My guest is Dr. Yinka Davies and she wants to once and for all help us with our gut health. When to take a probiotic, is a pre-biotic necessary, how many trillions do we need, how do we support our children’s microbiome and how do we know what really works. We did not go woo woo. Dr. Davies did her fellowship as a Pediatric Gastroenterologist at the Stanford University Medical Center. She is as “doctor” as they get, but realized early on that PREVENTION is paramount. What we eat impacts our health. Dr. Davies is a new crop of doctors trying to create a practice around our modern-day lives, our lifestyles with what food we have access to, and how to do our best to bridge some of the gaps. Information we can all use.
Listen to the episode here:
- Getting Into Gut Health [00:02:32]
- Delivery and Healthy Microbiome [00:08:21]
- Removing Protein From Diet [00:11:12]
- Balancing Gut Health [00:18:05]
- Staying Away From Dairy [00:21:30]
- Pre and Pro Biotics [00:26:43]
- Driving Positive Change and Impact [00:33:06]
- Athletes’ Health [00:35:53]
- Gut-Brain Connection [00:43:02]
- Additional Facts About Pro Biotics and Pre Biotics [00:45:19]
- Daily Life as a Mom and a G.I. [00:47:47]
- Sugar is Bad [00:58:04]
- Taking Some Foods Out [01:08:55]
- Lyvecap Strong [01:15:17]
Dr. Yinka Davies – Gut Health, Microbiome, Pre & Pro Biotics
My guest is Dr. Yinka Davies. I’m so excited because Dr. Davies is here to help us understand how we can best support our gut health and get into best practices. For me personally, I’m always confused about probiotics, for example. Do I need to take them? If I am taking them, what is the best time? How should I take them? What should I take? Now I wonder, if I’m taking a probiotic, does that mean I have to take a prebiotic? We also discuss, you get the bottles, is it in the billions? Is it a trillion?
For a lot of us, it’s wildly confusing. Dr. Davies breaks it all down. She even shares how we can support our children even young, their microbiome and the importance of that. You hear it over and over. We have more serotonin receptors in our gut than we do in our brain. It’s something that the more we can get familiar with and take care of, the better.
The other thing that I appreciate about Dr. Davies is her conversation not only around lifestyle, but the importance of what we’re eating, movement, and how that impacts our health. Imagine that, a holistic approach, even though she’s a Western-trained doctor. This idea of prevention, how can we prevent problems in the future? She’s clear and she’s informative. I learned a lot. I hope you enjoy the conversation.
Dr. Yinka Davies, welcome to the show. I’m excited. I always learn so much from my guests, but I’m excited to talk to you because prebiotics, probiotics, microbiome, and gut health are things that we’re all interested in. Especially when you start going, “It’s your first brain,” and all of these things that impact your emotional well-being, your physical well-being, your personality, and all of these things. I’m curious, when you went to medical school, what got you interested in drilling down? More specifically, I know you also have a more general practice, but how did you get lured into this part of health?
It was probably a combination of occurrences that happened. Early on when I was in training, I started at Stanford and I ran across the kid who was profoundly ill. She had significant gut distension, uncomfortable profound diarrhea. We had tried everything at that time. We did the routine stool cultures. Everything was clean.
I ran into somebody in the vet lab at Stanford and he had connected me with someone at the state lab. I said, “I’ve got this sick kid. I don’t know what’s going on. Our stool culture says it’s fine, but she has that significant gas.” We sent her off to the state lab and I got a call back to say, “She’s wiped out her gut flora. She had one bug growing,” which clinically correlated to this child who had significant belly distension, upset, lots of diarrhea. At that time, Gabby, I tried everything on the market to give her to replenish her gut flora.
Is it food that crushes our microbiome? Is it a compromised microbiome that then gets worse with the wrong kinds of foods and not that information? How does a young child get into that position? In her case, how did she get into that position?
She was a vaginal delivery, which is great because she picks up the vaginal flora for mom, which isn’t what we see now. We see such a rise of C-sections, which people need to keep in mind that baby is now delivered sterile. The bacteria they’re picking up is what you find in the hospitals. It’s not mama’s bacteria that are now populating and giving you that good flora to build off of. You’re picking up the bacteria from the bassinet, the cabinets, and everything else. That’s how you’re setting up shop to develop. She did have multiple courses of antibiotics for otitis media ear infection and that might have been our setup.
How old was she?
She was 8. She also had a history of swimming in the lake, but we couldn’t find any pathogens. Nothing came up. I went at that point to our ethics committee and thought, “Should we give her a fecal transplant.” Mind you, this is years ago and everyone’s like, “No, we are not doing a fecal transplant on this 8-year-old.”
I found a probiotic that I had shipped over and started giving a tour in the family. It was in Italy at the time. The family was desperate. I tried every probiotic on the market. I was working with the state lab who was checking her stools and saying, “She’s not populating. Nothing’s changing.” All of a sudden, they said, “I don’t know what you’re doing, but she’s starting to populate her gut flora.”
That’s when I understood the importance of our well-being, our health, and our gut flora, and how much it plays a huge impact. That was one incident that set the fire going for me down this pathway. My research is in gut immunology, particularly primary sclerosing cholangitis, which is interesting. It’s a rare liver disease. These patients typically go on to needing a transplant.
My mentor, who’s brilliant, discovered that oral vancomycin, which doesn’t get absorbed in the body, goes in the gut. We’re not quite sure what it does, but it changes the bacteria and changes the microbiome, and the disease stops, halts. They have rectal bleeding, diarrhea, progression of their liver disease, oral antibiotic. It doesn’t get absorbed in the body. It changes the environment of the gut, reverses and halts the disease. It was a combination of those two that got me down this pathway of going, “We’ve got to do better on what’s happening out there,” and looking more into it.
Maybe we could start from the beginning. Let’s talk about C-section. I had my first daughter. I went into labor. I was healthy through my pregnancy. After sixteen hours of labor, I pushed for two hours. Her vitals were going up and down. She was a bigger baby and she had quite a big head. She still has a big head. It’s working out for her. I couldn’t even get her into a birthing position. She didn’t even dropdown.
They say sometimes to a lot of athletes, either cough them out or hold them in, and I hold them in. I had to have a C-section. I was well aware of the benefits of delivering a child vaginally for their sake when you talk about getting exposed to all the good bacteria and things like that. Let’s say aside from like, “I’m scheduling my birth,” you’re in an unpredicted C section. Is there something you could do right away besides nursing that would boost your child’s ability to at least develop a healthy microbiome if they had an unexpected C-section or a C-section?
Absolutely. More and more, we’re looking at getting the vaginal secretions to the baby at birth. Many hospitals are starting to do that now and inoculating that. Then probiotics, starting the baby with the right breast milk to give that good bacteria and give that good breast milk to allow it to feed the bacteria. Then probiotics in infants, which more and more people are starting to accept. Initially, we were all a little bit hesitant about giving probiotics to infants being born, especially on preemies. They are probably the highest risk babies. Most of them are C-sections. Mom had a course of antibiotics. Usually, a delivery baby gets courses of antibiotics so they’re a high-risk population. Breastfeeding is number one and probiotics are number two.
How would you administer that to a preemie?
In preemies, they lavage feed if they are not feeding by mouth. They put a small in G-tube and inoculate it. It starts helping to build that microbiome and helps the immunity establish. On the older infants that can bottle feed, they just deliver it. There are now probiotics that have good clinical research behind them that are targeted towards infants, which are truly effective on those babies.
Let’s say you have someone who’s given birth and for whatever myriad of reasons, they’re not able to nurse, which happens occasionally, this would be another way to at least support them. I have to be honest, part of me is always a little like, “Ugh,” on some of the formula that’s out there and the actual nutritional support that’s in there. I’m not ragging on it. There are also additional things that if a mom has a situation like she can’t nurse, that she could support the baby.
You’re right about that with formulas. They’re not all the same. People forget this is cow’s milk. Formulas are derived from cow’s milk. They’re doing their best to try to break down some of the proteins. Many formula companies are now adding probiotics into their formulas because of the benefits in infants and young babies.
Speaking about cosmic, there’s a lot of research that shows that a lot of people do have a hard time with whey, even though it’s highly bioavailable. What’s going on there?
It’s tough. From my practice, I’m a pediatric gastroenterologist and I see so many kids. I say this all the time, “If you hang out with me just one day in clinic, you would say, ‘What’s happening? What are you seeing? Why are all these kids coming in with multiple, not just allergies but intolerances?’” Many of my patients in clinic and especially my inflammatory bowel disease patients don’t do dairy because it’s a large protein. It’s measured in kilodaltons. It mounts a huge immune response and can cause inflammation in the gut.
We try to remove that in the diet, particularly patients with Crohn’s disease, who come in and maybe are not interested in medicine. I get patients that come in and are like, “I don’t want that list of meds. We’re not going down that pathway. You’ve got to talk to us about diet.” I talk about what’s called specific carbohydrate diet. Dairy comes out, sugars come out, grains come out. You see the disease progression go back to normalcy.
The first patient that I saw like this was in training. If I hadn’t have seen that kid with my own eyes, I wouldn’t have believed it. He’s sick, low numbers, anemic. Albumin was low and narrowing in the small intestine. The parents gave me a book and they said, “We’re going to educate you and we want you to read this.” I hop back to my attending and I said, “They said no to the medicine, but they want me to read this book.”
It was the book Breaking the Vicious Cycle. It was talking about diet and it is well used in multiple Crohn’s patients today that have not done medicine. Just that diet and things go back to normal. Here you had this kid who had dropped significant weight, small bowel narrowing, albumin low, anemic. Change diet and everything goes back to normal.
Dr. Davies, I prescribe probably towards that side, my lifestyle, medicines, food, and things like that. You’re a formally trained doctor. You went through real serious institutions. What in you is like, “Sure, let me read your book and let me mull that over,” to the patient? First of all, you guys are busy. You’re dealing with so many different elements. You’re trying to problem solve all these people, their situations, like formulas. Sometimes it does become almost like an equation on paper, not just the person.
I’m fascinated because I have this conversation all the time. I respectfully say that a lot of times, I’m still amazed that a lot of doctors don’t connect our lifestyles with our health. It’s like, “You’ve got this so take this.” You were dealing with small children that you maybe were more open-minded. What is it in you that you’re like, “I’m going to go read this book.”
First of all, we didn’t have a choice. They weren’t doing meds. We saw the patient getting better and better. The patient came back, where we repeat the labs. We didn’t prescribe anything. The patient’s getting better. Labs are getting better. You’ve got to, at that point, question. There’s true data. Medicine isn’t just what we write on the script. It was true accountability for what goes in. That was the start.
I’m still so grateful to that family. As physicians, we’ve got to do better at this. I say this all the time, we treat disease well. We don’t keep you well. We don’t do prevention well, although we’re getting better. The accountability is on us because families are coming to us with their Google research. “What about this? I read this and my friend said this.” There is this accountability that we’ve got to look at. The answer isn’t just in medicine.
If I hadn’t seen this child change over time, maybe I wouldn’t have come down this pathway of starting to look at, “We’ve got to do medicine a lot better than what we traditionally were trained in med school.” I had a year in pharmacology, three weeks of nutrition. Coming out, you can see where we write scripts. More and more of us are starting to look at that whole-body wellness and how we change things.
Maybe it wasn’t on the medical school training play originally because our food wasn’t so weird and we weren’t so sedentary. The systems have gotten wonky. Now it’s almost like we’re going to ask the medical system to catch up with our new lifestyles that nobody probably could account for. Maybe we could start to break down, let’s say someone overall is healthy, adult or child. Are we treating it overall similarly? I know there are hormones and there are different things happening. Is it safe to say, “The general rule is good for both.” Do we need to approach it differently if they’re in decent health?
In general, you can approach it the same.
Let’s say someone’s reading this and they think, “I’m curious about my gut health.” There’s a crazy book called 10% Human. That implication is that we’re here to help colonize all the bacterias of the world and they’re in charge. There are different ones in different locations. Like my elbows are dry, there are different kinds of bacteria in dry. Even the fact that certain systems in our bodies didn’t develop certain attributes because the cooperation with our microbiome was doing the job. There’s all this fascinating information. Let’s say someone’s like, “I’m interested for myself or for my family, or both to begin the process to look at balancing my gut.” What does that look like?
Food is number one. We’ve got to look at what’s available in our food system. You’re absolutely right. If you look back many years ago, breads used to turn moldy and green. That doesn’t happen anymore. You’ve had a look at what has changed. Many of us could do dairy, wheat, gluten, and all those things many years ago, and granted, that has changed.
When you see what happened in allergy clinics and gastroenterology clinics across the board, adult or pediatrics, there’s this rise of chronic disease. When I was in training, I probably saw 5 to 8 eosinophilic esophagitis, which is an allergy component of the throat per year. Now, you’ll probably see 1 to 2 a day coming in. The game has changed drastically.
When you talk about, “How do I get that wellness?” A lot of it starts from what goes in the body, what you’re eating, and what you’re consuming. That’s where there needs to be a lot of education because when I see patients in clinic who want to do well, they want to eat right, you find that the wool is being pulled over their eyes. Because they’re walking into the store and it says all-natural, but it’s made with chemicals. We’ve got to start with that on how we start with wellness and not just look at supplementation of the gut. There has to be that accountability of what’s going in.
[bctt tweet=”When you talk about, “How do I get that wellness?” A lot of it starts from what goes in the body, what you’re eating, and what you’re consuming. “]
At times, that can be as simple or complicated as we make it. The people gave you the book, if they came in and you go, “Great. We can drill down. We can talk about grains.” Maybe people are starting to get that. It’s getting them to understand sugar without fiber, how that goes. With fiber, it goes to the gut, the microbiome, eat some of that and it helps us versus straight to the liver if it’s sugar with no fiber and the debacle of fatty liver, insulin resistance, and all of that.
Let’s say someone comes in and they go, “I need you to chunk it out for me.” Because the other side of this is we could get into the oils, industrialized oils, and the inflammation. Let’s start with the person who’s like, “I’m trying to survive in my life and I don’t know that much about nutrition.” How do we chunk it out for them and go, “This is what we’re going to steer towards. This is what we’re going to stay away from and why.” What’s that conversation?
I push more plant-based. It’s what I live. It’s what my kids live on. It’s what we do. I stay away from dairy. We stay away from anything processed.
It’s funny because I know smart people who go, “I get the calcium,” and I go, “It’s fortified. It’s total BS. Why are we drinking other animals’ milk?” That’s been culturally put in there that it was good for us and we still haven’t gotten away from that. Specifically about dairy, is it because it’s processed? Why would you say to somebody, “Stay away from dairy.”
From my perspective and as a gastroenterologist, it’s a large protein. It causes a lot of inflammation within the gut. We don’t need it. We have been told for years and years that that’s what gives you strong bones and strong teeth. I hear it from my patients, but there isn’t one study that has shown that. In fact, the only study that was out there was pulled because it showed the opposite. There isn’t any data.
I hear it all the time, “You need the protein from the dairy.” You get plenty of protein from your plant-based diet. The whole mindset has to change because we have been programmed off of this pyramid, which probably hasn’t been correct over the years. That’s what has gotten us down this road. I definitely start off with patients by pushing more plant-based because if you can push that and push more of the vegetables, the beans, legumes, and the complex grains, there’s not much left to try to fill in.
You can’t screw it up.
They typically do well from that. There is a lot of advertisements that gears our patients down this other pathway. They look for 100% this or it says all-natural. What’s happening is the wool is being pulled over the eyes of the consumers and more education has to occur.
Do you get in trouble for talking like this? This is stuff that we’ve talked about for many years in our house, but I know that when you are a serious medical doctor, you’re not saying you’re a naturopath even. I’m always fascinated by people who are willing to deal with pushback based on their convictions and their knowledge. People say, “Come on. Dairy.”
I definitely hear it still from a lot of my colleagues. They will say, “Diet doesn’t affect GI disease.” Or I’ll have a patient that says, “So-and-so told me that that doesn’t matter and I should be drinking this much.” “I saw a dietitian who said I need the milk every single day.” I wouldn’t say get pushed back, but I still see that it’s quite prevalent out there. This old-school thinking, how we definitely have to be drinking milk from a cow. I call it nursing from the cow. We have to continue to nurse from the cow. We have to continue to eat these foods. It’s the pathway we need to go. Many of my colleagues don’t look at probiotics. Many don’t look at diet. We are medicine-driven. Don’t get me wrong, medicines work. We’ve got to keep you well.
You talked about plant-based. I know Mark Hyman a little bit and he was talking about polyphenols helping your microbiome. Could you visit around that? Because those are connected.
What happens is the feeding of the microbiome. You want to propagate the right type of bacteria to come through. Remember, there’s a balance of good and bad. You’re always trying to establish that balanced microbiome. It doesn’t take much for that to be shifted, whether or not it’s antibiotics or stress or C-sections and many other things within our food that can shift that. What you are looking at is how do you be that bacteria. That is one of the pathways to try to supplement and propagate it.
We’re all so different and then you’ll get these pills, a prebiotic or a probiotic, and you think, “This is like a gunshot approach.” Because we are different in how we feed it specifically. People come to you and they get a specific examine to look at what’s going on with them in particular. If someone has a child that gets sick and they need the antibiotics, like I have friends that are like, “I had to give my kid antibiotics,” and I’m like, “That’s what it’s for.” It’s not your first thing to do but if you had to do it, then that’s what they’re there for. If your kid is now done with this cycle of antibiotics or a person, how would you say you’d try to boost them and support the good flora in their microbiome? Are you just saying, “We’d get back to our good diet.”
I’m a big believer that everyone should be on probiotics all the time. You nailed it. Our foods are different now. We have a different lifestyle. We don’t have the same types of foods that we had many years ago. We definitely have antibiotics in many of our foods that have changed the game of things, and that changes the gut flora.
From day one, someone should be on probiotics all the time so that they are able to hopefully withstand that antibiotic course rather than, “I’ve taken my antibiotic and now I’m going to rescue and get back and try to repopulate.” I went to visit a guy at UCLA, a phenomenal microbiologist. He said to me, “I want to show you what you people do.” This is one of the world-renowned experts in microbiology and he’s referring to you people, me. “What you people do is you just write your antibiotic for ten days for your infection.”
He takes me back to his lab and this was me first learning this. I didn’t learn this in med school. It takes up to a year to repopulate the gut flora from one course of antibiotics. I can’t tell you how many patients in clinic I’ve had that have come to me with a presentation of inflammatory bowel disease, either Crohn’s or ulcerative colitis. It was that antibiotic that tipped them over for a presentation. The gut-wrenching feeling from their parents is like, “I shouldn’t have done that.”
There’s no take back at that point, but what we can do is try to strengthen who we are in the beginning. Hopefully, we can withstand the environmental hits from our water or like, “Yes, you do have to have that antibiotic. That is what you’re going to need for this infection.” There’s stress or that food that you had or you’re at a restaurant and the food that they used was meat that was raised with antibiotics. We have to be able to withstand these ups and downs rather than us doing rescue for our overall wellness. I don’t think we should be taking them after but rather all the time on being on every day.
Now there’s more confusion, but then people will be like, “We’ve got prebiotics and now we’ve got probiotics. Do I need to take probiotics in order for probiotics to work?” Can you break down the real difference and how they should be used and even taken. It’s like, “Should it be with food? Should it be with an empty stomach? You go into the more curated health markets, and then now they’re refrigerated. Do I need to do that?”
Could you guide me a little bit about a system that seems, first of all, doable? If we make it too hard for people, nobody can comply with it, including you, including me, even when you know better. Tell me the relationship and the point of the probiotics and the probiotics, and maybe the easiest or most impactful way to take it.
A probiotic is best on an empty stomach first in the morning. It should be taken on an empty stomach daily. It is confusing. I’ve walked down that aisle and I’ve seen the refrigerated section and then the dry section, and all the edgy claims that everyone is making. That is the noise that definitely we’re trying to breakthrough. It’s consuming for the consumer. I see it coming through in clinic where they’re like, “I took up this and this is what I picked up.”
Typically, what you’re looking for in a probiotic is one that’s clinically studied. There are few on the market that have done it. The way they get around it is they get a probiotic, which they buy from the house. You can go buy some strains of bacteria or you can buy the species and strains, and put it together. As long as you don’t make any health claims, you’re all good.
Now we’ve called it Gabby’s probiotic. It’s great. It’s good for gut health. It helps you feel great, and that’s okay. That’s what people have done, but that isn’t what shows efficacy. I say this a lot, you can’t just randomly grab bacteria together and hope that magic happens in the gut. You have to bring the right strains together and immunologically change the game in the gut flora.
When I see many of these probiotics on the market, they’re like, “We have gazillion strains,” and all these probiotics. There’s zero data for them and no research to show, “Show me the true efficacy if you bought these together.” That did change the game. Keep in mind, 70% to 80% of your immune system is in your gut, so it’s important for your overall wellness and your health. My advice when people are looking for probiotic is to look for a probiotic that has true clinical research and data for that combination of the strains that they brought together.
frustration is probably what led you to do your own products because you’re researching it and you’re seeing it. Now, it’s moving into business. You’re in the medical practice, you’re researching, you’re into data, and now you’re doing business. I always appreciate when people are willing to move out of their comfort zone because they think, “I feel like I can do something that’s of value.” I can imagine that when you’re at medical school, you’re like, “I’m going to be making probiotic formulations to offer people.” You say, “I can impact this in a positive way.” How do you now manage your practice, your self-care, children, and now you’re in the business?
I’m trying. I’m learning. Your practice, you get training on. As a mom, you don’t get training. It’s all on the go as I do that. The business aspect has been interesting, but it is my passion. It is what I know best. When you see a rise of unwellness out there and you see that something has to change, you definitely want to be a part of that change.
I was fortunate to be connected with Claudio De Simone, who’s a world-renowned expert in microflora. He invented the formulation of Lyvecap strains and put them together and did the research behind it. The De Simone Formulation has MD-published research journals and peer-reviewed journals. Using the strong formulation, he’s the one that did the research and put it together.
I am now starting that business aspect of it. I enjoy it. It’s fun. I’m learning. It’s definitely a different world. I am definitely out of my comfort zone. It feels good. When you’re moving things in the right direction and you’re making a change, it doesn’t feel like work but rather part of an extension of what you’ve trained to do all along. I like it. Right now, I’m targeting athletes.
Are there formulas specifically for kids of a certain age and then older Dewey? Or is it like, “This is the stuff that we know that supports your gut health.”
That’s the beauty. When you see things out there like, “This is for women aged 48 to 50,” I’m like, “Really? How does that work?” That’s when you’re pulling the wool over the eyes. It’s a formulation that works for the gut flora because our gut intestine is made up of trillions of bacteria.
You said you’re talking to athletes. The funny thing is athletes are good, too because they’re willing to almost do anything to get an edge. Some will say, “It’s good for my health,” and then this will be better and it’s like, “If this will make me better, then I’ll do it.” I was reading about how probiotics can regulate your muscle metabolism. Speaking of athletes, maybe you could share that connection.
It’s interesting, especially on this formulation that we have. With the strong formulation, we suspect that the bacteria digest the fiber and you produce short-chain fatty acids, and that allows you to help the gut barrier so it’s much tighter. Even endurance athletes, especially a lot of these long-distance runners or high-intense athletes, the gut barrier is impaired. They have tons of GI discomfort because there has been some destruction in that. This helps bring the gut barrier much tighter.
It has been shown to decrease lactic acid, which allows them to recover quicker and trade much harder. Some of these athletes will ask me, “Does this make me faster?” No, it doesn’t make you faster, although we’ve seen that. It makes the right athlete feel well, be able to push their limits, and be able to recover much better.
[bctt tweet=”I’m a big believer that everyone should be on probiotics all the time.”]
Athletes are interesting because not only are they willing to try anything to get an edge, but they also know their bodies well. They’re able to guide me almost when they start to say, “On day eleven, this is what I started to see.” It was a perfect medium for people to start with because they could give us feedback on what they saw. The feedback has been phenomenal on what they’ve seen on the probiotic, how they’re training, how they’re sleeping, and their mental clarity because of this whole gut-brain access. Overall, that feeling of decreasing lactic acid, so less muscle soreness, and able to train much harder the next day adds up to that extra edge that many of those athletes are looking for.
It’s almost like putting your body in that optimum position to do what it does. You’re not saying, “We’re going to give you extra. We’re going to set you up to be your best to then perform.” I don’t know the statistic of how much percentage of the tissue that develops the brain and also develops the microbiome. It’s 85% or something.
Athletes are a sharp end of the stick. They use their body in a different way, even though they might take care of it better as far as getting to bed, nutrition, and other ways. Explain to me how is that end up compromising that level of exercise or that duration of exercise, how that ends up negatively impacting the gut. What happens there?
You mean particularly in endurance athletes.
Poor endurance athletes. The heart gets it. Now I’m finding that the microbiome gets it. What is it? Is it the miles?
What happens is as you’re working out, the blood is going to your heart, in your muscles, and it’s pulling away from the gut. There is this transient ischemia that happens in the gut. That’s why you see in long-distance runners, they get diarrhea and some of them get rectal bleeding because there is no blood flow. When that happens, that affects and disrupts the integrity of the gut barrier, and that can affect the mucosa and affect the bacteria.
You have these runners or athletes that have GI discomfort, increased gas, GI dysbiosis. There’s more gas production. The more they’re pushing harder and working harder, there’s less blood flow to the gut. They’re getting deeper in the cycle. You don’t just recover and it all goes back to normal. There has been this impact and this hit to these athletes. Supplementing these athletes with not only the right fuel meeting what they’re eating right to make sure they’re feeding the bacteria properly, but supplementing with the right bacteria is also important.
They’re not going to do less miles. How does this keep the gut, even the thickness of it, in check? Because it’s not going to bring more blood flow. How does it nurture that environment?
You said it exactly right. It nurtures the gut barrier. When you have bacteria that are feeding off, you get production of short-chain fatty acids. Whether you’re taking acetate or butyrate, or any one of those, those increase your immune function. They have better absorption so they’re absorbing nutrients from the food much better. They nourish the gut barrier and they have decrease inflammation. All of that has been seen and has been documented in many studies. That is the direct effect of short-chain fatty acids.
They talk about the gut-brain connection, that if you could decrease the inflammation in your gut, would that also impact your ability? If you’re eating better, then you’re not having that chronic inflammation everywhere. It’d be interesting to know, if you could settle your gut down, would that impact the inflammation of your brain?
The gut has at least some indications of like, I’m inflamed or irritated,” but the brain doesn’t. People get to a certain age and it’s game-on with worrying about dementia or Alzheimer’s and things like that. It’d be interesting to see studies showing that that’s one more card we could use to at least support our brain cognitive.
We definitely know that now. We know that there is this connection. When there is this degree of dysbiosis, there is this fogginess that many people also talk about. “I don’t feel so clear. I don’t feel right.” What we hear a lot is, “I feel a lot better. Am I supposed to be sleeping better? I feel good. I feel like I’m ready to go.” There definitely is this connection.
Not only will we learn more because there’s this push on looking at the microbiome, but we’ll learn more about what other impacts are out there. If we can see the impact of an oral antibiotic that doesn’t get absorbed in the body that changes disease, then what other supplementations for the gut microbiome will have a huge impact on the disease state? We have more research to be done, but it’s definitely an exciting area.
I always find it fascinating that in a way, we screwed up the real natural system. We ate plants with dirt on it. Now we have to get to these highly sophisticated studies and pills to get back to the stuff that we naturally do.
Farm-raised kids are the healthiest kids out there. I get it all the time. Patients are coming in and they’ve got Purell hanging off of their diaper bag. “Eat the cracker fell to the floor. It’s good for you.” Nobody does that anymore. I walk in the grocery store and it’s like, “Wash your fruit with this special spray.” I’m like, “Really? I need a special spray?”
We’ve gone all the way to the other side and now we all look over like, “What’s going on? Why do we have this unbelievable state of unwellness?” We have created this when you think about it. Rise of C-section, use of antibiotics, super clean. Coming out of this pandemic, we’re probably going to be even more hypersensitive about cleanliness, and vulnerable.
Let’s go back to prebiotics and probiotics. Probiotics is best on an empty stomach in the morning. Does it matter if it’s refrigerated?
Probiotics are refrigerated. Most probiotics that are refrigerated are the best because that shows the viability. You can have some probiotics that are freeze-dried and still have true efficacy if they’ve been tested because there’s no FDA regulation on probiotics. The majority of them are dead on the shelf, then they won’t even survive getting through the gastric mucosa, the gastric environment of the pH, and then deliver into the intestine where they need to play a role and have to effect. It can be refrigerated or it can be freeze-dried and it needs to be clinically studied.
Do you have to take a prebiotic in order for a probiotic to work? I love the numbers. I’m like, “There’s a trillion. That’s got to be even better for me.” Tell me about prebiotics, so I have to have them.
This is the game. More is better. You definitely need a good amount of bacteria to change the game and you need enough bacteria that when they deliver in there, there is going to be an immunological difference and you’re going to see a clinical change. You have to bring the right strains together. It has to be the right amount and it gets to be clinically studied. It’s not a guess. It’s not like someone at home going, “Let’s grab that number and put it all together and put our label on it.” You have to have the right number and the right strains that change the game.
What happens is that you’ll see many people saying, “This specie has been studied,” or, “This strain has been clinically studied.” Remember strains are like, you have a German Shepherd and I have a poodle, but they’re both dogs. My German Shepherd is different than your poodle, but we’re both calling them dogs. That’s exactly what happens in the probiotic world. The strains matter and the strains that are studied matter. That’s what people have to look for.
Give me a day for you personally and with your children, as far as how you make sure that you’re trying to cover your basis.
My kids have been on a probiotic since they were one. That was their first dose. Their mom is a GI doc and my research is gut immunology. Of course, it’s what they’re going to get. They were C-section boys, so you knew the risk coming out. They stay on a probiotic every day of their lives. They’re plant-based and a little bit of fish. We juice for them every day. They’ve eaten oatmeal every single day of their lives with breakfast, except when we’re on the road. We make some exceptions then.
I take my practicality of what I do at home into clinic because it is important as a mom to get in the shoes of that patient to understand. I hear it all the time, “I can’t do all that.” We just have to get in the car and grab what we can grab. “Here’s your food. Let’s go. We’ve got our next softball game.” Families are on the go. That’s what led to this whole craziness about eating.
We clean. Because I’m able to do it, I manage to practice, and do all that, I know it’s doable. I said this in clinic to a patient, “What do you eat before you came?” She said, “I ate a muffin.” A muffin is like a cupcake. It was a chocolate muffin. I’m like, “That’s a cupcake.” I’m trying to educate them, “You could grab that oatmeal on your way here. You could have grabbed that banana.” We’ve got to get back to the basics of what food is and how to nourish it. That becomes important for not just patients, but everyone overall.
I hate to say it, we have to prepare more food at home. Unfortunately, whether we like it or not, you don’t know how things are getting made. I try hard to eat three types of oil, the avocado, the unfiltered olive oil, and coconut. I do my best to stay away from the other oils which are way less expensive and it’s already hard enough to make food profitable in the food business.
You have parents that come and you say, “You’re going to go to the store and you’re going to do your best to shop around the outside.” Let’s bullet point. These are things that are staples for people in certain cultures, like rice. Certain foods are grain. Can we substitute something? Are you asking them to avoid breads as well?
The particular patients in my clinic that avoid grains are Crohn’s patients. Crohn’s patients avoid grains and dairy sugars. For the general masses, grains are okay. People live on rice and rice can be fine. Getting people more on brown rice would be much better for them because it’s a complex carb. We have seen this trend of people that don’t do well on gluten and there are substitutes for that.
I have two boys that don’t do well on gluten themselves and I’m seeing the clinical implications of what happens to them. There are many other foods. There’s potato and there’s rice. All kinds of beans are phenomenal. We’ve got to look at those basic foods on how we nourish. The other thing we have to get away from is trying to make things like, “I got that yesterday and I can’t get that today.”
[bctt tweet=”When you’re moving things in the right direction and you’re making a change, it doesn’t feel like work but rather part of an extension of what you’ve trained to do all along.”]
I say all the time, somehow in every other country, in some days, they feed their kid the same thing over and over again and these kids stay healthy. We have to get back to the basics of nourishing our souls. Eat oat meal every single day. Get the rice and beans and eat that. Grab an avocado and eat that with some sea salt. Grab your two bananas and get back to nourishing. We’re making this more complex than it actually is.
Many countries are becoming more westernized. Mind you, we’re seeing a rise of cardiovascular disease and all these other diseases in these countries that as they become, we’ve got to go back to what we know is best. There are so many studies that show eating more plant-based and eating more simple foods. Food prep is tough for a lot of people to do. It takes a lot of time. I couldn’t do prep because I don’t know if I have time to do that. I make it simple that I’m like, “Here are your three bananas in your bag. Here’s your thing of rice that I cooked and your thing of beans.”
Getting our kids to understand how to nourish. I do this in clinic with great success with the families. I know those patients are desperate because they’re sick. They’re coming in and they’ve got a different circumstance. We still need to apply the simplicity of food to the general masses, of the right foods to be eaten.
You started your children out that way and that’s easier to carry out than asking people to make real change. It’s interesting, the parent will make the change for the child before they’ll make the change for themselves. You’re also creating a bottom-up learning and change where the kid is impacting even the parents that way. Just so I’m clear, do we need a prebiotic?
You can get prebiotics from food, but it doesn’t hurt to take a prebiotic. Prebiotic is an oligosaccharide. It’s a complex carb that feeds your existing bacteria. The reason we even talk about probiotics and prebiotics is because we’ve shifted this gut flora to a mess of dysbiosis, not just from our foods, our stress, and our lifestyles, but our daily living. What we have now and the amount of unwellness that we see, a prebiotic would be good for someone to take. Especially if they have discomfort, IBS, “I’ve got bloating,” or, “I don’t feel great,” to try to re-establish that gut flora, someone should take a probiotic every day. Probiotics can be delivered in food.
One of my daughters can’t take pills. I’ve tried to give her certain capsules, even in the gel. I know we can through the food, but if we’re saying, “We’re trying to supplement for our children,” what are some of the best things out there? Lyvecap is a supplement. The other confusing thing is so many times, they tout dairy products as our best form of getting a probiotic, and then you have kids that are lactose intolerant. We’re trying to stay away from these homogenized, pasteurized, all these foods that are high in sugar, by the way. Share some ideas on how to get a kid probiotics that can’t take a capsule. “Give them yogurt, probiotics, and all this,” and you have kids that are lactose intolerant.
Probiotics, you can definitely get an oral suspension. Even if it’s in a capsule, not all of them but some of them, you can open them up with the capsule into something and have them drink it. You can find a clinically studied probiotic in powder form for any child to take. Many companies are targeting more of this. You’re right, probiotics in yogurt. If you were to take a probiotic in yogurt, although it is dairy, it is still your fermented foods that we used to do thousands of years ago that we’ve moved away from.
The kombucha, there’s nothing to it. We did that thousands of years ago. It’s just that we moved away from it and be like, “Let’s get back to all of that and try to go back to what we used to do.” I don’t think we’re in a state where our food supply is great that we can rely on eating like we did 30 years ago. We just can’t.
Supplementing a probiotic and an oral solution form for kids, I wouldn’t supplement it from a yogurt exactly because of the dairy product. It’s not enough. You’d have to do at least 25 of those yogurts today to get to the amount that would change the game. Same as kombucha, it’s a good start and it sounds good. You like the fizz and it feels good, but it doesn’t change the gut flora enough to make a huge difference. You want that supplementation of that dietary supplement in them daily.
Forget the Crohn’s patients because there’s stuff we probably shouldn’t be eating. Do you have other foods on your list to avoid?
The reason why sugar is so bad is because it feeds the bacteria. If I were to test you and you said, “I don’t feel good. I’ve got some discomfort. I’ve got some bloating.” I want to know if you’ve got bacterial overgrowth, which you hear a lot. We do a breath test where I give you sugar. I test and look at the gas that’s coming. We can measure the peaks to know that there is some bacterial overgrowth going.
When you’re doing sugar on a daily basis, you’re feeding the bad bacteria to propagate and produce more gases. Gas distends the belly and causes more pain. As you stretch the belly with gas, that elicits more pain. That’s the discomfort from IBS. You have poor motility and you’re not going to the bathroom. Sugars are the worst. Simple carbohydrates are next because they broke down into pure sugars.
So pasta, bagels.
When you look at our diets, it’s this vicious cycle. Think about it, when you walk down the aisle or when you go out to eat, it becomes more and more difficult to find foods that don’t propagate this madness. It’s your bagel. It’s your pasta. Now I see these drinks that are huge and big and they’ve got all this sugar and stuff in them. The kids are walking around with them. You see this cycle going through and through. Mind you, we see this rise of Crohn’s, ulcerative colitis, intolerances, eczema, and asthma that we’ve got to say, “What’s happening here?”
We’re talking about probiotics in the gut but you’re saying, “All of lifestyle impacts the gut.” The longer overexercising, I’ve understood, but probiotics is one part of the puzzle. When you have patients come in, how do you dissect the buckets for them and say, “Your kid has to move around. They need to get to sleep.” Maybe we could touch upon how those things impact and support your gut.
To touch on like fatty livers and kids, that is an area that isn’t talked about. We see a high percentage of fatty livers in Latino kids, Asians, and blacks. You see that kid and grandma thinks he’s just a little chubby, looks great, and looks healthy. You get an ultrasound of his liver and it’s filled with fat, which leads to cirrhosis. On that population, it’s diet, it’s exercise, its lifestyle.
I sit with the families and look at this and say, “This ultrasound isn’t good. This is what’s leading your child to head down this pathway of Type 2 diabetes and possibly cirrhosis of the liver. At times, I want to scream from the mountaintops to say, “What are we doing? Who’s talking about this for this population and these kids?” That’s one population that you deal with.
The other population that you see is the Crohn’s and ulcerative colitis patients that come in. It’s heart-wrenching. I did procedures and there were four new diagnoses of Crohn’s on my procedure day. The anesthesiologists kept saying to me, “Is this another new diagnosis? Look at his gut.” When you see that in a child, there’s no take back.
What are you doing in these procedures exactly?
Endoscopy and colonoscopy. These patients come to me with either right lower quadrant pain, diarrhea, blood in the stool, weight loss, joint issues, or rashes. One of the kids had swollen lips and multiple ulcers in his mouth that weren’t healing. When you see this with a family, things have changed. The immune system has changed, so there’s no take back. You can’t go, “What were you saying about the food and the probiotic every day?”
This is why I say it’s prevention. It’s eating right in the beginning. It’s changing the game. It’s implementing the change in your families. It’s adding probiotics daily. It’s the exercise. It’s all of it. For those patients, it’s a different game because now they’re in a disease state. For someone who comes in where they’re tipping over or they’re going into that position, it is changing and reversing that bus and turning it around and saying, “This is where you’re heading, but we’ve got to change your diet. We’ve got to make sure you’re exercising. We’ve got to make sure you’re eating right.”
They are unbelievably receptive to it. I hear it from my doc colleagues that say, “No one’s going to do the diet,” but they do. It’s a different environment for parents and their kids. That combination is powerful. We walk the Earth for our kids. That’s what we do. If you sit there with a parent and they see disease and they see inflammation, they’re changing diet immediately. They’re doing what they need to do to get their kids well. I get kids in a disease state, but what we should be doing is changing the game for these kids before they come in because once they’re in a disease state, there’s no going back.
I know Dr. Robert Lustig. He’s an endocrinologist and he worked a lot with child obesity. That’s where he started learning about fatty liver. It put him to sugar, but it was really the study of obesity. He’s involved in programs like, “Eat real food for school lunches.” Trying to figure out also when you talk about this prevention, in every level, how can we support children to get the nutrients that support them? People go, “It’s too expensive.” There are ways to do it that cost the same.
My kids play tennis and I was at a tennis tournament one time. There was a baseball field and I could see reels of blue, green, and yellow drinks that you thought, “We’ve got to stop this.” We’ve got to stop and go, “What do you think in that blue drink is doing anything for this child?” You’re right, it’s not just school but it’s athletics. It’s changing the mindset and understanding how we feel athletes and how we fuel our kids and how we nourish them. That has to change.
There’s so much power in advertising and marketing that we start to believe this stuff is real. I said to a patient one morning, “Have you ever seen a Taki tree?” She looked at me and she said, “What?” I said, “The tree that flourishes and all the Takis come out.” She thought, “Where have you taken me?” She looked at above and I said, “You haven’t because they’re made in a lab.” We’ve got to call it like it is. The mom was like, “In the lab?” I’m like, “Yeah. That’s exactly where they make them. These are chemicals.”
I love the idea of hitting the palate harder than anything that’s flavored in nature, but then design it so it dissipates quickly, so then you grab another one. The food engineers are completely lined up and of course, why you can’t eat just one is because you get switched on. That’s our biology at the moment where you’re supposed to get a lot of it when you can because of scarcity, but we don’t live like that anymore. I get that.
If someone’s reading this and they’re saying, “I want to look at this.” There’s another part I’m curious about. Let’s say your gut is not in a great state, which then does impact your emotional state. There’s an interesting thing where I go, “Do people get behind the eight ball and they can’t get in front of it enough to make the choices that will make them feel better? That will help them get that clarity? That will give them that emotional homeostasis?” Because we are so connected to our waistline. How do you invite people who may be feeling like crap and they can’t stop feeling like crap long enough to go, “I’m going to make these better choices.” How do we reach them?
I was talking to a friend about this because she teaches yoga. She said, “There’s so much unwellness. People don’t feel good.” I don’t think us, meaning the medical community, do a good job of helping those patients. We give IBS medication, which then stops the bowel from moving. You feel good for a while, but we haven’t fixed anything. We’ve got to be better at fixing things.
For those people that don’t feel great and figuring out how to get ahead, it’s one step at a time. It becomes too overwhelming to throw everything at them, especially in the state of unwellness when they’re like, “I hear you, but I don’t feel good. I don’t even have the energy to hear about that walk you want me to take.” It is trying to embrace one step at a time. Once they start to feel well, it’s game on. They start moving step by step. That is the motivation, hopefully, for them to keep going.
Is there a hierarchy of like, “Let’s see if we can get some of these foods out of our everyday lives.” Food is the king. What’s your slow trickle hierarchy after that?
What I go to first is drinks. They take out everything but water because I find that there’s so much supplementation with teas and juice. They found this and they’re drinking this and they’re picking up that drink from this coffee shop. I find that if I just go, “Nothing but water,” that takes care of a good chunk because those are the simple carbs that are hitting the gut, causing some discomfort right away. They get some bloating from that. Just removing that helps them get in a better state quickly and right away. That’s powerful.
I am biased on meats and more plant-based. I’m trying to move them away from that and integrate more vegetables into their diet. That in itself usually gets them on the pathway of feeling well. They can now go take that walk. They feel a little bit better that they say, “I can do it,” but it is overwhelming when someone is in a state of unwellness. Try to give them the book.
You’re asking them to do things that they can’t even get to the place to make the choices. I can’t be like, “Do ten reps.” It’s like, “What are you? Crazy? I’m surviving. I’m white-knuckling this right now.” I’ve read some statistics that we drink 20% of our calories, so that is a beautiful way to start. For my own curiosity, I want to ask you about probiotics activating your vagus nerve for digestive health.
[bctt tweet=”When you’re moving things in the right direction and you’re making a change, it doesn’t feel like work but rather part of an extension of what you’ve trained to do all along.”]
It’s interesting because I’ve seen that. There’s no true study to show. It does help in digestion because it helps in absorption and that’s because it helps with the integrity of the mucosa. That’s where you get down this fringe side of things where it’s like, “It does this and this is what happens.” You have to almost stare back and go, “We’re going to stay with the science. We’re going to show the data. This is where it happens. This is what truly happens and this is what you see.” Not good data on that, but I’ve seen that.
I have to ask if that’s even true. We know the drink is early, no food. I know this sounds fringy, but I often think sometimes when we consider our gut, even the importance of it, our instincts. When we eat something, the idea of where it’s going to go and things like that, we’re becoming aware of that part of our body because we have learned also to live in discomfort. It’s like, “When I eat, that’s how I feel.” Instead of realizing that mostly you shouldn’t feel bloated and gassy. Your elimination should be regular.
It’s also bringing awareness and reminding people that we’re not supposed to feel tired all the time. I call it the window of faith. Is it 30 days or is it 45 days where if people just gave it that faith time, that it would get them in that place where they are feeling better, and then you don’t have to sell them on it? Is there a period of time where they clean up a little bit? Is it a couple of weeks where they start to feel a little better?
Do you mean as far as food or probiotics or both?
Both. Getting people to go, “Just ride with me for a little bit here.”
It’s up to four weeks for both. What’s interesting is that for the probiotic, we will hear from people 2 to 4 weeks in, “I feel like I’m sleeping better. My discomfort is gone.” You’re absolutely right about the state of their normalcy, that state of unwellness. I hear someone in clinic say, “My whole family has gut issues,” as if that is now all accepted. We all have to accept that we have gut issues where we don’t accept normalcy and we’ve lost perspective of what normal is.
From the GI perspective and physician perspective, shifting the paradigm of things and getting you to understand where you are now is not the norm. We definitely see four weeks. I spoke to you about the studies that we do in PSE. What’s interesting is we see the liver numbers changing from 4 to 8 weeks completely when it changes. We know that that is what we see in the right probiotic. When population happens, you’ve got the right strains, and you are now populating the gut flora, clinically you’ll see a change by four weeks.
By eliminating that sugar, too, you get that liver a chance to regenerate. Dr. Davies, I appreciate this education. Can people order the Lyvecap online?
Yeah, it’s available.
Do you have a favorite probiotic that you would give a teenager or a kid? Is there one that you say, “I appreciate their studies.”
De Simone Formulation for this biome is phenomenal. That’s the gold standard. Lyvecap is based on that. That is for the general masses. Does it help athletes? Absolutely. Could everybody take Lyvecap Strong? 100%. A well-studied probiotic that is shown to efficacy, eight strains that have been brought together to show the difference and the change. Everyone should definitely take either his biome or Lyvecap.
Finally, I want to throw this in. You’re a big advocate of fermented foods. We live in Hawaii and a friend of ours here who is Japanese, natto. They love that. Is there anything that we have to be mindful of when we buy fermented foods? What I’m saying is even to navigate that part of it because at times, they can put some undesirable things inside the fermented foods. When people are like, “Make sure you understand what the ingredients are if you’re buying kimchi or sauerkraut,” do you have any other favorite ones?
Kimchi is my favorite. I love that. It’s mild as far as it won’t cause any harm in the gut. It’s mild as far as the amount of bacteria that are there. There’s nothing that would happen to you from taking it. We need to go back to trying to populate that more and more. Mind you, those foods like kimchi and kombucha don’t change immunity. If you’re looking for foods to supplement, those are the foods, especially if there’s some GI discomfort. Generally speaking, they’re safe to take.
Is there anything that is important for people to know that I have left out?
One thing that’s important that people ask is, “If you come off of a probiotic, what happens?” Then you go back to what you had before. A probiotic is a transient change. You are taking it daily to populate the gut with that bacteria. That’s why it’s important for it to happen and take daily. We talked about the diet, and it’s not just taking a probiotic and everything’s happy. It’s the combination of your sleep, your diet, your exercise. We talked about educating on the right probiotic, what to look for. Careful when they talk about studies that are not always there. We hit it all. Lyvecap is available. It is convenient and out there.
I’m definitely going to explore because you can get me when you talk about regulating muscle metabolism and things like that.
I’d love you to try it. We’d love to hear how you feel about it.
I appreciate your approach in talking about prevention. I have a friend who is a heart surgeon. He’s maybe in his late 60s now and he’s a healthy guy. He said, “I would have gotten into preventative medicine,” because by the time they get to me, I can even ask him to stop smoking. Usually, it’s hard. Our food system has gotten wonky and it might even be to get into food politics. I’m hopeful that there are people like yourself out there, what one would call a conventionally trained doctor, connecting the dots for people.
I do think that we’re at a place where we do need to support patients when you’re talking about these populations that are so vulnerable. Real people trust real doctors. Sometimes the others are considered woo-woo still, even if the information is solid. I want to say thank you because like you said with your colleagues, they probably roll their eyes and they’re like, “There’s Dr. Davies talking about eating plants.” Thank you for that and I appreciate that.
This has been great. Thanks for bringing this up. Thank you.
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- Dr. Yinka Davies
- Breaking the Vicious Cycle
- 10% Human
- Mark Hyman
- De Simone Formulation
- Dr. Robert Lustig
- Lyvecap Strong
About Nate Ebner
Pediatric gastroenterologist trained at Stanford and have been practicing for over 15 years. Currently an adjunct clinical professor at Stanford – involved in multiple clinical trials involving the human microbiome and how it relates to both disease and unwellness. Through my countless experiences in the clinic and moreover my career, I realized that a balanced gut is critical for health and wellness.