110 Feed the Beast Change Biome

Transcript

Dr. Nicole Beurkens

Hello, and welcome to The Better Biome Podcast where we explore the universe within. I'm your host, Dr. Nicole Beurkens, and on today's show, I'm talking with Dr. Marvin Singh about his unique journey into Integrative Gastroenterology and why the gut microbiome has become a focus of his clinical work.

Dr. Marvin Singh is America's premier wellness concierge. He practices as an Integrative Gastroenterologist in San Diego, California, is a diplomat of The American Board of Integrative Medicine, board-certified Internist and Gastroenterologist. Dr. Singh was trained by Dr. Andrew Weil, a pioneer in the field of Integrative Medicine at the University of Arizona Center for Integrative Medicine. Dr. Singh is currently a voluntary Assistant Clinical Professor at UCSD in the Department of Family Medicine and Public Health. Prior to this, he has been a clinical assistant professor at UCLA and an assistant professor of medicine at Johns Hopkins University. Dr. Singh is a member of the American Academy of Anti-Aging Medicine, American College of Lifestyle medicine, and the True Health Initiative among many other societies. He's also actively involved in the American Gastroenterological Association and American Medical Association. He's a co-editor of the Textbook of Integrative Gastroenterology, Second Edition, and has already written several book chapters and articles. He is dedicated to guiding his patients toward optimal wellness every step of the way, in whatever manner they need, and he uses cutting-edge tests and personally designed protocols to develop a truly individualized plan based on genetics, microbiome metabolism and lifestyle. Welcome to the show, Dr. Singh.

Dr. Marvin Singh

Thank you. Wow, what a great introduction. I wasn't even sure that was me you were talking about!

Dr. Nicole Beurkens

And you made me say long words, lots of times, I think we got that right. You and I have had a chance to chat now a few times, prior to recording this. I have to say, I'm really impressed and inspired by the journey that your training and career has taken. You started out trained, as a traditional GI doc, and really, that has evolved over the years and you have come into practicing in this really integrated way. And I would love to start by having you share that journey with our listeners, because I think it's really fascinating.

Dr. Marvin Singh

Yeah, thank you. So yeah, I started very traditionally trained, did my residency and fellowship in Gastroenterology, and when I started practicing after a few years, I kind of felt that something was kind of missing from my own health and from the way that we take care of patients. And I was almost so frustrated that I still remember the day in the kitchen, I think, late in the evening, talking to my wife and saying "Maybe I just wasn't supposed to be a doctor, maybe this just doesn't feel right. I shouldn't even be doing this. I'm a smart guy. I know medicine, I understand the body and how it works. But something's just not working out right." And so she's always been supportive of me from the beginning, and she said "Why don't you start reading about something else, something different? Integrative medicine. I'll even get you the GI book on it." I said "There is a GI book on this? What is this?" So she got me the book, Integrative Gastroenterology, and I was very pessimistic looking at it. And I went to some of the hardest topics: Liver disease, inflammatory bowel disease, and I was starting to look at it. I was reading through the chapters and I was like "They are citing literature here. There's science behind some of this stuff. They are giving good rationale. It seems like it might help." And so I realized that the author of the book, the editor of the book, was one of my former colleagues at Johns Hopkins when I was — The first job I took out of training was assistant professor at Johns Hopkins. And he actually happened to be one of the main guys that ever talked to me there. So it's really funny how the world works. And so I emailed him, it's Gerry Mullin I'm talking about, and I said, "Hey Gerry, tell me a little bit about this integrative medicine and how it works in GI." And he kind of got me really interested in learning more about it. He encouraged me to do Andrew Weil's fellowship, and so that was kind of like a big leap of faith for me. I wasn't sure what to expect or what I was going to get out of it, but I went in kind of just blindly knowing a little bit, but not a whole heck of a lot. And I learned so many different things. I tried different kinds of foods, tried tempeh for the first time, I didn't even know what it was at the time. I learned how to meditate. We learned about hypnosis, we learned about herbs, we learn all different kinds of things. I was doing Qi Gong at sunrise. These are things that I would never have imagined that I would ever be doing.

Dr. Nicole Beurkens

Your wife was probably like, "Who are you?" when you got back, right?

Dr. Marvin Singh

I know! I came back and I felt like it was just a total rejuvenation, it was like somebody blew a breath of fresh air into my body. And I said to my wife, "We are going to start doing some of this in our own life." And so over the period of several months, we just started integrating a lot of these principles into our own life. I started reading and learning a lot more. So when you do a training program, a fellowship, it gives you a lot of information, a lot of overarching principles and concepts. But really, in order to kind of accelerate that, I started reading. And in order for me to get through books really fast —I 'm not like Jim Kwik, maybe he's got to teach me a couple of things, but I started getting audiobooks. So it's 20 minutes to work and 20 minutes back to home, so I just pop in an audio book, and in a week, I could do a book. And so now I've maybe gone through 110-120 books. That's a lot of stuff in addition to what you are already leet learning and reading in the literature. And so you get a lot of different perspectives. I was reading about quantum theory, I started learning about detoxification programs. Every kind of diet book that came out, I started reading, learning, deciding what I liked, what I didn't like, what I thought was real, what I thought was not real, forming my own opinions. And that really kind of got me to learn about my own body, my own health, and I started applying a lot of those principles to my own health. And then over time, I started losing a lot of weight. I did have fatty liver disease, and my liver enzymes were elevated, they normalized, and I just felt much better, more clear-headed. And that, to me, was kind of the impetus. Like this stuff really actually works. It's not just a bunch of people talking about it. In real life, it actually does do something. And then I just said, I've got to start bringing this to my patients, and I totally changed the way that I practice and the way that I think and how I approach things.

Dr. Nicole Beurkens

It's such an incredible journey for yourself. And I love that because I think for us as practitioners, it's important that we are looking at our own health and living the things that we are talking to patients about, right? And so one of the things I really appreciate is that you said "I've got to apply some of this to myself and my family first. Let me see what happens with that. Let me improve my own health and then share that with patients", which I think is ultimately a really powerful thing in working with patients, right?

Dr. Marvin Singh

Right. Yeah. Meditation, for example, is one of the hardest things to talk to people about. They always ask me, kind of almost as a rebuttal, "Do you meditate? Do you do breathwork?" I'm like, "Yes." And then they have nothing to say. As far as weight loss is concerned, I talk to people about meditation when we are talking about weight loss, because I felt in my own self, that all the diet and all the other things, were improving my weight, and then I kind of reached a plateau where nothing else was happening beyond that. And then I started — I was always doing a little bit of the breath work, but I kicked it up a little, kicked it up a notch, and then the weight started coming off again. So I really do believe that the stress levels that we have and how we kind of view life and our environment play a large role in a lot of different things, and stress management is huge as far as weight loss and whole health is concerned.

Dr. Nicole Beurkens

Yeah. And I think you are right that most people don't connect to those things, right? They think about weight as simply being something that's connected to what they are eating and maybe how they are moving their body. And we know that there's so many more pieces to that. I want to delve more into that lifestyle piece, but I want to back up because when you were telling your story, you said you had been practicing for a while in teaching, and you sort of reached this point where you were like, "Is this all there is?", and let's just put some context here: To be board certified in gastroenterology and internal medicine and have done everything — I mean, you had not gone to school for a brief amount of time.

Dr. Marvin Singh

No, I graduated from University of Michigan with residency. [inaudible 0:10:26.1] clinic and gastroenterology fellowship.

Dr. Nicole Beurkens

You had done all the big stuff and been in school a long time and done all that. And yet, you were sort of like, is this what we have to offer patients? So I'm curious, what were the kinds of things that you were seeing patients coming in with that you were feeling frustrated with? Because certainly, there's acute things that your training, I'm sure, was really well-suited to helping you treat, right? But then there's the more chronic things. So I'm curious, what were the types of things that you were feeling just frustrated by, or you didn't have enough tools for in your toolkit?

Dr. Marvin Singh

Yeah, medicine and technology are really good at helping people when they are acutely ill. So you go to the emergency department, you are having a heart attack, they can take all the correct steps so that you don't die. We are really good at that stuff. It's more of a reactive type of medicine. The problem is that we are not proactive enough in medicine and preventing the problems and understanding where those things come from. And then you find that there are unhappy people coming to your office over and over and over again with the same problems. There's abdominal pain or bloating or constipation, or on the other side, diarrhea, heartburn, "I can't eat this, I can't eat that." And in a busy medical practice, where you have 15-20 minutes to see somebody and follow up, nobody has time to really talk through all of those things. And that's actually really bad to say, but that's just the nature of the beast here, at least in this country. That's the reality of how it is. And there's a lot of problems with why that is that way. It has to do with the government and Medicare, and there's a lot more powers than just the doctor, because the doctor actually wants to spend the time, but the doctor can't spend the time, because if the doctor spends two hours talking to you, the doctor is not going to be able to feed his own family at the end of the day. So that's just the nature of the systematic problem. This was becoming very frustrating to me, because I really, genuinely wanted to help these people as much as I could. But in the very short period of time that you have, you really just couldn't figure out how to do it, because you are not giving yourself the chance to do that. And you find that the patients are just being passed, "Oh, I'll go to see this other doctor", see this other doctor, see this other doctor — and they just keep going around and around in a circle. And all it does is build frustration. And so at the end of the day, you kind of have this kind of feeling of "What are we actually doing? Am I actually accomplishing something here or what?", I know if they call me to the hospital and somebody's bleeding to death, I can save their life. But that's only the situation that you get once in a while. Most of the people coming to your office have these other problems.

Dr. Nicole Beurkens

Right. Absolutely. So we are talking about these chronic things, these people coming in appointment after appointment with the same symptom complaints, and wanting to look at a more proactive way or a more root level way, maybe is more of what I want to say there, to address that because those acute sort of techniques, or maybe what we might call "band-aids", like certain prescriptions or things like ,that just don't help long term, right? So one of the things I know that you talk a lot about is inflammation being really one of the root issues that's going on that underlies all these kinds of symptoms. I mean, we might look on the surface and say, well, somebody with chronic diarrhea and somebody with chronic constipation, those are two totally different issues, right? But you talk about this inflammation piece as being important to understand and then to treat. So I would like to have you talk about that.

Dr. Marvin Singh

Yeah, sure. So inflammation drives so many different problems. And the problem is there's two kinds of inflammation, I guess we should talk about: There's an acute inflammation and a chronic inflammation. Acute inflammation, you cut your finger, and you get an inflammatory response there. That's actually good because you want all the white cells and the immune cells to kind of get to that area, clean up the mess and help you heal your finger because you've got a paper cut. It's actually a good analogy with the kind of patient we are talking about. When you have an acute patient in the hospital, you can take care of them. So the body's good at doing that. The problem is that when the inflammation becomes chronic, or as we were talking about in the other example, when the patient becomes chronic or their symptoms become chronic, that's really the problem. And then you have to figure out where that is coming from so that you can address that. And where that is coming from, in the large part, is the gut and the microbiome, which is the trillions of bacteria that live inside of our gastrointestinal tract. 70% of the immune system is located in the gastrointestinal tract. So for someone to say that the gut has nothing to do with inflammation, it's just not accurate. I mean, it's pretty clear now that we know that a vast majority of our immune system is in the gut, and the microbiome modulates or regulates how this reaction happens. So when there's a problem in the microbiome, the inflammatory response is not able to be taken care of the right way, and then you get chronic inflammation. When you get chronic inflammation, then you can get chronic problems. In me, it might be rheumatoid arthritis, in you could be lupus, in somebody else, it could be ulcerative colitis, or in somebody else, it could be Alzheimer's. So the inflammation is the underlying root cause of a lot of these chronic problems, and most Americans have at least some sort of chronic condition.

Dr. Nicole Beurkens

So it sounds like it's a case, then, where really, the immune system sort of gets stuck in this reactive place. You talked about: You cut your finger, you get that acute immune response, it causes it to be inflamed, which is a good thing, it heals up and that inflammation response goes away, good, it's healed. But in these chronic things, it's like that inflammatory response gets stuck, and it just stays turned on. And then that causes a cascade of health problems, right? So I want to delve a bit more into the microbiome piece of that, because I think this is really important for listeners to understand, whether they are dealing with their own health issues, maybe in their children, in other family members, because it seems like on the surface, so many of these conditions can't be related, right? Like you just mentioned: Rheumatoid arthritis, lupus, Crohn's, all these different things, and you go, "Well, but I've been sent to 14 different specialists, each of whom looks at one of those pieces", and really, what you are saying is, no, actually, there's common underpinnings, and it has to do with the health of the gut, and specifically the gut microbiome. So what are some things that you think are important for people to know about how the gut microbiome influences that, and maybe things like what we are doing in terms of our diet and lifestyle and those kinds of things that are impacting the health of that microbiome?

Dr. Marvin Singh

Yeah, exactly. So if you think about chronic inflammation, or a chronic imbalance in the gut microbiome, you want to also think about what are things that are chronically causing or driving that problem? And it's not just one answer, it's usually never one answer. I mean somebody could say, "Well, I eat really healthy, organic vegetables and I exercise every day." Well, you are also drinking three drinks a night, and you are sleeping four hours a day, and you are anxious and yelling at everybody at work. So there's a problem there, and that's driving your inflammation. Inflammation isn't that simple.

Dr. Nicole Beurkens

But we love the idea that it could just be one thing, right? "Just give me the pill or the diet or tell me the thing that I need to do to fix this." But it's multisystemic, right? There's multiple pieces.

Dr. Marvin Singh

That pill for your ill concept that we have. So there's a lot of things that go into driving inflammation. And there's a lot of great literature showing how all of these elements, whether it's diet, exercise, sleep, toxin avoidance — and we can talk a little bit more about toxins because that's a large topic there. Stress Reduction, and even social interconnectedness, all of these things actually influence the composition of the gut, which is also a risk factor for inflammation because the gut composition is a risk factor for inflammation. We even know that, talking about something unusual, is social interconnectedness. So they have even done studies where they looked at the microbiomes of people that live in neighborhoods that have low social cohesion, and eliminated other things like diet and things like that, that could influence the microbiome. And they found that when you are in a neighborhood where there's low social cohesion, which means that you can't really trust people, your neighbors aren't talking to each other. It's not that friendly, Leave It To Beaver type of community, that their microbiomes were less diverse. We are very social organisms, and we are built to adapt in a lot of different ways. But I guess our inner nature really thrives on love and compassion. I talked about that at the conference. And the microbiome is sensitive to that. It's almost like a toxin if you don't have that feeling. And that doesn't mean you need to have 100 friends. I think studies show that all you really need is one person. One person that you can trust, whether it's a teacher, a mentor, or a spouse, or a friend, or a sibling, or a parent, just one person.

Dr. Nicole Beurkens

We are really wired for connectedness. I love this, because I'm thinking about this, we talk all the time on this show about this community of microorganisms that live in and on and around us, and that idea of community and what you are talking about in terms of social connectedness and social emotional community, and how that impacts even the community of microorganisms in us, I mean, it's just really profound the interconnectedness of all of this.

Dr. Marvin Singh

Those microorganisms release dopamine and GABA. There's actually a microorganism called Lactobacillus reuteri that can actually increase plasma levels of oxytocin. That's the love hormone that we talk about. Oxytocin is a very complex molecule, actually, but one of the things we often associate it with is love and bonding. So isn't that kind of crazy, fascinating, that this bacteria actually releases oxytocin into your bloodstream? And so that really kind of drives home the point that the microbiome is associated with every function. And when Hippocrates said, "All disease begins in the gut." This is like many, many, many years ago. He was the OG of the microbiome and probably didn't even know what he was talking about exactly, but he just had a gut feeling or an instinct.

Dr. Nicole Beurkens

He knew, even then. So you have talked about a lot of things that impact our health in general, but specifically the health of the microbiome, so you mentioned food, stress, sleep, those kinds of things. Let's delve into that a bit. What are some of the things that you find in practice, a patient comes in, they are having these kinds of chronic symptom complaints, what are some of the top things you see that people are doing that really is negatively impacting that gut microbiome and sort of driving this systemic inflammation?

Dr. Marvin Singh

By far, I think probably one of the worst things is stress. I mean, people understand diet. Everyone understands, "Yeah, I ate the donut. I know it was bad. I shouldn't have done that. But I liked it. But I know I shouldn't", people can relate to that, people can relate to exercise. I think stress is really not given enough credit in the real world. Stress really is like one of the worst toxins. Stress decreases the motility of the gastrointestinal tract. So the gut is sensing that something bad is happening, even if something bad is not happening. We have stress response built into us for a reason, and that's so that we can escape the tiger running after us so that we can survive. But when there is no tiger, and we put our mindset in the place where it's like the tiger is always in the room and looking at me, and could jump at me at any time, but there's no tiger, there never was a tiger. But your brain and your nervous system isn't that smart really, to understand that there actually is no tiger. So you are in this fight or flight stage chronically. And it's that same theme of chronic exposure. It's one thing to have the fire alarm go off, and we all run out because we think there's a fire, and there is a fire, and we saved ourselves, that was good. We needed that. But when the fire alarm never stops — just imagine if you were in your house and the fire alarm just never stopped. You kind of go crazy, right? So your body's going crazy. That's what's happening. The fire alarm doesn't turn off. And as a result, your body has all these mechanisms built in for survival, because the human body wants to survive. The human body doesn't want to just die if anything happens. And so it'll adapt, and it'll do things that are actually maladaptive to you, that you actually don't want to happen to you, but it doesn't know. It thinks that that's what you need, that's what's better for you. And so then you get into this chronics stage, where you are just kind of stuck. The motility doesn't happen as well. You get constipated, you get bloated, you get nauseous. Now you say "I can't eat this food or that food", you think you have a food sensitivity. And you may have a food sensitivity, you may be eating the wrong kinds of foods, but the underlying, underpinning issue in a lot of times could be stress. There's some very interesting research that is actually in a chapter in our book, The integrative gastroenterology Second Edition book, where we talk about how food and eating is a multidimensional experience for the body. When you eat, it's not just like, oh, you put the food in, you chew it, it goes down, no big deal. It's a multi dimensional experience. So that means that the smells that are occurring in the room, the tastes, even if there's wind blowing on your face, all these little cues, the visual of it, the mood you are in when the food is put on the table, all of these things are packaged in a little bundle in your brain. You haven't even eaten the food yet. And then you eat the food, and whatever reactions occur in your body, what chemicals and hormones and neurotransmitters are released as a result, they get bundled with this memory package. And so later on in life, I think that's where the comfort foods idea comes from. So I gave an example one time to somebody: Say you get hurt, say you have your first relationship in high school, just make it up, and you are feeling upset, you are really sad, you are emotional. And you see a chocolate bar there. You go eat the chocolate bar. Chocolate bar doesn't make you feel better forever, but makes you feel better just for that period of time. You feel some relaxation. All that dopamine just got released. And so your brain says, "Oh, you were feeling bad. Now you are feeling good. This is what happened to make that happen. Boom, let's store that as a program, I downloaded that app." And so later on in life, in college, say you get engaged, and then you break up with your fiancé, then the brain says, "Oh, you are sad, you want to feel good, I remember that app, let's open it", boom, and you are walking in the in the CVS to get something else, you see the chocolate bar, you eat it. So this can really affect food eating behaviors. So that's actually how complex — you would never imagine that. You are not thinking, "Oh, this app opened in my head and this is why I want this chocolate bar", you are thinking "I don't know, there's a chocolate bar, I'm in a bad mood, let me just eat it", but the body actually made you do that. And so part of understanding how to eat better and how to eat for better health, is to understand the process that this thing can exist ,appreciate it that this is how the body is designed, and then learn techniques to try to intervene. So you say, "Oh, that app is opening, I don't need that app. That's from a long time ago", delete, and boom, it's gone. But it's not that easy. This is where the work is, right? But if you don't have the awareness or you don't believe that this could actually be a possibility, you will never get to the option where you can delete that app.

Dr. Nicole Beurkens

So powerful. You talk about the stress and the tiger, which for most of us isn't actually a real tiger. But what is the Tiger of today? It's overscheduled, busy, busy, busy, relationships that aren't working in our lives that we are not dealing with, all of these things that does is create a really toxic level of stress. And I'm even thinking as you are talking about the amazing process of all the things that go into eating and digestion, it's not just food goes in and goes down, right? I'm thinking how do most people eat today? They are eating standing up, grabbing things as they go, going through a drive-thru, eating in the car. I even think about kids that I work with, who are growing up in the back of the car, just eating processed things as they can, rushing, soccer, quick, eat some fries and a cheeseburger or whatever. So it's not just about the food itself, it's about the whole process around that. And it just strikes me as I'm listening to you talk, how stressful even the process of eating is. So we can talk to patients about the need to eat better, but it's not just about what we are having them eat, right? It's about this whole piece of how they are eating. And it strikes me too, that sometimes in the world of integrative health or just health care in general, we maybe create more stress for people by telling them all the things they are supposed to do, but not walking them through that in a way that really helps them feel empowered to do it. So they leave an office with something like, "Oh my gosh, here's 17 things I have to do." And we just take their stress and push it way up. And then they might start doing some of those things, but not really getting better. So it's probably the case that we have to walk people through a sequence of this and make it manageable, right?

Dr. Marvin Singh

So this is really one of the main concepts that I talk to people about. I will often tell them about all the different things, but I'll say "Don't worry about this whole section, we are going to push this to the side, we are acknowledging that this is what we are going to talk about later. But right now, your priority may be in this. And so let's focus on this one topic." And even in that one topic, we will go one step at a time. So you can't tell somebody, even me, even you, if I told you, "You need to do these 10 things for your life", you are not going to be able to do it. And so the whole concept of lifestyle medicine is that it's for your life, not for five minutes from now, or for 30 days and then you can go back to how you were. You want these things, these concepts to be sustainable. That's the missing piece in a lot of the delivery of the information. And so if that means that, I have to say, "Make one change a week", I'm good with that. Because if you make 52 changes in a year, man, you are going to be so much better than most other people. And one change a week could be, "I'm going to eat blueberries today." Or "Instead of putting two sugars in my coffee, I'm going to go with one sugar. And then next time, I'll try no sugar." And so it's one step at a time. And what the fascinating thing is, is that what I found in my own life, when I did this to myself, is that we say one thing a week, and you start with that. But what happens is that when you start noticing that these one things are cumulatively helping you, you start feeling better. And then the one thing becomes five things, becomes six things a week, and then you find out "I've made all these changes", your goal was 52 changes, maybe you made 150 changes in a year. And so just like health can snowball out of control, health can snowball into control. And that's one of my famous things that I tell people about.

Dr. Nicole Beurkens

Yeah, well, that's powerful. Because sometimes people say "Doctor, if I just do one thing, I'm going to be seeing you 10 years from now and still not better." But that's an important thing for them to understand: You start where you can. Do something, and I find, too, as a clinician that it does, it snowballs from there, but it has to be manageable for people, because otherwise I think we just create more stress, and they just stay sick because they can't do all the things we are asking them to do. Then they feel guilty and all of that. So I would love to have you share a couple of things that you think are great starting points for people, whether we are talking about food or stress, I mean, you said that the stress piece is such a big piece. What are some things that you often find yourself recommending to people, that are great starting points?

Dr. Marvin Singh

So food, obviously. Food is a funny and complex thing when you are talking to somebody about diet. And so I don't necessarily tell people that you have to go from the way that you are eating now, and completely flip it on its head. So if somebody is really hard-pressed on "In the morning, you are supposed to eat cereal. I have to have cereal for breakfast. That's how I've been eating for 50 years" I say, "Okay, fine. Instead of that cereal that you are eating that's highly processed. Can you maybe think about organic steel cut oatmeal instead?" So you make little changes like that. You are not changing their entire paradigm, but you are making a step in the direction of progress, like a swap. Then next time, you can say, "Okay, you want to throw some walnuts on there and a little bit of flax? Maybe some blueberries instead of syrup or honey?" and so then you are shifting how they go. And once they start seeing the benefits in that, then they'll be more motivated as well. Just kind of helping them understand how they can make a change. One of the biggest complaints that people have is eating healthy is hard, because they have to prepare all the food, and who has time for that? That is a very real concern. And it's a concern that I myself and my family experienced when we started to make the change, because I may want to eat a salad every day for lunch, but who has time to make a salad at lunch? And so what you do for example is you tell them, go grocery shopping on Saturday, okay? It takes like an hour or so to go grocery shopping. Get all the stuff, and that's it. On Sunday, you spend another hour or two. Maybe you have to invest in some Pyrex or something if you don't have that. And what we did was — This is almost like a factory. So I had all the Pyrex lined up on the counter table, I had all the knives and the cutting board and the mandolin, make sure you have gloves on so you don't your finger off, I came pretty close a couple of times, and it's all ready to go. You just come in, you wash, you dry, and you chop, chop, chop. It is time consuming, but spending a couple of hours on one day — if you tried to make a salad every day, I mean, it might take you 20 or 30 minutes to make the salad. And then you are annoyed, and then it's like it took up all this time. So you do all this, you chop it up, you prepare. Even if you want to cook protein like fish, or chicken or whatever, you can cook it in big batches. Do it all at one time, put it in your fridge, make your fridge look like it's just completely filled with glass, it actually looks kind of cool, And so then when you want to go to work, the salad's already made for you. You just grab it, put it in a bag, and you go. And if you are going to prepare a meal for dinner, for example, you can really quickly increase the number of vegetables you are eating in each meal if it's already prepped. The food prep is actually the hard part. If the asparagus is already ready to go, if the Brussels sprouts are, are cleaned up and ready to go, the broccoli and the cauliflower is ready to go, it's already sitting there. All you've got to do is just boom, boom, boom, throw it in the different pans or put it in the oven, and you are done. And now in one hour plus food prep, it's like 20-30 minutes for the food to cook. And so you can rapidly increase the amount of good foods that you get that way. So that's, I think, one of the biggest things people have a hard time wrapping their heads around how they can actually implement it. So helping someone understand that there is an easier way to do that makes a lot of difference actually.

Dr. Nicole Beurkens

For sure, making it easier for yourself and your family to make those healthy choices by doing some work up front. And I was thinking, I often recommend to parents: Get your kids involved with that if they are old enough, right? All my kids, they all know how to cook, they know how to prep, we get home from the grocery store, and they go to work with it.

Dr. Marvin Singh

Make them do and make them feel — Do you know the smell of organic broccoli or organic kale, when you are first cutting it fresh from the store? It is just awesome. What you are actually doing, I think, is actually developing that bond with the food. The food now becomes more like a necessity, you are looking at it as medicine for your body, and that this is actually something that I'm doing for myself. And when you eat the food, you have a greater appreciation for it because you took the time preparing it, and the kids are much more tuned into it than the adults, too. And so what I would do is actually, we would pick one food, and I would have a couple of talking points. Kids' attention isn't that long. I would be like, "Okay."So we do what we call a food lesson. After it's chopped up, I would have the food right there in front of me, in front of us. We sit at the table and I say "Broccoli has sulforaphane. This is what that does. These are the vitamins in broccoli. These are the minerals in broccoli. And just imagine that you wouldn't need to have a vitamin if you could eat the broccoli, because the broccoli is like the vitamin." And what was fascinating in my kids is — they love broccoli, so broccoli was a bad example for my own kids, but when we when we use foods that they didn't ordinarily like, or that that they were like, "I don't know what that is", like dragon fruit, for example. You tell them about that, and that absolute first reaction is "Okay, let's try it."

Dr. Nicole Beurkens

That's right. The exposure is so powerful for helping expand kids' comfortability and expanding their palates with that. It's so important, and this kind of brings us back to that social connectedness and community piece too, that here we are talking about prepping food and cooking as incorporating an element of social connectedness too, whether we are doing that with our partner, our kids, a friend, whatever, it's like, you can kind of hit a lot of these even just in the same kind of routine.

Dr. Marvin Singh

That's a lot of what they do in the Blue Zones: Collecting the food, cooking the food, eating the food together. I mean, these are three lifestyle modifications we just talked about right there. It's all happening for the same process.

Dr. Nicole Beurkens

Right. It can be simple things. I think that's just such a powerful concept, and I love that somebody as credentialed as you is talking about that, because we people say, "Oh, I've been struggling with these things for 30 years. You can't tell me that something as simple as doing some meal prep or spending some time with friends is going to make a difference in that", but you are saying yes, these simple things are really powerful.

Dr. Marvin Singh

They are at the root, they are the foundation of making any other interventions. You've got to work on that first. Why? Because these things modulate the impacts of the microbiome and what the microbiome is doing. It also affects gene expression at the same time. Elizabeth Blackburn is the Nobel Prize winning scientist who discovered telomeres and telomerase. I was really anxious to get her book The Telomere Effect, because I wanted to know: What is she saying about how we live long, and how to make the telomeres longer? What's the special sauce? What's the thing that I don't know about? And the book is great, it's a great book, everyone should read it. But exactly the same things that she's talking about for Gene health, DNA health, increasing telomerase and telomere length are the exact same things that we know about that are important for making a better microbiome, the exact same things. And that's how cool the body is, that these same simple concepts can actually impact your gene health, and can impact your microbial health. And we even have published literature. There was an article I came across recently that outlined that if you did four or more lifestyle interventions, just four, that you are all-cause mortality is reduced by 66% 66%! That means death by any cause.

Dr. Nicole Beurkens

Wow. So we often hear about, when it comes to the microbiome, or health or things in general, like all of the nitty gritty of all these complicated things, this diet and that diet, and this probiotic or that one, or these supplements, or all these fancy treatments, and what you are saying is, yeah, for some people, some of those things are going to be important, but this is where we need to start with these fundamentals, and we cannot overlook them.

Dr. Marvin Singh

You cannot probiotic yourself out of a McDonald's diet. You just can't do it.

Dr. Nicole Beurkens

That's going to be the quote for this episode right there. I love that. I love that, "You cannot probiotic yourself out of the McDonald's diet. That's perfect.

Dr. Marvin Singh

People will come and they are like, "I'm on all these supplements to heal my gut, but I still have these problems." I'm like, "Well, you checked on your social history that you drink three drinks per day, is that correct? And looks like you take Advil every day because you have a hangover from the drinking. So people have this skewed view of what it really means to heal your gut. Yes, all those supplements may be beneficial and may be helpful, but you can't be pouring the poison on top of the treatment otherwise, it's not going to balance out the right way.

Dr. Nicole Beurkens

Yeah, you can't get away with ignoring some of these really foundational pieces, as far as stress and lifestyle and that kind of thing.

Dr. Marvin Singh

You may not even need half the supplements if you focused on that foundation.

Dr. Nicole Beurkens

That's right. So what do you say to people who are listening who are like "I have a gastroenterologist, I have all these specialists, I have all these people that I see, and nobody's talking about these things. Nobody's helping me with these things." What do you say to them about where they might be able to get some support in these areas? Or do you have certain things that you recommend that they read or certain things that they start with? Because there's probably a lot of people listening who are like, my GI doctor doesn't talk to me about this.

Dr. Marvin Singh

Well, you can come see me in San Diego, or outside of that, I think it is very important to actually find somebody that you can identify with, that you can work with. Like we were saying sometimes all it takes is to have one trusted friend, the practitioner-patient relationship is really important. It improves compliance, and improves outcomes in a large variety of circumstances. There's actually a lot of published literature on the nature of the patient-physician relationship and the success of any treatment. And so it's very important to try to find somebody you can identify with. There are some resources where people can go to find practitioners that are like-minded. The University of Arizona, The Andrew Weil Center for Integrative Medicine, where I did my fellowship has a psycho-portal, or a search thing on the website that you can go to and you can say where you live, and you can look and see who's in the area and then you can look up what their background is and kind of get an idea if you might identify with them. IFM also has the same thing. And so these big organizations have these mechanisms where people can seek out like-minded practitioners, so that's one of the most important things because if you are already at a failure before you even start anything, then you are going to have a harder time getting going.

Dr. Nicole Beurkens

Yeah, I love that. Finding somebody that in whatever field or specific profession they are in who can hear you and you can identify with and feel that connection with is really foundational.

Dr. Marvin Singh

And ask. Don't feel bad to ask, because you are not going to offend somebody if you are asking "Well, do somebody that can help with such a such thing?" Because the beauty of actually linking in with somebody, like for me for example, I am an integrative trained gastroenterologist. I won't say that I'm like the world's expert on psychiatric disease or hormone imbalance or any other subspecialties. I may know a lot about these things, and we will talk about these things. But I know the people that are. And so what happens is when you start, when you get into a relationship with a practitioner that is like minded as you, the referrals you start getting to other people to help you are also like minded. And so now you find yourself in a nice circle of people that you can trust more. That's what happens in the real world within conventional medicine. "Oh, I know this cardiologist, I know this endocrinologist, I'll refer you to him. He's a good guy. He's a good guy." That happens on the other side as well.

Dr. Nicole Beurkens

So kind of creating a supportive community around yourself of providers who can listen and all be on the same page with the direction you want to move in.

Dr. Marvin Singh

Yeah, because a lot of complaints are that they go to see an integrative practitioner who tells them — PPIs are a classic example, that you shouldn't be on PPI. And they go to see another doctor, and they put them on a PPI,

Dr. Nicole Beurkens

Talk about creating stress for the patient, right? I feel like we could just talk all day about so much of this. In the interest of your time and our listeners' time, we will wrap up here, but I would like to ask one final question. For our listeners, what would be one simple starting point? Something that you would recommend to people that they could start thinking about or doing even right now or tomorrow, that you think would make a powerful difference in their health and in their microbiome? What would you say?

Dr. Marvin Singh

That's a very good question, a complicated question. One way to kind of focus, I think a good example is one of the first exercises I do with people when they come see me for my wellness program, I ask them, and I won't pretend like this is my idea, because Dan Buettner is really good at writing his books, and this came from the Blue Zones of Happiness. So what I do is I have a handout paper, and it says the three P's on it: Pleasure, purpose, and pride. And so I actually make them answer all three of those questions. What brings you pleasure in life? What makes you get out of bed? What makes the fire in your belly burn? And what are you proud of in life? Like what accomplishments make you feel good about yourself? And then after they answer those questions, even if it's one word, or one concept in each one of those answers, then I frame it and say "This pleasure, purpose and pride, these three P's, there's a reason why it's described as a three piece of happiness. It's because these are the three things that make up who you are, your inner being, what you are made up of, where you really come from. And a lot of the time, I say most of the time, we forget that. You forget who you are. I challenge you to write down your three P's, and see if you think about those three P's every day, when you wake up, while you are doing your regular routine, and when you go to sleep, are those three P's always on your mind? I bet most of the time, the answer is going to be no. And so I tell them to keep that paper and put it on their mirror in the morning and remind themselves of the three P's. And whenever they feel like they are lost, or they are stressed out, remind yourself of the three P's because that is who makes you. And that is what your world revolves around. And oftentimes, I would say eight or nine times out of ten, the answer is family, believe it or not. But what is the one thing that we do when we are so busy and stressed out? We neglect the family, and we don't pay attention to the kids, we don't talk to our spouse, we don't talk to our friends. We are too busy. I'm too busy. And that goes back to social interconnectedness. And so if you remind yourself that, really, "I am doing this for my family, my family makes me proud. The reason why I get up and go to work every day is so that I can provide for my family," then you remember that the family in this example is the center of your life. And that reminds you what your priorities are. And then all the other decisions you make in life, in business, in health and in finances, everything gets re-centered around that main purpose.

Dr. Nicole Beurkens

Such a practical and powerful thing that listeners can do even right now. I encourage you, if you are listening, you just heard Dr. Singh talk about that. Get out a piece of paper. Write that down, start with your three P's and really make that a grounding resource going forward. Such amazing information. Thank you so much for being here today. Really enjoyed the talk with you.

Dr. Marvin Singh

Thanks for having me, I appreciate it.

Dr. Nicole Beurkens

And thanks to all of you for joining us for today's episode of The Better Biome Podcast. Tune in next week to continue with us as we journey through the universe within.

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Source: https://betterbiome.com/blogs/podcasts/episode-14

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