Real Talk with a Dietitian and Neuronutrition Expert
The Nutritional Mental Health Podcast. Host: Annika. Guest: Gabrielle Palmeri.
Annika: Welcome to the Nutritional Mental Health Podcast, the podcast where we talk about the intersection of nutrition and psychological sciences. I’m your host, Annika, a nutritional mental health practitioner with a master’s in health psychology. I’m passionate about making science accessible. To dive deeper into nutritional psychology, you can find me on Instagram at @thenutrmindlab. And now, let’s get into this episode.
We’re cutting through all the wellness industry noise on gut health with registered dietitian Gabrielle Palmeri. Gabrielle takes a root-cause approach to all of her clients’ gastrointestinal concerns, and she is a social media educator on the nutritional science of what gut health truly is. Thank you so much for coming on. I’m excited to talk all about gut health with you.
Gabrielle: Hello, thanks for having me. Me too!
Annika: What actually was your journey into gut health, and why do you educate people on it nowadays?
Gabrielle: I could take this in a lot of different ways, but the whole reason I’m a dietitian is because I struggled with an eating disorder and disordered eating. I did have some GI issues when I was a child, but they got worse because of my eating disorder and disordered eating. I felt like I was teaching my body how to eat food and break down food all over again. And I felt like it was such a common space, where everyone is always talking about being bloated or having GI issues. I also have some people in my family with colon cancer, IBD, diverticulitis, stuff like that, and IBS, where we don’t really know exactly what’s going on, we just know that things are uncomfortable. So I was always interested in it, and I started learning about it.
Then, when I was working in the hospital, one job offer was at a children’s hospital to do inpatient and outpatient care. I ended up doing pretty much everything, but my main area was GI. I got to work with a lot of inflammatory bowel disease patients, celiac disease patients, food allergies, sensitivities, EoE. There are just so many cases where someone needs to be on an elimination diet, even if it’s only for a short period of time. So it was partly interest, partly personal experience, and partly that colon cancer is on the rise. I’d love to help people not feel like they have to plan out their day according to their pooping schedule. Like, “Oh, I can’t go to this because I’m going to have diarrhea.” Sorry!
To be honest, I think a lot of people’s lives get halted very easily if they have GI issues, and not a lot of people talk about it because it’s somewhat uncomfortable to talk about on the internet. I like talking about it because I feel like it’s helped a lot of people.
Annika: Yeah. Even just introducing the Bristol chart, making sure people actually know what they’re supposed to look like. You’re not supposed to have very runny stools all the time, or have a lot of difficulty passing them. That’s not normal.
Gabrielle: No, it’s not normal. And with a lot of patients, it’s not that simple. We’re not going to have one appointment and figure out exactly what’s going on. But then there are some people where I could talk to them for 30 minutes and tell them what they could do to feel significantly better. I don’t want to say what they’re doing wrong, but what they could change. So I think it’s the education and awareness. A lot of times in GI, you’ll wait months to get into a GI doctor, and then they just say, “Oh, you have IBS,” or “You’re just a little constipated, do a MiraLAX cleanse or something.” That’s not to discredit GI doctors. They’re brilliant, and they’re definitely looking for very important things. But for IBS patients, where it’s more like, “I have diarrhea sometimes, I have constipation other times, something’s off, I feel more bloated,” a doctor is not going to have the time to sit down and talk to you about it.
What I really love about my practice, and about educating on gut health in general, is being able to ask questions about my patients’ medical history, even their travel history, different foods, food poisoning, antibiotic use, all of that. I like to dive deep and put the puzzle pieces together, and it’s really interesting when we get to the bottom of it. Sometimes the bottom of it is past eating patterns.
Disordered eating, stress, and gut health
Annika: I think of my own experience, and similar to you, I did some disordered eating and have had to retrain my body to even digest properly. Is that a common trope that you see, people with disordered eating histories ending up with gut health issues?
Gabrielle: I think what I see more is people coming to me after they did a food sensitivity test or some other test, and at this point they’re just scared of food. So it’s not necessarily that they had disordered eating and that caused gut issues, which does happen a lot. Most of the people I see, it’s because of their GI issues that they’re now a little disordered. I don’t necessarily label it as disordered, but we talk about the importance of not being scared to eat certain foods, because when you are scared to eat certain foods, your body is going to be in fight or flight, and you’re not going to digest the food.
Annika: That’s a really good thing to talk about, because when we have stress, our body doesn’t process nutrients as effectively as it could. We’re in fight or flight instead of rest and digest. How could chronic fight or flight influence our gut microbiome?
Gabrielle: I’m sure you talk about this a lot. Our nervous system has the parasympathetic and the sympathetic nervous system. Sympathetic is fight or flight, the stressed state. Parasympathetic is rest and digest. The name implies it: the more relaxed you are, the better you’re going to digest your food. Chronic stress doesn’t necessarily need to be a big event like you lost a job or had a breakup. It can just be your day-to-day activities, because we’re in the US and we’re always go, go, go. It can be any time you’re rushing. If you’re late to something and eating quickly on the go, your body is focused on getting to the destination. It’s not focused on digesting. It’s focused on your driving, for instance, your heartbeat, the major things. It’s not going to focus on the small digestion of the protein you’re eating.
It all starts in our mouth, but honestly, it starts in our brain. If we’re not focused on the meal, and we’re on the go, standing up, eating too fast, you look at your plate and don’t even remember eating it. I’ve done it too. You didn’t make it an experience, and that’s not giving your body enough time to know that digestion is occurring. Even just the thought of food, the smell of food, can increase saliva production in your mouth. If you talk about it, you will have more.
Annika: I was going to say, my mouth is watering right now.
Gabrielle: That’s what just happened to me too! Increased saliva production releases salivary amylase, which is partly what breaks down carbohydrates. That release triggers the whole system. You swallow your food, your food hits your stomach, and it mixes with stomach acid, if you have enough. If you’re in a stress state, or you’re eating too fast, or you’re on a PPI, an acid reflux medication, your stomach acid might be a little low. I don’t want to say low, that’s not the right term, but you might not have enough stomach acid because of the medication. Then the food might not mix properly. In an ideal world, your food mixes with the stomach acid and moves to your small intestine, and that movement from your stomach to your small intestine triggers more digestive enzymes, bile, the whole thing to digest all your food. So it really starts at the top and goes down.
Generally, when I work with someone, we want to start at the top. The stress thing is something you’re always going to have to deal with, but even just doing some deep breathing or box breathing before meals, limiting the number of times you eat really fast or on the go or in a stressed state, and chewing your food enough can help. Doing things at the start of the digestive process can help with the rest of the process.
Annika: It kind of sounds like it’s twofold. When you already have gastrointestinal issues, there’s that fear that if you eat something, it’s going to disrupt your system, or if you don’t eat correctly, or don’t pair your protein and carbs effectively, or whatever. There’s a lot of stress and fear coming from there. And then there’s also stress and fear around food coming from social media, with all the “how to improve your gut” content. When in reality, it sounds like just being aware of how you’re eating and what your perspective is will do a really important thing for your digestive system.
Gabrielle: Yeah. No matter what the issue is, whether you have an allergy or an intolerance, or sometimes people’s immune system is activated by something and they end up being intolerant to histamine, there are a lot more complex issues at play. But whether it’s complex or more simplified, everyone really needs to start there. That’s the only advice that I would say is not individualized. Everyone needs to work on relaxing more and putting themselves in a rest-and-digest state for eating. That doesn’t mean that doing some of the other things, like eliminating certain foods, isn’t also going to make a huge difference. So it’s a combination of things. It’s hard to pick one.
Supplements and gut health
Annika: Going back to how there’s a lot on social media, what are some common gut health myths, or things that you keep seeing online that you find to be ineffective or unhelpful messaging?
Gabrielle: I’m a very open-minded person when it comes to supplements in general. I think the issue with social media is, one, it’s a platform to make money, so ads are disingenuous from time to time. They make statements that aren’t actually that accurate. And another thing is that people are really passionate about sharing their health, but they didn’t have the educational background that I did, or some other healthcare provider did. They don’t really understand the dangers behind recommending certain things. I’m always happy when people find something that works for them and they want to share it, but it is not that black and white. I sometimes read the comments on those posts, and people are like, “Oh, I should get betaine HCl, and that’s going to help.”
I think one supplement probably isn’t going to make the world of a difference. I mean, it can, but it could also be partly in your head. I don’t want to say in your head, but sometimes if you take a supplement expecting it to benefit your gut health, it does, because you’re automatically feeling more relaxed. Take digestive enzymes. I love digestive enzymes, and I think they definitely have a purpose. But if you’re taking digestive enzymes, one, it’s going to provide you more digestive enzymes, and two, you’re also going to feel a little more secure going into that meal because you know you have them. So it’s a little more complex. I don’t know if people really need to be educating on that complexity on the internet. I just think a lot of people are buying supplements that could hurt them.
The best example would be betaine HCl. Betaine HCl is taken if you don’t have enough stomach acid, which, like I said, helps you break down your food and move it to the small intestine. It can be helpful for some people, but if you have gastritis or acid reflux, it really depends why you have the acid reflux, because adding more acidity could cause some issues for you, like in your esophagus.
Annika: I had reflux, and I had to learn that there are multiple types of reflux. It’s not just high stomach acid. It could be low stomach acid, or it could simply be your LES, your lower esophageal sphincter, being too loosey-goosey. It’s not one-size-fits-all. For me, if I added digestive enzymes, I’m pretty sure it would have harmed my reflux, because I think I had the type where I had too much acid. That’s why when my reflux acts up, drinking lemon or lime tends to help improve my digestion. So it’s definitely about figuring out for yourself what is going to improve it.
Gabrielle: And it can be hard, because people don’t want to spend money or waste their time on another provider if they didn’t feel like they were listened to or heard by the first one. There are a lot of people on social media who are awesome and who see clients and patients. I understand it being difficult and more of an investment, but I definitely think it’s worth it, so you really don’t waste money in the long run trying different supplements. But yeah, I think there are a lot of claims about the simplicity of gut health in general, and it’s okay, but I just don’t want people to be misled.
Annika: No, I think that’s exactly it. That’s what bothers me personally, because it’s shown to be very simple when in reality there’s way too much nuance and complexity to put it into a “this is the protocol for everybody.”
Gabrielle: Exactly. Not everyone needs to go low FODMAP, right?
Annika: Right. For some people, obviously, it’s going to really improve their symptoms, and then ideally you add more foods back as you work with someone who knows what they’re doing. But nothing is one-size-fits-all.
Gut microbiome research
Annika: One thing that I think about as a gut health social media thing is how everybody knows now, which is amazing and I love this, that 95% of our serotonin is created in our gut.
Gabrielle: And that’s true. But the thing is, it’s not necessarily there to help our brain. Yes, it can communicate with our brain through the different axes, like the HPA axis, or the vagus nerve, or cytokines. But it’s not there to improve our mental health specifically. It’s there to help regulate our digestive system, gut motility.
Annika: Isn’t it different from serotonin in the brain? I kind of thought that was debunked in a way, but maybe it wasn’t debunked, maybe it was more of a nuance. Can you explain the difference between serotonin in our gut versus serotonin in our brain, and what the benefits would be?
Gabrielle: It’s both very simple and very complex at the same time.
Annika: Yeah, yeah.
Gabrielle: When we take in tryptophan, it turns into serotonin. It can also cross our blood-brain barrier and then turn into serotonin there, so it turns into serotonin in two places. This is a really fun fact: when you eat your carbohydrates with a tryptophan-rich food, which tends to be protein, we actually see increases in tryptophan crossing the blood-brain barrier, which then means more serotonin, which is awesome for our brain. So eat your carbs. That’s the moral of the story here.
Annika: Make you happy. They do, they actually do.
Gabrielle: Which is awesome. So the serotonin in our brain is typically connected with depression and anxiety, those two specifically, for most mental health conditions we think about. The serotonin in our gut is more connected, like I said, with improving our digestive function. It’s possible that it’s connected with the stress aspect, too. When we’re under more chronic stress, or in more of a fight-or-flight response, our gut serotonin doesn’t get created as much, which may be a reason why we tend to experience more gastrointestinal distress when we’re stressed or going through chronic stress.
Annika: So cool.
Gabrielle: It is really cool. But there is still a correlation, because there’s research out there that when you take an SSRI, it improves your ratios of Bifidobacterium and the Firmicutes-to-Bacteroidetes ratio, and increases Bifidobacterium. All of those are also associated with increases of serotonin in the gut, so there is some sort of bidirectional relationship.
Annika: Really cool.
Gabrielle: There are a lot of people who are put on anxiety medication, for instance, and their IBS symptoms go away once they’re on anxiety meds.
Annika: Which is crazy. That’s how I got rid of my GERD. I went on an anxiety medication, and then I was like, “Oh wait, I’m not throwing up all the time.”
Gabrielle: That just goes to show exactly what I said at the beginning. Your brain is such a big part of it, and that’s going to change day to day. I notice the difference on days that I’m more stressed versus not, immediately, with my digestion and everything. It’s the nervous stomach. I’ve had clients come to me where the doctor just told them, “You have a nervous stomach, and that’s why you have IBS,” and I’m like, okay, well, yeah, but let’s work on not being so nervous.
Annika: So if someone came to you and that’s what their doctor told them, what are some steps you typically help them take?
Steps to take to improve gut health
Gabrielle: We start from the beginning. It’s basically a Q&A for a while. We’ll talk about medical history, family history, what they’ve tried in the past, what worked and what didn’t. I will go very in depth through their medications and any supplements they’re taking, so multivitamins, single-ingredient supplements, protein powders, greens powders, all of that. We talk about any food sensitivities they’ve experienced, any food allergies, any medication allergies, how much water they’re drinking, if they’re sleeping enough, their stress level, what their day-to-day looks like, what their work environment is like, and if they’re traveling a lot. I’ll ask when symptoms started if I really want to gauge a pattern. I’ve had some clients say, “Oh, my symptoms started around COVID,” or “My symptoms started after I came back from a trip abroad.” That could have been due to food poisoning, for instance. A lot of times, food poisoning can really disrupt your gut microbiome for a long time.
Another thing people will live with for a long time without realizing it is H. pylori, a bacteria in the stomach. That bacteria thrives in a neutral environment in our stomach, and we want our stomach to be acidic, so neutral isn’t where we want it to be. Basically, they’re not digesting their food because they’re living with H. pylori, so then we have to fix the H. pylori.
But sometimes it’s simple. Someone is just really, really stressed, they’re not drinking enough water, they’re not eating enough fiber. I’ll have them give me an idea of what they’re eating. Let’s say they’re eating a lot of carbohydrate-rich foods and they get symptoms with onions and garlic, for instance. That could be an indicator of, okay, maybe we should try a low FODMAP diet. But typically, if it’s not that obvious in the beginning, I like to do the initial assessment, get all the information, and then do a diet recall. I’ll give them some tips on where to find fiber and how to increase it gradually, and I will ask them to track their food for a week or two weeks, at least giving us a few days to review it and follow up so we can notice any patterns in their eating habits. So really journaling about how you felt before and after the meal mentally, how fast you ate, what you ate, whether it was takeout or something you made at home. It’s more of a slow process, but I try to get a good idea of what they’re doing now and go from there.
Annika: With that, do you typically see people just not eating enough fiber? Is that a common experience?
Gabrielle: Pretty much everyone. But it’s never just that. There are some people who just aren’t eating enough fiber, and then they eat it and they feel a lot better. But maybe they’re also trying to lose weight or stay motivated. People come to me primarily for gut health, but there are always more things we’re dealing with when it comes to our health and wellness and nutrition in general. So it ends up being more long term: okay, how can we keep your gut health optimal for a longer period of time? How can we help you get to the gym, or help you with weight loss, or improve your relationship with food if you struggle with disordered eating, or lower your cholesterol? It’s a combination of things.
Annika: I see so many science educators for nutrition online talking about how 2024 was the year of fiber, and I loved that.
Gabrielle: I loved it too. It was just amazing. And there are so many really good resources. My main goal when I work with people, whether it’s gut health or not, is to have them understand where their food sources are coming from. I want them to understand food. It’s not going to be the same as how I do, but I want them to learn it how I learned it. I first learned all the carbohydrate sources, all the protein sources, all the fiber sources, different types of healthy fats, all the different ingredients. I want them to learn so they can make better choices. When you learn all your fiber sources, it becomes easy to get to your fiber goal, and if not, there are so many supplements that are awesome to incorporate as well.
I’m very big on educating so people can understand things long term, because you’re not just going to take something out and then have that help you for the next 10 years. If you can understand where to get more optimal nutrition sources, and at least understand how your body works, maybe alcohol is a really big trigger for you, or coffee is a big trigger, or maybe you just don’t tolerate gluten very well, or dairy. If you can understand where your symptoms are coming from, it makes it a lot easier to manage. I would be lying if I said my gut health is perfect. “Gut health” is a really hard term to explain, because I doubt anyone’s gut health is perfect on every single day. People might say it is, but every day is going to be different. You might have been exposed to something, food poisoning-wise, or, like I said earlier, if I’m nervous or stressed around mealtime, I get a stomachache. That happens. But at least I know why I have a stomachache, and I think that’s what’s really important for me to help people understand.
Whenever I’m working with someone and they say, “Things are going really well, but I ate this, and then I understood why my symptoms happened,” I’m so happy. As long as you can understand where it’s coming from and you know your triggers, it’s better than being blindsided: “Why is my stomach killing me while I’m at work right now? Why is this happening?” That’s where people come to me feeling very lost, because they’re reacting to all these things and they have no idea why.
Annika: Just cultivating bodily intuition, which has been stripped from us basically since diet culture existed.
Gabrielle: True.
What if you’re sensitive to fiber?
Annika: With sensitivities, a trend I’ve been seeing online is people saying that they’re sensitive to fiber and then completely cutting out all fiber sources. What is your take on all this as a gut health dietitian? What should we be thinking about?
Gabrielle: It makes me sad, because no one wants to live like that. I mean, you might, but I don’t think anyone really wants to be eating steak for every meal for the rest of their life. If there are foods that you love and you feel better taking them out, awesome, but you should understand why they upset you in the first place. I think people don’t feel like they’re getting the care they can get, so they resort to, “Okay, if I eliminate all these and feel better, then that’s that. I have to just keep them out.” But that’s not necessarily the case. You might have to take them out short term, just to lower the inflammation, which is essentially what’s happening. But the goal would be to reintroduce foods and improve your tolerance to those foods.
There are a couple of examples. If you were to go on the carnivore diet, for instance, you’re essentially eating whole foods. You’re eating meats, you’re eating dairy, you’re eating grass-fed beef and grass-fed butter, everything is very clean. So you’re going to feel good. You’re automatically going to be buying less packaged, processed food, because you’re on the carnivore diet and you’re going to stick to it. So you’re automatically going to feel better. The foods that have fiber in them, people can be sensitive to, and it’s because their body’s not used to the fiber component, or they just have too much inflammation going on. So you gradually increase the fiber and find out which foods really are triggering you.
For instance, take cruciferous vegetables: broccoli, Brussels sprouts, cauliflower, asparagus. Those make a lot of people gassy. So maybe you cut those out and eat the others, and you’d be fine. Or sometimes eating cooked veggies or peeling your veggies can help.
Some people will take a food sensitivity test and it says they’re reactive to all these foods. That’s because the main issue at play, when you’re reacting to all those foods, is either that you’re not used to fiber or that you have leaky gut, essentially. The lining of your gut is not protecting you, and you’re allowing bad bacteria in and it’s multiplying, and we’re not providing enough good gut bacteria. If you’re already in that situation and then you take out all the fiber, you’re never going to repopulate your good gut bacteria, so you’re always going to feel like that. You’re going to be on a restrictive diet that masks those symptoms, but you might end up without enough vitamin C or different electrolytes. I think even Carnivore MD said he was getting really lethargic and needed to supplement with electrolytes. So the diet is changing, but I think it’s an okay option short term. I would love for people to let someone help them find what’s actually going on.
Histamine intolerance is something I’ve been… sorry, I’m ranting.
Annika: No, please keep going. I’m so interested.
Gabrielle: I recently had a client, and I’ve had a couple like this, who had a really bad bacterial infection in her gut. She basically got food poisoning to the extreme, had to go to the hospital, and was on antibiotics for a while. The food poisoning pretty much destroyed her gut. The antibiotics got rid of all the bad bacteria, but they also got rid of all the good gut bacteria, which is a common trend, and not a lot of people are educating on the importance of, after antibiotic use, how we can repopulate your healthy gut bacteria. Probiotics can be really helpful after antibiotic use.
But she was having somewhat of an immune response even after the antibiotics. She didn’t have the bacterial infection anymore, but she had major migraines, and all of a sudden she was sensitive to all these foods. This also happens with patients who had COVID and their body never really fully went back down. The best way to put it: you get sick, you get better, so you’re technically better, but your body still thinks something is trying to hurt it. It thinks there’s still some type of invader, and it’s going to attack itself. That’s mast cell activation. Our mast cells are basically immune cells that release antibodies and other things to protect us when we’re sick. After you’re sick, those should usually go back down to a normal level, but if they’re still activated, then there are foods that contain histamine or naturally release histamine, and histamine is a mediator that’s released when you’re in an inflammatory state.
So people might eat tomatoes or fermented foods. This is a good myth to bust: kombucha, sauerkraut, any fermented food. It’s good for your gut, but it’s not good for your gut if, let’s say, you’re now sensitive to histamine. If anything, it’s going to exacerbate your symptoms. There are a lot of really healthy foods that contain or can release histamine. If someone is going through something more chronic that’s causing a lot of ongoing GI issues, it could be worth looking into, okay, let’s try a low histamine diet. Sometimes it’s pretty simple. We start a low histamine diet, and some clients find it easier than others, but typically they start to notice that they tolerate foods they once didn’t, because we’ve lowered the inflammation in their body and calmed things down.
It’s really cool, but I think it can be overwhelming, so it’s easier to just take out certain foods and live your life like that. But there are a lot of good nutrients that you could become deficient in, especially women. When we’re menstruating, and with our hormones, we need so many good vitamins and minerals. If we’re not supporting our body and our detoxing organs with all the nutrients they need, I don’t think that’s really a way to live.
Annika: No, it really isn’t. And that’s something I’ve had to learn for myself too. It’s one thing to not eat all the foods that trigger you, and if that makes you feel okay, that’s amazing. But if you’re also at a point in your life where your inflammation went down because you did a lower fiber diet for a while, or a low FODMAP or low histamine diet, then your body has sort of reset. Ideally, we would be able to start adding foods back and building up our tolerance again.
Gabrielle: Yeah. That’s why, when I first became a dietitian, I got certified to do food sensitivity tests. Not to say we should completely discredit them, but it’s interesting. I had a patient that I put on a low histamine diet, and she ended up sending me a food sensitivity test a while later, and it did say she was sensitive to a lot of histamine foods. If I had seen that before we started the low histamine diet, it could have given me a clue that maybe we should try one. But when you are going through something GI related, your body is going to be reacting to a lot of different foods. You don’t have to, but you should work with someone to help you find the root cause, because once you find it, such as not enough stomach acid or pancreatic enzyme insufficiency, and address those issues, you notice that you can tolerate foods again.
So if you’re not tolerating a bunch of foods, you don’t need a food sensitivity test to tell you that. Maybe you need a stool test, or sometimes I don’t even need a stool test, just a Q&A with me or some other healthcare provider, because there are so many little things that could be going on, and they could be quite simple to address if we’re motivated and open to doing it.
Annika: I think that’s the other part: the motivation to actually do this. That’s really hard. It’s one thing to say, “Okay, maybe it will help me if I don’t eat as many histamine foods,” but that’s a lot of things to think about, so you think, “Whatever, I’m just going to keep going through my life.”
Gabrielle: There are people who are really incredible and really good at disciplining themselves. For me, I’m not as good at that, because with my history of an eating disorder and disordered eating, if I get disciplined, I get really, really disciplined, and it’s not good for me. I’ll take it to the extreme. I haven’t really gone down that path in a while, but when I was having more GI issues, about two years ago, I did a stool test and I worked with a dietitian. I knew the information, but I needed someone to guide me, and I was definitely learning. Stool tests are definitely stuff I didn’t learn in school, so it helped to work with someone with a little more experience than me in that area at the time. But it was mostly for the accountability. Having someone tell me what to do and then check in on me is what I need, and that’s what a lot of people need. It’s definitely an investment, but I felt like it helped me so much to hire someone to work with me so I wasn’t just doing it on my own.
Annika: That’s super important, especially for people with a lot of mental health conditions. Specifically ADHD, obviously, that one will probably benefit the most from an external source of motivation. But even depression: it’s really hard to get the motivation to do things for yourself when you’re feeling that way, but if you have someone else cheering you on, asking, “Hey, did you do this?” it’s so much easier. It’s just easier to do things for other people when you’re feeling that way.
Gabrielle: Yeah, I agree.
Annika: I have one more question about fiber. Say a person got rid of fiber for some reason, because they wanted to reset and then hopefully improve their tolerance to fiber. There are lots of different types of fiber, so maybe we should break that down first. What types of fiber would we want to start to implement first?
Gabrielle: I’ve talked about soluble versus insoluble fiber, and while I think about it, I think it causes confusion in people and makes them worry about the types of fiber. I really don’t want people to worry about the types. I just want people to get fiber, but you want diversity. So you want fiber from whole grains, nuts, seeds, legumes, beans, fruits, and vegetables. I think a lot of people think fiber is only in fruits and vegetables, but if anything, it’s even more in whole grains and beans and legumes. The goal is to gradually increase, maybe by five grams every week, though it really depends on where you’re at, by adding in more diversity, so different food groups. Then you’re naturally going to get all the different types of fibers. There are so many different types of soluble and insoluble fibers.
Basically, soluble fiber is what helps bulk up your stool, so it can be helpful if you have diarrhea. It can also be helpful with constipation, but primarily, if we’re having a lot of diarrhea, maybe we take psyllium husk, which is a soluble fiber that can help bulk things up. Insoluble fiber I think of like a water hose. It just flushes you out. Insoluble fiber is going to add more water and help things move, and soluble fiber is going to bulk up your stool and help form it. The skins, seeds, and nuts are really high in insoluble fiber. Chia seeds are really high in insoluble fiber, too. Kiwi, with the skin and the seeds, is higher in insoluble fiber, but it also has soluble fiber. If you’re eating a piece of fruit, you’re going to get both. But there are some foods, so sometimes if someone is having a lot of diarrhea, we might want to think about adding some more soluble fibers. Overall, just work on adding a fruit and a vegetable to most of your meals, and adding a whole grain. That can be a piece of whole wheat toast, brown rice, or even white rice with a lot of veggies or beans to get fiber. It can be Ezekiel bread or pastas. Just getting more diversity in your diet and trying new things is what I want people to do.
That’s why I did a 30-day “Fuel with Color” challenge, and I want to build on it. Essentially, I’m asking people to eat three different colored veggies and two different colored fruits every day, just to get the diversity. You could even build on that by trying a new grain. Maybe you try quinoa, maybe you try farro, maybe you make some soup with lentils. I think that’s the most important thing. And when you are increasing your fiber, make sure you drink enough water. A lot of people will get stomachaches and say, “Oh, the fiber is the problem, it’s not good.” But you just need to give your body some water to help move the fiber through, because once it’s moved through, it helps. Some people don’t get to that step and they get scared because of the way it makes them feel, but sometimes you just need to be more patient, or start at a lower amount of fiber, make sure you’re drinking enough water, and go from there.
Annika: Nice. I really want to emphasize that the reason we want to add fiber is that fiber is the food for our gut microbiome. If we do not eat our fiber, our gut microbiome diversity is significantly impaired. Through so many studies, the more gut diversity we have, the better we see mental health, and the more health benefits in general. We see improvements in cardiovascular health, in digestive function typically, and we also see decreases in all-cause mortality. The more fiber we have, and the more diversity we tend to have, the better. That’s a super important reason to eat our fiber and not do a restrictive diet long term, if we can help it.
Gabrielle: For sure. Especially when we think about colon cancer being on the rise, we want to support our gut and give it the energy it needs. There are fiber-rich foods, fermented foods, and foods with prebiotics and probiotics. Those foods are fueling our gut and helping build a space of good bacteria and protection, so we don’t get bad bacteria in there that can lead to health consequences. It doesn’t need to be as overwhelming as people make it out to be. But if you’re struggling with increasing your fiber, and not everyone is going to be able to tolerate kombucha, for example, if they have a histamine issue going on, then if you’re really not tolerating foods but you feel like you’re eating really healthy, definitely work with someone, because there’s probably something else going on that you have to address first before you can increase your fiber, besides just taking everything out.
Annika: That’s exactly what I see in the literature all the time: the more diversity of food, the more diversity of plants specifically.
Gabrielle: And that’s just how it goes with nutrition in general. I think people want an answer to a lot of things when it’s not black and white. We don’t have a lot of answers on seed oils, we don’t have a lot of answers on a lot of the additives in foods. But that’s why it’s important to not consume the same thing every day. Get whole foods primarily, rotate your foods, get more diversity, and you should be in good shape, because you’re not overconsuming anything either.
Annika: That’s the exact advice I always see. I do a lot of research, I’m a nutrition scientist, I love researching, and that’s what comes up every time: increase your diversity of diet, don’t eat the same thing all day if you can help it. I know that if you have autism, it’s hard to do that.
Gabrielle: Yeah, I used to work in pediatrics, so it’s hard. I feel bad for those parents. But there are a lot of things you can do. Occupational therapists can help a lot, too.
Annika: We love OTs!
Gabrielle: Oh, they’re so helpful. They’re awesome. I’ve learned a lot from them.
Annika: If someone was listening, is struggling with all these gut health issues, and liked hearing you, can you tell us more about how to find you and how to work with you, all the good stuff?
Gabrielle: Yes! I’m on Instagram and TikTok. If you go to the link in my bio on my Instagram or TikTok, it’ll take you to a page where you can apply to work with me and see some of the products I have. I have that healthy eating challenge up there right now. It’s free. You can just print off the colorful piece of paper, and hopefully it can inspire you to eat more fruits and vegetables. I have an email flow, so you’ll get some more resources each week. That’s the best way to reach me. You can also email me at [email address]. Definitely email me if you’re on the fence about working with a dietitian, or you aren’t able to commit to three months. I usually work with people for three months, but I definitely like to help people in any way I can, so I’ll try to find something that can work for you.
Annika: I just love how you know a lot, you’re very open-minded, and you love listening to people and their experiences to help them. Thank you so much!
Gabrielle: Thanks, I appreciate it.
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