The Gut Health Podcast

Sorting Fact from Fad: What to Do When Science Isn't Settled

• Kate Scarlata and Megan Riehl • Episode 26

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This year on The Gut Health Podcast, we dug deeper than ever into the science that shapes our bodies, the myths that confuse us, and the everyday habits that actually move the needle. We challenged probiotic controversies, rethought alcohol culture, explored resilience from gravity to mindset, and turned stress management into practical, usable skills. We broached the topic of vagus nerve stimulation and the potential role of psychedelics and the gut-brain connection!

The theme in 2025 was connection: the conversation between food and microbes, the way those microbes steer our mood and gut motility, the posture-driven shifts in biology, and the everyday choices that ignite changes across the whole body.

It’s not just gut health—it’s a map of how we think, feel, move, and live. And we’re just getting started.

Key topics in this episode include:

• the evolving research with gut science and why personalization matters
• facts vs fads on probiotics, ferments, and “leaky gut syndrome”
• lifestyle foundations that beat quick fixes
• alcohol reduction strategies and social swaps
• food–mood links, excess fructose, and serotonin
• stress prescriptions such as adding diaphragmatic breathing into your daily routine
• how to build gravity resilience 
• what's happening in the psilocybin research landscape and safety considerations
• practical habit stacking for hydration, movement, and sleep
• communicating with providers when evidence conflicts to help you navigate your personal gut health needs.

Looking to boost overall wellbeing with meditation, breathing exercises or better sleep? Calm has you covered with 40% off a premium subscription. Visit http://calm.com/guthealthpod. 


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, MPH, RDN:

Maintaining a healthy gut is key for overall physical and mental well-being. Whether you're a health conscious advocate, an individual navigating the complexities of living with GI issues, or a healthcare provider, you are in the right place. 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. Megan 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. I'm Dr. Megan Riehl, a GI psychologist.

Kate Scarlata, MPH, RDN:

And I'm Kate Scarlata, a GI dietitian. So what a year, seriously. Thanks for spending time with us, hitting play, and convincing your friends and patients that we're worth a listen. We really appreciate the community here. And thanks for all the support. That's right.

Dr. Megan Riehl:

I mean, it has been quite a year. This podcast has become a really special place. We were just laughing as we prepare for our monthly podcasts. And we certainly threw some series in this year. So that was a fun addition to our second year of the gut health podcast. And we're just really proud of creating this special place where there has been learning and connection. And it's really because of everybody that has been tuning in and sharing. And we are so excited for what is to come. So as we turn into the new year, we hope that you'll take a couple minutes to reflect, as we both have been, on what has supported your gut health. This is why we're doing this. Not only for you, but for us too. We started even just episode one talking about how we were going to be using some of the information that we talk about. And so we invite you to kind of carry along some curiosity, some kindness for yourself, a lot of self-compassion, because a lot of the things that we talk about are not meant to be implemented right away, done to perfection. You can't do it all. But maybe as you're listening to us here at the end of 2025, you're able to maybe notice something different that you've added to your gut health repertoire.

Kate Scarlata, MPH, RDN:

I love that. And I think about, you know, when we started this, Megan, it was like, let's do it for a year. I think I can give you two. And it's been so fun and such a great learning opportunity for me. I love speaking to these experts, worldwide experts that we're bringing in and really just gaining some very unique insights into science and research that's evolving. And it's it really has been amazing. So as 2025 winds down, we're really taking a moment to look back at the gut health topics we explored this year. Really the surprising science, and there was some surprising science. And really stories that resonated with us and really the simple habits that we have hopefully imparted to get your gut a little healthier and a little happier and maybe a little more calm, even. Hey, we love that. Maybe you'll mind your gut. Maybe you will. Maybe you will.

Dr. Megan Riehl:

So let's kind of dive into this. We really want to highlight that as we go from 2025 into 2026, our goal is to continue to kind of support our mind, our body. We know that they're very interconnected. That mind-gut connection is real. We've heard that over and over and over this year. And so why don't we start to do a little digging?

Kate Scarlata, MPH, RDN:

Yes, we're gonna dig into, you know, how we really did a lot of myth busting and helping hopefully the listeners sort facts from fads, you know, especially in this age of social media. Everyone's hearing the latest, whether it's a she is e internal shower or, you know, coffee enemas, there's a lot of misinformation maybe out there. And we hope that we've helped you sort of sort through some of these fads. And we also, you know, have explored different topics, different experts that maybe have different views. And I think that can be confusing, certainly, to our listeners. And, you know, part of that is that science is really evolving. And if you know science, you know that the answer is never final. There's always gonna be more and more learning that we're doing. And some of our experts are very, very deep into their own research. And when you get really deep into one area, you get a little biased and you really are entrenched in just sometimes just one side of the story. So we're gonna review some of the podcast episodes that we have done that maybe conflicted a little bit with each other, but kind of just talk through that a little bit because although it is a little confusing, that is really where science is right now in this gut health space. And one of the things that, you know, I often say, and I'm actually saying it tonight in a PowerPoint presentation that I'm giving, is you know, when your only tool is a hammer, and what I mean by that is just a narrow focus on your own perspective of something, you're really looking for the nails. You're focused on looking at the nails. And so you just get narrow, a little maybe narrow-minded, maybe just very, very focused. And science is a little bit further zoomed out. And so hopefully, we'll expand this a little bit and talk through some of these conflicting points that came out a little bit during the year. So, good science needs a full toolbox, is what you're saying. Absolutely.

Dr. Megan Riehl:

Not just the hammer. That's right. We need people that are carrying the hammers. That research is so important. But for those of us that are just humans existing in the world and hopefully trying to benefit from some of the science out there, we do need to kind of ask these questions about how it personalizes to me, because sometimes it's just not going to translate that easily.

Kate Scarlata, MPH, RDN:

Absolutely. I mean, we talked a lot about probiotics with one of the worldwide experts, Dr. Sanders. And, you know, even with that, it's like probiotics are not really for everyone. And there are conditions where they would be contraindicated and maybe actually increase risk of complications, where many others, it may be just absolutely fine. Yep. And we talked about fermented foods, and I thought it was really interesting talking about just the notion that some people we think about fermented foods as being so gut healthy. And I think, again, vast majority of people, that's the truth. But there are people that experience histamine intolerance, and fermented foods tend to be a high histamine food, kind of like lactose intolerance, right? You don't want to have a lot of lactose when you have lactose intolerance, so you're probably gonna be running to the bathroom and not too comfortable. Pretty bloated. Yep. Pretty bloated is right. Histamine intolerance follows suit, and it's a little bit of a different reaction, but there are gut symptoms associated with that. So again, fermented foods might be good for some people and not everyone. And then we also dived into leaky gut syndrome with Dr. Alessio Fasano, another really like so fun. He's such an interesting guy. And that episode really led me into like just slowing down, cooking more, going to the farmer's market. He really delved into just amazing lifestyle sort of habits that genuinely really probably lower our risk of having a leaky gut. So leaky gut syndrome, not really a clinical term. Having a leaky gut or having maybe like a more permeable gut, yeah, we're seeing that in the scientific side of things. But you know what many of these episodes have really reinforced is that it's positive lifestyle. It goes back to laying off the alcohol, getting your good quality sleep, getting that stress under control, having a good, healthy, balanced diet. And I know this isn't sexy, but these are really the foundations of health, even for our gut and for everyone, you know?

Dr. Megan Riehl:

And that's the thing is we haven't found the pill for everyone. We haven't found the probiotic for everyone, we haven't found the right fermented food for everyone. But you'll be hard-pressed to find one person that will not benefit from at least attempting to modify and improve those lifestyle habits. And again, are we gonna get it right every single time, all the time? No. But I think they're good places to return back to. And that's what we've heard these world-renowned scientists end up saying. You know, they're going around with their hammers, they're looking, they're looking, they're looking, they're looking, but ultimately they haven't found the golden ticket yet. But they will say, you know what is helpful? That's stress management, that sleep hygiene, good nutrition, social connection, all of those things. So keep that in mind that, you know, it's sometimes the simple, non-sexy stuff that can really, over the long term, make a really powerful difference for you.

Kate Scarlata, MPH, RDN:

You know, and I reflect back when we've asked people what they do for their own gut health and well-being. And so many of these experts are extraordinarily busy. They're, you know, really working long hours. Not that other people outside of science aren't working long hours, but they're all finding these moments, whether it's playing an instrument or going for a run or prioritizing their sleep or reducing alcohol, a number of different things came out. And hearing these comments from all of these experts, I don't know, I think you need to hear it like 15 times. Like, alcohol's really not good for you. And then the 15th time, you're like, yeah, I really am gonna work on that. So I think some of these messages, while they may feel like they're on repeat, they're really important for us to hear numerous times because it sometimes takes us a little while to really, you know, kind of get motivated to do that. We wanna really focus on things that are simple and sustainable, skip the trends and really think about what's working for you and what you enjoy to incorporate into your diet and lifestyle that those things will stick. And hopefully you got a few tips throughout the year. So, Megan, what's one conversation this year that really surprised you or maybe shifted your perspective?

Dr. Megan Riehl:

Well, speaking of the alcohol thing, the Sip Smart episode, based on what you just said, really was, I think, just reflecting on some of the changes and my relationship with alcohol that I decided to kind of work on because I was finding I just didn't enjoy it as much as I used to. And, you know, we go to these conferences and there's a cocktail and everything, every, and I would be holding a glass of wine that just didn't even taste good. And so I put those down, I would say, a lot in 2024. And then as we dove a little deeper into the research, I thought that it just made sense to lean into what I'm talking about on a pretty regular basis with my patients and the advice that I might share. So while I'm not an entirely sober person, my relationship with alcohol has changed a lot. And when science shows us just how detrimental alcohol can be on essentially all aspects of our physical and emotional health, it's made it a lot easier for me to limit to, you know, one drink. Or nowadays, you can find a great mocktail at most wonderful restaurants. I like to make them at home. I've experimented a bit with different recipes at home. And so it's, I think that we are in kind of a shift of our culture. I'm even prepping for a vacation in 2026, and I was noticing that almost every restaurant I'm going to has a mocktail NA section on the menu. And so it's not hard, it's becoming easier and easier.

Kate Scarlata, MPH, RDN:

Easier and delicious. And delicious. There's non-alcoholic beers, too, and it just like there's no need. You can participate, but not participate with the alcohol. So I do love it. There is a shift, and it's a positive one, I think, that's a long time coming.

Dr. Megan Riehl:

Yes, this idea that mommy needs a cocktail, it's not happening at our house anymore. What mommy needs is rest. Yeah. Mommy needs exercise, time outdoors, time with my girlfriends, time with daddy. Mommy doesn't need a cocktail, and we have to get out of this kind of mindset. So mommy needs health and well-being, and that's what we're focusing on. So, Kate, how about you? What is one of these conversations that just surprised you or shift your perspective or habits?

Kate Scarlata, MPH, RDN:

You know, I really enjoyed the psilocybin episode. And I'll say, like, when Erin Monty came to me, she was recruiting for a study, and I'm like, what the heck is psilocybin? And I don't know, I just had no clue that there was actually research centers, like at Stanford, U of M has one, you know, Mass General Hospital, these big institutions are looking at the role of psychedelics and really treating some difficult to treat conditions, PTSD, depression, really shifting sort of this whole gut-brain connection, looking at it in IBS. So while I am not doing any psychedelics myself personally, not yet, right? Not yet, not yet. I did find the science extraordinarily surprising and was a new one for me. And I keep following it now because I think they're on to something for some people, not everyone, but it's been really interesting.

Dr. Megan Riehl:

Yeah, I think it brings up this important point that we're not afraid to kind of shy away from some of these interesting, provocative topics. And is psilocybin going to be the answer for everyone with IBS? Of course not. And we have to be mindful of safety and science. But we are gonna be looking at lots of nuanced and provocative things on our podcast. And so it was when you brought that topic to me, I got into the weeds too and and learned quite a bit. So very fun. So fun, so fun. So from psilocybin to reducing alcohol, we also had some some big themes that came up, and we also had listeners tuning in from over 158 countries. Amazing. So the gut health podcast is global, and some of the top episodes were our leaky gut science with the ever insightful Dr. Alessio Fasano, the maverick himself, Dr. Mark Pimentel just brings it. And listeners are very interested in what he has to say. And we talked with him about the gut microbiome and dysbiosis, and it's likely he's gonna be back with us at some point too. Definitely. So we really appreciate these experts along with everybody else that we had on last year. And let's look at a couple of the other big themes from 2025.

Kate Scarlata, MPH, RDN:

You know, I think if we really just like put it all together, there's this interconnectedness, right? So we think about connection, obviously, with our listeners and these experts and connection with science. But when we really think about mind-body medicine and diet or the latest on the microbiome buzz, it's really amazing how everything really is synced and linked with one another. So we know food shifts the gut microbiota quickly, like within 24 hours, what we eat changes, who's there. And then our mood shifts the gut microbiota too. And those tiny microbes, they can really influence how the gut moves and how inflamed we are, and how different chemicals are made that protect inflammation. There's just so many things there that can influence how we feel day to day. Of course, it's never one size fits all, but this relationship that the gut and brain are talking, the microbes and food are interacting, so many things are going on that are connected. So I wanted to kind of talk a little bit. We did not dive deep into ultra-processed foods, but I wanted to talk about just like an example of how food, especially really extra processing of food, putting a lot of high fructose corn syrup, for instance, in food, which has a lot of excess fructose, and how that can play a role in even shaping our mood. So there's like this interesting science looking at foods that have excess fructose. So think sugary sodas and snacks that we might get into in a convenience store, for instance. These can actually lower our tryptophan levels, and tryptophan helps increase our serotonin levels. Remember, serotonin, we've talked about this neurotransmitter quite a bit, can really make us feel good, balanced. The tryptophan reduction can also reduce melatonin levels. And we know that melatonin really helps us with sleep and keeping our sleep less fragmented, and we could get a sound sleep, right? So if you have this effect on reducing serotonin, reducing melatonin, just with some of these highly processed excess fructose foods, it just shows you, again, an example of this interconnectedness with what we eat and how that affects neurotransmitters, which ultimately can, you know, result in mood changes. We'll also deep dive into serotonin and how it plays a key role in gravity resilience when we interview Dr. Brennan Spiegel. So we'll talk about that in just a minute.

Dr. Megan Riehl:

Yeah. Well, I think going back, you know, our habits are everything. So I think about even Halloween candy that might still be lingering in our house. And if you're a family that doesn't tend to have a whole lot of candy, you know, it's easy to grab one and then our brain kind of is drawn to, oh, a little endorphin there. And now you're eating five, and then there's a pile of wrappers next to you. And so the habit may be that you've just decided enough is enough. Because what is candy? It's all ultra-processed. Is candy the devil? Absolutely not. Can you have a little candy here and there? Of course. Same with my ice cream, right? Like I've talked about that probably several times. It's okay to have the ice cream, but I better be prepared that I either give myself the proper portion of the ice cream that I feel good about that's not gonna make me sick, or I don't have the ice cream easily accessible to us. So those are little habits that can help to reduce maybe you've identified I'd like to reduce my ultra-processed food intake. Maybe I want to replace some of that with something crunchy that is a vegetable or a fruit. And so those habits can make a big difference. And same with our stress, our stress management. And, you know, I like to give my patients stress management prescriptions, right? So this is this is what they love. It's not a pill and yet it's pretty clear instructions. So after pretty much every initial patient consult with me, I'm prescribing diaphragmatic breathing three times a day. And I have you anchor it to things that you're already doing. So two to three minutes of diaphragmatic breathing upon waking around lunchtime and when you're going to bed, or your commute to work, midday, and your drive home. And I'll even say, hey, what about scheduling it like you would any other appointment in your day? If we're talking about meditation or a relaxation practice, we can do the same prescription of that time use with exercise. So it's really prioritizing yourself in the same way that you would prioritize any other person that you're trying to show up for, and then doing it with consistency. And little phone alarms can be helpful. If you wear an Apple Watch, it's gonna ding and you just barely tap it, and you just know on with my day, I'm gonna do some breathing here. So there's also programs that can be pretty easily accessible these days. The Tom app has different modules and programs that you can do over, you know, a four-week period or a six-week period. And I think that's enough to kind of get that jumpstart of the habit. And then you can kind of explore more of what you're looking for. The Peloton app also has some really great meditations and programs again. So if for 2026 you're starting to think about, hey, I am stressed, I'm ending the year a bit out of whack, then make the commitment to find a program that you're interested in. They're usually very time-sensitive. So five minutes, 10 minutes, 15 minutes, building toward a 20-minute practice a day would be ideal, but five minutes from nothing is amazing. So prioritize yourself. It's a big step in some of these habit building strategies that we recommend.

Kate Scarlata, MPH, RDN:

I love that. And you know, as I'm sipping on my water here with my 20-ounce Yeti, same thing. You know, fill it up at in the morning, fill it up at lunch, fill it up at dinner time, and you will get the hydration that you need. It's it is creating these small habits that really can just become on the regular for you. And next thing you know, you're hydrating much better than you ever were, or you're really dealing with good stress management or breathing techniques on a regular basis, which can really do amazing things for your stress.

Dr. Megan Riehl:

That's right.

Kate Scarlata, MPH, RDN:

That's right. So while we talk about food can shape your gut microbiome, your gut can signal your brain, and your thoughts and stress influence how the gut works. This year we really explored so many things beyond that. We talked about the psilocybin episode, but we also talked about vagus nerve stimulation and gravity resilience with Dr. Brennan Spiegel, which I have to say, he's just, I love the way he thinks. I say that to him every day, but not every day, because I don't talk to him every day. But, you know, it's a little bit outside the box, right? So, but you know, a lot of these different therapeutics or interventions are are getting into the gut health space and really, really quite interesting.

Dr. Megan Riehl:

Yeah, that idea of gravity resilience. Again, it's not rocket science, but it helps me, you know, sit up a little straighter. And he's got some really good visual aids to remind yourself how if we're slumped over, what is that doing to our digestive system? It's crunching it all up. And so that standing straight, pulling your shoulders back, opening up the chest, thinking about our head upward toward the heavens, as he says, instead of down in hell, looking down, those are little takeaways that just a quick straighten up can do us wonders sometimes.

Kate Scarlata, MPH, RDN:

Exactly. And I really loved that he talked about the whole notion of joint hypermobility and how that can play a role in gravity intolerance. Because I think some of these different conditions, for people that are living with them, it might be like, oh, you know, I really do need to pay a little bit closer attention to some of these, you know, standing up straight, core strength. He talked about flotation in like a salt bath to give your gut a little bit of rest from the gravity pull. I thought, you know, some of these are really interesting and more probably appropriate or more significant for some people that have these really lax cables that are holding up their digestive tract, so to speak.

Dr. Megan Riehl:

Yeah, another plug for some of our other sub-specialists around our physical therapists and occupational therapists, how how important they are to the team for a variety of different reasons. Absolutely.

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Kate Scarlata, MPH, RDN:

So I loved episode 21 too with Dr. Iris Wang, who is from Mayo, and she really introduced this breathing technique for abdominophrenic dysneria. And just for those of you that didn't listen, please listen. But just as a little heads up, so this condition is when your belly and diaphragm don't work together like they're supposed to. So instead of the diaphragm relaxing and the abdominal muscles tightening, the opposite happens. So imagine your diaphragm pushing down towards your belly button. Your abs are relaxing and they push out. You have this distension, right? And so Dr. Wang talked about this special breathing technique that was sort of founded in Barcelona that can really help with abdominal distension. And we actually got feedback from one of our listeners saying that it was striking, this particular protocol for her, life-changing, actually. So you never know who you're gonna hit, right? Who someone will listen and it it'll resonate with them. But this particular special technique, we have a little video link on the show notes. And again, this was episode 21, but very, very interesting, you know, just to see this technique, breathing techniques, support someone with a, you know, visibly distended belly.

Dr. Megan Riehl:

Yeah, and it's a tough one. You know, patients really suffer with this, it's pretty prevalent. And so to take something that's non-pharmaceutical, a shift in your breathing, while you're preaching to the choir here, because here I am, diaphragmatic breathing is something that I am prescribing to all of my patients. And so I guess I'll just take this as my last opportunity of 2025 to remind you at this point. Drop your shoulders with me, expand your chest right now, wherever you are, keep your eyes open in case you're driving, and take that deep diaphragmatic breath. Hopefully, it's not the last diaphragmatic breath of 2025. Keep those going. But it's so important. Our breath can matter, and our breath can also massage those intestinal organs in different ways, which is why I recommend using it while you're taking your daily BM. So uh think of me, and and you're welcome on that nice experience for you in the bathroom, and just utilize that diaphragmatic breathing as much as you can. Exactly.

Kate Scarlata, MPH, RDN:

That breathing really can help engage that pelvic floor and help ease your bowel movements. So go for that. Yes. So I did want to talk about when Dr. Brennan Spiegel came in, specifically to talk about his new book poll, which really talks about gravity intolerance and gravity resilience. And, you know, he's linking the brain, the gut microbiome, diet, and serotonin to IBS, and that individuals with IBS may be more gravity intolerant. And there's interesting science to suggest that serotonin really is something that can boost gravity resilience. So allowing us to have more power behind gravity and being strong to counter sort of balance or counteract the effects of gravity. And so there's many ways we can boost our serotonin. One way is through tryptophan-rich foods. And in the book, he calls this the STACK TEN diet. And this includes for S seeds and salmon, T for turkey, A for avocado, C for chicken and chickpeas. We got food there for the vegans, K for kidney beans, T for tofu, lots for the vegans, E for eggs, and N for nuts. And tryptophan is the precursor to serotonin, so increasing these serotonin. Rich foods is, you know, one way to boost serotonin. Also, you know, getting good sunlight, especially in the morning. And when we had Dr. Spiegel on earlier for episode 13, he also talked about vagus nerve stimulation as another way to boost serotonin, too. So very interesting talking about neurotransmitters that can be, you know, increased through diet and other measures that can play a role in the way our body interacts with the Earth's constant pull. So very interesting.

Dr. Megan Riehl:

It was really a good read, a fast read with lots of good takeaways. Now, this brings us to some of the controversy. And, you know, it's fun. It's fun to think about. It's also, we've taken it on as our role, though, to help listeners that are like, wait, one person, one thing, another person said another, what do I do? And so we were really thrilled to welcome two very world-renowned experts in microbiome research, Dr. Pimentel and Dr. Saunders. And then we got some questions. And we also had previously gotten questions and about prebiotics and probiotics and postbiotics, which is why we did our gut dictionary episode. And so this is where it got interesting. When we asked Dr. Pimentel whether people should take a probiotic with antibiotics, he referenced one of the largest randomized control trials on the topic to date. And his takeaway was that taking probiotics with antibiotics doesn't prevent diarrhea or infections and may actually increase bloating, which goes against pretty common assumptions. And then on the other hand, Dr. Sanders said she thinks it's generally best to take a probiotic with your antibiotic. So, you know, I think the worst that can happen is that probiotic doesn't survive as well as it could until you stop your antibiotics. And most studies co-administer them. And so it's recommended to use one that's been specifically tested for antibiotic-associated diarrhea.

Kate Scarlata, MPH, RDN:

That's right. But let's talk about complicating the science a little bit because you know I've been following this for a long time, and there was a study, and it was quite some time ago, but it was out of Israel, out of the Weizmann Institute, and they had just a small study, 21 volunteers, that took antibiotics, and their gut microbiome was strongly disrupted. They were measuring a variety of different metrics, you know, in the stool and metabolites and things like that. And they found that those that took standard probiotics during treatment actually delayed their microbiome's natural recovery. So the other group kind of responded quickly. And what happens is when I say this, just for clarification, when we have stress in our just general stress or stressor of pregnancy, stress of surgery, stress of antibiotics, our gut microbiome can shift. And our goal is for it to resume back to its normal sort of state. And we call that stability of our gut microbiome. And it's a marker of a healthy gut microbiome when it can bounce back from those changes. And so seeing that a probiotic in this very small study actually delayed the return to the normal microbiome is sort of a signal that maybe we're doing not the right thing. So I think, you know, when we talk to different experts, you're always going to get their angle, their research experience. Dr. Pimentel lives very much in the deep world of SIBO research. While Dr. Saunders takes a much bigger picture view specifically at probiotics, you know, it's not a one size fits all. So I think it's important that you remind yourself that your gut microbiome is your own fingerprint, your clinical medical history is your own. And, you know, work with your healthcare provider to determine what the best route for probiotics during antibiotics is. But, you know, I think the science is a little unsettled in this area, which means there just needs to be more research. Yeah.

Dr. Megan Riehl:

And so I think when our listeners are talking to their provider, just keep in mind it's okay to ask questions because that's the thing. What I decide to do when I'm on an antibiotic versus what one of my patients might decide to do, and we can have the same provider, and their response based on knowing each of us may be a bit different. And so you can say things like, I've heard conflicting advice from so and so. What is your perspective on this and why? You can say that to your provider. You can also ask, you know, you're making this recommendation. How strong is the evidence for that approach? Our tone, did you see how I wasn't doing it in an accusatory way? Our tone makes a difference. We're not vilifying our doctors for making a certain recommendation, but as the consumer, you have every right to kind of understand their why. What is their pathway for you? And, you know, we know our colleagues are out there listening to. So you can help calm your patients' concerns over certain recommendations by not being afraid to share some of the literature with them on why you're making this recommendation. It is just extremely validating and comforting to patients to hear why you're considering something specifically for them and for my provider colleagues out there to use that language to say, you know, I've been working with you now for a while and I understand you, and this is why I'm making this recommendation. It might not be perfect, but this is what I think is the next best step for us. And I think patients really benefit and they feel validated when they have that connection with their provider.

Kate Scarlata, MPH, RDN:

Absolutely, versus saying, "I don't believe in probiotics." Period. Right. Period. Like, you know, I think everyone needs and deserves, you know, maybe the science isn't there for this, or with your past medical history, there's a contraindication for this. But we want to really encourage curiosity and not fear and validation for a good question because it makes it does make a lot of sense.

Dr. Megan Riehl:

Right. Or the other one, just I'm sorry, I have to throw this one out. You've tried 13 probiotics and it hasn't provided you relief yet. And so we're gonna we're gonna pivot and we're gonna go to something else. Maybe maybe we're gonna work on some stress management, or maybe we're gonna, you know, dive a little deeper into the dietary aspect of things.

Kate Scarlata, MPH, RDN:

Yes, exactly. Don't keep doing the same thing and expecting a different result after you've really exhausted your efforts, right?

Dr. Megan Riehl:

That's right. That's right.

Kate Scarlata, MPH, RDN:

All right. So whether it's mind-body medicine or microbiome breakthroughs or just simple everyday habits that you can just incorporate hopefully easily in enjoying them. 2025 highlighted that everything really is connected.

Dr. Megan Riehl:

Connection is our word of the year, I think. And and you mentioned some of it is gonna be easy, I hope, and some of it won't. And I think that's setting you up for just realistic expectations. If you feel like you have to like drag yourself to the gym or drag yourself out for a 20-minute walk in the beginning, I promise you, if you start in January and you keep it up by March, it'll feel and look different. So keep that in mind that you know, simple things can take some habit forming and then you can gather some speed. So, with that idea, we're gonna do a speed round and we introduced this also this year, but now we get to participate. So let's do this.

Kate Scarlata, MPH, RDN:

Let's definitely do this. So I've got some good questions for Dr. Riehl, and we're gonna fire them right now. So, what is your favorite mind-body takeaway from this year's episode?

Dr. Megan Riehl:

I mentioned it earlier. Reduced alcohol intake without reducing my social connections and fun. I love that.

Kate Scarlata, MPH, RDN:

Yeah, why should you? Right? You don't have to drink to be fun or have fun. Reminder. Yeah. I love that. One small daily habit that keeps your gut brain connection strong.

Dr. Megan Riehl:

At least 20 minutes of exercise a day. And sometimes I'm wearing exactly what I wore to work. And it might mean that I'm walking in the parking lot during my lunch break, but I will never regret it when I do it. So 20 minutes daily of movement.

Kate Scarlata, MPH, RDN:

That's just something that any of us can really probably do and really motivates me to make sure I get my 20 minutes. Although I have to say, Mabel makes sure I get my 20 minutes. Geez, or more. My chocolate lab's very busy. Okay, so which guest left you thinking about the conversation long after the recording?

Dr. Megan Riehl:

So, you know, I keep going back to the pelvic floor guru herself, Dr. Alicia Jeffrey-Thomas. That was episode 19. She really got me thinking and reminded me that it's never too late to start supporting your pelvic floor. So, you know, uh, ladies and gentlemen, I continue to think back to it's on my to-do list.

Kate Scarlata, MPH, RDN:

Yeah, it's an important one. I think probably like everyone should see a psychologist, everyone should see a dietitian, and probably most people, especially women, because of childbirth and the impacts on our pelvic floor, should at least see a pelvic floor at least once, if not many more times. Probably. So, what phrase or mantra got you through busy weeks?

Dr. Megan Riehl:

I can do hard things, and I don't have to do them alone.

Kate Scarlata, MPH, RDN:

Yeah, I have to say, I can do hard things. I've learned from you. I know it's not your direct quote, but you say that a lot, and I say it to myself too. And it is just such a good reminder that we can, and it's empowering. You've done hard things before, so you're gonna be able to do hard things again. And I I love that. So finish the sentence in 2026.

Dr. Megan Riehl:

I hope people feel I hope people feel motivated to take care of themselves. Small habits and choices matter more than we may realize in the moment. And when we're able, I really want people to just recognize that they can be a light and energy for others. But we can't do that if we're not caring for ourselves. So prioritize yourself. I love that.

Kate Scarlata, MPH, RDN:

Perfect.

Dr. Megan Riehl:

All right, girl. I'm ready. I'm ready. All right, Kate, what guest made you think outside the box?

Kate Scarlata, MPH, RDN:

Well, this is a hard one. So I would say Dr. Brennan Spiegel, but I would also say the psilocybin episode two with Erin Mauney and Emeran Mayer was also, they were both really made me think outside my box for sure.

Dr. Megan Riehl:

Yep. We're probably both getting fed psilocybin, psychedelic subverbation on our phones nowadays. Favorite food that makes your gut and your soul happy.

Kate Scarlata, MPH, RDN:

I know this is gonna sound so dietitian-like, but I really do love kale salad. I put a lot of yummy things in it, pomegranate airils, and apples, and toasted pumpkin seeds, and a little bit of cheese. And it's just, I had it last night and today, actually. It's just one of my favorite go-to's.

Dr. Megan Riehl:

I know. You make me hungry every time you post it on your social media. And I'm like eating my romaine lettuce salad.

Kate Scarlata, MPH, RDN:

Yes, go for kale. It's good calcium, great calcium source.

Dr. Megan Riehl:

There we go. What episode topic surprised you the most once you dug into the research?

Kate Scarlata, MPH, RDN:

Well, obviously the psilocybin one. And I'm a little obsessed. There's a Michael Pollin documentary where he talks a lot about psychedelics. And then more recently, there was one looking at some Navy SEALs and looking at psychedelic therapy for them. And these, of course, are documentaries. They're not scientific research, but I found that just interesting to see how psychedelics are being used in some, you know, difficult mental health conditions and can be really life-changing. So that research is really compelling to me. Yeah.

Dr. Megan Riehl:

And Kate, what do you prioritize in your life?

Kate Scarlata, MPH, RDN:

Well, you know, fun really is a big one for me. So family too. I just want, you know, I feel my family's listening. My family is very important to me. Fun with family is the key here. But I've always been someone that has factored fun into my schedule, even sometimes every day. And it might be something very small, like getting a coffee somewhere or meeting a friend while I have to walk my dog anyway, but those kinds of things. So fun and family for sure. And then, you know, I do have this quote that my dad, it was a Shakespeare quote that my dad always said, and that is, "To thine own self be true". And that is something I've really kind of lived my life through that lens a little bit, like following my own path, sticking with my morals and beliefs, and and following that. And that's really been a guiding sort of way of lived my life and my career.

Dr. Megan Riehl:

Yeah, it's something that I think connects us and has has really strengthened our relationship because we we tend to have that same belief system. So powerful. Yes. All right, finish this sentence.

Kate Scarlata, MPH, RDN:

In 2026, I hope people eat food that tastes delicious and that they enjoy eating because food should be fun, like everything I like in life. Fun, fun, fun. But it's not just about nutrients. And so I hope that you sit down to just food that you're really excited about, tasting all the different flavors. Healthy food can be fun and delicious too. So I just hope that people enjoy what they're eating. So, from both of us, thank you for being part of the gut health podcast community.

Dr. Megan Riehl:

Here's to another year of growth, learning, and good gut vibes.

Kate Scarlata, MPH, RDN:

Yes, cheers to good gut health in 2026.

Dr. Megan Riehl:

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 at 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

Host
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Megan Riehl

Host