of this
30:54kind of content on social media and how it can be quite toxic as well. If you're trying to look after
30:59your gut health, but you're constantly seeing skinny talk, it can be quite disarming and quite worrying,
31:04can't it? Yeah. And it's, I think it's just such a massive problem. You know, we've spoken about
31:10this. My daughter, who has made a full recovery now, went through having an eating disorder and,
31:17you know, as a mum, it's like your worst nightmare. And, you know, going back to, especially someone
31:23that's always been positive about food, but, you know, the problem is, is that the influence of social
31:28media and what is being pushed, not only social media, adverts on the tube, magazines, doctor
31:35surgery, you know, when you go into boots and you see adverts, especially for, you know,
31:39a Zen pic and whatever, you can get, get, get it anywhere pretty much. I mean, it's being pushed
31:43onto our young people everywhere and going onto what she was searching and what she was looking
31:48at. Yes. Skinny talk. And, you know, these, these crazy diets that, you know, restricting
31:54anything, anything in an extreme way is not healthy. And unfortunately, I mean, the social
32:00media with teenagers is a whole nother debate, but most of them have it. And so I think there
32:06should be a law on these wellness influences pushing extreme diets with no experience because
32:14it really is, you know, and a lot of her friends have been through the same thing. So it's, it's
32:20really tough. It's tough for us. It's tough for, you know, as a perimenopausal woman,
32:24as well, seeing so many people around me losing so much weight quickly. And you're like, oh
32:28my goodness, it's, it's tempting. It's tempting from a, from a vanity point of view, but there's
32:34so much, there's so much to it, isn't there? And I think like you were saying, these, these
32:40drugs can be great and really, really helpful if they're managed in the right way by health
32:44professionals. But unfortunately, they're easy to get hold of. And often people are going
32:50to them for just losing weight.
32:52Absolutely. And I wonder if there is a way to safeguard against that kind of thing. Dr.
32:57Megan, you mentioned things like calcium and protein. What role do supplements play here?
33:02Because obviously when we're talking about gut health, I've seen a lot of different supplements
33:07marketed as gut health supplements. Some of them look great. Some of them after a little
33:13bit of digging don't look so great. So I'm wondering, is a supplement likely to help if you are concerned
33:19about your gut health? Is a supplement likely to help you if you are, for example, taking
33:23one of these weight loss drugs? Is it likely to help you if you're recovering from disordered
33:28eating or if you're on a restrictive diet? Or is it just a case of the best way is to have
33:34a diverse diet full of different plants?
33:37That's such a great question. And I think when we think about supplements, there's so many
33:40different types, right? So certainly, you know, when, you know, in, in clinical practice,
33:45if someone is going on a very restrictive diet, often they need to lose weight faster to get
33:51certain surgery, right? They actually are recommended a supplement. So if you have to
33:57really reduce down for whatever reason, your, your nutrient intake, and aren't going to get
34:02enough of your calcium, your different B vitamins and stuff like that, then yes, we know that taking,
34:09you know, a multivitamin is, is worth doing, right? It's NHS recommends it, but that should
34:14be very, very few people, right? Only when it's medically indicated, because we don't want people
34:20to be losing weight really fast. That's what increases things like osteoporosis, like the
34:25bone loss, you know, you don't just lose fat, you lose healthy muscle. Therefore, you don't really
34:30want to go to the gym, you don't have as much energy, and we know higher muscle mass is associated
34:33with additional health benefits, right? So we don't want to be losing weight fast. And again,
34:39if you lose weight really fast, what happens is you're more likely to gain that weight and extra
34:45because you're disrupting often your gut metabolism connection. So in the long run,
34:49you're actually worse off, I think is a really important thing for people to be aware of.
34:54But then in terms of, I guess, gut health, right? So for brilliant gut health, you do not need to
35:00take a supplement, right? Having the super six, having the fermented foods is going to be key.
35:05And I think I did my PhD in pre and probiotics, which are hot buzzwords you mentioned at the start.
35:11So prebiotics is those food for the good microbes. So like fertilizers, but think about prebiotics,
35:16like one of the high sources of legumes, as you were speaking, like the chickpeas and lentils,
35:20right? So if you're eating across the super six, I very rarely, you know, in clinic would recommend
35:25someone needs to take a prebiotic supplement. Now probiotic supplements are actually quite different.
35:30And sadly, the way they've been marketed is just not science-based because there's no evidence out
35:36there suggesting that for general gut health, you should take a probiotic supplement, right?
35:40There's never been a clinical trial to show that.
35:42So for someone like Gemma's daughter, and thank you for sharing that story, by the way.
35:46No, no, it's something that's so important to me. And, you know, and also I've got a son who's a
35:50teenager and so, so big in teenage boys as well, you know.
35:55Yeah, I think we often, we do often forget about the teenage boys.
35:57We forget about the boys. It's a big thing. Thanks to programs like Love Island, you know,
36:01they're all so concerned about how they look.
36:03I wonder if she's using social media a lot. She's probably being bombarded with colorful
36:07packages and lots of different supplements and things that say probiotic. Is something
36:12like, is a product like that suitable for someone like Gemma's daughter? Or is it something
36:18that actually is just being marketed at teens?
36:20It's just being marketed at teens. Like when it comes to probiotics, each different type of
36:24probiotic called a strain actually does do different things. And it's one area where
36:28all scientists, all health authorities all agree that probiotic benefits are strain specific
36:33and dose specific. So for example, if, you know, your daughter had to go on antibiotics for
36:38whatever reason, then the World Gastro Organization recommends that people take the LGG strain of
36:43bacteria at a dose of 10 billion twice a day during an antibiotic period to protect their
36:47gut. Now I know that sounds quite clinical, but that's the way we need to use probiotics to
36:51get any benefit, right? Same with things like thrush. If you're, you know, your daughter really
36:57struggles with thrush, then again, there are placebo controlled randomized control trials
37:00showing that specific strains LA14 and LHN01 with lactoferrin as a combination significantly
37:09reduces risk of relapse compared to a placebo. So again, it's using the sites we've got to be
37:16very, you know, indication specific for what your daughter's going through, right? So I think that's
37:22why we need to really view supplements other than things like vitamin D. We know we should all be on
37:26that, not just for things like our mental health. Also, our gut health is really important for our
37:31gut lining during winter months. I mean, if you've darker skin than all year round. And then if you're
37:37not having, you know, oily fish, then omega-3 supplement is also one kind of generally. But
37:41everything else, I think mostly is indication specific based on your own personal needs.
37:47And that's it, isn't it? It's personal needs. So if someone's confused, they don't know whether
37:52their microbiome is healthy. They don't know what their personal need is. Where do they start? Where
37:56do they go? Who do they ask? Who do they follow online? What are your, what are both your tips for
38:01that? I mean, follow Dr. Megan. She's amazing. Follow, you know, people that have experience that are,
38:10you know, that are doctors that are really, really, really talking about, you know, have studied,
38:15they have the knowledge, not people that are getting paid ads to, you know, because a brand
38:22is paid to promote them. And, you know, really also, you know, follow people that make you feel
38:26good, that inspire you, that are talking about positive, toxic things. Don't follow people that
38:32are doing fads, that have no experience at all. They might call themselves a wellness expert,
38:37but anyone can be called a wellness expert. I think, you know, people like you who really know
38:43what they're talking about. And there's so many amazing people out there. Yeah, I think one thing
38:48I certainly see on social media is that, you know, similar to what you were saying, is that just
38:54because you're a doctor or a professor doesn't necessarily mean you know anything or have had any
38:58training in nutrition. And I always throw my husband under the bus. He is a brilliant NHS GP,
39:02right? Knows nothing about nutrition, because he got like maybe a day in his course, right?
39:08So, so small. Whereas I think a lot of people like, oh, you know, they're a doctor or they're
39:12a professor and it could be actually in, you know, you know, physics or something like that. But they
39:18see this title and like, all of a sudden, they're like, oh my God, I'll listen to whatever they say
39:22about the carnivore diet, when actually they've got no nutrition training. So I always say, do your
39:26research, find out, do they have training and what you want to learn about? And if they do,
39:31then obviously, it's likely they'll give you, you know, quality evidence or quality
39:35recommendations. That's good advice. And speaking of advice, I do want to ask you both one final
39:40question. I ask all my guests in every episode, what their one wellness non-negotiable would be.
39:46So let's start with you, Gemma. What is your one piece of health advice or one thing that you
39:50cannot live without? Sleep. That is my non-negotiable, especially since I've got older, you have to
39:56have a good night's sleep because everything else will be so much harder, you know, your physical
40:01health, your mental health. So whatever that looks like to you, you know, for me, it might be going
40:05to bed at 10 and getting up at 7. You don't need to fall into trends. The 5am club, getting up at 5am
40:11if you're tired, listen to your body. And also, you know, when you're on your cycle, things will
40:15change as well. Just, yes, sleep is, if I'm not sleeping well, everything else is going wrong. My diet,
40:21my mood, everything. So, yeah, that's my non-negotiable sleep. Yeah, that is the one.
40:26It is for me as well. Although I feel like every single person that gives me a good tip, I go,
40:31yeah, yeah, that's mine too. Yeah, yeah, they're also important. But I think, especially now I'm
40:35getting older, sleep is becoming so much more important to me, you know. I agree. And Dr.
40:41Miga, what would yours be? I would say, this is going to be really nerdy, but remember, I've
40:44dedicated my whole career to gut health and these little microbes. But my non-negotiable is
40:50that every meal I eat, I always think what's on here, obviously for my taste buds, because
40:55I wouldn't love food, but what's on there that's going to feed my microbes? And I think
40:59that mindset just, it's now just habitual. But like if I'm having a chocolate bar, I'll
41:04just have a handful of nuts. So I'm like, I want the chocolate bar for my taste buds.
41:08The microbes are going to get the fibers and the polyphenols from the nuts. So that is
41:11my non-negotiable. I love that. Does a whole nut count? Does a whole nut count when you've
41:16got the dairy milk whole nut? You've got the chocolate and the nuts. You know what?
41:20If you want to go there and do that, I mean, ideally it's more the ratios, right? Because
41:24you might get one nut in the whole bar. I think that's great advice. And we should
41:28all think maybe a little bit more like that. You know, what are we doing for ourselves?
41:31How are we feeding ourselves? And what can we do to feed ourselves a little bit better?
41:36Thank you both so much for joining me for this episode of the Well Enough podcast. I've
41:40learned so much and it's been so great to speak with you both. You can buy Dr. Megan's
41:43book, Eat More, Live Well, and Gemma's book, The Healing Cookbook, online and in all good
41:48bookstores. Thank you for being here with us. We'll see you next time. And in the meantime,
41:52stay well.
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