Episode 70: Gut Talk for the Guys

The content of this podcast has not been evaluated by Health Canada or the FDA. It is educational in nature and should not be taken as medical advice. Always consult a qualified medical professional to see if a diet, lifestyle change, or supplement is right for you. Any supplements mentioned are not intended to diagnose, treat, cure, or prevent any disease. Please note that the opinions of the guests or hosts are their own and may not reflect those of Advanced Orthomolecular Research, Inc.

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Welcome to Supplementing Health, a podcast presented by Advanced Orthomolecular Research. We are all about applying evidence based and effective dietary lifestyle and natural health product strategies for your optimal health. In each episode, we will feature very engaging clinicians and experts from the world of functional and naturopathic medicine to help achieve our mission to empower people to lead their best lives naturally.

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[01:10] Cassy Price: Hello and thank you for joining me today for another episode of Supplementing Health. From infancy to old age women are simply healthier than men. Out of the fifteen leading causes of death, men lead women in all of them except Alzheimer’s disease which may be because many men don’t live long enough to develop Alzheimer’s. Although the gender gap is closing, men still die on average five years younger than their wives. This month we are focusing on conversations that can help men move the needle toward a healthier, longer and more vibrant life. With me today to discuss irritable bowel syndrome and how it affects men is Michelle Probega, naturopathic doctor. Michelle helps her patients overcome their unique health obstacles and educates them on how to integrate new health habits into their modern lifestyles for sustainable benefits. Welcome Michelle, thanks so much for joining me today.

[01:54] Dr. Michelle Pobega, ND: Thank you so much for having me. I am really excited to be part of this.

[01:58] Cassy Price: So, you often hear about irritable bowel syndrome and Irritable Bowel Disease and they are used interchangeably. What is the actual difference between these two conditions?

[02:08] Dr. Michelle Pobega, ND: Okay. So, we have one which is irritable bowel syndrome. The acronym is IBS so you will often hear that thrown around in conversations, IBS. The other one is a category called IBD. It is actually not called Irritable Bowel Disease it is actually called Inflammatory Bowel Disease. There is a distinct difference between these two. IBS is considered a syndrome. Just in association of various kinds of clinical findings and symptoms but there isn’t an overt cause that can be identified from at least traditional medical standards and there isn’t gross tissue damage inside parts of the intestinal wall. IBD however, Inflammatory Bowel Disease, is a category of two types of diseases, Chron’s Disease and Ulcerative Colitis. These are autoimmune conditions. There is actually a known cause because the immune system has then attacked itself and therefore because of this quality of immune system it is attacking parts of the intestinal tract and it causes a gross amount of inflammation which can be observed on imaging studies so you can pinpoint actual damage and there is a known cause which is an imbalance in the immune system. Those are the main differences between the two, but they often have very similar and overlapping symptoms, so it is through diagnostic testing and symptoms and possibly imaging studies and lab tests that you get to identify which particular concern you are dealing with in practice.

[03:41] Cassy Price: So, then can IBS be cured?

[03:45] Dr. Michelle Pobega, ND: So, I always find the word cured funny because it is really about your definition. In the traditional sense a lot of things can be cured and then there are a lot of things that have been deemed incurable and you always have that outlier that are somehow cured of sporadic curing of cancer or stuff like that. You hear these random stories of people overcoming things that were deemed incurable. IBS, here is the thing with that. Our digestive system is influenced by so many different moving parts: what you eat, how you feel, toxin load, emotional stresses, liver toxicity, are you making enough stomach acid, are you making enough enzymes, are your bacteria in check, did you get a parasite? The thing with contributing factors to develop something like IBS, there are so many moving parts. I find cure is more of a relative term. I usually like to say IBS in remission because I find something that unravel that area of your digestive tract again if you are just not being mindful and taking care of it. I find a place where people can feel that they are back in the driver’s seat of their digestive issues, and it doesn’t plague their day to day life anymore. If they know that they can make certain choices that elevate their health and keep them in a really balanced place, or they can make choices that might allow things to unravel again. So, I find IBS for the most part you can really get a huge grip on it and feel so much better, but I usually find it is one of those things that I like to say in remission. I am someone who had IBS before and I find that if I am under a chronic state of stress, then little things will start to flare up again on me. I usually find that my digestive system is my weakest link. The weakest point of my body. It is my gauge for whether or not I am taking care of myself. If life’s circumstances are overwhelming for me, am I eating a way that honours my body or am I eating a way that really deteriorates health. So, I use it as my gauge for health. It is always something that I am a little bit mindful of. I am not sure we can say that it can be 100% cured but I think that you can really get a huge control over it and that can change your quality of life immensely.

[06:13] Cassy Price: So, then, if IBS is left untreated and unmanaged can it lead to IBD down the road?

[06:21] Dr. Michelle Pobega, ND: Yeah. So, here is the thing. IBS is considered a condition that is more of a functional digestive disturbance so there is an issue with how the digestive system is functioning and if it is left untreated then you can then have further breakdown of function and further breakdown of function and further breakdown of function. That leaves an innate vulnerability in your digestive tract after. Now, autoimmune diseases like Chron’s or Colitis, which are part of the IBD or Inflammatory Bowel Disease category, in functional medicine and naturopathic philosophies often people have a predisposition or a possible genetic predisposition for an autoimmune condition. But, the switch doesn’t necessarily get flipped on unless the situation is the right amount of chaos to flip that particular switch on. A lot of people attribute perfect storm within the digestive tract to be one of those things that can flip the genetic potential for an autoimmune condition to be turned on. So, things like Leaky Gut, which people might have heard, food sensitives, microbe overgrowths, those types of things have been shown to then put pressure on the immune system and allow for an imbalance where it might trigger an autoimmune condition. And, for some people that might mean that the autoimmune condition is centred or localized to the gut where you might end up with Chron’s or Ulcerative Colitis or another autoimmune condition not part of that category called Coeliacs Disease where when the immune system is triggered it attacks itself and it attacks the intestinal wall for all three of those categories. So, the potential is there. It doesn’t mean that that is the autoimmune condition that will show up, but the potential is definitely there if the digestive tract and your digestive health is not properly managed and what I find is that for any autoimmune condition, gut health is primary number one. That is what you have to heal, otherwise you are not going to get anywhere. It is like having a car in park and then pressing on the gas expecting to move forward. The gut has to be healed in order to repair any autoimmune condition.

[08:38] Cassy Price: Okay, so, is there an average age of onset for IBS or IBD?

[08:45] Dr. Michelle Pobega, ND: So, great question. Things like IBS, irritable bowel syndrome, statistics and research papers and medical literature tends to say that it is more prevalent in females, and it also says that age of onset is typically somewhere between the teenage years to age 40 where they start to see IBD symptoms come about. For conditions such as Inflammatory Bowel Disease, it tends to be between age 15 to 35. It tends to be most susceptible in that age category but then there seems to be another category between the ages of 55 to 70 where they are starting to see that manifesting in that population as well. It tends to have a two-tiered population hit. 15 to 35 and 55 to 70 for the IBD.

[09:38] Cassy Price: Is it a similar age frame for the men that do suffer from those?

[09:43] Dr. Michelle Pobega, ND: Yeah, that one doesn’t seem to be discriminatory between males and females although I find that females tend to be more susceptible to digestive things like IBS. IBD, I haven’t necessarily come across something that says otherwise. I think it is a little bit more even keeled.

[10:04] Cassy Price: Okay. So, statistically Canadian’s suffer from one of the highest rates of IBD in the world. What do you think from your experience contributes to that?

[10:16] Dr. Michelle Pobega, ND: Great question. I was doing a course or webinar a couple of years ago and they were actually looking at immune system function and autoimmune conditions and regards to things like IBD, inflammatory bowel disease, because it is an autoimmune condition, I think this particular research that they conducted will speak to why IBD is more prevalent in a country like Canada. They found that autoimmune conditions as a whole are increasing in prevalence in more industrialized and more modernized countries and societies. When they compared people who lived in more rural areas who lived more on farms or are more connected to earth or people who were in less affluent countries who are living in what would be deemed a more impoverished life where there was more contact with dirt and microbes and less computers and indoors and less stress and corporate world, they found that autoimmune conditions were less prevalent in those particular countries. Some conclusions that were drawn from that were because they were more connected to the earth. Their immune system, the muscles of the immune system, was constantly being flexed and strengthened because they had a much more robust exposure to different microbes and pathogens which are inherently how we develop our immune system.

[11:44] They also concluded that by having better sun exposure, by being more active, by eating less processed food, eating less chemically burdened food, being around less chemical exposure, all of those things create less of a burden on the body so the immune system is able to work more advantageously and more balanced and more in favour of how it had to protect the body. Autoimmune conditions are where there seems to be some sort of hiccup in communication and the body begins to attack itself when the immune system is triggered. The conclusions from the study were that the way we live in modern society, yes, our advances have been incredible for so many things but in other ways it has left us very short despite our advances in certain kinds of technologies and medical advances chronic health conditions have continued to increase and conditions like autoimmune conditions and allergies, another immune issue, have begun to become enflamed in this modern society. The conclusion is that it has to do with our disconnect with nature and our disconnect from our nutritious foods, our disconnect from sunlight and proper exercise. We are indoors all day. We are not breathing fresh air. We are surrounded by chemicals, and all of this continues to burden the body to the point where it begins to break down and there can be a disruption in function because of that. When you say the statistic saying that Canada is one of the most prevalent for IBD, that does not surprise me at all based on that type of research when it comes to autoimmune diseases in general.

[13:32] Then you have to add in the factor that we do so many things unfortunately in modern society which really effects digestive function. Chronic stress greatly effects digestive function. Stress isn’t necessarily somebody feeling ‘stressed’ or angry or agitated or anxious, chronic stress could be sitting in front of traffic. I am from Toronto, and it is horrendous. Chronic stress can be your boss yelling at you. Chronic stress can be financial stress. It can be internal where there is an excessive amount of inflammation so now your body is on high alert all of the time and that in itself creates stress hormones. When your body is in a chronic state of stress digestion is not prioritized because when your body feels that it is under a state of attack its feeling like it has to send its resource and arm its defence for whatever it feels it is being attacked by. Digestion is not held number one in that moment. It is deprioritized. When you are not prioritizing digestion, it is bound to have more breakdown. It is bound to have hiccups in function, and you are bound to start to express certain kinds of symptoms which them lead to vulnerability for other things to begin to develop possibly like IBD. Then we have to factor in how much processed food we eat in North America as well. All of this type of food that our body doesn’t actually recognize that comes along with chemicals and genetic modification or hybridization of grains, that is a really big one where our body no longer recognizes a lot of these molecules and it is not able to break them down, that in itself creates digestive issues and local upset in the digestive tract and possibly inflammation in the tissue and then symptoms like diarrhoea or constipation or excessive gas or stinky gas and things like that. Now we have this stage for a highly vulnerable area in our digestive tract for anything else to begin to manifest.

[15:47] Cassy Price: Do you find any of those symptoms are more prevalent for men over women? Do both genders present with similar type symptoms or can some of them be more tailored to one gender over the other?

[16:00] Dr. Michelle Pobega, ND: Its interesting. Here is the thing. I find that women in general are a little bit more attuned to the subtle changes in their body. They are more likely to voice something about that or seek help for it. In my practice I treat a lot of females with digestive health. It is probably like a five to one ratio or maybe bigger ratio of female to male that I treat. However, from a symptom perspective I find that IBS, gas, bloating, all of those things, it doesn’t discriminate male verse female. Now, females I find are a little bit more susceptible to things like gall stone development which can add further injury to digestive function just with oestrogen levels and how it effects bile production and possibly the formation of gall stones. We tend to be a little bit more vulnerable to that but beyond that I find gas, bloating, stinky poops, constipation, diarrhoea, all of the things that nobody wants to talk about, when it comes to digestive symptoms if somebody comes to me with IBS it can vary from person to person regardless of what gender they are. They all have unique presentation of how those symptoms come up. I don’t really find a huge distinct difference between males verses females. I think that females are more likely to come into the office and seek help for it, so I see it more frequently.

[17:25] Cassy Price: As you just mentioned, generally speaking men don’t go to the doctor as readily as women do. So, are there things that they can do at home to support their digestive issues prior to seeing a healthcare professional?

[17:44] Dr. Michelle Pobega, ND: Absolutely. The foundational work is so important, and it is all things that you can do at home that doesn’t require a pill. We take a lot of things for granted. We go into auto pilot, and we want things that are easy and convenient with what we intake into our bodies from a fuel and food source, but we need to start being more mindful about our choices. Men tend to be more meat potatoes and beer people. Women are more likely to eat a salad. So, women tend to have more fibre and more nutrient value across the board, as a general rule, as the patterns that I have seen this is more of a likely scenario. What I would say to men is begin to balance out your plate. It doesn’t mean you can’t eat a huge hunk of steak if that is what you really want but do you make sure that you have an ample amount of vegetables to be paired up with your meat? I find a lot of men are very meat-centric and protein-centric but vegetables tend to be an afterthought. It should be more of a priority. I have been in a relationship with my current partner for about seven years and only now despite my trying to hammer in the benefits of it and him seeing how I eat and when he eats with me, he feels so much better, but he just could not take the initiative for himself. It took him a few years to finally realize and connect the benefits of eating that way and beginning to prioritize that for himself and being an advocate for eating healthier for himself. He is reaping the benefits. Now he loves to brag to me about how much better he feels, full disclosure, how much better his poops are in the morning and how he doesn’t feel so bloated and how he is able to lose weight better and his energy is better and his sleep is better and all of these things because he is prioritizing a healthier eating habit. So, getting an abundance of vegetables is really important.

[19:42] Getting an abundance of green vegetables is extremely important. What I usually say as a rule of thumb is that half of your plate should be non-starchy vegetables so like your greens, your peppers and your cucumbers, cabbages, cauliflower, all of those things. An ample amount of greens in addition to all of the colourful vegetables is already a really big win when it comes to balancing out your meals. If you are thinking about pie charts and you are looking down at your plate you need to fraction it off like a pie chart, try to make half of it an ample amount of that non-starchy veg. then when it comes to the carbohydrates, I would encourage men to not just depend on the breads, the pastas and the grains for carbohydrates. Yes, they are easy, they are convenient, but they tend to be the things that have been the most chemically altered or genetically modified and have had the most food scientist influence on them. Sometimes our body doesn’t recognize them anymore or they tend to be more inflammatory now because of our interventions that we have done to make them in such mass production. I would say focusing less on grains all of the time doesn’t mean you can’t eat grains. It doesn’t mean that everybody has to be gluten free but try and change it up. Pick different sources of carbohydrates. Don’t always take white potatoes. Sometimes pick sweet potatoes. Sometimes pick purple potatoes. You can also try different root vegetables like casava root or Jamaican sweet potato or squashes. All variety of squashes are a source of carbohydrates, and they are very healing to gut tissues too especially roasted and they are super yummy with some salt and olive oil and spices. If you throw them on a roasting pan and let them cook for a good 25 to 30 minutes and they are delicious and easy on the digestive system and they can be very healing for the digestive system. I would also say other root vegetables.

[21:47] Look at things like carrots, beets, turnips, parsnips and rutabaga. I would include those as sources of carbohydrates. Creating more variety is really important and not just having the same thing day in and day out. Our body is made of a robust amount of bacteria and different kinds of microbes within our gut. It is called our microbiome. It is really important ecosystem that lives inside our digestive tract. The balance and the health of that ecosystem greatly influences your digestive function and your overall health and wellbeing. There is such a diverse amount of microbes that have to live in our gut and they feed off of and are fuelled by fibres and the fermentable kinds of sugars and starches that we get from vegetables, legumes, grains, starchy vegetables and fruits so creating a higher variety of what you eat actually creates a higher variety of food and fuels to feed the diversity of our microbiome as well. Not only are you getting a higher amount of nutrients that support optimal digestion and poop production and reducing poor bacteria you are also feeding the good bacteria by balancing out your plate this way. so, that is a really big things that most men could probably begin to be more considerate of. 

[23:14] Cassy Price: I actually have two questions that came out of all of that. One, is there a particular type of diet then that someone wanted to follow, say like, Whole30 or whole food 30 or Mediterranean or low fodmap or any of those. Is there one or any particular diets that are better for supporting the digestive tract then over others?

[23:37] Dr. Michelle Pobega, ND: Absolutely. I find diets always have got to be individualized. I find that as a good starting point the Mediterranean diet is pretty good but I was actually said something like the paleo diet is a really good starting ground, not meant for everybody, but it is a good starting ground because how they describe portioning plates and eating is the way that I would give general instructions to people to begin to set a better foundation where it is healthy clean proteins, so whether it is animal or vegetarian or vegan based proteins, making sure that you chose clean sources that haven’t been excessively manipulated by man with chemicals or genetic modification or what not. Those are going to be really important. Having a good amount of clean healthy fats. So, avoiding things like inflammatory oils like peanut oils, vegetable oil, throw away your margarine because it is terrible for you, the canola oils and grapeseed oils and peanut oils. Those are so inflammatory, so you want to focus on a good serving with each meal of your healthy fats that come from whole free run eggs, from avocados, from olive oil, from coconut oil, from organic grass fed butter or organics grass fed ghee. Having an abundance of fruit and vegetables, mainly vegetables, on your plate. Having a more mindful portion of carbohydrates and not just always been grain dependant on the carbohydrates.

[25:05] I find the paleo diet tends to cover those kinds of categories. Now, after that it might have to be become more specific based on the individual’s needs. Some people might need to do a low fodmap diet. IBS can benefit from a low fodmap diet, but this should never be a diet that someone is on indefinitely. It should be used strategically and for very concise period of time to help them overcome the bacterial imbalance that is contributing to their IBS symptoms or symptomatology. That type of diet, low fodmap, is not sustainable long term and should be used acutely and strategically with a really mindful treatment plan. Things like the Whole30 diet is also very clean. It is a little bit more restrictive I think than the paleo diet in the sense that you are eliminating a lot of common food allergens or inflammatory foods which obviously in the long run is really good. That can be something that people can experiment with. I find that general rule of thumb I am falling typically in the general rule of a paleo-esc type of recommendations and then after that I will get individualized treatment care for clients. For a lot of people with digestive concerns I will run testing for food sensitivities so they can identify uniquely for them what are the foods that are most irritating that they may need to take a temporary or extended break from to allow the body to fully reset or rebalance and strengthen or function again. I don’t think there is a one size fits all for diet or for anything or for anyone to be honest with you. It always has to be individualized. Like I said, the paleo diet tends to have a really good jumping point to maximize your diet on your behalf.

[27:02] Cassy Price: That all makes total sense to me. I know I actually used to suffer from symptoms of IBS and I know when I found out what my food sensitivities were and ate more paleo-esc, it wasn’t true paleo as in following it exactly but definitely more that style, it totally changed things and now I can enjoy some of those foods that I do have sensitivities to in moderation and so it is definitely shifted back to less restrictive and less rigid but now night and day compared to where I was before when things were enflamed and angry shall we say.

[27:42] Dr. Michelle Pobega, ND:  Totally. I’m a previous IBS sufferer myself and I had to do things where I started to realize gluten was a thing just by trial and error I started to realize that bread was affecting me and the symptoms would come on almost three hours later I would be doubled over in pain and I was finally clued into what it was. I was careful but then it became a slippery slope where I would have a little bit and a little bit more and then my symptoms would flare up again. Then my body had a breaking point several years ago where stress was at an all time high for various reasons including like my father getting sick, I left one of my clinics, I started my own business, there was a breakup in my relationship. There were so many things. I was an emotional basket case in all sense of the words and I was running on fumes. I was emotionally eating too in addition to that, and everything just fell apart. I lost so much weight. Food would not stay in me. It was a terrible moment. Then I finally bit the bullet, and I was like “okay, you know gluten is not a good thing for you, but I think it is beyond that.” I was like “fork out the money, run some tests and figure it out” and I finally invested in a food sensitivity test for myself which showed leaky gut at that time because my body was just so broken. My biggest hitters were gluten and dairy and eggs were high, temporarily I had to be careful around eggs for a while too. In addition to that I had to look at my microbiome stuff and stress resiliency and that really made me pivot with regards to stress resiliency too and working on my mental and emotional health because that is what now keeps me in a much better place.

[29:27] So, when stress really escalates my body doesn’t fall apart under the damage of stress anymore. That was a really big part of my journey. Like you were mentioning, having to go through that and being more, I don’t want to say restrictive because restrictive has a very negative connotation, but having to be very mindful of my food choices during that healing time was absolutely necessary and I had to get over that hump. Now I have to say that gluten is still my kryptonite. I’m half Italian I just want to eat focaccia bread and dip it in oil. I say that now I am 99% gluten free so I haven’t been tested for coeliacs because at that point in my life when things were so terrible, I just wanted to feel better and I couldn’t fathom continuing to eat something that I knew something didn’t agree with me just for the sake confirming this test and having to possibly wait two to three months to see the specialist and still feeling terrible. I have never been actually tested for coeliacs, but I just pretty much avoid gluten. If I go on a vacation, like I did go to Italy about a year after that whole dramatic event of my life, I was able to enjoy moments, but I didn’t go out of my way to eat a whole bowl of pasta at every meal. I didn’t go out of my way to eat pizza at every meal. I would choose a risotto. I would have an ossobuco or something like that and have some bread on the side. I was very mindful of my choices, and I was still able to enjoy my vacation and enjoy those moments without being completely derailed and when I came home, I knew I had to get myself back on track and feel my best again and do what I knew honoured my body.

[31:12] I can now pick and choose those moments, like you said from your own experience, you know you understand now that if you make a choice there might be a small consequence, but that consequence isn’t going to dictate the whole of your days anymore. You know how to bring it back it and bring yourself back to a place of feeling good again and now you can just pick and choose those moments if you feel it is worth it in in the moment. That is the ultimate goal for people. I always want people to get back to eating the highest variety of foods that they possibly can in a way that honours their body. That might change depending on where you are in life, right? Like when people get pregnant, they can’t stand certain foods so just like when you get excessively stressed your body might start to reject certain foods or the stress plus the food might cause looser stools, so you have to just be more mindful of what your diet choices in that more stressful period of time in your life. I find that going through the process of working on your digestive health is extremely empowering for people who have suffered from digestive issues and really felt lost, confused, out of control, it felt like their digestion was, like you mentioned, angry all the time and you didn’t know how to soothe it, when the ultimate goal is to get people to a place where they feel like that is not what dictates their life anymore. They dictate their life. They get to choose. That is always what I want for people. I want people to feel empowered by their health.

[32:37] Cassy Price: You had mentioned digestive enzymes. So, in your opinion what role does supplementation play in managing and addressing poor digestive health?

[32:45] Dr. Michelle Pobega, ND:  Huge. Especially for people that are healing, right? To get people to a place where their body is self-sufficient again, you are likely going to need other interventions beyond food. Food and a healthy diet or healthy lifestyle choices, we have to also give props to the fact that you need to drink good water, get good sleep, you need to move your body. You need to find health and clarity and resiliency from a mental, emotional, and even spiritual standpoint because that dictates your physical wellbeing too. That has to be foundational. That food and nutrition; everything you eat, if you eat something every day that works against you rather than for you, you bet you are going to feel lousy eventually so that food and foundational work is so key because that is what is going to provide longevity to your healing process. The supplements will need to be implemented typically at the onset of your healing process to really guide the course of treatment to help redirect things in your body to help rebalance things in your body to help reset, to heal tissue, to strengthen digestive function, to increase your stomach acid levels, to possibly support enzyme activity, to help your liver detox and clear out bile or improve the consistency of your bile so you can absorb your fats so you don’t have lose stools all the time. Supplements are going to be really important as long as they are used strategically and your supplement protocol might change based on where you are at in your healing process. I am not having people on the same thing for an indefinite period of time. We check in regularly and we adjust things based on how they adapted, how they felt, what stage of the healing they are at. That is an important part of the process because sometimes there is so much damage that is done that you need the extra artillery, and you need those extra tools to go in and help clean up that damage so that there is sustainability and you leave the body in a less vulnerable state so that you can continue to feel good for long periods of time. So, supplements do play a big role.

[34:53] Cassy Price: Would you say there is any supplements in particular that you would use for the majority of digestive cases? Of course, there is always going to be outliers but are there any in particular that you would say 90% of the time are included in your protocols?

[35:09] Dr. Michelle Pobega, ND: Yes. People probably think I am going to say probiotics but that is not really the case. People think “oh I’m going to see a naturopath; they’re going to put me on a probiotic.” There is a very good chance we might, but it might not always be the first step because I find for certain digestive conditions adding in a probiotic is going to make your symptoms worse. If you have IBD, Irritable Bowel Disease so either Chron’s or Colitis, and you are in the middle of flare having a probiotic might trigger your immune response to be little bit stronger and it might irritate your autoimmune condition because your probiotics are a key and pivotal component of your immune systems function and the wrong thing at the wrong time can be disastrous for the healing process. Probiotics are not my go to despite what people probably think with digestive health concerns. Usually, I might introduce something like a really good fibre supplement to help regulate bowel movements whether they have diarrhoea or constipation because that also begins to feed the good microbiome in an advantageous and more balanced way. Gut healing a gut soothing nutrients; things like L-glutamine can be very important at very strategic parts of the healing process in addition to demulcents. Demulcents coat any kind of irritated intestinal issue to help it heal.

[36:34] So, it creates almost a soothing mucosal like layer. Think about it this way, whenever you have an irritation in your sinuses which is also mucus membrane, your body makes mucus and mucus has this really thick gooey consistency because what it is supposed to do is create a coating on the irritated tissue so that whatever virus or microbic sector doesn’t continue to irritate the tissue and it allows the tissue to heal. That’s why it produced mucus. Our bodies are so incredible this way. the same goes for our digestive tract because our digestive tract is one big mucus membrane. So, for symptoms say with IBD like Chron’s or Colitis you might notice things like mucus in the stools because your body’s natural defence to the irritation and the damage to the intestinal walls and the inflammation there is to produce more mucus. What we can do with a supplement is the implement the demulcents that have mucus like activity so that your body doesn’t have to create so much mucus and it allows the healing of the intestinal tissues to happen at a better rate and a better pace. Demulcents are things like deglycerolized liquorice fruit, marshmallow roots, slippery elm. Those can be really important for the healing process. Sometimes I will look to digestive enzymes because at the end of the day it actually takes a lot of energy to digest food, a lot of energy. If your energy needs to be conserved so that you can heal the digestive tissues, sometimes taking the burden off the digestive tract a little bit is helpful for the healing process and a really good comprehensive digestive enzyme can be part of that to allow us to lift a bit of the burden so more energy and be directed to the healing instead. So, those can be some really big key players when it comes to dealing digestive function. Beyond that, if there is a microbial issue then I will add in strategic antimicrobials or antiparasitic or anticandidal plus liver support because the digestion, we forget that it is more than one moving part, it is not just a stomach. It is your mouth. It’s your stomach. It is your liver. It is your gall bladder. It is your pancreas. It is your small intestine. It is the microbiome in the small intestine. It is the large intestine. So, there is a lot of moving parts to factor in and consider when it comes to assessing and managing IBS or IBD conditions, but supplements are going to play a really key role 100%.

[39:09] Cassy Price: Awesome. Well, this has been a fantastic conversation. There has been tons of information that you have shared, and I really appreciate you taking the time to chat with me about this topic because I think it does effect so many people especially when you think of all those that suffer from IBS as well as those with IBD.

[39:25] Dr. Michelle Pobega, ND: Absolutely. I am really happy to be a part of this conversation through men’s health month at you guys are focusing on because I would love to be able to support and help more men. I want men to be more connected to how they feel and be more mindful about how they feel. You know, I think we are past the stage in our evolution as a society where we are just expecting men to just grin and bear it, suck it up, walk it off. You know the whole thing where you just get an injury on the field, “just walk it off.” No, we don’t have to be tough all of the time. You can ask for help. It is not a sign of weakness. It is actually a sign of empowerment to become the master and commander of your own body again, right? If you feel that things are out of sorts or out of control, then ask for help. Digestive health is going to influence everything else. If you want to be able to lift weights and be strong and be healthy you need to be able to absorb your nutrients. If you cannot do that from a digestive perspective how much weight do you think you are going to be able to lift in the gym? Are you going to be able to be an active dad for your children? Are you going to be able to think clearly when you go to work if you have brain fog, or you are exhausted all of the time because your body is just enflamed? I think we have normalized a lot of symptoms as just part of “this is just how it is in normal life” but excess of gas is not normal. Stinky gas is not normal. Having explosive poops is not normal.

[40:48] Constipation and diarrhoea or the flip flopping of those is not normal. Acid reflux is not normal. Getting bloated where you feel like there is a balloon in your stomach is not normal. Having brain fog or feeling tired or not being able to wake up in the morning or having restless sleep, all of these things is not normal. A lot of stuff actually stems from improper digestive health. I think that it is important to get men to think about their bodies differently and begin to become more attuned to that and just honour their bodies more. You know that can begin with what you put on your plate. Drink really good amounts of water. Eat more vegetables and least start there. That is a really good starting point. Also chew your food. Men eat really fast. I am just going to throw that in there at the last minute. Chew your food. Digestion starts in the mouth. That alone can make a huge difference to how everything else works downstream because this is the starting point. Chew your food well. If that alone is the take home message; eat more vegetables, drink really good water and chew your food and start to listen to your symptoms and ask for help because you have the potential to feel so much better than you realize.

[42:01] Cassy Price: That is so true. Once you start feeling better you wonder how you thought you felt good before really, at least in my experience.

[42:09] Dr. Michelle Pobega, ND: Absolutely. A lot of people have no idea how much food impacts their health until they begin to take strategic breaks from it and actually assess their digestive health and then they realize “I have been living in a cloud or in a fog. I was living suboptimal level of myself. There is such a higher level of my ability and my capacity to be present in this world and active and happy and joyful and energized and strong.” Sometimes people don’t realize how much food affects us until you are challenged to actually think about what you eat maybe make some adjustments and ten you are like “woah. This is a whole new world.” I love working with men because it is just frank conversations, and you can joke around, and you have a great time with it. The changes that happen in them and their responses are so incredible, and they are like “how come nobody has told me this before?” So, there is this level of a quality of life that might be untapped yet by you and if you start to work on digestive health and start taking measures to eat in a way that actually energizes and fuels you properly the sky is the limit.

[43:26] Cassy Price: So, if our listeners want to work with you, how would they go about doing that?

[43:31] Dr. Michelle Pobega, ND: So, you can go to my naturopathic website with is drmichellend.ca. I work in the Etobicoke location of the GTA, and I am also in Georgetown. Virtual appointments are also available. Due to my licence, I can only treat people who are also in Ontario. So, if you are in Ontario and you wanted to begin to assess and work on your digestive health then virtual appointments are available to you at both locations. I am also on Instagram where I am most active if people want to connect with me and understand my message and learn some tips and tricks before they even want to commit to an actual appointment, my Instagram handle is @dr.michelle_nd. There is have videos and helpful tips and all of these wonderful things and that is a really great way to start getting you on track before you jump into a full commitment of an appointment if you are not ready for that step.

[44:35] Cassy Price: Fantastic. Well, thank you so much. This has been a fantastic conversation and I really appreciate you joining me today.

[44:40] Dr. Michelle Pobega, ND: Thank you so much for having me. I loved this talk. I really hope this connects with a lot of men out there.

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Thank you for listening to Supplementing Health. For more information about our guests, past shows, and future topics, please visit AOR.ca/podcasts or AOR.us/podcasts. Do you have a topic you want us to cover? We invite you to engage with us on social media to request a future topic or email us at [email protected] We hope you tune in again next week to learn more about supplementing your health.

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