Marcus Thorpe 0:14

And we welcome you to the Wellness Conversation, an OhioHealth podcast. You know, when we think about the gut, we often think about digestion, bloating, maybe some heartburn. I think those words really come into play. Food sensitivities, but there's got to be more, and we got to find some solutions that go along with this too. So thanks for joining us. I'm Marcus Thorpe,

 

Katie Lowe 0:33

and I'm Katie Lowe. The truth is, gut health impacts far more than what's happening in your stomach. It plays a role in hormone balance, immune function, mood regulation, inflammation-the list goes on. For women in particular, the gut shifts across life stages, so from puberty to pregnancy to perimenopause, menopause, stress, sleep, antibiotics, diet culture-all of this influences our microbiome, that delicate ecosystem of bacteria living inside us.

 

Marcus Thorpe 1:04

So much going on. So thankfully, we don't have to answer all the questions because I don't have the answers. But somebody that does is Maddie Bidwell, who is joining us as our guest today, wellness consultant with Employer Solutions at OhioHealth, and a registered dietitian. We are so glad you're here because this is a confusing topic. There is a lot going on in the gut that most people really just don't know about. 

 

Marcus Thorpe 1:30

Well, you're going to help us sort things through. Let's just talk in general terms, right? You hear, if you watch any TV commercials, gut health is the thing that you hear about maybe the most of anything. What is gut health?

 

Maddie Bidwell 1:41

Right. So I love this question because it's kind of a unicorn. We throw the word around, but we never dive into it. Our gut. A lot of times we use the word stomach and gut interchangeably, but it's so far beyond that. It's everything from our mouth all the way down through our esophagus, our stomach, our intestines, all the way out, right? That whole canal, that alimentary canal, is our gut. So when we think about the health of it, we're thinking everything from digestion, right? What are we eating? Are we breaking it down properly to get the nutrients we need? But as Katie said, we're also thinking about the microbiome, and this is kind of wild. We're covered in these microbiomes, so we've got one in our mouth, we've got some on our skin, and our biggest microbiome is actually in our large intestine. So it's a collection of like bacteria, fungi, even viruses, which some people might be like, "Oh, that's bad, but you know, when they're all in symbiotic relationship with each other, as in they're getting along well, we get so much benefit from that. And so our gut health is when those are happy, our digestion's happy, and we're really thriving.

 

Katie Lowe 2:59

That's so interesting. To even your first answer, I'm like, wow! I already learned so much already. You know, when I hear gut, I think of really just digestion. Yeah. Let's talk a little bit more about women in particular. Are women affected differently when it comes to gut health than men?

 

Maddie Bidwell 3:16

100. So something that's kind of interesting is that there's research coming out showing that women are more prone to IBS-like symptoms than men, and so IBS, irritable bowel syndrome, right? So a lot of times we're thinking things like bloating, constipation, maybe some stomach discomfort, things like that. And so what we're learning is that it is all really hormonally driven, and so specifically we can look at the reproductive hormones, estrogen, progesterone, and as women we know, right? Those are constantly fluctuating, and what we're seeing is that higher levels of estrogen are actually associated with greater diversity in our gut. So we have upwards of 1000 different bacteria strains in our gut, and so estrogen actually helps kind of proliferate all of those. But the other thing we see with estrogen is that it might also increase some pain signaling in our gut, and so that's why we sometimes see women have more gut pain or discomfort. There might be some correlation there. Progesterone also, right, has its own host of different things that it's doing in the gut. So, at certain points in your cycle where progesterone's higher, like in our luteal phase or during pregnancy, we actually see like gut motility or how quickly everything's moving through slowdown, and so that's where we see more bloating and more constipation. So women are definitely being impacted all month, every month, you know, at different phases with different symptoms because of hormones.

 

Marcus Thorpe 4:58

I would imagine. Understanding the gut and what's going on from day to day, week to week, month to month has got to be a real challenge because we're constantly eating differently, or we have different stressors in our life, or we're taking a supplement that we weren't taking a month ago, and now this is causing an impact. How hard is it to nail down what's truly happening in the gut, or is it more of looking at it like, if you want to have good gut health, you need to have more consistency in what you're doing from a day to day, or putting in your body from a week to week.

 

Maddie Bidwell 5:31

Yeah, I love this question. This is something that I work with a lot of nutrition counseling clients on, and so what we see is if you have pretty healthy a pretty healthy gut. By that, I mean you're not having a bunch of constipation, bloating symptoms. You feel pretty good, energized, right? You're not super fatigued. Then what we're really focused on is just kind of maintenance, which that's the easy piece of okay. Let's focus on foods like fiber, which will kind of be the fuel of our healthy gut bacteria. They break it down into all of these beneficial things like short chain fatty acids, which have anti-inflammatory effects. We're making vitamins from that. Awesome. Focus on sleep, hydration. But when things start to go south, that's where we experiment, and this is where it can get really frustrating for women, especially because it's okay. Well, do I need to cut out inflammatory foods from my diet? Maybe that's I have a lot of high saturated fat, high sugar diet foods, you know, that I'm eating on the day to day. Maybe that's a piece of it. Maybe I've been on antibiotics for a long time, and you know I don't have the diversity in my gut of the different bacterias that I need. Maybe it's I'm not sleeping well, or I have chronic anxiety and stress, so my cortisol levels are through the roof, or my hormones are out of whack, and so I'm constantly telling women we need to advocate for ourselves. We know when something's wrong. We may be told by our doctor, "Well, you're you know you're fine. You seem healthy, but if something's wrong, we we know, and we can get more answers by reaching out to a dietitian. Maybe we're getting blood work done. We're talking with our OB/GYN, right? If you're going through menopause or pregnancy, maybe it's a gastroenterologist, right? Sometimes we just need to reach out to those different resources. But it's experimentation, truly. Like you said, there's so many factors.

 

Marcus Thorpe 7:36

Absolutely.

 

Katie Lowe 7:37

That was going to be my next question. It's just, I mean, there are so many underlying causes that can cause certain symptoms. It's so hard to know what's really going on. Yeah, and so for someone who does think, okay, something's wrong, they don't necessarily have to find that specialist right away. Like going to a registered dietitian, it can start with just bringing those concerns to their primary care doctor.

 

Maddie Bidwell 8:03

100% The way I like to see it is that healthcare is a network, and so we all should, you know, have access to that one provider, whether that's a nurse practitioner or a trusted doctor that we go to for our annual physical. Maybe it's even just a nurse. If you don't have a primary care doctor and you're going to do a yearly biometric screening with your employer, having that one person they can connect you with the people you need, so you don't have to have all the answers. Yeah,

 

Marcus Thorpe 8:35

there's so much science in this. I think about my 90-something-year-old grandma listening to this, going, "Are they speaking Spanish? I don't understand what any of this is. I mean, it, and even for me, like I try to pay attention to what's going on and trends, and it's confusing for me. And and so I could see how there's so much lost in translation from community to community. It's a lot.

 

Katie Lowe 8:56

Yeah, it's a lot. 100%

 

Marcus Thorpe 8:58

Let's talk about stress. We are all under stress, one way or another. Sometimes it's good stress. Sometimes it's not great stress. Talk about gut-brain connection and what we're actually seeing inside of that space from the research you've looked into and how you deal with clients and people on a regular basis.

 

Maddie Bidwell 9:17

Yeah, this is really cool. We could probably spend a week talking about this, but high-level overview: the gut-brain axis. It's also sometimes known as the gut-brain connectome. Basically, what's going on is we have nervous systems all over our body. We've got our central nervous system in our brain and like our spinal cord, but then we also have what's called the enteric nervous system, and it's these neurons in our gut, which is why sometimes when we're stressed, or you know, for example, I was coming on this podcast this morning. I was getting the butterflies in my stomach, right? Because it's some some nerves. The only reason. We can have butterflies in our stomach when we're anxious in our head is because of this pathway, and so what happens is the neurons in our gut are actually making hormones just like you know in our heads, right? So we're making dopamine, we're making serotonin, which is one of our mood regulators, and there's this bidirectional pathway where what's going on in our head impacts our gut, and what's going on in our gut impacts our head, and so especially when we start to talk about stress, anxiety, right? It starts in our head. Our hypothalamus is like something's going on. We need to tell our adrenal glands, you know, produce adrenaline and produce cortisol, our stress hormones, and when those start to build up, we see that they do impact our gut health, right? Because they're going along that pathway between our nervous systems. They're saying, "All right, gut, we need to slow down. We need to put energy towards our heart. We're not going to have quite so much blood flow to our gut. Really, what we're experiencing in our heads is gonna greatly impact what's going on in our gut, and vice versa.

 

Katie Lowe 11:10

It sounds like you know changes to your gut health, whether it's caused by stress or hormones. Those are normal and expected. It happens all the time. So, at what point does it become a red flag or something that you really need to start paying bigger attention to?

 

Maddie Bidwell 11:27

Absolutely. So, in nutrition, one of the fun things that I talk about with people is what is healthy, and so sometimes we get caught up on one piece of being healthy and we miss the whole big picture. So in my mind, healthy looks like my biometric values are in line. So my cholesterol, my blood pressure, my blood sugar. I'm sleeping well. My stress is under control. I'm feeling good in my body. My weight's kind of where I want it, and there's actually a variety of different dimensions of wellness. So we could even talk social connections, finances, you know, spirituality. So much more falls into being healthy. But when you start to notice one of those categories being off, you're like, this something's not right. I haven't necessarily changed anything in my lifestyle, but this thing is bothering me. This thing is coming up again and again. It could be blood work. It could be hormones. It could be just you know I'm gaining weight more quickly than I anticipated, or you know I am experiencing diarrhea or constipation, I don't know what's going on. That's when I start to ask questions and start to reach out because, again, what might be considered minor to someone else might be really important and really big for you. So it's going to look different for everybody, right? So I might have bloating after I eat pasta or popcorn. That's normal for me, right? I'm not really concerned about bloating in that case. But someone who's waking up and they're like, "I am bloated from the time I wake up till I go to bed, and I'm really uncomfortable. That's a whole different story. And so that's when we start to, you know, reach out to our doctor and ask, "What's going on? Let's let's do some more testing here. Figure out what we need to do next.

 

Marcus Thorpe 13:24

Yeah, I think that's a really good way of thinking about it. Is if there's a direct correlation that you know you can figure out on your own. Yeah, that makes sense, right? Yeah. I eat spicy food. It gives me indigestion, right? That's one of the things that some people can correlate. But if it's okay, this is out of the blue, and I don't know why I'm getting indigestion every single day, and it doesn't seem to be my diet. Now I need to start figuring out what it is, and maybe talking to somebody. So I think that's a good way of thinking. It's amazing

 

Katie Lowe 13:49

how often the answer starts with just listening to your body,

 

Marcus Thorpe 13:54

right? Yeah, yeah. And how much we ignore that. I mean, all the time. Like, oh, I'm just gonna. This is a one-off. I'm just going to move on to the next thing, and it's not. It's it's a repetition thing that you just haven't put all the pieces together.

 

Maddie Bidwell 14:06

That's something we talk about in counseling all the time. Of do we need to keep a food journal, and not even just to see okay what am I eating, but how do I feel when I eat it? And the number of people I've worked with who we start to food journal through how they feel after they eat, they're like, "Wow, I never actually realized that when I eat at Culver's or you know whatever restaurant, I don't feel good, and I don't know if that's worth it. You know, we just don't always put all the pieces together.

 

Marcus Thorpe 14:33

It's such a big industry right now too. Everybody's kind of clawing at you and trying to tell you what you need to be doing. How do you look at the commercials and and the advertisements and you know you go on TikTok or Instagram and if you're looking at gut health you're automatically going to be just bombarded with things. How do you look at those kind of things like probiotics and things you should be taking in supplements? How do you keep track of what's real and what you should stay away from?

 

Maddie Bidwell 15:00

I feel really jaded in this because my whole job is deciphering what's good nutrition information from misinformation. So I get very frustrated sometimes when I feel like people are being taken advantage of. So let's break it down really quick for the average listener who is like, gut health. This is new to me. What do I need to know? So, pre and probiotics-these are words that get thrown around all the time. Probiotics, really, all that is-that is the living bacteria that is in our gut. And so, there's probiotic supplements, but probiotic as the word is just the living organism. So, like you said, there's lots of supplements things out there. As a dietitian, I always recommend a food first approach. So, how can we get probiotics from food sources before turning to supplements? Because supplements are not FDA regulated, right? Before they go on the market. They may be recalled once they're on the market, but we don't always necessarily know exactly what we're putting in our body when it comes to supplements. There are safer ones out there, so I do recommend if you're told to take one, look for third-party certified supplements. So that could be a big USP on the label or a big NSF. These are kind of like watchdogs that make sure. Okay, what's in this supplement is actually what's in it. We can guarantee that we've tested it. But if we think a food first approach, this is going to be things like fermented foods, and sometimes in the American diet, we don't do a lot of those, so some ideas could be things like sauerkraut, kimchi. If you've never tried kefir, it's like a fermented yogurt drink, delicious in smoothies, and you can find it pretty much at every grocery store now. Miso, tempeh, so lots of different options out there.

 

Marcus Thorpe 17:00

I like the sauerkraut, but I also want to put it on like three brats, so it's probably not or Reuben, right? You know, probably a bad choice. 

 

Maddie Bidwell 17:07

Adding some benefit, right? And prebiotics too. This is just the food of our probiotics, so we think you're fiber. So in general, right? If we're getting a fiber-rich diet, we get that from things like beans and lentils, fruits and veggies, whole grains, right? That's gonna fuel the healthy gut bacteria that we have. So, I always recommend first and foremost fermented foods and fiber are kind of 2f's. I love four supplements. I think that's

 

Marcus Thorpe 17:34

a great way to think about it.

 

Katie Lowe 17:35

I was just about to say, I think a lot of people, including myself, embarrassingly, sometimes I just think of supplement as good, like you're giving yourself more things. You know what I mean? But it's important to know, you know, this is something you're putting into your body. You may not need it, and there could be some some consequences to that as well. So it's it's important that we do kind of debunk that myth. Let's talk about in terms of probiotics. Are there different strains maybe that women need versus men? This

 

Maddie Bidwell 18:07

is a good question, and so unfortunately, I feel like I don't have a. Here is the list of 100 strains that you should have, right? Because every person's microbiome is totally unique To them, we're actually in. We inherit our microbiome from our mothers when we're born, which is why we sometimes talk about the difference between vaginal versus cesarean section births. Right, the microbiomes in those babies can be different, and then we've been talking about environment, stress. Right, all of those things impact it, and so at the end of the day, when we eat a wide variety of whole foods, we're gonna be getting hundreds, if not 1000s, of different strains of probiotics into our diet. And the goal, which we've been talking about, is that diversity of the bacteria in our gut, and so to say, oh, you need you know this one or this one, is kind of just one little speck in the big picture. Got it. We need 1000s, so that's why that food first approach is really great. You're getting all of them.

 

Marcus Thorpe 19:17

I kind of want to leave folks with on these podcasts, with some take-home, right? Something they can go and say, "Okay, listen to this podcast. It was great. Had tons of information. Now, what do I do? Right. So let's let's share with our listeners and viewers kind of three takeaways, things they can do right now that might make a really big impact when it comes to gut health.

 

Maddie Bidwell 19:41

Absolutely, as a dietitian, I'm going to take the nutrition approach first. But my third one will be kind of holistic. I'm going to say the first things first is increasing our fiber intake. The average American is only getting about half as much fiber as we really need, so like 10 to 12 grams per day. Instead of we should be getting upwards of around 30-ish, right? It's going to be different for men and women, but can we just add an extra serving of beans? Can we switch to a whole wheat pasta or a whole wheat bread? You know, little simple switches like that to bump up our fiber so that we're fueling our gut bacteria. Can we add some fermented foods? That would be my number two. If you don't currently have any kind of fermented foods in your diet, what's one that you could experiment with? Maybe this week. Maybe you're like, well, I've heard of kimchi. I've never used it. I was gonna ask you:

 

Katie Lowe 20:36

Is there one like go-to first fermented food that you would suggest for someone who's just like totally new to that space?

 

Maddie Bidwell 20:45

Greek yogurt. Oh, okay. So Greek yogurt actually has a ton of different probiotics in it, and I feel like it's a pretty palatable option. It's not so sour, right? And you can kind of sweeten it up with some honey or some fresh fruit. So I always like to say, start with some Greek yogurt, and then my last takeaway would be any kind of stress management that we can do. Right, most of us are experiencing some kind of stressors on a day-to-day basis. You know, can we go on a walk? Can we do some breathing exercises? Can we declutter our minds. There's a lot of different strategies to kind of decrease our daily stress, but if we kind of have that chronic low-grade stress all the time, that cortisol builds up, but we can start to lower that right, lower inflammation in our gut. So I think that would be my three takeaways there. I

 

Marcus Thorpe 21:40

love it.

 

Katie Lowe 21:41

I think my my last question would just be any other myth out there that you would like to debunk? Because I know this is a kind of complicated topic that a lot of people don't know that much about.

 

Maddie Bidwell 21:54

Yeah, I think I would wrap a bunch together and say that there is no quick fix for our gut health. So I've seen everything from juice cleanses to apple cider vinegar shots to olive oil lemon shots, all kinds of different things that people are trying to restart their metabolism or reset their gut. But as we've mentioned, there's so many factors that go into it that we just have to do the work on the day-to-day basis of what's the next right step for me. Do I need to take care of my physical health, mental health, you know, my nutrition? So I wouldn't buy into those.

 

Speaker 2 22:39

 

 

Katie Lowe 22:40

that's good to know because I certainly have in the past.

 

Marcus Thorpe 22:43

TikTok over here, she likes to just scroll through different things to try to figure out what's going to work for her. So sure, sure, stay off the TikTok. I will say you've done something pretty incredible, Matty, because I've been Katie's relatively new to this podcast as far as co-hosting it, but I've been doing this for two years on this podcast, and I always kind of know what the topic is going to bring. This is the first time where I am walking away like, oh my gosh, I had no idea about any of this at all. Like I had no clue about true gut health and what it was. Like I've just surface leveled it, but this has been amazing.

 

Katie Lowe 23:18

No, I literally had no idea. I was telling Marcus before this podcast, so I have learned so much. We're so grateful that you've been able to come on here and share all of your expertise. Like we were saying again, gut health can be really overwhelming, and so I think you've given us clarity and some actual actionable steps people can take when it comes to gut health,

 

Marcus Thorpe 23:41

yeah. Thank you so much for joining us. It's been really insightful and really fun too.

 

Maddie Bidwell 23:44

Yeah, thanks for having me. This is fun, and we've just scratched the surface, but I feel like I've been able to just learn too as I've refreshed myself. I love it. There's so much out there. You've

 

Marcus Thorpe 23:55

got so much knowledge, and and we're going to tap into that, I'm sure, for a future episode too. So thanks, Maddie. We appreciate it, and of course, if you're experiencing any digestive symptoms or you just want better understanding about your own health, consult a professional. Like there's so many people out there, like Maddie, that are registered dietitians that know and work in this space. And I'm sure at OhioHealth.com you can find somebody and kind of start that journey for yourself.

 

Katie Lowe 24:19

Yeah, and thanks so much for listening to the wellness conversation. If you found today's episode helpful, be sure to subscribe. And wherever you get your podcasts, you can leave us a review. Those are so helpful. And share this episode with a friend who might benefit from it too.

 

Marcus Thorpe 24:35

And as always, we'll talk to you next time.