The Gut Health Podcast
The Gut Health Podcast explores the scientific connection between the gut, food, mood, microbes and well-being. Kate Scarlata is a world-renowned GI dietitian and Dr. Megan Riehl is a prominent GI psychologist at the University of Michigan and both are the co-authors of Mind Your Gut: The Science-based, Whole-body Guide to Living Well with IBS. Their unique lens with which they approach holistic conversations with leading experts in the field of gastroenterology will appeal to the millions of individuals impacted by gut health.
As leaders in their field, Kate and Megan dynamically plow through the common myths surrounding gut health and share evidence-backed information on navigating medical management, nutrition, behavioral interventions and more for those living with or without a GI condition.
The Gut Health Podcast is where science, expertise, and two enthusiastic advocates for wellness come together to help you live your best life.
Learn more about Kate and Megan at www.katescarlata.com and www.drriehl.com
Instagram: @Theguthealthpodcast
The Gut Health Podcast
Gut Health Strategies For First Responders (with guest Police Chief Michael Assad Jr.)
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What happens when the stress of being a first responder doesn’t just stay in your head but starts showing up in your gut?
Today, we’re joined by Police Chief Michael Assad Jr. of the Rochester, Massachusetts Police Department for an honest conversation about the often-overlooked connection between first responder stress, gut health, IBS, and nutrition.
From high-pressure calls and long shifts to those unexpected “code brown” moments, chronic stress can take a serious toll on the digestive system. We’ll talk about recognizing those warning signs, why gut health deserves more attention in the first responder community, and how nutrition, stress management and everyday habits can play a role in feeling better and performing at your best.
This is a conversation about stress, resilience, and taking care of the part of your body that may be trying to tell you it’s time to slow down and pay attention.
We share practical ways to build a culture where officers can recover from adrenaline, fuel better on shift, and get support without stigma.
• why shift work and disrupted routines can trigger IBS symptoms
• the “SHIT” acronym: shift work, high octane habits, irregular nutrition, tactical stress
• how energy drinks, dehydration, and gas station food can backfire fast
• simple leadership moves that normalize wellness and real help seeking
• fitness incentives, workout on duty, and building a wellness room
• on scene tools like box breathing and diaphragmatic breathing
• gentle diet cleanup basics: adjusting caffeine, alcohol, hydration, and fiber, per tolerance
• nicotine pouches and stress habits that can worsen gut symptoms
• when to see a doctor and what red flags to watch for
• why a clear diagnosis can lower stress and improve symptoms
Don't forget to subscribe, rate, and leave us a comment. You can also follow us on social media @TheGutHealthPodcast, where we'd love for you to share your thoughts, questions, and experiences.
This podcast was sponsored by Ardelyx.
Sorry for Kate’s raspy voice, she’s just getting over a cold! And a big thank-you to Megan for holding down the fort. ❤️
References:
Demo of diaphragmatic breathing.
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.
Why First Responders Need Gut Care
Dr. Megan RiehlThis podcast is sponsored by Ardelyx.
Kate Scarlata, MPH, RDNMaintaining a healthy guide 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. Hello, friends, and welcome to The Gut Health Podcasts. We are your hosts, I'm Kate Scarlata, a GI dietitian.
Dr. Megan RiehlAnd I'm Dr. Megan Riehl, a GI psychologist. Today we're shining a light on those who dedicate their lives to caring for others and asking an important question. Who takes care of the people who take care of us? We know that stress, adrenaline, disrupted routines, and being constantly on high alert can affect the gut. And for first responders, those are not occasional experiences. They are just part of the job. So we're taking the conversation behind the badge to talk about first responders, wellness, and of course, gut health. Our guest is Chief of Police Michael Assad Jr. of the Rochester Police Department in Massachusetts. And we can tell you one thing. He gets high marks from us for the support and wellness initiatives he's offering his team. Quite frankly, he's normalizing poop talk and giving officers tangible strategies to improve their well-being and performance. Chief Assad has strengthened partnerships across local, state, and federal agencies while modernizing department operations and prioritizing officer wellness. He has helped make Rochester one of southeastern Massachusetts' most community connected police agencies. And yes, we're even going to learn what a code brown means in the line of duty because digestive emergencies do not discriminate. Welcome, Chief Assad, or Mike, as you've given us permission to call you. I mean, you're the man in charge, so we want to make sure we're getting things correct here.
Chief Mike AssadAnd no Mike's fine.
Dr. Megan RiehlSo welcome to the podcast. We're going to jump in.
Chief Mike AssadI like it. Let's dive in.
Dr. Megan RiehlLet's dive in. Yeah. You talked about a memo that you put together. Tell us a little bit about what inspired that. Give us the title because it's a very provocative title. And a little bit about yourself and how you got to that memo.
The Code Brown Memo Origin
Chief Mike AssadThe memo, it's kind of funny how it came together because I didn't really know that much about IBS at all. And I met Michelle from Ardelyx. She was like, Chief, do you know anything about IBS and the correlation between first responders? And I was on a break. I was like, no, tell me about it. So she got into it. The gears started working in my head. I'm like, you know, it makes sense after being in law enforcement for 25 years. I'm like, oh wow, I I have a lot of that stuff that she's talking about. I'm like, this is weird. Obviously, this meeting was meant to happen. So I was like, you know what? We should come up with like a fun title to get more cops involved because let's call it what it is. Most cops, you know, they got the alpha personality. They think they know everything about everything, right? So I'm like, well, let's make something like a cool title, make it fun for them. So I was like, let's call it, let's talk about your shit. Or code Brown, let's talk about your shit. Because that'll definitely get our law enforcement brothers and sisters to like turn their head and be like, all right, let's see what that's all about. So that's how that came up. And I went back to my police department, I did a little research, and I came up with like a short memo that I put out to everybody saying, like, you know, there is a correlation. If you feel different things and you don't feel right when you're working, it makes sense. It's all linked, right? Your gut, mind, body, everything's linked together. So it's all one machine. So we focus a lot on mental health for officers, but I think also we need to uh flip the coin on that and focus on gut health because it's all one big present, one big package, right?
Dr. Megan RiehlBi-directional. You're absolutely right.
Chief Mike AssadThat's right.
Dr. Megan RiehlSo, what was the feedback? How did people begin to respond and how did you disseminate that information?
Chief Mike AssadSo I sent it out like as a mass email to my officers. And officers are coming up and they're like, Chief, that's all right, that's funny. And they're like, But you know what? A lot of the stuff that you said in there makes sense, right? So, you know, we have officers that work the midnight shift, and what do they start off drinking? Like an energy drink, right? To get themselves going. And then they're eating the shitty food at the gas station. Right. So now you're eating slim gyms or you're eating fast food and you're dehydrating yourself with all these energy drinks. And now you wonder why, like, you're like, oh man, I gotta go to the bathroom, or I have to go to the bathroom at the worst point in time. Like you may be chasing after a suspect or fighting a suspect, or or just simply just taking a call in the lobby and your stomach starts turning. You're like, like you can't go time out, you can't tell the bad guy, hold on a second, I gotta go take a shit. Because that's not gonna work out too well, right?
Kate Scarlata, MPH, RDNNo.
Chief Mike AssadSo a lot of the stuff that I kind of did like a quick research on it, like I know nothing about it. As I said, I'm very novice, know nothing about it. But I just did a little research on the internet and read some
Shift Work And The SHIT Acronym
Chief Mike Assadthings, and I put some stuff together, and I came up with like an acronym too to help officers. And it's called, what else would I call it? SHIT, right?
Dr. Megan RiehlYou're gonna hear this word a lot today. That's all right.
Chief Mike AssadIt is well, I'm trying to say it as many times as I can. So the S stands for shift work, right? So officers and first responders, firefighters, dispatchers, they work shift work, which is a lot of times it's not normal hours. So you got that going against you, right? Your circadian rhythm is all off, right? Other kind of stuff that adds to like the perfect storm of internal disaster, right? So the H in shit, like high octane habits. So you got the adrenaline dumps, you got the energy drinks, the coffees, the crappy food. It takes a toll on your body. The regular nutrition, that's the eye. So again, that goes back to kind of high octane habits. You're eating all this different crap, your nutrition's not great, you're not eating the healthy home cooked meals like you should be, like the clean meals. So that's a regular nutrition. And then T for tactical stress. So the constant, constant adrenaline dumps. You could be typing a report and then uh serious motor vehicle accident comes in, or a suspect just did a robbery or a shooting down the street. So there's your like tactical stress that all all this stuff comes together as like a perfect storm and why your gut is all messed up. And a lot of times your mental health is all messed up, also. So that's my quick reader's digest version on the shit acronym.
Dr. Megan RiehlI mean, it's so perfect. And what I love about it is that I would say first responders, veterans can be under-reporters, where they are just shitting and uncomfortable and dealing with it and think it's just that's the way it is. I think that by bringing awareness to this and talking about, like, hey, this acronym gives you some targets that we could help you modify that could make your life a lot better because you already have enough going on in your day-to-day work. And the problem is this carries over to home too. Like, oh, absolutely. For a lot of people in these scenarios, and I'm sure you've experienced this, like your body might be able to hold it together during the workday. And then maybe you have a couple of days off and you spend two of those, you know, with irregular bathroom patterns that are frustrating.
Chief Mike AssadIt's funny you say that because a quick story when I first became a police officer, some like 25 years ago, I get in as a rookie cop. I have my FTO next to me. He's like, all right, Boot, take me to get a cup of coffee. So we go and get a cup of coffee. That's the first thing we do on shift. Get a cup of coffee about 45 minutes later, after he's finished most of his coffee, he's like, All right, boot, code brown. So I look at him, I'm like, I'm looking at the log thing because I'm learning all the different codes. I'm like, sir, I don't see Code Brown on this. He goes, Dummy, I gotta take a shit. Get me back to the station, Code Brown. I'm like, oh, okay, okay, that makes sense. Yeah. But that all came in, you know, years of doing it now. I I definitely see how the stress, the tolls on your body, along with the irregular sleep and the bad eating habits, it does play a huge part in the IBS and first responders. Absolutely.
Dr. Megan RiehlAt Michigan, we actually did a study looking at shift work in nurses. And that population of workers also has increased IBS. And again, it's similar, the shift having an impact on so many different factors in our body and our behaviors. And with shift work, you're getting sleep one night and then sleep during the day another time. So it really can wreak havoc. And some people just don't have a choice. When you're a rookie, that's probably one of the shifts you're gonna get.
Chief Mike AssadYeah, you're gonna be on the midnight.
Dr. Megan RiehlThat's right. That's right. Regardless of what your career is, you usually start out in that capacity. So, how long ago did you implement this or send this memo? I'm just curious. So this was a year and a half ago?
Chief Mike AssadYeah. Shortly after I met Michelle, I came back and I just sent it out right away. And and it was a lot of great feedback. And because it makes sense. Everything, you know, that Michelle was saying and all the research I've done on it, it 100% makes sense. Especially after doing it 25 years. You know, it's not like I only have like a year experience in it. I can see throughout my career, you know, I've been affected by it. And I'm sure probably like I would say the percentage in first responders is probably very, very high compared to the normal public. I don't know if that's accurate saying that, but just people who I've talked to and different experience I've had with other first responders, it does seem like there's a very high percent of us that have some sort of IBS syndromes.
Dr. Megan RiehlI think that's a very fair statement to have. And also just the reality of the impact of trauma, the way in which you are engaged in traumatic situations, but maybe not processing how that affects the body even as much as the mind, right? I'm guessing that there's some psychological first aid that can take place with police officers. But does that first aid always cover the physiological aspect of the psychological difficulties that you might be faced with?
Chief Mike AssadRight. No, that makes sense.
Dr. Megan RiehlSo in terms of you've absolutely covered the effects of stress and adrenaline and how it's unpredictable. Those are all perfect storm mixes for something like IBS and other, you know, physical problems like insomnia, even, or anxiety, depression. It sounds like you have a really good beat on observing those things in the people that you're working with. How did you come to that kind of assessment that, hey, let's check in with people? And how do you think that benefits the officers?
Chief Mike AssadWe've been like 100% on to the mental health, right? So we're pushing a lot of stuff on mental health, but I think we're forgetting about the gut nutrition side of total body health. I'm very fortunate that a lot of my officers, they're younger. Some of them are single or they don't have kids, so they do food prep. A lot of these officers are doing their own food prep. They're cooking lean meats, you know, turkeys and doing their preps. They have everything lined up in the fridge. I do workout on duty too. So, you know, I encourage officers, you know, hey, if you have some downtime, go hit the gym. We want them to be smart, right? Be up to date with laws and different changes in laws, but we also need them to be healthy, right? And be able to go catch the bad guys or provide services to people. So we got to make sure that our own people are healthy before they can help other people. So my main goal is to get them in the weight room, get them up walking after a meal. A lot of times we'll cook our own meals there, we'll do the grill so it's cleaner food than the typical fast food. We don't have, we have a 24-7 gas station in town. So that's got a lot of crappy food, but we don't have a lot of fast food places or fried food places near us. So that kind of helps. We have, you know, a lot of nutritional places around us. So that works to our benefit. But it's all about, you know, you got to take care of your people because if you don't take care of your people, how are they gonna be able to take care of, you know, the community that they serve?
Dr. Megan RiehlSo I don't want to give Kate extra work, but I think about, you know, they're probably thinking heavy on the protein, right? Like that's where a lot of younger guys are thinking, well, we're gonna highlight fiber. Fiber for our gut is is another side of that, and and nutrition from the fruits and veggies side, but also being mindful that some of the fruits and veggies that they may unintentionally be consuming can sometimes be higher in what are called FODMAPs. So for any first responder that's listening to us for the first time, we welcome you. And also, we've got lots of good nutrition strategies that can supplement your protein regimens here. From your vantage point, as somebody that's been doing this for 25 years, when you suggest that your officers may need to kind of prioritize some aspect of their health, whether
Wellness Policies That Actually Work
Dr. Megan Riehlit be physical health, emotional health, how do you have some of those conversations? How do you bring that to them?
Chief Mike AssadI put out a wellness policy in general that officers can follow. And, you know, as I said, we offer a workout program. You can work out on duty, and at the end of each year, you can go take a PT assessment, and if you pass it, you get so many extra days off. And if you exceed on it, if you blow it out of the water, right? And you do really well, you get an extra almost week off. So that motivates guys to, you know, to stay in shape, guys and gals to stay in shape and and go out there and take care of their body. Also, I give everybody a mental health day, just like it's not on them, it's on me. It's a free day. And I I encourage people to go talk to somebody too, because I talk to my own person, and we gotta smash that stigma that you know it the old school way of hey, you see something horrible, you're fine, kid, go back and get in the cruiser and and go continue that shift, that doesn't work. That's archaic. That's a reason why we had probably have a high rate of suicide in law enforcement and first responders, because they subscribe to that old school method of I'm top dog, I'm alpha, nothing bothers me, I can go home and and it's just gonna brush off your shit. No, that's not how it works. So for me, I advocate to all my people, I tell them, hey, listen, I talk to somebody regularly. If I have an issue, I go talk to somebody that's trained and medically certified to be able to help me with what's going on in my head. I think it's equally as important that you speak to a nutritionist, though, too, to find out like I have to do it. You know, I I gotta get back on the on the wagon and really kind of like figure out my daily nutrition. And my wife's a rock star, she's the one that kind of gets me refocused and and puts it together. And and she's an amazing cook too. So she helps me with my nutrition. I never was big into avocados. Now I love avocado. Okay, it's a healthy fat, you know, all that because no, it's important just to have that, you know, like the as I said before, the total body thing, not just mine, mind, body, exercise, yeah, gut health, everything, everything.
Dr. Megan RiehlYeah, I'm so impressed at the modeling, right? It has to happen from our leaders in order to kind of have that model and that reassurance and validation that it is okay, that I'm not going to be penalized for taking my mental health day, that it's actually encouraged. And I also love that you're calling it a mental health day because, you know, one of the things I say all the time is that your mental health is just as important as your physical health. They really go hand in hand. And even something that I work with a lot of my patients on is they get the importance of exercise. You know, there's always that kind of concept of 20 minutes a day when you're starting out, if it's five minutes a day or 20 minutes a day, just get going with some habit and some ritual in moving your body as your body will allow. What we don't talk about as much is the importance of self-care and relaxation, that actually sitting still and practicing some breathing or body scanning, and that that piece is just as important. So we kind of have to carve out two 20 minutes for the whole spectrum of health to encompass that full mind-body interaction. And I would suspect that part is a little bit of a harder sell with some of your guys and girls, women, because certainly men and women are affected in similar yet different ways. So I just have to say, you know, kudos on taking that step. And I'm sure you see benefit from even just output of your officers.
Chief Mike AssadOh, absolutely. And I'm just waiting for a grant to come through and I'm gonna get a massage chair. We're setting up like a we're gonna have like a wellness room. So it'll be very feng shui with nice plants in the corner and uh a massage chair. So you can go in there if you need to decompress and take a minute and maybe put on soft jazz or whatever, whatever you like to listen to and sit there and get like a little massage and then go back out. I mean, that's as I said before, you gotta you gotta take care of your people. I because I grew up, you know, in 25 years of law enforcement. I never had leadership that did that. And I was always like, I'm not gonna be that dude if I get to a point in my career where I can lead an agency. I'm gonna make sure that I I do whatever I can to make it so my team wants to come to work every day. Because I I work for them. That's what I always say. I work for you guys. I'm here to make sure you want to come to work because there was plenty of times at my other PD that I just didn't want to go to work. So I want to make sure that that's not what it's like at our agency.
Dr. Megan RiehlSo your agency applications may go through the roof after as people hear. I'm curious, how does this compare to other locations? And it kind of sounds like you're you're setting a gold standard here. How do you feel your field does right now on a whole?
Chief Mike AssadI feel that we're doing better. Okay, we're definitely getting better. There's a lot of good leaders out there that are that are doing the wellness rooms. They're doing like a wellness policy. So I'm not the first one doing this at all. I'm just hoping that we get more and more leaders as we have more and more younger people progressing in the law enforcement career to positions where they can truly make a difference, right? Everybody can make a difference in an agency, but where you can affect change by changing policy and putting in your own way. I think it's very important that we continue moving forward in this in this wellness arena.
Dr. Megan RiehlWell, you've given a great suggestion in terms of looking for grants. There are grants out there.
Chief Mike AssadPlenty of grants.
Dr. Megan RiehlYeah. And so, you know, going after that from the mental health and holistic health perspective for first responders is certainly something that philanthropists and pharmaceutical companies are motivated for.
Chief Mike AssadAbsolutely.
Dr. Megan RiehlSo you've given some kind of on a day-to-day lifestyle interventions
Breathing Tools For High Stress Calls
Dr. Megan Riehland strategies that you recommend for your team. Are there kind of on the job, in the moment strategies that you might talk to police officers about, you know, when in the midst of the stress or how to keep kind of a calm head that may trickle down to help calm the gut a bit?
Chief Mike AssadYeah, I mean, like on high stress calls, if you go into a high stress call, just concentrate in your breathing. Maybe try to do a little box breathing or just slow your breathing down as you're going to a call. Think about what you're going to do, right? Every officer, you know, whatever call they're going to, they should be thinking, all right, when I arrive here, this is how I'm going to operate or this is what I'm going to do. These are the steps I'm going to take. So have a game plan in your mind. When it comes to, you know, you're working out on duty after you have lunch, go for a walk. You got plenty of time. Go walk around the station a couple of times, get the insides moving, get the body moving so everything's processing. But definitely work on breathing. You know, maybe go sit somewhere in a car and take a couple deep breaths, put on some relaxing music before you have to go to the next call. I mean, some days are tough. You're going from call to call to call, and there's no real fix at the moment for that. But we have very open conversations where, you know, they can go to a supervisor and be like, hey, I just need a minute. And absolutely, you know, all our supervisors and and leaders are buying into this, which is key, right? You have to have everybody at the agency buy into it or else it's not gonna work. And I I think some people at first are like, oh, this guy's full of shit.
Dr. Megan RiehlI might be on the on any given day.
Chief Mike AssadYeah, I mean maybe we're all a little full of shit, but they've seen after you know implementing the policies and procedures and and trying to make sure that they're taken care of, they they see that this is really not bullshit. This is legit stuff that's gonna that's gonna help them and and they're they're gonna be able to benefit from it. You're only as good as your people, right? So you may as well have you know customer service. We're providing a service to the community, right? So just like Google, Google takes care of their people and they they put them in nice areas and they they're able to relax and eat good food, and because you do that, they're gonna provide the best service to the customer. Well, that's what we're doing. Our customers are the people that we serve in town, right?
Dr. Megan RiehlYeah.
Chief Mike AssadAnd we're providing a service, and that's production. Professional policing. So, I mean, that's what we need to do. We need to model our agencies more like some of these corporate agencies that really know how to take care of their people. That's what I'm trying to do. I'm trying to do a little bit of that and mix it with law enforcement. And so far it's it's worked out pretty well.
Dr. Megan RiehlWell, and I mean, you can correct me if I'm wrong, but most times police officers are operating in a team scenario. And so, in a way, you have to be as healthy for yourself as you are for your team member, your brother or sister. And so also, you know, if your brother is constantly in the bathroom at unfortunate times, that is not very helpful. And also the unpredictability of are we going to have a code brown today or is it not a code brown day? And so giving officers a toolbox of strategies to use both in the moment as well as, hey, our lifestyle matters a lot in the totality of your health. So we're going to do these other things at kind of a broader level is also really critical. So, in addition to your four-square breathing, I'm going to recommend diaphragmatic breathing because that can actually activate the body's parasympathetic system. And it gives the intestines a nice little massage. So for that cramping urgency, your stomach is really upset. That specific type of breathing can be really helpful in a patrol car or in that lobby. We talk about this a lot on the podcast, but it sounds like it might be somewhat new for you. And I would be happy to share it with your uh team.
Chief Mike AssadIs that like stomach breathing?
Dr. Megan RiehlSo, yeah, it's also known as belly breathing, but belly breathing. Yep. You're breathing in through the nose, and that's making the belly and the ribs expand and then out through the mouth, and that's giving that diaphragm some movement, which allows for that massage of the intestines. So it may be a really nice little tip to have in the back pocket of everyone in those oh shit moments.
Chief Mike AssadYeah. I'm gonna bring it back to roll call training tomorrow, but I'll do a little roll-called stomach breathing.
Dr. Megan RiehlThat's right. That's right. Perfect. Perfect.
Chief Mike AssadPeople are gonna look at me and be like, Chief, you've gone off your rocker. What's the matter? I'll be like, no, just bear with me.
Dr. Megan RiehlI could also get into proper pooping position for you.
Chief Mike AssadSo we could do that too. We could do diagrams. We can feel the proper poop. Yep. Don't spend too much time on the toilet. Yeah, yeah.
Dr. Megan RiehlThat's another good tip if you're on the toilet for longer than five minutes or less. So if they're in there for 30, you need to be knocking on the door and have them go talk to maybe a GI psychologist. You could set them up with some behavioral strategies. We'll send you those resources. Don't worry. You can use that for it. With the diagrams, right? With the diagrams. That's right.
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Dr. Megan RiehlSo
Gentle Nutrition Fixes And Fiber
Dr. Megan Riehlas I'm kind of thinking, what organizations, healthcare providers or industry do you think helps support first responders the most and or that you're seeking out and reaching out for?
Chief Mike AssadSo I would say our mental health clinicians are our biggest support right now, because that's like the hottest topic is mental health for officers, you know, the SISM teams and you know, traumatic incidents that units come out and speak to officers and dispatchers and firefighters that all respond into one scene. So I would say that's probably our biggest organization that's helping us right now. I'd love to get maybe like a part-time nutritionist like set up a program. Kate, you're from Mass, right?
Kate Scarlata, MPH, RDNI am.
Chief Mike AssadSo I mean, I don't know if you know anybody that because we're a small PD, so obviously the monetary thing always comes into play, right? But what's an officer's health cost? You know what I'm saying? What's it worth to make sure you have a healthy officer? So that's what I try to think like that too. So I would love to have like maybe a like a part-time nutritionist come down to the station one day, and anybody who's interested, I can open it up and they can come down and and maybe have a nutritionist go over some healthy foods or or set up like a diet for a week, and you can just kind of do that for a six to eight week session to see how that works. I think that would be very helpful. So stuff like that would definitely help an agency that's small like mine.
Dr. Megan RiehlSo we may know some people.
Chief Mike AssadThat's what I figured. That's why I threw it out there.
Dr. Megan RiehlBecause one of the things that we talk about is we don't need to do sweeping dietary restrictions in a lot of instances with IBS. And so there are probably some very general in our book, we call it the gentle diet cleanup. And you've talked a little bit about that, having people monitor their caffeine intake, alcohol intake. If guys and girls are getting off of a shift and shifting to some alcohol, that's certainly from a mental health perspective, something we want to be mindful of, but also from a gut perspective that can be impacting hydration, water. You know, you talked about that too, being kind of chronically hydrated because you're chugging the energy drinks. So there are gentle things that we can suggest that would probably be helpful for everyone in the room. And then some kind of additional strategies around fiber. So, you know, we'd be looking at about 35 grams of fiber, generally speaking. 90% of Americans are not hitting their fiber goals. So you probably know a few. And not enough avocado. But he pointed it to himself there, though. It sounds like you're doing your best. And that's the other thing.
Chief Mike AssadYou can only do so much, right? You can only do so much. And that's what I tell a lot of them like, hey, listen, even if it's just cutting soda out, just cut something out, right? Just try one thing. Like if you're used to drinking soda every day, just cut the soda out, keep all the other crap that you're eating, but just cut the soda out for once, and then you can gradually, you know, make a step in the right direction by starting to cut other things out and replace them with good things, right? You don't doesn't mean if you get rid of something that's not great for you, it doesn't mean you're you don't have anything else to replace it with, right? Replace it with something better.
Kate Scarlata, MPH, RDNYep. I think one thing I'd like to say with my very raspy voice, sorry, listeners, is that focusing on what you can add sometimes can work even better because as Megan mentioned, most of us aren't not getting enough fiber. And so focusing on, you know, I'm gonna add one cup of blueberries to my diet on Mondays and an apple on Tuesdays, and thinking about just getting some plant variety going, that can in itself be more of a motivator than focusing so much on what we're taking out of the diet.
Chief Mike AssadSo and another big thing I've noticed is a lot of guys do the uh, unfortunately, they do the like the nicotine pouches.
Dr. Megan RiehlYes.
Chief Mike AssadThat's like a big thing in like first responders right now. And obviously, we all know, you know, nicotine's not good for you. There's no benefit at all that I know of. But maybe there's some medical stuff that I know nothing about, but yeah, well, I I know a lot of first responders that do those nicotine pouches.
Dr. Megan RiehlAnd I think some of that is out of habit, you know. Maybe they were a smoker in the past. Yeah, they were doing dip.
Chief Mike AssadYep.
Dr. Megan RiehlYep. And so then you just have some kind of fixation, right? You're stressed, and so you're you're putting that in. And awareness can be helpful in terms of, hey, have you noticed this? And risk modifications here. That, hey, let's cut the cigarette, maybe then try a pouch, maybe then try some gum, then try some mints and see if you can replace the nicotine, which to your point, it doesn't have any benefit, medically speaking, with you know, a healthier stress management strategy. But yes, we see that a lot. And I think some of it is just mindless, but they perceive and maybe do have some level of calming that comes with that. But from a gut perspective, probably not a healthy behavior that we want to keep around.
Chief Mike AssadDefinitely not.
Dr. Megan RiehlYeah. So is there anything that we haven't asked you about today that you think is really important for our listeners, or especially for the
Trauma, Red Flags, And Colonoscopy Talk
Dr. Megan Riehlfirst responders that we hope will find us today?
Chief Mike AssadI think it's just the stress too. It doesn't matter like if you're a dispatcher, if you're a nurse, if you're a firefighter, a police officer. Stress affects everybody, right? And it affects people differently. So the dispatcher taking the phone call, she may not be there, see what's going on, smell what's going on, but she's hearing what's going on, right? He or she that's a dispatcher. So I think we all gotta kind of come together as first responders and realize that we need to take care of each other, take care of our brains, take care of our guts, because we're all seeing a situation differently. But we're all experiencing that stress. If a critical incident happens, you know, a death of a child or a shooting or suicide. Everybody's experiencing that different. And so that would be my main thing that to get out there to the community that's listening to this. We're all dealing with stress differently because we see it, we hear it, we smell it. You know, so I want to say that we're all come together and try to help each other out and definitely try to work on our mental health and our gut health and our overall health of our person, I think is very important.
Dr. Megan RiehlI think that's such an important point. And Kate and I both feel that because we see a lot of patients in a lot of different walks of life. And I think sometimes people will compare their experience of a stress or a trauma and say, oh, but I wasn't, you know, I didn't experience it that way, or it was a little different. And I always kind of highlight your brain is your brain. Your brain is interpreting this for your own body too. And whatever that response is, however, your brain is interpreting that threat, that stress, that's what we're gonna deal with. We're gonna take your scenario.
Chief Mike AssadNot match it with somebody else.
Dr. Megan RiehlNo, yep, no, yeah, and even just you know, not comparing yourself to the next guy or the next woman that you know, your experience is your valid experience.
Chief Mike AssadJust like a fingerprint. Everybody's got an own their own unique fingerprint. Everybody's stress is their own unique stress.
Dr. Megan RiehlSo and that's the same for the microbiome, too. So that is why IBS, it doesn't discriminate, it shows up in lots of different ways. We know that it's super complex that you know, you could get one bout of post-infectious stomach upset, and that shifts the whole shit storm. And you know, or it's something that started out acute and it's become more chronic and more chronic and more chronic. And you're like all of a sudden Googling your symptoms and you're like, huh, yeah, I think I have IBS.
Chief Mike AssadYeah. And then you go down that Google thing where you're like, Oh, am I dying right now? Exactly.
Kate Scarlata, MPH, RDNDon't go too far.
Chief Mike AssadDon't go too far down that rabbit hole that can get you in trouble. It can get you more stressed and then you shit more. Yes. You don't want that.
Dr. Megan RiehlYes. No. So there are some red flags that, you know, I think there's some work that you're doing to just bring awareness to your officers around, you know, what a code brown might mean. Certainly if they're not having other alarm symptoms like blood in the stool or kind of hard with shift workers because we tend to say with IBS that nocturnal bowel movements are not usually a part of IBS, but it might be a slightly different clinical picture for somebody doing shift work. But those are some of the things that really we want to guide you. Okay, let's let's meet with a physician, let's decide do we need to do a colonoscopy? Can we just do a little bit more of a thorough clinical interview to get you that definitive diagnosis and then set you up with a multidisciplinary treatment of plan? Maybe you use some medications, maybe there's a dietary kind of component, maybe there's a behavioral component, but you certainly are creating a nice environment for people to be thinking about that brain gut connection. So thank you very much.
Chief Mike AssadAnd I love it that you just brought up colonoscopy, okay, because I just had one. I had one a little while ago.
Dr. Megan RiehlCongratulations.
Chief Mike AssadThank you, thank you. So I'm 46 years old. I had one, what was it? Must have been like six months ago. And I told everybody at work I came in, I'm like, I'm getting a colonoscopy.
Dr. Megan RiehlI love it.
Chief Mike AssadThere was no stigma behind it. I went in and I'm like, you know what? And I I came back in after, and I was like, that was the best sleep I have ever had. Nobody bothered me. I woke up refreshed. I was like, I said to the doctor, I'm like, can you put me out again just so I can have that sleep? But I don't have to go back again for another 10 years, whatever it is. That's what they said. Yes, no, I'm you must have had a that's right.
Dr. Megan RiehlGood. That's right. That's another really, I think, nice way to model, right? Like people think about colonoscopies and they can get a little concerned about the prep, but the benefits far outweigh whatever, you know, couple of hours, uh, you know, that the half day prep that it might be required. Getting that clean bill of health means a lot and it does take some of that pressure, especially if you have IBS, you know, and a lot of people don't need a colonoscopy before age 45. But if they do have some alarm symptoms, go check it out with your doctor and they'll they'll let you know whether they want to get in there and scope or not.
Chief Mike AssadAnd then if you get a clean bill of health, that just takes more of that stress off you. Exactly. If you're stressing about it, you know what I'm saying? You're like, because then they come back and like, hey, you're good. You're good for another five, 10 years. And then you're like, ah, that's right. That's right. Now just move on to something else that stresses me.
Dr. Megan RiehlHow about my blood pressure or something? How about my blood pressure?
Chief Mike AssadYeah, yeah,
Speed Round And Final Takeaways
Chief Mike Assadyeah.
Dr. Megan RiehlYes. All right. Well, we are ending with a speed round. So for you, no investigations, no evidence gathering, no paperwork. We are just going to have you choose the first answer that comes to mind.
Kate Scarlata, MPH, RDNOkay. So is it Red Sox or Patriots?
Chief Mike AssadPatriots.
Dr. Megan RiehlDo you have a perfectly organized desk or organized chaos?
Chief Mike AssadPerfectly organized desk.
Kate Scarlata, MPH, RDNOoh. What is a food or snack always in your fridge?
Chief Mike AssadCool whip.
Kate Scarlata, MPH, RDNThat is not even a food.
Chief Mike AssadOkay. Okay. All right. So I uh food then. Okay, you gotta be food. Grapes.
Dr. Megan RiehlOkay, I like that one. Do you prefer day shift or night shift?
Chief Mike AssadUh day shift because I can't see at night anymore.
Kate Scarlata, MPH, RDNOh, I know. Get your vitamin A. Yeah, right. Best window activity, exercise or relaxation?
Chief Mike AssadExercise.
Dr. Megan RiehlAll right. I'm gonna have to send you some some maybe meditation and some relaxation strategies for you to incorporate into that.
Kate Scarlata, MPH, RDNExactly.
Dr. Megan RiehlChief Assad, it's been an absolute pleasure to have you today. Such a fun and informative conversation that I hope will be modeled across our country because our first responders deserve to work in a place that you are providing your officers with. So thank you very much.
Chief Mike AssadOh, thank you. I'm honored to be on your program, and I and I truly appreciate both you and the work that you do to help us and and to identify different things that affect first responders. So I really appreciate it. Anything you guys need, let me know.
Kate Scarlata, MPH, RDNOh, you know it.
Chief Mike AssadPack your car down at the station, and we'll have coffee and well like donuts. Right. And some.
Dr. Megan RiehlWe love coffee. We love coffee. It just you have to be mindful.
Chief Mike AssadNo nutritional value at all in a donut. No, I'm just saying.
Dr. Megan RiehlNo, but a little bit of joy.
Chief Mike AssadYeah. A little bit of joy. Yeah. A little bit of joy.
Dr. Megan RiehlA little bit of joy. Thank you so much.
Dr. Megan RiehlThank 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 GutHealth Podcast, where we'd love for you to share your thoughts, questions, and experiences. Thanks for tuning in, friends.
