Melanie Cole, MS (Host): Welcome to Back to Health, your source for the latest in health, wellness, and medical care, keeping you informed so you can make informed healthcare choices for yourself and your whole family. Back to Health features conversations about trending health topics and medical breakthroughs from our team of world-renowned physicians at Weill Cornell Medicine.

I'm Melanie Cole. And today, our discussion focuses on gut healthy eating. Joining me is Dr. Carolyn Newberry. She's an Assistant Professor of Medicine at Weill Cornell Medical College, and an attending physician at New York-Presbyterian Hospital Weill Cornell Medical Center. Dr. Newberry, thank you so much for joining us today.

I'd like you to explain at the beginning as we get into this topic, because we are learning so much more about the gut microbiome and our overall health and autoimmune. I mean, we're just learning so much and it's happening quickly. Can you please explain a little bit about why gut health is so important throughout the different stages of life? What does gut health even mean?

Carolyn Newberry, MD: Right. I mean, I think that's a very challenging question to answer, I think in a succinct way, because gut health can mean so many different things. But I think when people use that term, they're talking about the type of bacteria in the microbiome that's in the gut that's helping you stay healthy and reduce disease. And a lot of that is reflective of a lot of the lifestyle changes that we make in everyday life.

Melanie Cole, MS: How does gut health impact overall wellbeing beyond just digestion? We typically think of GI, gut health as just our digestive system, but it's really involved in our overall wellbeing, isn't it?

Carolyn Newberry, MD: Yes. I mean, I think there's a lot of interesting literature that's coming out now that how healthy our gut microbiome is can sometimes be reflective of other health issues and being healthy. And so, I think there is a strong link between health and between the gut and that's one of the reasons why I love being a gastroenterologist.

Melanie Cole, MS: Yeah, it's really a fascinating field. And there are so many more tools in your toolbox, and it's moving so quickly. There are so many advances now. One of the questions that I have personally, is there really a connection between gut health and mood? How does that microbiome influence our mental health? Because I think, wow, if we can figure that one out, that's really huge.

Carolyn Newberry, MD: Yes. And I agree, if we could figure that one out, that would be really huge. I think anytime I talk about the gut microbiome and its association with particular health benefits or complications, I always want to put the caveat in that we're still learning a lot more in the literature and there isn't a lot of like robust scientific data to say eating this particular food or having this particular bacteria in the gut is going to all of a sudden cure depression or change your mood in like a meaningful way.

With that being said, I think there are specific lifestyle modifications, things like getting enough sleep, drinking enough water, eating enough fiber in your diet, reducing your intake of highly processed foods and foods that are high in easily digestible sugars that does portend a better, healthier gut, and that also portends a healthier you and a better mood. And so, there is some data to support those links in a very broad sense.

Melanie Cole, MS: Well, also, and we know as women, we could be bloated one day and feel really skinny another day, and that certainly affects our mood, right? That will affect anybody's mood. And as an older woman myself, I know that I can tell when I'm feeling really bloated, when I'm feeling fatigued, sluggish, like it's just not running through the way it should. Can you give us, Dr. Newberry, some signs of good gut health and gut health that maybe isn't perfect? I mean, obviously bloating is something that we all know about, but are there some other signs of good and bad that we should be aware of?

Carolyn Newberry, MD: Right. So I mean, I think that taking a check of how you feel when you're eating, after you're eating, before you go to bed at night from a belly perspective is really important just to get a pulse on your health. I do want to, again, put a caveat that feeling bloated sometimes is a very normal response to having excess swallowed air, eating something that gets metabolized into extra air, maybe not evacuating your stools as completely one day because maybe you didn't get enough fluid or you didn't sleep well, and so you're a little constipated. But overall, you want to feel good most of the time. Not really bloated, not really distended, having like complete bowel movements at whatever frequency is right for your body. And I often tell people that may be three times a day, that may be every three days. I mean, it depends on what your body needs. And that really is taking a check on how you feel when you're going that often and if you feel like everything is coming out that needs to.

Melanie Cole, MS: Well, as a postmenopausal woman, I can tell you it can vary from one hour to the next every single day. But I do see what you're saying, because I can tell when I'm feeling just not quite right and it does connect with bowel movements. But also, with what I eat and just right after I eat or how much water I drink or how much exercise I get, kind of all ties into it, right? So, I'd like you to speak about some practical ways we can support our mental health and our gut microbiome and kind of put it all together for us because what a great topic we're discussing here today.

Carolyn Newberry, MD: Right. And I think that this is a question that I get asked commonly and everybody wants me to tell them if they can take this particular supplement or eat this one food and all of a sudden everything's going to be magically healthier and better. And that's not really the way we approach it in the medical community. I think it's more of a patterns of behaviors that can help you be at your healthiest. And I think you touched on a lot of them. We've mentioned them during this conversation.

We want to make sure we're adequately hydrated, so we're drinking water throughout the day. We want to make sure we're getting enough sleep. Everybody's different in the exact amount of sleep they need, but probably somewhere around seven to eight hours per day for most adults is like an appropriate amount of sleep.

Then, for dietary habits, the science really says that the Mediterranean style diet is probably the "healthiest." This is reflective of eating fruits and vegetables, whole grains, lean proteins, limiting animal products in your diet, eating fewer processed meats, processed sugars, these different products on the market that have a lot of ingredients in their ingredient lists. So, all of these things together can help you have a healthier gut microbiome and also reduce your risk of chronic disease.

Melanie Cole, MS: Well, I agree with you. And certainly, the hydration as somebody who hydrates literally all day because I'm talking and I'm behind the microphone and I have to, but I do notice a difference when I don't, right? I notice the feeling of fullness, of sluggishness.

Now, you mentioned supplements, Dr. Newberry. Probiotics, prebiotics. We're hearing these words being bandied about, and then we're also hearing things about kombucha and yogurt that are containing these things. Fermented foods, kimchi. I love kimchi, so we eat a lot of that in my house. But can you tell us about those things that we're hearing now, the prebiotics, the probiotics, and where we'll find them?

Carolyn Newberry, MD: Sure. Yeah. Another very popular topic and question for patients. So, the concept is that prebiotics are something that feeds probiotics. So, probiotics are bacteria that can be consumed that may portend health benefits in the gut by changing the gut microbiome composition. And then, prebiotics are what the probiotics, so these types of bugs, actually feed on.

And so in general, we think of these as types of fibers, because our gut microbiome likes to feed on fiber sources. And so, there's a lot of products on the market now that-- our prebiotic formulation, sometimes it's a prebiotic with a probiotic that they call a symbiotic actually, because they have a symbiotic relationship, a combination relationship.

But in terms of whether we all need to be on probiotics, whether we need these types of supplements, it's pretty unclear. And actually, our current guidelines from the gastroenterological societies say that most people probably can get the prebiotics and probiotics they need to support a healthy gut microbiome from foods that they eat. And so, you touched on some sources that may be beneficial. Yogurt is a good source of probiotics if you are dairy-tolerant. And you want to actually look for unsweetened yogurts, ideally, to be able to deliver those bugs to the gut.

Other fermented foods, things like kimchi or things like kombucha, also do likely have some health beneficial probiotics. Things you do want to watch out for, particularly in the kombucha space, are that there are a lot of added sugars along with the kombucha product, which is something that they will sometimes put in because those teas tend to be a little bit more bitter and sour like at baseline.

But yes, I mean, I think that in general, looking for these types of foods, incorporating them into your diet if you like them can help. And additionally, a lot of the things we already discussed, reducing emulsifiers, reducing added sugars, these different things that make that microbiome less healthy, and then getting enough natural fiber, fruits, the vegetables, the whole grains. I love some ground flaxseed or chia seed. These are like really great sources to feed the gut microbiome. And it means you don't necessarily need to take the over-the-counter probiotic supplement.

Melanie Cole, MS: That's really great advice. And when my kids were little and they had some gas problems, my pediatrician had recommended some probiotics. So, I used to tell the kids it was bugs in oil. Because they were taking their little fish oil and it was kind of a little combo. "Here's your bugs in oil." They thought that was pretty cool. But we did notice a difference for them at the time.

Now, 20 years later, they're great. So, my question to you is, when we think of the diet itself, cruciferous vegetables specifically, we hear we're supposed to do Mediterranean. We hear that we're supposed to do all our leafy greens and all of these things, but certain foods make us gassy. Is there any connection, Dr. Newberry, between being gassy and those foods and our gut health? Does one connect to the other or not really?

Carolyn Newberry, MD: So, yes, I think you're bringing up a good point that not all fiber is created equally, and the different types of fiber have different fermentability. So, different ways that the gut microbiome can break them down and produce extra gas. Cruciferous vegetables are one of the notorious ones for being a gas-forming food. And so, some people don't tolerate them well.

With that being said, there are sometimes ways that you can prepare these types of cruciferous vegetables. You can sauté them with some olive oil. You can steam them. You can cook them. You can chop them up into a super smoothie that may make them more palatable to the microbiome and produce less gas.

But overall, you want to consider the different types of fibers that are available to you. There certainly are different types of fruits and vegetables that are less gas-forming. So if you're somebody that's more prone to that, you may do better with just a different type of vegetable. Maybe the brussel sprouts are never going to be your friend, but hopefully you can eat an alternative, peas or beans or sautéed spinach or something to still get those nutrients in your body. And I think that just because they cause symptoms doesn't mean they're not healthy. It may just be your body also needing to get used to them. So, there's some literature that says that when you eat certain types of foods, like the microbiome can actually change. And so, you may not tolerate them at the beginning. You may find over time as you continue to eat these foods in small quantities that you have better tolerance and can adapt them into your diet. So, I just tell people to listen to what your body is saying and try to adapt things, and obviously speak with a doctor or a dietician if you feel like something is off.

Melanie Cole, MS: Isn't it great when we get to talk about my issues specifically? But really, they definitely do apply all around. And Dr. Newberry, you've given us so much great information today, and this is really a fascinating topic. Can you wrap it up for us with your very best advice about our gut microbiome? That association with mental health, which is fascinating to me. Really, really an interesting field of study, our mood. And what you tell your patients every single day that we should be doing to really give us a positive microbiome and help us to feel just better over overall.

Carolyn Newberry, MD: Yes. I think that wrapping it up that a lot of the advice is very not sexy. It's not a supplement. It's not some fancy routine that you're doing in a particular way. It's really just getting back to the basics of those lifestyle modifications. We've talked about sleep and hydration and avoidance of processed foods and eating more whole foods. And I think that all of those things are going to help support a healthy gut microbiome and help you feel your best and stay healthier. So, I wish I had a magic pill and my patients are always looking for that, but it really just comes back to the basic.

Melanie Cole, MS: What a great guest you are. Thank you so much, Dr. Newberry, for joining us today and sharing your incredible expertise with patients. And Weill Cornell Medicine continues to see our patients in person as well as through video visits, and you can be confident of the safety of your appointments at Weill Cornell Medicine.

That concludes today's episode of Back to Health. We'd like to invite our audience to download, subscribe, rate, and review Back To Health on Apple Podcast, Spotify, iHeart, and Pandora. For more health tips, go to weillcornell.org and search podcasts. And parents, don't forget to check out our Kids Health Cast. There's so many great podcasts there. I'm Melanie Cole. Thanks so much for joining us today.

Promo: Every parent wants what's best for their children, but in the age of the internet, it can be difficult to navigate what is actually fact-based or pure speculation. Cut through the noise with Kids Health Cast featuring Weill Cornell Medicine's expert physicians and researchers discussing a wide range of health topics, providing information on the latest medical science.

Finally, a podcast to help you make informed choices for your family's health and wellness. Subscribe wherever you listen to podcasts. Also, don't forget to rate us five stars.

disclaimer: All information contained in this podcast is intended for informational and educational purposes. The information is not intended nor suited to be a replacement or substitute for professional medical treatment or for professional medical advice relative to a specific medical question or condition. We urge you to always seek the advice of your physician or medical professional with respect to your medical condition or questions. Weill Cornell Medicine makes no warranty, guarantee, or representation as to the accuracy or sufficiency of the information featured in this podcast, and any reliance on such information is done at your own risk.

Participants may have consulting, equity, board membership, or other relationships with pharmaceutical, biotech, or device companies unrelated to their role in this podcast. No payments have been made by any company to endorse any treatments, devices, or procedures. And Weill Cornell Medicine does not endorse, approve, or recommend any product, service, or entity mentioned in this podcast.

Opinions expressed in this podcast are those of the speaker and do not represent the perspectives of Weill Cornell Medicine as an institution.