← The Rich Roll Podcast
The Rich Roll Podcast
Gut Health Compilation: Leading Experts On Fiber, Inflammation, Cancer Survival, & How Your Gut Predicts Your Future Health
01:10:53
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- [00:02]
Dr. Will Bulsiewicz
I was at a microbiome meeting recently and blown away by what's happening in cancer research. With the microbiome complete game changer, the.
- [00:12]
Dr. Mark Hyman
Gut bacteria actually guide that immune response. They're constantly sending signals to the immune cells.
- [00:19]
Dr. Michael Greger
The microbiome helps fight aging, helps fight cancer, sorts out allergies.
- [00:24]
Dr. Will Bulsiewicz
Our modern lifestyle is basically activating these inflammatory mechanisms in a chronic smoldering.
- [00:32]
Dr. Michael Greger
We need to be focusing on the quality of food. And that's totally clear.
- [00:37]
Dr. Mark Hyman
What we should all be aiming for is this concept of a Goldilocks immune system.
- [00:41]
Dr. Will Bulsiewicz
This is not just us describing the microbiome. We're talking about manipulating the microbiome to save people's lives.
- [00:52]
Rich Roll
You think you're eating healthy, you think you're doing everything right, but your gut may still be screaming for help. You'll feel it everywhere. Brain fog, anxiety, fatigue, inflammation, weight gain. But here's the problem. Most people are still treating symptoms, taking probiotics, cutting carbs, drinking detox teas, while ignoring the real issue. The ecosystem living inside of you is out of balance, and we're going to get right into it in a sec. But first, foreign is brought to you by Roka. You know, it's funny. We don't often think of eyewear as performance gear until it starts to get in the way. And if you're like me, somebody who has contended with eyesight impairment my entire life, it's a very real thing without a real solution for athletes. I cannot tell you how many times I've been mid run, constantly shoving my glasses back up my nose, tripping on roots and rocks because I couldn't see them or my glasses had fogged up. Or what about out on the bike where the treachery is obviously far more intense? Well, this is why Roka has been a godsend for me. Approaching prescription eyewear from a performance perspective first, but not at the cost of fashion. I should say helping not only people like me, but all kinds of athletes, including Tour de France cyclists and ironman champions, with everyday frames designed for movement. Their secret is their proprietary gecko technology. Patented nose and temple pads that grip even more securely when you sweat. No slipping, no distractions. And they're insanely lightweight. Most frames weigh less than a pencil. Super light, even with prescription lenses. Beyond the function, the craftsmanship is next level. Razor sharp optics, durable construction, and a design that actually is beautiful and keeps up with you. So put them on, feel the difference, and wear without limits. Unlock 20% off your order with code richroll@roka.com that's R O P ka.com we're brought to you today by AG1. I know that I've been a loyal consumer and partner with AG1 for many years at this point, but I couldn't actually remember how long it's been specifically, so I decided to do some research. I mined my inbox to try to figure out when it all began and I discovered it's actually been 10 years. A decade in which I've seen this brand iterate its formula many times but nothing like what just happened, which is a just launched massive next generation formula upgrade in which AG1 has enhanced its profile for broad spectrum nutritional coverage, five new vitamins and minerals, four upgraded ingredient forms that work better with your body, and upgraded probiotics for enhanced digestive support and immune health. Along the way, AG1 went beyond industry standards to rigorously test the upgrade with four human clinical trials to back up its efficacy and make a great, great product even better. Now, clinically backed with an advanced formula, this is the perfect time to try AG1. If you haven't yet. I've been drinking AG1 for many years now, as I mentioned, a decade, and I'm so happy to be partnering with them. So subscribe today to try the next gen of AG1. If you use my link, you'll also get a free bottle of AG D3K2, an AG1 welcome kit, and five of the upgraded AG1 travel packs with your first order. So make sure to check out drinkag1.com richroll and get started with AG1's next gen and notice the benefits for yourself. That's drinkag1.com richroll okay, in this episode, some of the world's leading doctors and researchers break down what's really going on inside your gut and how to fix it with food, fiber and science, not fads. So if you've been bloated, constipated, wired, tired or inflamed, keep listening. Your gut will thank you. What has got you excited in terms of the latest literature and what we're discovering about the microbiome?
- [05:20]
Dr. Will Bulsiewicz
I was at a microbiome meeting recently and blown away by. And this is coming from, you know, the guy who's nerding out on microbiome studies all day. Blown away by what's happening in cancer research with the microbiome complete game changer. So what we're seeing here is that first of all, going back a few years, we discovered that cancer has a microbiome.
- [05:44]
Rich Roll
Like, how does that work? Like a distinct microbiome that is differentiated from how we commonly think about it. Explain that.
- [05:52]
Dr. Will Bulsiewicz
I'm not even talking about the gut microbiome. So let me start with this. Microbes are everywhere. They cover us from the top of our head to the tip of our toes. They're most concentrated inside of our gut. But they're on plants. They're part of the plant microbiome. They're in the soil. Obviously, everything that's alive in this planet either is a microbiome or has a microbiome. Those are the two choices. So everything has a microbiome. And I thought, like a tumor would be a sterile mass of cells. And a few years ago, they discovered that tumors, cancer, tumors actually have their own microbiome separate from the gut microbiome. They have their own microbiome. And they took this further. They were taking a look at pancreatic cancer, which is one of our most deadly cancers, and they analyzed the microbiome of the tumor, not the person's gut microbiome of the tumor, and discovered that a person who has a low diversity within the tumor microbiome has a worse prognosis or a lower likelihood of survival relative to the person whose tumor has a high diversity.
- [07:04]
Rich Roll
So explain what that means, low diversity.
- [07:06]
Dr. Will Bulsiewicz
So diversity is looking at sort of the spectrum of different types of microbes, so, like, different varieties of microbes and how strongly they're represented. So, like, inside of us as humans, inside of our gut microbiome, we could have anywhere from hundreds up to potentially a thousand different varieties of microbes living inside of our gut. And one of the things that we would look at in terms of the health of the gut microbiome in a human being is the diversity within that system.
- [07:34]
Rich Roll
Sure.
- [07:34]
Dr. Will Bulsiewicz
So what we find rich is that if you look at ecosystems, whatever that ecosystem may be, it could be the Amazon rainforest, it could be the Great Barrier Reef, and it can be actually our personal gut microbiome, which is an ecosystem. And what we discover, biologists will tell you this, is that diversity within the ecosystem is a measure of health.
- [07:53]
Rich Roll
Right. It makes it more robust and resilient.
- [07:56]
Dr. Will Bulsiewicz
Right. Because there are different players that are there, and they all have different unique skills that they can basically contribute to the greater good. And if you, for example, if you take the rainforest diversity and remove the snakes from the forest, I'm not a huge fan of snakes. You remove the snakes. The problem is that the other animals, they're not snakes. They're not really designed to fill that role within the ecosystem. And so when you remove the snakes, it actually has a ripple Effect, because all these other animals are being affected by the fact that you have disrupted the balance that exists within that ecosystem. So, anyway, getting back to the cancer, they discovered that these cancer cells have their own microbiome and that the diversity within that microbiome could indicate prognosis. Now, this is quite fascinating. And so they continued down this path to look into this in more detail. And there have been a number of major discoveries. First, in acute myeloid leukemia, one of the treatments that they will give people are stem cell transplants. And it's basically trying to throw Hail Mary and save a person's life. And there are some people who do great, and there are some people who do not. What they discovered recently is that the microbiome, the gut microbiome of the individual people who received the stem cell transplant actually is difference making. If you have high diversity within your personal gut microbiome and you receive the stem cell transplant, your survival is actually much better.
- [09:23]
Rich Roll
But conversely, if the diversity of the microbiome with respect to the tumor is high, that would correlate negatively with treatment receptivity. Is that what you're saying? So if the microbiome on the tumor is very diverse and robust, then it's gonna be much more treatment resistant?
- [09:43]
Dr. Will Bulsiewicz
No, actually, it does better.
- [09:45]
Rich Roll
Oh, I see. Cause I was thinking the diversity of that microbiome is there to support the tumor growth. So the less resistant it is, then, the weaker it is.
- [09:54]
Dr. Will Bulsiewicz
No, actually. So in both cases, a more diverse microbiome, whether it's inside the tumor or whether it's the patient's actual gut microbiome, in both cases, a more diverse gut microbiome is associated with a better prognosis. So now MD Anderson is, like, taking the ball and running with this. And they're doing quite fascinating research with melanoma specifically, which is a skin cancer. It's the most deadly form of skin cancer that exists. And one of the ways that they will commonly treat melanoma is with immunotherapy. Now, they've been doing this for about 10 years, and it can be highly effective. But of course, there are people that it does not work for. So how do we determine who are the people that it's good for versus the people that it's not good for? Well, kind of building up to the most recent stuff. That's just from a couple of weeks ago. A few years ago, M.D. anderson did a study where they looked at the effect of antibiotics immediately prior to receiving this treatment for melanoma. Antibiotics reduced diversity within the gut microbiome and what they found is that in doing this, they actually were reducing the effectiveness.
- [10:57]
Rich Roll
That's fascinating.
- [10:58]
Dr. Will Bulsiewicz
Of their treatment. Taking it a step further, they then took a group of people and they showed that once again, if you have a higher diversity of your microbiome, you are more likely to survive and have a good result from immunotherapy. They gave them a fecal transplant, so they started giving fecal transplants to people. And when you received a fecal transplant to boost your diversity temporarily, people had a better survival and better outcome from immunotherapy.
- [11:26]
Rich Roll
That's amazing.
- [11:27]
Dr. Will Bulsiewicz
So now, bringing it all the way forward to where we are today, more recent research has shown that the diversity within a person's gut microbiome, their gut microbiome, is very relevant to this melanoma. And they've identified specific species. And what's interesting is that the species that you want to have that basically portend a better prognosis are the exact same ones that help us to process and digest our fiber and produce short chain fatty acids. And these short chain fatty acids, they are the product of fiber degradation by our gut microbes.
- [12:05]
Rich Roll
Wow.
- [12:06]
Dr. Will Bulsiewicz
Fiber is the prebiotic. Our gut microbes are the probiotics. And when they come together, the fiber, the prebiotic with the probiotic bacteria, they basically create this new compound which we would call a postbiotic. And these are the short chain fatty acids, like butyrate. So they showed in this research that melanoma patients have a better survival if they have higher levels of these butyrate producing microbes in their gut.
- [12:34]
Rich Roll
Wow.
- [12:35]
Dr. Will Bulsiewicz
So they did a new study looking at dietary fiber. What happens when people are eating more dietary fiber? And again, this is in the context of treating the melanoma with this intervention immunotherapy. And the cutoff that they used was 20 grams of fiber per day. Now, let me just first comment and say this is actually less than the recommended minimum.
- [13:00]
Rich Roll
This is not very much.
- [13:02]
Dr. Will Bulsiewicz
It's not very much.
- [13:02]
Rich Roll
Probably more than most people are eating.
- [13:05]
Dr. Will Bulsiewicz
Yes. So in this cohort of people where this cutoff is 20 grams of fiber, so they considered it to be like if you're more than 20 grams of fiber, you're a high fiber consumer. I'm just gonna tell you the minimal recommended amount for A woman is 25 grams of fiber.
- [13:19]
Rich Roll
And you're probably eating, I don't know, 200 grams of fiber a day.
- [13:22]
Dr. Will Bulsiewicz
I'm supercharged on as much fiber as possible. The average for a man, the minimal recommended amount for a man is 38 grams. Of fiber. Right. So even at 20 grams, we are low. 71% of the people in this study did not hit 20 grams of fiber. And what they discovered is that the people who were the high fiber consumers, this 29%, they had a significantly improved survival after the immunotherapy for melanoma on the high fiber diet.
- [13:53]
Rich Roll
Wow.
- [13:54]
Dr. Will Bulsiewicz
So check this out. This is where, like, my mind is blown when I saw this. For every 5 grams that you increased your fiber consumption, you increase your survival by 30%.
- [14:07]
Rich Roll
That's an insane number. That's crazy. So the most general takeaway from that is if you are suffering from cancer and you're about to undergo treatment or you're currently undergoing treatment, you should be boosting your fiber intake as much as possible.
- [14:21]
Dr. Will Bulsiewicz
So I would expect that that would be true. We can't necessarily apply that to every single cancer. But here's what I can say, what we just saw, it's not gonna hurt you. No, it's not gonna hurt you.
- [14:32]
Rich Roll
Yeah.
- [14:32]
Dr. Will Bulsiewicz
This 5 grams of fiber translating into a 30% greater survival is giving me deja vu. From a colon cancer study that came out in 2018, where if you increased your fiber intake after you were diagnosed with colon cancer. Now these are, by the way, people who did not have metastatic colon cancer. Okay. So because metastatic's a totally different animal. But among people who do not have metastatic colon cancer, if you increased your fiber intake after you were diagnosed, for every five grams that you increased your fiber intake, you saw an 18% increased likelihood of survival.
- [15:13]
Rich Roll
Wow.
- [15:13]
Dr. Will Bulsiewicz
So we're seeing the pattern showing up among different types of cancers. And further study is going to push this even further along. Melanoma is where we have the most robust research because MD Anderson has really taken an interest in this particular topic. But I think this is the future. This is where people are going to be looking. And what's exciting, Rich, is that this is not just us describing the microbiome. We're talking about manipulating the microbiome by quite simply eating plants to save people's lives.
- [15:44]
Dr. Michael Greger
The microbiome is the term we use for the community of microbes, microorganisms that live in. In our bodies. And we generally refer to the 99% that live in our lower intestine, our colon. And the microbiome really refers to the genes of those microbes, should technically be called the microbiota. We just use the most microbiome because I'm not fussy about words. And everyone now understands that. So these. There are some dispute about how Many there are, but they're probably. There are certainly trillions, maybe 100 trillion or so, roughly the same numbers of cells in our body. Most of them are. The ones we know about, are bacteria, but there are also these other related species called archaea. And there are fungi and yeasts, and there are viruses, five times as many viruses as bacteria that feed off them called phages, which also have a role in health. And there are even parasites that virtually all of us have to some extent, in our guts, and some of which turn out to be beneficial as well. So it's this whole community, a bit like an ecosystem that is living within us, and it best considered as a virtual organ. Stick them all together, they weigh about 2kg, same as your brain. And they basically, as I said, these. These mini pharmacies pumping out chemicals which send signals all over our body, but particularly to all the immune cells, the majority of which, our immune cells are actually lining our gut. And so they interact with those immune cells on a constant basis, signaling whether to be aggressive or be passive and modifying them, tuning them up and down. That helps fight aging, helps fight cancer, sorts out allergies, et cetera, et cetera. In fact, fights infections. And they also produce lots of chemicals that might go to our brain, responsible for serotonins and many other pathways in the brain as well. So affects our mood and obviously our metabolism and how we digest food, amongst others.
- [17:58]
Rich Roll
Right. Like so many things.
- [17:59]
Dr. Michael Greger
Right things.
- [18:00]
Rich Roll
But this idea that our immune system really resides in our gut is kind of a shocking revelation. Like, I always understood that our immune system originates in our bone marrow. And, you know, this is where we're producing all these cells. And, yeah, this is what. Yeah, this is. And why is it that we didn't begin to really even put these pieces together in a methodical way until, I don't know, the early 2000s. Like, it seems like you kind of got into this around 2011. Right. Like, this is all extremely recent because prior to that, conventional wisdom was sort of like, you know, we got to get rid of parasites and all this stuff. These are plaguing the human body. And at some point, somebody figured out, like, actually, we're living symbiotically with all of this, and this is crucial to every facet of health. And we're still, it feels like in the very early beginning stages of trying to understand the true and vast implications of this incredibly complex system.
- [19:05]
Dr. Michael Greger
I think it was medical hubris that says that, you know, our powerful drugs can get rid of this stuff. We're fighting the rest of the world. We know that microbes have killed lots of people in history. Infectious diseases, you know, were vitally important. And we survived them. Therefore, you know, we can beat them. And antibiotics, sterilizing creams, you know, keeping people away from dirt. This is the way we're going to conquer our sort of our fears. And I think it was a blind spot to realize that the gut health really was important and for so long just regarded that the intestine is a tube to get rid of toxins.
- [19:47]
Rich Roll
Right.
- [19:47]
Dr. Michael Greger
And that sits absorb nutrients. Some people still believe that.
- [19:51]
Rich Roll
Right.
- [19:51]
Dr. Michael Greger
But, you know, particularly the toxin bit, but the not realizing it had such major implications as a vital organ for us. And I think it was, you know, few people guessed at it. And even, you know, you go back to the days of 100 years ago, Mechenkoff and Pastor talking about yogurt, they thought it worked because it deputrefied the body, you know, got rid of those toxins. They couldn't still imagine that it was feeding other. Other microbes inside there. So I think we just had a blind spot to it.
- [20:29]
Dr. Mark Hyman
Most of the immune system is physically located in your gut, about 70 to 80% of it. And so when we talk about the immune system, we do a little immunology 101. And, you know, full disclosure, I'm not an immunologist, I'm a gastroenterologist. But let me give folks some basics. So we're really talking about two systems. We're talking about the innate immune system that you're born with and an acquired immune system, sometimes called the adaptive immune system that you acquire over time. The innate immune system works quickly, but it's sort of nonspecific. So, for example, if you get a cut, it works to help protect you from the bacteria that may be invading through that open wound or. But in a very nonspecific way. The acquired immune system develops over time, and it actually keeps a record of every pathogen that you're exposed to so that it can remember it and mount a response. So it's sort of like that person who never forgets and holds a grudge and is like, oh, yeah, in first grade, you kick me under the table.
- [21:26]
Rich Roll
Right, Like a crow crows. Never forget.
- [21:29]
Dr. Mark Hyman
Exactly. So the acquired immune system is able to. It takes a little bit longer to work, and particularly if it's a new organism, but it. It remembers, and then it is able to release antibodies. So the acquired immune system involves T lymphocytes, B lymphocytes, and the B1s make the antibodies, and the T lymphocytes are kind of like air traffic control, destroying cells that have been infected, et cetera. But if you think about the adaptive immune system, the point that I like to make for people is that that is a basis of vaccines, for example. Right. A vaccine introduces a tiny little bit of the viral protein. Not enough, ideally, to make you sick, but enough for your adaptive immune system to start to create antibodies against it for the next time it encounters that virus. And so if you think about some of these things, like with measles, for example, a virus that's very old, if you get measles and you have the illness, your immune system remembers so that the next time you're exposed to measles, you're immune. Now, a vaccine can do the same thing. Right. But so can having the disease in that particular instance. And so what we see is that the adaptive immune system can make you less sick or not sick at all the next time you encounter something.
- [22:49]
Rich Roll
Sure. So the innate immune system, the acquired immune system. So when we talk about, I think you said 70% of the immune system resides in the gut, like, so what is it exactly that is in the gut? Is it these lymphocytes? Is it these systems and pathways? Like, what are we talking about?
- [23:07]
Dr. Mark Hyman
It's these actual cells. So when you think about the gut lining, this is a razor thin lining. It is literally a millimeter or two thick. And it's a net. It's a permeable net, like a fishing net with tiny holes, and it allows some things to go through. So typically, digested food digested into the micronutrients passes through, and then the excrement, the waste matter from cells, passes out. And remember that when something is in your GI tract, it's not actually inside your body. It's in this long hollow tube from mouth to anus. And so things get passed out. Well, the immune cells are on one side, they're on the inside part of the net, inside your body, and your trillions of microbes are on the outside, on the other side of the gut lining. And of course, there's a thick mucus layer also surrounding the gut microbes. But it is literally this hand and relationship, and there's constant communication. So the gut bacteria actually guide that immune response. They're constantly sending signals to the immune cells to tell them what to do. And I'll give you a great example of that, is there is a bacteria in the gut called bacteroidetes. It's a sort of type of bacteria, and there are many different strains. And when Certain viruses enter the GI tract, bacteroides, in the gut lining, right there in the lumen against the lining, will trigger a message, interferons, and they're called interferons, cause they interfere with viruses to release certain cytokines to destroy the viruses. And so if your complement of gut bacteria are off and you don't have a healthy microbiome and you don't have sufficient quantities or the right strains of Bacteroide disease, you might not trigger that release of interferons and this sort of virus slaying capabilities, if you will. So it's both a functional relationship and it's an actual physical relationship, Rich. Because they're right there next to each other, constantly communicating. And when you think about it, your immune system, your gut lumen is exposed to trillions of different things, right? Because again, it's in contact with the environment, what we're eating and swallowing, and everything's going into this open tube. And your immune system has to look at this morass of a gazillion, different organisms and figure out what's friend and what's foe. And it's really the gut microbiome that is directing that. And that's literally saying, yeah, this one, you need to be really worried, do something big. This one just ignore. Yeah, this one's actually helping. So it's that back and forth relationship, that communication that's happening all the time in our gut, right?
- [25:51]
Rich Roll
So essentially these things are completely interwoven. You can't talk about the gut without talking about the immune system and vice versa. They are 100% dependent upon each other in terms of their functionality. And when we talk about immune system dysregulation, that can come in two forms. Either it's hyperactive, and then you see all of these like sort of autoimmune diseases or allergies to foods and such. The cytokine storm that comes with, you know, certain people who succumb to Covid, et cetera, or the underperforming immune system that you mentioned, where you're not producing the interferons and the cytokines necessary to combat the disease on the front lines, the virus on the front lines, is that.
- [26:33]
Dr. Mark Hyman
Yeah, that's a beautiful summary. And I think even dividing it further into internal threats and external threats can help to clarify it even more. But you gave a beautiful summary of what it is. So if we think about an overactive immune system, on the one hand, I want people to think about internal threats, and that would manifest as autoimmune disease. So that's Basically, when your body is reacting to your own body's normal tissue, it's recognizing your own joints, skin, et cetera, as foreign and mounting an immune response. And so we see that with autoimmune disease affect 1 in 4Americans, there are over 100 different autoimmune diseases now. And this is a list that's growing, unfortunately. We can talk about why that's happening later. When we look still in the category of an overactive immune system, we look at external threats. And so that would be people who are having allergies, peanut allergies, severe allergies to bee stings. I was exploring the marsh in beaufort, south carolina, my husband's hometown, back in May, and we had the unfortunate privilege of being bitten up by chiggers. These insects and his healed in about two or three weeks, and mine are still active four months later. I have this sort of unknown delayed hypersensitivity reaction to it. And maybe because he grew up in South Carolina, and he's been bitten by chiggers before as a kid, and I never have. But that's an example of an exaggerated response to this external threat. So that's all. Overactive immune system, underactive immune system. If we again look at the two categories of internal threat and external threat, the internal threat would be people developing cancer. Because your immune system doesn't just protect you from infection, it also helps with cancer surveillance. So as our cells start dividing, sometimes they start to divide a little precariously, and that reproduction leads to errors in the genetic material of the cell. And over time, that can transform to cancer. And so the internal cancer surveillance system is also something that our immune system does, and it would weed out those cells so that they die off and they're not continuing to proliferate and form cancer. So with an underactive immune system, your cancer surveillance is off, and you're at increased risk for cancer on the internal side. And on the external side, that would be infection. Viral, bacterial, fungal, et cetera. So what we're should all be aiming for is this concept of a goldilocks immune system, right? An immune system that is active enough to clear a virus, but not so active that we end up with a cytokine storm. You mentioned this overblown immune response. And the really fascinating thing when we look at this pandemic is that a lot of the deaths and the illness have been due primarily to the immune response. Not so much a virus itself, but it's our body's unregulated or dysregulated response to that virus that's causing the acute respiratory distress syndrome or, you know, other severe illnesses and sometimes even death.
- [29:39]
Rich Roll
Yeah, sure. So there's so much in what he just said to unpack, but to kind of pull some threads on this. I mean, first of all, yes. Like in, you know, in this era of COVID I think we can all agree that we've been on the receiving end of a lot of conflicting information and social vitriol that kind of swirled around what is fact, what is fiction. Certainly one truth that was kind of underrepresented was that there was not enough messaging about the personal responsibility that we have for our own health. And much of what you talk about and is in your book is the malleability, the adaptability of the gut microbiome and in turn, our immune system when we sort of get rid of certain things. Things, or stop certain habits and adapt new habits. Like, it really is resilient in that regard. And we're all capable of creating a Goldilocks immune system. I mean, most of the languaging is around boosting our immune system. Obviously, that's problematic for the reasons that you just said. It is this Goldilocks immune system that we're all striving for. Today's episode is brought to you by Roka. You know, it's funny. We don't often think of eyewear as performance gear until it starts to get in the way. And if you're like me, somebody who has contended with eyesight impairment my entire life, it's a very real thing without a real solution for athletes. I cannot tell you how many times I've been mid run, constantly shoving my glasses back up my nose, tripping on roots and rocks because I couldn't see them, or my glasses had fogged up. Or what about out on the bike where the treachery is obviously far more intense? Well, this is why Roka has been a godsend for me, approaching prescription eyewear from a performance perspective first, but not at the cost of fashion. I should say helping not only people like me, but all kinds of athletes. Athletes including Tour de France cyclists and Ironman champions, with everyday frames designed for movement. Their secret is their proprietary gecko technology, patented nose and temple pads that grip even more securely when you sweat. No slipping, no distractions. And they're insanely lightweight. Most frames weigh less than a pencil. Super light, even with prescription lenses. Beyond the function, the craftsmanship is next level. Razor sharp optics, durable construction, and a design that actually is beautiful and keeps up with you. So put them on. Feel the difference. And wear without limits. Unlock 20% off your order with code rich roll@roka.com that's R O K A dot com I love coffee, but the jittery anxiety that comes with it, not so much. And while I've tried my share of coffee alternatives, most fall pretty far short when it comes to that satisfying boost that I'm looking for. So when Peak sent me Nandaka, their adaptogenic coffee alternative, let's just say I was a bit dubious that this would be any different from the others. But I gotta tell you, I was pleasantly surprised. It definitely leaves me feeling elevated, energized for sure, but also calm, focused but steady. And this is because it's made with fermented Pu erh tea which provides a slow release of caffeine. The formula is legit. It's made not only from gut health promoting probiotic teas, but also triple toxin screened fruiting body mushrooms, not mycelium, including chaga, reishi, cordyceps and lion's mane. It also has ceremonial grade cacao warming spices like ginger and cinnamon and cacao butter for enhanced absorption. All organic, all vegan, no junk. And listen, it tastes great. So if you're looking to adjust your morning ritual, now's a great time to try Nandaka. You can get 20% off for life and a free starter kit that's a rechargeable frother and glass beaker when you visit peaklife.com richroll that's P I Q U E life.com rich roll, rich roll. Let's bust a few diet myths, right? Like macros, calorie counting, like come at me like I, I know you got a lot to say about this kind of thing.
- [34:15]
Dr. Michael Greger
They exist, but, you know, their importance has been massively hyped. And the idea you can describe food by calories and by macronutrients has been exploited to the nth degree by the food companies. And that's why they can sell us all these products with these health claims on them when we know they're rotten, they're artificial, you know, they're just, they're fake food. But because they have the right macronutrients on the label, they get a nice tick and we're poisoning ourselves. So I think, you know, we haven't really changed in 100 years. Our basic concept of how to discuss nutrition properly. And we're only just starting to get into this discussion of what ultra processed food is and the different levels of food processing which the food industry doesn't want us to discuss because the last thing they want is some definition that they would have to apply to. So they are keeping muddying the water on it. So the, the fact that they, you know, the companies I discuss this in the book, you know, love the idea of calories. They love calorie things on menus and they describing food by its, as if you can tell if it's food good or bad by its calorie count and its fat content. It's complete nonsense. There is no real correlation. And there are good and bad fats and there is good and bad calories foods. You know, we need to be focusing on the quality of food. And that's totally clear. Like the example I gave you in the Zoe study of people given an identical calorie muffin. And some people react to that in a very different way and get a sugar dip and will overeat by 300 calories later in the day. Others won't. If you describe food purely in terms of that all calories are equal and you just gave everyone these bad, bad foods, you wouldn't know that this is what this effect they're having on mood and energy and everything else. So smokescreen that we just need to get rid of and we need to start talking about quality of foods. What's whole food? You know, what's a whole plant food? Not these foods that are made in a way to falsify real food. You know, they're designed to reformulate actual food using fake ingredients, extracts. And I think that's, you know, no one denies that calories exist. But we can go into the whole thing about why calorie counting diets fail the vast majority of people. It will work for a few weeks, then your body just readjusts and bounces back. Same way exercise for most people does the same, because your body adapts to that exercise. You know, we're not just furnaces, we're finely tuned machines that change. So these are concepts that have just stayed because of the market, the force of the calorie counting diet market, the force of the food industry trying to sell us worse and worse food with more and more health claims. And I think the science is now out there to show how so irrelevant they are and how they are just a smokescreen.
- [37:55]
Rich Roll
Yeah, there's sort of an arms race also because as the public becomes increasingly more and more aware of the ills of ultra processed foods, at the same time, the giant conglomerate food companies are getting better and better and better at dialing in palatability and the addictive nature of, of these Foods with the exact recipe or combination of salt, sugar and fat to kind of light up the dopamine centers and make it impossible to just have one. So it creates this sort of compulsive relationship with foods we know are not good for us and yet we find ourselves powerless to deny. Right. So education takes us to a certain place and, you know, human frailty and weakness, you know, accounts for the rest. So, you know, it's, it's, it's sticky to like.
- [38:52]
Dr. Michael Greger
Well, I've got, no, I don't really have a beef with foods that are obviously unhealthy but super tasty. Right. But when something is wrapped up in a, in, in all this healthy packaging and is sold to you as a healthy, low calorie, low fat alternative, that's, you know, that's criminal. It's, it's, it's like dressing up cigarettes as, as healthy because they, they're low in like it used to be low tar or low nicotine, therefore they're fine.
- [39:28]
Rich Roll
Right. Yeah, that's, that's forgotten. Sort of the tobacco company version of greenwashing. It makes us just feel a little bit better about that purchase, you know, making that purchase.
- [39:38]
Dr. Michael Greger
Exactly. So, you know, let's have, we're not going to get rid of them, but let's, let's have them with health warnings, let's have them with a tax that reflects the huge burden on the, on the taxpayer that all these foods are costing us. You know, so it's hundreds of billions of dollars a year just because of, we're eating these foods. And why should the taxpayer be basically paying for all this when the food companies are making all the money and they're getting massive subsidies to do it, whereas anyone producing whole plants and fruits is not getting those same subsidies.
- [40:18]
Rich Roll
Right. I mean, I agree with you completely. But then it becomes a question of political will and kind of penetrating the battalion of lobbyists who are, you know, very invested in the status quo. So while we're all getting diabetes and becoming obese and dying, there will be.
- [40:36]
Dr. Michael Greger
A point in the country just won't be able to afford it.
- [40:38]
Rich Roll
You know, the healthcare system is broken. So it's, it is. And it's a national security. It becomes a national security issue. Honestly, like, it's a really huge problem and yet it continues to persist and metastasize, which is disturbing. But perhaps we can pivot to a more optimistic or helpful conversation around how to guide people towards those better choices. We all know more fruits and vegetables, nuts, seeds. That's the kind of Thumbnail. But for the conscious consumer who's just going to the supermarket and shopping for their family and is on some level of budget, what are some of the guiding principles about what to avoid and what to invest in?
- [41:25]
Dr. Michael Greger
Well, there's a lot to avoid. But in writing the book, there were some surprising findings that I found that things that are relatively cheap aren't always unhealthy. So things in cans. Many studies have shown that some canned tomatoes can have higher nutrients levels than fresh tomatoes. For example, get a can of beans. They're just as healthy as getting your dried beans and doing them yourself. And they're often extremely cheap. Really good source of protein. Most frozen vegetables and berries are also highly nutritious and really good for you and cost virtually nothing. So we tend to think of anything frozen or in cans or in packaging is all the same. It's absolutely not true. As long as the source, it doesn't have, you know, an artificial source in it, it's going to be really good for you. So that was a surprising finding for that many of these products you can get out of season. Frozen berries, for example, out of the freezer. Really good for you.
- [42:37]
Rich Roll
Not.
- [42:38]
Dr. Michael Greger
And you know, there's nothing wrong with nuts as a snack. And there's a big difference between some artificially created snacks like, I don't know, you know, things like Pringles, which have very little potato in them. They're actually made of all kinds of a composite of other things versus some artisan potato chips that you can get that only have potato and olive oil oil or sunflower oil. So there are some surprising ones in there. But unfortunately, the vast majority of ready meals that you buy have large lists of ingredients in them that you can't, wouldn't find in your home. And they're the ones that will cause you problems, they will make you overeat and they will be bad for your gut microbes. And I think that's a really important educational message that needs to get out there is that it's not about the fat, it's not about the calories. It's the fact they have this really harmful effect on your immune system. And you're going to eat more and more of them. So they might be cheaper, but you're going to. They're made for a purpose so that you'll be overeating your family and you will put on weight and have all these other diseases. So I think it's this education about what's on going wrong with certain foods that are, you know, ultra refined, have no fiber, very little nutrients get into your bloodstream quickly, don't fill you up. And they're just plain wrong. We weren't designed by evolution to eat them. Right, that. So to my mind, it's, it's, it's an educational way of thinking, but realizing there are some, you know, things that look quite similar that actually are still very good for people, but they're not eating.
- [44:25]
Rich Roll
Yeah. Your dietary perspective and recommendations, although very plant focused and kind of plant centric, are not ideologically sort of driven and they're not super strict in that regard. They're more like, this is what looks like the science supports and this is what I'm advising you to do and not do. And an added wrinkle on top of that that I found really interesting in the book is addressing not only how the food is prepared, like, have you cooked it? Is it better to eat raw? Or this is stuff I've thought about often, like, should I eat this vegetable raw or is it better cooked? Is it better to light? What happens if you overcook it? Am I destroying all the nutrients in it? And then also, how is the food, food packaged? What is the impact of, you know, food that's wrapped in plastic and particularly if you end up like heating that food up while it's in the plastic and you kind of address all of these, which I think are, you know, kind of common questions we all think about but maybe don't pay enough attention about. So can you kind of unravel some of that?
- [45:36]
Dr. Michael Greger
Well, it's a lot to unravel.
- [45:37]
Rich Roll
Yeah. I mean, there's, it is, I mean, you can read the book, but like maybe some sort of general principles around that.
- [45:43]
Dr. Michael Greger
Yeah, well, I think a lot of it comes down to understanding a bit more about the structure of food and cooking changes the structure of food. So, yeah, there was a common misconception that raw food is better for you. And the raw food movement has led a lot of this. But all the science suggests that actually lightly cooking food is the optimal. So lightly steaming your food, but breaks down the structures, allows the nutrients to come out without destroying some of these vitamins and nutrients. And these polyphenols we talk about, these defense chemicals that are in all plants, that are really rocket fuel for our gut microbes that are really what we should all be trying to get more of, that definitely aren't in ultra processed foods. So understanding the structure of food and how you're cooking is really important. Understanding that, you know, freezing stuff, even microwaving is fine. Before I researched the book I was, oh, I got rid of my microwave. I thought, this is terrible. You know, it's sort of. But it turns out that actually it doesn't destroy nutrients in any way. It's actually good and it's much better for the planet. So in terms of the energy used, you know, if you say a baked potato in a microwave is much more efficient for climate change to use, from.
- [47:04]
Rich Roll
An energy expenditure, expenditure perspective, it may not taste the idea of like having a microwave, but go ahead.
- [47:11]
Dr. Michael Greger
But. Well, I was like you, but in a way, having researched the book, I've said, well, if I care about the planet, I should use both of these tools, you know, and not be so obsessed with, with my prior beliefs. So structured food's important how you cook, it's important what you cook it with. So just combining foods together will change their nutrient value as well. So a lot of these Mediterranean dishes would use olive oil and garlic and onions. Collectively, they actually produce many more healthy chemicals together than they do when you have the them alone. Chopping up your garlic 10 minutes before you use it actually trebles the amount of these really beneficial nutrients in, in the garlic that otherwise would get broken down. So there's all these kind of funny, weird stuff about structure of food is useful for people to know in everyday life about how to cook things. Obviously cooking stuff close to plastics, and you've alluded to some of this, you know, the problem of microplastics is something we should be aware of. We don't really know enough about it, except there's lots far too much plastic around. And so limiting the plastic that's close to our food is also important. And I think the other thing I realized is that no one had really written a book before that looks at all the different food groups and first takes health, then takes the ethics. So, you know, we're animals, you know, engineer. What's, what's the, what's the ethical basis of that or what? A lot of. There's a lot of new stuff about child slave labor, for example, chocolate in that and coffee and various other tropical things that we need to be aware of. But also finally, the big other area is the environment.
- [49:19]
Rich Roll
Sure.
- [49:20]
Dr. Michael Greger
And it was a bit of an eye opener because it's quite hard often to balance these three things. When you're making, you're going into a store and you want to buy something nice and you're trying to work out all of, you know, to get all three perfectly aligned at the same time is kind of tough. And so, and particularly when it comes to something like artificial milks. So I found that really interesting because I'd experimented with cutting out dairy milk and the main reason for me to cut out dairy is because of its harmful effect on the planet when you calculate how much cows and methane and land, land use etc. So it makes obvious sense to cut that out. So I switched to oat milk, which, you know, I didn't mind. The taste of it seemed quite good. But then I put a CGM on me while I was drinking oat milk and I saw it shoot up. So suddenly I've swapped what was this reasonably healthy fat, mild sugar mixture for a much higher sugar, much more refined product. Meant that if I was having regular oat milk, for me it'd be bad. Other people might be fine, but that would be better for the planet if we all switched to oat milk, but it would probably cause more have some disease consequences as well. So there are lots of examples of how tough it is to balance some of these things. Foreign.
- [50:57]
Rich Roll
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- [54:20]
Dr. Will Bulsiewicz
Not in the way that we have with the cancer research. And I think part of that is the investment of money into cancer research that's out there, but I think it's going to come. Here's what we do have. We first have dietary data, and we have interventional data, like, not epidemiology studies, but instead an interventional trial where we will ramp up a person's fiber intake and we will see improvement of mood disorders. So I'm talking about things like depression, and so we have these dietary interventions, but at the same time, more recently, we have microbiome data. So we can see actually in the microbes a specific pattern that exists among people that have mood disorders. This is true of both anxiety and also major depression.
- [55:06]
Rich Roll
What about people who are suffering from some form of trauma or ptsd? Does that overlap?
- [55:12]
Dr. Will Bulsiewicz
Oh, man, I want to talk about that. So let me hold that for a moment and we'll come back in just a second. So, in the microbiome, here's what we're seeing. We first of all see a loss of diversity. Again, a trend that we've been talking about this whole time. But Also the specific microbes have been altered. There are more inflammatory microbes. These are the microbes that have been associated with poor health outcomes. And simultaneously we see in these people that suffer, for example, with major depression with less of the anti inflammatory short chain fatty acid producing microbes. So part of the theory or idea behind this and like, why is the fiber intervention valuable to a person with a mood disorder? The fiber intervention is valuable because it can change the microbiome and it can also lead to the production of more short chain fatty acids. And we believe that the anti inflammatory nature is helping to combat the inflammation of depression. Depression is an inflammatory disorder.
- [56:11]
Rich Roll
That's super interesting. I've never heard anybody say depression is an inflammatory disorder.
- [56:16]
Dr. Will Bulsiewicz
It 100% is.
- [56:18]
Rich Roll
Explain that a little bit more.
- [56:20]
Dr. Will Bulsiewicz
Well, basically our body has an inflammatory mechanism and we evolved to have this with good reason. So if we go back to the time of like cavemen, paleolithic times, the top causes of death were infection and injury. And so inflammation is the way that we fight infection. Inflammation is the way that we heal from an injury. Inflammation is supposed to be our friend. But you Fast forward to 2022 and our modern lifestyle is basically activating these inflammatory mechanisms in a chronic smoldering way. So it's not the big burst of inflammation that you would get from say an infection or a big injury, but what it is is it's just kind of perpetual activation of the immune system to create inflammation. And that inflammation is tied to most of the major health related issues that we see as problems in 2022. So that includes coronary artery disease, that includes cancer. And I'm here telling you, and I don't think this is a big shock, but that includes mood disorders like anxiety and depression.
- [57:26]
Rich Roll
Wow.
- [57:26]
Dr. Will Bulsiewicz
So we have food and mood, we have microbes and mood, but what we're missing is the full cascade. Food translating into microbes translating into mood. And that's a study I'm working on.
- [57:41]
Rich Roll
Right, Meaning we don't have it because it hasn't been adequately looked at.
- [57:45]
Dr. Will Bulsiewicz
It's tough because you need the right data in order to do this.
- [57:49]
Rich Roll
That's a tough study to conduct properly.
- [57:52]
Dr. Will Bulsiewicz
So what we're doing, one of the things that's interesting is with Zoe, when people participate, they have the app and they can enter into the app how they're feeling on a daily basis so they could enter in their energy levels. And it's done on what we call a visual analog scale, where you basically slide a bar from 0 to 100. Now this visual analog scale is actually a validated measure, meaning that it's been proven through research to be valid and consistently useful for clinical research. So people enter into the app whether or not they're feeling anxious and we can measure this for 14 days. And now using the Zoe data, even though the entire thing was built for metabolism, we have the ability to go back and look at what are they eating, what does their microbiome say and what is their mood.
- [58:35]
Rich Roll
Right. It seems like there should be an API where that data set would be supplemented with the data that you would get from say, whoop, that's tracking heart rate variability, sleep states, respiratory rate, et cetera, skin temperature to be a more accurate predictor rather than just consumer reporting, which obviously can be problematic.
- [58:59]
Dr. Will Bulsiewicz
So we have the large scale consumer reporting where we're going to hopefully have millions of people who participate and that's going to be intensely powerful because the number of people. But where we started, going back to what predates 2020 and the release of the commercial product was a clinical trial called Predict 1. And in the Predict 1 trial, Matthew Walker actually has been working with us.
- [59:21]
Rich Roll
Oh cool.
- [59:21]
Dr. Will Bulsiewicz
And so he's the sleep expert for those who don't know. And we actually published a sleep study very recently looking at our data because we actually did collect that. We had people wearing the accelerometer and collecting the sleep data so that we could actually do those types of analyses. So the predict one study was not done. It was over 1000 people and it was not done using the at home kit. It was instead done more like a clinical trial.
- [59:45]
Rich Roll
Yeah, I think that's really important. I just noticed in wearing a CGM that the quality and duration of my sleep had a major impact on my body's ability to stabilize blood sugar and I don't know like what's causing what, but there's definitely a relationship and an interplay there.
- [60:03]
Dr. Will Bulsiewicz
Yeah.
- [60:04]
Rich Roll
What about bowel movements? We talked about this before, but I think we should touch on it a little bit. Like what can we infer from, you know, taking a look at what's happening down there? You can refer a lot. It's incredible about how like I have a thing with this because like mine don't really measure up based upon what you're telling me they should look like.
- [60:24]
Dr. Will Bulsiewicz
Well, so I think at the end of the day, how do you feel?
- [60:27]
Rich Roll
I feel fine, but it's pretty runny down there.
- [60:30]
Dr. Will Bulsiewicz
Yeah, it may be very runny because you are so high in fiber that you're producing a shit ton of short chain fatty acids. That ultimately are making it a little bit more on the loose side.
- [60:41]
Rich Roll
Although when I really ramp up the fiber and I'm kind of crushing, like super dense high fiber smoothies and the like, there tends to be a little bit more form. I found that it's runnier when I'm off my perfect game.
- [60:55]
Dr. Will Bulsiewicz
Yeah, well, so I think that looking into. I think that the key here is this. We have stigmatized bowel movements. And that's kind of silly from my perspective.
- [61:06]
Rich Roll
Yeah, I feel bad. I'm like, I'm supposed to know how to do this, and I'm not. I'm not getting that optimal, like form.
- [61:13]
Dr. Will Bulsiewicz
Our body thrives on rhythm, right? So if I take you, you are a runner and you rely on the rhythm of your heart in order to facilitate your ability to run. If I throw you into an abnormal heart rhythm, I could literally make it so you can't even walk up a flight of stairs. Right. Despite the fact that you're training for a marathon. And the same is true with our gut. Our gut thrives on rhythm. And rhythm means that we are having good, regular, complete, and dare I say it, satisfying bowel movements. Like, they're supposed to feel good, you're supposed to look forward to bathroom time, and the best way to start your day is a great bowel movement. And so the problem that we run into is that there are a lot of people out there who this is not what they experience. It's not in rhythm. They struggle with it. It doesn't come regularly. They fear bowel movements because they have to strain just to have, like a little nugget. Right. These are people who are out of rhythm. And ultimately they manifest symptoms as a result of that. Our stool is not the excrement of our food. Our stool is predominantly made up of our gut microbes. Your bowel movement is a window into the health of your gut microbiome. And what we look at is not just how often you go. That to me is in itself usually not super helpful. Now I will say if you tell me, hey, Dr. B, I haven't pooped in seven days. Okay, you're constipated. I can say that for sure. But the problem is that there are a ton of people who poop every day. They are constipated. They poop a couple times a day. They are constipated. There are people who have diarrhea that are actually constipated. And it's kind of mind blowing. But what's happening there is that we're missing the second Part of the story, which is really critical, which is, do you have a complete evacuation? So when you go, do you feel like you're really, completely going? Because if the answer is no, and you're simultaneously suffering with digestive symptoms, the number one symptom of constipation is gas and bloating. The number one cause of gas and bloating in my clinic is not histamine intolerance, even though I've been hyping this up. The number one cause of gas and bloating is constipation. So if you are someone who has incomplete bowel movements, even if it's every day, and you're suffering with gas and bloating, I am guessing you are probably constipated. And if you strain to have these little nugget turds and you do that four times a day, you go into my office and you say, Dr. B. I'm having four bowel movements a day. Yeah, but what do they look like?
- [63:56]
Rich Roll
Right?
- [63:57]
Dr. Will Bulsiewicz
Are you completely evacuating? You go, oh, I'm not really evacuating, Dr. B. They're these little chicken nuggets.
- [64:02]
Rich Roll
But is it a kind of you know it when you feel it thing? Like that satisfaction that you get where you're like, yeah, man, that thing. I emptied it out.
- [64:10]
Dr. Will Bulsiewicz
When you whip this door open and you strut out in slow motion, right? Like, that is proof in an illness.
- [64:16]
Rich Roll
And there's that weird pride, you know, you're like, yeah, man, I crushed that one.
- [64:20]
Dr. Will Bulsiewicz
Oh, 100%. Right. But the problem is there's a lot of people out there that aren't experiencing that. And, you know, the last thing that I want people to hear about, because I really hope that there are people who benefit from this, is that there is a group of people that have what is called overflow diarrhea. And these are people who chronically suffer with constipation. And one day, the poop gets impacted, and you have a column of solid stool that is not moving. And the only thing that can get through sneaking through the cracks and the.
- [64:50]
Rich Roll
Crevices is the liquid.
- [64:51]
Dr. Will Bulsiewicz
Is the liquid, yeah. And it comes down to the bottom. And our bottom is not designed to stop liquid from coming out. And so you get urgency. You rush to the restroom, and it explodes out as diarrhea. And you go into your doctor and you say, I'm having diarrhea. And they say, take Imodium. And imodium slows down your motility even more, and your problem gets worse. It gets worse.
- [65:13]
Rich Roll
Yeah.
- [65:14]
Dr. Will Bulsiewicz
The paradoxical solution in this particular case with a person who has this overflow diarrhea, the paradoxical solution is to flush it out. You gotta get it out and then start over.
- [65:26]
Rich Roll
I wanna get to colon cleanses in a second. I wanna touch on that. But first I'm going to take advantage of the fact that you're here. I think I'm on the opposite end of this spectrum because I do a number two, like six times a day. And I'm thinking this can't be like, it's so much more often or frequent than most people that I know. And Julie's just. My wife's like, yeah, but you're like a furnace. Everything down there is churning like so hot all the time. But what would a gastroenterologist say about this?
- [65:58]
Dr. Will Bulsiewicz
How do you feel?
- [65:59]
Rich Roll
Like, am I unhealthy in the other direction?
- [66:01]
Dr. Will Bulsiewicz
How do you feel?
- [66:02]
Rich Roll
I feel fine.
- [66:03]
Dr. Will Bulsiewicz
Yeah. So from my perspective, a guy who's consuming a super high fiber diet, we know that, right? We know you're consuming a high fiber diet and you're a runner. And that actually stimulates motility and keeps things moving along. Like, we know that there's this common pattern among runners called the runner's trots.
- [66:21]
Rich Roll
Yeah. I mean, I'll do a full blown bowel movement in the morning and think I'm totally empty and then I'll go running. And 30 minutes into the run, I got to pull over to the side of the trail 100%.
- [66:31]
Dr. Will Bulsiewicz
So when you move, this is important for people to know at home, like, independent of talking about what's happening with you is that when you move, your intestines move, you are stimulating motility. Our sedentary lifestyle is part of what's contributing to the epidemic of constipation that we see out there these days. Constipation is far more common of a problem than diarrhea is. But when you move, your intestines move. People who run quite frequently will have more frequent bowel movements because they're a runner. So you take a gentleman yourself who's on a high fiber diet, a high fiber diet by itself. You were not a runner, Rich. If you were a sedentary man, you would still probably be having three or four bowel movements a day. But then you add in the fact that you are going on these runs and you are accelerating that motility a little bit, and that's probably what's contributing to not only the frequency but the form.
- [67:18]
Rich Roll
Right. But if you're somebody who is constipated and perhaps not even aware of it, for the reasons you mentioned. But you've got this skyscraper stuck inside of you. Would that be somebody who would be a candidate for a colon cleanse? Like, I'm sure you're not in favor of these kind of, you know, cleaning out the colon from the rear side. Sure, because it's gonna, you know, take out a lot of that microbiome that you want in there.
- [67:44]
Dr. Will Bulsiewicz
Right.
- [67:44]
Rich Roll
But would that be a scenario in which maybe that would be a good idea for that person, or would you just amp up their fiber until the motility enhances and it all gets cleaned up?
- [67:54]
Dr. Will Bulsiewicz
Well, I think you're bringing up a very important point that I'm glad that we get to address and bring out to the.
- [67:59]
Rich Roll
Who else am I going to talk about this with?
- [68:00]
Dr. Will Bulsiewicz
Yeah. So I think the important point that I want to touch on real quick, and then we'll talk more about the cleanse part, is that fiber isn't always the solution to constipation. So in people who have mild constipation, meaning not every day and not going on for days at a time, but instead, like a touch and go here and there, maybe twice a month, Right. In that person, you turn up the fiber, you increase your water consumption, you get some exercise, maybe you literally take a walk after dinner, something like that. Those people will poop, and they will be good. So lucky them. The people that I've seen in my clinic, that's not them. You know, people with moderate to severe constipation, that's not going to work.
- [68:44]
Rich Roll
And there's a problem even if they do like psyllium, you know, those psyllium husks that you can put in water that are supposed to enhance your ability. You can try, get it out.
- [68:52]
Dr. Will Bulsiewicz
You can try. But here's my word of warning. I just want people to be empowered with understanding what potentially could happen so that they can react and respond to what they experience in terms of their symptoms. So when fiber is moving through, fiber is your friend. But when fiber gets locked up, it turns into cement. And your gut microbes are given unlimited access to ferment that fiber. And what we see is that people who are constipated, they, at baseline, produce more gas. And there's this interesting vicious cycle that exists, rich, where we have discovered that methane gas, which is the product of the fermentation of fiber, Methane gas actually slows bowel motility. So you get constipated, you produce more gas. That gas makes you more constipated. Now, you pour fiber into this equation, and it's effectively pouring gasoline on the fire. Now if you pour the fiber in there and all of a sudden, boom, here we go. We're moving again. We're back in business. You're.
- [70:01]
Rich Roll
That'S it for today. Thank you for listening. I truly hope you enjoyed the conversation. To learn more about today's guest, including links and resources related to everything discussed today, visit the episode page@richroll.com where you can find the entire podcast archive, my books Finding Ultra Voicing Change and the Plant Power Way, as well as the Plant Power Way meal planner@mealplanner.richroll.com if you'd like to support the podcast, the easiest and most impactful thing you can do is to subscribe to the show on Apple Podcasts, on Spotify and on YouTube and leave a review and or comment. And sharing the show or your favorite episode with friends or on social media is of course awesome and very helpful. This show just wouldn't be possible without the help of our amazing, amazing sponsors who keep this podcast running wild and free. To check out all their amazing offers, head to richroll.com sponsors and finally, for podcast updates, special offers on books and other subjects, please subscribe to our newsletter, which you can find on the footer of any page@richroll.com Today's show was produced and engineered by Jason Cameolo. The video edition of the podcast was created by Blake Curtis and Morgan McRae, with assistance from our Creative Director, Dan Drake, content management by Shana Savoy, copywriting by Ben Prior, and of course, our theme music was created all the way back in 2012 by Tyler Pyatt, Trapper Pyatt, and Harry Mathis. Appreciate the love, love the support. See you back here soon. Peace Plants Almost there.
- [71:40]
Dr. Michael Greger
That.