Latest / Fork U with Dr. Terry Simpson / Keep Your Poop in a Group

Transcript

Keep Your Poop in a Group · Fork U with Dr. Terry Simpson

• 0:03
  >> Dr. Terry Simpson: M Today, we're going to talk about poop. Keep your
• 0:06
  poop in a group. Get your together. All right,
• 0:09
  we're going to talk about fiber. And before you
• 0:12
  turn this off, a fair warning. There will be a few
• 0:15
  dad jokes today, because every dad needs a dad
• 0:18
  joke or two. And if you can't laugh while learning
• 0:21
  about digestion, you're taking life and yourself a
• 0:24
  little too seriously. Now, fiber is about poop,
• 0:28
  but it's also about a lot more than poop. It's
• 0:31
  about lowering your risk of colon cancer. It's
• 0:34
  about smoothing glucose spikes. It's about
• 0:37
  avoiding hemorrhoids, diverticulosis,
• 0:39
  diverticulitis, and spending less time in the
• 0:42
  bathroom wondering if the phone is about to fall
• 0:44
  into the toilet. I know you've had it happen. I
• 0:48
  saw. And by the way, that's not a productivity
• 0:50
  issue. It's a fiber issue. When I run into the
• 0:54
  true carnivores and they always identify
• 0:57
  themselves immediately, they are very eager to
• 1:00
  tell me fiber is not an essential nutrient. And
• 1:03
  technically, they are correct. There is no classic
• 1:06
  fiber deficiency disease, no scurvy of spinach, no
• 1:11
  berry berry of bran. But medicine isn't just about
• 1:14
  what kills you quickly. It is about what breaks
• 1:18
  systems down slowly. And here is the part that
• 1:22
  never gets mentioned. I hear influencer after
• 1:25
  influencer obsess about protein, protein goals,
• 1:29
  protein timing, protein powders with names that
• 1:32
  sound like Marvel villains. And yet true protein
• 1:35
  deficiency in the United States, even among
• 1:37
  bariatric surgery patients, is rare. But 92% of
• 1:42
  Americans do not get enough fiber. 92%. And that
• 1:46
  lack of fiber is exactly why some people are stuck
• 1:49
  on the toilet with the latest squatty, potty
• 1:51
  scrolling, waiting, hoping, maybe even listening
• 1:55
  to my podcast, but quietly increasing their risk
• 1:58
  of rupturing a diverticulum or developing worse
• 2:01
  hemorrhoids. So today on 4Q, we are going to make
• 2:05
  sense of the madness of fiber. I am your Chief
• 2:11
  Medical Explanationist, Dr. Terry Simpson, and
• 2:14
  this is 4Q Fork University, where we bust a few
• 2:18
  myths, make sense of the madness, and teach you a
• 2:20
  little bit about food and medicine. Let me tell
• 2:27
  you a story about oats. Everyone except a few
• 2:31
  rubbish people agree that oats are healthy. The
• 2:34
  vast majority of literature shows that people who
• 2:36
  eat oats have less obesity, less diabetes, smaller
• 2:39
  circumference of their waistline. And everybody
• 2:42
  knows that oats have fiber. And steel cut oats
• 2:45
  probably have the most fiber. Well, groats have
• 2:47
  the most fiber, goes groats, steel cut oats,
• 2:49
  rolled oats, instant oats. But so One week, I
• 2:52
  decided to be very responsible and increase my
• 2:55
  morning fiber. Now, this was many years ago when
• 2:58
  I, um, was not so sophisticated about all this
• 3:00
  stuff. And I was in meetings all that week with
• 3:02
  colleagues. And every morning there was coffee and
• 3:04
  steel cut oatmeal. And they made it deliciously
• 3:07
  steel cut. It was nutty. It was delicious. So I
• 3:10
  joined in. Day one, fine. Day two, my bowels
• 3:13
  started getting the message. I was full. I was a
• 3:17
  little bloated. I was a little m expressive. By
• 3:21
  the time I got back to my office, this was no
• 3:23
  longer subtle. So I did what any reasonable
• 3:26
  physician would do. I opened a window and I lit a
• 3:29
  candle. I had one of those big old school desks,
• 3:32
  papers everywhere, large oak frame. And then I got
• 3:35
  a phone call. And I turned my back on the desk
• 3:38
  while I was answering the phone call. When I
• 3:40
  turned around, some papers were on fire and I had
• 3:43
  to put it out. And for years, that dark scorch
• 3:47
  mark on my desk reminded me of a very important
• 3:50
  lesson. Do not jump from low fiber to high fiber
• 3:55
  overnight. Your gut needs time to adapt. And yes,
• 4:00
  my desk paid the price for my confidence. That's
• 4:03
  why it's called a trial by fiber.
• 4:08
  >> Dr. Terry Simpson: Hi, it's producer Ivo jumping in here, saying I
• 4:11
  had no advance warning of any of this.
• 4:17
  >> Dr. Terry Simpson: All right, so what does fiber actually do? Or as
• 4:21
  some might say, what does fiber does? Fiber is a
• 4:24
  carbohydrate that humans don't digest. So you
• 4:26
  would never count it as a part of the fiber if
• 4:28
  you're counting carbs, which you shouldn't be, but
• 4:30
  you would never count it for added sugar. But
• 4:33
  there are different types of fiber. Okay, so we're
• 4:36
  going to go over this. It's not that boring, I
• 4:38
  promise. I want you to think of soluble fiber like
• 4:41
  the oats that I had. Barley beans, psyllium. And
• 4:43
  they form a gel in your gut. This gel slows
• 4:46
  absorption, which means that the glucose isn't
• 4:49
  absorbed as rapidly, so the glucose doesn't spike.
• 4:52
  And because your liver makes cholesterol, how it
• 4:55
  gets your cholesterol into your bloodstream is it
• 4:57
  dumps the cholesterol into your bile, which goes
• 4:59
  into your small bowel.
• 5:01
  >> Dr. Terry Simpson: And.
• 5:01
  >> Dr. Terry Simpson: And when you have fiber, it absorbs some of that
• 5:04
  cholesterol, which is why fiber lowers your low
• 5:07
  density lipoprotein cholesterol. And that, by the
• 5:10
  way, is why psyllium shows up in all the clinical
• 5:12
  guidelines. Now, insoluble fiber is simpler. This
• 5:16
  is what. Well, we'll call it the make your poop
• 5:18
  better fiber. It adds bulk, it speeds transit, and
• 5:21
  it makes things predictable. It also does the
• 5:25
  opposite. So if you have really loose stools,
• 5:28
  let's say you ate something you shouldn't have or
• 5:31
  have a little bit of distress fiber will actually
• 5:33
  help you. People who have problems with bile,
• 5:36
  salt, diarrhea, we put them on a higher fiber
• 5:38
  diet. People who have fatty diarrhea or other
• 5:41
  things, we put them on a higher fiber diet. But
• 5:44
  here's the thing. If you're on a GLP1, I am, for
• 5:47
  example, and you're constipated, I am not. You
• 5:50
  need to have fiber in your diet. Magnesium gummies
• 5:54
  are not a long term bowel plan. They're a side
• 5:57
  hustle. Insoluble fiber is the plumbing that you
• 6:00
  need. So I want you to realize that fiber just
• 6:04
  keeps things moving forward. All right, I'll see
• 6:09
  myself out.
• 6:10
  >> Dr. Terry Simpson: Yeah. If you honestly believe he's through, you're
• 6:13
  fooling yourself or haven't listened to these long
• 6:16
  enough. Okay, let's go, doc.
• 6:19
  >> Dr. Terry Simpson: Here's the other part that gives some people
• 6:21
  trouble. It's called fermentable fiber. This is
• 6:24
  things like beans, onions, garlic, asparagus,
• 6:27
  resistant starches. This is the fiber that feeds
• 6:30
  your gut bacteria. And when you feed the so called
• 6:34
  good bacteria, the part of your microbiome that
• 6:36
  you want, those microbiome tend to grow better and
• 6:40
  they will crowd out, uh, those bacteria that don't
• 6:43
  like fiber as much. And those good bacteria, they
• 6:47
  produce short chain fatty acids. This isn't fat.
• 6:51
  These are short chain fatty acids that your body
• 6:53
  uses for basic building blocks. And the most
• 6:55
  important one they make is butyrate. Which brings
• 6:58
  me to one of my favorite Internet myths. I've had
• 7:01
  carnivore people tell me very confidently that
• 7:04
  butyrate comes from butter. That butter is called
• 7:07
  butter because it contains butyrate. No, butter is
• 7:11
  called butter because the word comes from the
• 7:12
  Latin and the Greek, meaning cow cheese. Now,
• 7:15
  butyric acid was named because it was first
• 7:18
  isolated from a rancid butter, but not because
• 7:21
  butter is a good way to get it. The butyrate that
• 7:23
  matters is made in your colon by bacteria from
• 7:27
  fermentable fiber. Dietary butyrate from butter is
• 7:32
  absorbed in the small intestine and disappears. I
• 7:35
  mean, if butter were good colon therapy,
• 7:37
  gastroenterologists would prescribe croissants.
• 7:40
  And sadly, they do not. I mean, if croissants
• 7:44
  fixed your gut, Paris would be the healthiest city
• 7:46
  on, on earth. Now, let's talk about fiber
• 7:49
  supplements. And there are a lot of them out
• 7:51
  There. Benefiber, psyllium, husk, metamucil,
• 7:54
  citrusyl, others. And most of them will give you 4
• 7:56
  to 5 grams of fiber. That's about 10% of what you
• 8:00
  should get in a day. Helpful? Yes. Enough, No. I
• 8:05
  personally like a fiber supplement called Loam L O
• 8:08
  A M M which gives you about 12 grams of mixed
• 8:11
  fiber. And I use it in my morning smoothie. Now
• 8:14
  that's a bridge. It's not a replacement. But if
• 8:16
  your entire fiber strategy fits in a scoop, you're
• 8:20
  missing the point. Let's talk about irritable
• 8:23
  bowel syndrome or ibs. These people are the ones
• 8:25
  that'll say fiber makes them feel worse. Sometimes
• 8:29
  at first they're right. Because fermentable fiber
• 8:32
  produces gas and IBS guts are sensitive to gas.
• 8:37
  We're all sensitive to gas. Some clinicians use
• 8:41
  what's called the fodmap diet as a temporary
• 8:43
  elimination tool to identify the triggers. But we
• 8:46
  don't live there. We use a Mediterranean style
• 8:49
  diet, which in recent series has been shown more
• 8:51
  important to identify problems and reintroduce
• 8:53
  foods. Now, I've heard some of the paleo ancestral
• 8:57
  diet people say, oh, use the whole 30. It's an
• 8:59
  elimination diet. It's not. It's low carb cosplay.
• 9:03
  We eliminate to learn, not to live. Afraid of
• 9:07
  food. Now people ask, what does eating enough
• 9:10
  fiber actually look like? Because you want to do
• 9:12
  this without thinking about it. And if you want, I
• 9:15
  have a three day Mediterranean diet that's free on
• 9:18
  terrysimpson.com but let me walk you through a
• 9:20
  simple day. In my morning, I have oats, berries, a
• 9:23
  little bit of nuts, maybe some chia seeds. In my
• 9:26
  smoothie that's a combination of soluble and
• 9:28
  insoluble fibers and some polyphenols. For lunch,
• 9:32
  I'll have some vegetables, carrots, some beans or
• 9:35
  lentils. I'll have some whole grains, like maybe
• 9:37
  a, uh, sandwich. And this is where the microbiome
• 9:40
  starts smiling. For snack, I'll have a stone
• 9:43
  fruit, maybe some nuts. I don't have a protein
• 9:46
  bar. Most of those kind of have the texture of
• 9:48
  drywall and the taste close to what I would
• 9:50
  imagine drywall would taste like. And dinner is
• 9:53
  pretty simple. I have some vegetables and I have
• 9:55
  whole grains like farro and some fish or poultry.
• 9:59
  Now, this kind of eating routinely delivers about
• 10:01
  25 to 40 grams of fiber. No spreadsheets, no apps,
• 10:05
  no drama. And with my loam, I'm getting in at
• 10:09
  least 37 to 50 grams of fiber easily. So if you're
• 10:14
  part of that 92%. And if you're listening to this,
• 10:17
  you probably are that are not getting enough
• 10:19
  fiber. Go slow, increase gradually. Make sure
• 10:22
  you're well hydrated. Remember my desk. And
• 10:25
  remember this. You're not fragile, but you might
• 10:28
  be flammable. Now, fiber isn't magic. It's not
• 10:36
  trendy. It doesn't have any influencers. It needs
• 10:40
  forks. And if you're bringing your phone into the
• 10:43
  bathroom just in case, that's not aging, that's
• 10:46
  fiber deficiency. Please see the blog associated
• 10:54
  with this@yourdoctorsorders.com and and check out
• 10:58
  my substack@drsimpson.com the podcast was
• 11:02
  researched and written by me, Dr. Terry Simpson.
• 11:04
  And while I am a board certified physician, I am
• 11:07
  not your physician. And before making any changes
• 11:10
  to your diet, please talk with your board
• 11:11
  certified physician and a registered dietitian.
• 11:14
  Don't talk to a chiropractor or some functional
• 11:16
  medicine witch doctor guru. All things audio are
• 11:19
  done by my friends at Simpler media. And the pod
• 11:21
  got himself Mr. Evo 2 Tara. And producer girl
• 11:24
  Productions is responsible for making me more
• 11:27
  interesting than I am. Have a good week,
• 11:29
  everybody. Hey, Evo, what's your favorite fiber?
• 11:45
  And keep candles away from the oats, buddy.
• 11:50
  >> Dr. Terry Simpson: Yeah, I'm pretty sure the problem was really more
• 11:53
  about the methane, uh, than the oats themselves.