Muscle for Life with Mike Matthews - Dr. Mike Ruscio on How to Improve Your Gut Health (and Why)

Episode Date: November 2, 2018

Gut health has become something of a buzzword these days and, quite frankly, a bit of a red flag, like “detoxing” or “pH.” Whenever I hear someone talking about how to improve gut health, my S...pidey sense starts to tingle because there’s a fair chance that shenanigans are afoot. That said, it’s not all quackery. Gut health is a very real thing and impacts your overall health and wellbeing in a number of different ways, and that’s what Dr. Mike Ruscio and I discuss in today’s episode. Before I continue, however, I just have to give a sincerely sloppy kiss to my friends Sal, Adam, Justin, and Doug over at Mind Pump Media for inviting me to their #PODCASTHARD event where I met and interviewed Dr. Ruscio. They have one of the biggest podcasts in the fitness space and are a bunch of cool dudes to boot, so head over their way and if you like what you hear, tell them I sent you. Okay so back to business. In this episode, you’re going to hear from Dr. Ruscio on a number of hot-button issues, including… - What is a healthy gut, actually? - What is leaky gut and what can you do about it? - How can you tell what foods are good or bad for your gut? - Is gluten as bad for your gut as people say? - How does eating sugar affect your gut health? - And more. 5:54 - What is gut health? 7:43 - What are inflammatory foods? 8:30 - Why do certain foods trigger an immune response? 11:27 - What is the low-FODMAP diet? 12:27 - What are soluble and insoluble fibers? 15:24 - What is leaky gut? 16:22 - What are symptoms of leaky gut? 17:59- How does gluten affect your gut health? 25:06 - How can we improve our gut health? 27:42 - How does sugar affect our gut health? 30:19 - Why does sugar lead to weight gain? 33:06 - Do artificial sweeteners affect your gut health? 36:44 - How do probiotics help? 43:23 - Are the probiotics at the store shelves already dead? 45:09 - Where can people find your book? 46:07 - Where can people purchase your supplements? 46:28 - Can lifestyle factors improve gut health? 49:16 - Is there a connection with exercise and gut health? Want to get my best advice on how to gain muscle and strength and lose fat faster? Sign up for my free newsletter! Click here: https://www.muscleforlife.com/signup/

Transcript
Discussion (0)
Starting point is 00:00:00 From a gut health perspective, a paleo type diet, just a kind of loose version of the paleo diet and give that a trial for three weeks and see how you do. And then if you're feeling better, I would say ride that wave until you hit a plateau and then reintroduce and see if you notice any funky stuff coming back when you bring in certain foods. bring in certain foods. Hey, Mike Matthews here from Muscle for Life and Legion Athletics, back with another episode of the podcast. And this time around, I interview Dr. Mike Ruscio on the topic of gut health. Now, that has become something of a buzzword these days, and quite frankly, it's a bit of a red flag, like detoxing or pH. Whenever I hear someone talking about how we can improve our gut health, my spidey sense starts to tingle because it usually means there are some shenanigans afoot. some shenanigans afoot. That said, the topic itself, it's not all quackery. Gut health is a very real thing. And yes, it does impact your overall health and well-being in a number of
Starting point is 00:01:14 different ways. And in some cases, it's pretty counterintuitive. And that's what Mike and I discuss in today's episode. Now, before I continue selling you on listening to the episode, I just want to give a sincerely sloppy kiss to my favorite boyfriends, Sal, Adam, Justin, and Doug over at Mind Pump Media for inviting me just this last month. When was I there? Was it already a month? Yeah, last month or so to their podcast hard event, which they held in Lake Tahoe, California.
Starting point is 00:01:51 First time being there, super beautiful. And they invited a number of health and fitness podcasters to a house that they rented. And then they set up a bunch of interviews. And so that is where I met and interviewed Dr. Ruscio. Now, if you don't know about the Mind Pump guys, they have one of the biggest podcasts in the fitness space and are a bunch of cool dudes to boot. Genuinely nice guys, good guys. So head over their way. I believe their website's mindpumpmedia.com. But if you just Google Mind Pump Media, all of their stuff will come up. And if you happen to like what you hear, please do tell them that I sent you.
Starting point is 00:02:30 Okay, so back to business. In this episode, you are going to hear from Dr. Ruscio on a number of hot-button issues related to the gut, including what is gut health, actually, what is leaky gut and what can be done about it? How can you tell which foods are good and bad for you and your gut? Is gluten as bad for your gut and health as many people say? What about sugar? How does that affect your gut health? And more. This is where I would normally plug a sponsor to pay the bills, but I'm not big on promoting stuff that I don't personally use and believe in. So instead, I'm just going to quickly tell you about something of mine, specifically my fitness book for women, thinner, leaner, stronger. Now this book has sold over 150,000 copies in the
Starting point is 00:03:18 last several years, and it has helped thousands of women build their best bodies ever, which is why it currently has over 1,200 reviews on Amazon with a four and a half star average. So if you want to know the biggest lies and myths that keep women from ever achieving the lean, sexy, strong, and healthy bodies they truly desire. they truly desire. And if you want to learn the simple science of building the ultimate female body, then you want to read Thinner, Leaner, Stronger today, which you can find on all major online retailers like Audible, Amazon, iTunes, Kobo, and Google Play. Now, speaking of Audible, I should also mention that you can actually get the audio book 100% free when you sign up for an Audible account, which I highly recommend that you do if you're not currently listening to audio books. I myself love them because they let me make the time that I spend doing things like commuting, prepping food,
Starting point is 00:04:15 walking my dog, and so forth into more valuable and productive activities. So if you want to take Audible up on this offer and get my book for free, simply go to www.bitly.com slash free TLS book. And that will take you to Audible. And then you just have to click the sign up today and save button, create your account. And voila, you get to listen to Thinner, Leaner, Stronger for free. All righty. That is enough shameless plugging for now, at least. Let's get to the show. So here we are podcasting hard. I haven't done this many. And this is a lot of podcasts and a lot of talking. That was a great idea that they had. Yeah, no, it's awesome. Podcasting all weekend. For sure. And it's's fun i just came off of like i was saying 80 hours sitting in a chair recording audiobooks oh so that was just recently
Starting point is 00:05:09 you finished yeah that was yeah like you're probably sick of talking at this point yeah whatever i can't complain right our lives are so easy at least we're not uh living in a communist country no i mean at least i'm not working an office job that's one thing i feel thankful for not a knock to anybody that is but i just feel grateful that I don't have to. But it's after many, many, many years of long, hard days. So it's not like I guess you get there without a fight. Yeah. Yeah.
Starting point is 00:05:35 A couple of my neighbors are doctors, so I understand from just seeing it firsthand. Yeah. All right. So let's talk, obviously, so gut health is your specialty, right? It is. Okay, cool. And I've, uh, I've read and written a little bit about it, but I'm going to just play completely ignorant because, um, compared to you, I am completely ignorant about this. So what does that even mean exactly? What does it mean? What does that, what is that even referring to? Yeah. Well, I guess there's a different ways you could define it. I like thinking of, of gut health as being devoid of any digestive symptoms. That would be your parameter one, right? Because if you're bloated or you have reflux or you have ulcers or you have constipation or you have abdominal pain or you have loose stools, obviously your gut's not healthy, right? But the more interesting thing is people can have silent gut inflammation that's only manifesting
Starting point is 00:06:28 externally, like as joint pain, skin lesions or pimples, brain fog, insomnia, thyroid imbalances. And that's the really interesting thing. And now we're seeing this plume of research literature to really tie these things together scientifically that yes, someone can have, as an example, a bacterial overgrowth in their small intestines. And treating that can help with something like brain fog and anxiety. It must be really hard to pin down, to diagnose. So that's why one of the things I recommend people do is first take some basic steps to improve their diet and lifestyle. So get off the processed food, get off the inflammatory foods. And whether you do paleo or keto or Mediterranean, I don't think it makes a huge difference.
Starting point is 00:07:16 Just get yourself in that healthier dietary camp. Make sure you're getting enough sleep. Make sure you're getting adequate exercise. You have some enjoyment in your life that you, right? Some of these basic health fundamentals. And then if you're not feeling healthy, if you still have these lingering symptoms, doesn't matter what they are, I would then recommend going through a protocol or a process to try to optimize your gut health. Because you may have that joint pain that you're struggling with or the insomnia, it could be a derivative of your gut.
Starting point is 00:07:45 Interesting. You mentioned inflammatory foods. What does that mean exactly? Yeah. It's another great question because it's a term that's used kind of loosely. Yeah. It can get kind of quacky, right? Well, yeah.
Starting point is 00:07:57 If we're being literal, then yes. Because it's not always inflammation. But sometimes it's easier than saying, well, avoid foods that can elicit an immune response. Avoid foods that you don't digest enzymatically well because you're deficient. Avoid foods that produce more gas pressure than your nociceptors in your gut can handle without being tripped off and causing a pain response. So to give a naming of each mechanism is a bit tedious. So you kind of throw out this catch-all term, inflammatory. Which just sounds bad, so people go, okay.
Starting point is 00:08:26 Yeah, exactly. And it generally gets you there. But there may be a number of mechanisms occurring. One may be immune, so some foods will elicit an immune response. And now that immune response might be, well, this comes back to, I think, the most powerful chance we have to improve the health of our population's guts, which is one's upbringing. So we know that children that are cesarean birth and that are formula fed have a higher incidence of inflammatory disorders and allergy later in life. And we also know that those in Western societies that are more hygienic have more allergy and asthma and inflammatory and autoimmune conditions than non-Westernized societies that are in closer contact with dirt and animals and have less hygiene. It's kind of counterintuitive.
Starting point is 00:09:15 Yeah. Well, if you think about it this way- I mean, it makes sense, but in some degree. So the immune system is like an army and they need training to have a discerning aim. So if you were a soldier and you never went to target practice, you wouldn't really be good at hitting the target. So if our immune systems don't grow up in an environment where they're constantly having to discern, okay, that's an animal, you know, dander, that's dust, that's another kind of bacteria, and that's a food particle, that's an intestinal particle, so we're not going to hit those. If they don't have that practice, they can get kind of sloppy aim. And that's what seems to happen in more hygienic societies. And the research literature
Starting point is 00:09:54 has shown pretty compellingly, there was one paper published in the New England Journal of Medicine that showed that as certain exposure to certain infectious agents has gone down, which isn't a bad thing necessarily, but as that's gone down, there's been a corresponding rise of inflammatory and autoimmune conditions. So there's a trade-off, right? And our trade-off is we have less infantile death and longer life expectancy, but we may have gone a little bit too far where our society now is so hygienic that our immune systems are a little bit crippled.
Starting point is 00:10:23 That's interesting. God, there's such a corollary to the psychological side too, right? With this outrage culture and everything's offensive. Right, exactly. You need to have some insults. To fight against, I guess, right? Yeah, some insults to keep you balanced. And so that may be where some of the inflammation ultimately comes from.
Starting point is 00:10:40 Genetics combined with environment, and the environment in this case is, you can't change your genetics, but you can change the environment and if the environment doesn't give you that target practice now this may be why some people for example attack gluten where others don't and that's a controversial issue and you know we can get into some of that if you want because you know there's just kind of two extremes where everyone should be gluten-free and then gluten-free is kind of a fad. The truth lies somewhere in more of a reasonable middle, but inflammation may be one of the mechanisms of what underlies a reaction to foods. But what's also interesting is for some people, it's not necessarily inflammation. It's that they don't do well with how a certain
Starting point is 00:11:22 food jives with a bacterial population in their gut, for lack of a better term. And this is where the low FODMAP diet enters in. Have you heard of the low FODMAP diet? Sure. I've written about it. Quickly just explain for people who didn't know this. So the low FODMAP diet is essentially a diet that's low in prebiotics. And prebiotics, not to be confused with probiotics, prebiotics feed bacteria. Probiotics are actually the bacteria. And- Prebiotics are a fiber, right? Well, I guess maybe not all, but soluble fiber.
Starting point is 00:11:51 Many foods that are rich in fiber and carbohydrate are also rich in prebiotic. Okay. And so what's a little bit counterintuitive here is that for some people, these high prebiotic or high FODMAP foods that feed gut bacteria, that actually doesn't work well with a person's gut. Now, some people, they have guts that are hypersensitive to the gases
Starting point is 00:12:14 that these bacteria release. So you feed anything or you feed a motor, it gives you some energy, but it also spits out gas out of the tailpipe, right? So you feed these gut bacteria with these prebiotics that are contained in the FODMAP foods, and they do some good stuff. Just to be clear, just to actually clarify for myself, so these are molecules that are often contained in fiber. I might've had that a little bit mixed up. My understanding was that like soluble fiber is a prebiotic substance, but that sounds wrong.
Starting point is 00:12:42 Soluble fiber is fermentable. Yes. Insoluble fiber is not fermentable and that has to do with the solubility, but there's also forms of carbohydrates that will have more or less of these FODMAPs and it has to do with the carbohydrate structure. So if you break down the FODMAP name, that's fermentable, oligo, di, monosaccharides, and polyols. So it's just different bonding structures of carbohydrates that we can't cleave the bonds and we can't break down. So we outsource it to intestinal bacteria. Again, that's not a bad thing, but for some people, if they have too much bacteria to begin with, or if they're hypersensitive to the gases bacteria releases part of their metabolism, that can lead to bloating or
Starting point is 00:13:22 overgrowth of bacteria. And that overgrowth of bacteria has been documented, drawing a bit of an inference here, but it can cause leaky gut and it can cause changes in things like serotonin cell density in the gut and it can cause an immune reaction. And I'm getting a little bit far afield here, but what's really interesting about the low FODMAP diet is someone would have to cut out foods that we probably stereotypically associate to being healthy. Asparagus, broccoli, cauliflower, beans. But for some people, that will actually get them a resurrection of their gut symptoms. So, I mean, there's a few more mechanisms, but those are a couple of them. If you have an immune response to a food, how well the food sits with your
Starting point is 00:14:01 microbiota, and then maybe a third major one we should categorize is if you have the enzymes to digest the food. This is where people who are like lactose intolerant. But what's interesting here also is that the villi, if you look at your hand, your fingers are like little villi of your intestine, these little projections of the intestinal lining that help you absorb food,
Starting point is 00:14:20 but they also secrete enzymes. And it has been shown that when people improve the health of their gut, those tips, your fingers become more healthy and they can secrete more enzymes. And then you can rectify in some cases, lactose intolerance or even histamine intolerance, which is a different type of intolerance. Those would be like three of the more major categories that we kind of summate underneath the umbrella term of inflammation. Cool.
Starting point is 00:14:42 that we kind of summate underneath the umbrella term of inflammation. Cool. Hey, quickly, before we carry on, if you are liking my podcast, would you please help spread the word about it? Because no amount of marketing or advertising gimmicks can match the power of word of mouth. So if you are enjoying this episode and you think of someone else who might enjoy it as well, please do tell them about it. It really helps me. And if you are going to post about it on
Starting point is 00:15:12 social media, definitely tag me so I can say thank you. You can find me on Instagram at Muscle for Life Fitness, Twitter at Muscle for Life, and Facebook at Muscle for Life Fitness. Twitter at Muscle for Life and Facebook at Muscle for Life Fitness. And you had mentioned leaky gut. What's that? Leaky gut, again, it's another thing that in some realms of alternative medicine, it's kind of like a runaway term where it's thrown out all the time. And I think that might be a little bit excessive, but there is documentation of leaky gut more technically is known as intestinal permeability. And this is when you have too much stuff getting through that of leaky gut, more technically is known as intestinal permeability. And this is when you have too much stuff getting through that lining of your gut,
Starting point is 00:15:53 because we all know that we absorb nutrients in our gut and we want nutrients to come through, but we don't want too much stuff to come through. We don't want macro particles of food, so big particles of food that haven't been digested. We don't want those going through. Why? Well, because they will then be tagged by the immune system. Because when that gets in your bloodstream, that's not something that is programmed to be acceptable to be in circulation. So that's part of what will elicit the immune response.
Starting point is 00:16:18 And inflammation is what the immune system uses as part of that response. So if the molecules are too big, it will elicit immune response and inflammation. And how does that manifest? Symptomatically? Yeah. Well, for some people- Somebody out there who might have this, what might- Well, so that's the crux and that's the paradox. For some people, it might be simple.
Starting point is 00:16:35 I feel bloated after I eat dairy or I have diarrhea after I eat dairy. But for other people, they may eat too much FODMAPs and they notice that they get joint pain and brain fog. So that's what's challenging to discern this is the symptoms aren't always readily apparent. And if it was always digestive symptoms, it'd be easy to pin that down. But because- Yeah, you eat the food, you feel bad. Right.
Starting point is 00:16:55 You know. So that's why I recommend people, because people are probably confronted, right? If they've improved their diet, improved their lifestyle, and they're still not feeling well, then they start thinking, what do I do? They go on the internet, they start searching and, oh, it could be metal toxicity. It could be mold exposure. It could be adrenal fatigue. It could be hypothyroidism, right? It could be all these different things. And it's hard for people to try to figure out, okay, what of all these possibilities would be the best starting point? I think trying to optimize one's gut health is the
Starting point is 00:17:26 best starting point. It's not the only starting point. It's not a cure-all. I don't want to paint it as that, but that would be the most beneficial step for the highest majority of people. Sure. Kind of low-hanging fruit. Exactly. Exactly. So like we've been talking about, look at it more so from a perspective of try to work through this hierarchy of self-optimization. And if you still have any lingering symptoms after you've made some basic improvements to your diet and lifestyle, then I would take some steps to optimize your gut health because the symptoms are so nonspecific, right? So it's hard to tell just from symptoms
Starting point is 00:18:00 alone. Makes sense. So you'd mentioned gluten-free earlier and tell us about this. Yeah. So let's talk about gluten because this is a topic that I think does equal harm as it does good, which is really unfortunate. Now, it's great that we've seen increased awareness of gluten being a potentially problematic food for people. And this is the rise of non-celiac gluten sensitivity, which is the technical term for people who don't have celiac, but have a problem with gluten. And this has been documented in the research literature. I believe there's been to date 11 papers. There's, I think now 13 actually, that have been randomized control trials that have isolated for the effect of gluten. And they've done this, again, placebo-controlled elimination reintroduction.
Starting point is 00:18:48 And they have found that gluten does elicit symptoms in these people. So it's not just this placebo effect. Right. Now, to be fair, two of those studies found that it was actually the FODMAP content and not the gluten. Yeah. So the consumer has to be careful because those two studies were taken and extrapolated. Oh, gluten-free is complete BS. Okay, that's not true either.
Starting point is 00:19:10 That's going too far in the other direction. So we want to be reasonable in the conclusions that we draw. So it can be gluten or it can be FODMAPs. But regarding gluten specifically, I think some progressive circles of healthcare have gotten way overzealous with how quickly they just dole out the gluten-free recommendation. And why is that a problem? Because if you believe that you shouldn't have any gluten or you're going to upregulate inflammation in your body for months after having the gluten, sometimes it's parroted. Really?
Starting point is 00:19:42 Oh, yeah. Like one meal? Yeah. Oh, wow. It depends on how deep into the zealotry you go. It's parroted. Really? Like one meal? Yeah. Oh, wow. It depends on how deep into the zealotry you go. But that's definitely one. You get to the inner circle. Right, right.
Starting point is 00:19:52 Yeah, the epicenter. But why that's problematic is if people are led to believe that they have to avoid this food, absent of actually going through their own elimination and reintroduction experiment, then they're just doing it on blind faith. And so now Thursday night rolls around. It's an after work party and everyone's having some food and some drink. And they're worried. And now you're worried.
Starting point is 00:20:14 Oh my God, like what's in that sauce? Asking to have gluten. Exactly. Go on your phone, Googling. And then you just get this whole runaway monkey brain where you're constantly worried and you're constantly in fear. And that is not good for your health. Obviously, that constant worry and fear is not healthy. So there was recently a study done in Italy that I think was probably the best done study trying to document how prevalent is non-celiac gluten
Starting point is 00:20:36 sensitivity, what are the symptoms that manifest as a result, what are the comorbidities that result along with this. And this group of researchers, it was a multi-center trial in Italy, and they looked at 12,225 patients. So that's a good sample size. And they had a thorough assessment. It was over a 60-point assessment looking at physical exam history, lab markers. And so this was a group that wasn't trying to comprise a BS study to vilify. They were really looking at this in a genuine fashion. They weren't going into it with the conclusion already written. Right, exactly, exactly.
Starting point is 00:21:13 And I thought their conclusions were very fair. They found a 3% prevalence of non-celiac gluten sensitivity. Now, is that something? Yes. Does that mean that non-celiac gluten sensitivity is a legitimate condition? Yes, it does. But does it mean it's 70, 80% of the population as some circles would have you believe? No. And so that's an important, I think, re-centering that needs to occur. The other thing that- So what that means for somebody listening is it's safe to assume that's not you. I mean, just by probabilities, right? If you're going to assume you're looking
Starting point is 00:21:44 at a bell curve here and you have some outliers and just as many people, we like to maybe think that we're outliers in the ways that we like to think, but also in things like this. I mean, if you disagree, please tell me, but that's what I would say to somebody. And I've said this many times, actually, people emailing me with no symptoms whatsoever, just actually wondering. And I'm like, yeah, the chances are no then. You know what I mean? Let's just actually wondering. And I'm like, yeah, the chances are no then, you know what I mean? That's, let's just start there. And it correlates with a, with a general posit where, you know, if you're a clinician and this is one thing when I'm, when I'm talking with other clinicians, you know, I tell them if you can't get it perfect,
Starting point is 00:22:16 if you can only shoot over or shoot under, meaning making someone think they're more ill than they are, or making someone think they're less ill than they are. We always want to make someone think they're less ill than they are, right? So I would agree in that vein where there's a higher probability that you don't have a problem with occludin. So carry that expectation forward, carry this empowering placebo effect forward. But if you're not feeling well, I would go through an elimination reintroduction just to be sure. But one of the counterpoints is often provided against that stat is there's more glyphosate use in the US, which is herbicide, which may make gluten more allergenic or inflammatory or however you want to term it. And I think there's some plausibility to that argument. This same paper cites similar studies in the US that have found a 0.6 to a 6%
Starting point is 00:23:06 incidence of non-celiac gluten sensitivity. So it may be as much as double. And let's say even if those studies were underreporting still, and let's say you even doubled that doubling and you got to 12%, that's still the minority of people. Again, it's not to say that if you're currently eating gluten-free and it's really benefiting you that I'm saying to discard that, right? But what I'm trying to do is present a voice of reason where people learn to listen to their own bodies, do elimination followed by a reintroduction, and then trust their experience and not feel kind of inculcated by the gluten-free sphere that's kind of growing in influence. Yeah. Is it still growing? Do you know? Well, I'm in a particular spot where I'm seeing patients who are suffering with gastrointestinal ailments.
Starting point is 00:23:51 And so almost everyone has tried gluten-free. Okay. And a lot of them are doing dietary research and probably getting some of the parroted lines from some of the far left. The first page of Google. Yeah. Gluten-free spectrum. Yeah. some of the far left first page of google yeah gluten-free spectrum yeah so i may be getting
Starting point is 00:24:05 a skewed read on this but i do see people who this is negatively impacting their lives and so that's why i you know i try to be just discerning about giving people a well-crafted message and not citing a bunch of celiac stats yeah and then making everyone think that we can conflate that to the general population makes sense so what would would you say for a few of people that are listening who maybe aren't having any particular issues? Because there'd be no, again, it makes sense that when you have that, it takes a bit more work to kind of pin down what's going on here. But I mean, I'm asking personally, selfishly here, because I don't have any, I guess the only GI distress I can say I have sometimes if I eat too much vegetables in
Starting point is 00:24:46 one sitting, like sometimes I'll overdo it at dinner. I didn't usually simple vegetables, meat or whatever. Um, I'll get gassy and, and the vegetables usually cruciferous. Um, so it'd be like if I eat too much broccoli in one sitting, there's your FODMAPs. Yeah, exactly. And however, if I eat a moderate amount, I don't notice anything. And so generally speaking, I think, uh, I'm fairly symptom free and there are a speaking, I think I'm fairly symptom-free. And there are a lot of other people probably listening that are as well. What though are some simple things that we can do to improve gut health? Things that are just like, here are some basic things that everyone can do.
Starting point is 00:25:17 So there's a couple of dietary maneuvers you can make. A paleo diet, I think is a pretty good starting point. And I, you know, there's some paleo diet, I think is a pretty good starting point. And I, you know, there, there's some paleo diets that are super strict. Yeah. Be specific. What do you mean by that? Exactly. I would say kind of a loose paleo diet, meaning you essentially cut out for a few weeks, all grains, dairy, soy, processed foods, and you essentially try to make the majority of your diet. Again, you don't have to be anal about it. And if you have one or two off-plan meals,
Starting point is 00:25:54 get concerned. But focusing on fruits, vegetables, meats, fish, eggs, nuts and seeds, and try to make everything that you eat non-processed. And I'm assuming your take on saturated fat is keep it reasonable, don't go out of control. Yes. But if someone's doing a ketogenic diet, I think they can allow a little bit more saturated fat in their diet. And I think as a general perspective, having your carb intake and your overall fat intake share an inverse relationship is a good balance to shoot for. So the more carbs you're eating. The more carbs, the more carbs, the less fat. And that's something that is very, I think, case-by-case basis dialing in your macros.
Starting point is 00:26:26 And it may also depend, and you probably know this far better than I do, but if you're in a different phase of your training cycle or athletic performance, you may want to modulate those things in a different way. Sure. But from a gut health perspective, a paleo-type diet, just a kind of loose version of the paleo diet, and give that a trial for three weeks and see how you do. And then if you're feeling better, I would say ride that wave until you hit a plateau and then reintroduce and see if you notice any funky stuff coming back when you bring in certain foods to kind of personalize. And so do it, um, obviously in a, in a controlled manner, bring, bring a food back and see, okay, how do you feel? Exactly. Exactly. Because if you do notice, man, all of a sudden I'm feeling gassy again, but you brought back in four or five foods, it's really hard to pin down those variables. Exactly.
Starting point is 00:27:13 And then the next thing someone could try is a low FODMAP diet. And to your point, sometimes people are feeling good, but they could feel even better. Sure. Right? Like there's all different degrees, shades of gray of feeling good. Like I feel good. I feel good. I feel Sure. Right. Like there's, there's all different degrees, shades of gray of feeling good. Like I feel good. I feel good. I feel good. Right. There's all those different degrees and we may never know how good we actually can feel. That's reality, right? Exactly. So a low FODMAP diet would be another one to try. And there's, there's some lifestyle factors as well. Yes. And that's where you want to go touch more on diet stuff. I don't want to get off that too
Starting point is 00:27:43 quickly, but one or two other things. What about sugar? When I say sugar, I mean sucrose, just refined, high fructose corn syrup. Refined sugars, added sugar, however you want to term it. Well, I mean, I would use those sparingly. But, and this is getting more so into artificial sweeteners. That's another good one too. So in the book, I review the literature on this pretty copiously.
Starting point is 00:28:15 So, you know, in the book, I review the literature on this pretty copiously. And again, I really try to be intellectually honest and not take the fact that I lean more toward the natural, skew the conclusion that I provide people. Yeah, I'm the same way. I mean, you're deeper into the research and I stay in my lane. Right. But yeah, I understand that. Yeah, and you try to- I don't want to try to impose my own personal what I just like. Exactly. And I really respect that. And I think that's one of the reasons why we wanted to podcast together because we had that similar sort of mentality. What you look at when you look at the artificial sweetener research, with the exception of Stevia, where I don't think when I was writing the book, there was quite enough research on Stevia to draw strong conclusions. That research I think is available now, but this is just based upon non-stevia and artificial sweeteners. You see that the general trend is no benefit. And there's also potentially a trend of the artificial sweeteners showing detriment in terms of leading to waist circumference gain or weight gain. And so when
Starting point is 00:29:02 you look at the data, no conclusive benefit and maybe downside. I don't know why anyone would habitually, I'm not saying, hey, you know, you're on the go, you need something quick here and there. Fine. I choose some gum sometimes at work. Right, right. I'm not worried about that. Not a big deal. And the one study that I think really pinned this down nicely was the San Antonio longitudinal study on aging, I believe was the title of the study.
Starting point is 00:29:28 And what they show, and they can, so they found that the more artificially sweetened sodas one group drank, the larger their waste became. But they also controlled for the fact, and this is what I get so excited about, that sometimes people who are already overweight and gaining weight have a higher predilection toward choosing artificially sweetened sodas. Sure. So you have to control for that variable. Because of the diet code. Exactly. Exactly. So you have to control for that variable or you could have misrepresenting data or a data set.
Starting point is 00:29:57 So they did an excellent job in controlling for that. And they had some people who were healthy and didn't want to change their weight. And they put them in the group that was assigned to drink artificially sweetened soda. So they really controlled for that variable, and they found even those people started to gain waist circumference when they were drinking artificially sweetened sodas. That's just one study, but it was probably the most compelling study of the whole body of research. And what were the proposed mechanisms there? Was it messing with hunger? of the whole body of research.
Starting point is 00:30:23 And what were the proposed mechanisms there? Was it messing with hunger? You know, satiate. So what's funny is you don't see that same level toward weight gain in children. And we had on our podcast, Susan Swithers, who is an artificial sweetener researcher. And I think she posited this in one of her papers, which is the satiation apparatus
Starting point is 00:30:44 may be more intact in children. And so you can't mess it up with artificial sweeteners as much until you get into it. I think everything's more intact. Right, exactly. Exactly. So in adulthood, you know, there's been more antibiotic use, more stress, more sugar, more alcohol, more maybe yo-yo dieting. And now that apparatus is more sensitive to perturbations from the outside. So it might be satiation, essentially skewing the satiation apparatus and the artificial sweeteners may actually lead you to eat more food. So that, I think that's the primary mechanism. Although there was one study,
Starting point is 00:31:17 and this is where we know far less, but one study that took the gut microbiota of patients who were, and so, and there's, I'm sorry, there's another concept here where some of the research shows what's known as artificial sweetener responders and non-responders. And the responders are ones who gain weight and the non-responders are the ones that don't. And one study found that the people who gain weight have different gut microbiota or different gut colonies of bacteria. And then when they transplanted both the responders, the weight gain and the non-responders and non-weight gain microbiota into rats, only the weight gaining humans cause a corresponding weight gain in rats. It's a clever design. Yeah. It's a clever design.
Starting point is 00:32:01 Yeah. Yeah. So there also may be a manipulation of the gut microbiota, which may somehow influence how well you harvest calories from food that leads to weight gain. Interesting. Makes me think of, there was, I listened to an interview, I forget his name, researcher on alcohol and had done a lot of research or a lot of review of the alcohol literature. And his conclusion was similar to what you're saying, where he was basically, he did not believe that alcohol was beneficial for anybody, but basically that some people's bodies could just deal with it better. And it seemed to not have much of a,
Starting point is 00:32:33 of course too much becomes a problem, but even at a moderate intake, it was like, it seemed that some people, their bodies just deal with it and some people's didn't. But anyways, I just think of that. That's, it sounds like that's kind of what it is. it is. So with artificial sweeteners, yeah, you might be okay. It's not going to help you, but it may hurt you. And what about gut health? Yeah, and to your point, that's why it's so important not to look at one study. Because one study may have selected unintentionally a group of people who do or don't respond to that stimulus in a certain way. And that's why I'm a big advocate of looking at the breadth of data.
Starting point is 00:33:04 Right. Weight of the evidence. Yeah. And then looking what I'm a big advocate of looking at the breadth of data. Right. Weight of the evidence, right? Yeah. And then looking what the trend shows. Exactly. Yeah. Exactly. What about gut health and artificial sweeteners? Is there, because that's also something that's commonly like, oh, they destroy your microbiota. Well, I think that's a theory. I think you would have mentioned that.
Starting point is 00:33:17 Yeah. But ironically, I didn't really come across anything showing an increased prevalence of IBS or other gastrointestinal complaints. It makes sense that because these are non-absorbed, it's just like a piece of insoluble fiber that's not absorbed. And so it's going to be bumping along your bacteria the whole way until it comes out the other end. But I haven't seen any data showing that there's an appreciable increase in digestive upset, although it may change the bacteria, like we talked about, in that responder-non-responder group. And that may impact the amount of calories that you absorb from food, but it doesn't seem to actively cause any kind of symptoms. Okay. Great. So let's get back to then, is there anything else dietary-wise that people can do?
Starting point is 00:34:04 We got off on a good tangent. I think those are two really good starting points. In my book, I lay out a couple other diets that you can consider. And I kind of lay them out for people in two tracks where you can start with paleo or you can start with low FODMAP. And you can try either one. You can start with either one, but if you notice you do well on one, then there's another derivation you can kind of escalate to. So you could go to- So you'd recommend this for even someone like me, even though I guess my diet is kind of
Starting point is 00:34:31 paleo-ish, I guess. I don't eat very much grains. I am mostly just meat, fruit, vegetables, avocado, nuts, stuff like that. But so even just saying somebody who's like, okay, I'm feeling pretty good. And then you're saying, okay, you might be able to feel them better here. Try this. Yeah. I would say only if you want to experiment, you know, if you're feeling good, if it ain't broke, don't fix it. I totally get that. But if you're saying, yeah, you know what? I'm in a good place in my life. I'm kind of wanting to do some experimentation. Then I'd
Starting point is 00:34:57 say have at it with some other things like getting on a good probiotic. I think that's something that even if someone's healthy, wouldn't be a bad idea to at least periodically use a probiotic because there's some evidence showing other health benefits of probiotics outside of just helping with digestive maladies. It's interesting. That's an area I'm completely ignorant. I'm going to parrot something from, do you know the website examine? No. Really? Oh, you probably, you probably appreciate it. Um, examine.com. It's a premier resource for scientific information on supplementation in particular. And there's a guy named Curtis Frank who works with me in my supplement business.
Starting point is 00:35:31 I can note about that right now. Yeah, you'll like it. You'll appreciate it. And so Curtis, he works with me, but he was the co-founder of Examine and the lead researcher and writer. And so whatever you find in there that you read that you like was probably written by Curtis. I mean, he himself has personally reviewed and not just reviewed, but studied and collated and he built their database over 40,000 papers. I mean, he's like a pharmacy in terms of his understanding of supplementation. Anyways. So what I'm saying is I'm going to parrot him and I don't want to put words in his mouth, but I've asked him about
Starting point is 00:36:01 probiotics because he works with me on formulations. I mean, I'm giving him all the credit for anyone that looks at any of my supplements is like that's that's a a clever product i like that product the the credit goes to curtis um but i've asked him about probiotics because they're popular and that's and that's not a reason to sell them but it's a reason to look into it right sure and his take has been like he doesn't think they're shit he doesn't he's like oh they're all crap but he um and this is at least as of let's say six months ago so if he's listening i'm being very i'm very careful i appreciate yes yes but but he was basically saying that and this is an area that he doesn't he has not done enough research himself he's looked into it quite a bit but he just doesn't feel like he has the strain and okay this is what we do yeah and that he feels that everybody could benefit from it he knows of
Starting point is 00:36:44 course we have certain things to do with people, certain problems, but if it's someone who's just healthy, what are your thoughts on that? Yeah. He makes a good point, which is when you're looking at probiotics in a strain by strain basis and trying to find one strain for one condition, I think you miss the trees for the forest, so to speak. And there is a website that attempts to do this. It's called Probiotic Advisor, and there's also a version of it in Canada. But again, I think what's happening there is they're making probiotics. They're trying to look at probiotics in a drug model, and they're also making probiotics more complicated than they have to be.
Starting point is 00:37:20 And this is one of the things that in going through the breadth of the probiotic research was very insightful for me if you look at probiotics you can really organize them into four categories but one category you can't really obtain in the u.s so i just say for sake of conversation three categories these are your your lactobacillus bifidobacterium predominated strains so if you look on the label you'll see lactobacillus acidophil, bifidobacterium-predominated strains. So if you look on the label, you'll see lactobacillus acidophilus, bifidobacterium infantis, and you'll see maybe 7, 10, 15 strains, all of those types of designations. Category 2 is Saccharomyces boulardii, which is a healthy fungus. And then Category 3 are sometimes labeled as soil-based or spore-forming probiotics.
Starting point is 00:38:04 And these are your bacillus strains, bacillus coagulans, bacillus subtilis, bacillus lichenformis. And there are studies on all of these. Category one, by far and away, the lactobacillus bifidobacterium has the most studies. And there's impressive literature, most impressive for IBS, which makes sense, right? Now, sometimes you see a supplement company or a guru saying, this is the strain that's been shown to help constipation. I saw this thread emerge like three years ago when the first, roughly three years ago, when the first study showing a probiotic could improve constipation was published. And I said, hmm, I've been using a
Starting point is 00:38:41 similar formula, but not that exact formula, but seeing people with constipation improve after using probiotics. I'm thinking that there will be another study published in six months with a different formula showing the same benefit. What do you know? That happened. And today I think there's been three or four different formulas that have shown the ability to improve constipation. So to my point, I don't think you need this one bacterial strain because these bacteria, it's not that these bacteria, most, most probiotic bacteria do not colonize you, but rather they have this transient impact. Ironically, I think one of the strongest impacts probiotics have amongst a few others, but definitely the most ironic is that they're
Starting point is 00:39:22 actually antibacterial, antifungal and antiparasitic. And this is why there are some trials, for example, there's been at least four in small intestinal bacterial overgrowth or SIBO showing that taking a probiotic can actually clear that overgrowth. And other data have shown that I believe there was one head-to-head with Saccharomyces against metronidazole, which is an antibiotic showing equal efficacy in clearing infections. So these can be pretty powerful. And I can say in the clinic, we see patients who have lab work showing SIBO or candida, and sometimes all we have to do is use a probiotic. Wow. Now, there have been two meta-analyses, which are just summaries of the available clinical trials.
Starting point is 00:40:04 A study of studies, right? Yeah, a study of studies. So very high-level scientific evidence showing you can have a positive impact on anxiety and depression when using probiotics. Now, a more recent meta-analysis has challenged that meta-analysis, saying that the cohorts studied were not predominantly depressed, you know, diagnosed depressed and diagnosed anxious. But they were rather people who were generally healthy. They took a happiness inventory essentially, and then their happiness score is improved after the probiotics. So we have to be a little bit careful where they can help with anxiety and depression. May they be an effective soul therapy for clinically diagnosed anxiety and depression? Maybe not, but they can definitely get you moving in a better
Starting point is 00:40:45 direction, it seems. And there's been some evidence showing an improvement in blood pressure, although the effect is modest, blood cholesterol, although the effect is also modest, and I believe in chronic fatigue, pain scores and pain scores of chronic fatigue and also the fatigue scores of chronic fatigue. And there was also a low FODMAP diet trial showing the same thing. So that's just a few of the studies on probiotics. But the Category 1 has the most studies. Category 2 has a reasonable amount of studies also.
Starting point is 00:41:19 And actually, just touching on Category 2, another meta-analysis has shown that when people are trying to clear H. pylori, which is a bacterium that can cause ulcers, that Saccharomyces boulardii is synergistic with the antibiotics used to treat H. pylori. So sometimes people think that if I'm taking an antibiotic, I shouldn't take a probiotic because the antibiotic is going to kill the probiotic. Sure. And it's not really true, actually. The probiotic may actually be synergistic. Can increase the efficacy. Exactly, exactly. And then the final category, I believe there's been 14 trials with the soil-based organisms showing improvements in, one showed
Starting point is 00:41:56 an improvement in leaky gut, and then the other 13 showed improvements in IBS. And then, I'm sorry, coming back to category one, there was actually one study that showed an improvement in periodontitis, so infections in the mouth. And this is the gut connecting to all these different systems of the body. One of the systems is the mouth. So there's a lot of literature and we see some good documentation, but we have to be careful not to fall into the trying product after product after product. And that's where people, I think, get sucked into the black hole of different supplement companies trying to market different probiotics. And what they'll do is they'll find that one study on the one strain for constipation and
Starting point is 00:42:35 say, this is the best probiotic for IBS and for constipation. We have the study and we have the research and they put forward a very scientific looking argument, but it's kind of, you know, what do they say? Marketing is just telling the truth attractively. So they're kind of telling the truth, but they're also cherry-picking the data. So what I'd recommend people do is try one formula from each of the categories and see what feels best for you. And some people may notice one category. This might be a stupid question, but combining them is a no-no or the products don't do that.
Starting point is 00:43:08 So that's exactly what I was coming to, which is some people may notice that one strain doesn't feel well in their gut. So you can combine them, but I think initially, so as to determine how you respond, isolate them. And then if you want to try a combo product later, you could. Interesting. So I've heard, for example, that then if you want to try a combo product later, you could. Interesting. So I've heard, for example, that probiotics that are sitting on the shelf are anywhere, are probably in any store you might go to, are probably just dead and garbage. Is that true? True for Category 1 and 2, although there's been a couple new Category 1 probiotics that have selected only non-heat-sensitive strains.
Starting point is 00:43:48 But for the most part, Category 1 and Category 2 should be refrigerated. But they can spend a little bit of time out of the fridge. We have some people who go through our book protocol and use our probiotic, and they email in saying, when the probiotic got here, the ice pack was melted. Oh, it might, yeah, yeah. It's okay. They can really be out of the fridge for a couple days, maybe even a couple weeks. It's the storage that you want to have be done in a refrigeration unit.
Starting point is 00:44:13 And then the category three, the bacillus or spore forming, they do not require refrigeration. Okay, so you have a probiotic. Do you have category one, two, three? Yeah, so exactly what I did with the probiotics that we created for- I'm going to take them. They coincide with- Cool.
Starting point is 00:44:26 I want to know about them. Yeah, so they're- My wife too, actually. She's taken probiotics in the past and has noticed positive. She has felt better and I didn't know enough about it. So I didn't have, I don't know. I was like, Sarah's with Sarah's. Sure, I mean, it's very expensive.
Starting point is 00:44:42 It was some like trendy LA thing, but she was like, I actually really noticed like my digestion everything felt better and I was like um what thirty dollars a shot that's probably she's taking a shot of them well that's how they do it like it's a little it's like a trendy you know what I mean trend these trendy things and so she'd been asking um about probiotics I wasn't able to give her enough good information because I mean uh you can attest to it takes a lot of work to go through all the literature and so so now that I'm asking again, selfishly, exactly for her as well, the simple take homes. Yeah. Um, and that's about your product. I want to know what it is and where can, yeah. Yeah. So, um, if people go to, if they want to learn more about the book
Starting point is 00:45:18 and then the book connects you to the store, what's the name of the probiotics are the book is healthy, gut, healthy, you cool. And if people go to healthy, go to Healthy Gut, Healthy You book, and they can buy the, I would recommend getting the book because it gives you the specific protocols on how to do everything like way beyond diet and probiotics. But for the- Is it on Amazon as well? It's on Amazon. Okay, cool.
Starting point is 00:45:36 But for the probiotics, I just, I named our products in alignment with this. So one is called Lactobifido Blend. Okay. The other is called Saccharomyces Blardi. And the third is called lactobifido blend. The other is called Saccharomyces boulardii. And the third is called soil-based. And it makes it easy. And that's what I try to do with everything that I do in my work, my research is not looking to make things more complicated, but looking to make things more simplified. Yeah. Well, that's the difficult thing is simplifying. Yeah. Even in communication, right? It's easy to throw words
Starting point is 00:46:05 around, but it's much more difficult to explain things in a way that anyone can understand them. So where can people get the supplements? Where can I get supplements? So the, I don't actually know the store URL off the top of my head, but if you go to either Healthy Gut, Healthy You book. Okay, good. So you can find it. You can find it through there or through our homepage, which is drruscio.com, which is D-R-R-U-S-C-I-O.com. And there's a little tab that says store. Okay, good. Then you'll be able to navigate your way from there. Okay, perfect. And before we wrap up, I just want to see if there are any other lifestyle
Starting point is 00:46:32 factors that you'd recommend for improving gut health. So this was another interesting thing, which is there's this research being done mostly in Asia on what's known as forest bathing. Have you heard of this? It rings a bell, but I couldn't tell you what it is. research being done mostly in Asia on what's known as forest bathing. Have you heard of this? It's, it rings a bell, but I couldn't tell you what it is. So they're, they're taking two groups of people and they're giving them a break to take a
Starting point is 00:46:51 walk. Okay. But one group takes a walk in the forest and one takes a, you know, like a stroll through the downtown. And it's only the group that's taking a walk in nature that sees a documentable decrease in depression and anxiety and an increase in subjective well-being, like happiness and energy. So there's something therapeutic about being in nature.
Starting point is 00:47:13 Have you seen the research on that? It was just looking at pictures. Yes. Yeah, of nature versus, and even that had somewhat of a positive impact. So there's something therapeutic about being in nature. Now, I'm a big outcome guy, meaning show me the outcome data. You can tell me all these mechanisms all you want, like phyto, cytokines, I may be mispronouncing it, but a compound in trees has been shown to help lower blood pressure. Cool. But show me less deaths from heart attack or show me a measurable, you know, clinical
Starting point is 00:47:49 outcome in lowering someone's blood pressure. Yeah. Effect size. What are we really looking at here? Show me some kind of outcome because you can get so wrapped up in the mechanism and misled by mechanism. So observational epidemiological data has shown that those that live closer to a forest, a green zone, or an ocean, a blue zone,
Starting point is 00:48:05 have a longer life expectancy and a lower all-cause mortality. So there's definitely something therapeutic about getting in nature. It's free, right? It doesn't cost you anything. And I would say, if you're also trying to maximize your in for your out, I would say, take a walk in nature with a friend because social bonding is so important. And it seems that when women are going through health stress or any kind of stress, they have a higher need for connection than men do. Shelly Taylor is a researcher who calls this women, men have fight or flight and women have tend and a friend. And so especially for women, but also for the bros, go for a walk in nature with a friend. And so especially for women, but also for the bros, go for a walk in nature with a friend. And I would say that if you could do that once or twice a week, that'd be a very simple,
Starting point is 00:48:53 powerful lifestyle experience that would have a lot of benefit. Cool. And approximately how long? I would say at least 20. I don't know if the, that's actually a great question, if the forest bathing researchers have found a minimal threshold, but I would say definitely more than five. Probably 20 to 30 at least would be a good minimum to shoot for. Makes sense. How about exercise? Is there a connection there with gut health? We know that people who are sedentary and then start exercising actually have healthier gut bacteria from doing that.
Starting point is 00:49:28 And athletes tend to have healthier bacteria than sedentary. But there's also this law of diminishing returns and then even detriment if you go too far. Because too much exercise then opens the door for infection, probably secondary to immunosuppression. Because exercise, it's an immunosuppressive stimulus, and we need a degree of that, right? We don't want our immune systems to be on overdrive. But then if we suppress them too much, then we open the door for infection. But specifically, that's something that you have to take on a case-by-case basis. But what I would offer people, especially if it's more of like a fit crowd,
Starting point is 00:50:02 which I'm assuming we're talking to here, be careful that you're not overtraining. And if you're a little bit tired, if you're noticing that you fall asleep and then wake up an hour later, or you always wake up like 45 minutes before your alarm clock goes off and you can't fall back to sleep, some of those are signs of overtraining. So maybe consider supplement or replacing one training day with that walk in nature with a friend and see if that reduction of your training load gets you to where you want to be. Great. Perfect. Hey there, it is Mike again. I hope you enjoyed this episode and found it interesting and helpful. And if you did, and don't mind doing me a favor and want to help me make this the most popular health and fitness podcast on the internet,
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