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Digestive Wellness Probiotics and the Gut Microbiome with Dr. Liz Lipski

Today I’m interviewing digestive expert Dr. Liz Lipski. The book we’re focusing on today is called Digestion Connection: The Simple Natural Plan to Combat Diabetes, Heart Disease, Osteoporosis, Arthritis, Acid Reflux, and More. It is seriously a bible of digestive health.

Evelyne: Today I’m interviewing digestive expert Dr. Liz Lipski.  The book we’re focusing on today is called Digestion Connection: The Simple Natural Plan to Combat Diabetes, Heart Disease, Osteoporosis, Arthritis, Acid Reflux, and More.  It is seriously a bible of digestive health.  And as you can tell by the title, yes we’ll be talking about some common digestive issues, but also covering some issues that you might not have thought are related to a problem with the digestive system.  So if you or someone you know has migraines, fibromyalgia, any kind of autoimmune disease, chronic fatigue syndrome, or any of the things I mentioned in the title, please pass this show along and recommend Liz’s book to them. You might seriously save someone’s life.

I also want to give a shout-out to my friend George Bryant from The Civilized Caveman. He was on the show a few months ago, and his cookbook The Paleo Kitchen with co-author Juli Bauer comes out today.  So I wanted to pass that along. It’s called The Paleo Kitchen. Congratulations, you guys!

Last week, if you missed the show, I interviewed Dr. Tierona Low Dog and learned so much from her.  She’s a phenomenal speaker.  We talked about her book Healthy at Home and she shared remedies you can make at home for colds, coughs, stress, and more.  Most of the time it’s not necessary to take drugs for little issues like that, so you can check that show out on BlogTalkRadio or on iTunes.  Also next week, I’m interviewing Dr. Lise Alschuler, we’ll be talking about cancer prevention and thriving after cancer treatment.

So moving on to today’s guest. Dr. Liz Lipski is the Director of Academic Development for the Nutrition and Integrative Health programs at Maryland University of Integrative Health. She has been working in the fields of nutrition, holistic health, herbology, and lifestyle management for more than 30 years. Prior to joining MUIH, she served as Director of Doctoral Studies and Educational Director at Hawthorne University. She has been extensively published in many academic journals and is the author of four books, including Digestive Wellness, which is in its 4th edition, Digestive Wellness for Children, Leaky Gut Syndrome, and  Digestion Connection. Dr. Lipski speaks nationally and internationally and is on the faculty at the Institute for Functional Medicine. She received her doctorate in Clinical Nutrition from the Union Institute with a specialization in functional medicine, is board certified in Clinical Nutrition (CCN) and Holistic Nutrition (CHN), and is a Certified Nutrition Specialist (CNS).

Liz, welcome to the show!

Dr. Lipski: Thanks, it’s so great to be here. And wow, you have had some great guests in the past and next week people are in for a treat listening to Lise.

Evelyne: Yes, she’s great. I saw her talk at the conference we were at, the National Association of Nutrition Professionals conference.

Dr. Lipski: She’s really one of the handful of experts in the area of integrative cancer therapies, and such a wonderful woman at the same time.

Dr. Liz Lipski on Elevate Your Energy Radio

“I just kind of shifted my focus back to food when I realized that the word ‘diet’ comes from Greek and it means a manner of living or a way of life.”

Evelyne: I’m looking forward to it. So Liz, can you share how you got so interested in nutrition and tell us a little bit more about your journey?

Dr. Lipski: Sure.  I think that I got into nutrition really because my mom loved cooking and we used to watch cooking shows together and from the time I was really small I would cook with her and watch her cook. Family meals were where everything happened. On Sundays all of the relatives would come and they would sit around the dining room table for hours and hours, talking about each other and family and fighting about politics and talking about finances. And you know, it seemed like world peace was going to happen at that table – either that or world war. And it was just such an important part of family.

Then when I was in college I was studying herbal medicine and I started reading Euell Gibbons’ books, Stalking the Wild Asparagus and Stalking the Blue-Eyed Scallop, and I just kind of shifted my focus back to food when I realized that the word “diet” comes from Greek and it means a manner of living or a way of life. And our diet, in the broadest sense, is everything we take in, and that’s how we move our bodies and our relationships and TV shows we watch and the things we read and the food that we eat. And it seemed like all of that was so much more foundational to health than just studying herbs. So that’s kind of what began my journey.

Evelyne: Very cool. So I love your book, it’s definitely an indispensable manual for everything related to the digestive system. But why did you write this one after all the other editions of Digestive Wellness?

Dr. Lipski: That’s actually a really simple answer.  This is a 4.1 version of Digestive Wellness and it has only about fifty pages that are different that I added to it.  And honestly, I got a call one day from Rodale Books and they said, “McGraw Hill just sold us the direct marketing rights for Digestive Wellness and we’d like you to add some content to it so we can say it’s a new book.” So both of them are really good books. [Chuckle]

Evelyne: Perfect.  I think Digestion Connection is a little harder to find than Digestive Wellness.

Dr. Lipski: It’s a lot harder to find because it’s only sold through Rodale, and you can find Digestive Wellness anywhere.

Evelyne: Perfect. So in the book, you set out to answer “What if imbalances in the digestive system cause not only digestive symptoms, complaints, and disease, but also symptoms, imbalances, and disease throughout the body?”  Can you talk about this a little bit more?

Dr. Lipski: Sure. The reason that we eat in the first place is to nourish every single cell in the body. So if our digestive system isn’t working right, then we’re going to feel tired. Our mental and emotional well-being is going to be compromised, and we’re going to be moody, maybe depressed, maybe anxious. In fact, some of the earliest nutrition insufficiencies show up as depression and lack of energy and anxiety – which we seem to have a lot of in our culture – and also things like inability to concentrate and focus, because the brain uses so much of our energy. But if we’re not getting the nourishment to our cells, then pretty much nothing works right. And so your skin doesn’t heal, your neurotransmitters aren’t made because they’re not actually able to break down proteins into the right amino acids and then reformulate them because you don’t have all the nutrients that are needed like tyrosine and zinc and B vitamins. So there are just so many things that break down. Bones don’t get rebuilt. Muscles feel weak and tired. So digestion is really the underlying key for how we build our bodies.

You know, they always say “You are what you eat.” And we are what we eat but we are also not only what we eat but what we can digest and what we can take into our bloodstream in the right form.  Then we’ve got to get it to the cells in a usable fashion and then we need to excrete it. And so digestion can break down on any of those levels. Somebody with diabetes can’t get the glucose into the cells, or somebody who is constipated can’t excrete the wastes and so the wastes end up recirculating and we end up pulling back in not only water back into our body, which is a pretty good thing, but we also pull back in hormones and things that we’ve gotten rid of. So what people might not realize is that when you’re chronically constipated, you increase your risk for breast cancer and other hormone-dependent cancers in both men and women. And that’s why I’m really so fascinated with digestion, because it’s the key to health, and at least a third to 40 percent of us have some kind of digestive issue every couple of months.

The other thing that we’re starting to learn about is the gut microbiome, which I think you have other questions about. The gut microbiome is comprised of viruses and yeast and fungi and bacteria. It weighs about three-and-a-half to four pounds. It’s the size of our liver and it’s the most metabolically active in our body. It runs our metabolism and determines whether we are fat or thin, it affects whether we are happy or depressed, it makes B vitamins and vitamin K for us, it modulates our immune function and does so many more different things. And many of the things that we do in our lives disrupt that. And when it’s disrupted, then we don’t feel well.  So again, digestion for me is such a key place to begin with health.

Evelyne: Since you mentioned constipation, I guess we can’t talk about digestive wellness without talking about poop, right? [Chuckle]

Dr. Lipski: Right.

Evelyne: So why should you consider testing bowel transit time and how do you test for that?

Dr. Lipski: Okay. Well, the first thing people should know is that even if you’re having a bowel movement every single day, what you ate yesterday might not be what’s coming out.  Because the average American has a bowel transit time that is somewhere between two and three days, and what’s optimal is that when we eat something, the waste ought to come out of us within 18 to 24 hours – something like that. And what’s considered to be normal in medical circles is somewhere between three bowel movements a day to three bowel movements a week. And that’s a pretty big range. What concerns me is if somebody’s having three bowel movements a week, then what’s happing is that stool is sitting there for a very long time and it tends to get hard and dry. It’s harder to have an easy bowel movement. Your wastes have been sitting in you for a long time and that can be inflammatory throughout your body, and it’s also uncomfortable. Some people don’t feel right when they’re only having three bowel movements a week. And believe it or not, I’ve had clients in the past who’ve only had a bowel movement once a week or once every two weeks, or they’ve never had a bowel movement without using a laxative. So it’s a big problem. It affects a large percentage of the population. And people generally feel better when they have regular bowel movements.

So one of the simple things you can do at home that’s a fun experiment and some of us do it by accident, is you can eat a lot of tomatoes, or you can take a tablespoon or so of sesame seeds, or you can eat beets, or you can take some charcoal tablets, and you can see when you see a change in your stool. So you eat them, and you would see undigested tomato seeds or sesame seeds in your stool. And you want to check when is the first time you see them and when is the last time you see them. And you also can use beets, although this doesn’t work with everyone. But for most people, you can eat a big pile of beets and a day or two later you’ll see that your stool is red. It’s not blood, it’s the color in the beets. And other people can use charcoal tablets which also have the added benefit of mopping up gas. So you take maybe ten charcoal tablets and you wait to see when you have a black stool. And if it comes through you really fast, in 12 hours or less, then your bowel transit time is way too fast and you know you’re actually not absorbing all of your nutrients. If you find that your stool transit time is somewhere between 18 and 24 hours, maybe even a little bit longer, you’re doing exactly the right thing. And if it’s longer than that, then you start thinking about “What can I do to decrease my stool transit time?”

Dr. Liz Lipski on Elevate Your Energy RadioFor constipation, there are so many things that are beneficial. The average person doesn’t get enough fiber, so that’s a really logical place to start. Eat more root vegetables and eat more whole grains. Beans are such a good source of fiber, so add some kidney beans to a salad or have hummus with vegetables as part of your lunch or for a snack.  You can just start with fiber.  Also, drinking plenty of water is really important for keeping those stools easy. And then some people just like to take a couple tablespoons of flax or chia seeds to increase fiber, but it also increases some of the essential fatty acids that also help us not be constipated. So you can put that either sprinkled over cereal or oatmeal or put it in a smoothie, and that seems to work really well for some people. And then if you’re still constipated, one of the things I like to do is ask people to increase their magnesium intake by taking some magnesium supplements, and kind of keep increasing their magnesium until they have loose stools or until they have explosive stools – which means you took really too much – and then kind of back down from that. According to government statistics, about 70 percent of us are magnesium-insufficient because we don’t get enough in our diet. And in the past when I saw clients, so often when I just asked somebody to start taking a few 100 or more mg of magnesium every day, they found that their bowels were completely regular.  And I know that for me, I need a lot of magnesium – more than I get in my diet, even though I eat a lot of greens and grains. I just need more. And so some people might just need more. And if that still doesn’t work, then I would start considering small intestinal bacterial overgrowth or yeast overgrowth or something a little bit deeper.

Evelyne: That’s interesting.  Last week on the show, Dr. Low Dog also talked about magnesium. She needs it so much at higher doses to prevent migraines, for her. There are so many different reasons why we need magnesium.

Dr. Lipski: Three hundred different reasons. The body uses magnesium in three hundred different enzyme systems. So some of the important things about magnesium that I love are that you need it to relax your muscles. So if your muscles feel tight and tense, you probably need a little bit more magnesium. We also need it to relax our nervous system. So if you’re really irritable and anxious all the time, you probably need some more.  Another tip-off of magnesium deficiency is the occurrence of eyelid twitches or muscle twitches anywhere in the body, or menstrual cramps, foot cramps or cramping anywhere in the body. Another big tip-off for me is when people are really sensitive to noise. So I used to ask clients, “Does traffic really bother you? Do lawn mowers or loud TVs really bother you?” And most people would just kind of look at me like “Huh?” But a lot of people go, “Yeah, I’m really sensitive to noise and I startle really easily if somebody comes up behind me.” And those are all signs that somebody really needs more magnesium.

Evelyne: You helped develop the D-I-G-I-N model, or the “DIGIN” model. How do you say it? [Chuckle]

Dr. Lipski: “Dig In.”

Evelyne: Yeah. DIGIN, like digging in to the digestive system, with the Institute for Functional Medicine to assess digestive issues. Can you explain what the acronym stands for and talk about why each part is important?

Dr. Lipski: I will. I developed this with Patrick Hanaway, and I teach it with him and Jerry Mullen and Tom Sult. They’re all medical doctors and I’m the nutritionist on the team.  And one day Patrick and I were sitting in an airport and he said, “I’m beginning to really realize that no matter what your diagnosis is, that there are underlying causes that are really behind it.” So for example, you could be working with somebody with small intestinal bacterial overgrowth, and one person could present that as irritable bowel syndrome, and another person could present that as fibromyalgia, and a third could present that as restless leg syndrome, and a fourth person could present that as interstitial cystitis, which is inflammation in the bladder. And so knowing that, the name of what you’ve got sometimes isn’t as important as the underlying condition. On the other hand, you could have people who have the same condition but different outcomes. You could have people who have inflammation, and inflammation could show up in different ways. It can show up as inflammatory bowel disease, or it can show up as eczema on your skin, or psoriasis, or it could show up as headaches or arthritis. And so it seems more important rather than diagnosing, which Dr. Sid Baker says “We like to name it, blame it, and tame it”, and Dr. Mark Hyman says we like to “Name the ill and give a pill.” It’s more important to really understand what’s going on underneath and what the mechanisms are. And so as Dr. Hanaway and I started talking about it, he said “these are the things that I think are underlying it,” and then I spent a long time trying to figure out how we could make an acronym that would work with this, once we discussed it. I kind of liked “DIG IT”, but “DIG IN” is where we ended up.

So here’s what it means. First, it’s digestion and absorption. At the beginning of this interview I said that if you can’t actually digest your foods then you’re not going to get nourishment to the cells. And so what we find is there are people who have gallbladder issues, and they don’t break down fats very well. There are people who have low hydrochloric acid in their stomach and they don’t digest their protein adequately, which means that we can’t use it to make muscle or neurotransmitters or some hormones. Also, when we don’t have enough hydrochloric acid, then we have poor absorption of many of our minerals, including iron and calcium. So low hydrochloric acid is something we investigate. We also look and see if somebody has enough digestive enzymes. Are they actually able to digest their food, because their pancreas knows when to secrete those enzymes? And so that’s the digestion piece. Can you actually digest your food? And moving backward, so many of us gobble our food down and eat so fast that we make the process of digestion really difficult. So the one really simple digestive tip is chew your food well and don’t wash it down with liquids. You can drink, but don’t wash it down. So that’s D for the DIG IN.

The first I stands for intestinal permeability, which is also known as “leaky gut syndrome.”  The small intestine has a paradoxical function which is to keep big molecules out of our bloodstream but to allow passage of small food molecules, nutrients, and other phytonutrients into the bloodstream. And when we have leaky gut, one of the things that happens is that molecules that are too big to normally pass into the bloodstream come into the bloodstream, and the immune system then has to pick them up and say “Well, this is garbage,” because the bloodstream can’t digest the food. So we start getting yeast overgrowth because we get fungus and yeast on our foods. We get bacterial overgrowth because bacteria comes in our foods. We bring in parasites on our foods, and all of these can slip into the bloodstream as well as chemicals in our food, preservatives in our food, and food molecules that are actually too big for the cells to use. And so that’s one of the reasons we start getting food sensitivities and food allergies. And those food sensitivities and allergies then lead to systemic issues like psoriasis, eczema, migraines, arthritis, autoimmune conditions, mood disorders, depression, and so many other things. So look to see if the small intestine is intact and working really well, or leaky.

Then the G stands for the gut microbiome which I started talking about. And that’s those three-and-a-half to four-and-a-half pounds of microbes that live inside of us. And they modulate our immunity, make vitamins for us, and actually talk with our genes. What we’re finding out and what new research has indicated is that there are ten times more bacteria in your digestive system than cells in your body. And in those bacteria, if you compare the DNA in the bacteria to human DNA, we have 150 times more bacterial DNA in our gut than we have cellular DNA in our bodies. And it’s really easy to upset this balance, so that people end up with low-grade bacterial infections or fungal overgrowth or parasites. And when that happens, we don’t feel our best. You might have gas and bloating or you might have poor energy or whatever. And the other thing about these microbes is that they’re continually talking to our own genes and saying, “Hey, settle down buddy, there’s nothing to be so upset about,” or “You’re old, it’s time for you to actually die,” or “Here’s some nutrients, you can really be soothed,” or “It’s time for you to replicate.” So they’re always talking to our own DNA. And the more we find out about them, a lot of us are beginning to think that we are just big sacks, or like big buses that carry around these microbes. And we think we’re smart but maybe it’s just the microbes that are smart. [Chuckle] So that’s the G for DIG IN.

And then we move to the next I, and the I is about inflammation and the immune system. So we can have inflammation in the digestive system that will cause skin inflammation and brain inflammation and lung inflammation and asthma, and cause us to have pain almost anywhere in our body, like fibromyalgia or arthritis. And so we always want to look and say, “Does somebody have inflammation? Is their immune system overreacting?” So for somebody with an autoimmune disease – somebody like Dr. Terry Wahls, who had multiple sclerosis, she worked with her diet and with some supplements and with some electrical stimulation and got herself out of a wheelchair, because she really corrected her imbalances, and most of all she corrected her digestive imbalances. So we want to take a look at that. Or somebody who has Crohn’s Disease or ulcerative colitis, we want to look at their diet and see what they might be eating is causing inflammation. We want to look at their lifestyle and their sleep and make sure they’re sleeping well. And we want to look at all aspects of their life, and then we want to use soothing foods, soothing supplements, and sometimes drugs when they’re needed, to try to bring down inflammation.

And then the final letter is N, which stands for the nervous system, because we have a nervous system that’s actually in our digestive system that’s called the enteric nervous system. And that nervous system is really active. So for example, we make all of the neurotransmitters that we make in our brain. We make all of those in our digestive system in larger amounts.  So for example, serotonin is a neurotransmitter that we think of that when levels are low, people might be depressed. But what we know is that we make about 80 percent of the serotonin we need in our gut, and we use it to regulate bowel function to see if we’re actually regular and having normal bowel movements. So there are so many pieces to that. And then the other piece is not only that the digestive system helps regulate the nervous system, but our brain and our gut talk to each other. I had a client a long time ago who said to me, “I only work with six people but every time I have to make a presentation, I get diarrhea before I walk in.” And so how many people feel butterflies in their stomach or get nervous and react in a digestive way? We know that that’s really true. So there is a lot of communication between the brain and the digestive system. And we want to make sure that that’s all working right, too. And so rather than looking at diagnoses, it’s good to know that somebody has Crohn’s disease or they have irritable bowel syndrome. Those are important things to know, or that they have migraines or arthritis. But it’s also really important to know what these things are. So for example, inflammation, think GERD.  Well, there’s inflammation there. What’s causing that inflammation? Is there a way that we can calm that inflammation down? I’ve had different clients who have stopped eating gluten-containing grains and their GERD just disappeared. Another client where we couldn’t quite figure it out and we did food sensitivity testing and eggs showed up, and she discovered and realized that every time she ate eggs that she had heartburn. It’s like some days she would say, “I really feel like an omelet,” so she would take some digestive enzymes or some bitters along with it to see if she could help protect herself. But it was a choice that she made and at least she knew and understood why she was experiencing that.

And so the whole work that a good nutritionist can do is to really help you explore your own lifestyle, your own body, and what makes you feel better and what makes you feel worse, and to teach you so that you become the expert, because you actually are the expert in how your body works and what makes you feel well.  And sometimes it’s good to work with a professional who can kind of coach you through it, lead you through it, and the two of you together can really discover what’s going on. And then you have more tools to make better decisions about what’s going to help you feel your best.

Listen to the full interview on Elevate Your Energy Radio or by subscribing to the podcast on iTunes. You can also read the full transcript in one of the upcoming Elevate Your Energy Expert Guides by opting in below!

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