395: Nurturing Your Gut: The Key to Holistic Health | Dr. Pritesh Mutha

Maya Acosta  00:00

Dr. Pritesh mootai is a board certified physician in internal medicine and gastroenterology with advanced training in interventional Gastroenterology and endoscopy. He is an associate professor at UT Health Houston and has published several peer reviewed publications and top medical journals. In this session Dr. Muto will discuss the role of plants in a healthier gut microbiome, and how that translates to better gut health and better overall health. Let's listen in.

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Thank you, thank you for that kind introduction. And thank you Dr. Charla for, you know, organizing this and opportunity to talk to you all about whole food plant based diet was a perfect platform for me to talk about gut, we learned about overall health. Then we talked about mindfulness, mental health, and then Dr. Ami talk about oral microbiome. So now we move on to the gut. The next step after us the digestion begins in your mouth, we had a healthy meal. And let's see what that meal does in your gut, or, and so we'll go over and talk about that. Now, before we start just a quick question. I'll go over what are the points we're going to do? And then we'll go over a quick question. So we'll go over some of the cases that I've had just for you to understand the different kinds of patients that feel better after changing their gut microbiome, and then we'll understand what is gut microbiome interaction between gut microbiome and gut wall factors that cause unhealthy gut? And how can we improve our gut health? So we will go in stepwise fashion and understand that. So first of all, what is the root cause of more than 80% of illness and health in your body? So one thing is brain? Heart, anybody thinks heart is the cause? Lungs? Gut? All right, okay. No bias whatsoever. All right. So let's do some of the case studies that some of my patients who are suffering from different kinds of illnesses and how do they improve their health after they change their gut microbiome, their gut health by working on the diet and lifestyle. So I had this patient 39 year old female with Crohn's disease, Crohn's disease, inflammation of your small bowel, she was suffering from it for a years, they were giving her immunomodulators suppressing her immunity, they were gonna go up higher on the dose before and right around that time she reached out to me that I'm miserable. I'm taking these medications. What can we do the work with her. Three months later, she was symptoms free and disease free. Now they're even questioning if she ever had Crohn's after treating her for years doing her multiple when they're like probably she didn't have it. Of course she did. 45 year old female with chronic abdominal pain, tried every single possible treatment she can think of everything was done, very expensive test, everything was done. Eventually, she reached out to me, worked on her diet 90% improvement. She was like I used to be curled up in the bed all the time. Now no pain at all. 36 year old me with chronic allergies. Talked about it. Allergic rhinitis, runny nose for more than 20 years, we changed the diet. 12 months later, all the medicines had expired. No symptoms hardly ever a couple of times a year, maybe off of all the medications. And we can talk about it how that happens. But and 39 year old male with new onset diabetes, high cholesterol. Six weeks later, no diabetes, no high cholesterol off of medication. And that's probably the easiest thing to do fix her diabetes and high blood, high blood pressure, cholesterol, the easiest thing to do of all the things. All right, so what is gut microbiome? I talked about it a couple of times. gut microbiome. Gut means of course, our GI tract microbiome, as Dr. Riz mentioned, we get a lot of press about it. And we've heard about it in press. So this is the gut and your colon large intestine has about 100 trillion bacteria. That's, that's the gut microbiome. So micro organisms in our gut is called microbiota, our microbiome just for easier understanding. There are about 100 trillion bacteria. They're not just bacteria, there are fungi, viruses, everything is sitting in our cooler. As we go from mouth all the way down to your colon the number of microorganisms keeps on rising. And by the time we reach our colon, there are 100 trillion of them. There are more than 3000 Different species, lots and lots of different species. But when you when you boil it down, there are 30 to 40 Major and you further boil it down and you realize there are two major categories, Prevotella species and bacteroides species and And Prevotella is the good one. And the other one is bad one, of course. So we have to just figure out which one's the right one for you. And how we can increase that one. The number of cells in our body are about 30 trillion 30 trillion, but the bacteria are more than three times our number of cells. So many times you say, it's the genetics that we have that's causing the problem, or it runs in my family, my father had my grandfather, my grandma, but it's not your genes, the genes of these bacteria, because our genetic material is 1%. And or maybe 10%, at most, more than 90% of genes in our body is from these bacteria. How is that important? We're going to learn about that very soon. So these bacteria are actually playing a huge role in our body. That's why whenever we think of genetic problem, it's not really, there's very small fraction where you truly have these dominant genes coming from your parents. But more than 90% of the time, it's not just your genes is the genes that you have in your bacteria and what kind of bacteria you carry. So, interaction between gut microbiome and gut wall, let's try and understand what these genes and what these bacteria do. So healthy gut microbiome equal to healthy gut. Every gene produces a chemical, or it activates certain do certain, you know, enzymes processes, and create certain enzymes. And these enzymes work with our body to give good or bad effects. So they help in digestion. They break down complex starches, which previously we thought, oh, they were fiber is good for, you know, just roughage to help you move your bowels, but it wasn't just that we don't digest it. But these bacteria do these bacteria in our colon, the starches go down to your colon, large intestine, and these bacteria will digest the food that you're eating to produce something called as short chain fatty acids. Now, short chain fatty acids, they're the most powerful tool for your body. This is the nutrition. These are the sources. Now butyric acid, there are three types of short chain fatty acids butyric acid, or butyrate. That's the source of colonic cells, nutrition. So large intestine cells, the inner lining of the large intestine, thrives on this lives on this, if you don't give it is going to be malnourished, gonna get inflamed, you're gonna end up with all sorts of problems. Ulcerative Colitis, being the worst of all. Acetic acid gives you cells to your muscle. That's and the third one is propionic acid or propionate gives you it helps in production of ATP, the energy in your liver. But not just that. There is something I mentioned here GLP one agonist Have you guys heard of that? GLP? One agonist No, let me ask you something, as Have you guys heard of ozempic. Of course, we go, we, of course, people celebrate, I got approved for we go we as a big my insurance is going to cover it. You don't need that $1,000 medication per month, which is going to give you a ton of side effects. And then you're going to come see me because I have gastroparesis. Now, I need to do procedure on you, you don't need that just have fiber, and guess what is gonna produce propionic acid is gonna do the exact same thing, but in a better way, without giving you any side effects. So super cheap, it's for free, you can do it every single day. You don't need it. And it does many other things. But I'm just highlighting the major ones. Otherwise, we'll be talking about short chain fatty acids for an hour. So chemicals they produce, they're important in metabolism. Now, this is a little bit technical, there are the liver produces bile acids, and our gut breaks it down into secondary bile acids, which are very important for digestion. So that's done by these bacteria. They play an important role in your health or disease. If you have disease, then we start thinking of maybe bile acids are a problem, we need to change the composition. They synthesize vitamin B, vitamin K biotin, folate, these bacteria do. But what we do is we kill these bacteria by taking tons of antibiotics and all sorts of other stuffs. They not only these good bacteria not only help you in all these things, but they inhibit bad bacteria directly regulate your immune system. They protect against infection 70% of our immune system is located in our gut 70% of our immune cells, you can imagine that we never even think about it, like go improve your immune system, but how we never even thought about it. It's all located in your GI tract. I'll talk briefly about it later on. And it's regulated by the gut microbiome. So if you have autoimmune disease, where's the problem? It's the gut. It's the gut. If you have autoimmune disease of brain, it's still the gut

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or just a little But how brain is connected to our gut, it's a little little scientific slide, but it still walk you through. So maybe this will be better. So you see all kinds of food that we eat arrows and so on the left side, there is all the foods that we eat, then our digestive enzymes in our stomach, they will break it down and produce these natural bioactive compounds, they will interact with the bacteria that are located, you know, gut. Now, that intestinal epithelium that's, that's our inner lining of our gut, and right on top there is mucous layer, that's the protective layer. So it will interact with the mucous layer, then interact with your gut wall, get absorbed, that cell on the left side is the nerve cell that goes to and connect talks to your brain. So that is, will get recognized the pattern and send signals to your brain cross the blood brain barrier. So everything that you eat is either giving you pleasure, or pain, it's not the movies, it's not the vacations. It's all happening here. It's all happening here. So all the happy hormone and optimistic hormone and this and that everything is coming from here. So these are all the names and there's many more, but the whole point is, it's all happening here. Second brain is your gut, and it works on what you eat based on what you eat. Of course, there are other factors, but this very important factor. This these are the good ones produced by good gut bacteria by breaking down healthy foods. All right, so going a little bit slower, so I need to so these gut bacteria the good chemicals will help you digest they'll keep you lean, improve your immunity, improve your response to medicines, I don't recommend taking medicines, I generally take people off of medications, D Prescription like Dr. Clapper talked about and to heal your entire body but bad bacteria will give you poor digestion, obesity, impaired immunity, impaired response to medicines and inflammation in your entire body. So you're not just what you eat you are you You are what you eat, but you are more than your bacteria what they eat. That's what who you are. So you are what you and what they eat. We always think I'm what I eat, but it's not just me, it's the bacteria, what do you feed them? We say what are the plant you want to grow, we'll feed the bacteria that you want to grow and good bacteria will be grown by fiber. So interaction between just quickly interaction between gut microbiota and immune system is a little complex, intimidating, but look on the left side symbol. So this is the gut wall. The green layer is the protective mucus. The top green rods are the bacteria. So bacteria, there's mucus then there is intestinal epithelium and inside. So there is protective anti anti antibiotics produced by bacteria, there is antibodies produced by gut wall, deserts in harmony in symbiosis. But when we mess it up, then what happens that protective layer is destroyed, bad bacteria gets access to the gut wall, those little black lines that you see those are any bit tight junctions. Now they're loose, there are no tight junctions now everything is has access to your gut wall. And now you have autoimmune inflammatory response and you have autoimmune diseases. So bad bacteria has access because we destroyed the gut wall by producing more and more bacteria. It's the same slide. healthy gut villi versus damaged leaky gut based on what we eat and what we do to our gut immune system. Alright, so effects, some people eat less and gain more weight, and some eat so much and don't gain weight. Well, they realized that they took stool from obese patient, put it in germ free mice, the mice that does not have bacteria, and the bias became obese, whereas they put stool from lean person put it in the same mice. And that still leaves same food, but one became obese, one stayed lean, because of the food that we give them. Also do colitis, patients got better after stool transplant and depressed patient got better happy after they got happy patients stool? Is that the solution? Well, it doesn't stay that way. Right. It's very dynamic. It will keep going back and forth. So what you eat constantly is what matters. So increased risk of irritable bowel syndrome, inflammatory bowel disease, immune disorders, cancers, reflux, constipation, all gi diseases, but not just that heart, diabetes, brain, liver, skin, mental illness, every single thing is affected everything. So what causes unhealthy gut bacteria? What is the most common deficiency in western world protein? Anybody for protein, vitamin D 12. Fiber fiber deficiency, less than 5% of Americans get the recommended daily dose of fiber. And as was mentioned earlier, animal products have Zero fiber, but they destroy your microbiome decreed bad bacteria. You've learned about that dairy products, eggs, meats, refined processed foods, chemicals, all of these are going to destroy your gut microbiome. Antibiotics, toxins in environment sleep pattern when it's poor lack of exercise stress matter of bird that's not under your control. But you can walk we these are the factors that affect breastfeed versus formula milk. So increases your inflammation risk to catch more than 80% of all the diseases. So how can we improve the gut health so we can improve gut health by fiber. Fiber is the key. That's the key. That's the bottom line. current recommendation is 25 grams for females, and 38 gram for meals. But ideally, you should consume more than 8200 grams, and different variety, different kinds of fiber, not just one type, must consume in Whole Foods, not the preservative laden, these fiber supplements, which has these potential carcinogens in them. Sometimes I have to start that on my patients to get them kick started. But truly, you don't shouldn't be consuming any supplements. Consume whole foods. Foods rich in fiber. You've learned that all day long, right? fruits, grains, legumes, vegetables, plus nuts and seeds. That's essentially the bottom line. You've heard this over and over, over and over. And y'all know this. We're preaching to the choir here. But still, these are the things you should not be consuming animal products, anything that is that has eyes, or has a mom, you shouldn't be consuming. Simple as that. Right? Our our, that came from soy dairy products, that's also something shouldn't consume. And then there is oil, sugar, refined processed food, flowers, all sorts of stuff. are so we're good on time. I thought we were okay. I ran through some of the slides. Any of the slides that you had questions about consensus about you want me to talk about a little more? So far? Everybody's good. Okay. Okay. All right. So whole food plant based diet, it should be coming from farm URL, it should not go to the factory, if if the food is going from farm to factory to table, you should not be consuming. It should go from farm to table. So it should straightaway come from farm to table. If it's going to factory and then coming to your your packaging and processing and opening those boxes. You know, there's a problem you shouldn't be consuming that. It's as simple as that. So how do you improve your gut microbiome? If I go? Fiber? All right, thrives on fiber, simple as that fiber, more than 40 grams per day, the goal should be at 200 grams. Some some say No, when I have fiber, what happens I get bloated? Well, anytime you start any D addiction process, you're gonna get have problems. Even alcoholics when they stop drinking alcohol, we have to hospitalized them. So our body hasn't seen fiber for so long, has seen all sorts of junk foods. So bad bacteria, of course, don't like it. So you have problems, just get through those two to three weeks, which are going to be tough, and you're going to be fine afterwards. So low fat Whole Foods, plant based diet, fruits, vegetables, legumes, whole grains, seeds, nuts, herbs, spices, and combination of all of these rainbow diet, as we talked about earlier, no processed foods, no chemicals, preservatives, emulsifiers. They directly destroy that protective layer inside your gut the mucus and give access free access to the stuff that we were never going to be exposed to. And once we get exposed, like celiac disease, how did that happen? There are some studies, nobody talks about it. Now I'm the Doctor, I'm gonna talk about it. There's this microbial transglutaminase, which is you will find in all these processed foods. Celiac disease is antibodies towards this transglutaminase enzyme. And what happens is when you eat processed foods, the protective layer is gone. Now that refined food has access to the gut wall, and gut wall produces all these antibodies against whatever it sees. It's looking at this microbial transglutaminase Oh, it's foreign body, let's go and attack. But then these antibodies start circulating your body and they're like, Wait, if similar looking protein here that must be foreign body. And guess what? It starts attacking your own transglutaminase and you ended up with celiac disease for a lifetime. So these processed foods and having all the other substances along with that without any fiber without any protective layer. Now you're going to get exposed to all sorts of badness, and it's going to result in all sorts of autoimmune diseases.

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So healthy gut microbiome besides the diet. The other thing that we talked about is exercise, sir Read in rhythm, like we have our own circadian rhythm bugs have their own circadian rhythm, it's pretty much the same. So that's why never to eat after six o'clock or seven o'clock, because you eat late in the night. Your bugs are active now you're disrupting their circadian rhythm, you're disrupting your circadian rhythm. So when sunsets you should stop eating. Now here, it's a little different stories and may start at eight 9pm. And you're like, Oh, I never. So don't do that. Even if sunsets at eight or 9pm, stop eating at 6pm 7pm. Stress Management, mindfulness, we heard great lectures about it earlier today. Healthy Relationships and volunteering. normal delivery where if you have an option, because I see a lot of people don't want to go through that process, and they voluntarily go for C section, don't do that. Breastfeeding, whenever it's possible, that's the best way that's going to help build the microbiome for the baby. Now one of the factors that we must not forget, we talked about being with nature, you know, that helps with stress, but it helps also helps replenish your gut microbiome. So playing outdoors, being in nature, being in woods hiking, so being out and about in environment, being with nature, will help replenish your bacteria. Now, of course, the soil should be rich, not laden with all sorts of pesticides and insecticides, that's gonna cause different problems. So in your yard, if you're putting tons of you know, weeding and feed and all kinds of pesticides, insecticides, and that's going to cause a problem. So don't use those things and go out in nature where this is not contaminated. It is essential in the evolution of human gut, since childhood, so always have your kids play in the outdoors is a major inoculant and provide a provider of beneficial gut micro organisms. It helps improve our diversity of our microbiome. Now, diversity is one big thing in microbiome world, oh, you should have diverse micro bacteria. But you can have diverse and all of those could be bad. So we don't want that we want good diversity. All right, and good diversity come from the things that we talked about. B 12 deficiency, or we think that animals produce beautiful, right? No, animals don't produce, it's the bacteria eat. But the thing is, people think if I consume animal products, I'm gonna get vitro. I see so many patients all day long, we're consuming all sorts of animal products, and still are deficient in vitro. Because now animals are also not out in the open. So they're also not getting their bacteria. And they're also not producing beautiful. We need to go out, be in the environment, replenish our microbiome, and the soil is going to produce beautiful. We focus so much on probiotics, we don't need probiotics. All we need is good food to grow. Let the lead that good bacteria grow. Remember, feed the good bacteria and it will grow. And you won't need to have additional probiotic, and risks associated with that. Everybody has unique signature, your microbiome is very unique to you compared to someone else, but you can improve to make it a good microbiome for you based on the diet. It improves your immune system, no doubt about that. And that's one of the factors that all these allergic reactions started going down. One of the big factors, of course, it also reduces your GERD and then you don't have any acid reflux that's triggering your mucosa. And then you have to produce extra mucus to sue them that heal that area. And then you end up with acid reflux, you end up with nasal issues, shortness of breath, all of that. But when you do all of this, you don't have that problem. It decreases your risk for inflammatory bowel disease, Crohn's disease, ulcerative colitis, you have 1000s of dollars of medication per month that we have to give them for the rest of their life. And we always think, oh, it's the autoimmune disease. It's not you change their diet, they're going to be fine. I have so many patients. I just give you an example of one in the beginning. But I have other patients too, for determined they want to make the changes, they make their change, their disease disappeared, comes under control. They're like, Oh, my mom came and she was like, No, you have to eat this protein. I went on this diet, my symptoms came back, of course, and then they switch their diet back and symptoms disappear. And initially your symptoms will go away. mucosal healing will take some more time, but it will happen. It takes your body will need sometimes three months, six months, 12 months to heal completely. So be patient with it. Sometimes you may feel things are getting worse, and that's okay. Your body's just detoxifying. It's gonna get better as the time progresses. Okay, so trust the process as long as you know the science behind it. So healthy gut microbiome, poor diet and lifestyle unhealthy and you change the diet and lifestyle healthy. It's a reversible process. So it's not like we are as I was mentioning earlier reduction in If we want to do one thing, one food, what's the best food? What's the best fruit was the best medicine? No, that's not how it works. It works in together, we are a complex creature, we need multiple different things, we need to maintain that. Okay, and just make it a lifestyle. So it's not something that you're doing. When you're doing a diet, when you're doing something, you have a certain goal that I'm going to stop after I get better. If I lose 20 pounds. That's a problem because you have a deadline, then you're going to fall back to your old ways. So don't worry about outcomes. Don't worry about specific nutrients, just do the right thing. And everything else will be taken care of your all your nutrients will be taken care of all your diseases will be taken care of, you're going to have weight loss, you don't have the set deadline, because the moment you have deadline, guess what, you're going to fall back, you're going to start cheating. And all your efforts are going to go are going to go in vain. So don't do that don't have these set deadlines just work on there. But the thing is, we start making exceptions, I do everything except just this much doesn't work, you have to be all or none here, you do these little exceptions. It's a slippery slope. Before you know it 50% of your stuff is happening. And you're like, No, I'm very careful. Well, you you count the calories and you realize I mean, you know all the Indians, we eat rice, and we put g on that everybody loves ghee. One bowl of rice is 125 calories, and you put one spoon of ghee, and that's 125 calories, all of a sudden 50% of your calories came from. It was just somebody who you're a guest, you're going somewhere we like to give more, right? We put two spoons. And now, two thirds of your calories are from that. So don't make exceptions. You make exceptions. And you've no idea where you went very reached and all of your efforts are totally gone in vain. So don't do that. So in summary, human gut microbiome plays a crucial role in more than 80% I dare say 95%, or even more diseases. human gut is the main seat of your immune system. It's the main thing, even in our VEDA, if some of you know or whether they have this shloka they talk about your immune system is located in your gut. And I was impressed. I was amazed when I heard that for the first time years ago. Most common nutrient deficiencies, fiber, not protein, you don't need that protein supplement. You don't need I've seen so many people are even taking, you know what happens to that excess protein turns into fat. And then you're like, I wonder I'm taking protein powder and still gaining weight and not losing weight? Well, you don't need that protein. Most consume fiber more than 40 grams. We should consumers consume about all animal products and processed food, exercise, sleep, stress management, avoid toxins, play outdoors, exposure to soil to replenish your microbiome. Thank you all. I'll go back to life.

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Content, we can take some questions Yes. How do you okay? Just being out in the nature. That's one of the ways going out hiking, you know, you're going to do lots of things. And before you know it, you're going to replenish your sources. If you're out there, you're going in the farm, you can go in organic farms, you can eat raw fruits and vegetables, they have some soil on it. And if you're kids, you can be barefoot and be playing in soil, literally, you can play any sport and that should be fine. What happens is we are so conscious we are washing our hands 15 times, not just washing washing is still okay, what we're gonna do, you know, put all that hand sanitizer, which itself is a carcinogen in there many times it has carcinogens in there, we use that and record that. So how are we gonna get good bacteria on our on our body on our replenisher stores? Plus get all these raw fruits and vegetables then we watched him like a million times. So we really don't we try excessively hard because we're all germophobes we think all germs are bad. The goal was for you to understand and for me to convey that not all germs are bad. We are surrounded by bacteria in our mouth. We were told 200 billion bacteria in our gut 100 trillion our skin, trillions and trillions of bacteria around us on us inside us. Not just bacteria, viruses as well. And all these infections we think of these are on us inside us all the time. It's when our immunity goes down. That's when we have infection. It's not because of the bacteria or the virus. We always have Oh, because they had this viral infection. I had the problem. That's not the case. That guy didn't do anything. It was your immunity. It was your immunity that wasn't ready to handle anything. So we need to boost our immune system by making sure we're strong enough so nothing bothers me. My wife and my husband we were living with a family they all had COVID Everybody, all three of us didn't have any any symptom, nothing. living under the same roof. And there are kids, the kids don't listen, they don't care. They don't cover up. We didn't have infection. The point is your immune system is the key. What do you why do you take vaccines, the thought process behind us we boost our immune system. So that even if you get exposed, we don't get infected, right? You don't need vaccines. You just need healthy gut. That's all. After taking your antibiotics, good idea to take a probiotic. So that's a debatable thing. What I do tell my patients is so question everybody understood the question. After you take antibiotics, is it a good idea to take a probiotic? Now with probiotic? Which one should you take? Is kefir good? Is lactobacillus good is, it's always a question, What I generally tell my patients is generally by the time they come to me, they already taken it, I'm gonna take it for six weeks. If it's not doing anything for you, you can stop when you are taking antibiotics absolutely are completely wiping off bad and good bacteria, so everything. So sometimes it might be a good a good idea to take it, especially those who have really bad diarrhea because of the antibiotics. So they take VSL number three, or any lactobacillus, and they will start feeling good. It's okay, you can take for a few days. But don't keep on taking it for months and months and months. You don't need it. Don't focus on probiotics focus on prebiotics. And what is a prebiotic fiber? Is this different word for fiber? It's all about fiber, different kinds of fiber, not just one, though. You may have better answer than that.

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What does that look like? You don't have to count. Just change the diet and you'll get all of it. That's the whole point is you just change the diet and you're gonna get more than plenty. And your body is very smart will tell you when it's hungry, will tell you how much it needs. Just make sure everything fruits, veggies, nuts, bean seeds, whole grains, herbs, spices, everything aside. So when you consume that you can get your Yeah, the moment you start going to processed foods or animal products, then you have zero fiber, then you're in trouble. So when you have not everybody is going to be we are we are humans, we are in society, we are going to have days when we have to work extra hard, you're going to be have a lot, we're going to have longer days, just give yourself time to recuperate. And you know what decreases your sleep requirement. whole food plant based diet, dairy will add one to two hours to your to your sleep time, meats will add more time because your body needs to process and heal for a much longer period of time. So you go on this diet, your sleep requirement goes down. Further, if you meditate, we heard about meditation, more you meditate if you start meditating 30 minutes, your sleep is gonna go down by one hour, two hour. So more you meditate less sleep, you need more whole food, plant based diet, less sleep you need. You know, I've had professors who used to teach for eight days, he used to teach for 18 hours is to sleep only for three hours, but he would meditate for two hours. So one to two hours meditation a day and he will only need three hours and he was always energetic. So sleep is so powerful. Absolutely. These are all autoimmune diseases, we just learned the mechanism how it happens. So this going on whole food plant based diet, decreasing your exposure. And they're more mean of course, with the talk only focus on the focus was only on one thing, there are many more things that you need to do after but this is the this is the starter pack. You got to start from here and there's more things you need to add on to it don't substitute add on to it. And that's a whole different talk. We can do a whole day course on just on the steps of it. But yes, that's the beginning you must do this.

Maya Acosta  33:56

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