Optimal Nutrition for Gut Health

Podcast Transcript

Scott Steele: Butts & Guts, A Cleveland Clinic podcast exploring your digestive and surgical health from end to end.

Hi again everyone, and welcome to another episode of Butts & Guts. I'm your host, Scott Steele, the President of Main Campus here at Cleveland Clinic in beautiful Cleveland, Ohio, and colorectal surgeon. And today I'm super excited to have Kendra Weekley on, who's a registered dietician at the Cleveland Clinic Center for Human Nutrition. Today we're going to talk about optimal nutrition for gut health. So Kendra, welcome to Butts and Guts.

Kendra Weekley: Thank you for having me. I'm excited to be here.

Scott Steele: Well, we are excited to have you as well. And so we always like to start out here with a little bit of a background about yourself. So give us a little bit of information where you're from, where'd you train, and how did it come to the point that you're here at the Cleveland Clinic?

Kendra Weekley: So I'm born and raised in Cleveland, Ohio. I love the city. Yeah, it's where I only know. So I did my undergrad at the University of Akron and then I got my master's degree at the University of Concordia Chicago. So I've been a dietician for 10 years this year. So it's my decade. I'm pretty excited about that. I've worked in a variety of populations, including geriatrics and then all the way to pediatrics. And I've been in outpatient inflammatory bowel disease for the last three years now. So I'm part of the inflammatory bowel disease medical home. I'm really happy to be here and I've learned so much about the gut and with all of my providers. So it's a lot. It's really cool. It's really fun.

Scott Steele: Well, we are glad to have you here and today, as I said, we're going to be talking a little bit about the optimal nutrition for gut health. So lots of different terms out there. And to start for our listeners, what is gut health or some other people call it the gut microbiome?

Kendra Weekley: I think that's a really big question, because you're right, there are a lot of terms that can get a little misconstrued or even just replaced and used interchangeably. But the gut microbiome is trillions of microscopic organisms, specifically in your intestines. We have multiple biomes in the body and our mouth and our lungs, on our skin. But the gut microbiome is specifically in the gut. And a few things with the biome is that it's very diverse. It changes all the time, which has been notoriously really hard to study because just so different and we're having a, not a hard time, but we are getting a lot of data, but we don't know how to interpret that data yet, kind of. We're getting there. The gut microbiome is fairly new on the horizon for studies, only in the last 20 so years where multiple conditions have been studied for decades. So I think the gut health in particular is how functional your gut microbiome is and how that can relate to different symptoms and chronic disease.

Scott Steele: So what are the symptoms associated with having poor gut health? And kind of opposite that is what does good gut health look like?

Kendra Weekley: So poor gut health I think can also mean a variety of things. But common signs of a wonky gut is of course dysbiosis, which is the unbalanced of gut bacteria. We can have not enough good bacteria versus having too much bad bacteria, that unbalance, which often is associated with bloating, irregular bowel patterns like constipation and diarrhea, and then also increased risk for infection. You get sick a lot or you have a lot of GI bugs. That can all pertain to poor gut health. And then on the flip side of that, that good gut health can be that normal bowel movements. Normal is different for everyone depending on if you have different disease conditions or surgical history, as colorectal you know that not everyone sometimes is all connected, but a healthy functioning gut.

Scott Steele: So why is fiber so important to gut health? And I understand that there's different fiber sources out there that maybe some might have more beneficial for feeding gut bacteria and that good type of gut bacteria. Can you walk us through a little bit of that?

Kendra Weekley: Yeah, I think fiber gets a lot of press on social media and I think there's a lot of information out there on fiber that can be misconstrued. So fiber is the carbohydrate in plants that is fermented in the gut, which comes from general examples like whole grains, fruits and vegetables, beans, nuts and seeds. So the American Gut Project, which is this big collection of stool samples out of the US, the UK, and Australia that studied the microbiome, looked at the intake of fiber and how that relates to the gut, the gut diversity, and the benefits of that.

So I'm going to eventually come back to that because I have a big point, but there's a couple different kinds of fiber. We have soluble and insoluble fiber and I think that often gets lumped together into one, but that soluble fiber, think of anything that's going to dissolve in water. So like cooked fruits and vegetables. If you were to take cooked carrots and mix them into a glass of water, they're eventually going to dissolve and that can be really easy to break down. And if you have a lot of inflammation or if you had surgery, it might be more important to stick to that more soluble fiber kind of diet just to help manage some of your symptoms and rebuild healthy tissue if you've had surgery.

Insoluble fiber is going to be that crunchy, hard, raw veggie. Think about putting that same example, that regular carrots into a glass of water, stirring them up. What happens? Nothing. Why those two fibers are important is that soluble fiber is going to help absorb water, give more form to the stool while the insoluble fiber is going to help with motility. Different types of fiber also help with development of short chain fatty acids. So the production of short chain fatty acids are really important as well, and that's going to help with the different types of fibers. So that is made in the colon. So when you get that type of fiber that eventually gets to the colon, that insoluble fiber, that is going to help make those short chain fatty acids, which can help with immunity, mood, brain health, diabetes, obesity. So having that balance of both soluble and insoluble fiber is really important.

Scott Steele: There's certain types of foods and one of the foods that are out there is fermented foods. Can you talk about what these are and how do they impact the gut microbiome? And any advice that you have into incorporating these type of foods into our everyday diet?

Kendra Weekley: Yes. Fermented foods have been around for centuries. We used to, well, we still kind of use it as a preservation, as a canning and a jarring method, but basically these fermented foods are easier to tolerate because they're partially broken down outside of the body. So common fermented foods are things like kimchi and sauerkraut that have been pickled and sat and what happens is that that bacteria that's naturally occurring on those types of foods are going to eat the sugar, the carbohydrates, on those foods, releasing air and gas and creating this environment that is shelf stable. And by those bacterias growing now you have this surplus of good bacteria that's going to help the diversity of your gut. And they also taste really good and they give you a lot of different kinds of fruits and vegetables. Some even have protein like yogurt and kefir. Even yogurt in general has been shown to reduce things like cardiovascular disease and type 2 diabetes. And a lot of that is that good bacteria. Even things like kefir have been shown to be as equivalent or better to over-the-counter probiotics. And I think that's really neat, using that food first approach to get a lot of good gut bacteria.

We know that adding more food is going to increase the diversity of the gut. We don't really know if the diversity of the gut is important or what kinds of bacteria in the gut are most important, but we've seen that people who have a higher diversity of gut microbiome is also going to have a decreased risk of infections, disease, obesity, diabetes, the list goes on. So some really great ways to get fermented foods in the diet of course are those cabbage dishes like kimchi and sauerkraut. We have fermented dairy like yogurt and kefir. Kombucha is like a fermented tea that is very popular. Miso and tempeh are fermented soy products. Some cheeses are fermented as well, pickled foods, and then grains like sourdough. You'll often find that sourdough is on a sensitive belly because it's partially fermented, it doesn't use yeast to rise, it uses fermentation. Fermented foods are a win in my book, especially for that food first approach. Overall, it's going to help increase that biome diversity and it's going to help get you a lot of new nutrition into your diet.

Scott Steele: So one of the things that always comes out there is probiotics, and I swear to you it's been the magic cure for just about everything, but can probiotics actually repair a damaged gut barrier?

Kendra Weekley: So a lot of the information we have on probiotics are in animal studies so sometimes we have to extrapolate or make some estimates when we're applying that to humans. But we do know that probiotics do play a role in changing that gut microbiome by assisting the host, which is you, in building a healthy gut mucosa.

So we're still learning about how probiotics can help. Our gut has its own flora, it has its own personality, it has its core. And it can change on it day to day, but it's still going to be that main core set of biome organisms and we can influence that by what we eat and supplementing with probiotics, but we also have to remember is the probiotic going to make it to the colon? So it's got to survive the stomach, it's got to survive the small intestine, and it has to get to the large intestine.

It can play a critical role in that colonization of good bacteria to help fight bad bacteria, which then ultimately is going to repair the gut and the gut mucosa and those epithelial cells that we all know and love. So there has been some links to making more mucus in the gut from more probiotics, which then is going to help repair any damage that might have occurred to the gut. So I think big picture is that it can be helpful. I think we have to still know how much. The different doses and strains are still up in the air and jury's out for that. But overall, I do think that probiotics can help repair a damaged gut.

Scott Steele: And what timeframe are we talking about for either probiotics or for potentially for the way that we eat and dietary changes influencing that gut microbiome?

Kendra Weekley: Yeah, great question. So timeframe can be as quick as that day, that 24 to 48 hour period. Cells in the mucosa or in the small intestine as well can regenerate every five days. So I always use that example when I'm talking about like alcohol. We know that alcohol has a direct impact on the gut mucosa and can increase the permeability of the gut. That permeability means that it's going to let in bad stuff, not absorb nutrients correctly. But if our gut regenerates every five days, having a drink at your wedding might not tank your gut health.

Also, when they looked at different biome studies, there was always a washout period in between different diet interventions. So for example, they had a plant-based diet group and then a animal-based diet group, and they took biome studies and then they told them to go back to their normal diet and they found that their biome went back to the original biome within three days of going back to their normal diet. So it's quick, it can happen quick. Which then I think brings us to how do we keep that change, and it's all about building healthy habits and being consistent. You have to have habitual dietary fiber, probiotics, all the time so that your gut gets used to it, it's always there, it's changing, it's adapting. Because things change, taste changes, your gut change. We see that in these studies. Just in the course of a day, your gut microbiome could be different. So having constant good nutrition is really important.

Scott Steele: So in general, are there any other nutrition guidelines or best practices that our listeners can follow for gut health?

Kendra Weekley: Yeah, and kind of circling back to that American Gut Project. They found that people who ingest 30 different plants per week had a more diverse biome than someone who only ingested about 10 or less plants per week. So they came up with this 30 unique plant challenge where if you can try to get 30 different plants within your diet every week, you're more likely to have a good biome. And I really like that challenge because I feel like in our day-to-day lives, we just get stuck in a rut. You get home and you eat your meat, potato, broccoli, and then you go on with your day, you wake up in the morning and your breakfast is always going to be an oatmeal and a banana. So I think that when you track and when you look at what you're eating, you're like, "Oh, wow, I only eat 10 plants every week. I need to do better."

I did this challenge with my mom last summer and as a dietitian, you think I'd be good, but I had some room for improvement and it was a really good challenge. So I think 30 unique plants is a really achievable and fun and creative way to get more food into your diet. I also think too, that getting in your protein is important because that's ultimately going to help regenerate new cells. So making sure that your diet is rich in protein. And that also plays a role, having variety in your protein as well. Chicken, fish, turkey, your lean proteins that are going to help promote that more Mediterranean lifestyle for all kinds of disease.

Scott Steele: So a couple of rapid-fire questions for you. Very straightforward, yes, no. Are food sensitivities increasing? Yes, no.

Kendra Weekley: Yes.

Scott Steele: Does gut health play a role in food sensitivities? Yes, no.

Kendra Weekley: Yes.

Scott Steele: Does gut health really impact our immune system?

Kendra Weekley: Yes.

Scott Steele: Does gut health play a role in weight loss?

Kendra Weekley: I'm going to go with debatable.

Scott Steele: Okay. Is intermittent fasting beneficial for gut health?

Kendra Weekley: No.

Scott Steele: And is gut health connected to our metabolism?

Kendra Weekley: Yes.

Scott Steele: Good job on our fast-track answers. So now it's time to get to know you a little bit better as we go to our quick hitter. So first of all, what is your, as a dietitian, favorite food?

Kendra Weekley: Oh, man. Okay, you're going to laugh. So I am very Irish, so my favorite food is potatoes of all kind. I think they're so versatile. And when it comes to the gut too, we're starting to learn that potatoes also offer you something called resistance starch, which can favor a prolific amount of different kinds of bacteria. Potatoes get such a bad rap in the weight loss community, and I don't know why, because they are one of the most satiating foods. They make you feel the fullest. And just you can do anything with them, right? Mash them, what is it? Peel it, mash them, put them in a stew. There's white potatoes, sweet potatoes, like 10 out of 10 potatoes.

Scott Steele: What was your first car?

Kendra Weekley: I drove this beater, red Mitsubishi Galant. And that thing smelled like a shoe. It was like someone else's first car and then someone else's first car. But it was awesome. I loved that thing.

Scott Steele: Fantastic. What is one place in the world that you would recommend people travel to?

Kendra Weekley: I recommend, does it have to be in the United States or is it international?

Scott Steele: Anywhere you want it to be.

Kendra Weekley: Anywhere? Okay. Switzerland. I know that's a broad country. I know it's a little expensive. But there's three national languages there. So you can be in three, you can be in French culture, Italian culture, German culture, all in a very small country, and I think that's awesome. So Switzerland is a great experience.

Scott Steele: And finally, what is a recent book or movie that you've read or watched that you would recommend to our listeners?

Kendra Weekley: I'm going to give a lame answer for this because it's a self-help, but I tell a lot of my because I not only coach clients, but I have some athletes too, and Atomic Habits by James Clear. It's all about how to build long-term habits, whether it's nutrition, weight loss, saving money, learning a new language. It is a really easy read. I don't like to read so I listen to my books on audio and it's like a five-hour listen. And it is just really inspiring and really just kind of gets you thinking on the brain power that goes behind making new habits.

Scott Steele: Fantastic. So give us a final take home message to our listeners regarding gut health.

Kendra Weekley: Yes. So I think big thing is variety in foods. We can't get stuck in a rut. We have to add a different kinds of not only just fruits and vegetables, but nuts and seeds, and of course your proteins are really important, but also a balance of fiber. Making sure you're getting enough of the soft stuff and the crunchy stuff is really important. And then more colors. We always say eating a rainbow. But that stuff really does hold true. I know it sounds kind of cliche. Of course, the dietitian to eat more fruits and vegetables. But the data shows it. So that's why we have those recommendations. So variety, colors, and I think those are the big takeaways.

Scott Steele: Fantastic. So to learn more about nutrition therapy at Cleveland Clinic, please visit clevelandclinic.org/nutrition. That's clevelandclinic.org/nutrition. You can also call us here at 216.444.7000. That's 216.444.7000. Kendra, thanks so much for joining us on Butts & Guts.

Kendra Weekley: Thank you for having me.

Scott Steele: That wraps things up here at Cleveland Clinic. Until next time, thanks for listening to Butts & Guts.