Let's Gut Real - Easy to Digest Nutrition Science (Andrea Hardy)

Are all fermented foods probiotics? Learn the important difference, and how to include them in your diet!

In this episode of Let's Gut Real, I interview Bob Hutkins, PhD and Mary Ellen Sanders, PhD on the important difference between fermented foods and probiotics.

We also talk about:

• What are fermented foods?
• What are probiotics?
• How fermented foods and probiotics differ and why it’s important to define a difference?
• Why do we need to be precise with conversations on probiotics?
• Discuss the new AGA's Clinical Practice Guidelines for Probiotics
• Where evidence exists to support the use of probiotics
• Bacterial persistence – if they don’t join our microbes why do they benefit us?
• How one would use fermented foods versus probiotics
• A bit about the history of fermented foods & our health
• Why including fermented foods in our diet is a good idea
• Is the research strong enough to recommend fermented foods in the diet? What evidence exists?

You can find up to date information on ISAPP by visiting https://isappscience.org or, if you listen to this before July 1st, you can sign up to their upcoming webinar ‘Fermented Food – Separating Hype from Facts.’ At 1pm BST (6 am MST).

Nutrition is central to a functioning immune system. It impacts our ability to fight precancerous cells, ward off pathogens, heal injuries, and support our bodies through disease. This week I interview Doug Cook, RD on the role that nutrition plays in our immune function.

Doug Cook is a registered dietitian with over 21 years of experience. With a Master of Health Science in Nutrition, he specializes in functional and integrative nutrition. Doug dives deep into the research on nutrition and science to provide his patients, and the public expert up-to-date information, questioning the way that we’ve ‘always done it’ through his blog www.dougcookrd.com and on his podcast Pursuit of Health. I always personally learn so much from him - especially in the way of brain health, and micronutrients. I appreciate that perspective because a lot of times when I’m looking at patients I’m strictly focusing on digestive symptoms. So, it’s nice to kind of take a step back and learn from colleges who actually do their research.

We talk about:

• How Cook decide to become a dietitian
• The importance of critically reviewing the up-to-date research instead of trusting the way that things have always been done
• How nutrition plays a role in immune function
• What a functioning immune system means in contrast to the idea of people wanting to ‘boost’ their immune system
• Some of the key nutrients we should be aware of and why
• Some of the gaps often seen in people’s diets in regards to nutrition & immune function
• How the gut plays a role in immune function and where nutrition fits in
• What gut permeability/leaky gut is, why is it so trendy right now, and what the science actually says
• Some nutrition basics for improving gut permeability and supporting good immune function

Connect with Cook on his website at www.dougcookrd.com on his podcast Pursuit of Health on Instagram @your.nutrition.education on Twitter or on his Facebook here as well!

Today I interview Dr. Kelly Peterson on the role pelvic floor, abdominal muscles, and diaphragm play in digestion and digestive comfort - an often under recognized contributor to digestive symptoms!

Dr. Kelly Peterson is a Doctor of Physical Therapy and specializes in visceral and pelvic Physical Therapy. She currently practices at an outpatient clinic in Huntington Beach, California. She created her own online business providing Telehealth and in-person treatments for pelvic and visceral physical therapy as the “Belly Whisperer”. She also works part-time as a home health physical therapist through out Orange County, California.

Her mission as a visceral and pelvic Physical Therapist is to help educate patients about their body (especially the intimate parts!) and provide a safe environment to discuss and treat abdominopelvic issues at all ages. Her goal is to provide an outlet for patients to seek medical treatment and advise on issues that often go undiagnosed or may not be effectively treated with current, widely practiced management strategies. 

She followed in my mother’s footsteps as a physical therapist and strive every day to serve those not only in need of skilled medical treatment, but more importantly compassion and understanding. 

Dr. Peterson and I discuss:

• What manual therapy is
• How normal movement of the viscera contributes to digestive wellness
• The different systems that influence digestion including the diaphragm, abdominal wall, and pelvic floor
• The vagus nerve and its influence on digestion
• What is diaphragmatic breathing
• How diaphragmatic breathing influences nervous system function, and proper muscle tone influencing digestion
• How normal versus maximal inhalation influences movement of the organs
• How to get back to basics to have a good foundation to strengthen your core

Want to learn more about physical therapy for digestive issues? Follow Kelly on Instagram @BellyWhisperer

Is dysbiosis fact or fiction? And can we use the information we have about the gut microbiome to diagnose and treat disease?

In this episode of Let's Gut Real I interview Gabrielle Fundaro, PhD on more deeply understanding gut microbiome science, and how practitioners and clinicians need to communicate that science in a connective way for their patients.

Gabrielle Fundaro holds a PhD in Human Nutrition, Foods, and Exercise from Virginia Tech as well as a BS in Exercise, Sport, and Health Education from Radford University. She is an ACE-certified Health Coach with both Monash Low-FODMAP and ISSN Sport Nutritionist certifications and provides client-centered coaching and consulting telehealth services via Vitamin PhD Nutrition that focus both on gastrointestinal disorders and health behavior change. In her free time, she enjoys hiking, reading, spending time with my dogs, and lifting weights.

In this episode, Gabrielle and I chat about:

• Her research with the gut microbiome and lipopolysaccharides (LPS)
• How do we define gut health?
• Dysbiosis – what is it? Is there a diagnostic test? The problems with this?
• Why do you see patients gravitate towards gut microbiota tests and other gut health tests that aren’t validated?
• How do we find the balance between discussing science and connecting with patients?
• Can the results of 1 study to provide health interventions?
• Red flags & green flags to watch out for when reading about the gut microbiome on the internet
• How health care providers need to do a better job at communicating and connecting with their patients -and how to do that! 

To learn more from Gabrielle, follow her on Instagram  @vitaminphd or visit her website at www.vitaminphdnutrition.com

Justine Dowd and I chat about

• Her experience with celiac disease and fertility
• How her experience shaped her approach to a wholistic approach to care - focusing not just on disease treatment but the role mindset plays
• How to connect the mind & body through mindfulness
• How 'making friends' with your digestive health problem can change the outlook of your disease and help aide in getting better
• Self-compassion to help with management of digestive struggles
  • Her published research in this area looks at how self-compassion directly (and indirectly) predicts better quality of life and adherence to the gluten free diet among adults with celiac disease
• Gut-brain connection - the science of how the vagus nerve influences digestion, and how self-compassion & mindfulness can help
• How exercise influences our digestive disorders - Justine's research in this area (published, in press/under review) – MOVE-C was a 12 week HIIT exercise training program that found improved resting heart rate, changes in the gut microbiota, quality of life, gut symptoms, and self-compassion
• Practical nutrition tips to manage digestive disorders & how self compassion plays a role (especially during COVID)
• Sleep & digestive disorders
• Her books: You’ve Got This Mama, Too & You’ve Got This, Healthy Mama

Justine is running a FREE coping with COVID 4 week workshop launching May 11th, 2020 for those with digestive disorders. To join, email Justine at guthealthyyc@gmail.com

Although the etiology of primary sclerosing cholangitis (PSC) is poorly understood it is a progressive disease characterized by inflammation of the bile ducts.

This week I interview RD Brittany Roman-Green and we discuss primary sclerosing cholangitis, its relationship to ulcerative colitis and what the current research says about it.

Brittany Roman-Green is the founder of Romanwell and is an IBD focused registered dietitian nutritionist, certified personal trainer, and behavior change specialist. Brittany's the national coleader of the diet and nutrition national scientific advisory committee for the Crohn's and Colitis Foundation and the national leader of the registered dietitians in IBD practice group for the Academy of Nutrition and Dietetics. Brittany has lived with ulcerative colitis for over 20 years and also has IBS and PSC. 

We talk about:

• What is primary sclerosing cholangitis (PSC)
• What are the symptoms of PSC?
• Why do people with IBD develop PSC?
• Does nutrition influence PSC management?
• Nutrition management of IBD, including a discussion about inflammatory foods
• The use of restrictive diets and their potential side effects
• The 2020 International Organization for the study of IBD guidelines

Connect with Roman-Green on her website at romanwell.com on Instagram @weareromanwell or on her Facebook here as well! You can also checkout their IBD starter kit that's full of tips for advocating for oneself when you have IBD.

Dragana Skokovic Sunjic is a clinical pharmacist and the leader in knowledge mobilization for probiotics in Canada and the US. As the author of the Clinical Guide to Probiotic Supplements for both Canada and the US, she has spoken around the world on the latest evidence for the use of probiotics.

This week, Andrea interviews Dragana on the most up-to-date evidence on probiotics. Spoiler alert: It's not enough to say 'pick a probiotic with at least 10 billion bacteria!'

We discuss:

• what impacts your gut microbiota from a pharmaceutical perspective
• what probiotics are
• why patients are taking probiotics, and what health care providers need to discuss with their patients about probiotics
• why we should start thinking about probiotics like drugs - they're not just natural health products anymore!
• matching the right strain of bacteria to the right condition
• how to pick the RIGHT probiotic
• where to find up to date evidence on probiotics

To access the probiotic chart visit www.probioticchart.ca in Canada and www.usprobioticguide.com in the US.

Or download the app by searching 'probiotic guide'.

Learn more about the Alliance for Education on Probiotics at www.aeprobio.com 

Now more than ever, mental health and behavioral health are important. Working with a GI psychologist is typically short-term, but significantly helpful in improving your quality of life, coping with stress and decreasing the severity of your GI condition.

Today, I interview Dr. Megan Riehl who is a GI psychologist who specializes in psychogastroenterology and anxiety related-disorders. She is the Clinical Director of the GI behavioral health program at the University of Michigan and Director of Behavioral Health Services and Support for Gastro Girl, INC., a co-parent owner of GI OnDemand. Dr. Riehl’s clinical research focuses on the delivery of GI behavioral health treatment for patients with disorders of the gut-brain and IBD. Dr. Riehl participates on several national committees dedicated to research and education to enhance the psychosocial functioning of patients with gastrointestinal problems.   

We talk about:

• how Megan became interested in gastroenterology as a psychologist
• what is psychogastroenterology?
• why does psychogastroenterology help digestive disorders?
• what is the brain-gut connection?
• how does the brain-gut connection play a role in digestive disorders?
• how does psychotherapy alter the brain-gut connection?
• different types of therapy proven to help those with IBS
• what is the difference between gut-directed hypnotherapy and mindfulness?
• how does food fears drive symptoms? How does psychogastroenterology help reduce food fears?

To learn more, you can follow Megan on twitter @DrRiehl or on Instagram @DrRiehl

The number of people who have reached out to me and shared how the podcast has changed their practice, understanding, and life seriously can't be understated. Unfortunately, after three years and so many personal changes, I've decided to put the podcast on a hiatus. I feel so many mixed emotions about this, and given my personality, it's hard to take a step back but I look forward to bringing you more amazing content in the future.

I talk about:

1)    How nutrition science is rarely sensational or extreme. As well as the importance of doing what feels good for your body - without making it dogmatic.

2)    The value in trying to eat as many plant foods as you can each and every day. The importance of choosing a variety of foods that are acceptable to your palate, culture, budget, and lifestyle.

3)    The value of having a member on your health care team that advocates for you, whether that's your dietitian, pharmacist, doctor, or physio. If you're struggling to advocate for yourself and your medical needs, it is important to find an allied health provider that can get the best care possible for you. 

Connect with me on my website at www.andreahardyrd.com, my clinic website at ignitenutrition.ca, on Instagram @andreahardyrd, or Twitter or Facebook here as well!

This episode, you get Andrea Hardy, Canada's Gut Health Dietitian (me!) to talk about which diet is best for your gut microbiota.

A bit about me: I'm a registered dietitian and owner of Ignite Nutrition in Calgary Alberta.

This week I give you the update on:

• The role nutrition plays in your gut microbiota
• Your gut barrier - why it's important and how good nutrition helps maintain it
• I rank each diet on its impact on the gut microbiota and:
  • The paleo diet
  • The keto diet
  • A vegetarian and vegan diet
  • The Mediterranean diet
• And give you my top tips to take care of the gut microbiota.

Interested in working on your gut health? My team of dietitians are here to help. Visit Ignite Nutrition to book an appointment!

Pain is a predominant feature in the majority of functional gut disorders. The higher risk of anxiety and depression when coping with any chronic illness, including GI disorders, as well as anxiety and depression impacting symptoms and symptom perception in many GI conditions are all very important aspect of medical care.

This week I interview Dr. Katia Tonkin on the role that cannabis plays in medical care – including in the treatment of anxiety, depression, and pain.

Dr. Tonkin is a medical oncologist who worked at The Cross Cancer Institute in Edmonton Alberta Canada for 20 years and in London, Ontario Canada for 6 years prior to that. She became interested in medical cannabis in 2016 as many patients started asking about cannabis. After researching into it, Dr. Tonkin felt cannabis was likely to help many patients with a wide variety of problems. She started treating patients in April 2017 and wants to contribute to clinical research to further medical knowledge into appropriate uses of medical cannabis, as well as educating health care providers on the proper use of cannabis. She works out of Optimum Wellness Center as well as other clinics as a medical prescriber.

We talk about:

• Tonkin’s background as a clinician and how they became interested in the role cannabis plays in medical care.
• What cannabis is.
• The components of the plant that have therapeutic impacts.
• The role of a medical prescriber.
• How cannabis, that is medically prescribed, differs from cannabis you might find in stores and why ’self medicating’ is not the best strategy to realize the benefits of cannabis
• The conditions we have evidence for using cannabis with (including anxiety, depression and pain)
• How these overlaps with gastrointestinal disorders.
• How to find a medical prescriber.

Connect with Dr. Katia Tonkin at Optimum Wellness Centres in Edmonton, Alberta.

Did you know? Your skin has its own microbiome that influences this important organs overall health. While less populous than the gut, the skin microbiota plays an important role in our health. This week we talk about what we currently know about the skin microbiome, the gut-skin axis, and future research with microbiologist Elie Knaizeh.

Elie Knaizeh is a microbiologist with a speciality in antimicrobial resistance who became skincare obsessed. He decided to use his training in scientific investigation to explain the science behind skincare and the skin, in a fun and approachable manner on his Instagram @skinsciencezaddy. His goal is to empower people to make informed decisions about their skin health.

In this episode we discuss:

• How a microbiologist became interested in skin health
• What is the skin microbiome?
• How does the skin microbiome influence our skin health
• Probiotics, prebiotics & postbiotics in skin care  
• Variance in the regions of our skin (interpersonal and intrapersonal differences)
• Skin care products catered to taking care of our skin microbes – helpful or hype?
• What is the gut-skin axis?
• Internal probiotics and skin health
• His #1 tip for taking care of the skin

You can follow Elie @skinsciencezaddy on Instagram!

Enzymes are important for any living organism and play a huge part in the day-to-day operations of the human body. Enzymes provide a number of very vital processes – not only for digestion but for the nervous system, muscles, and many other important bodily functions.

This week I interview Anjie Liu and David Hachuel creators of FODZYME® to discuss how digestive enzymes can specifically help with IBS symptoms.

Co-founded by Anjie Liu and David Hachuel, MPH, Kiwi Biosciences is a human-centered biotech company developing elegant scientific solutions for extraordinary gut relief. 

FODZYME® was developed with a group of world-class experts in enzymology, biotechnology, medicine, and nutrition, FODZYME® was released to the world in Spring 2021. 

On a mission to make more foods painless, the team is working on a novel polyol-targeting enzyme to address the polyol group of the FODMAP family in development. The new solution will be transforming polyols like sorbitol and mannitol into sorbose and mannose that are more readily absorbed in the gut.

We talk about:

• What enzymes are, and how they work in the body
• Why certain enzymes are beneficial in IBS
• Why FODMAPs cause symptoms
• What enzymes are found in FODZYME® (including information about alpha galactosidase, lactase, and inulinase) and what their research has found
• How FODZYME® and its unique delivery system works to improve patient symptoms
• How the production of fructose occurs with inulinase, and when this may or may not be problematic
• Glucose isomerase - is it beneficial to fructose malabsorption? Why or why not
• Next steps in novel enzyme development
•  

Connect with FODZYME® on their website at fodzyme.com on Instagram @fodzyme or on Twitter or on their Facebook here as well!

We discuss how under-nourishing, which can arise from restricted eating can lead to slower digestion, exacerbate gut symptoms and lead to further restricted eating patterns.

This week I interview Rachael Hartley, fellow digestive health dietician on the intersection between IBS and eating disorders.

Rachael Hartley, RD, LD, is a Columbia, SC-based nutrition therapist, certified intuitive eating counselor and nationally-recognized food and nutrition expert who is passionate about helping others rediscover the joy of eating and foster a healthier relationship with food.

She is the founder of Rachael Hartley Nutrition, a weight-inclusive practice where she specializes in disordered eating and healing from chronic dieting, IBS and other digestive disorders, and women's health. She also runs the popular blog The Joy of Eating, where she shares practical intuitive eating advice and non-diet recipes and is featured regularly in national media outlets. Rachael also presents regularly about intuitive eating and non-diet nutrition to professional audiences and the general public.

We talk about:

• How Rachael became interested in the field of eating disorders
• The prevalence of digestive symptoms in eating disorders/disordered eating
• Some screening/red flags to consider when working with clients with IBS
• How to treat digestive symptoms in a patient with eating disorders
• What role does the gut-brain connection play in cases of IBS and eating disorders?
• What other interventions we can implement that doesn’t require restricted eating
• What is the link between feeling stressed about eating and the reaction our gut experiences as a result of that?
• Who is a good candidate for low-FODMAP diet?
• What are the risks of the low-FODMAP diet?
• Pathologizing bloating
• What about gut directed hypnotherapy?
• Does medication have a place in IBS management?

Connect with Rachael at https://www.rachaelhartleynutrition.com/my-book-gentle-nutrition or on instagram @rachaelhartleyrd or on her Facebook here as well!

Did you know, how you experience bloating can say a lot about what is going on in your gut? Bloating and distension can give us clues as to what is going on in your gut and how to best help!

This week I interview Tamara Duker Freuman, RD on IBS symptom language and why it's KEY to understanding what a patients bloating means. Plus, we cover different gut disorders and how bloating and distension present with each - getting clear on how to discuss bloating with patients so you can 'sleuth out' what is going on!

Tamara Duker Freuman is a registered dietitian and is nationally known for her expertise in digestive health and medical nutrition therapy for gastrointestinal diseases.  She works out of East River Gastroenterology & Nutrition (www.eastrivergastro.com), a private Manhattan-based practice known for its expertise in disorders of the gut-brain axis and specialized diagnostics.

In addition to her clinical work, Tamara is a high-profile nutrition writer whose advice on healthy living and dietary management of digestive disease has been read by hundreds of thousands of people each month.

Tamara is the author of one of my favorite books - The Bloated Belly Whisperer. If you haven’t read it, you absolutely need to. Today, she is here to talk to us about everything bloating related.

We talk about:

• Tamara’s background and how she became interested in digestive disorders
• The difference between bloating and distension and why they occur
• How bloating and distension relate to IBS symptom management
• The symptoms of constipation-induced bloating
• The symptom of upper gut bloating / early onset bloating 
• Functional dyspepsia what it is, and how it is different from IBS
• The symptoms of impaired gastric accommodation
• Whether bloating is always related to food
• If ‘I feel bloated’ is the new ‘I feel fat’ and what people should know about the intersection of body image and bloating
• Body dysmorphia, how to identify it in patients and the different treatment approaches to consider

Connect with Tamara on her website at www.eastrivergastro.com on Instagram @tamarafreuman or on Twitter or on her Facebook here as well!

I've been getting an overwhelming amount of questions about COVID-19 and probiotics, IBD, IBS, and immunity. I wanted to take some time to answer these in a simple way for our listeners.

The information was recorded March 19th and therefore, statistics and recommendations may change - always check with your doctor.

We cover:

• What is COVID-19?
• Why is COVID-19 a concern?
• Who is most at risk?
• GI Symptoms and COVID-19 - should I be concerned?
• "I have IBD and am worried about getting COVID - what do I need to know?"
• Your gut and your immune system
• How nutrition plays a role in your immune system
• Probiotics & COVID-19
• How to take care of your health during this challenging time

Citations

1. Gao, Q. Y., Chen, Y. X., & Fang, J. Y. (2020). 2019 novel coronavirus infection and gastrointestinal tract. Journal of Digestive Diseases.
2. Mao, R., Liang, J., Shen, J., Ghosh, S., Zhu, L. R., Yang, H., ... & Chen, M. H. (2020). Implications of COVID-19 for patients with pre-existing digestive diseases. The Lancet Gastroenterology & Hepatology.
3. Gu, J., Han, B., & Wang, J. (2020). COVID-19: Gastrointestinal manifestations and potential fecal-oral transmission. Gastroenterology.
4. Xiao, F., Tang, M., Zheng, X., Li, C., He, J., Hong, Z., ... & Lai, R. (2020). Evidence for gastrointestinal infection of SARS-CoV-2. medRxiv.
5. Resources for IBD Healthcare Professionals: 2019 Novel Coronavirus (COVID-19). (2020, March 17). Retrieved March 18, 2020, from https://www.crohnscolitisfoundation.org/coronavirus/professional-resources
6. Mizumoto K, Chowell G. Estimating risk for death from 2019 novel coronavirus disease, China, January–February 2020. Emerg Infect Dis. 2020 Jun [Retreived March 18, 2020]. https://doi.org/10.3201/eid2606.200233

Stress has a profound impact on our bodies. It impacts our nervous system by way of altering the gut-brain connection. Some people experience stress in the form of hypermotility (as seen with IBS-D) and other people experience it as hypomotility (as seen with IBS-C). Learning to manage our mindset is a helpful tool which can help improve how we cope with IBS and other digestive symptoms.

This week I interview Dr. Parastoo Jangouk on the gut-brain connection and the ways that our mindset perspective influences our intestinal health.

Dr Parastoo Jangouk is dual board certified in Gastroenterology, Internal Medicine and a life coach. She has particular interest in gut health, brain-gut interaction, gut microbiome, fitness, weight loss and mindset work. Dr Jangouk incorporates her coaching skills in promoting gut health, weight loss and treating patients with functional gastrointestinal disorders. She authored numerous peer-reviewed publications in prestigious medical journals.

She is currently living in Austin, TX where she practices Gastroenterology.

We talk about:

• How Dr. Jangouk became interested in the field of gastroenterology
• The gut-brain connection
• The role that hormones play in digestion
• How our gut microbiome interacts with our gut
• Where the main source of serotonin production is in our bodies
• What influences our digestive health and how it impacts our gut microbiome
• The interaction between our gut and our immune system
• How stress, what we think about food, and our symptoms influence digestive disorders
• The difference between circumstances and thoughts
• How to deal with stressful situations
• How shifting our thoughts influences our symptom perception and builds resiliency 
• How to shift our mindset perspective and strategies to help resolve unhelpful thoughts

Connect with Parastoo on her website at mindgutfitmd.com on Instagram @mindgutfitmd or on Twitter or on her Facebook here as well!

It’s not always easy to identify what may be causing infant colic or infant allergy reactions. Infant food sensitivities are common and can result in projectile vomiting, reflux, mucousy/bloody stool, and more - which can be very distressing to parents and lead to unnecessary dietary restrictions.

This week I interview Dr. Trill Paullin on Infant Food Sensitivities, how they arise and what we can do to help manage them

Dr Trill is a Molecular Biologist and mother to two daughters who had severe infant food sensitivities and reactions to proteins transferred from my diet to her breast milk.  After she processed the painful fact that she could hurt my children through breastfeeding, she started researching how to produce breast milk they could properly digest.  She discovered that many parents experience the same troubling situation. Through this experience, she wanted to create a place for parents to find answers to their questions about infant food sensitivities and empower them to continue their breastfeeding journey.  That was how Free to Feed was born.  Free to Feed is starting this mission by first creating an at-home test strip that will allow mothers to analyze their breast milk for allergens.

We talk about:

• How Trill became interested in the field of infant allergies
• The origin of Trill’s company Free to Feed

• What the differences are between non-Ige mediated allergies (FPIAP and FPIES) and IgE mediated allergies
• How the symptoms between these three diagnoses differ
• How to identify what may be causing infant allergies
• What the treatment options are for mothers trying to cope with infant allergies
• How Trill was able to gather data in this area of research that was largely unrepresented in the literature.
• The research around transferability and reaction timing
• The lack of support for families dealing with non-IgE mediated infant allergies and the importance of validating these experiences
• What Free to Feed offers today to help parents navigate this journey.
• At-home breastmilk test strips as well as infant allergen friendly multivitamins

Connect with Trill on her website at freetofeed.com on Instagram @free.to.free on Twitter or on her Facebook here as well!

Feeling full, nausea and vomiting are all symptoms of gastroparesis, yet other gut conditions can present like this too – so how do we know which it is? This week I interview Dr. Linda Nguyen on gastroparesis and other digestive disorder look-alikes like IBS, functional dyspepsia, cyclic vomiting syndrome and how she works with patients to improve their quality of life. 

Dr. Linda Nguyen is a Clinical Professor of Medicine at Stanford University and Clinic Chief in the Digestive Health Center. Her clinical and research interests include GI motility disorders and disorders of gut brain interaction, with an emphasis on gastroparesis, functional dyspepsia and chronic abdominal pain. Her current research includes identifying biomarkers to better diagnose motility disorders, understanding the role/impact of physiologic testing on clinical care, exploring novel therapies for gastroparesis and expanding the role of neuromodulation in the treatment of GI motility disorders and pain. She is also passionate about quality of life, professional development and physician wellness.

We talk about:

• How Linda came to work in the field of digestive health and her interest in GI motility and gastroparesis
• What gastroparesis is, how it develops, what the symptoms are, and how common it is
• The tests for gastroparesis
• How patients with gastroparesis develop a change in motility or emptying of their stomach
• Treatment options for gastroparesis
• Functional dyspepsia, how it similar or different from gastroparesis, and what the symptoms are
• Cyclic vomiting syndrome, how it similar or different from gastroparesis, and how is it treated / managed
• The use of implanted gastric stimulators for gastroparesis treatment
• The nutrition management of gastroparesis

You can learn from Dr. Nguyen on Twitter @ LindaNguyenMD

What are some conditions that look a lot like irritable bowel syndrome? Kate explores conditions that can masquerade as IBS and often lead to prolonged digestive symptoms! 

Kate Scarlata, MPH, RDN, LDN is a Boston-based dietitian with 30 years of experience. Kate’s expertise is in gastrointestinal disorders and food intolerance, with a particular focus on the application of the low FODMAP diet for functional gut disorders. She was awarded the Outstanding Massachusetts Dietitian Award and recognized as Boston’s Best Dietitian by Boston Magazine. Kate is the author of numerous books and articles on digestive health topics including the New York Times Best Seller, The 21 Day Tummy Diet. Her latest book is The Low FODMAP Diet Step by Step. Kate completed her postgraduate training at Brigham and Women’s Hospital, a Harvard Medical School teaching affiliate.

Kate and I talked about the conditions typically on the radar which include:

• Inflammatory bowel disease
• Celiac disease
• Colorectal Cancer
• Microscopic Colitis

And then we get into conditions not typically on the radar, which include:

• GI infections
• Mast cell activation syndrome
• Milk protein intolerance
• SIBO
• Sucrase isomaltase deficiency (CSID)

And also discuss the importance of recognizing that IBS is a very real condition that has several excellent management options too! 

If you don’t already follow Kate, you should she is on Instagram @katescarlata and on Twitter @KateScarlata_RD: and can learn more at katescarlata.com 

Bile acid diarrhea is a common cause of diarrhea in patients with IBS and IBD. Currently, our diagnostic tools are unaccessible and often, therapeutic trials with bile acid sequestrants are used in the diagnosis. Dr Robert Battat shares his research with a new diagnostic marker, C4, in the diagnosis and management of B.A.D., leading to more targeted care for patients.

Robert J. Battat, M.D. is an expert in inflammatory bowel disease specializing in Crohn's Disease and Ulcerative Colitis. He is an Assistant Attending Physician at the New York-Presbyterian Hospital/Weill Cornell Medicine and the Jill Roberts Center for Inflammatory Bowel Disease.    

Dr. Battat obtained his medical degree and completed both his internal medicine residency training and clinical gastroenterology fellowship at McGill University in Montreal, Canada. He subsequently completed a clinical and research fellowship in inflammatory bowel disease at the University of California, San Diego and at Robarts Clinical Trials under Dr. William Sandborn and Dr. Brian Feagan.      

He has a major interest in personalized medicine in inflammatory bowel disease and has extensively published scientific articles on this topic. This includes the development of a serum tess to diagnose bile acid malabsorption -which leads well into our topic today!

Dr Battat and I discuss:

• What is bile acid diarrhea? 
• How does bile acid diarrhea develop?
• How is it diagnosed? 
• • SEHCAT Test
  • Therapeutic trial
  • C4 Testing as a measurement for precursor to bile acids
• Is it a common cause of unexplained diarrhea in your practice?
• How is BAD managed? 
• Do you often see an overlap between BAD and IBS? IBD & BAD? 
• Where the research is going with BAD diagnosis and management and what can patients and health care providers expect?

You can read Dr. Battat's research here:

Battat, R., Duijvestein, M., Casteele, N. V., Singh, S., Dulai, P. S., Valasek, M. A., ... & Jain, A. (2019). Serum Concentrations of 7α-hydroxy-4-cholesten-3-one are Associated with Bile Acid Diarrhea in Patients with Crohn’s Disease. Clinical Gastroenterology and Hepatology, 17(13), 2722-2730.

Hypermobility spectrum disorders are estimated to be among 3% of the general population. So, every GI practitioner should be aware of hypermobility and the symptoms, because whether we recognize it or not, we’re seeing these patients all the time.This week I interview Cheryl Harris, RD on the overlap between hypermobility and GI disorders to help guide practitioners towards recognizing it in their digestive health patients.

Cheryl Harris, MPH RD has been a dietitian for 20 years and has specializing in digestive disorders for 15 years. She was recognized as one of the top nutritionists in the DC metro area by the Washingtonian and was selected as the “Emerging Dietetics Leader of the Year” for Virginia. She has presented and written widely on digestive concerns and was honored to teach part of the AND Certificate of Training in Gluten-related disorders. She is honored to serve on the International Consortium for Ehlers-Danlos and Hypermobility Spectrum Disorders Diet and Nutrition Working Group.

We talk about:

• how Cheryl started working in GI
• What EDS is
• How digestion is impacted by EDS
• How EDS is currently managed
• Some important nutritional considerations in the management of EDS
• Conditions that overlap with EDS including POTS and MCAS
• What POTS is
• Why these conditions overlap and how the presentation of multiple lesser-recognized conditions complicate management for patients
• How nutrition plays a role in POTS
• How dietitians & other health care providers can better screen for, recognize and refer to ensure patients get a more timely diagnosis. What some of the red-flags are and who should they refer to.

Connect with Cheryl on her website at harriswholehealth.com on her email at cheryl(at)harriswholehealth(dot)com or on Twitter or on her Facebook here as well!

This week I interview Renee Simons, RMT on her massage and visceral manipulation work with patients with digestive disorders. In particular, we highlight a discussion around polyvagal theory, that can be applied to massage practice to enhance patient wellbeing and symptoms, especially in functional gut disorders.

Renee's interest in human kinetics and functional muscle movement began with Kinesiology studies at Simon Fraser University (SFU). In 2004, she graduated from Okanagan Valley College of Massage Therapy completing a 3000hr program and is a member of the College of Massage Therapists of BC and the Canadian Massage and Osteopathic Therapists of Alberta.

Since becoming a Registered Massage Therapist, Renee has focused her post-graduate training and clinical practice around Myofascial Release and Visceral Manipulation techniques and is committed to providing patients with individualized treatments to discover and resolve the underlying reasons why they may have pain and dysfunction in their bodies. Her practice has a strong connection to women’s health, GI dysfunctions and the Gut-Brain Axis.

Renee’s treatment paradigm follows a biopsychosocial model and Stephen Porges Polyvagal Theory. Teaching is a way for Renee to pay it forward and share her passion about massage therapy and mentor the next generation of therapists. She currently teaches for Alberta College of Massage Therapy.

Renee and I talk about:

• How does massage fit within digestive disorders?
• What is visceral manipulation & myofascial release?
• How do physical restrictions contribute to pain in digestive disorders?
• Who is visceral manipulation suited for?
• What can you expect when going for massage therapy that is focused on visceral manipulation and myofascial release?
• What is polyvagal theory?
• What role does the vagus nerve play in digestion?
• Regulating vagus nerve function
• Tips on how to shift your nervous system into ventral vagus in order to improve/assist digestion and digestive symptoms like constipation.
• Ways to stimulate the vagus nerve to increase vagal tone.

Sign up for Spectrum Therapeutics newsletter by visiting Renee’s website and we will send you a daily practice to stimulate your vagus nerve! 

EDS is a rare connective tissue disorder that can drive many digestive symptoms. Hannah discusses her journey with digestive dysfunction, how it lead to developing an eating disorder as a way to control her symptoms, finally being diagnosed with EDS, and how she came to practice in cognitive hypnotherapy through her own personal journey when she had exhausted all medical management options. 

Hannah is a Cognitive Hypnotherapist and works with women all over the world to overcome struggles with food, their emotions and the fear of not being good enough. She has a BSc Biological Sciences, MSc Psychology, Cognitive Hypnotherapy and Neuro-linguistic Programming (NLP). She has a special interest in the link between food issues and digestive problems and combines mind and body approaches to support her clients holisitically in their journeys. 

We discuss:

- How Hannah’s GI issues led to an eating disorder

- What is Ehlers-Danlos Syndrome (EDS) 

- What are the symptoms of EDS?

- How is it diagnosed? 

- How she journeyed from ED, to EDS, to the field of cognitive hypnotherapy

- What is cognitive hypnotherapy?

- How does accessing our subconscious influence our body's reactions to food & symptoms

- How does cognitive hypnotherapy help digestive disorders?

You can find Hannah on Instagram @hani_living_unleashed

Dr. Armin Alaedini is a faculty member of the Department of Medicine at Columbia University and is on the adjunct faculty of New York Medical College. He is also a faculty member and graduate mentor at the Institute of Human Nutrition at Columbia University. For 20 years his research has focused on the gut ecosystem, host-microbe interaction, and inflammation in the context of complex disorders. Dr. Alaedini has been awarded research grants from the National Institutes of Health (NIH), the U.S. Department of Defense, and private foundations, and has served as chair and reviewer on multiple NIH grant study sections. His expert commentaries have appeared in various media outlets, including the New York Times, BBC, U.S. News & World Report, Associated Press, Reuters, NBC News, Science, and Nature. He is a recipient of the 2014 Idea Award from the Department of Defense and the 2016 Tsunoda Senior Fellow Award from Columbia University. He previously served on the Executive Board of the Society for the Study of Celiac Disease and is on the Scientific Advisory Board of several organizations.

Dr. Alaedini and I discuss:

• The difference between celiac and NCWS
• How to diagnose NCWS
• Symptoms of NCWS
• What components in wheat may contribute to this food sensitivity (Gluten as a dietary antigen vs other components in wheat)
• What could contribute to a loss of tolerance in recognizing these components as safe?
• Possible rates of occurrence or populations that may be at higher risk of NCWS
• Could there be a biomarker available soon?
• How will this contribute to therapies for NCWS in the future?
• How does the gut microbiota play a role in the development of NCWS?
• How the gut-immune-brain axis may play a role in NCWS
• Extra-intestinal symptoms & the gut-immune-brain axis in NCWS
• How do we take care of patients with NCWS?

Research around digestive health is constantly changing, and it is one of those areas where we don’t necessarily know all the answers. This week I interview RD Abby Langer on fighting nutrition misinformation and debunking some popular digestive health claims.

Abby Langer has been a Registered Dietitian since 1999. Abby is passionate about all aspects of nutrition, from physiology to teaching to cooking. Her approach to nutrition is permissive and relaxed, and she is a true believer in living your best life without dieting. She has written in depth about debunking fad diets and nutrition myths and focuses on body respect and intuitive-style eating.

When she’s not working, Abby loves running, spinning, discovering new foods, and spending time with her husband and two daughters.

We talk about:

• How Langer became passionate in fighting nutrition misinformation
• Some of the worst gut health offenders
• Current claims and popular myths in the digestive health field
• Tips for dietitians looking to tackle misinformation and what to watch for
• How to be vigilant when so many things look credible
• How to address when other dietitians promote things that aren’t evidence based
• The importance of keeping up to date with scientific research
• Tips to consider when trying to make sense of research findings and which types of evidence are stronger than others

Connect with Langer on her website at abbylangernutrition.com on Instagram @langernutrition or on Twitter or on her Facebook here as well!

Dr Megan Rossi, also known as The Gut Health Doctor, is a Registered Dietitian and Nutritionist with an award-winning PhD in gut health, as well as the author of Love Your Gut, an easy-to-digest lifestyle guide to gut health and beyond, coming out in the US in January 2021.

Megan is considered one of the most influential gut health specialists internationally and her PhD was recognised for its contribution to science receiving the Dean’s Award for outstanding research.

As a leading Research Fellow at King’s College London, Megan is currently investigating nutrition-based therapies in gut health, including prebiotics, probiotics, dietary fibres, plant-based diversity, the low-FODMAP diet and food additives, as well as having set up The Gut Health Clinic, where she leads a team of gut-specialist dietitians to make an evidence-based approach more accessible. More recently, Megan has created her own gut health food company, Bio&Me, to bridge the gap between science and food industry.

Frustrated that her research findings weren’t reaching the public, and instead seeing fad and potentially dangerous misinformation on gut health being spread, Megan took to social media to share credible information and science-based advice, building an active community with over 245,000 of people so far.

Megan has also been recognised as Business Insider’s Top 100 Coolest People in Food & Drink and was named Young Australian Achiever of the Year in the UK 2020.

Megan and I discuss:

• How she became interested in digestive health and the gut microbiome
• Probiotics – when should I take them?
• Fermented foods and our health
• Is sugar bad for gut health?
• What does candida do in our gut? Is it bad for us?
• Her top tips for a healthy gut

Connect with Megan at www.theguthealthdoctor.com. Or on Instagram or Facebook @TheGutHealthDoctor

The gut barrier plays a key role in our immune system and chronic inflammation. Desiree Nielsen, RD and I discuss how important nutrition and lifestyle factors influence our gut barrier and how elimination diets may be bad for our health.

Desiree Nielsen is a registered dietitian, author and host based in Vancouver, British Columbia. She runs a nutrition consulting practice with a focus on inflammation, digestion and plant-centred diets. Desiree is the host of the internationally syndicated cooking show The Urban Vegetarian and the author of a book on anti-inflammatory nutrition called Un-Junk Your Diet: How to shop, cook and eat to fight inflammation and feel better, forever and her new cookbook, Eat More Plants: 100 Anti-inflammatory Plant-centred Recipes for Vibrant Living is a #1 National Bestseller. She co-founded the world’s first evidence-based self-management app for celiac disease, My Healthy Gut and is currently working on her third book, a culinary nutrition cookbook focused on gut health.

Desiree and I discuss:

• What is inflammation?
• Why is inflammation a problem?
• What can too much inflammation do to the body?
• What are causes of inflammation? And how is digestive health involved?
• What is the current evidence for diet in playing a role inflammation?
• How does our gut microbiota play a role?
• What is the gut barrier?
• What is leaky gut?
• What happens when it isn’t working properly?
• How does this impact our immune system and immune function?
• What should people focus on doing to help reduce their risk of inflammation

You can learn more about Desiree on her website or follow her on Instagram @DesireeNielsenRD

Resistant starch is something we get a lot less of in the diet, but plays an important role as a prebiotic, as well as exerting benefits to our health by way of the gut microbiota. This week I interview Solnul's Jason Leibert and Dr. Jason Bush on their research around resistant starch.

Dr. Jason Bush is an investigator of the microbiome. As the Chief Scientific Officer at MSP Starch Products Inc., he has led two clinical trials, which unlocked numerous clues explaining how resistant starch is utilized in the gut microbiome to influence human health.

Jason Leibert is a resistant starch advocate and storyteller. He has a successful track recorded of business development within the life sciences sector and, as the Chief Growth Officer at MSP Starch Products Inc., leads the business trajectory of SolnulTM and strategic growth for the company. Over the last several years, he's built an internal team and an international village of believers to help bring back the ancestral story of prebiotic potato fiber and preach the resistant starch benefits. 

In this episode we discuss:

• A bit about Solnul from Winnipeg MB
• What is resistant starch?
• How much resistant starch do we get in the diet?
• How were ancestral diets rich in resistant starch in comparison with modern diets?
• How does resistant starch fuel bacteria in the gut microbiota
• How resistant starch stimulates changes in the metabolism of humans
• How resistant starch improves insulin resistance
• How resistant starch improves IBS-like symptoms at a 7 gram dose, and still has prebiotic like effects without increasing gassiness

You can learn more about Solnul(tm) at their website here.

Were you recently diagnosed with celiac disease? Having celiac disease can mean something different for each patient. There are many different symptoms and yet some people may not experience any symptoms at all.

This week I interview RD Selena Devries about different ways to advocate for yourself if you have been diagnosed with celiac disease and helpful ways to encourage your transition into eating gluten-free.

Selena Devries is a registered dietitian from BC Canada.  She completed her dietetic training at Kelowna General Hospital in 2013 and was, shortly, after diagnosed with celiac disease myself.  Through her diagnosis, she started to volunteer with the Canadian Celiac Association and ended up working on their national board of directors as well as their professional advisory council with other celiac dietitians and gastroenterologists.   She is also trained in the low FODMAP diet for IBS through Monash University.  Her own diagnosis and follow up led her to discover gaps in care for celiac disease which led her to private practice with a focus on the dietary management of celiac disease.   With her online nutrition practice, she helps celiacs fall back in love with food. She helps them resolve persistent symptoms despite a GF diet, help the newly diagnosed get off on their best foot, and help celiacs eat out with confidence.  

We talk about:

• How Selena became interested in celiac disease
• What is celiac disease? 
• The common symptoms of celiac disease and some emerging symptoms (GI and otherwise) 
• The mainstay in celiac treatment
• What you see as major gaps as a dietitian working with celiac and living with celiac when it comes to celiac education
• High risk gluten-free grains
• Tips for eating out while gluten-free
• What to do when symptoms don’t improve
• How to advocate for yourself as a patient with celiac disease
• Health monitoring protocols like annual blood labs
• The overlap with IBS and SIBO or other gastrointestinal issues

Connect with Selena on her website at Healthbean.ca on Instagram @Celiac_dietitian or on her Twitter here as well!

Concussions can have a profound impact on our brains and are not always the result of a direct blow to the head.

This week I interview Erik Bustillo, RD on concussions, what they are, how they impact the brain, how they can happen, nutrition supported recovery and the impact they can have on mental health.

Erik Bustillo, MS, RD, FISSN, CISSN, CSC, CPT practices as a Registered Dietitian, Strength Coach, Fitness Trainer, and Health Coach. He attended Florida International University and earned his B.S. in Dietetics & Nutrition and his M.S. in Applied Exercise Science with a concentration in Sports Nutrition from Concordia University Chicago. Additionally, Erik is the current Co-Vice President and a Fellow of the International Society of Sports Nutrition (ISSN) as well as a Certified Sports Nutritionist (CISSN), a Certified Strength Coach through the National Council on Strength & Fitness (NCSF), and a Certified Personal Trainer through the National Strength & Conditioning Association (NSCA).

Erik has experience in research and working with professional, collegiate & tactical athletes, weekend warriors, avid CrossFitters, and in an outpatient setting helping individuals with weight loss/gain as desired outcomes using motivational interviewing and seeing medical nutrition therapy patients.

We talk about:

• How Erik became interested in sports nutrition 
• What is a concussion and how does it affect our brain? 
• Are there any implications on mental health from concussions?
• What sports are at risk of concussions
• Long term impacts of concussions
• How does nutrition play a role following a concussion? Can it impact return to sport?
• With all the crazy supplements out there focused on enhancing brain health - are there any supplements to take or avoid in concussion recovery?
• Is there any link between gut health and concussion recovery?
• What about Probiotic use for concussion recovery? 

Connect with Erik on Instagram or on Twitter or on his Facebook here as well!

Did you know that it is more common to have anxiety and depressive symptoms if you have IBS compared to if you don’t have IBS?

This week I interview dietitian Heidi Staudacher to discuss how patients can often end up in a vicious cycle where they have gastrointestinal symptoms that lead to mental health problems and then that further leads to more gut symptoms.

Heidi Staudacher is an accredited practising dietitian and has had extensive experience in the clinical management of people with clinically functional gastrointestinal disorders. Heidi completed her PhD at King’s College London in 2016 in which she investigated the use of the low FODMAP diet in irritable bowel syndrome and its impact on symptoms, the microbiota and diet quality. Her research interests include understanding the effect of different dietary components on gut microbiota, and therapeutic diets for gut disorders and their influence on gut microbial composition. She is passionate about conducting high quality research in the field of diet and gut health.

We talk about:

• How Staudacher became interested in the area of functional gut disorders and mental health
• The prevalence of mental health disorders in IBS
• How IBS impacts mental health
• Whether or not developing IBS predisposes individuals to developing mental health issues
• How it is the chicken or the egg when it comes to mental health and IBS
• How so many patients have heard the phrase ‘it’s all in your head’ and how the onus is placed on patients to ‘fix’ their IBS and how distressing that can be
• How patients have often felt like it’s their own fault through challenges with their mental health that they have IBS
• How nutrition influences mental health in IBS
• Some interventions for IBS that have been shown to improve mental health
• Whether or not changing the gut microbiota might influence mental health and IBS.
• The role of probiotic, prebiotics, and dietary changes in order to change the gut microbiota
• The influence of diet on mental health in IBS. Including the impact of disordered eating and eating disorders
• The big take aways clinicians need to know regarding the intersection of mental health in functional gut disorders

Connect with Staudacher on Twitter or on her website at foodandmoodcentre.com.au as well!

Dr. Parnell is an Associate Professor at Mount Royal University in the Department of Health and Physical Education. She obtained her PhD in medical sciences at the University of Calgary researching novel nutritional therapies for obesity and associated co-morbidities. Presently, she maintains an active research portfolio in the field of performance nutrition, and works with youth athletes, Paralympic athletes, and endurance runners. Her research focuses on diet quality, ergogenic aids, and exercise induced gastrointestinal symptoms. 

Dr. Parnell & I talk about:

• What runner’s diarrhea/runner’s gut is
• How runner’s gut influences motility of the gut
• How exercise stress influences gut symptoms
• How the gut microbiota changes gut function in runner’s gut
• How patients with IBS may be more prone towards gut symptoms during exercise
• The link between cortisol, high intensity physical activity, and gut symptoms
• Nutrition tips to reduce runner’s gut
  • Timing
  • Food consistency & digestibility
  • Food choices/types of foods
  • The role of FODMAPs in exercise & the gut
• Getting more specific on recommendations so diets don’t need to be so restrictive
• How choosing the right concentration of carbohydrate can be helpful
• How caffeine is an ergogenic (performance enhancing) aide but to be aware of how it influences the gut
• How to better absorb hydration
• Ideas around food first carbohydrates during events
• Training the gut for events
• How your gut microbiota influences your ability to perform in sport

Diet culture has a profound impact on our beliefs about nutrition and health. It can impact our behaviours and may lead to disordered eating which can have far reaching impacts on our bodies ability to digest food and further lead to uncomfortable digestive symptoms.

This week I interview Jessica Begg, RD on how emotional eating and binge eating influences our digestive symptoms.

Jessica Begg is both a Registered Dietitian as well as a Registered Clinical Counsellor. Jessica’s double qualifications make her uniquely suited to helping clients address the psychological issues that underpin their challenges with eating. She has been working in the area of disordered eating and within eating disorders treatment programs since 2006. Jessica works from a trauma-informed, emotion-focused, weight-inclusive and weight-neutral, anti-diet or non-diet approach. Jessica’s approach allows her clients to live their lives to the full by unshackling their beliefs about diet culture.

She is currently living in Vancouver where she practices clinical nutrition counselling.

We talk about:

• How Jessica became involved in working with patients with eating disorders
• The prevalence of digestive symptoms in eating disorders and what symptoms people usually complain of
• Why manipulating the diet, being the knee jerk approach that registered dietitians MIGHT use, may not be appropriate (Especially registered dietitians without eating disorder experience)
• The importance of screening for eating disorder behaviours
• How emotional and binge eating influences digestive symptoms
• Important things to consider/do to reduce emotional and binge eating
• How restrictive diets for digestive disorders might trigger binge eating /emotional eating, and the problems with that

Connect with Jessica on her website at shiftnutrition.com or on Instagram or on her Facebook or on Twitter here as well!

*the podcast will be changing to every other week during the COVID-19 outbreak due to my interviewees busy schedules*

Jessie is a registered dietitian with a PhD in nutritional sciences. Her graduate work researched the effects of nutritional components and environmental factors on gut health and cardiovascular disease. She has a passion for educating individuals about nutrition and the power of nourishing body and mind.  Jessie's overall goal is to make nutrition science attainable.  From breaking down nutrition science to busting myths that are so prevalent in today's society, she strives to empower individuals to become responsible consumers of social media content and experts on their own bodies.

Jessie & I talk about:

• in animal models, how pollutants interact with the microbiome & overall host health
• polychlorinated biphenyls (PCB's) as a persistent pollutant
• how we are exposed to PCB's (primarily fish, fatty meats, & fatty dairy products)
• how PCB's influence the mouse microbiota 
• how PCB's influenced inflammation and 'leaky gut' (gut permeability)
• how dietary fibre (inulin) helped to attenuate these changes in the gut microbiota
• inulin increased good bacteria
• Jessies big take-away message for humans & PCB's
• why humans are NOT rats, but what we can change in our diet to have positive health outcomes
• pesticides & the gut microbiota
• conventional versus organic produce - what should you choose?

Want to learn more from Jessie? Follow her on Instagram at @jessiehoffman_phd

Two previous guest of our Let’s Gut Real Podcast, Dr. Drossman and Johannah Ruddy, join us again today to talk about their newly released book. Gut Feelings: The Patient's Story Personal Accounts of the Illness Journey A Guide for Patients and Doctors Gut Feelings: A Patient’s Story. Now available on Amazon.

Dr. Drossman received his M.D. degree at Albert Einstein College of Medicine and subspecialized in biopsychosocial medicine and Gastroenterology. He received his gastroenterology training at the University of North Carolina where he founded the UNC for Functional GI and Motility Disorders.  Currently he is Professor Emeritus of Medicine and Psychiatry in Gastroenterology at UNC. He is a Fellow of the American College of Physicians, a Master of the American College of Gastroenterology, Past-President of the American Psychosomatic Society (1997) and Founder and President of the Rome Foundation for 29 years. In addition, he founded the Drossman Center for the Education and Practice of Biopsychosocial Care as an entity to help train physicians in relationship-centered biopsychosocial care with an emphasis on communication skills and enhancing the patient-doctor relationship.

Dr. Drossman is joined today by co-author Johannah Ruddy who is a national expert, researcher, and writer on teaching communications skills to patients and providers. Johannah currently serves as the Executive Director of the Rome Foundation. She has 22 years of executive leadership experience working with a variety of non-profit organizations nationwide and a strong background in writing for patients as well as a speaker at GI practices, medical centers, and conferences in the area of provider communication and patient advocacy. She holds a Bachelor of science degree from the University of New Mexico in Political Science, a Masters of Education from New Mexico Highlands University and is a doctoral student at Campbell University. She lives in Wake Forest, North Carolina with her husband of 21 years and their two sons.

Dr. Drossman, Johannah Ruddy and I talk about:

- Dr. Drossman’s and Mrs. Ruddy’s backgrounds and how they came to work together

- Disorders of gut brain interaction

- Typical patient experiences with these diagnoses and the reasons why they hold so much stigma

- Each of their biggest learnings as practitioner and patient in doing these interviews

- Common mistakes/pitfalls practitioners experience in working with patients and how this may be a disservice to our patients

- The key things clinicians can take away from this book, with a focus on patient centred care.

- How patients advocate for themselves to feel heard in their journey

You can find their new book: Gut Feelings: The Patient's Story Personal Accounts of the Illness Journey A Guide for Patients and Doctors Gut Feelings: A Patient’s Story

which is also available on Amazon: https://romedross.video/patient-story

You can find their previous book: Gut Feelings- Disorders of Gut-Brain Interactions, A Guide for Patients and Doctors which is available on Amazon: https://romedross.video/GutFeelingsWebsite

Check out the video version of the audio recording excerpt featured in this presentation: https://romedross.video/LesleyGutFeelings4X

Connect with Johannah on Instagram @johannahruddy on Twitter @JohannahRuddy or on LinkedIn.

Learn more about the Theromefoundation.org or here: https://romeonline.org

Today I have Kara Siedman here to chat with us about sucrase isomaltase deficiency (CSID) and discuss overlap with IBS presentation. Once thought of as extremely rare and only diagnosed in paediatrics, CSID is being found to be more prevalent than we once thought. With symptoms overlapping with IBS, learn how the conditions are similar, and how to move through helping patients find the right diagnosis.

Kara Siedman is a Registered Dietitian Nutritionist, Certified Diabetes Educator, and the Manager of a well-established nutrition practice within a large gastroenterology clinic in Colorado. Kara is also a certified yoga teacher whose nutrition philosophy embraces real food, integrative medicine and mindfulness. Kara’s goal is to help patients reach their maximum potential in health and wellness through a whole foods, individual and functional approach. In her spare time, you can find Kara on the yoga mat or kickboxing at home and playing in the woods with her husband and fur baby.

Kara and I chat about:

• What sucrose intolerance (congenital sucrase isomaltase deficiency or CSID) is
• What are the symptoms?
• Who is at risk?
• How is it diagnosed?
• What sorts of foods do people have to avoid or limit?
• How diet plays a role in managing symptoms, and considerations with overlap in IBS patients
• What medication options are there? 

You can learn more about Kara's practice at www.rmgnutrition.com

I interview Dr Suzanne Devkota on her research on the gut microbiota and inflammatory bowel disease (Crohn's and colitis) and the role our diet plays in fostering a healthy microbiome, and possibly reducing the incidence of IBD. We also discuss how microbial changes have been implicated in the pathogenesis of IBD.

Dr. Devkota is a gut microbiome researcher who has been studying the effect of diet on the gut microbiome and inflammatory diseases for the past 12 years. She is the Director of Microbiome Research at Cedars-Sinai Medical Center in Los Angeles and assistant professor at UCLA. She serves on several national microbiome initiatives including the American Gastroenterological Association’s Center for Gut Microbiome Research and Education, as well as the Human Gut Cell Atlas, and has recently spoken on expert panels at the Nobel Prize Dialogues in Berlin and Tokyo. She is a Branco Weiss fellow, and former Lindau Nobel fellow. Dr. Devkota earned her Ph.D from The University of Chicago, and did her post-doctoral training at Harvard Medical School.

Dr. Devkota and I discuss:

• how diet has changed our gut microbiome since moving to a Westernized diet
• are microbes involved in the development of inflammatory bowel disease (IBD)
• populations at risk of inflammatory bowel disease
• how diet may play a role in the prevention or management of IBD
• environmental influences on the gut microbiota + the development of IBD
• how fat influences changes in the microbiome and subsequent development of IBD
• how diets and bile acids influence your gut microbiome and may be implicated in IBD
• microbial extinction – speculations and disease development through the generations
• where is the research going to prevent negative changes in the gut microbiome
• Pre, pro and post biotics
• future research (we could touch on whatever you like, diet, FMT, etc.) 
• Suzanne’s experience of intermittent fasting  & how it may impact the microbiome

Want to learn more from Dr. Suzanne Devkota? Follow her on Instagram!

Food made in a lab using microbes? It's happening now! New tech can be scary and none of us are immune to being mislead or adopting a belief based on misinformation. 

In this episode Chana Davis, PhD and I discuss new and exciting food technology using microbes, and how improving scientific literacy can help to shape the conversation around food technology!

We talk about:

• How Chana got involved in science communication
• What is a critical thinking mindset? How do you get one?
• How to find credible sources of information?
• What are the limitations of science?
• Why science isn’t perfect
• How can we ‘pressure test’ the news?
• What is ‘food tech’?
• How do microbes help us in making food and food ingredients?
• What’s the future of our food?
• Plant based diets and the movement towards new food technology for sustainability and increasing options for different dietary patterns
• Why food technology isn’t something to be afraid of
• Molecular diagnostics – what is it?

To learn more about Chana, here are her social links!

Website & Newsletter: https://fueledbyscience.com/

Social: Instagram, Twitter, Facebook (@fueledbyscience)

Get Real Health Podcast & YouTube

Dr. Ali Rezaie is a gastroenterologist and epidemiologist out of Los Angeles California who practices in and researches irritable bowel syndrome, motility disorders in patients with inflammatory bowel disease and does population-based data analysis. He runs the Rezaie Lab out of Cedars Sinai and has published over 60 research articles in peer-reviewed journals including Gastroenterology, American Journal of Gastroenterology, Digestive Diseases and Sciences and Canadian Journal of Gastroenterology. His works have been cited more than 4,000 times by other scientific journals. Dr. Rezaie serves as the associate editor of the Journal of Digestive Disease and Sciences. He also trained in my home province in both Calgary and Edmonton where I’ve worked – so I feel like we’re connected in that way!  

Dr. Ali Rezaie and I discuss:

• What is SIBO?
• The most common causes of SIBO
• Phases of digestion
• What tests are evidence-based for SIBO?
• What are the benefits and limitations of small bowel cultures versus hydrogen and methane breath testing
• How is SIBO diagnosed
• Where science is going to diagnose SIBO
• Is stool testing an appropriate test for SIBO?
• How do you respond when someone says ‘SIBO isn’t a real diagnosis’
• What are some current challenges with SIBO diagnosis and what research is needed?
• Why we need biomarkers for subtypes of IBS
• Current therapies to treat SIBO
• How should someone struggling with digestive issues who maybe think they have SIBO get started

Stay up to date on his work on Twitter @AliRezaieMD or through The Rezaie Research Lab.

Today I interview Dr. Kumkum Sarkar Patel on gut motility in functional gut disorders, what normal motility is, and how and why this changes in pregnancy.

Dr. Patel explains:

• what gut motility is
• what the timing for normal motility is
• types of tests to diagnose motility disorders & dysfunction
• reasons why gut motility changes
• self management of gut motility issues and why a diagnosis is so important
• why do disturbances in motility occur IBS and other functional gut disorders
• how does pregnancy influence motility in the gut
• common gut symptoms in pregnancy
• what to do during and after pregnancy to manage digestive symptoms
• the overlap between pregnancy and an IBS diagnosis

You can follow Dr. Patel on Instagram @dr.gut_motility

In this episode of Let's Gut Real, I interview Colin Hill Ph.D on how our microbiome develops, the role it plays in our health, current research limitations and mistakes we make when looking at the gut microbiome, and things we can get excited about for future research. 

Colin Hill has a Ph.D in molecular microbiology and is Professor of Microbiology at University College Cork, Ireland. His main interests are in infectious disease, particularly in the role of the gut microbiome in protecting against microbial infections. He is also a Principal Investigator in APC Microbiome Ireland in Cork, a large Science Foundation Ireland supported research centre working with industry devoted to the study of the role of the gut microbiota in health and disease.  In 2005 Prof. Hill was awarded a Doctor of Science by the National University of Ireland in recognition of his contributions to research. In 2009 he was elected to the Royal Irish Academy and in 2010 he received the Metchnikoff Prize in Microbiology and was elected to the American Academy of Microbiology.  More than 75 students have done their PhD’s in his laboratory.  He has published more than 550 papers and holds 25 patents.

We talk about

• The evolution of humans and microbes
• Why you ‘get the microbiome you deserve’
• How will we define a healthy microbiome, what are the limitations?
• Thoughts on commercial kits – can we really interpret them in individual care?
• Getting back to what Mother Nature has given us as a form of drug therapy by way of using microbes and microbial chemicals to treat disease

To learn more about Colin Hill, see his research at University College Cork or follow him on Twitter

With diets like keto and carnivore gaining traction, I've had many people ask - what impact do plants specifically have on our microbiome and human health? 

Today I interview Dr. Veronique Braesco, Dr. Petra Louis, and Dr. Ian Rowland, researchers that have contributed to the latest scientific update summarizing the impact of plant-based diets on the gut microbiome and published through the Alpro Foundation.

The Alpro Foundation has been a scientific platform for over 25 years dedicated to supporting research and the dissemination of evidence-based knowledge on plant-based nutrition and its impact on health and environment amongst academics, healthcare professionals and key stakeholders in nutrition. The ultimate aim is to help drive the transition to more healthful plant-based diets for human and planetary health.

Underpinning Alpro Foundation’s scientific integrity is an independent Scientific Advisory Board of 8 leading academic experts who provide direction and advice and ensure the scientific credibility of the education tools. Professor Ian Rowland is the chair of this Scientific Advisory Board.

Professor Ian Rowland is editor-in-chief of the European Journal of Nutrition. Until his recent retirement, he was the Hugh Sinclair Professor of Human Nutrition at University of Reading. He holds a BSc and PhD in microbiology from University College London. Prof. Rowland’s main research area is the role of diet (in particular probiotics, prebiotics, phytoestrogens, and phytochemicals) in the prevention of colon, breast and prostate cancer. In his current research, he is investigating the role of fruit and vegetable intake on markers of cancer risk. In 2005 he was awarded an honorary doctorate from the University of Gent in Belgium for his work on nutrition and cancer. Professor Rowland has published over 300 papers.

Petra Louis is a molecular microbiologist with an interest in the human gut microbiome, diet and health. She obtained her Diploma in Biology and PhD in Microbiology from the University of Bonn, Germany, where she conducted research on osmoadaptation in halophilic bacteria.

Véronique Braesco holds a PhD in human nutrition. Her academic carrier in Public Research at INRA, as senior scientist, has been focused on vitamins. She then headed the Nutrition Research Department of the Danone Group. In this position, she managed the design and implementation of scientific strategies, in particular in the field of probiotics. She was later responsible for the Human Nutrition Research Centre in Auvergne, dedicated to studying the role of diet in healthy aging. She is now at the head of VAB-nutrition, a consulting firm specialized in human nutrition that she created in 2007.

We talk about:

The most recent Scientific update with the Alpro Foundation is about the 'Interaction of Plant-based diets and gut microbiota'

Our diet, the balance of our gut microbiome, and fibre intake can have significant impacts on our digestive health and disease outcomes. This week I interview Dr. Genelle Healey on the use of exclusive enteral nutrition (EEN) treatment for IBD patients.

Dr Genelle Healey undertook her PhD in Nutritional Science at Massey University in New Zealand. Her research looked at what influence habitual dietary fibre intake has on gut microbiota response to a prebiotic (fibre) intervention. Prior to commencing her PhD, Genelle worked as a New Zealand registered Dietitian caring for patients with various diseases including gastrointestinal cancer, inflammatory bowel disease (IBD), renal disease and diabetes.

In 2017, Genelle moved to Vancouver to start a postdoctoral fellowship at University of British Columbia. The focus of her research is to better understand the impact nutrition, particularly fibre, has on the gut microbiome and disease outcomes for patients with IBD. During her postdoctoral fellowship she utilized models of IBD to investigate the therapeutic potential of novel nutritional interventions with the hope that these therapies can one day be used to positively impact the health and wellbeing of patients with IBD. Specifically, she has demonstrated that exclusive enteral nutrition (EEN) enriched with fibre leads to beneficial changes in the gut microbiome, less inflammation and better disease outcomes compared to EEN without fibre.

We talk about:

• How Healey became interested in the field of digestive health
• What IBD is
• How diet plays a role in the management of IBD
• Some prescriptive diets that could put a patient into remission.
• The role of ‘enteral nutrition’ in IBD
• The difference between PEN and EEN
• The mechanism of action in which we believe PEN/EEN can induce remission in IBD patients
• How the gut microbiome is involved
• The formulas used in IBD management and their ingredients, including emulsifiers
• The overall complexity of IBD

Connect with Dr. Healey on her researchgate profile or on Twitter

Andrea Hardy, RD introduces you to her new podcast, Let's Gut Real.

She touches on how the podcast started, and focuses on the basics of understanding YOUR gut microbiota, and how to take care of it.

She Discusses:

• what is the gut microbiota?
• what are the components of the gut microbiota?
• "test your gut microbiota quiz"
• what does the gut microbiota do for us?
• how are disease and the gut microbiota related?
• can we harness the power of the gut microbiota to prevent or treat disease?
• what things help or hinder our gut microbiota?
• how do you take care of your gut microbiota - what is evidence based and what isn't
• 3 easy tips to take care of your gut microbiota

Resources

Andrea's TedX Talk - Quit Killing Human Connection with Science - How to Make Patient Care Meaningful

Work with a gut health dietitian or learn more on our blog at www.ignitenutrition.ca 

Learn more about Andrea at www.andreahardyrd.com 

Joanna and I talk about how food chemical sensitivity often presents like IBS but is unresolved with typical IBS interventions. In addition, these patients also have extra-intestinal symptoms. We discuss salicylates, glutamates, and amines as well as other sources of food chemicals, and gaps in the current literature around food chemical sensitivity.

Joanna Baker is an accredited practicing dietitian and registered nurse from Victoria, Australia. Her passion is to help others eat well, be well and feel great, without giving up the foods that they love. She founded a private practice called Every Day nutrition in 2013.

Due to her medical background, Joanna is particularly adept at managing complex medical conditions like diabetes and heart disease alongside gut health issues

Joanna has also suffered with Irritable Bowel Syndrome (IBS) and food intolerance her entire life. She knows first-hand what it’s like to live with unpredictable gut upsets and dietary restrictions. At Everyday Nutrition, she aims to help people to pinpoint their food triggers, enabling them to identify what foods they can enjoy while keeping their gut happy at the same time.

We discuss:

• What is food chemical sensitivity & how does it differ from IBS?
• What are symptoms of a food chemical sensitivity
• When would you consider food chemical sensitivity instead of IBS?
• What we think happens in patients who have a food chemical sensitivity to cause symptoms?
• What is a low food chemical diet?
• Food sources of salicylates, glutamates, amines and other food chemicals
• What are current limitations in the research with food chemical sensitivity and where should research go?
• Where can people find information on food chemical sensitivity?

Follow Joanna at www.everydaynutrition.com or on Facebook or Instagram.

We discuss how the psychosocial approach to patient care, which looks at both the psychological and social aspects of a patient’s life, impacts a patient’s symptoms and overall quality of life.

This week I interview Johannah Ruddy on the psychosocial approach to IBS treatment.

Johannah Ruddy is a national expert, researcher, and writer on teaching communications skills to patients and providers and currently serves as the Executive Director of the Rome Foundation. She has 22 years of executive leadership experience working with a variety of non-profit organizations nationwide and a strong background in writing for patients as well as a speaker at GI practices, medical centers, and conferences in the area of provider communication and patient advocacy.                                                                                                  

Her new book, co-authored with Dr. Drossman, Gut Feelings- Disorders of Gut-Brain Interactions, A Guide for Patients and Doctors is now available on Amazon.

She holds a Bachelor of science degree from the University of New Mexico in Political Science, a Masters of Education from New Mexico Highlands University and is a doctoral student at Campbell University. She lives in Wake Forest, North Carolina with her husband of 21 years and their two sons.

We talk about:

• How Johannah became interested in IBS
• Johannah’s own experience with IBS
• Johannah’s work as a patient advocate & her current work in disorders of the gut-brain interaction
• Frustrations for patients diagnosed with IBS
• How to better communicate IBS symptoms with doctors
• How clinicians can diagnose and treat IBS and other digestive disorders
• How health care providers can properly communicate with patients who have disorders of the gut-brain interaction
• Why patient centered care matters and how it can benefit both the doctor and the patient
• What IBS patients wish they knew about their diagnosis and the journey?

• The relationship between functional diseases and associated stigma

• The stigma with IBS? How does disorders of the gut-brain interaction research change that? 

• Role of stigma in the patient’s acceptance of an IBS diagnosis and their quality of life

Connect with Johannah on Instagram @johannahruddy on Twitter @JohannahRuddy or on LinkedIn. You can find her book: Gut Feelings- Disorders of Gut-Brain Interactions, A Guide for Patients and Doctors which is now available on Amazon: https://romedross.video/GutFeelingsWebsite

Dr. Heather Finley is a Registered Dietitian nutritionist specializing in functional and integrative approaches to reduce gastrointestinal symptoms and mood issues by addressing the root cause and addressing nutritional, lifestyle and stress related factors. Heather created her in-person and virtual nutrition practice, Nourish Functional Health to provide personalized nutrition and wellness solutions using cutting edge science alongside evidence based medical nutrition therapy. Heather niched down to gastrointestinal issues due to her own journey with GI issues and anxiety that for years was confusing and frustrating. Heather turned one of her biggest struggles into her passion and has helped hundreds of individuals find relief from gastrointestinal issues and live their best lives symptom free with her integrative and personalized approach. Heather lives in Coppell, TX with her husband Dave and daughter Charlotte. 

We talk about:

• How nutrition isn’t the ONLY thing that influences gut issues
• How sleep effects gut health
• How people can improve their sleep for digestive health
• How the gut and the brain are connected, and how it ties to mood
• How gut health effects mood
• Nutrition Myths: Can nutrition ‘treat’ anxiety? Can probiotics treat anxiety?
• How a rigid, restricted diet can do more damage than good
• How food fears can precipitate gut symptoms
• Gut-brain reactions – and how to relax those stressful reactions

To learn more about Heather’s work, you can follow her on Instagram @gutbrain.nutrition, learn more about her counselling services and online course!

The amount of stigma there is around non-structural disease (like IBS) has a fair amount of history - dating all the way back to the 17th century!

Dr. Drossman has led the field pioneering the Rome Foundation, and how we not only diagnose and treat disorders of the gut brain interaction (formally known as functional gut disorders), but more importantly, how we treat patients. 

Dr. Drossman received his M.D. degree at Albert Einstein College of Medicine and subspecialized in biopsychosocial medicine and Gastroenterology. He received his gastroenterology training at the University of North Carolina where he founded the UNC for Functional GI and Motility Disorders.  Currently he is Professor Emeritus of Medicine and Psychiatry in Gastroenterology at UNC. He is a Fellow of the American College of Physicians, a Master of the American College of Gastroenterology, Past-President of the American Psychosomatic Society (1997) and Founder and President of the Rome Foundation for 29 years. In addition, he founded the Drossman Center for the Education and Practice of Biopsychosocial Care as an entity to help train physicians in relationship-centered biopsychosocial care with an emphasis on communication skills and enhancing the patient-doctor relationship.

Dr. Drossman and I talk about:

• Dr. Drossman’s background and how he became involved in neurogastroenterology
• why did we shift from ‘functional gut disorders’ to ‘disorders of the gut-brain interaction’ and why is this important?
• what is ‘mind body dualism’ and how has it influenced medicine and patient care?
• how has the field of neurogastroenterology evolved?
• how does this shift in approach help us to provide better care and interventions for patients & improving the patient doctor relationship?
• what types of therapies are evidence-based to help treat DGBI’s
• Dr. Drossman’s tips for health care providers improve relationships with their patients to provide good quality care

You can learn more about Dr. Drossman and pick up a copy of his amazing new book, ‘Gut Feelings- Disorders of the Gut Brain Interaction and the Patient-Doctor Relationship 

Diary is a highly debated food. Does it contain hormones? Does it cause inflammation? This week I interview RD Lauren Twigge on how dairy is shaped by media perception and what the research shows.

Lauren Twigge is a Dallas based registered and licensed Dietitian with a Master’s degree in Clinical Nutrition and a bachelor’s degree in Animal Science. She works in corporate wellness and counsels private clients by day and runs her growing Instagram account by night. Lauren was born and raised in a family of farmers located in central California and is an outspoken supporter of the agricultural industry. Growing up on a dairy and being raised around farming her whole life has given Lauren a unique perspective on food and her passion is to work at the crux of agriculture and human nutrition to fight misinformation and give consumers back their food confidence.

We talk about:

• How Lauren became interested in the field of dietetics
• Where the fear of dairy comes from
• Misinformation around agriculture
• The difference between a dairy intolerance vs allergy
• Why do we consume dairy / is it good for us?
• Does dairy cause inflammation?
• Does dairy cause autoimmune conditions like IBD?
• Do the hormones in dairy affect my hormones?
• Does the type of milk I choose matter? (organic, non-GMO, grass fed, etc.)
• The safety and nutrition of different types of milk on the market
• Organic vs. conventional dairy
• Are there antibiotics in milk?

Connect with Lauren on Instagram @nutrition.at.its.roots or on her website laurentwiggenutrition.com

Long-COVID is defined by The National Health Service as having symptoms that develop during or after a COVID infection which continue for more than 12 weeks. This week I interview Marlee Coldwell, RD on how long COVID presents and ways that it can be managed in our patients.

Marlee has been working with patients who have complex digestive health issues and food intolerances for the past 5 years. Marlee specializes in providing nutritional support for digestive disorders including IBS, IBD, SIBO, fatty liver disease, and much more. Marlee is the team lead dietitian for Ignite Nutrition, one of Canada’s top digestive health nutrition practices. With her specialized knowledge of gastrointestinal health, she also helps to train and support other dietitians to work with those who have unique and complex food intolerances and GI disorders. 

In 2019, Marlee also wrote a cookbook called ‘Insulin Resistance Diet for Beginners’, which showcases her other great passion, women’s health and PCOS management.

We talk about:

·      What long COVID is

·      How many people experience it

·      What the symptoms are

·      How we see it influencing our IBS patients and how nutrition can help

·      The influence of COVID on the GI tract

·      The taste and smell changes, how they influence people’s nutrition, and if there is anything to help

·      The inflammatory immune-mediated symptoms like rashes, brain fog, joint pain, chronic fatigue, gut pain, and diarrhea

·      Why people have been curious about a low histamine diet when it comes to long COVID

·      The overlap between MCAS and long covid, and why people are being managed like MCAS patients

·      If using a MCAS approach can ´fix´ long COVID

Connect with Coldwell on at ignitenutrition.ca on Instagram here @ignite.nutrition.inc

Non-alcoholic fatty liver disease (NAFLD) is a chronic disease where fat accumulates in the liver, and can progress to inflammation (non-alcoholic steatohepatitis or NASH), and hardening of the liver (cirrhosis). It is a silent disease, often completely symptomless, however, trying to catch it early is important due to its progressive nature.

This week I interview RD Neha Shah on what NAFLD is, how it may be reversed and the overlap between gut issues and NAFLD.

Neha has been specializing in gastroenterology and hepatology for the past 16 years. She initially began her career as an inpatient dietitian at Stanford Health Care, counseling patients by bedside recovering from gastrointestinal surgery. She later came into the Digestive Health Center there to inaugurate and build Nutrition Services for all programs within the GI and Liver Clinics. She is now at UCSF, specializing in GI, IBD, and intestinal rehabilitation. Neha also owns a GI and liver nutrition private practice, Neha Shah Nutrition, with the intent to bring specialized GI and liver nutrition care to the community. 

In addition to patient care, Neha has authored over 20 articles in reputable journals related to GI nutrition. She is co-founder and is Director of Operations of the international South Asian IBD Alliance and is a member of the Crohn's and Colitis Medical Advisory Committee of Northern California. Her goal is to continue to be involved with GI initiatives to advance nutrition care to improve outcomes. 

We talk about:

• How she got involved as a dietitian in gastroenterology
• What NAFLD is
• How NAFLD develops and how prevalent NAFLD is
• What some of the risk factors are for developing NAFLD
• What the standard treatment is for NAFLD 
• What the gut-liver axis is and how it relates to NAFLD
• If probiotics or prebiotics play a role in NAFLD management 
• Why NAFLD often overlaps with other gut conditions - and how to manage both at the same time

Connect with Shah on her website at www.nehanutrition.com on Instagram @Nehagastrord or on her Twitter here as well!

Simone Withecomb is a clinical research coordinator in GI currently working on the IMAGINE study – which is looking at the interactions between the inflammation, microbiome, diet and mental health in patients with inflammatory bowel disease (IBD) and irritable bowel syndrome (IBS). Through her personal struggles with IBS, she became passionate about how she could help patients who are diagnosed with gut disorders.

• Hear her story about her IBS journey, and how she joined the IMAGINE study (Inflammation, Microbiome, and Alimentation: Gastro-Intestinal and Neuropsychiatric Effects)
• How she uses story telling & sharing supports patients with digestive disorders
• What the IMAGINE study is
• Why this research is important to discover all the different factors that influence IBS & IBD symptoms and quality of life
• How patients are getting involved in the IMAGINE study
• How their study is looking at diet, probiotics & treatment options for IBS & IBD
• The microbiota-gut-brain axis – the link between depression & the gut microbiota
• Mental health and the gut microbiota – how fibre plays a role
• Do you have IBS or IBD and live in Canada? You can participate in the IMAGINE study! Get involved in the IMAGINE study at – imaginespor.com – there’s over 20 sites across Canada!

Kristina Campbell, a science and medical writer from Victoria, Canada, is co-author of Gut Microbiota: Interactive Effects on Nutrition and Health, and author of The Well-Fed Microbiome Cookbook. She covers the field of microbiome science and gut health, aiming to cut through the hype. Her work has appeared in online and print media throughout Europe and North America, and she currently holds the position of contributing editor at Microbiome Times.

Kristina and I discuss:

• The difference between gut microbiome and gut microbiota
• What do you think is the single most important thing people can do to take care of the gut microbiota?
• How does nutrition impact the gut microbiota?
• Kristina’s cookbook
• Clues as to what fibre does in the gut microbiota and how to feed them
• What are the things the media gets wrong about the gut microbiota?
• Why the term ‘healthy gut microbiota’ needs to be used with caution
• What can people look forward to in terms of science trends around the gut microbiota in 2020?
• Drug development aspects of probiotics
• Next-generation probiotics – probiotics harvested from the human gut that are used as a regulated prescription drug
• Live bugs as medicines – how this will change the prescription drug landscape & nutrition landscape
• Diet + drug (probiotic) combinations to treat health conditions
• What should people be cautious of in the gut microbiota space (fecal microbiota transplant, gut microbiota testing)
• How to keep up-to-date on gut microbiota interventions

Stay up to date on her work by signing up for her newsletter at bykriscampbell.com or follow her on Twitter @bykriscampbell

IBS doesn't just effect the child, but the whole family. Diet is one tool to help manage this condition in kids, and many times we see the Low FODMAP diet as a first line approach. But should we be using the Low FODMAP diet in kids?

Julia Celestini, RD and I discuss how and when to properly use the Low FODMAP diet in paediatrics.

Julia is a Registered Dietitian in Ontario, Canada. Julia completed her dietetic training at SickKids hospital in Toronto, Ontario in 2019. SickKids hospital is one of the largest pediatric centres in Canada and uniquely offers a pediatric-focused dietetic internship. Julia is also trained in the low FODMAP diet for irritable bowel syndrome (IBS) through Monash University. Following her internship Julia started her own private practice combing her 2 greatest passions - pediatric nutrition and digestive health. She provides family-centred care to infants, children and teenagers with complex gastrointestinal conditions across (most of) the country. She supports her patients in their journey to finding symptom relief and developing a positive relationship with food.

Julia and I discuss:

• IBS in kids – what is the prevalence and impact
• What is a FODMAP & the low FODMAP diet?
• Is the low FODMAP diet appropriate in kids?
• What to consider before the low FODMAP diet in kids?
• How to implement the low FODMAP diet for kids?
• Can we use a modified low FODMAP diet in kids with success?
• What other non-food things can we do to manage IBS in kids without using the low FODMAP diet?
• How can practitioners talk about digestive symptoms with kids & teens?
• Where are kids getting nutrition information from?
• Why is helping children develop a healthy relationship with food in gut disorders important?

Connect with Julia at https://juliacelestini.com or on Instagram @happybelliesnutrition. You can join Julia's Low FODMAP for Kids Facebook Group here as well!