Dr. Ruscio and Susan Discuss Personal Dietary Experiments

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Dr. Ruscio and Susan Discuss Their Personal Dietary Experiments- Episode 58

Do you ever wonder what a health professional’s diet looks like? This week we take a look at some tinkering Susan McCauley and I have done with our diets based on how we look, feel and perform.

If you need help finding your ideal diet, click here.

Dr. R’s Fast Facts

  • Dr. Ruscio was experiencing some negative digestive symptoms so he made some diet and lifestyle changes.
  • Caffeine is a gastric irritant and can also be a laxative.
  • Dr. Ruscio decided to step away from everything he knew and made a decision to eat what sounded good. He lowered his vegetables (fiber) and increased his carbohydrates, including gluten.
  • He noticed positive results right away and now plans to isolate the changes and reintroduce more fiber and then, reduce carbohydrates to see if it was one or both that made him feel better.
  • People with IBD, IBS and other gut issues sometimes do better on a lower fiber diet.
  • You can figure out a lot by listening to your body.
  • Susan decided to cycle carbohydrates, fat and calories within the template of a gluten-free, dairy-free Paleo Diet.
  • It’s best to avoid dogma when it comes to diet. There is no one diet that works well for all people.
  • Dr. Ruscio likes to start his patients off with a lower fiber, lower carb diet and slowly increase to find the sweet spot.

podcast-artwork new

Topics:
Fast Facts….. 0:38
Episode Intro….. 2:00
Dr. Ruscio’s Diet and Lifestyle Changes….. 3:34
Susan’s Diet and Lifestyle Changes….. 21:22
Episode Wrap-up….. 35:31

Links:
(21:53) High Carb or Low Carb, What the Science Actually Says with Dr. Christopher Gardner
(22:51) Jason Seib
(23:03) AltShift Diet

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Welcome to Dr. Ruscio Radio, discussing the cutting edge in health, nutrition, and functional medicine. To make sure you’re up to date on this and other important topics, visit DrRuscio.com and sign up to receive weekly updates. That’s D-R-R-U-S-C-I-O.com.

The following discussion is for educational purposes only and is not intended to diagnose or treat any disease. Please do not apply any of this information without first speaking with your doctor.

Now, let’s head to the show!

Fast Facts

Susan McCauley: Hey, everyone. Susan McCauley here from Evolve Nutrition, bringing you this week’s Fast Facts.

Recently Dr. Ruscio was experiencing some negative digestive symptoms, so he made diet and lifestyle changes to try and rectify this. I hate to break it to you, but caffeine is a gastric irritant and can also be a laxative.

Dr. R decided to step away from everything he knew and made a decision to eat what sounded good. He lowered his vegetables, which was fiber, and increased his carbohydrates, including gluten. He noticed positive results right away and now plans to isolate the changes and reintroduce more fiber and then reintroduce carbohydrates to see if it was one or both that made him feel better.

People with IBD, IBS, and other gut issues sometimes do better on a lower-fiber diet. You can figure out a lot by listening to your body. I decided to cycle carbohydrates, fat, and calories within the template of a gluten-free, dairy-free Paleo diet and was pretty amazed with the results. It’s best to avoid dogma when it comes to diet. There is no one diet that works well for all people.

Dr. R likes to start his patients off with a lower-fiber, lower-carb diet and slowly increase to find that sweet spot.

OK, that’s it for the Fast Facts. Now, on to the episode.

Episode Intro

Dr. Michael Ruscio: Hey, folks. Welcome to Dr. Ruscio Radio. This is Dr. Ruscio. I’m here with Susan McCauley from Evolve Nutrition. Hey, Susan. What’s going on?

SM: Not much. I just made myself a cup of oolong tea. It’s kind of cloudy and about to start raining here, so a cup of tea just felt like the right thing to make ready for our podcast!

DR: Nice. Yeah, it’s raining where I am, and I’m about an hour away from you, I think, so I’m sure the rain is on its way to you, too.

SM: Yeah, we’re south, so we are going to get the tail end of it, which is nice. We could use the break!

DR: Yeah, definitely!

SM: So what do you have going for us today?

DR: Well, today I thought I could share some tinkering that I’m doing and some stuff that I’ve been kind of experimenting with in my diet and things that I’ve learned. I know that you’ve been doing some tinkering, too, Susan, so I thought maybe we could each share some of those things that we’re experimenting with from a diet and/or lifestyle perspective. Then there are a couple of other things, maybe, that we can touch on also, but I thought this could just kind of be like a sharing session, so to speak.

SM: Cool. Yeah, because I have been playing around with some stuff mostly because after working on the podcast and editing—I do edit the shows that I’m not on, so I listen to every single podcast—things that I didn’t know before or I didn’t think were true, then I start listening to things, and it’s like it kind of changes my perspective on things, so I’ve made some changes, but let’s hear about you.

DR: Well, good. I’m glad to hear that it’s helping! That’s a good sign!

Dr. Ruscio’s Diet and Lifestyle Changes

DR: Yeah, for me, over the past, maybe, year I’ve noticed that my sleep hasn’t been as good as it normally is, and I’ve also noticed, to be a bit graphic, that my stool consistency hasn’t been textbook. It’s been a little bit more like a fluffier, looser stool. Then on the tail end of that, for a couple of months I noticed I was getting a little bit of bloating after eating, which was very unusual for me. There have been some lifestyle things that have definitely not been as they should be. With everything growing with the research studies and the research team and the website and everything else and the teaching and the speaking, my workdays have been admittedly much longer than they should be for quite a period of time. There’s definitely some overtaxing from a work perspective and along with that maybe a little bit too much caffeine consumption. That tends to go hand in hand with that.

SM: Mm-hmm.

DR: I think the underlying cause of why some of these things started to bud was predominantly from lifestyle—stress, caffeine. The thing about caffeine that I think is under-appreciated sometimes is that caffeine in and of itself, irrespective of the form, is a gastric irritant. It does absorb directly through the gastric mucosa, and it can be an irritant. It can also be a laxative.

Now, this doesn’t mean that no one can ever have any caffeine, but it does mean that for people that are a bit more sensitive in terms of the irritating effect of caffeine, this may be something that doesn’t work in your favor. It’s just something to keep in mind.

That’s what I started noticing, and I also typically eat a diet that consists of probably eating around every four hours usually, and it’s usually a protein-and-vegetable-based kind of meal. I don’t do a lot of carbs. I just notice I feel better with less carbs, except for in the evening. I typically kind of eat lower carb morning, noon, afternoon, and then in the evening, after I train, typically that’s when I’ll have my starchy carbohydrate, whether it be a potato, sweet potato, an indulgence in even some clean potato chips or rice or what have you, maybe a gluten-free bread, a tortilla.

That’s typically what I’ve been doing, so it’s a pretty high-fiber, moderate-to-lower-carb type of diet, but like I said, I started noticing that sleep wasn’t as good as it typically is and that also correlated with stool consistency not being perfect and a little bit of bloating. None of these things were severe, but you notice these little things starting to creep up. So I just decided to take a couple of weeks where I would completely ignore any of the nutritional advice I’ve ever heard, seen, or read anywhere and completely just kind of take my own advice, which is to kind of step away from some of this stuff and not be neurotic about it.

SM: Mm-hmm.

DR: I said, I’m just going to do some experimenting and eat purely what appeals to me.

SM: Oooh.

DR: And to be honest with you, I had gotten kind of sick of vegetables. I typically love vegetables, I eat a lot of them, but I just started losing my affinity for vegetables. So the diet that I ended up settling into was one that was much higher in carbs and much lower in fiber. For a breakfast, lunch, and dinner example pre to post, a previous diet would have been I’d wake up and have maybe two or three eggs where I’d saute in some spinach and drizzle on some feta cheese. Then for lunch I would have maybe some baked chicken with some broccoli, and then for dinner I would have maybe chicken again with chard and maybe a potato, something like that.

What I ended up shifting to was pretty much taking out the vegetables and adding in carbs. So it’d be two eggs in a tortilla with avocado. Then for lunch I would have maybe chicken and I would have that either in a tortilla or with gluten-free bread or with half a potato or what have you. Then for dinner it would be kind of same thing.

I really brought down my protein and fat and just kind of bumped up my carbs, and I noticed that everything really improved from that. My sleep changed quite dramatically. My stool consistency got better, and the bloating went away completely. Now I’m in the process of trying to tinker with, was it more so the carbs or more so the fiber that had to do with this, because those are two main variables that changed. I really brought down the fiber, and as I brought down the fiber, I brought up the carbs. And to clarify, I brought down the highly insoluble vegetable-type fibers and had more of the soluble fibers that you find in things like tortillas and gluten-free bread and things like that.

SM: Just to clarify, when you say “tortilla,” I know everybody is thinking right now, you’re not talking about a flour tortilla. You’re talking probably about a corn tortilla or a gluten-free tortilla.

DR: Actually I experimented with both.

SM: OK, interesting!

DR: I experimented with both because I haven’t noticed a very consistent reaction—if any reaction—to gluten.

SM: That’s interesting. Oh, it makes me jealous!

DR: I still can’t say I notice a definitive reaction to gluten, but I think if I have too much gluten over too many days in a row it may slightly affect my mood.

SM: Mm-hmm.

DR: If there is anything I can notice, that would be it. There’s no gastrointestinal change. That’s the only thing that I still can’t say I’ve definitively noticed, but maybe I’ve noticed, that if I have gluten for three meals a day for three days in a row, and especially if it’s really poor quality, processed, non-organic, non-sprouted, what have you, I may notice a little bit of a dip in my mood.

But after some tinkering with gluten, because that was another variable I just didn’t think needed to be thrown into the mix, I in the long term, for most of that experimentation, just used a corn, flax, gluten-free type of tortilla and was pretty much gluten free for most of that.

SM: OK, interesting. Like I said, I’ll live vicariously through you because a little bit of gluten still for me right now throws me. Oh, yeah, we don’t want to talk about that! Yeah, I just stay gluten free. Somebody was posting a picture today on Facebook of this donut from this donut shop where I grew up, this warm, delicious glazed donut, and I was just like, one of these days I might be able to have my glazed donut!

DR: Well, you know, I think this discrepancy that we have or this difference that we have in our tolerability for gluten, it’s important just to showcase that because it showcases what people will likely find. Some people may be like me and don’t really notice much, and then great, they don’t have to subject themselves to the rigors of a high level of avoidance. But there are others like yourself, Susan, that will need to be a bit more careful with this. I think it’s just important that we all find what our own truth is in that regard and then just live accordingly.

SM: Right, and I also think it’s a spectrum. Everybody lies on the gluten spectrum somewhere, whether it be on the low end like you or me on the high end, but I also believe if you don’t have celiac disease and you heal yourself… and maybe I’m just fooling myself that one of these days, that if I heal my IBD and I’m in remission for a specific period of time, that maybe once in a while I can have gluten.

DR: You know, I would be inclined to think so. Typically people notice as their gut health improves, their resilience to food reactivity also improves.

SM: Right.

DR: And I noticed that same thing myself. When I was in the initial phases of recovering from the amoebic infection I had years and years and years ago, I couldn’t do anything, and now I can do pretty much anything. So, yeah, there is definitely truth to that. Is it a guarantee? No, but there’s hope.

SM: Yeah. Thank you. I need hope! I need a light at the end of the tunnel! Or a glazed donut at the end of the tunnel, right?!

DR: Yeah, a glazed donut! Yeah!

So that was the experimenting that I did. I know people are probably saying, well, maybe I was too low carb, and I certainly think that’s a fair question. It’s something I see with patients, definitely.

I should also maybe mention that my energy didn’t really seem to change much, and my weight also didn’t seem to change, which was interesting for me, because I was thinking, boy, am I going to put on some weight from increasing the carbs? But I think probably what ended up happening is that my overall caloric consumption stayed roughly the same because I just listened to my body, and as I was eating more carbs, I felt less driven to have a large portion of protein, so I started having a small portion of protein, and I ended up eating less fat also.

SM: I think that’s important. People don’t realize when they say, well, I need to add carbs back, they forget that then they’re just adding calories on top, so what should I take out if I’m going to add something back?

DR: Exactly. And even though there’s criticism of calories… and I used to be one that was more of the belief that calories don’t matter, and it’s more so the carb content for weight loss. There is definitely truth to that. Some of the studies and some of the best evidence we have shows for weight loss that lower-carb diets are better for weight loss, but this doesn’t mean that if you have a healthy metabolism and you’re eating healthy food and you shift from healthy foods that are higher in protein and lower in carbs to other healthy foods that are higher in carbs and lower in protein, it doesn’t mean that you’re going to gain weight, especially if you’re listening to your body and kind of auto-regulating your caloric intake.

SM: Right.

DR: That was a shift, and now what I’m doing is I’m trying to isolate to bring back in fiber and see. If things regress as I increase fiber, then it tells me that the fiber was the culprit and maybe I was having too much fiber. If things regress when I bring the carbs back down, that tells me it was carbs that I actually needed. So I’m doing some tinkering with that. My inclination is that probably there was a little bit too much fiber, especially the cellulose-type, insoluble fibers. There was a little bit too much fiber for the level of the stress and the amount of caffeine that I was drinking, and both those can kind of irritate your gut.

This is something that is much more representative of someone that might have IBD, actually, right? Those with inflammation in the bowel or any type of inflammatory bowel disease tend to be better on a lower-fiber diet, although I should also say that it’s not just the inflammatory bowel disease patient group, if you will, that does better on lower fiber, because we do see the same thing with low-FODMAP diets, which to some extent tend to be lower fiber, and the SCD diet, which also tends to be in that same grouping. We see those with IBS and SIBO also have a tendency to do better on a little bit less fiber—using the term “fiber” loosely—and a little bit less prebiotics. What exactly it means, I’m still working that out, but right now, again, I’m in the process of bringing fiber back in, and then I’ll see how that goes, and then I’ll just bring the carbs back up while keeping the fiber low and see what effect that has.

Those are some things that I did and I found helpful, and I thought maybe one of the more salient or important points for people to hopefully take away from that is sometimes it’s really good to learn to just listen to your body. The one bad thing, I think, about the wealth of the available information on the internet is it can get people out of the habit of listening to their own body because they’re always so busy listening to what everyone else is saying. It’s not that we shouldn’t use the wonderful resource of the internet and all the information there, but we also don’t want to forget about just listening to your body, listening to your intuition, literally listening to your gut—I guess, both literally and figuratively—because there’s a lot that you can figure out by doing that.

That’s some of what I’ve been tinkering with, Susan.

SM: I second on the fiber and the IBD because I do have IBD. It’s artichoke season here in California, which is a pretty big thing. When they come out in the spring, we all want to eat artichokes all the time. My husband doesn’t like them, so I bought a four-pack of small artichokes from Trader Joe’s, and I made them, which means I needed to eat a small artichoke about every day, and artichokes are really, really high in fiber.

DR: Right.

SM: And after the fourth day, I realized I can’t do that. I need to have one every once in a while. I can’t eat an artichoke a day for four days. My gut was just a wreck.

DR: Mm-hmm.

SM: I think an artichoke has… 15 grams of fiber? Ten to 15 grams for a small artichoke, which is a lot. A cup of broccoli, I think, only has one or two grams of fiber.

DR: Yeah, and it has a pretty good dose of prebiotics in there also.

SM: Yeah. It’s high up there on the FODMAP list.

DR: Yeah. That’s a really interesting point that you make, Susan, and it reminds me of a lot of what we’ve spoken about in previous articles, podcasts, videos, what have you, which is the importance of looking at these dietary interventions through a clinical lens rather than more of an observational or microbiota research or cultural comparison lens. Bottom line, the thing that I get worried about is we read so much about the Africans and how to have a Paleo gut and all these kinds of things. That’s all fine and good, but what it really comes down to is, if you have a healthy gut, you can go buck wild and have a lot of fiber and start eating more like an African with a super-high-fiber diet, but for the large percentage of people that either have IBS or SIBO or IBD or are recovering from some sort of gut inflammatory condition, those things have a high probability of making you worse.

It’s important to keep that in mind because it’s easy to fall into a rhythm of doing something that is going to harm yourself because you’re trying to do what you think is good, which is to “become more like an African,” but we are not Africans. We didn’t grow up in the dirt, breastfed, in a community of people living as hunter-gatherers. We had a different upbringing—probably exposure to antibiotics, not the greatest window of being breastfed, potentially having a Cesarean section birth, potentially being formula fed, not having a lot of exposure in our early years to develop our microbiota. All this affects our immune system, our gut, and that changes the type of diet that’s going to jive best with that system.

SM: Yeah, and it also changes some of the hacks that are out there. I know when I tried the potato starch, because that was around a couple of years ago, and I think a lot of people still do it, but because I have IBD, it wrecked my gut! It really did, just like the artichokes did. I have to be really careful. When I think about doing what I call an n=1 experiment or I see something on the internet that I’d like to try, I always need to look at the context of me, of Susan, and what that could do to me.

DR: Exactly. It’s a really important point, which is that advice of potato starch and things like that work great if you have a generally healthy gut. They’re nice little easy add-ons. But if you don’t, they tend to make you worse. It can be such a travesty for the online healthcare consumer because it’s the people that are the sickest, if they come across this, that are probably going to do the worst with it.

SM: Mm-hmm.

DR: That’s why we’re trying to provide a voice of reason here with this stuff.

So have you been doing anything, Susan? I know you said you had some things that you’ve been tinkering with yourself.

Susan’s Diet and Lifestyle Changes

SM: Yeah, I’ve been tinkering for about six months now, which is crazy to think that it’s been that long. In general, the idea of carbs and fat together, it started probably about nine months ago that something… it just didn’t sit right with me, high carb and high fat at the same time. Low-carb diets are good for weight loss, low-fat diets still can be good for weight loss, just not quite as good as low carb, if you listened to the episode with Christopher Gardner.

DR: Right.

SM: So low-fat diets do work, and low-carb diets do work, and I was kind of in a rut. I’ve been a healthy body composition. I think six months ago—I don’t know what I am right now—but I was at like 27 percent body fat. I’m in my late 40s, so that’s reasonable. I was a good size, not overweight, not underweight. I ate what I wanted, within the realm of Susan. I didn’t eat gluten. But I was kind of getting in a rut where I’d eat my breakfast and then I wouldn’t eat for hours and hours and hours and hours, and then all of a sudden I’d be starving and it would be too close to dinner to eat, and so I started snacking on plantain chips or the “clean potato chips!” And my weight went up a little bit, and then a colleague of mine and yours, Jason Seib—I don’t know if you’re familiar with his work.

DR: Just very superficially, yeah.

SM: Yeah. He’s a trainer, and he works predominantly with women. He came out with a protocol called AltShift, and so I thought, well, I’ll take a look at it. I always read new stuff. When something comes out from somebody I trust, I get it and I read it. I’m not going to give the specifics of it, but it’s basically carb cycling and fat cycling, which results in calorie cycling as well, where you do some low carb, then you do some low fat, and you keep going back and forth, and I thought, interesting.

I was a Weight Watcher person, so it scared me a little bit, but I wasn’t a Weight Watcher person in the realm of whole foods. I did a lot of processed, icky, diet sodas and one-point popcorn, all that processed food. And so I just kind of went into it with my eyes open, thinking, I don’t really need to lose weight, but it would be nice to lean out a little bit. And I was, quite frankly, floored by how good I felt and how it changed the way I thought about certain foods. I mean, I can’t eat gluten, but in the last three years, the gluten-free food industry has just boomed.

DR: Yes.

SM: So whereas before, I didn’t eat a lot of treats because they weren’t there, and now all of a sudden, there are gluten-free cookies at Target and these Oreo gluten-free things at Trader Joe’s!

DR: You have been doing your homework!

SM: All those kinds of junk foods started creeping back in, but if you don’t eat high carb and high fat at the same time, it takes away a lot of those snacky foods.

DR: Right.

SM: I think that’s wherein it lay. My sleep got better because I was eating quite a bit of carbs on the low-fat days because you have to eat a lot of starch to feel full, and it was just really interesting. So I’m doing it. I’ve lost, like, 15 pounds, which for me, not being very big to start with, was really crazy. I feel really good. I need to get some blood work done because I have one marker that’s always out of range when everything else is perfect, and that’s my LDL. I’m curious if it changed that at all. And my IBD went into almost complete remission, so it’s just really interesting to kind of play around with macronutrients and different foods because on the low-fat days I was eating a lot different foods than I’m used to, and I really liked it.

DR: Yeah. Well, it’s always interesting to just experiment with diet and not to be afraid to try something because it’s one of the best ways to learn. Yeah, I’m happy that you’ve done that experimentation and that you’ve learned some stuff. It just goes to show you something that we’ve spoken about before, which is it’s not good practice, in my opinion, to be very hard driving on one position because there really are a number of different things that work well, and to say everyone should be high carb or everyone should be low carb is really misguided. It’s just an issue of we have a number of things available; let’s determine what’s going to work best for you and have you do more of that.

SM: Right. We always say, well, when they took the fat out of our diet, that’s when the obesity epidemic really started, and there is a little bit of truth to that, but also we can’t throw the baby out with the bathwater, like with the Christopher Gardner study, low-fat diets, although my problem with them is they’re just not sustainable because they really aren’t that flavorful, and so people tend to relapse off of them, I would say. It’s hard to get people to stay on them as opposed to low carb, which tends to me to be more satiating and flavorful and more of a foodie-type thing. In the Paleo world, we pooh-pooh low fat all the time, but let’s take a look at it. There could be some good things about it. Let’s not get dogmatic about it.

DR: Exactly. Just like a lower-carb Paleo enthusiast might get frustrated at the higher-carb person and say, “Ugh. Why can’t this person just look at some of the studies that Paleo has done?! Look at some of the research! Why can’t they just look at this?!” Well, if you do the same thing to them, then you’re really just being the same way they are, which is dogmatic and narrow minded, but doing it with what you think is right.

SM: Mm-hmm.

DR: I think that people in the Paleo community, for the most part, are pretty good about being open minded, and I’m hoping that some of our conversations are continuing to help steer people in this direction of let’s not fall into that narrow-minded approach, and let’s pride ourselves on being part of a movement that is open minded and progressive. As both of our individual experiences can attest to—and I know many other people that have found that they do better on a little bit different of a macronutrient profile—there are many people that changing things around a little bit works really well for. And maybe, Susan, it’s not as simple as one or the other. One thing my father always says to me and has been saying to me since I was a little kid is, it doesn’t have to be either/or; it can be both/and.

SM: Mm-hmm.

DR: There’s definitely some ancestral plausibility to that, and what I mean is you don’t have to be high carb or low carb. You can oscillate between the two, and there’s definitely some ancestral plausibility to that because as seasons change, foodstuff availability changes and macronutrient consumption typically changes. This has been well documented even with modern-day hunter-gatherers. From season to season, their proportions of proteins, carbs, and fat oscillate as the food supply changes.

Yeah, to have one diet that we are hard driving on is maybe a bit silly, especially when you look at it through an evolutionary kind of perspective.

SM: Right, because if you think about it, if you have a tribe and you have a kill of a big mammal, you’re not going to say, “Oh, wait, I need to get my fibrous vegetables in.” You’re just going to eat as much of that hippo or elk or whatever it is because there are no refrigerators!

DR: Yeah!

SM: And then when that ran out and things were scarce, you’d be pulling up the tubers!

DR: Exactly.

SM: And you’d be eating the herbs and whatever. And in the summertime you’d be eating your fruit.

DR: Yeah. It comes back to something that I know Mike T. Nelson, who was on the podcast a few times a while back, talked about. I’m not sure if he talked about it much on our podcast, but I know he has lectured on this concept of metabolic flexibility, meaning a healthy metabolism is one that can do better on a variation of macronutrients. I definitely think that there’s something to that because you kind of give your metabolism exercise, so to speak, if you oscillate between different macronutrient intakes, and that kind of keeps your metabolism adaptable. Just like we should be able to move in different positions, perhaps our metabolism needs to be able to metabolize different types of foodstuffs.

SM: Definitely. Yeah, I’ve been super happy. And you know, there might be something that comes around next month and I might want to try it. I’ve tried a lot of things, and certain things have worked and certain things haven’t. I can sometimes fall into the binge eating thing where enough is never enough, especially with some of the processed baked goods, and that’s why I try to stay away from them. So I’ve tried stuff like carb night, where you eat all the carbs you want one night a week, and that triggered me into feeling so bad the next day because I had so much sugar!

DR: Right.

SM: I tried the potato starch thing. Sometimes things work and sometimes they don’t, but it’s all about the research and continuing to know who you are and what health conditions you have and what your body can and cannot do. If the “try gluten for a week” diet came out next week, I would never try that!

DR: Sure. You make a good point about the research, Susan, and maybe to add how I see what the research shows and what I see in the clinic, how that correlates, generally speaking, the research will give you the ability to pretty accurately predict how someone is going to do on something. This is why a long while ago I made the comment that I foresee these high prebiotic interventions not being good for those with IBS and SIBO and those with IBD because this is what has been shown in the clinical trials. Now every day I hear of another person who has tried these fancy kinds of prebiotic and fiber support programs to only eventually feel like they’ve gotten worse. Now, there are definitely a number of people that these things help, but there’s also a large subset of people that these things don’t work well for and they even make them worse, and this is the people with IBS, SIBO, IBD, and other gut inflammation or imbalances.

Now, that being said, does this mean that prebiotics are going to be a problem for everyone with IBS or IBD? No. There’s a small number of people where these will be beneficial, but again, the research shows you that if you have SIBO, IBS, or IBD, you have maybe an 80-ish percent chance that a really high prebiotic, really high fiber intervention is probably going to make you worse.

SM: Right.

DR: What’s nice about having that information, especially as a clinician, is it prevents you from having people do stuff that’s going to make them worse, which is ultimately a pretty important thing if you’re a clinician! You want to be able to have some experience and tenure and be able to guide people to the treatments that are going to be the best for them. If not, we could make a list of treatments and just say, well, we’re just going to try all these one by one until we find one that works. OK, that’s one method, but not the most efficient road to get the result.

SM: Right. Then with the allopathic gastrointestinal community, for IBD, they usually recommend a low-fiber diet, and a lot of people in the natural community say that that’s wrong. But like you said, 80 percent of people. It’s going to work for most people, a low-fiber diet, and it’s going to be something that’s going to get them a reduction in symptoms pretty soon. They may not be too far off. They probably should make a lot more recommendations besides just low fiber—and probably white bread isn’t a good example of low fiber if you have IBD because that’s on their low-fiber diet—but it’s something to think about. I have to be really careful about my fiber intake, like I said with the artichoke example!

DR: Right. This is something that I outline in the book, which is looking at fiber kind of like I look at carbs, where we’ll start lower carb and lower fiber, and then we’ll work our way up on each of those to see where someone’s sweet spot is. Looking at it in that light prevents you from just saying, “I am just going to eat this way for the rest of my life.” Let’s start with kind of a safe diet, so to speak, a little bit lower fiber, a little bit lower carb. See how that goes, ride that improvement for a few months, and then start to open up the boundaries to see how much latitude I have here and where that point is where I go from having enough carbs to having too much carbs, or having enough fiber to having too much fiber. I know this is not super-sexy like “everyone has to do this all the time because of X,” but this is truly the process that I think is most important, which is individualization.

SM: Yeah. I think if you hear somebody say, “Everybody needs to do this,” you should probably run away.

DR: I would agree!

Episode Wrap-Up

SM: Well, I think we’re about out of time unless you have anything else you want to bring up.

DR: No. I think that was a good kind of editorial for us to share some of the stuff that we have going on, and hopefully that will be helpful for people. If you have thoughts or comments on that and you want to post them, please go ahead.

I should maybe make this reiteration that people sometimes email my office when they have a question about podcast stuff. Thank you, but really the best place to put a comment for this stuff is not to email my office, but it’s to use the comments section on the website because that is where other people can see and participate in the discussion and have a dialogue. The office email, which you’ll see on our website, that’s meant for patients and prospective patients. If you have a comment or question that’s related to this information, then the best spot for that is on the comments section associated with this episode. That way, I can join in and other people can join in and we can really have a community conversation rather than one on one. Typically I’m not able to respond to the emails that are sent directly to the office anyway, so the best way for me to see it and for us to have a conversation would be via the comments section of the website.

SM: Yeah, so to get there, you would go to DrRuscio.com. Then there’s a podcast button. Click that and that will take you to all the podcasts. Each show has its own page, so you just find the show, click on it, and the comments section is at the bottom.

DR: Absolutely. Another thing that’s very helpful is our search box.

SM: Oh, yeah!

DR: Sometimes people have questions on, say, a podcast from a year ago. It may be hard to find that in the feed because it will be kind of low down, but you can go to the search box and just type in “iodine,” and then—boom!—all the stuff that we’ve done on iodine will be right there at your fingertips.

SM: Perfect. That’s a great idea. Then also you can head over from the show notes to iTunes and give us a review if you feel like it. We’d appreciate it!

DR: Yeah, those reviews are always appreciated, guys, because you’ll help us reach more people and help more people.

SM: Yes. OK, well, I think that’s a wrap. We will see you guys next week with more great topics!

DR: Thanks, guys.

Thank you for listening to Dr. Ruscio Radio today. Check us out on iTunes and leave a review. Visit DrRuscio.com to ask a question for an upcoming podcast, post comments for today’s show, and sign up to receive weekly updates. That’s D-R-R-U-S-C-I-O.com.

If you need help finding your ideal diet, click here.

What do you think? I would like to hear your thoughts or experience with this.

Discussion

I care about answering your questions and sharing my knowledge with you. Leave a comment or connect with me on social media asking any health question you may have and I just might incorporate it into our next listener questions podcast episode just for you!