The Unseen Links Between Mental Health, IBS and Your Gut

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You can sign up for your $1 a month trial today at Shopify.com/achiever. Shopify.com/achiever. And you can hear your sales go. What if you could improve your mental health by improving your gut health? I'm more errands melee and this is the anxious achiever. The show that looks at the intersection of mental health, leadership and work and how we can do them all better. Physical ailments are absolutely linked to our mental health. We all know this. But there's one trend in particular. I feel like I've been noticing anecdotally. Not something we've talked about on the show before, but it's the idea that a whole lot of high achievers out there, people I talk to every day, seem to not just have anxiety, but also digestive issues, especially irritable bowel syndrome or IBS. Saturday night live in its 50th anniversary extravaganza even went so far as to make a video about the fact that, as they say, all performers on SNL comedy legends that are household names, have anxiety and IBS. According to the American College of Gastroenterology, 10 to 15% of Americans might suffer from IBS. And our guest today says that number is really probably much higher. Dr. Will Bulsowitz is a gastroenterologist and gut health expert and he is the founder of 38 Terra. And he's here to shed light on all the ways we haven't realized that our gut and our mental health are connected. This, y'all, it's a workplace issue. It's a leadership issue. It's an issue that especially if you're in charge of people or if you're in HR and in charge of people's well-being, should be on your radar. And it might be already because it's really common. Enjoy my conversation with Dr. Will. Can you just share at a very high level how gut health and mental health and stress are all associated? I would go so far as to say that throughout my career, my greatest moments as a medical doctor have not been changing a person's diet, getting them to consume more fiber. In fact, I would actually argue that my greatest moments as a doctor have been when I've brought a person's attention to this space because the opportunity for healing is intensely powerful. And in my mind, the visual that I have for what this looks like is I've had many people throughout my career that they would come to me perhaps after one of my books came out and said, like I've done everything that you're saying. I follow the meal plan. I'm exercising, I'm sleeping, I'm doing all this stuff and I'm not getting better. And that person to me is like a rocket that's trying to take off, but it's changed to the ground. And if you can break that chain, it's unbelievable to see what happened. And I think that many of us, myself included, deal with things that are on this issue on some level and it's different for different people. But to answer your question as sort of an introductory explanation, what we're really talking about here is the gut brain connection. And the realization that yes, we may study science as realms of specialization, but that's not the way that the body works. And in the body, everything is interconnected. And there's the realization that the things that are happening in our gut for reasons that I'm more than happy to explain it on pack are impacting what's happening in your brain, which includes your mood and your cognitive function, meaning like your ability to perform complex neurologic tasks during the day, your endurance. But let's just pause on that for a sec because I think that's huge. So you're not only saying it's affecting your mood, your emotional health, it's actually affecting your performance, your cognitive abilities. 100% and the people that you're describing, let's put aside for the moment, the idea of some sort of diagnosable illness. And let's just talk about high performers, which is that if you want your brain to perform at optimal function, which means smart, fast, have a great memory, being able to perform multiple different tasks and to sustain that with endurance during the course of a stressful day, you absolutely need to get your gut health into alignment as much as possible because of the ways in which the gut is influencing those different processes. So they may be separate, but they are talking to each other literally right now. And the things that are happening in your gut are affecting what's happening in your brain and the things that are happening in your brain are affecting what's happening in your gut. To really dumb this down for me, when I'm having IBS when things just aren't working, what is my gut trying to tell my brain? Alright, so let's zoom in on IBS as an example. It's a fascinating, it's a fascinating condition because it's a syndrome, which basically means to this day more than 40 years since we started to see this pattern emerging. We don't have a diagnostic test. Like there's no blood work, there's no CAT scan. No, I've been through it myself. Right. I had a colonoscopy though. I think that was for my insurance company mostly. Well, it's not to say that you shouldn't do colonoscopy. You need to make sure that it's not an alternative thing because there can be alternative things that can be accurate. And actually PSA, I had polyps that were very nasty and my doctor said if you hadn't gotten these out now, you would have had colon cancer at 50. So I'm glad I did. Yeah, that's a separate conversation, but you've just exemplified why I'm a big believer in cancer screening and including colonoscopy as a part of that. So we have this like basically pattern of symptoms. This is how we make the diagnosis determined by what's called the Rome criteria, Rome ROME. And the backstory to the Rome criteria is actually this is my mentor at the University of North Carolina, who's the founder of the Rome Foundation to this day. And they have, I think they're on their fourth version of the book to bring people up to date on how to make the diagnosis of multiple different digestive health conditions, including your role-ball syndrome. But basically if we're to simplify it, IBS is this. You have to have abdominal discomfort and you have to have a change in your bowel habits. So it's not just discomfort, it's not just pain. It's also that you're somewhere in the spectrum of diarrhea, constipation, or back and forth. And classically, people that have IBS, their discomfort is remedied by pooping. They feel better when they go. All right, so this is the classic pattern. And again, different things can masquerade as this. So you need to rule out, you know, celiac disease and inflammatory bowel disease and all these different things. But at the end of the day, this is what's going on. Okay, so what's actually happening in the body? Well, it's taken us a long time to get to this. And part of what's happening here involves the microbiome. The microbiome is struggling. And if you were to look under the hood, every single person, you would have to look at the person that has your role bowel syndrome has a damaged gut, which we would call dysbiosis. That's the language that we would use. In part, the microbiome, when it's struggling, that affects our health because the microbes produce chemicals that affect our gut barrier, our immune system, the motility of our intestines, like how our intestines move and process and digest our food, and affect nerves. We have this thing that people refer to as the second brain. By the way, I would argue it's the first brain. We can talk about that if you want to, but we also call this the interrac nervous system. The second brain or the interrac nervous system. This is the nerves that are involved with your intestines, which are something on the order of 20 to 25 feet long, and there's 500 million nerves. By the way, 500 million is actually five times what you would find in your spinal cord. Your brain has more nerves, but that's the only organ in the body that has more nerves than your gut. These 500 million nerves are constantly feeling and sensing, and the job of a nerve is to receive information and transmit. It's receiving information from deep inside of you, and the problem is that they can become dysfunctional like any other organ in the body. When it's dysfunctional, you develop something that we would describe as hypersensitivity, which means that things that should not trigger you to feel pain, it will trigger you to feel pain. Then information gets relayed up to the brain and then you say, "I got to go." I got to go. In essence, here's the package of symptoms. Disfunctional gut microbiome, which is affecting gut motility because gut motility is affected. Now we have either diarrhea, constipation, or both. And simultaneously, you have developed what we call visceral hypersensitivity, which means 500 million nerves are not functioning the way that they're supposed to, and you're feeling things that make you feel unwell. That's a real thing, by the way, I'm not in any way trying to make it sound like the body is making this up. It's not. It's just that the brain and the nerves are not functioning the way they're supposed to, so you're hypersensitive. In short, this is actually the underpinning. I just basically gave you the class on what every gastroenterologist in America should know about the way in which we manifest this condition that we don't have a diagnostic test for. Why? Because you can't have a diagnostic for 500 million nerves and you can't have a diagnostic for gut motility and you can't have a diagnostic for the gut microbiome that's reliable enough. So this is the issue, but then it affects the brain because we can get into all of this, but it affects the brain through a number of channels because these things are not functioning the way they're supposed to. I got my copy of the health beat from Harvard Medical School yesterday a few days ago, and it said, "There's emerging evidence that psychosocial factors may alter the types of bacteria that live in your gut which can contribute to chronic inflammation." And I'm assuming a lot of these features. So they're saying that your psychosocial life might actually affect your bacteria? A hundred percent. There's no doubt about this in my mind. But the science emerges and over time catches up with observations that every single one of us has already seen with our own eyes, which is that we need each other. And there's a word that I'm a bit attached to. And that is connection because as humans, you have to understand where we came from, that we can't change. It's hardwired into us. We came from a tribe, and that tribe offered us protection and survival. So we became very attached to having that tribe. And the measure of wealth, if we were to go back 10,000 years, was not money in your bank account. It was the size of your family and the size of your tribe and the number of connections that you had. And you can't knock that out of us as much as society changes and culture changes. We may want to knock it out of us. We can't. And so we may become fixated on new things like the size of our bank account or our home or our car and these types of things. And that does not actually foster connection and make you feel safer and supported and comfortable. I would also argue that there's cultural aspects that we have embraced such as individualism. Right? It's not just money. It's also individualism to say that I was raised with the belief and I would not say this was necessarily the belief of my parents trying to instill this on me. I would say that this was the culture that I was raised in. And I assume you were a high performer. You were good at school, all those things. Yeah, I'm the type of that you described and I can't change that. That's who I am. But I was raised within a culture that says that success is not just the bank account. Success is that you have separated from your parents and are independent and own a home. And within that home, you are separate. And if you are truly successful, then that home is so big that everyone has their own room. And I think I would imagine that the listeners can relate to what I'm describing and everything that I've just described if you actually think about it is pulling you away from human connection. Right? We should be multi-generational. We should be sharing tight spaces. We should not view ourselves as succeeding or failing based upon independence because actually the opposite is true that again, success is defined by your connections. So I would make the argument that our emotional health is highly contingent on these particular things that unfortunately we actually are not being intentional about. I want to share something. I think my husband would be okay, but I will say that this time when I went to the doctor and I had just horrible IBS, it was a really confusing time because I was so skinny. And I got all this feedback. I'm like, you look great. And I was like, I feel awful, which is confusing. But very true in our society, but I think that looking back, it happened at a time that my marriage was really in a rocky place. That fundamental connection in my life, my best friend, my husband of almost 20 years and I were really not in a great place. And when we got better, I got better. Yeah, first of all, I'm very grateful that you shared that and want to acknowledge that there's courage involved in sharing our own story because it's personal and many times emotionally charged. And I think that what I would say to the listeners at home is that how does this apply to your own life and ask the question, is there something, by the way, I want to preface this by saying that life is not defined by trauma. We're not passive victims on a journey through life that there is love and human connection and opportunities and to a lot of beauty that comes in that. But there can be things along the way that can deeply affect our soul in places that are not necessarily physically visible. It can be within our non-conscious mind or sort of our core self. But you can think of it as bodily injury, even though I'm not describing it in a physical way, I'm describing it in a, you know, the non-conscious mind, alternative place. Yeah, it is bodily injury that needs to be healed. So not everything that makes us uncomfortable is causing this level of injury. But there can be things that do exist within our life that do cause this level of injury. And if we ignore them, which most of the time that's the path that we choose because they're painful, don't want to touch an open wound. If we ignore them, then they fester and they don't heal. And this is getting back to my analogy of the rocket ship that's chained down, I'm describing the chain. And breaking the chain means identifying that this exists. So let me say I'm not a psychiatrist, we're a psychologist or a mental health professional. I'm a gastroenterologist. So the way that I approach this is that I am helping my patients to acknowledge that this exists. That's my role. And then the next step is to say I want to make it better and to find the help that you need in order to accomplish that. And I feel like there's many dimensions to what help looks like. Part of it is helping ourselves to forgive on some things, right? But it's not always that easy, many times we need outside assistance from people that are trained health professionals. So we turn to them. And there should be no shame or stigma with that. We should want the people in this world, all of them, to heal those wounds and to find better health. And the amazing thing about it is I said that this is not a physical thing, but it manifests in a physical way. when we heal the things that are afflicting us within the core self or the non-conscious mind, when we heal those things, we can manifest physical health as a result, because no longer hold us back. And by the way, I am a helipathic medical doctor, and I am also a very, very big believer in science, and this may sound very woo-woo. And I am telling you that this is not, and depending on how much time you want to spend, I could dig into the physiology that involves a hormone called corticotropin releasing hormone or C-R-H that explains why this is happening. It's our stress hormone. And the issue with when someone has something like this that's happening, this sort of deeper, emotional wound, is that we're activating our stress response perpetually. And therefore, we're not able to get ourselves into a place of comfort and safety, because we never actually, we may not be able to acknowledge this, because again, it's maybe not in our conscious mind, but we're not able to feel safe and comfortable, because we constantly feel threatened, because of this thing. Well, in "Right, there's a whole emerging field of chronic pain science that is a little bit similar, that when we never feel safe, our body creates pain, right? Yes, and actually what you've just described, we can see in the gut, because we're talking about hypersensitivity of these nerves, 500 million nerves, and those nerves are part of what makes them sensitive is inflammation. And chronic inflammation affects the functionality of many parts of our body, including our nerves and how we receive that sensory information that can include discomfort or pain. But it's important to see what's happening there, which is that inflammation is activation of the immune system, if we're going to really simplify it. It's just activation of the immune system. It's a bunch of cells sending out the fire truck, right? So they got the fire truck and the police and all these different things, all these different units and maybe the Army and the National Guard in response to a threat. And when the threat is real, such as an infection or cancer cell, absolutely you want to send in those units and get it cleaned up, right? That's why we developed inflammation. The problem that we have in the modern world is a threat that's not even there. And we're just sending them out for the sake of sending them out. And that has consequences. And there's many ways in which that inflammation can manifest with consequences that affects pain in the way that you've described. But I would also make the argument that it affects our brain and brain function, something called neuro-inflammation. And neuro-inflammation has been associated with mood disorders, such as major depression. But also with other neurologic conditions such as Alzheimer's disease, Parkinson's disease, multiple sclerosis. I remember the thrill of filing the LLC paperwork for my first business in 2009. I felt legitimate. But the truth is I needed a lot of help. I wish that I had had Northwest registered agent. 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Sign up for your $1 a month trial today at shopify.com/anxiousachiever. Go to shopify.com/anxiousachiever. And here your sales go. One of the things I love, I found you through Zoe. What I love about Zoe, and I'll give Zoe a free plug here, is that Zoe applies science to things that we know in our hearts, but have often been told is woo-woo. Although I'm very pro-woo-woo, but I think it's such an unusual group of scientists in that you give us permission to know what we know in a way, which I love. Well I think that there is a search that we have for answers. Why is this happening? And to claim that it's genetic is first of all not true, and really diminishes it, because then it turns us into, hey, you were born this way and despite everything in your life and no matter what you did, this was inevitable. When you say it's not genetic, do you mean gut problems? So when I say that it's not genetic, and thank you for allowing me to expand on that a little bit, because I mean they're cruel. We are certain conditions. Don't get me wrong. Scystic fibrosis is a genetic health condition. If you don't have the gene, you can't develop that condition. But the vast majority of health conditions, the vast majority, there are genes that may predispose and they increase the risk of a very small percentage. And whether or not we develop heart disease and cancer and an astroke and diabetes, that's not predetermined at birth. It's based upon the multiple factors within our life that include our lifestyle and the factors that we're discussing with a greater amount of attention here today, including mental health and emotional health and spiritual health. I think that all those things are extremely important and not to be diminished. With Zoe, I guess when we just say real quick more, hope you don't mind to that, our founder is Professor Tim Specter and he's one of the most published scientists on the planet. I mean, I'm staggering to look at his, all the papers that he's published over a thousand in the most elite medical journals. But really where this comes from is that Tim was studying genetics back in the 90s in twins. And far too often he found that people would have identical genetics and different risks for disease. And he was searching for an understanding because he's a scientist and where that search led him was into the gut microbiome. And when you open up, this is the same thing, by the way, and some on some level, I'm just a few years younger than Tim. But in the same way, in a parallel journey, I didn't know who he was back in 2013, 2014, but I myself was discovering and gastrorology. That gut microbiome is an important part of the story of these people that are walking through these doors. And so when you get into this, what you discover is, okay, well, what are the levers? What are the levers that I can pull? And the answer is that there's many, but food is perhaps the dominant one. I want to get into that because, but I want to go through it for our audience. This is a show about work. I want to talk about food. I want to talk about your plant. based fiber, heavy approach. We've talked a lot about emotional, psychosocial, mental, spiritual health, which is a huge piece. Many people right now, and especially people who listen to my show, are unemployed. And they're not happily unemployed. They've been like, "Go. They are looking for jobs. The job market is rough." In my anecdotal experience, when you are unemployed and you don't want to be and you have financial insecurity and everything that comes along with it, your gut becomes a mess. They can't get hired tomorrow. What can they do? It's a valid question. And when we have some specific thing that is holding us back, of course, of course, we should address that specific thing. And I would, by the way, say acknowledging this, as you were saying, as I'm thinking in my mind of other examples that can be very challenging, that you don't necessarily have complete and total control over. An example would be infertility, right, is stressful for a young couple on par with cancer therapy. That's what research has shown. So we don't have complete and total control over these things. And so yes, we should take steps to address those issues, acknowledging that there's not any simple and easy resolution. And simultaneously, I'm of the belief that our health is multifaceted and that taking steps to address other aspects of our health that are not the one thing, rises the tide, right? I'm of the belief that when we do things that are going to put our body into alignment, we receive benefits that may be the result of like the direct goal that you have. Hey, I want to eat for better gut health. What do I eat? Dr. B. Okay, let me tell you. But by the way, this is not just going to affect your gut health. It's going to affect many other aspects. For example, they have shown that there are dietary patterns that can be followed to improve our mental health in the smiles trial by Felicia Jacque from Australia, Deacon University, that they put people on a plant predominant Mediterranean diet that aligns with my views and treated major depression. And yes, we should address these different facets of our health that I would encourage and recommend. And there's a place for professional help in addition to that. These are not mutually exclusive things where we do one and we ignore the other. I'm of the belief, this is my general approach to health as a medical doctor, that we should put on the table all of the things that can benefit us and then make choices about what we are willing to do. You're not going to do all of them. Where can we start? What's most valuable? What for you specifically is actually going to stick? Right. Right. Because stuff isn't easy. No, it's not. And we have many different things that can hold us back. I don't need to create the laundry list here. We all know what they are. Last night I had a lot of wine and ice cream. It's a great start to Sunday night, not in a great place, feeling stressed. Yeah. Just a lot of wine and ice cream. Yeah. Well, and I don't think that you should feel bad about that. But I feel bad in my body. Sure. Because you're trying to cope with something else that's bothering you. And what you've just brought up it by the way speaks to my belief that we have to create space to forgive ourselves and accept imperfection. I never want to present information, making it sound like the perfect diet exists or that anyone eats that way. Because I sure don't. You don't? What do you eat? Talk us through a week in your life. Well, my diet has been an evolution. I grew up in a family. This is kind of, you know, leads into some of the things for me personally. My parents were divorced. We were poor. My mom worked hard to provide for us. And I came home from school. And we cooked hot dogs every day. And I had a snack. And that's what we ate. And we loved them. And it tasted great. And so grilled hot dogs. And I thought I was invincible. And I continued to eat this way despite increasing intensity and rigors of my education and professional life as I became pre-mad and went to medical school and then was working at a hospital in Chicago and then was working at the University of North Carolina in my gastroenterology fellowship. And it caught up to me. And I kind of reached a point of crisis where I was unwell. And the ironic thing is that again, joy and happiness are not defined by individual accomplishments. You were so accomplished, right? Yeah. And don't get me wrong. I am like, I can't change who I am. I'm a goal oriented person. I line up goals. I go after them. The minute I've accomplished them, my wife says to me, you should celebrate. And I said, well, I'm already moving on to the next time. What's next? Exactly. And that's just who I am. And it's okay to embrace like we should love and embrace who we are. But to put people where I was, we're talking about 15 years ago. And I was around 30 years old. And I was in a dark place. And it was weird because if you looked at my CV, you would think that I was thriving because I was accomplishing all of my goals and actually more than that. Things that were far beyond what I expected. I won the highest award at Northwestern University, among 60 doctors, all of whom I thought were more brilliant than me. And it's just an example, but like these kinds of things were happening. And yet, where was I? Well, I was by myself, at home in a dark room, under a blanket. I wanted to be left alone and I was watching Bravo. All right. That's where I was at. And I knew that I wasn't well. I was 50 pounds over way. I was anxious. I was depressed. I just sincerely believe like I to me, the world was coming at me in shades of different gray. And I also had insanely low self esteem, considering. And there were many facets that I needed to heal. And part of what I needed to heal was diet and lifestyle based, because I was eating an inflammatory diet filled with fast food, multiple times a day. But I don't think that that's just the only thing that was going on there. I do think that the things that happened to me when I was seven years old and my parents got divorced. And the complex relationship that I had with my dad from that point forward, that was actually my fault. That was catching up to me because I was trying to push it down and ignore it and say it doesn't matter. And yet here I was on this quest to prove myself when all I needed to do was accept that my dad loved me. And so the question that you asked me, I apologize for getting divergent there. But I love it. And I can't tell you knowing my audience as I do so many of them are vibing with you right now. But I think that the, you know, the question that you asked me is, how do we cope when we're going through tough times? And my answer to this question is that we should do the things that we can control and make the most of them, right? And then with the things that we can't control, we should do our best and make a plan but also create some space with grace to understand that we're doing our best and we can't control everything. I'm very lucky in that I live in a house full of computer nerds and they wouldn't let me take my laptop and my data out in the world, unprotected. Going online without ExpressVPN is like driving without car insurance. You might be a great driver, but with everyone who's on the road today, why take that risk? Everyone needs a VPN. 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It doesn't have to be that way. That's the good news, and you don't need a new job to do it. Patrick Lentioni, who is author of the legendary book, Five Disfunctions of a Team, and more than a dozen other bestsellers, created the working genius assessment to help you pinpoint the kind of work, the tasks at work that give you energy, and the kind that drains your energy. Over a million people, including me, have taken it. It's simple, it's effective, it's affordable, and if you take the assessment today and you use the code Achiever at workinginus.com, you'll get 20% off. You know, I had Patrick Lentioni on the show, and he's a neurodivergent leader. Yes, he is, and he's very open also about his former existence as an anxious achiever. But Patrick credits what is now working genius with the change in how he works, a workday that finds him playing to his strengths, and not doing the things that no matter how hard he tries, he's never going to be good at. So check out the working genius assessment and get 20% off with the code Achiever at workinginus.com. So your diet has evolved. Yeah, my diet has evolved. What is a good week, what does a week look like? If I were to play a simple concept on the table, like where I started was with smoothies, not smoothies in a pouch, just like literally pulling out, I was a single guy, and I didn't want to cook, and I was tired, I was working hard. And so I pulled out a blender and I started throwing stuff in there. That's it. And it worked. It was a great starting point for me. And then where I've evolved over the course of time is that I have incorporated plant-based food into my diet and really looked for, and this is like by the way constantly happening, where I'm looking for new opportunities to continue to tweak and optimize. So when I did make these changes, by the way, I had like really pretty substantial health improvements that happened very quickly. So I lost 50 pounds, blood pressure, high cholesterol issues got better, my mood improved, my confidence soared. A lot of great things happened. By the way, that does also coincide with me meeting my wife. Which happened first? Actually, I met my wife first. Because a lot of what I'm describing was me being ignorant to my diet, which is bizarre because I'm a medical doctor. You would think like eating a fast food diet. Yeah, come on. Like eating a fast food diet isn't that obvious. But actually me, my wife, and then seeing the way that she ate, which was her own way, and she never asked me to make any changes, she just did her thing. But observing that was like, wow, that's incredible. So anyway, my diet is built around plant-based foods. On the weekends, I might have avocado toast and cover it up on a sourdough and cover it up with like accoutrements that I enjoy, put some extra virgin olive oil and some nice balsamic vinegar on the toast. Delicious. Right? Or I might do a yogurt. I might opt for a plant-based yogurt, but there's certainly nothing wrong with regular yogurt. And take a yogurt and add seeds and nuts and berries. It's a delicious meal. It's very seasheding. And then lunchtime, I am a big fan of like soups and sandwiches and salads. So a kick that I've been on recently and I don't recommend this for people that are new to this way of eating. All right? This is what I've evolved into over the course of like more than 10 years. But I've been on like a soup plus beans kick where I will take for example a minishrone soup and I'll add an entire can of chickpeas to it. And if I ate that way 10 years ago, I would have been folded over and pain because you have to build your gut to that point and get used to this. I can eat three bunches of kale, no problem. Nice. Which I'm very proud of. You're really amazing. So 20 years of eating like insane amount of fiber. I think once you get used to eating a certain way like you the one of the important messages is that your gut microbiome is adaptable. It's adapting. It's adapting as we speak. The choices that you make today are reflected in your gut microbiome by tomorrow. But that doesn't mean that you should make radical change all at once because that's not how you allow good adaptation. Right. Like starting low and easing into something. I say start low and go slow. Starting low and easing into something is the same thing that you would do for exercise. Right. So think of your gut as a muscle. It can be trained. It can be made stronger. It can be more resilient. It can be more powerful. More functional. And all of that is possible. But there is a program and a process. It doesn't happen in one day. You know, so anyway, soup and chickpeas for lunch. And then for dinner, it varies. Like on Tuesdays, we do tacos. And we get and basically the way we do as a family is we put out all the different accoutrements and you choose what works for you. Or we'll do like I'm a huge fan of anything in a bowl. So like to me, a nice foundation is to take a bowl and have some sort of whole grain like I like farrow. Some sort of bean or legume. And then just like, you know, similar to doing the tacos, like if you're doing a burrito bowl or you're doing a tie bowl or whatever Korean bowl or Mediterranean bowl. It's like get out the stuff that goes with that and then just throw in whatever it is that makes you happy and excited to eat. You don't need any meat. I don't eat meat. You don't need dairy. So from a dairy perspective, like I'm not super picky, I tend to favor non-dairy. So like for example, our kids, we drink soy milk. We do an organic soy milk and it's like the beauty of the one that we get is literally it's got two ingredients. Soy beans and water, that's it. So there's no like fillers or any other stuff. So but like these are choices that we make and I will fully acknowledge that there are ethical motivations that exist when it comes to my consumption of meat. I haven't had red meat in a very long time, but do I think that you're unhealthy if you eat that food? Absolutely not. My approach is not about or nothing. My approach is about helping you to fill in the things that are missing that will bring you better health. And I've built my foundation around fiber because fiber is the essential nutrient. For it got microbes, essential. They can't get by without it. And 95% of Americans are deficient in fiber. And I'm of the belief that if we addressed this one issue, that we would be so much healthier as a society. But to be clear, I actually hate dietary labels. I hate them. Like vegan vegetarian, omnivore, vegetarian, paleo, keto, whatever. I hate it because it distracts us from what really matters, which is nutritional quality. Quality is what matters. And when I say quality, that's across food groups. So there's junk beans and there's good beans. There's junk dairy and there's good dairy. There's junk, I mean in every single category, junk fat, good fat, junk carbs, good carbs, fibers, and carbs. I mean, my son is a vegetarian and some of the frozen meals are like just sodium. Basically, you know, this is why I don't like these labels because you walk into your supermarket and there's a box that says plant based on it. And if I were there, I would shred it. Because it's not a healthy meal, but they're marketing. Because I go out there and I tell you to eat more fiber and eat more plants. And then what shows up in your supermarket is that on a box. And it's just a manipulation. So really what it is, so let's just get back to whole foods. If you do that, whatever they are, you're definitely moving in the right direction. I have one last question for you, which is of personal interest. And I think we'll be of interest. And this is just, I don't know if this is an area of expertise for you. So I have bipolar disorder and it has been suggested to me many times to try keto. I have tried keto and it's really hard. It's to me unsustainable and when I do it, I get so thin and it's just miserable and it's expensive. But then I feel guilty. It does seem to be good data also around even things like Alzheimer's. And I'm just curious how you stand on mental health and keto. And I care about above all else is thriving, happy, healthy people. That is my agenda. So if a person were to say to me, "I'm thriving and doing really well with whatever dietary pattern," that's amazing. There's an interesting explanation for what's happening with these types of approaches of going keto. And part of it is that it's an excellent framework to eliminate unhealthy, refined carbohydrates, like sugar and flour. This is an excellent framework that people really quickly understand and get it. And if you're successful, which by the way, I don't think people are as often successful with keto as they think they are unless they're being really serious about it. I tried to eat less than 30 grams of carbohydrates for five weeks, six weeks, and it was I just couldn't anymore. Yeah. And there's downsides to this, right? That's a quite unnatural approach. And our body does have, like people who do ultra-low carb diets, they run into health issues frequently when they continue with this. And if you look out into the world, you will see this because basically you deplete glycogen stores in your liver and there's a body, there's a reason why the body has this. The body is designed for balance. So the physiology, though, is a bit interesting. So I want to talk about that for a quick moment, which is that when you do successfully achieve ketosis, which again, I don't believe the majority of people actually do, I think the majority of people what they do is they get rid of carbs, like sugar. But that's a good thing. But if you do achieve ketosis, the classic ketone is beta hydroxybutyrate. And there's another one called acetoacetate. And it turns out that these ketones are activating the same receptor that butyrate and acetate activate. And butyrate and acetate are produced from fiber. Fiber comes into contact with our gut microbes, the microbes digest the fiber. Fiber doesn't, like some fiber does pass through us, don't get me wrong. But there's what we call prebiotic fiber that's food for our microbiome. And fiber produces these, what we call short-chain fatty acids, butyrate and acetate. Well, 95% of America's deficient fiber. So they're not actually providing the body with what it needs to produce butyrate and acetate. And if in theory you were to go on a ketogenic diet and achieve ketosis, then your body automatically flips and it produces beta hydroxybutyrate and acetate, which activate the same receptors. Basically what I'm saying is the body is telling you that when you're eating that you would benefit from the consumption of fiber. And when you're starving, the body used this as being so important that during starvation mode, your body will protect this by continuing to provide. But the problem is that beta hydroxybutyrate and acetate are not as good or as strong as the real thing, which we get from fiber. So you're partially activating it. So here's my point. If you take the Western diet, the standard American diet, and you plug in at ketogenic diet and you actually achieve ketosis, I've just defined for you the reason why this may be beneficial on a number of different health levels, including repairing and restoring the blood brain barrier, which is how we get many of the benefits. But we don't need to necessarily go that route. In fact, we could provide even more benefit to our body, be healthier and have a healthier gut microbiome if we were to actually just normalize our fiber consumption. So that's my argument in favor of that approach. That's it for this episode of the Anxious Achiever. The show is produced and edited by Mary Dew with production support and sound engineering by Nick Crinco. If you like what you heard, head to your favorite podcast app. Leave us a review. It really matters and we appreciate the time and effort it takes. And if you don't subscribe or follow the show already, now's the time. And let us know what you'd like to hear more of. I get some of my best ideas from my listener, so find me on LinkedIn and send me a message. You could find my weekly newsletter there as well. A big thanks to LinkedIn and all the listeners out there and our guests in the Anxious Achiever world. Until next time.