Raising Healthy Families with Moms Meet and KIWI

How to Nourish a Healthy Gut From an Integrative Gastroenterologist

June 28, 2022 Moms Meet and KIWI magazine Season 4 Episode 5
Raising Healthy Families with Moms Meet and KIWI
How to Nourish a Healthy Gut From an Integrative Gastroenterologist
Show Notes Transcript

It’s no secret that having a healthy gut is important, but there’s so much more to it than that! Discover how nourishing your gut microbiome can improve your hormone balance, support your mental health, help your overall wellness, and more from integrative gastroenterologist Dr. Vanessa Mendez. In this episode, she shares more about what the gut microbiome is, why it’s so crucial, and her tips for keeping it happy and healthy.

Chrissy:

Welcome to raising healthy families with Moms Meet and KIWI. We're giving you the tools to enjoy the beauty and chaos of life with little ones in the healthiest way possible.

Maureen:

Hi everyone, I'm Maureen Frost, editorial director and today's host. In this episode, I'm talking with Dr. Vanessa Mendes all about nourishing a healthy gut. This episode is brought to you in part by Dirt Kitchen. Better snacking options are a must for busy families. Dirt Kitchen pressed bars are a delicious new bar experience made from real veggies, fruit seeds and nuts. With bold flavors and nothing to hide, you can feel good about grabbing one of these as you head out the door, or to hold you over until your next meal. Made with real ingredients that are simply pressed together with no binders, added sugar, or artificial ingredients you can truly taste the different textures and flavors in every bite. Today we're joined by Dr. Vanessa Mendez, a triple board certified gastroenterologist, internist, and lifestyle medicine physician. She spe- specializes in digestive disorders, which includes liver disease, inflammatory bowel disease and nutrition based disorders, such as obesity and constipation. Her approach to patients and their diseases is holistic and comprehensive. Her goal is not just to treat the symptoms, but to get to the root cause of an ailment and provide lasting relief. All her methods are evidence based and she is a proponent of lifestyle changes first to promote wellness. You can find her on Instagram at plantbasedgutdoc, thank you so much for joining us today. Dr. Mendez, we're so excited to have you.

Dr. Vanessa Mendez:

Thank you so much for having me. I'm excited to dig into all sorts of topics with you guys today.

Maureen:

Yeah, so gut health is something that we hear about so much now, especially how it is tied to overall health. And I'm excited to chat more with you about how to nourish our gut. But before we jump in, I'd really love to learn how you got into this area of health and kind of share your approach with us a little bit more.

Dr. Vanessa Mendez:

Yeah, absolutely. I think there's two influencing events in my life. I think that when I was I think it started when I was a teenager, basically, in high school, I suffered from cystic acne. And, you know, I went through the traditional methods of going to a dermatologist that was a traditional dermatologist, and all they did was you know, prescribe medications, antibiotics, whatnot. And you know, those work for a lot of people. In my case, my acne just kept on coming back after I would stop the medication to the point that I had to be started on Accutane, which is a very strong oral pill that basically has been associated with things such as inflammatory bowel disease and other conditions. So, you know, again, my acne would come back. So I was like, Okay, there's something that I could, what could I do, you know, from, from something that I can have control over, because at that point, it was all within the control of the doctor that I was seeing. And again, it wasn't curing my, my acne. So I started digging at that point that was like the beginning of the internet for a lot of us. So I started there was no Google back then or anything like that. So I just started looking up things on the internet and I came across an anti inflammatory diet. At that point, the big thing was Doctor wheels anti inflammatory diet, which basically had you avoiding processed foods, dairy and red meat as some of the drivers of like hormonal shifts in the body. So I avoided all those things, I cut them out completely. And honestly, within a few weeks, I, my acne cleared up and actually never came back. And I never had to go on medication again, for acne. And, you know, I also saw that I was able to, you know, I had lost way I was felt more energized, etc, I was feeling great. So that was my first taste of the power of nutrition and lifestyle, in in changing and really redirecting the course of our of our illnesses of our of our health. So that always stayed with me, you know, and I knew I was gonna go to medical school at some point, because I had, from a very young age, a desire to be a doctor. So that stayed with me throughout my training and then fast forward, you know, I went to college completely and did all the beneficial changes I had done..

Maureen:

As we all do, yeah.

Dr. Vanessa Mendez:

Live your life. So I went to college, typical college lifestyle, no sleep, lots of stress, cramming for exams, drinking and eating, you know, garbage. So then I went on to do my training, you know, my 10 years of training Being in first medical school and then residency and then finally my fellowship in gastroenterology. And, and, you know, a lot of people asked me so that that initial event was something that really stayed with me from a nutrition and lifestyle standpoint. Then the other question is why gut health? You know, what, what led you to, to be a gastroenterologist, which is a male dominated field. And you know, you know, until recently, there were very few women and even now, there's still very few women in GI even though we're growing a number. But so my husband who I met really early on in my life, he we met when we were middle school, and we dated on and off throughout the years, he actually was diagnosed with moderate to severe Crohn's disease with just one of the inflammatory bowel diseases. When he was 17 years old. And he was diagnosed, when he almost people, doctors couldn't figure out what he had at that time. And he was very anemic to the point that he showed up to the hospital with a hemoglobin of four to six on which is, you know, almost not compatible with life, the 4.1. So, you know, I think that had a big impact on me. And already wanting to go into medicine, I started digging deeper into gut health, and what was this inflammatory bowel disease? And why did he get this and, you know, then I started, just seeing how prevalent it was becoming. And I think that was one of the main, you know, pushing factors that led me to become a gastroenterologist, because though that world opened up for me, and it was just such a fascinating world, with so many unknowns, you know, I get bored very easily. So if you have a specialty, where there's a lot of knowns, that gets boring to me, you know, so in gastroenterology, I fell in love with it from a very early age. So I was one of the few, you know, medical students that knew that she wanted to be a gastroenterologist. So most medical students don't, don't know that, that what fellowship they want to go and go into. And gastroenterology is just such a broad field. It basically, you know, the digestive system, you know, it starts with our salivary glands, it starts with our mouth, and ends up you know, in our bottom, but it also has so many other organ systems and so many other organs, you know, our liver or pancreas, our gallbladder. And more recently, we've, you know, a lot of us have are classifying the gut microbiome as its own organs. I know we're gonna dig into that very deeply later on. But, um, and the other aspect, so not only broad, like, it's such a wide system, and you can really specialize in so many different aspects of gastroenterology, whether it's inflammatory bowel disease, whether it's function or motility, so many different parts of Gi that you can sub specialize in. But also the fact that you're not in clinic the whole day, and you're not in procedures the whole day. So you split your days between doing procedures and doing clinic. So again, going back to I get bored easily, that felt like a good balance. For me, I can spend half the day talking to patients, diagnosing them, and really guiding them. And then the other half that they are diagnosing them with procedures treating preventing colon cancer by removing polyps, and really having a hands on approach to medicine. So that balance really sit well with me and keeps me on my toes. And you know that that was another aspect that really appealed to me, when I went into this field.

Maureen:

It's so interesting that your own family's like health history is what guided you down this path. I mean, that's great. It's kind of like you were you were meant to go in this way. And I love that, you know, just off the bat, you're, you realize like your home aha moment was how much nutrition is tied in with your overall health and how, you know, focusing on that really can can make you feel better and in ways that you didn't realize in your body. So that's, that's awesome. So upfront, I just want to cover the basics. I'm sure that our audience has a good idea, but can you just share with us why a healthy gut is so important?

Dr. Vanessa Mendez:

Yeah. So first of all, what's a healthy gut you know, so we know that we put food in our mouths and then it somehow makes its way throughout our digestive system. It's absorbing digesting nutrients, breaking them down and then absorbing nutrients to provide those nutrients to the rest of the body. Right. So we know about the gut, right? Intuitively, we know that the gut affects the rest of the body. So what is a healthy gut? Basically, you know, healthy gut means that when you eat, you are able to absorb the nutrients that you need, so you're not going to be anemic, you're not going to have nutrient deficiencies that you're gonna feel well, when you eat, that you're gonna have normal digestive processes, like you might get a little bit of bloating after you eat, that's normal, but you're not going to get uncomfortable bloating. Repeatedly, you're gonna have bowel movements that are comfortable, easy, and soft, you're not going to be straining, and on the other end, you're not going to have diarrhea, etc, you're not going to have heartburn. So digestive health really encompasses just feeling well, when you eat, you know, and around the time of eating and also evacuating our bowels. So that's really what digestive health means as a foundational aspect. However, now with the growth of research in the microbiome area, we know that that actually extends to a lot of more processes throughout the body. But in general, digestive health really means, you know, feeling well around the time of eating, being able to absorb all those nutrients and feeling well around the time that you're evacuating your bowels.

Maureen:

Okay, so let's get into the microbiome a little bit. Can you explain it to us a little bit more?

Dr. Vanessa Mendez:

Yeah, absolutely. So, as I mentioned before, the microbiome, a lot of us are referring to it now as its own organ, or organ system. So the microbiome has been with us, throughout human evolution. So it's evolved inside of us, and alongside us, throughout our, our evolution. So we have different microbiomes throughout our body, like our skin has its own skin microbiome, oral microbiome. And you know, in our private parts, we have a vaginal microbiome, for example. But the biggest the most vast microbiome is our gut microbiome. And this one is made out of trillions of microbes in our predominantly in our colon, even though there are microbes throughout our whole digestive system, most of the microbes are in our colon, and which is the larger, the larger the last part of our of our digestive tract. And there's trillions of microbes, these microbes are made out of viruses, bacteria, fungi and other organisms that at first, we didn't know, you know, what was their point? What are these microbes doing in there now, in the last 10 to 20 years, the research has really pumped out. So basically, has brought to light so many of the functions that the microbiome is involved in. So let's break it down. So we thought that our digestive system was a hollow tube, and yeah, that we would absorb nutrients here and there. But actually, our microbiome has a big role in the digestive process, because foods that don't get broken down in the rest of our digestive system and make it to the colon, mostly untouched, such as fiber. So fiber only comes from plant based foods, such as fruits, vegetables, whole grains, legumes, nuts, and seeds, the fiber that doesn't get broken down upstream in the rest of the digestive tract, makes its way to the colon where the microbes have a field day. So these foods basically, are used by the microbes, the microbes break them down, they are responsible for breaking them fiber. And they use fiber not only as their fuel source as their source of energy to replicate, but they also use fiber to create different metabolites. And some of these I'm sure you guys have heard are things like short chain fatty acids, like acetate, and butyrate, which actually have a lot of different functions on their own, aside from the microbiome itself having different functions. So one, they break down fiber, and that is essential knowledge. Because when it comes to you have issues digesting fiber, will that points to an issue, like lean your gut microbiome, and a lot of food intolerance is point to issues in your gut microbiome. And we can dig into that later. So they break down fiber, they ferment it, and they basically secrete these byproducts such as short chain fatty acids, that's one of their functions. One of the other major functions is that they communicate with the immune system. And they have since we were born, basically, so the microbiome and I know we're gonna get into this a little bit later, but basically, you know, when a child is born, and they come into contact with either with the bat with the birth canal, with the vagina, or they come in contact through C section with the environmental air and the mother skin, that's their big like, surge of swallowing microbes, even though now we have some evidence showing that there is some On translocation of microbes when we're in the womb, that is still emerging data. But the big rush happens at birth. So that rush of microbes into the baby's digestive system is what sets the groundwork for this colonization of the gut microbiome. And then as soon as that happens, it starts communicating with the immune system. And it starts priming the immune system for many different things recognizing friend versus foe. When it comes to environmental, environmental toxins, when it comes to foods, it's a start communicating with with the immune system, whether these things should be tolerated or should be fought against, so further fault. So our microbiome, so that's the beginning of the communication between the immune system and the microbiome. But that communication continues throughout life. And it's constant. Why, because 70 to 80% of our immune system is actually in our gut, in our digestive tract. So and this is in a certain type of tissue called gut associated lymphoid tissue, or Galt, and it is separated from the gut microbiome by a very thin layer of cells, which are the epithelial layer of cells that line the colon. So we have our microbiome, we have our thin layer, colon cells, and then on the other side on the part of the inside of the body is the 70 to 80% of our immune system. So these are in constant communication, constant communication back and forth. So that's one of the major functions of the immune of the gut microbiome. Other functions include secreting these byproducts such as short chain fatty acids that actually traveled throughout the body, and can even cross the blood brain barrier. So very few molecules can cross the blood brain barrier. And short chain fatty acids are one of these molecules that is secreted by the gut microbiome. But even more recently, we have found that actually, the gut microbiome also regulates things like glucose levels, and insulin levels and lipid deposition throughout our body. So you know, things like type two diabetes and obesity have also been associated with microbiome disturbances, aside from autoimmune disorders, because of the constant communication with the immune system, and many, many other other factors. So And lastly, that's not enough, the gut microbiome actually is one of the functions of the gut microbiome is to turn on and off genes. So we all been taught, you know, since an early age, oh, my God, we inherit these genes. But so that means we're doomed or we either have good genetic material, or we're doomed, right. But it's not like that at all. In fact, many things that happen in the body turned on and off genes. And the microbiome is one of these are factors that turns on and off genes, depending on the conditions. Still, you know, a lot of disorders, such as inflammatory bowel disease, for example, which is my specialty within Gi, so I specialize in Crohn's and Colitis. We don't really know the cons of Crohn's and Colitis. But we know that, you know, you're genetically predisposed to these autoimmune conditions. But a lot of people, there's been over 108 genes identified with inflammatory bowel disease. And a lot of people have these genes, that doesn't mean that they actually go on to develop these disorders. So something else is happening throughout the body, that is actually not allowing these conditions to manifest to for you to be diagnosed with them. So first, you have the genetic material, but it doesn't mean it has to be turned on, then some environmental trigger affects the gut microbiome, the microbiome becomes this biotic or imbalanced. And that is actually what communicates with the immune system and triggers the surge of these autoimmune conditions. So it's like a really fascinating, but very complicated cascade of events that has to happen for somebody to develop these autoimmune disorders. So that's just a little taste of what the gut microbiome does.

Maureen:

Wow. Wow. That's like, Yeah, I did not know the the close proximity. When you're talking about the immune system to the microbiome, that makes a lot of sense when they say that, that what did you say 70% of your immune system? Yeah, that makes a lot of sense. And the way that you're explaining how the genes turn on and off based on the microbiome is that's, I didn't realize that that's really eye opening. Thank you for for going into detail there. That's awesome. So another area that I would love to try At more about is the connection between your gut and hormones. I know like as women, we deal with hormonal changes on a monthly basis when you're, if you're pregnant if you're postpartum and things like that. I feel like I'm always like, Oh, my hormones. But um, I know that the gut has an interaction. Can you kind of dig into that and explain that a little bit more to us?

Dr. Vanessa Mendez:

Yeah, absolutely. So this is all emerging data. So again, when it comes to these to the microbiome, there's a lot of unknowns. But if you so I remember looking back and and seeing where this connection stems from. And I remember reading these Nurses Health Studies, and I don't know if you've heard about Nurses Health Studies are these major studies with 10s of 1000 1000s of nurses throughout the United States, so they're called the Nurses Health Studies, they've been doing them over the past like more than 50 years. And they're in these studies, they found the connection between things such as plant based diet or more plant forward eating, so like vegans, vegetarians, Mediterranean diet, pescatarians, and these populations having less risk of things like breast cancer, and things like different you know, ova- ovarian and uterine cancer, and, and actually things like PCOS, infertility and endometriosis. So, now fast forward. So these have been going on for the last couple of decades, these studies. So fast forward now. And we saw that association between plant based eating and decreased risk of these conditions. But now fast forward to the data that's emerging now in terms of the gut microbiome. And we know now it's termed the it's, it's termed the estrogen microbiome axis. So this axis, basically, what they have found in these emerging studies is that microbiome imbalances are associated with things like PCOS, endometriosis, and breast cancer and other types of, you know, hormone driven cancers. So that that to me as a gastroenterologist explains the link between you know, a plant for diet, and, and the decreased risk of these conditions because a plant based eating is associated with feeding the gut microbiome and creating a more balanced microbial profile. Obviously, there are many other factors that affect this, the gut microbiome. But now we know that plant based eating is one of these things that creates a more diverse, and a microbiome that is more varied and able to do all the functions that we talked about previously, right. But in terms of this emerging evidence in terms of hormone regulation, we know that for example, the gut microbiome secretes enzyme that is the precursor to estrogen. It also, it also is responsible for cholesterol creation, which is also the precursor for estrogen and progesterone. So the the estrogen microbiome axis is up has multiple pathways where the gut microbiome is actually influencing our hormone levels. So I mean, the data emerging, makes sense to me, because when I told that story about acne, for example, and we know acne, and is very associated with hormonal levels, when I cleaned up my diet, and I actually, you know, avoided you know, processed foods, dairy and red meat, I naturally up my intake of fiber rich products. Obviously, I avoided the refined sugars and you know, processed foods and the saturated fat from red and red meat and dairy, but I upped my intake of fiber, which products I was able to balance out my hormone levels, cure my acne, but as a side effect, I also improved my menstrual cramps. And then so like throughout high school when I was eating like that, I actually did well and then it went to college and back to all these destructive habits, making alcohol like every weekend, the worst cramps of my life. So I was able to see the effects not only myself, but I see it in my patients, you know, we have from these Nurses Health Studies, they've turned the fertility diet, which are more plant poor diets, and it because it's because this style of eating obviously associated with other improvements in other lifestyle factors, regulate your microbiome and then therefore regulates your hormone levels where you're going to have less, you know, less fluctuations around your monthly cycles. have less pain, you know, not as heavy bleeding, less acne right before your period or during your period and improved outcomes in terms of, you know, fertility. If this is one of the major things that is affecting your fertility.

Maureen:

That's wow. So, would you say that going plant based would help a fix or alleviate some of these health issues? Like is that like a recommendation across the board for anyone that's dealing with, you know, PCOS or endometriosis or anything like that? That makes so much sense so much sense. And I feel

Dr. Vanessa Mendez:

So yeah, so what we termed as a fertility diet, decreased risk of endometriosis and PCOS, we want people to switch to a more plant forward diet. So when we say plant based, it doesn't have to be 100% plant based, you know, it means that the foundation of your food is composed of fruits, vegetables, whole grains, legumes, nuts, and seeds. And yes, you can have, you know, on animal protein if you want, if you want, you're still having a plant based diet, like the Mediterranean diet, even though it includes dairy, and fish and chicken and red meat here. And they're still considered one of the plant based diets because the foundation of these diets is plant based foods. So yeah, the recommendation is definitely to go more plant board. Definitely not go the way of keto, because that's too much high saturated fat. And it's a precursor for hormonal, not only imbalances in your microbiome, but also hormonal imbalances. So yeah, these is this, these are one of the major factors, obviously, there's others, right? Decreasing refined sugars and processed foods, minimizing alcohol consumption, smoking, getting enough exercise, but altogether, they actually influenced the gut microbiome, so named me named me one lifestyle factor. And I can tell you, it's influenced in the gut microbiome, it's that it's that huge, you know, so I always tell people, don't, don't micromanage yourself, don't obsess, focus on the totality of your behaviors, at the end of the week, take an intake of your of what you did throughout the week, if you had more positive, you know, more positive lifestyle habits than negative, perfect, you're winning already. You know, we want that balance, right. So if you had more days where you were able to get good restorative sleep, you're winning there, you know, if you were able to get out and do like 20 minutes of outdoor walking or exercise three times a week. Okay, that's crazy. You're winning there. So it's the totality of all of our health habits that influences the microbiome, and therefore influences the rest of the body. So you know, I am I'm probably biased as a gastroenterologist. But a lot of you know, I think, a lot of the conclusion in within the scientific community is that, yeah, we used to think, oh, yeah, eating is so important for how, of course, healthy habits are so important for health. But what how exactly are these working within your body, and a lot of it has to do with the gut microbiome, like this is helpful for a lot of people out of women who have to deal with these different hormonal things, whether they have any dresses or anything like that. And even myself, I just, you know, I'm still dealing with hormonal fluctuation from stopping breastfeeding a few months ago. And it's just like, knowing that if I'm eating a more plant for diet, if I'm focusing on my health in many different ways that I am actually doing things to make myself feel better. So sometimes you feel a little hopeless in this realm. I know I have. So it's good that there's actionable steps and it's, it's steps that we've heard about so many times, but now you know, what you are doing to help yourself so that's, I appreciate you explaining that there really to us. Kind of on that note, how would someone know that they need that healing in the first place? Are there indicators that people come to you with? Yeah, absolutely. So you know, as an integrative gastroenterologist, i i in my private practice, I'm able to spend a lot of time with my patients and really get to the bottom of what's ailing them. Why are they coming to me? And I go from head to toe like I asked them. How are your energy levels? How is your sleep? Do you wake up rested? How's your skin do you feel like your skin is healthy glowing? You know? Not too dry, not too natural, oily. Are you getting rashes? Are you getting acne? How about your digestive system? Obviously, how are you feeling around the time your E How are you feeling in general with your you know, your bowel habits and And really the list keeps on going right? If you have brain fog, do you feel sharp? All of these give me insight into somebody's gut microbiome. Because they've all been associated with either a balanced microbiome or an imbalanced microbiome. Currently, we do not have validated stool studies that can tell us for sure, because of many factors can tell us for sure if you have a balanced or imbalanced microbiome, because of many factors, because those studies actually only measure the genetic material or the microbes that are shedding the stool, but actually, a lot of them are just adhering to the colon wall, then they wouldn't come out in your stool, right. So then a stool study wouldn't be as useful for that, even though they are getting better with some really advanced, you know, shotgun sequencing on these scientific terms. So that's 111 factor, why microbiome tests are not validated at this time. But another crucial factor is that each of us has a completely unique gut microbiome, you and your child's microbiome are not the same, they are the closest that to will be when they are born, and then they start to go their own separate ways. But no two people have the same exact microbiome profile. And we have already established that the microbiome is affected by our genetic profile by our environmental experiences and exposures. And many things like childhood trauma, for example. So because each of us has a completely unique microbiome profile, that's another reason why it's hard to really decipher what is a healthy microbiome. And we also don't know, these are all associations, we don't know, we know that our microbiome imbalances are associated with inflammatory conditions, cardiovascular disease, obesity, type two diabetes, and the list goes on and on. But these are just associations at the end of the day. So scientists are actively working on all of this and just recently attended the gut microbiome, like World Congress, where the leading scientists internationally get together, and they ask the question every year, Are we anywhere near cracking this code of being able to really say, that's an optimal gut microbiome, or, you know, this is a stool test that we can do to really find out what we need to do to improve our gut microbiome. So we're not there yet. But clinically, we can tell a lot about the microbiome, from how people are feeling and putting together all these things. So if there's a digestive symptoms, symptom, like bloating, or constipation, or diarrhea, and there's something else happening in the body, like your skin, or your sleep, or brain fog usually goes back to the microbiome being at the at the, at the root cause of it. And so we start working to improve that gut microbiome. And then comes the idea of identifying what factors are not optimizing your life, right? Did you just go through around the antibiotics? And is that the reason for your microbiome being unbalanced or imbalanced? Did you have childhood trauma, and you actually have been suffering with microbiome imbalances, since a young age I have a lot of patients who had childhood trauma, and had as their first symptom of microbiome imbalance that constipation developing very early on in life, you know, again, kids can develop constipation, just because they are very vulnerable to developing like, not the best habits, you know, when it comes to toileting. So that could be the issue, why you develop constipation. But, you know, we go back to childhood, and we see what some of these factors are, that have been affecting you, either for a long time, or just recently.

Maureen:

That's so interesting that you're saying childhood trauma could be affecting your gut microbiome. That's, that's shocking to me.

Dr. Vanessa Mendez:

So that's actually documented, you know, like when it turns when we talk about IBS, irritable bowel syndrome. We know that actually childhood trauma is one of these triggers for IBS just like getting a GI infection. So if we go to another country, and we get a viral gastroenteritis, stomach bug, that actually is one of the triggers for IBS. So it's childhood trauma. We know that we have studies on this. And yeah, it's fascinating. The data is fascinating that childhood trauma actually develops an abnormal gut brain connection. And we haven't even talked about that. But yeah, that's one of the things that affects the gut microbiome.

Maureen:

Right? Well, let's talk about the gut brain connection. Can you share a little bit more about that for us?

Dr. Vanessa Mendez:

Yeah, absolutely. So again, another really exciting emerging field in gastroenterology. So we used to think that you know, like IBS. Yeah, like first they women were dismissed and they are still dismissed throughout the world when it comes to irritable bowel syndrome, or even diagnosed with IBS, without actually it being IBS without undergoing the proper workup. IBS or irritable bowel syndrome is a diagnosis of exclusion. That means we've done tests, blood imaging, and sometimes endoscopy and colonoscopy, and we can't figure out what's happening, then we actually boil it back to there's an abnormal gut brain connection. And what is that what is happening there, it's affecting your, how sensitive you are, how sensitive your nerve connections in your gut are, and the motility whether things are moving too quickly or too fast. So the gut brain connection is basically made up of different pathways. So we talked about one of the pathways already, we said that the gut microbiome affects creates these short chain fatty acids like butyrate acetate, which actually traveled throughout the body and can cross the blood brain barrier. So that is one part of the pathway, where the gut and the brain are influencing each other. Okay. The other part of this pathway is through the vagus nerve. So Doug got actually has the second highest number of nerve connections in the body, outside of the nervous of the nervous system of the brain, and in the nervous system. So the gut has the second largest number of nerve connections, meaning there's many different nerve connections in the gut, making the gut prime real estate, or there being dysfunctions in how sensitive these nerve connections are. So one of the major pathways is through the vagus nerve. So the vagus nerve is a major nerve that travels from the gut to the brain and vice versa, like back and forth, communicating with each other, right, just like the immune system and the gut microbiome communicate with each other, the brain and the gut communicate with each other through the vagus nerve. The third aspect of this so the product as the first one was the short chain fatty acids, they can travel and cross the blood brain barrier. The second one is the vagus nerve. And the enteric nervous system, which is the nervous system of the gut communicating with the brain. And the last one is because the gut does secrete a lot of hormones and neurotransmitters. So actually, a lot of these hormones and neurotransmitters cannot cross the, the blood brain barrier, they actually don't they exert influence on in the gut, and throughout the body, but they can cross to the brain, but they still communicate with the brain. So yeah, when people say, okay, you know, 90% of serotonin is created in the gut. And that's why I have depression, it's not like that it is there actually cross the brain, the blood brain barrier, but it does communicate, and it does exert an influence over over our mental health, but also our cognitive health. So our mental health, meaning xiety of depression, but our cognitive health, meaning dementia, Parkinson's disease, and other neurologic disorders have been associated with disturbances in the gut microbiome,

Maureen:

Right. So what you're telling us is that the gut is so important and plays such a huge role in everything. So I kind of want to focus a little bit on what do we do to nourish a healthy gut? What do we do if we need to heal our gut? And I know that we've talked about the food aspect, too. But are there other things as well? Can you kind of give us like, what's your rundown on how you would treat somebody who needs to balance their microbiome?

Dr. Vanessa Mendez:

Yeah, absolutely. So let's start from childhood, right? Like from that moment on baby makes its way out of the mom. So what are some of the things we can do? Because we know that you know, for example, I'll give you my my story, right? I have a seven week old baby, I just gave birth.

Maureen:

Oh my gosh, congratulations.

Dr. Vanessa Mendez:

Yeah. So um, so basically, if you could take the poster child for not microbiome optimal non microbiome optimization, that would be my case, okay. And then I'm going to give you the positive aspect of that. So I had to have a C section because I was with my first baby. I was 30 hours in labor, I was not able. He got stuck. And he was actually born with bruising on his on his nose because of trying to come out. I wanted to do a natural birth as natural as possible. And then you know, things didn't work out and I'm having a C section I had, I had GBS positive, which is, you know, a colonizer in your, in your vaginal microbiome that actually meant that I had to have antibiotics around the time that my my baby was born. So I was given antibiotics for those 30 hours, I ended up having the C section, then because of all the trauma of that birth, I actually couldn't breastfeed for a long time. And I didn't seek the support that I needed. So that was actually one of the inciting events. For me really digging this was three and a half years ago, digging deep into the microbiome world. Because it's a gastroenterologist, we weren't trained to know anything about like a microbiome. And at the same time, all this data is coming out, and I freaked out, I'm like, Oh, my God, is my child doomed? Because of all the things that you know, surrounding his birth? Well, let me tell you that this child has never been sick in his life. He's three and a half years old. And because of the steps that I took, so what are the steps? So now with my second child, I did things differently, I still had to have a C section. I tried to do vaginal again, did not work. I actually almost ruptured my my uterine wall, because I tried to do vaginal again. So again, always be flexible. And this is one of my number one recommendations when it comes to optimizing the microbiome in your children and in yourself be flexible, right? We're human beings. So by definition, we are imperfect. So the good news is, the microbiome is incredibly resilient. So in one day, in 24 hours, we actually have 50 new generations of microbes, because their replication rate is like 20 to 30 minutes, for example, in many cases of bacteria. So in 24 hours, we actually have 50 new generations. So that means that our habits accumulate. So that's why I say at the end of the week, did you have more positive habits than not? So let's start from birth. One of the things that you want to do, whether you know, you're pregnant, or just had a baby is get as much support as possible, right? Ask for support, friends, neighbors, online chat rooms, there's communities of moms, in any city on Facebook, so search for them. If you need the support, ask for these women, these communities of women, they will batch cook for you, and then you can freeze all of that, like there's so much support out there, we just have to ask for it. Because if we aren't, if we don't ask we won't receive. So get as much support as possible. Because that will ensure that either your fridge is stocked with food, that maybe somebody can watch your child and you can get extra sleep, or when you're pregnant, you can get extra rest, etc. Get as much support as possible, including lactation support. With my first pregnancy, I did not see, I just saw the lactation consultants once in the hospital. My recommendation to moms is have the lactation consultant come as many times as you need in that 24 to 72 hours thing. Have them come every time you you breastfeed if you want to they can that's part of your car.

Maureen:

It's so true. It's such a foreign thing. And it could be so difficult. Yeah, you need to get them into the room every single time you can.

Dr. Vanessa Mendez:

Yes. And the great news is that each Lactation Support consultant has a completely different technique and different recommendations. So I saw a couple in the hospital this time. And they each gave me tips that helped me, you know, and then afterwards, I also saw one at home. And you know, there are resources for women to see Lactation Support consultants after they go home as well. So, but at least in the hospital, see them every time that you're going to try to breastfeed, they will be really helpful. So that is, you know, a major recommendation. And regardless of where you ended up, either, even if you end up just being able to provide one week of you know, maybe three ounces of breast milk a day, let's say the minimum right. That is still more than nothing. And yes, a lot we know that breastfeeding is not free at all. It's the most costly thing. If I am strictly pumping right now, for example, if it wasn't because my husband is at home and worked from home, I would not be able to do this. There's absolutely no way I would be able to do this. So we know that this is one of the most constantly things so there's no there shouldn't be guilt. And I know we have tons of guilt but there shouldn't be guilt or shame. Even if we're able to provide just one ounce of breast milk per day. Any little thing helps. Okay, so that's one and then if you In the formula feeding, that's okay, I formula fed, mostly my first child. And I had to go back to work right away, I didn't think the support that I needed, and the trauma from his birth, forgetting that was the recipe for not being able to produce enough milk. So, formula has become a lot better at, similarly, you know, simulating, imitating breast milk, obviously, never gonna be breast milk. But it is becoming a lot better. You know, now, formulas have probiotics. And we know that they have these prebiotics in them as well, which is what breast milk has, again, it's never going to be 100%, but it is getting better. And at the end of the day, it's the totality of what you do for your child that's really going to determine, you know whether health outcomes will be better or not. So the other newborn recommendation I have is, skin to skin, do skin to skin from the moment the child is born, why not only does that regulate moms and babies, hormones, but also circadian rhythm. So their sleep cycle all of that, so to as much skin to skin that will also stimulate your your milk production and your milk letdown. Do it as much as possible. And guess what do it also with the immediate family members. So your partner, if you have other kids do that, because that means that the baby's actually getting the family's microbiome into their mouth. Because what happens they're putting their cheek on then they're sucking their hands, the your skin microbiome is making its way and your your gut microbiome is actually also making its way into the child's got microbiome and colonizing it. So a lot of skin to skin with immediate family members obviously wash your hands, but just like that skin here, that's our native skin flora, you know, not our hands, but this one, that's really good. So just to have as much skin skin as possible. The other newborn recommendation I have. And this one is for adults to get out into nature. So when we're out in nature, not only are we you know, getting that vitamin D from the sun, which is really important for the gut microbiome, but we're also breathing in when we breathe in, we're actually getting microbes who are swallowing because we swallow air when we breathe. So we're getting microbes from nature into our gut microbiome. And my recommendation is to ours out in nature, even if that means a little patio, where you have a little stand of soil and you're getting your hands in the soil that is good. Or you can go out on a walk, obviously, if you can go out on a hike, but really any natural environment counts because the trees, right, they let down a lot of different microbes from the ecosystems that are the trees, right, the trees each have their own ecosystem. So all of these are really important recommendations for just fostering a beneficial microbiome from birth, right? Whether you had to have a C section, whether you were able to breastfeed or not. Most moms are able to do skin to skin you know, even if your babies in the NICU, you're able to go and maybe do a little bit skin to skin for a couple minutes. And then you know, so all of these are recommendations from the beginning. Now, for the rest of childhood and adulthood. We talked about I saw getting, you know, fostering like, just getting kids involved in the kitchen, from grocery shopping, get them excited, have them help you prepare food, wash some of the fruit that gets them really excited about eating, because then that's going to develop habits of getting them excited about trying different foods. And you know, I hate the term picky eating, all of us are competing, all of us are picky. We have likes and dislikes. So I don't like that term. But it's just getting the kids involved in the kitchen, getting them excited throughout the different cooking, you know, the whole process of shopping and cooking and preparing foods. And then putting stuff on the plate, whether they eat or not, it's up to them. They're their own person. Our jobs as parents is to provide the food for them. But whether they choose to eat or not, we can't we can't force them, you know. So I know moms have a lot of guilt and a lot of you know, a lot of a lot of pressure we put on ourselves to make sure that our kids are eating their whole plate. No, the kid here to one day, they're gonna eat a lot another day, they're gonna eat a little bit. That's okay. It's the totality of what they're eating. They're eating patterns at the at the end of the week that you do that intake and then you're like, okay, yeah, you know what, my kid tried two different new foods that's perfect for our wedding. So that's the food aspect of it. And then the nature aspect So we talked about that means that they're getting physical activity as well. So physical activity is really important to foster a balanced microbiome. So getting out, you know, getting out as much as possible, really involving the whole family in physical activity is is going to be beneficial to the gut microbiome. And then some of the things that we want to minimize, you know, we want to minimize, and I don't say avoid, because again, we're human and we live in, we live a human life. So things that you want to minimize are, you know, refined sugars, processed foods, so refined sugars and processed foods. So processed foods have these things called emulsifiers. They're chemical additives, that are binders. There's over 30 to 50 of them. And they if you can't recognize an ingredient on a list, is usually an emulsifier. These are actually things that affect the gut microbiome and in studies show that they they affect the microbiome negatively creating more of an imbalanced gut microbiome, and have been associated with things such as Crohn's and Colitis, for example, which is one of the autoimmune disorders, such as you know, trying to minimize processed foods going for more whole foods, right? minimally processed is fine. It's just like minimally processed means naturally production of food, for example, like washing, storing, etc. But overly processed foods such as what we call, you know, junk food, like foods that are high in saturated salt. I mean, saturated fat, salt, and refined sugar is where we turn what we know, as overly processed foods, your great grandfather can recognize the food, then you should minimize it, you know, and just making things at home, that doesn't mean we can't do desserts. Absolutely not, you know, I have to have a dessert every day, just trying to do more desserts at home, with better quality ingredients that are less processed. That way, we're not getting all these chemical additives in the food and paying a high price for them anyway. Um, so those would be my recommendations. And for adults, you know, unfortunately, alcohol is something that affects the gut microbiome. I like my whiskey. I'm a whiskey girl. I actually like bourbon, you know, I trained in Louisiana. So. But yeah, I mean, you know, like, again, it's that pattern, are you having it mostly, most days of the week, then it's time to cut back. So things like that would be where we would want to shift that balance of, okay, we're doing more positive things for our microbiome at the end of the week, versus some of these that are negatively associated.

Maureen:

I think that's such a great outlook, you're looking at the whole of your week, not just it will produce less shame for yourself. If you're, you know, oh, just, I had that thing that I shouldn't have. But that's not it, and what else are you doing positively? And, and is that, you know, occasional or is that all the time, so I really appreciate that. And I think that that makes it easier for people to actually move in this direction and, and really make healthier habits and healthier changes. I also want to say that I'm also a two times C section mama, so we got to stick together. Those are hard situations to be in and I, you know, I when I had my first it was an emergency, and I didn't even think about, you know, the differences between what that means. As far as microbiome. I've since learned more about it. But I appreciate you saying that, you know, there are other things that you can do to nourish your child's microbiome and set them up for a healthier life going forward. And, and it's good to know also for moms that use formula that it has improved, and it is getting better.

Dr. Vanessa Mendez:

So yeah, and then the last thing to add, because we talked about the gut brain axis as well. Fostering you know, coping mechanisms from an early age is really important for kids to build that resilience. So you know, getting kids involved in deep breathing, you know, so now there are apps that have turned tuned into this like we personally use headspace but on YouTube, you can find any meditation for kids that are you know, that are free. And they have like Sesame Street, teaching them how to do the breathing or meditation or tuning in with themselves. It's really important to discuss these things from an early age and teach them how to you know how to manage stress and how to manage difficult situations. Because not only does that build mental resilience, actually it is crucial for the gut microbiome because we talked about How childhood trauma can and does predispose you to a lot of a lot of conditions, not only anxiety and depression, and ADHD, but also autoimmune disorders as well. So it's really important to teach them from even from a toddler age how to do the breathing when they feel overwhelmed or sad, or, you know, angry, really talk to them about emotions and have them see you like when they're when they're having a tantrum. We, we are not great at it, but we have a method of, okay, let's tune into our deep breathing, we're gonna count we're gonna do three deep breaths, and we're gonna do inhale for one, exhale for two. And you do that for three full breaths, you know, so that after he does that, my son like you can see his fight or flight just down regulates, and he's able to kind of like, re reset himself, and, and really balance his emotions out in a way that he's able to communicate them better, and is able to just cope with it. Over time, these deep breedings are tuning in to our emotions, they build a lot of resilience, not only mentally, but also, you know, when it comes to the gut microbiome.

Maureen:

Hmm, that's a really interesting point, too. I'm so glad you fit that into how we manage to I mean, stresses everywhere, and everyone's dealing with it. So how that affects your microbiome to was really important. So we're wrapping up now. And I just wanted to say thank you so much for joining us, Dr. Mendez, this conversation has been so eye opening, and you are just a wealth of knowledge and, and this area. So interesting. I'm sure we could go on in Nevada. But I really appreciate you joining us. So thank you so much for being here.

Dr. Vanessa Mendez:

My pleasure. It's always fun to talk about this stuff. Because again, I that stuff, nobody teaches you in medical training, you have to kind of like, learn it on your own. And it's information that everybody should have access to. So we can educate and empower moms and our families to build healthier and more resilient families.

Maureen:

Absolutely. And I appreciate you as a resource so much, because I agree it's hard to find this information out there, especially when you're just going to your regular doctor. So it's so great to have you as a resource and to learn more about this and, and how it all plays in together for the microbiome some thank you again. And thank you for listening everyone and thank you to one of our episodes sponsors Koe Kombucha. Be good to your gut when you enjoy Koe Kombucha. With billions of live probiotic cultures and over 200% of your daily recommended dose of vitamin C, the benefits of this delicious drink are wonderful. It's also low in sugar and each 12 ounce can has only 25 calories. Koe offers seven fruit

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