The Gut Health Podcast

Gut Check: Kate Scarlata and Dr. Megan Riehl's Top 10 Strategies for Gut Health and Wellness

• Kate Scarlata and Megan Riehl • Season 1 • Episode 11

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Did you know that a balanced gut microbiome can improve nutrient absorption, reduce inflammation, and support mood regulation? Incorporating simple habits into your daily routine—such as eating fiber-rich foods, staying hydrated, restful sleep and managing stress—can make a significant difference in how your digestive system works and gut microbiota function. Join Kate Scarlata and Dr. Megan Riehl on this must-listen episode of The Gut Health Podcast as they break down their top 10 tips for gut health and offer actionable strategies for overall wellness!

You will learn the key elements that link stress to our digestive health, exploring everything from the impact on gut motility to the downstream effects on our resident gut microbiota. Learn the science behind cognitive behavioral therapy (CBT), meditation, and the connection to digestion.

Explore the power of nutrition to supercharge your gut microbiota but also the fascinating impact of diet on mood. With guidance on incorporating fiber-rich and fermented foods into your diet, Kate and Dr. Riehl emphasize gentle introductions for sensitive tummies and the many benefits of regular exercise for both the body and the mind. Tune in for engaging tips and personal stories that empower your journey to a balanced and happy life for you (and your gut!).

Podcast Reviews (Thank you!!)

References:

Cognitive behavioral therapy for irritable bowel syndrome induces bidirectional alterations in the brain-gut-microbiome axis associated with gastrointestinal symptom improvement

Alteration of faecal microbiota balance related to long-term deep meditation


Diet and Gut Microbiome: https://pmc.ncbi.nlm.nih.gov/articles/PMC9455721/

Benefits of Forest bathing: https://pmc.ncbi.nlm.nih.gov/articles/PMC6886167/pdf/12199_2019_Article_822.pdf

Learn more about Kate and Dr. Riehl:

Website: www.katescarlata.com and www.drriehl.com
Instagram: @katescarlata @drriehl and @theguthealthpodcast

Order Kate and Dr. Riehl's book, Mind Your Gut: The Science-Based, Whole-body Guide to Living Well with IBS.

The information included in this podcast is not a substitute for professional medical advice, examination, diagnosis or treatment. Always seek the advice of your physician or other qualified health care provider before starting any new treatment or making changes to existing treatment.

Kate Scarlata:

Thank you. The Gut Health Podcast will empower you with a fascinating scientific connection between your brain, food and the gut. Come join us. We welcome you.

Dr. Riehl:

Hello friends, and welcome to The Gut Health Podcast, where we talk about all things related to your gut and well-being. We are your hosts

Dr. Riehl:

I'm Dr Megan Riehl, a GI health psychologist

Kate Scarlata:

and I'm Kate Scarlata, a GI dietitian. We started The Gut Health Podcast to share science-based information in a very digestible way. Just two friends who wrote a book about IBS. We really like to have fun together and we wanted everyone to have access to science-based information to live a balanced, full and happy life. Check out the show notes because we have some really wonderful reviews of The Gut Health Podcast thus far and we are really pleased with the feedback we're getting on this little side project that we have started this year.

Dr. Riehl:

Yeah, it's a side project, but, man, we are building a wonderful community and it is so fun to read the reviews and see our friends and colleagues and patients sharing this podcast with their loved ones, our own loved ones sharing The Gut Health Podcast. So we're really excited for this episode, where it's Kate and I and we're going to be giving you our top 10 easy and actionable strategies for your gut health and overall wellness, because, let's face it, gut health matters for everyone.

Kate Scarlata:

You got it.

Dr. Riehl:

Yes, we've got it. We've got it. When we talk about gut health, the impact of stress is typically a part of this conversation, right? Stress management is one of our top 10 essentials for your gut health and beyond. Kate, you ever been stressed?

Kate Scarlata:

Just a little bit. Just a little bit, especially when you have a 10-month-old crazy chocolate lab. That's right, it's a bit crazy. And, Megan, do you feel stressed?

Dr. Riehl:

Never, never! Working mom, three littles, husband, job, podcast, book, right. No one is immune to stress, but those of us that can learn and implement healthy coping strategies tend to manage the stress a little bit better and the stress has less of an effect on our body. And that's the reality here is that we think about stress as something that's emotional, and it can be, but it also can have really profound impacts on our sleep, on headaches, on our cardiovascular health and our gut health. So here are a few reasons why managing stress is essential for all of us to have a happy gut. Let's start with the gut-brain connection. The gut-brain are interconnected through this complex network that we now know as the gut-brain axis. It's a communication superhighway and that highway is bidirectional. It goes from gut to brain and brain to gut, and stress can alter this communication that happens between this brain and this gut of ours and, from a GI perspective, it can certainly affect our digestive processes and our gut function, and you may see some of these alterations with changes in gut motility. So motility is how fast or how slow things move through the digestive tract, those things typically being food, and this can result in symptoms like diarrhea or constipation, depending on whether motility is increased or decreased. Stress can affect this.

Dr. Riehl:

We also see that stress can alter our gut microbiota. We've talked about this a lot over the last year with the introduction of The Gut Health Podcast. So chronic stress can negatively affect the balance of the gut bacteria that are in our system, and this can lead to something called dysbiosis and, just as an FYI, we're going to be covering this again in 2025. But dysbiosis is an imbalance of the microorganisms that live in our human body, or what we like to refer to as our microbiome, and this is a really hot topic because this imbalance can contribute to not just gastrointestinal issues, but many other aspects of our physical health, a couple other ways that stress can impact our body. So this is a big topic too how stress can trigger inflammatory responses in our body, and this can certainly affect our gut, and this is another reason why, for people that are living with IBS, as well as inflammatory bowel disease or IBD, we like to look at how are we managing our stress, because increased levels of stress hormones like cortisol can promote inflammation, which can exacerbate these conditions, and finally, we can see changes in appetite.

Dr. Riehl:

So I know I think I've talked about this before that when the stress goes up, my trips to the grocery store and including some Ben and Jerry's pints of ice cream also tends to go up, and so stress can impact how we eat, it can impact the food choices that we make as well, as for some people it increases their appetite, for some it decreases, and really along that spectrum, we need to focus on our nutrient intake to help our microbiome, to help our overall gut health. So did you know that the gut microbiome, those trillions of microbes living in our digestive tract, play a crucial role in managing our mind and our overall health? And what's fascinating is that this relationship, just like that gut-brain connection, is also a two-way street. Just like your microbiome impacts your brain, your brain profoundly influences the composition and functionality of our gut microbiome, and so that's why a couple stress management tips can be really beneficial from both a brain perspective, but also a gut perspective. So what do you think about this, Kate?

Kate Scarlata:

It's so fascinating, Dr. Megan Riehl, it is so fascinating, and I see that in my own experiences. I'm one of those people that loses their appetite when they're stressed. It's the last thing I can do is eat, even before I get on to do a speaking engagement at a conference, like no, you know. See me afterwards, though, and I'm eating a large lunch, but before not so much, so I resonated with what you were saying, for sure.

Dr. Riehl:

Yeah. So throughout today's episode we're going to give some smart gut tips. What we want to inspire are some very actionable strategies that, when you're done listening today, hopefully you'll remember Kate and I and you'll choose a couple of these gut tips to kind of engage in, or you'll pat yourself on the back and be like, hey, I'm already doing that. So healthy gut, healthy mind here. So my first tip is that over the next month, you will dedicate 10 minutes to start a mindfulness practice, and if the concept of mindfulness meditation is just too much for you, then start with 10 minutes of just muscle relaxation and there are a lot of apps out there.

Dr. Riehl:

You can google passive muscle relaxation we've talked about this a little bit in previous episodes and just spend 10 minutes a day focusing on calming your body, releasing stress and tension from your muscles. You can track this, if that's your jam, using a journal or an app and just kind of keep track of, very brief, how you've been feeling from a gut perspective, mood perspective, stress levels, and what you'll start to find is that you look forward to this. And if you really want to pro tip, something that I do as part of my practice is I spend my 10 minutes. I do this close to bed in the evening and then I pair it with a nice warm cup of calming herbal tea I like sleepy time tea. Or you can do a light snack like a probiotic rich yogurt and after a month I really feel like you will not only benefit from a stress management perspective, but you will look forward to this little treat for yourself in the evening.

Kate Scarlata:

I love that. And I think about your Instagram, Dr Riehl, where you have these mindful minute opportunities. I mean that would be a really good starting point, just to go onto your Instagram account and take part in some of those beautiful scenes that you have on your Instagram account. What is the handle, again, for your Instagram @DrRiehl? That's pretty easy, Dr, pretty easy R-I-E-H-L. Dr Riehl. You got it. Love that.

Kate Scarlata:

Okay, so you know one of my top essentials for gut health, obviously. Okay, so you know one of my top essentials for gut health obviously is eating a nutritious diet. As a dietitian, obviously I got into this field because I believe in the power of good nutrition and I believe that diet matters particularly for our gut and overall well-being. So our philosophy, though, has never been restrict, restrict, restrict. When it comes to eating, we really think about balancing and not banning food, so think about eating a diverse range of foods. So, when it comes to really maintaining gut health, there are some key factors about our diet that really can help hinder or help our gut microbiome.

Kate Scarlata:

Diet in itself. There's many components within food itself that can be very positive for the gut microbiome. These are your primarily focus on foods that are rich in fiber, rich in plants, different types of colors. So when we think about plant foods, they are really our top fuel for our gut microbiota. They love, love, love fiber. So eating a variety of different types of plants allows our gut microbes to also be diverse, and a more diverse microbiome, lots of different types of microbes, is associated with a healthier microbiome. So lots of different plants leads to lots of different microbes, positive changes in the gut microbiome and the two key things in plants are polyphenols and fiber. There's other nutrients and vitamins and deliciousness and fruits and plant-based foods, but remember fiber, number one fuel. So focus on fiber, because dietary fiber is essential for gut health and, of course, as I mentioned, the gut microbes' favorite fuel. It acts as a prebiotic, which this means it is fuel for health-promoting microbes. So we'll talk a little bit more in depth about fiber in a little bit. But also polyphenols are in food and these often give color to different types of fruits and vegetables. Polyphenol-rich foods include things like extra virgin olive oil, berries, bright colored kiwi fruit and even dark chocolate and wine yay, in moderation, in moderation are rich in polyphenols and these also act like prebiotics. Again, food for health-promoting microbes. So that's awesome. A couple other components when it comes to good nutrition is healthy fats, and when we talk about healthy fats, think avocado, think omega-3 fats, like found in flaxseed and walnuts, even in fatty fish like salmon. These all can have anti-inflammatory effects and are really good for our gut health. Conversely, fats that are saturated, found in red meats and butter, those seem to be less favorable to the gut microbiome.

Kate Scarlata:

Meal timing is also really important, and we have talked a lot about this throughout various episodes. But when you eat, you instigate this gastrocolic reflex. This is a really powerful reflex that stimulates colonic motility. So eating breakfast is really important because the gastrocolic reflexlux is working its best. So for those of you that tend to have a sluggish gut, try to for sure eat breakfast and really get that gastrocolic reflux up and running.

Kate Scarlata:

You also want to give a little break between eating, so grazing and gut health.

Kate Scarlata:

It may seem like that's what you should be doing, but you really want to give your gut a little break in between eating, and the reason being is that you need to be in a fasting state for your gut to initiate what we call the MMC phase three.

Kate Scarlata:

This is a migrating motor complex phase three that only will do a housekeeping wave of the small intestine, getting rid of food debris out of the small gut when you're fasting.

Kate Scarlata:

So if you're not giving breaks and you're constantly sipping on something that has calories and nibbling on some pretzels 24-7, you're not really giving your gut that little bit of a break. So a good two to three hour break in between eating you can, of course, drink water anytime. That's not going to interrupt this cleansing wave. But eating discreet meals and giving your gut a little break is also really, really important. The other thing is that food not only delivers nutrition, it's really a source of joy. I mean, I've never met a croissant that didn't make me happy. I'm just saying and you have to remember that we're on this planet for such a short time that food should also be joyful and fun and not exclude your cultural favorites. So just remember that while we sometimes have to eliminate certain things from our diet for those with celiac disease or allergies, for most of us, really being on a restrictive diet is really unnecessary.

Dr. Riehl:

So fun to eat the rainbow right, like that's how we can inspire, getting access to these different polyphenols and our different fibers and exposing our kids. So that's been something where you've inspired me, which inspires my family and hopefully all of our listeners, to make food fun and joyful. And that's the name of the game, right.

Kate Scarlata:

Totally agree with you. And you know a colorful meal is like more enticing, it's pretty. You know it's intriguing to look at a lot of different colors in a salad or a fruit salad or just on your plate, right? Yep, exactly. So what is a good goal to sort of think about as you're navigating variety, eating, more plants, thinking about good tips for diet and your gut microbiome?

Kate Scarlata:

I always say start with some fruit, vegetable, legume, nut, seed that you have never tried. This is a great thing to do with kids too. Have them help select this item to try and I'll sit down and try this new food. I did this a lot when my kids were little and it really did expand their palates and got them interested and less fearful of trying new foods. So try to do that as sort of a little tip to try something that you've never tried. Step outside of that box. And then another really quick and easy tip is just try to embark on eating breakfast. You know it is an important meal, fuels your mind for the day, fuels your body for the day. If you're prone to constipation, it's really a non-negotiable. You should be eating breakfast and see how that changes, how you feel, on a regular basis. So those are a couple just smart tips, easy strategies to get going.

Dr. Riehl:

So those are a couple, just smart tips, easy strategies to get going. Yes, so this combination our food, our mood, it all works together. And you know, our next topic is our gut instinct, basically. Learning to listen to your gut and engage in the gut brain therapies that are available to help us do that is incredibly powerful. And the gut is the second brain, hence the gut-brain. So these gut instincts are real and it's so important to pay attention to our body's signals. Symptoms after eating can indicate food intolerances. Symptoms after stressors could be your body's way of cueing you to stop something, reflect on your needs and then activate your healthy coping skills.

Dr. Riehl:

I'm going to kind of get into some of the brain-gut therapies that are available, but I think that it's really important that we recognize that we can't just process our thoughts and emotions, you know, with our big brain, our second brain, our gut brain also focuses on impacting us in a variety of ways, from that gut instinct all the way to orchestrating the digestion of food and how we absorb nutrients and that motility I was talking about earlier. So this unique system is equipped with its own reflexes and sensory capabilities, enabling it to adapt to the gut's distinct conditions in real time independent of the brain's oversight. In fact, there's been research on this that has found that the gut could still operate without direction from the brain, and this is fascinating to me. I'm sure our listeners also listen to this. I mean, the gut could operate even without the brain. So it shows how powerful this is and under normal conditions, however, our gut and our brain lean on each other and they really work together with this intricate bidirectional communication pathway. So let's talk a little bit about some of the gut-brain therapies.

Dr. Riehl:

One that I commonly use in clinical practice every day is something called cognitive behavioral therapy or CBT. Many people have heard of this and for people with IBS there have now been studies that show that CBT doesn't just ease brain activity related to stress, and we do this by teaching people different coping strategies, different ways of thinking, called cognitive reframing. So CBT doesn't just ease kind of our mental load, but it also alters our gut microbes and this is very new research because again, we used to think about these psychological therapies as mostly affecting our brain and kind of trickling down to affect the gut, but now we see these brain-gut behavioral therapies as altering our gut microbes and because of this, CBT really helps to teach us these flexible thinking patterns and how to process stress more effectively, which ultimately can impact how we manage things like IBS as well as inflammatory bowel disease and other GI conditions.

Dr. Riehl:

There's also a really fascinating study looking at the immersion of meditation to affect, again, those living with IBS-type symptoms and other gastrointestinal conditions. So long-term regular meditation has been shown to shift the composition of the gut microbiota. Now, this was in Tibetan monks. So you know, Kate and I are probably not necessarily utilizing meditation in the same capacity that Tibetan monks are, but we could, because I really. I think my take home with this is that the implementation of meditation skills is a lifelong practice. So if it doesn't feel comfortable right now, that's okay.

Dr. Riehl:

Taking again just a mindful minute, like Kate was sharing from my Instagram stories, that's dipping your toe into reaping the benefits of calming your mind for 60 seconds and that can build upon itself and as you kind of dive a little deeper into mindfulness practices, that can, over time, really help to not just calm your mind but also help your gut thrive. A takeaway, a smart gut goal of thinking about this powerful communication pathway and the ways in which we can use psychological therapies to help our overall gut health is a technique called the three C's, and this is coming from a CBT concept, and we know that our thoughts impact how we feel emotionally and physically, and so the three C's stands for catch it, check it, change it. When you're experiencing times of stress, typically those first thoughts that pop into your mind about the stressor may not be your most constructive, thoughtful thoughts, and so when you can kind of keep in your mind and chant to yourself, catch those thoughts, check them for accuracy and change them to something that's more beneficial for that present moment, that can be a really great not only stress management but also cognitive strategy that you can apply. And you can use this for gut health, but you could use this just for general life stressors, and we talk more about this technique in our book Mind Your Gut. So think about the three C's, catch a, check it, change it and utilize this in your day to day. Catch a, check it, change it and utilize this in your day-to-day.

Dr. Riehl:

So our number four concept to really be thinking about was from an episode that we just loved with Dr Cathy Goldstein. That really helped to remind us about the importance of prioritizing sleep, and sleep impacts digestion, and it's something that I have prioritized over the last year with my self-imposed 10:30 bedtime. And really, Dr. Goldstein brought up this concept that many people experience called psychophysiological insomnia, and this is becoming too focused on controlling sleep, which leads to lack of sleep. So the real things that we want to focus on when it comes to the quality of our sleep, which can be so crucial for gut health, are to establish a routine for sleep aiming for seven to nine hours of restful sleep. It's no longer cool to brag about not getting a lot of sleep. It's just not healthy. It's not a good way to take care of yourself, and so optimizing the quality of your sleep and prioritizing this is something that we want for every single listener.

Dr. Riehl:

So don't let your bed become your kitchen table or your workspace or where you watch a lot of TV. The bed is for sleep and sex. That's it Sleep and sex those two things, and you want to make it a really wonderful, comfortable environment. So think about your sheet quality. Darkness is also important and the routine that you can follow. So consistency is the goal. Set a bedtime and stick to it. No screens after your bedtime, roll over and allow yourself to settle into your bed, relax your muscles and go off to sleepy dreamland.

Kate Scarlata:

Did you know IBS impacts about 11% of people globally. It's a complex disorder to treat and certainly one to live with, but we have a solution. Mind Your Gut: The Science-based, Whole- body Guide to Living Well with IBS. In Mind Your Gut authors Kate Scarlata, a GI expert, registered dietitian, and Dr Megan Riehl, a GI expert psychologist, create a holistic guide to help you get your life back and feel your best. You will learn the link between the gut, brain and food, why stress and food can exacerbate symptoms, and symptom-based solutions to calming the gut-brain connection and help you modify diet triggers. Mind Your Gut offers targeted mind-gut behavioral therapies, such as body relaxation methods and stress management tools, as well as delicious gut-soothing recipes and many practical nutrition tips. Mind your Gut is the first of its kind to provide a full toolbox of therapeutic options for IBS symptom management. Mind Your Gut the science-based whole body guide to living well with IBS, is available in hardcover and as an audio book on Amazon, Target and more.

Dr. Riehl:

So, Kate,

Dr. Riehl:

What's next?

Kate Scarlata:

So well, I wanted to get back to fiber, because you know I'm all about nutrition. That's right. These key factors for gut health and nutrition, particularly and just the messaging that we're getting on TikTok and with many influencers, you know, eat more fiber plant, plant, plant, plant, plant plant, which I'm all about. However, there is an ecosystem that lives in your colon. It's full of these trillions of microbes. I mentioned earlier that they just love fiber and when they have and consume fiber, they make a lot of gas. We want to change that ecosystem very slowly, and that means that when we start addressing our fiber intake, we want to do that in a slow manner, particularly if you are one that has irritable bowel syndrome or inflammatory bowel disease, one that may be more sensitive in the gut, intestinal space. So really important strategy here is, when you're changing your diet, do so in a gradual manner. This will allow that ecosystem in the microbes to just adjust to that new change in diet. So it's really really important.

Kate Scarlata:

So one of the tips that I often say for this is just increment by adding a couple high fiber foods to your diet over the course of a week. So if you decided, oh, you love chia seeds, a tablespoon has five grams of fiber, I wouldn't be loading up with a tablespoon of breakfast, lunch and dinner. Maybe just start with maybe a teaspoon or two, particularly if you're sensitive, and then maybe add a new fruit or vegetable with dinner and just slowly increment so that you get to your goals. We're looking at somewhere between 25 and 35 grams of fiber per day, more so for men, a little less for women. In that range is a really good goal.

Kate Scarlata:

I did want to talk a little bit about fiber too and mood, because again we think of just the gut and brain being sort of separate entities and clearly at this point I think you're understanding they are so highly linked and I find you know, just before I get into my study with mood and fiber, what I find so intriguing with what Dr Riehl said is just changing in your stress management skills can change the microbes that reside in your gut. How crazy is that? That it just draws to the connection that your brain has so much influence over these microbes as well. Obviously what we're feeding them has that makes so much sense. But then when you think about just managing stress, it can change your mood, can change your microbes, so so cool.

Dr. Riehl:

And nobody is immune to this. Like we said earlier, this is important for all of us to remember and that's why, even those that are living without a digestive health condition that's diagnosed, you may see little blips in the course of a year where you're like man my stomach just hurts more often, or I'm going to the bathroom more or less, and you know, if you draw the kind of line back, you're probably going to find either you had been traveling and there was a change there, you have had a different stress in your life, or there's something going on with your nutrition. There's a variety of factors, but I think in our clinical practices we can usually look at patterns and help people gain some insights here.

Kate Scarlata:

Absolutely so. There was a really interesting randomized control trial looking at a high prebiotic diet so high fiber, plant-based, with polyphenols and they found that the diet improved not only mood but anxiety, stress and improved sleep in adults that had moderate psychological distress as sort of a baseline. So the diet involved consuming at least seven daily servings of soluble fiber-rich foods and these included items like asparagus and garlic and onion and oats, whole wheat and beans. And when they compared that to a probiotic supplement, the probiotic really didn't make a difference. But it was this dietary change that was feeding the microbes that reside in the gut, these beneficial nutritional components that they enjoy. So very, very interesting. The probiotic didn't really help with mental health benefits, but the enhanced beneficial diet did so, just really highlighting the potential of dietary interventions and enhancing mental health through this gut and brain communication.

Kate Scarlata:

And as I mentioned, when you're adding, I just want to reiterate you know a couple tips for some gentle fibers to add into your diet. And when I say gentle, these just tend to be even tolerated by those with the most sensitive of guts. So starting with things like a couple teaspoons of chia seeds is a good little extra fiber boost. Green kiwi fruit has a lot of polyphenols, excellent fiber. Oatmeal oats tend to be tolerated. If you need a gluten-free diet, make sure that the oats are certified gluten-free. A whole orange, a russet potato even eating the skin and even some blueberries those are good gentle fibers to start with if you just want to start enhancing your fiber intake. But even if you have a sensitive gut, those are good starting fiber-rich foods to go with.

Dr. Riehl:

Yeah, so my pandemic experimentation with chia seed pudding. I learned the very, very hard way, where my recipe was like two tablespoons of chia seed and I made five of those and ate them three days in a row and by day four I was a bloated mess. I thought I was going to explode. And guess what I did? I was texting my GI dietitian friends going did I overdo it? On something To which they immediately responded with oh my gosh, yes, like back it up a little bit. So low and slow on the fiber introduction here.

Kate Scarlata:

Oh my gosh, absolutely

Dr. Riehl:

Build your way up, build your way up and to go along with that. Like you know, when we're stressed, sometimes just finding little things that we can control can be really beneficial. A lot of times, stress and anxiety are driven by things that are uncontrollable, they're unpredictable, and that just makes us kind of anxious and afraid and looking for something that we can control. And so something that you can is staying hydrated.

Dr. Riehl:

Water certainly supports our digestion and can help prevent constipation. It's probably one of the first things that we ask people that are constipated is how much are you drinking in a day? So, aiming to drink enough water, we recommend eight cups of eight ounces of water a day, so eight eight-ounce glasses per day. And that is especially important as you're increasing your fiber intake. So just keep that in mind. Drink that water with every meal and at snack time. My God, a water bottle is available on every corner these days. We can't leave without like having six cups in our hands. We keep our kids hydrated. Everybody's got a water bottle, so just make sure you're actually using it. And you can check your pee color. If you're looking a light hay color most of the time, that's the goal. So if it's bright yellow, you better fill up that Stanley and get drinking Absolutely.

Kate Scarlata:

And you know it will be a little bright in the morning. You haven't been drinking, most likely while you were sleeping, or people don't when they're sleeping. Maybe you do so. If it's a little darker in the morning, that's okay, you should expect that. But as you start hydrating during the day, that light hay color, that is definitely a good goal. You don't want it see-through like clear water because you're probably just pushing through even more than you need to. But look for that light hay color. That is definitely the goal.

Dr. Riehl:

So you get a little endorphin bump when you look down there and you're headed in the right color trajectory and you know that right there is going to give you a little like, hey, you met a goal and you're doing this, your day is going well,

Kate Scarlata:

yes, and you know, the brain is 70% water.

Kate Scarlata:

It's like let's hydrate that brain. We kind of need it, right Dr

Kate Scarlata:

Riehl?

Dr. Riehl:

That's right, very important, very important.

Kate Scarlata:

Okay, so we're moving down through these 10 top tips and now we're on number seven, and that is incorporating some fermented foods, and fermented foods don't necessarily mean that they're probiotic rich. And fermented foods don't necessarily mean that they're probiotic rich, but they are made with some type of live and active culture and that live and active culture appears to enhance gut health. And there was a very key seminal study out of Stanford University, however very small but very interesting, and we talked about this, I believe, in our very first podcast. But just to review quickly, this was a small study in 36 healthy adults. They split the group and gave one group fermented food six servings per day. The fermented food that they chose all had live and active cultures, so they weren't like sourdough bread that had live and active cultures, and then they baked it and now they're not live anymore. They stuck with things like kimchi, sauerkraut, for instance, and yogurt with live and active cultures. And then the other group had a high-fiber diet 40 grams of fiber, so we're talking pretty, pretty high.

Kate Scarlata:

And they did all sorts of measurements, looking at different types of metabolites, they looked at immune profiling in these individuals and they found that the fermented food diet arm those that got the six servings of fermented food had a greater diversity in their gut microbiome.

Kate Scarlata:

Again, this is a marker of good gut health. The high-fiber diet arm did not have that. They did have some changes, but not to this great diversity that they witnessed in the fermented foods. So just like a check positive for getting in those fermented foods, they also looked at these different types of immune cells and they found that they were less activated in the fermented food group, particularly interleukin-6, which has been linked to conditions such as rheumatoid arthritis, type 2 diabetes and chronic stress. So our smart strategy and tip for you today is to think about getting in a fermented food at least once every day, maybe every other day if you can, and we're looking for getting those with live and active cultures. So good things like cultured cottage cheese, kombucha, kimchi, yogurt those tend to be the ones that are alive and just try to incorporate a little fermented, get a little cultured, get a little cultured.

Dr. Riehl:

And you know, I think that this is kind of a fun experiment with your kids too. These flavors can be really intense and some kids are going to gravitate right toward it. Probably the earlier you can introduce it the better, so that it's just a part of their food culture, their food repertoire. But it can be fun to kind of smell it, taste it. I will be very honest these aren't foods that are in a ton of my day-to-day. Certainly, yogurts I'm good with that, but I think setting the example as the parent, to try it as a family and talk about how it really is helpful for our body, it's a fun little challenge. So check back in 2025 about how the Riehl family is doing on our kimchi challenges.

Kate Scarlata:

Yeah and as a dietitian I often think of things like kombucha could be mixed in with another type of juice. You could also try yogurt and make it into a ranch dip, or mix it with peanut butter, or explore different recipes using either cottage cheese or yogurt, so you can kind of play around with the food itself. If, straight up, plain yogurt isn't your kid's jam, then maybe mixing it with some vanilla and a little bit of maple syrup might get them a little bit more intrigued If it looks like whipped cream or tastes like sour cream, we're in so that is a fantastic idea, I love that A lot of times we'll use Greek yogurt, we put just a little bit of taco seasoning in it and we pop that on top of tacos or over our nachos and it's delicious.

Kate Scarlata:

So there's one tip there to get a little more fermented foods in your diet. And then number eight, which is really near and dear to me, because exercise has always been a huge part of my just mental health and everyday living, with a chocolate lab these days. So moving your body very important, and I think you just. It's really important to find something that is fun for you, whether that's dancing in your kitchen or getting out in nature, which is my favorite thing to do, walking the beach and listening to those calming waves Whatever really like fills your cup. That is the way you should move your body. If it's a really jazzercise class or a yoga class, whatever it is, find what it is and get it happening, and find at least 30 minutes a day to be moving your body. That's just all we really need.

Kate Scarlata:

I'm a big forest bather, tree hugger, you know whatever you want to call it, but there is some benefits to exercising in nature, and so forest bathing has been shown to enhance immunity, helps treat chronic diseases, regulate mood, reduce anxiety and depression. It's really interesting some of the health benefits of just really being covered in a tree area, quiet on your own, which I absolutely love. So, as part of your strategy, well, let's first start, megan, what's your jam? What are you liking to do these days with your exercise?

Dr. Riehl:

Yeah, I'm still a Peloton girl. I mean, hey, alex Toussaint, he has supported the American College of Gastroenterology with rides before, so we love Alex on The Gut Health Podcast. I just love the music, I love the energy. I love an instructor that's telling me to just keep going, and a lot of times my kids are like running around in the basement. They are still playing, but they are also seeing mom prioritize exercise as not just good for my physical health, but certainly I'm a better person after I've gotten some exercise in.

Kate Scarlata:

I love that.

Dr. Riehl:

So that is really what I prioritize. And then just family walks, like getting out with the kids especially. We had our first snow in Michigan yesterday. That meant I was getting out the snow pants, the boots, the hats, the gloves because we are still going outside. We are going outside to play, the weather will not stop us. And then I think that that is really an important thing for all of us to kind of think about. Is we got to continue to get outside, get that fresh air? Move your body, don't let the elements get in the way, and I will give you a plug too. So if you want some inspiration, if you want to see a cute dog waddling down the path no disrespect, Lucy, none,

Kate Scarlata:

Mabel.

Dr. Riehl:

Oh, shoot, oh. Rest in peace, sorry.

Kate Scarlata:

You know, Lucy gets a little cred. She was number one chocolate lab. She was number one.

Dr. Riehl:

Lucy was the number one, and now Mabel is waddling behind her in all her glory forest bathing with you, absolutely. Yeah, so if you want a cute puppy to inspire you and to see Kate and her husband out there. Getting out together as a couple is also really wonderful. Follow Kate on Instagram. What's your handle, Kate?

Kate Scarlata:

@KateScarlata

Kate Scarlata:

So, yes, definitely join us. We're out and about quite a bit these days. And, just to your point, when the kids were younger my kids are older, I'm almost going to be a grandma in about a month we always got a babysitter so that we could run together and it really was just a wonderful time. We just prioritized that opportunity to get together and just even as a husband and wife and talk and regroup for the week. So that's always fun too. And I'm a Peloton girl too and I do really enjoy the spinning as well. I'm much more of an outdoor girl. That is my priority. But I know, as a young mom, the indoor activities. I did all indoor activities when my kids were little. Because you're a little bit more on house arrest, should we say.

Dr. Riehl:

That's right. And if there is a gym that offers daycare, think about that as an investment. That if you can go on a cold Saturday and the kids get to go play in the daycare and you get time to go for a walk on a track or go for a swim, again, they can be financial investments, but they are going to help you in the long run and especially those of you that are struggling a bit with your gut health. The exercise is a really important piece of all of this. So with that, I think it's a really good segue to our ninth strategy and an essential and this is applying a personalized approach. And this is something that I ask people in therapy, but I also ask my friends and loved ones, and that is "how are you really doing? What are your needs? If you're somebody that's really struggling with stress or anxiety, maybe that's one aspect of your health that you take a look at and set small goals. Maybe that means that you are going to connect with a therapist in the coming months. Maybe that means you have recognized that your diet's a little out of whack and you want to give it what we call the gentle diet cleanup and really just start to make you know. Maybe it's you begin to have breakfast every day. So picking just one or two aspects of your health based on what your needs are and setting small goals is really essential here. And maybe it's also that you're just rushing too much in your life. Again, none of us are immune to this. We all can do better. But I'm going to make a little gut health suggestion here. So maybe you take the opportunity that we all have what's something that we all do Poop. That's right, we all poop. So use the time on the porcelain throne that we all hopefully will have in a given day as a mini self-care moment. Leave your phone outside the bathroom. Get yourself in proper pooping position, which means that you're seated at about a 30-degree angle, sitting with your straight spine gently leaning forward, feet up, preferably on something like a squatty potty or a stool that puts your knees slightly above your hips. So you're in that proper pooping position. Whether you have a GI issue or not, this is the ideal position to defecate. Allow yourself just three to five diaphragmatic breaths while you're sitting there. Allow yourself just three to five diaphragmatic breaths while you're sitting there. Relax your system and commit to doing this every time you go, because, darn it, if you have a cleansing poop, it's going to make your day better, and so mini self-care moment on the porcelain throne is really something that you can gift yourself every single day. Amen, amen, amen, all right, amen, amen, amen, all right.

Dr. Riehl:

So number 10, we've made it to the end of our list. This has been fun. I'm excited. So I'm excited to share this last one with you.

Dr. Riehl:

If you are somebody, if you are a listener, if you are listening and sharing this information with somebody else and you're really struggling with a digestive health condition, our last strategy is to get yourself your Dream Team, and this Dream Team is typically made up of a good gastroenterologist, an amazing GI dietitian, a GI psychologist, and there are a lot of other partners that we can bring into the team as well, such as a pelvic floor physical therapist, as an example. So if you are somebody that continues to have gut problems and you do not have a dream team or you have not felt heard by your medical professional, you deserve it. You deserve to know that you can live better than suffering every day, and through a variety of strategies whether it be the combination of nutrition, mental health, behavioral health strategies addressing the gut brain, you can really experience improvements in not just your symptoms but your overall perspective on living with a health issue. So, Dream Team, everybody, it is so very important and deserved by everybody to enjoy gut health. What do we think about that?

Kate Scarlata:

You know I was just going to say I mean, there's evidence to prove that, having a Dream Team, you will have better results in your symptoms, in your healthcare experience. So it's not just we like the Dream Team approach. It has evidence to suggest that it's really the best approach, especially for irritable bowel syndrome, which you know, I'm sure, across many other digestive diseases and conditions it would be beneficial as well. But you know my data that I've read is primarily looking at it in irritable bowel syndrome. So, yeah, get your right people in place so that you feel supported on your healthcare journey in a way that matters to you.

Dr. Riehl:

Yep, it's truly the gold standard in IBS care and, as you said, really important for other chronic gut issues. So, Kate, it's December 2024. What are your personal takeaways from this incredibly exciting past year?

Kate Scarlata:

Well, first of all, I can't believe that we one wrote a book and published it, that we decided off, kind of the cuff, like we need to do a gut health podcast because there's really not a lot of evidence-based information out there, and geez, we just made that happen really quickly and I'm really proud of the work that you and I have done. I have survived somehow raising a very busy chocolate lab in the midst of all this and learned that I'm going to be a grandmother. So there's been just such an incredibly rewarding and exciting year. A lot of hard work I'm going to say a lot, a lot of hard work, but amazing and just with all of the GI community is so fabulous and I'm so grateful to be friends with many of the experts that we were able to bring on just so easily. They provided their time to share their knowledge, so, so amazing. And, yeah, I'm looking forward to 2025 because we have some incredible guests already lined up in some really fabulous topics. How about you, Megan?

Dr. Riehl:

I mean, yeah, it's been a whirlwind and I have truly enjoyed every opportunity to engage with my patients. I still have a full-time clinical practice and I love that work. I love my job at conferences and at meetings this past year, and then make my way home to do what every parent has to do, and that's figure out what to feed our kids and model healthy behaviors and have some fun in between. So, man, it can be hard out there as a working mom and this year especially, I have been so thankful for the incredible community, especially of Women in GI. There are rock star physicians, dietitians, pelvic floor therapists that are doing such amazing work in the GI space and again I'm so thankful to have them have my back, and again I'm so thankful to have them have my back and I certainly have theirs as we navigate this, you know, interesting time in the world.

Dr. Riehl:

So, just to your point too, every conversation that we've had with people on the podcast and also out in the community has just deepened my knowledge and fueled my curiosity and it truly just makes me excited about really the wonders of the gut and the mind. And so we're not going anywhere. We've got a lot of exciting things coming up. So we really we want to express our profound gratitude for our listeners, our guests and our sponsors, and all those that are doing their best to live a healthy life and all those that are doing their best to live a healthy life. Thank you for every like, share and comment. Keep them coming. We have exciting shows planned for 2025.

Kate Scarlata:

Thanks everyone for joining us on this really fun journey and hope that you have learned a lot from both of us and our wonderful guests.

Dr. Riehl:

Thanks friends, thank you for joining us as we grow this gut health community. We hope you enjoyed this episode and don't forget to subscribe, rate and leave us a comment. You can also follow us on social media @The Gut Health Podcast, where we'd love for you to share your thoughts, questions and experiences. Thanks for tuning in, friends.

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Kate Scarlata

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Megan Riehl

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