Wearing a face mask (except the N95s, please leave those for medical professionals) helps protect other people from you. Even if you have no symptoms, you could be carrying and spreading the COVID 19 virus, so it's important to keep the moisture from coughs, sneezes — perhaps even breaths — contained. So please, do wear a mask if you're out and about among people.

Protecting others is awesome. Protecting yourself and those you love? Priceless.

One of the most unknown and underrated ways to strengthen your immune response is gut health. Science is only beginning to understand the importance of a healthy gut, including what all the gut does (a lot) and how best to protect and feed it.

Dr Erika La VellaWe took these questions to a gut health expert: Dr. Erika La Vella of lavellayourguts.com. She is a board-certified metabolic surgeon and describes herself as a "wife, and mother who is passionate about health in the most preventative and holistic of ways." She talked with Gennev Director of Health Coaching Stasi Kasianchuk about what the gut biome is, how it works, and some of the many ways we're finding that a balanced gut biome makes us healthier — and an unbalanced one can disrupt our health.

So. especially in a time when we all REALLY want and need the most robust immune response we can have, how do we feed our gut and protect it?

Listen up and find out!

Prefer to watch AND listen? Check out the video of our Gut Health webinar on YouTube. Be sure to subscribe to our channel for more great content about COVID 19, menopause, and women's health in midlife.

More webinars are planned, so if you like this, take a look at what's coming up. Register to attend the live webinar and/or to receive links to the webinar on-demand as a podcast or video. 

 

 

 

 

TRANSCRIPT:

Coach Stasi Kasianchuk

Thank you so much for joining on this webinar for on gut gut health related to immune function. So I am Stasi Kasianchuk and I'm the director of health coaching here at Gennev, and we have the pleasure of introducing or talking with Dr. Erika La Vella today, but I'm really excited to have her here today to talk on this. She has an extensive background and expertise in this area. She's and lots of great practical tips as well to bring to you today. So welcome, Erika, and thank you for joining.

Dr. Erika La Vella

Thank you Stasi. And thank you, Gennev for inviting me. Yeah, so I am a current practicing metabolic and weight loss surgeon and I didn't always think I wanted to be a surgeon. I was motivated and excited to go to medical school. I love to work with my hands. I love practicality. I love learning about physiology, the kind of physiology that overwhelms a person's immune system and turns on sepsis and you know, emergency surgeries and things like that. And so ultimately I ended up finding surgery and then found this glorious niche of health coaching meets nutrition meets surgery. And now I do weight loss surgery. And my love for, for gut health has really blossomed out of my own personal journey. So in the midst of my medical school career, I was having a lot of GI issues and that was gosh, almost 10 years over 10 years ago now.

And I discovered that I had a GI parasite. And that process of learning about the parasite, learning about my body, learning about the biochemistry, learning how stress was impacting my ability to to respond to my body’s needs has really shaped my love and desire for talking to everybody I know about gut health. And I'm a total nerd. I read research papers like they are novels. So I I just, I love, love, love the information and I've developed quite the network of colleagues in this field. And yeah, thank you so much for having me.

Stasi Kasianchuk

So let's start off Erika, by giving our audience just an understanding of what the gut microbiome is. We hear this term gut microbiome, I think we're all learning a little bit more about that as it becomes more known and more researched, but love to get you to just give your overview. So we all at the same starting place.

Dr. Erika La Vella

Yeah. So we have in our bodies and on our bodies, trillions of bacteria organisms, and it's believed that these organisms are absolutely essential for health. So that's been part of the big paradigm shift, so to speak, in our language around health is that no longer are all these bacteria deemed to be problematic. So urinary tract infections, yeast infections on the skin, all of this is a sign and symptom that you don't have a healthy microbiome balance in your body. So while we have these tons and tons and tons of different cells, there's also a very time sequence in which we are naturally exposed to them. And so we can talk a little bit about that later. But the microbiome in, in just the broadest sense is this very intricate, interdependent relationship. It's like a rain forest, you know, it's like, it's like your backyard. If you remove flowers that pollinate bees, then you see this downstream, sequelae effect.

And so it really is an ecosystem and we have to think about health in terms of how do we nourish this entire ecosystem. And while there are bacteria themselves and you know, probiotic, which what we're talking about with supplements, the types of bacteria that are present in our bodies, they have the ability to take nutrients from our diet. So what we eat feeds them. And then the chemicals that they make then act as a sort of language that then communicates not only to our cells and to our DNA, but also communicate to each other. And so this is a thing that I find just, it's so beautiful. They really are sentient creatures that have evolved on this planet well before humans even walked the earth. Literally every living organism on earth has a microbiome. Their ability to then communicate with each other by releasing these chemicals. And it's all based off of the basic biology of eating and, and, and pooping. Because what the bacteria poop out is this chemical soup that then confers. Are we then going to be healthy inside or are we going to turn on genes that spawn inflammation? And yeah, so I hope that answers everyone's question because again, you have to think about it very broadly. It really is an ecosystem.

Stasi Kasianchuk

I love your comparison to the rainforest and the downward effect cause I think that illustrates the symbiosis that we see with the different microbiome micro organisms in terms of how it all works together. So that's a good analogy there. What would you say, so, I mean, thinking about the development of our microbiome, how does that occur in terms of how do we, how do you mentioned eating and pooping, which are certainly really natural things. We don't talk, we talk about eating a lot. Pooping doesn't always get the attention, but I tell clients all the time, if you're not pooping, we have bigger problems than if you are. So, you know, it's a, it's a natural thing that we all do. And and certainly related to the gut microbiome, but how does that what's the role of just how the microbiome gets developed?

Dr. Erika La Vella

Yeah. and just a little side note, I am very comfortable talking about pooping. It's like a tabletop conversation at my house. And I think as a, as a surgeon, any general surgeon out there can agree, it's like the first sign that your patient can go home is when they’re pooping. So I, we, we celebrate poop. So the gut microbiome is, used to be belief. So right now our technology and our science is changing so rapidly. I mean the fact that we can all sit remotely and have this conversation is pretty magical. And even our science and our ability to test not only what types of bacteria are growing in somebody's stool, but then also what are those chemical messengers that are now in somebody's bloodstream. So that's kind of where this whole microbiome thing is now going is a blood test that tests for those chemical messages and what's healthy and what's not healthy.

The gut microbiome or the vaginal microbiome, the mouth microbiome, the biomes on your skin, “biome” just means the collection of organisms that is there. It used to be believed that your placenta or a placenta, whichever one you were born into, was sterile. And what is currently being debated is, is it really sterile or is it not? And what we have discovered, we being scientists is that it's not always sterile. And then, okay, when is it not always sterile? Well, sometimes if the mother has a cavity or if the mother has a bacterial vaginosis or if the mother has the word is dysbiosis. And dysbiosis just means that your microbiome is causing inflammation or some sort of imbalance in your body. And it again, it's not very prescriptive. Different bacteria are really healthy in some people. And then in other people they aren't necessarily doing helpful things.

So it really starts in utero. And I even like to talk to people, it really starts preconception. So as a woman, if you can, if you are blessed with the opportunity to anticipate and plan your pregnancy, we need to start working on gut health and dental health and getting your body as dialed in as possible so that you have a really healthy pregnancy. There are some data out there suggesting that if the woman has dental disease or cavity or caries, they are actually at seven times increased risk of having premature delivery. Same thing with vaginal yeast infection, not yeast infections, but dysbiosis. So we don't always have the mechanisms mapped out yet, but we know that sometimes bacteria from a mother's gut, from their vagina, from their oral cavity can get into the placenta. And right now it's estimated that half do and half don't.

But then the birth route becomes really important because when a baby is pushed out of the vagina naturally, it actually bathes in the the bacteria and the yeast and the microbiome of the woman's vagina. But also usually during that process, the woman's pushing, and again, we're going to talk about poop and it's not sexy to talk about pooping during delivery, but it often happens and that baby's coming in really close contact with that perineum. This is now believed to be a Keystone event and Keystone species from mom get transferred to baby. They get on their eyes and their nose and in their mouth. And currently most gynecology or obstetric practices have actually modified C-section deliveries to start doing vaginal swabs with Q-tips, put a Q-tip in the vagina while you're in labor and then let it soak and then they swab the baby's nose and mouth with it and they're studying their microbiome for the next several months after delivery.

And they're finding that the Q-tip swapped babies tend to be on a similar health trajectory as those that are born by C-section. What happens when you get born by C-section as you don't make contact with that flora and so your gut and your as a baby, it kind of goes into this rapid development of of what what looks like to be like more like an adult microbiome. And so these stages seem to be very necessary for the stage of development that we're in when we're born, when we're born, we really are only designed to digest breast milk, digest colostrum. And actually that's the next piece to that is when we do start breastfeeding, which is right away colostrum, we, we'd get a lot of our immune benefit from our mom. So the breast milk actually puts that into it. And then that feeds the baby.

Not only that, but the different layers of the gut. And I would love to tell people about the anatomy of the gut and how the different different layers and different functions both on the microbiome side, but also on the human side, the different layers that are really important to help protect you, not only from bad bacteria that you accidentally eat but even just from food and undigested food particles. So your largest immune system’s in your gut. And it's believed that these key sequences prime your immune system for healthy functioning. And it's all related to, again, as a fetus, they call it the fourth trimester, right? You're just, you're born without any real ability to fend for yourself and survive in the environment as if you do when you're a fully developed adult or adolescent. So all of these functions between mammals, nursing mammals and their young, are very important for this kind of sequential development of the immune system. So there's, you know, immunoglobulins and you know, all lots of big medical and scientific immune speak, which I could blurt out. But I think for, for your listeners, just acknowledging this relationship and this in this time sequence contact with these things at these very specific times.

Stasi Kasianchuk

Excellent. Well that's a great foundation. I think you know, the start of our immune system and really right now as we are in this pandemic and all of us wanting our immune systems to be as strong as possible. I'd love to just hear now you, you alluded to the role of the gut and the immune function. So if we can dive a little bit deeper, maybe that comes into some of the layers. But really what does the gut, how does the gut play a role in our immune system in general and then maybe perhaps what it may be doing right now. I know we're learning a lot, so there's nothing out there that's definitive, but if you've come across anything in terms of what might be happening as our guts are supporting us and hopefully supporting our immune system during this pandemic.

Dr. Erika La Vella

Yeah. So I've been, you know, scouring the literature to date. There's not a microbiome, COVID 19 study. But there is a lot of good literature out there documenting what happens in HIV and HIV is, you know, it's, it's, it's a totally different virus, but what HIV has the ability or what it does is it really damages the host immune function to the point sometimes where the immune cell count, the CD4 count, which is a type of immune cell, gets so low that patients with this type of disease can't, can't fight off any infection on their own. And you know, that's kind of the definition of immunocompromised. And the literature regarding the microbiome: simple, simple, simple — kefir. Kefir actually helped reverse the evidence of HIV and actually helped rebound the CD4 counts. And so it's, it's this connection again, the largest immune cell collection is really under the gut lining and your gut is only one cell layer thick and it's brand new.

The turnover, the cellular turnover turnover is about three days. So every three days you can think, just like we shed the layers of our skin, we shed the inner layer of our gut, but it really is only one cell layer thick. And under that Oh, somebody asks what is kefir. I can see that I should define kefir. Kefir is a fermented yogurt, like a fermented milk drink. And it's, it's, it's awesome because it has over, well some of my favorite brands, if I can speak brands, my favorite brand is Nancy's because Nancy is right here in Oregon. But also they make it with organic grass fed dairy from whole milk cows. And then they also add a fiber to it called inulin, which I would love to tell people what inulin is. And then it has 13 different beneficial strains of bacteria in it.

And again, it's an ecosystem. So when you're thinking about probiotics and how do you support your natural immune system in this way, when we have been evolved to eat probiotic foods before refrigerators, we were, everything's fermenting. In fact, the magic of fermentation is really how long something sits out on your counter. And so if you really want to you, you can make kefir at home. The little it's called kerfir pearl and the you put it in, in, in milk and you just leave it on your counter for a few days and it will, it will start to grow and culture. That's what a culture is. But yeah, so again, there are many different ways I keep, I'm getting a little distracted. I see the chat box pop up every once in a while. There are vegan options. If you're a non dairy person, of course you can put this stuff in coconut water.

There's, there's coconut kefir or water kefir. But in general, bacteria needs some sort of sugar substrate. And so lactose, bacteria just love lactose and cultures all over the world for a very long time have been eating dairy in this way. In fact, buttermilk is a cultured product. Buttermilk is a fermented food. And you know, back in the days when people just used to have their own dairy cow on their own property, they'd milk a cow. They wouldn't pasteurize it, they’d bring it home. It'd be what they would drink would be fresh, scoop off the butter and then leave it on your counter for three days. And now you have buttermilk. So fermentation is in the air. These bacteria, these wild yeast, they again, they grow in our bodies, they grow in our soil. And the farming practices that exist today have been shown and rumored to be depleting the soil of those probiotics that naturally grow in the food.

And as a personal experience I do grow a garden. I do care for my own soil and I love fermenting things. I make my own sauerkraut. I make my own kvaas  and make my own sourdough bread. And there is a big difference between picking something fresh, like a cabbage out of my garden, barely rinsing it off. Maybe if even I just dust off the dirt. And then chopping it up and watching it ferment in my, in my kitchen versus during the wintertime having to go to the grocery store even if it's organic or not, you know, that stuff's just pressure wash sprayed with antifungals. It just, it doesn't ferment the same. That's all I have to say. It doesn't ferment the same. So again, this idea behind immunity, it, it really is as simple as you just, you have a lot of immune cells right underneath the, the barrier. And so the gut barrier, I'm just like, we have a blood brain barrier trying to protect our brain, which by the way, the brain is not sterile.

Exactly. There's just more layers. These bacteria are literally all over our body. The, the problem is, is in the past we haven't been able to culture them, you know, and it's not like we're going around doing brain biopsies to culture them. But now we have different DNA sequencing techniques and we have different ways to extract the those little chemical communicative language to identify what, what some of these, these things are. So the gut barrier it consists of the bacteria that are present but also on your body, what the mucus layer is like. And this is where I just have to do my plug about ibuprofen, Aleve, Neproxin, all the nonsteroidal antiinflammatory medications, which are so commonly prescribed, they are ruining your mucus layer. They just poke holes in it. And there have been tons of studies documenting that. Not only can it cause an ulcer in your stomach, absolutely it can, but on an endoscopy, when they look with the camera and they take biopsies, people can have ulcerations and be losing iron and bleeding just from taking ibuprofen.

And again, it's the whole class of medicines. So that is usually rule number one to anybody who wants to heal their gut. Stop taking those medicines. And if you have pain and you think pain is inflammatory, well then that's another opportunity to really think about your body, what you're feeding your gut, and how can you optimize the state of ecosystem balance within your body. Because when our gut layer in the mucus, layer is, it has holes in it. What happens is the bacteria on the top, they're not all good, but again, they work in in a ecosystem type way to keep each other in balance. I don't know if your listeners have heard of Clostridium difficile, but that's abbreviated C diff. And that is often a bacterial infection that happens when we take antibiotics. So when we take antibiotics, we are effectively reducing that ecosystem balance.

Not all the population dies, but some of them, because the antibiotics have different mechanism of function, some of them do. And so when the pH changes and when that balance, that diversity, you want tons of different, you want that rain forest of ecosystems. You don't want like just, you know, three or four, you want tons. So when that balance gets disturbed, then this other type of bacteria that is always present within you starts to over flourish. If we have States of inflammation in a weakened mucus layer, then the cells underneath start to also become effected. They can get leaky so they aren't as tight, they can leak. And then that allows not only on digested food particles, so inflammatory things from our diet, but also bacteria and bacterial toxins to leak across that membrane as well. And then underneath that layer is where the immune system is. And so anything that your immune system scans, it's like, it's like going through security scans and determines is not safe, is not human and is not recognizable as having an intended function in biology like making cholesterol, making skeletal muscle, you know, doing different functions of biology. Then your immune system gets over-reactive. It treats it like it's a virus. It treats it like it's an invasive bacteria.

Stasi Kasianchuk

So then that that action of the immune system tack tackling something that it's perceived as foreign is when we feel symptoms of being sick, would that be a correct?

Dr. Erika La Vella

That would be a correct statement, yes.

Stasi Kasianchuk

Okay. All right, well that's a great, really good insight. In terms of the connection there, I'm certainly, especially that one cell layer that you mentioned within our gut being being the barrier between foreign foreign particles that we digest and take in and the the actual our inside and that immune system, that's a pretty small barrier there.

Dr. Erika La Vella

It's fragile and it just deserves some intention.

Stasi Kasianchuk

Yes. Well, let's transition here and we have a couple of questions coming in. So I'm going to take a break to go back to there are some questions on the kefir, so I’m going to take a break to go back to those and then let's jump into things that our audience can do right now to nourish their guts and, and support their immune system. But we'll start with these questions first. So where can you buy the kefir pearl if you wanted to do do you have any recommendations, whether it's online or where you found, where you found them.

Dr. Erika La Vella

Locally? I go to my co op. But yes, you can also do it online.

Stasi Kasianchuk

Okay. and then we have another question about that. Someone that says they drink Nancy's kefir, but a GI doctor mentioned to them that most bottled probiotics get destroyed by stomach acid. What is your thought on that?

Dr. Erika La Vella

I think a lot of doctors under-appreciate the complexity and also the millennia of time that humans have been living with probiotic foods and the benefit. So yes, your stomach acid might be killing the bacteria, but it's not the bacteria that are giving you the benefit. It's the chemicals, the poop remember, they're active, they're very active. They're alive. So I love Nancy's because it adds inulin, which is a food for them, a prebiotic. They're eating it, they're digesting it. In the fridgerator, fermentation slows down, but it doesn't stop completely. Whereas on the counter, because of the temperature, fermentation kind of speeds up. And so anyway, even though it's in the refrigerator, it's still alive. Maybe it's just a little sleepy, but it's still alive. When you eat it again, it's bound to food. It's bound to that lactose.

It's not like your stomach acid destroys everything that you ever eat and then you never get any nutritional value from it. That's not how digestion works. Our stomach acid breaks down protein, but it's not really designed to kill things. Again, pH is important. But also it's those chemicals of fermentation, those chemical messengers and those are called postbiotics. And postbiotics, there's not a lot of literature on it right now. At least not commercially and, but I think you're going to see that change. In fact, Dr Axe, I just started searching this yesterday, tried to see how many practical tips I could find for, for your listeners. But Dr Axe’s website actually does a pretty good job detailing out what a postbiotic is and how you get the benefits from them.

Stasi Kasianchuk

Excellent. Yeah. So the, based on what you said, it sounds like the purpose of our stomach acid in addition to breaking down proteins is really to maintain a pH environment within our stomach, which can protect us in some ways, kill some things, but perhaps the the, the beneficial probiotics that are, we're consuming from different foods, especially the pH may actually not have the same impact on, on those beneficial organisms.

Dr Erika La Vella

Yeah, it's, it's, it's a little more, it's just, it's, it's more nuanced because it's not that you're, it's not that your, your stomach, your body isn't designed to host of probiotics. So if you were to do a stool sample, you would very rarely find that the probiotics that you've been taking are actually living in your gut. I look at it more like a fertilizer, and again, it's a fertilizer because it's not necessarily that the lactobacillus itself being alive is going to burrow its way in, take root within you. It's literally communicating to the rest of your native microbiome and it can do that through stomach acid. Does that make sense? Yeah.

Stasi Kasianchuk

Yeah. There's again, back to that relationship. Everything. There's not existing in a bubble and it's not good and bad, it’s really about the relationship.

Dr Erika La Vella

Yeah. That the bacteria don't have to be alive when you eat them. They have to have been actively fermenting. And so you have to have those post fermenting, I call it bacteria poop cause it's what they make. But you have to have that to get the benefit. And when you eat a fermented food, an active live food, if it's alive, when you eat it, then you know you're getting the postbiotics.

Stasi Kasianchuk

Well, let's jump into some of those. Because I think it sounds like those are what they might be. Steps that can help keep our gut healthy and then also support our immune system. In return. We had a question. Someone asked what is kvaas and if you wouldn't mind sharing.

Dr Erika La Vella

Yeah. So I, I've done a little bit of research and I'm not a huge food historian, but I believe it comes from Eastern Europe, maybe even Russia. And this is how I make it because these are all just variations of the same, same practice of fermenting food. I take filtered water and from my garden, I can't make kvaas  from things from the grocery store, so from my garden. I take fennel, beet, carrot, celery, and dill. And I put it in a Mason jar with a little bit of sea salt, just a pinch. And then I put a I usually do coffee filter paper and a rubber band over the top. And because of the beets, the water turns this gorgeous fuchsia pink. And it has this almost, I, it's, it's kinda like the savoryness of a bloody Mary, but it's like very refreshing because it's, again, carrots, beets, celery, fennel, and dill.

And any way you can make your own kvass recipe in any way you want, but it's the fermentation drink that comes from these vegetables that you grow on, on your kitchen counter. I think in grocery stores now you can find products called gut shots. And basically it's the juice off of sauerkraut. You know, it's all it is, is the, the byproducts of fermentation. And again, I think all of this stuff, you can make your own recipe. It's just fermentation's a very intimate process. You're constantly looking at it, you're smelling it, you fail more than you succeed when you're in the beginning stages. But it's just can you foster this relationship in your environment with more living organisms? Because again, it's what they make, it’s those byproducts of fermentation. That is like the fertilizer, the compost for your guts.

Stasi Kasianchuk

Excellent. Great comparison there. We also did have someone share related to the C diff that you mentioned the C difficile unfortunately sorry to our listener that had to experience this, but their mother did die from C diff after being overdosed on antibiotics. So it is something that's unfortunately not uncommon.

Dr Erika La Vella

No. And our hospital has published a few papers on this, but we use kefir in the hospital and you can also use miso. So, so we, miso is also a very potent, very, very potent probiotic food. And again, a little bit of miso, warm water, right? You can even use boiling water in your miso and still get the benefit of the probiotic. And this is on the same parallel as the stomach acid killing the bacteria. The boiling water isn't going to have the bacteria survive, but it's already been actively fermenting, sometimes for five years buried underground in a soy fermenting crock. So it's the byproducts of the fermentation that are really overlaying all the health to the host. Yeah.

Stasi Kasianchuk

Yeah. No, that's a good reminder of someone just shared that they tried to get gut shot, they love gut shot and it was sold out at the grocery store in Poulsbo yesterday. So probably a lot of the immune boosting things are, well what are some recommendations, Erika, that you see as being simple, accessible, potentially not sold out right now that our listeners could start doing if they aren't already to support their gut health?

Dr Erika La Vella

Yeah. so I like to think about the pre pro post idea, but also number one, take care of you. And what I mean by that is get some good sleep and practice mindfulness. There was a study in 2002 and I just discovered this in the last year and a half, and it resonates so deeply with my own experience because all of my gut problems, I probably had an intestinal parasite for many years, but it didn't show itself until the stress of medical school. And so right now a lot of us are feeling intermittent anxiety, grief, uncertainty. Some people have been laid off jobs, aren't gonna be able to pay their mortgage. There's just a lot of fear about our own health right now. And the media, I find myself checking the statistics on the COVID 19 crisis a little too frequently. So I, I'm, I'm speaking from my own heart, my own experience right now. When we take time to practice mindfulness and actually get our nervous system in resonance with our parasympathetic state, which controls the vagus nerve, the vagus nerve …

 Oh, I have to, I have to, because this is what really ties the whole gut thing together. If we focus on diet alone, we can get overly anxious about what we're eating. Gluten or not, keto or no, too many carbs or not you know, dairy or not. And all the other bandwagon things I find diet and nutrition to be sometimes as inflammatory as religion. When we focus on bringing our bodies to that state of, of balance. And like I said, really practicing, practicing mindfulness. Our, our nervous system is trying to navigate all of our sensory inputs at one time, not only from our gut. In fact, the vagus nerve, which is the big connector from the brain to, to the intestines and organs of your abdomen has about nine, nine nerves going from the gut to the brain for every one going from the brain to the gut.

And the vagus nerve is just two, but then it spirals out into a web of, you know, this neural network and communication. In fact, the gut barrier is now synonymous with the blood brain barrier above and below. And so I just love that reciprocity that exists everywhere in nature. When we have a nervous system that is primed for fight or flight, which is what is happening right now. When we see the media and we have all this, all these concerns, our mind gets overly busy. Our body doesn't put blood to our abdominal organs. And also when we get an overdose of cortisol, cortisol being our stress hormone, it is natural and normal to have cortisol. It naturally peaks in the morning, naturally peaks in the afternoon and it dips low enough to where we can get sleepy at night and then we can get the hormones of sleep, which is melatonin.

If we aren't in that, if we are in an overly stimulated sympathetic state, too much cortisol actually also has negative effects on that gut lining. And what happens is the tight junctions, which links the cells like this, there is a enzyme in the, in the, in the bloodstream that has a cortisol receptor that breaks down the tight junction that holds our gut together. So really I think in, in today's world, you can not expect your body to be working the best way for you without addressing this piece as well. So the parasympathetic state and the vagus nerve being kind of the, the not the opposite, but again, that reciprocating balance, that side, when we're in parasympathetic state, we have a resting heart rate that is calm. We have a digestion and blood flow going to our bowels that is working. We have peristalsis. So there's a nerves that control the rate in which we eat and poop. By the way. Everybody eat some beets. And if you don't see beets in the toilet within 24 hours, you aren't eating enough fiber and your motility is not where it should be.

Stasi Kasianchuk

And how would people know if they see the beets?

Dr Erika La Vella

Bright red. You're going to think you're bleeding.

Stasi Kasianchuk

We don't want whole beets coming out though.

Dr Erika La Vella

No, no, no. Should be digested. That's right. That's it. But so the work that I do I teach, I teach gut microbiome workshops. In fact, I'm teaching one tomorrow in a very similar platform. But I, I, I teach a lot about the gut function, the gut microbiome, the integrity of, of the anatomy and how, again, our environment, but also our mindset and our nervous system and an even you can even layer this on to post traumatic experiences and and how how you get re-triggered. Again your whole organism is constantly trying to keep you safe and to protect you and it only has the information available to do it free from your actual thought and assessment. Your body has no judgment. But when our nervous system gets activated in a way that triggers an over sympathetic response and over cortisol response, again your bacteria and your heart, your, your body, the bacteria are almost sentient on their own front.

While they are, they're trying to keep you healthy. Like in the case of the C diff patient and the mother you story, you just, you just shared. If the bacteria sense that the host is too sick to survive, certain bacteria get extra infectious because then they become contagious and then they know that they can jump onto the different host. These, that's a theory and I think it's a very natural way to think about the body and natural way to think about these organisms is that they are only trying to survive as well. And so I try to teach a practice of how can you make your body the sexiest, healthiest like you know, a five star hotel that all of these creatures want to live in. When you keep them really healthy and really happy, then you don't get sick. You don't get diseases.

Stasi Kasianchuk

Yes. Yeah. Having that, that system basically to help fight off anything that comes in. And even if even if people do get sick, would you say that if you have a stronger microbiome immune system, perhaps the symptoms are less? Or the recovery’s faster?

Dr Erika La Vella

Yeah, that's precisely my working theory right now regarding the asymptomatic individuals carrying COVID 19. we saw the same thing with HIV. There was plenty of people who got infected with the virus but didn't have symptoms. And so this idea of, of of a an independent organism, whether it's a virus or bacteria, the idea of it having its primary job to only cause disease is, I don't know, maybe I'm just too much of a softy, but it kind of breaks my heart. Like, that's not the viewpoint I like to have of the world. I like to have the viewpoint of, Oh, it's just trying to find its best home. And so when we can have, again, an internal environment that can foster healthy bacteria, healthy immune systems, it doesn't mean we don't get sick, but it means that, you know, our immune system can work for us and we can recover more quickly.

Stasi Kasianchuk

Excellent. Well, you mentioned the mindfulness. That's a great piece and there's, we could do a whole other podcast on mindfulness but certainly finding something that's mindful and I like what you put on. What makes you feel the best right now and how can we work to manage the stress we may be experiencing? It may not be realistic that it's going to go away, but how can we change our response to that? And certainly a developing a mindfulness practice could be one thing. What else do you recommend on really just making this five star hotel, this stellar host for healthy bacteria?

Dr Erika La Vella

That's right. I know, I'm trying to imagine what that would look like on like the cover of a magazine. So prebiotics which is food that we eat and the most simplest potent prebiotics is a substance called inulin. And inulin, yes, you can buy it as a supplement. I do supplement my three year old daughter because I can't get her to eat her fruits and vegetables as well as I would like. But you don't have to supplement in fact onions, raw onions, raw garlic or even gently cooked garlic. Those are some of the two most common inexpensive sources of prebiotics out there. And then beyond that, the, the levels of that inulin and in fiber. So fiber in general is the best thing you can feed, feed your body. There is so many nutritional studies out there looking at how much fiber a person eats correlates to what those post biotic chemical messengers are in the blood and also in the stool.

And there's a handful of ones if you ever want to go over stool analysis and all those details. But basically if you have sufficient fiber intake and a sufficient mucus layer, then the fiber and the post biotic chemicals help treat constipation, your bowel actually speeds up its transit and the bulk of your stool improves. And then you know, again that mucus layer eating more fiber beefs up that mucus layer as well. Asparagus, bok choy, literally every vegetable you can ever imagine you have to eat more. And I recommend 10 cups of vegetables a day.

Stasi Kasianchuk

All right, well that's definitely a goal. What would you say if people are at one cup, where should they start and how should they work up to that 10? What would you be your recommendation?

Dr Erika La Vella

Okay, so especially if you go from eating one, one cup to eating 10 cups, you are going to be stinking up your whole house. Okay. You will be getting some stinky farts. I think our culture is very like … nobody wants to pass gas anymore. But that's also a sign of a pretty healthy, healthy gut. You don't want to eat so much fiber at once to where you bloat uncontrollably, but do acknowledge that a little bit of gas and a little bit of bloating is also normal because your body, you're stimulating growth of different bacteria that haven't really been woken up in a while. But I like to play the game of going to the grocery store and picking one new vegetable you've never tried before. Just one. And then make a recipe where that is in it. And then usually that recipe has other vegetables in it that you also have to force yourself to buy and eat.

And then I also like to make salads. Like I make big salads in kind of bulk and then I'll like roast a bunch of vegetables or something and then I'll, I'll pair them in different ways to where leftovers for the next day is just this glorious Buddha bowl of all these different nutrients? And I like to combine things where you have a little bit of whole grains as like a texture that's cold. And then you have a little bit of raw leafy greens and then you have a little bit of cooked leafy greens. Right? There's certain greens that are just better digested, cooked. I know that if I eat raw broccoli, I am miserable. But if I cook it a little bit, even just steam it for five minutes, I can, I can tolerate it so much better. And then don't be afraid of soups and just again, anything that you cook now add vegetables to it.

Stasi Kasianchuk

That's a great suggestion. I like your idea too of just having that salad prepared. And I know that that's something that I'll just throw a handful of greens on top of a lunch. It's easy when it's already prepared and you don't already have to do that. I know that getting a fresh vegetables for some of my clients right now is a challenge either because they're not going to the grocery store as much or they are not available as much just depending on where they live. This is where certainly having a garden could be helpful if that's accessible to you. You did mention growing a garden and even something you've told me before, starting with just plants you know, a few pots could even be an option.

Dr Erika La Vella

Yeah. And, and herbs like culinary herbs, just getting something fresh and nutrient dense is really the key because the gut bacteria, just like your DNA, they thrive off of antioxidants and antioxidants is those really vibrant color rich, flavorful herbs too. And also broccoli sprouts and sprouting in general. So that's something that all you need is a seed packet, a Mason jar, and you fill up, you put the seeds in the Mason jar and then you just fill it up with a little bit of filtered water and then you just change the water out every day.

And what'll happen is over the course of a couple of days, you'll actually get little, little tiny little little vegetable sprouts. And what they've discovered, this is well documented with broccoli, but it's the same with every plant out there, the entire antioxidant potential of one plant — so imagine broccoli, a big old head of broccoli — is all in that one little sprout. So if you don't have a lot of growing room or you weren't really able to go to the grocery store, sprouting is such an easy thing to do at home and you can sprout with any seed, you can sprout with whole grains. Sprouted whole grains is actually a really beautiful way to also increase the ability to absorb all their nutrients.

Stasi Kasianchuk

Yeah, that's a good point too. I'm having the sprouted grains or sprouted seeds are also ways to, if you are struggling with digestion, getting those nutrients and starting to support your gut with some easier to digest forms of different vegetables, but in a lower fiber form, but still in nutrient packed form. . And then also a great science experiment for those of you homeschooling right now.

Dr Erika La Vella

Yes. Yeah. Kids love it. Kids love seeds. They love watching things grow.

Stasi Kasianchuk

So that could be another activity. Well, we're coming up to the end. We have about 12 minutes left, so if anyone has additional questions, please put them in the appropriate places. And then just wanted to see. Erika, is there anything else? We talked about mindfulness, fiber, vegetables, we can't get enough of them. Any of the other tips that you have found that's worked for you or the individuals that you've worked with?

Dr Erika La Vella

I think the, the other big one for me, I keep saying filtered water. It depends on where you live and your municipal water supply. But my, I mean, we have really good water here in Oregon, especially in Corvallis, but the, the water is chlorinated and it's chlorinated just enough to actually stop anything from fermenting if I use it.

So I do have a water pitcher on my counter. I also like room temp water. That's just what I like for my body. But I, I do filter all of my water, especially for my own consumption and then also for any fermentation thing that I'm doing. I do make my own sauerkraut at home. I, I, I love that intimacy with these things. In general, yes, eat lots of lots of vegetables, grow your own, be outside, mindfulness. It really is that simple. And if you are having gut problems, you have to go to the basics before you spend all that money on GI testing and fancy meal replacements and gut supplements. You gotta go to the basics. Medicines that you're taking can often interact with the gut microbiome in a way that may not be beneficial. And two come to mind, three come to mind.

The first one being ibuprofen and those related medicines, you will not have a healthy gut barrier if you're taking those. The second one that comes to mind is an antacid. The pH of the stomach is supposed to be acidic so that we can actually halt growth of bacteria in the upper GI tract. You actually don't want bacteria growing there. You want bacteria growing near the colon and in the lower small intestine. And again, this is how we're, how we're, how we're designed and made to function. So if you're taking an antacid, I encourage you to seriously find out why. I am a gut surgeon and if somebody has acid reflux, I like to work them up for a hiatal hernia or some anatomical reason that might be related to that. Oftentimes weight gain can contribute to having acid reflux as well. So by tackling a couple of those things and reducing your need on those medicines, you're going to have a healthier gut.

The third one that comes to mind is hormonal contraceptive pills and the like, mainly because it depletes the body of zinc and zinc is essential for healthy immune function, gut barrier function, and tons of other enzymatic processes in the body. So if you are taking some version of a hormone, it's good to probably just get on a really high quality multivitamin or get your zinc levels checked and make sure that you are getting enough of those nutrients instead of being depleted in them so that you can have healthy gut function.

Stasi Kasianchuk

Okay. Those are good points and something to keep in mind too just for our listeners, Erika is providing her expertise as a physician. But if you are on any of these, please check with your doctor first. She made a good point. Just ask the question why and, and, and get some information.

Especially when it comes to things that might be treating other symptoms to, to manage your health. So recommendations here, but always keep your primary care physician in the loop and ask those questions. We did get some questions here on first one was on your opinion on Metamucil. This person has IBS, low motility and on a restricted diet due to gout and they recently added Metamucil to their daily regimen. It seems to be helping as there's many vegetables they cannot eat.

Do you have thoughts on Metamucil?

Dr. Erika La Vella

Metamucil, it's a fine fiber. It's, it's one very specific type of fiber. So don't rely on it as the means to a healthier gut. Yes, it will bulk your stool and yes, it will help with constipation, but I encourage you to find whatever vegetables you are allowed to safely eat and comfortably eat on your diet and make sure you are eating those at every meal.

Stasi Kasianchuk

All right? Make it making the most of what you can do there. The other question is about a hormonal IUD. Do you know if this has the same effect on the gut microbiome as the oral contraceptives you mentioned?

Dr. Erika La Vella

I can't comment on that. My guess is it would have some effect but I really can't, can't comment on that.

Stasi Kasianchuk

Okay. And then another question here. So do wine and beer count as fermented beverages that contribute to gut health? Where do they fall in the, in the fermentation?

Dr. Erika La Vella

Thank you for asking that. Yeah, so my husband is a wine maker and I'm always trying to give him creative ideas to help him market to my demographic. And I'm always asking him, I'm like, Hey, what are the post biotic metabolites in wine? And we look it up. And to be honest, I think this idea of looking so closely at the microbiology, within not only humans but also within fermentation, like those, those studies, our technology is just now taking off to, to look at those, those things. I don't know. I don't know. I think the balance comes into you know, a little bit is probably beneficial. And there's actually a lot of studies that show, you know, one glass of wine a day is shown to be cardioprotective for women or in two for men. And the reality is, is everybody's different and how our livers function is also directly related to our gut.

And if we're having liver dysfunction and we aren’t able to metabolize or detoxify that alcohol very well, then it's probably not helping you. When I was in medical school and I was having the florid gut issues, I could not have one drink without having muscle pain for three days. So, in that case, alcohol in no way any fermented or not, was never good for me. As soon as I got my gut back on, on, on pace, I could, you know, have those things again and feel, feel great. You know, if you feel fine, I can have one glass of wine and feel fine. If I have more than that then maybe I get a little headache or something like that. But so yeah. So everything in moderation, my guess is in the big scheme of things, the way that humans have traditionally evolved to ferment things to the point of becoming alcohol, there probably is some post biotic chemical messengers left.

But again, most of those yeast kind of die off because of that fermentation process. Alcohol, alcohol kills things.

Stasi Kasianchuk

All right. Well these are really great questions. And thank you so much for your participation. Before we close out here, one final question that came in. You mentioned reading and doing a lot of research on your own. Do you have recommendations for reputable resources that our participants could go to if they want to learn more about the gut microbiome through their own research?

Dr. Erika La Vella

I love Google scholar. You can go Google scholar and search anything you want to and you can become your own scientist. I do. If you, if it's, again, a lot of this information because we live in the world of information, the internet is a very powerful place for you to develop your own sense of the language, your own sense of what are these words mean.

Most, most physicians do not understand gut health to this complexity. They just don't. And I encourage you to have those conversations with them, have those conversations with each other. You know, largely what we're talking about here is just taking care of your body and taking care of your body in a way that sounds, feels good for you. So yes, go to Google scholar, you can type in gut microbiome. There's literally been like, I think the last time I counted, which was over a month and a half ago, 75,000 research papers on human gut microbiome. And reading, well, I haven't read that much, but I've read a few hundred and so look for the ones that have been cited the most. Look for the ones that are the newest and look for good review papers. So a review paper is going to give you a good kind of synopsis start to finish of what all the cumulative research has shown to date and kind of organize it in a way that reads a little bit more like a book.

Stasi Kasianchuk

Okay. Excellent. Good point. One other question that just came through, can you give a few more examples of fermented foods? Is pickling considered fermented?

Dr. Erika La Vella

Pickling can be because make the process of making vinegar is, is, is a a product of fermentation. It depends on where you get your vinegar though. Like I think like white vinegar over the counter…. I don't know if that's still considered a live food. You know, when you buy I think it's Bragg's Apple cider vinegar. It says raw Apple cider vinegar right on the, the front. And you look at it at an almost kind of has that kombucha type type layering effect in it. So I would say if you want to go that route, look for live cultured vinegars. And then also there's another company out there that I like called Pickled Planet and everything that they make is fermented as well.

So yes, pickles can be as well as kombucha. And I think kombucha has a lot of health benefits to it. It's it's a yeast that grows in the, in a product instead of like a bacteria, but that's still all beneficial. It's still considered a probiotic. The kombucha has a decent amount of sugar in it and that's what fuels the fermentation process. If it's a fermented food and it's something like kombucha, you really only need a couple of ounces to get a benefit. So I don't… I discourage my patients, especially my weight loss patients from, you know, drinking 16 ounces of it at a day. You kind of just turn it into a new soda. But you can, you know, buy a bottle, maybe put a splash or two in the water that you're drinking, flavor your water a little bit, but you don't need a drink a whole 16 ounces a day.

Stasi Kasianchuk

And then along those lines, what are your thoughts on kimchi?

Dr Erika La Vella

Absolutely. Kimchi is right up there with sauerkraut. So yeah, and there's lots of different fermented food products out there and the, the commonality is the bacteria come from the environment or live on the food in which they're being fermented and there has to be some sort of carbohydrate source for the bacteria to eat.

Stasi Kasianchuk

Okay. Excellent. So lots of good options out there to look for. And just a way to be able to really make that five star hotel. I'm going to start using that is really the place that every bacteria wants to go. You want it, you want to be that host. Well awesome, this was great, Erika. How can you mentioned that you have a webinar tomorrow. How can our listeners get in touch with you or get your information for after this?

Dr Erika La Vella

Yeah, I'd love that. So I have a website called Lavellayourguts.com and you can find me on Instagram at Lavellayourguts. And I have a Facebook page. I think the name on that is Dr. Conscious Metabolism. But anyway, you can probably come to my website. On my website I have a sign up form for webinar that I'm doing tomorrow and I'm going to try to use the same format and have it go live streaming to Facebook as well. And I'm giving my webinar out for free. I'm doing my four, four hour workshop series called primordial paradigm. And I called it primordial because primordial means since the beginning of time. And that really is sums it up, how how humans and how these bacteria have really co-evolved. And so everything that I do and everything I teach really tries to speak to those just innate connections between human and environment. It's Lavella your guts. G. U. T. S it's a plan: Love your guts.

Stasi Kasianchuk

Awesome. Well got it. And we'll follow up with those resources in the email that we send out with the recording. So everybody that's watching will have that have those links as well. And just a few things. So from a Gennev standpoint if you are interested in working with one of our health coaches, including myself as a health coach please feel free to sign up. I'm a registered dietitian and exercise physiologist and have background in terms of supporting you and supporting your gut health as well as nutrition, exercise and all of those pieces that are a part of creating that host for those that bacteria. And we also do offer telemedicine with our OB GYNs across the country. And right now some of the States some in some States we are also offering primary care to help support you during this COVID 19 crisis, keeping you out of doctor's office and for those of you whose doctors may have been called to the front lines where we have physicians that are able to step up on a telemedicine platform.

So keep that in mind. Two other things for you if you're interested. For our listeners, we are also, I'm working on establishing a women-supporting women community right now and part of our webinar series we're seeing a lot of women who are supporting other women. So Handful Activewear, you can use the code GENNEV and get 20% off of your order on their website if you're interested in that.

Right now we're all in this together and we're going to be in this together. We're all gonna make it through to the other side and eat some kimchi. Eat some vegetables and that will just support it that much, that much more.

All right, well thank you again, Erika. We appreciate your time. I know you have a busy schedule as well. And thank you so much for sharing your information, and those of you that want to learn more, sign up for her webinar tomorrow and take a deeper dive.

Dr. Erika La Vella

Yeah, thank you.

If you're struggling with COVID 19, menopause, isolation, or anything related to the above, please visit the Gennev Community Forums. There are good discussions happening, and you can find answers, support, and camaraderie. We hope to see you there!

 
Join 100,000 other women and take our Menopause Assessment today

Have you taken our Menopause Assessment?

Join over 100,000 women to learn more about your symptoms and where you are in the menopause journey.