Hello, and welcome to our podcast with nourishing insights. This is our first podcast, and I'm very excited that we are joined today by Christine Bishara, who is joining us from her home in Manhattan, in New York. And we're very excited because today we're going to be talking about a paper that Christine has been involved with, which is looking at issues around gut bacteria and the role that they may play in prevention of the recent, COVID infection. So, we're going to talk about that in a minute, but first of all, I'm just going to say, welcome Christine. And we're going to talk a little bit about give your bio and then, get you to join in with a little bit of background. So first of all, Christine is an MD and is the founder of, from within medical, which is a medical wellness practice that places a real emphasis on the mind, body and gut brain access to prevent and manage disease.
So those of you who know me can see why already we're connected. So, with over 20 years of clinical experience, time and time again, Dr. Bishara has discovered that the connection between these systems plays a significant role in disease prevention and management, but it's something that's not adequately been addressed. So, Dr. Bishara is all certified in internal medicine by the national board of physicians and surgeons and is certified in integrated medical weight loss by the American academy of antiaging. She has previously served as assistant professor and clinical preceptor at New York medical college and her professional experiences span academically and clinically in both inpatient and outpatient settings. Christine is also a busy mom of three. And so, she very much understands the impact of daily stresses on modern living and on her. Consequently, her therapies involve very much in multidimensional and customized approach based on many factors.
And she focuses a lot on the immune system as you'll see very shortly as we begin our discussions, she's also into the role of aesthetics and has just started, looking at non-invasive techniques for personalized, skin rejuvenation. So that is a little bit of background. So, Christine, thanks very much for joining us. And it's just so exciting to have you and to be discussing this topic and those of who know me, you know, I'm so excited about gut health. I'm always talking about gut health. So, tell us, how did you get into wellness medicine?
Well, thank you so much for, inviting me to join you in your first podcast. And I'm so delighted that we're able to join forces and to connect, even though we're on different continents, but we have, a lot in common. and so, like you said, I've been a practicing internist for over 20 years. And what I've seen is that the patients that I've had over the years have many chronic illnesses, which we've been treating, however, as much as we been taught to treat with medications and hospitalizations, we really haven't guided patients, in preventive medicine, as much as I'd like to. And so that's been a passion of mine and it's something that I really focused on because I saw so many conditions that were preventable and with the right lifestyle changes with the right tools, with the right guidance, it's definitely doable.
And so, my passion was to really just try to help as many as I can, because I think feeling great then kind of expresses itself externally and then you want to look great. And it's just something that, I think everyone wants. So, this is really my passion, my personal journey as well. I was obese as a teenager and I struggled with my weight in my early twenties, but I found the right formula for me. And again, it it's so much, related to personalized care as well because we're all different. We all have different hormonal changes. We all have different metabolisms. And so, my, my goal is to help everyone find that personalized guidance that they need to help them achieve their best health.
Beverley 00:04:01 Okay. Thank you. And it's interesting. Cause I think a lot of people who get into wellness medicine or lifestyle medicine, or functional medicine are very much people like yourself. Who've had that personal journey, that personal experience, but who also have a real passion in wanting to help people and to help get to the root of their, their problems. And very often the root is in fact lifestyle medicine and nothing more than that. It's these lifestyle factors of food, stress, sleep inactivity. It's the same things that come up again and again and again, but it's, it's helping people to navigate that and also having an evidence-based approach to be able to do that. And that's what these functional approaches give us.
Dr. Bishara 00:04:39 Absolutely. and I'm a big believer in, once you are empowered with the knowledge and tools, then you will take control of your own health. your doctor's not going to be able to help you. No, one's going to be able to help you until you're empowered. And given that knowledge, and I think we all want to be in control of our own health, but unfortunately, so many of us don't have that right guidance or the knowledge. And so that's, that's where I really want to just help people to learn, to understand how your body works, how your immune system works, how your gut is so linked to your mind, your, your body, it's a very intricate system and, and our bodies are designed for survival and, with the proper care and lifestyle changes, we're, we're all able to change our health.
Beverley 00:05:20 Absolutely. So, we're doing a bit of a reverse interview, aren't we, because Christine's going to play this podcast at home, to her followers as well. So, so I think I'm handing over to you now to, to take a hot seat for the interviewer. <laugh>.
Dr. Bishara 00:05:37 Sure. Well, so, so what we wanted to discuss, and this is something that I've really, been passionate about, but, what we found recently, and I think it's very pertinent that we're talking today because of what's going on in the world with, the COVID 19 infections that we've seen, unfortunately, New York city has been the epicentre of this pandemic, and we've seen so many cases of patients who are getting ill. Of course, we know that the elderly are very vulnerable, those with comorbid conditions. But what we've also seen is that the majority of non-elderly patients that are getting hospitalized are patients who are either obese, diabetic or insulin resistance. And this is definitely not a coincidence. And so, my colleagues and I decided to do a little bit more research to find out, what may be driving this increased susceptibility to infection.
Dr. Bishara 00:06:32 and we first, looked into, it was like a light bulb moment. my husband is an ICU physician and, we would in the beginning when, when it was really busy and he was treating so many patients and of course, you know, this is a, infection that many of us are kind of learning for the first time. But he and I discussed the role of cytokine storm and the role of interleukins and how they're driving. Mm-hmm <affirmative>, the severity of these infections. And so, what, what I found and that, again, like I said, it was my light bulb moment where I said, you know what we need to find out, why are these, specific subsets of people getting sicker than others? And it kind of went back to children and children are not really getting sick, right? We're, we're not seeing as many children.
Dr. Bishara 00:07:20 I mean, I know there's a small set of children who are getting a little bit sicker where they're having that inflammatory syndrome. We can talk a little bit more about that, but overall, in general, children are not getting as sick as adults are. And so, we decided to do a little bit of research on why that might be. and, you know, as someone who's a proponent of gut health, that's where I started to do my research. And what we found was very interesting. we found overall children’s guts are much healthier than adults, but why are they much healthier? Mm-hmm <affirmative>, we found that their gut, distribution of gut bacteria is very different from adults. and in particular, one specific gut bacteria called bifido bacterium, which has been known to play a role in immune modulation and immuno protection. And that specific bacterium is, higher in children
Dr. Bishara 00:08:10 And as we age the levels start to decline. and interestingly enough, the majority of children have, bifido bacteria occupies the majority of their gut, about 60 to 70%. On average, again, you know, these numbers can change based on many factors mm-hmm <affirmative>, but that's what we found on average. And we found that as people age, it, drops down to the point where, some elderly patients have less than 1% mm-hmm <affirmative>. ironically, we also found in our study that, certain centenarians, in Italy and Japan were found to have, higher levels of BFI bacteria, men, those in the elderly population that are younger than them. Mm-hmm <affirmative>. And so, there's definitely a link we believe. again, this is a hypothesis that we found much research on and we would need to do clinical trials. But what we found is that bifido bacterium definitely modulates the immune response. It coordinates the decrease of pro-inflammatory markers and, and the increase of anti-inflammatory markers. So, we can discuss that a little bit further as well. and I can go into it now, if you'd like, or if you want to ask some more questions just to bring it up.
Beverley 00:09:22 Yeah, no, I think that it's good. You've set the scene there really, really well. And I think that, you know, globally, we we're getting to understand these issues, the fact that it is the older people, and it is these people with metabolic conditions, people who are overweight, who are more susceptible, to this virus. but again, even in the UK impression has been put on the government by a number of, medical, professionals here. One of particular I can think of. I see Malhotra, who's a cardiologist in London and he's certainly been shouting off the rooftops about this problem and saying that we really need to be targeting the underlying challenges, which is the obesity epidemic. Absolutely. And, and getting to grip with that, because it's the, these challenges, it's these inflammatory conditions, which are making these, these people fall pre, on wittingly to this horrible virus.
Beverley 00:10:11 but there's always going to be another virus in another virus. So surely shouldn't we be tackling these underlying challenges because these are the things that is, is making these people vulnerable to this nasty attack from a virus that really their immune system should be able to tackle quite well. you know, the immune system is pretty clever, pretty impressive, set of unique Sy systems, checks and balances are in place to be able to cope with anything that life throws our way, but we need to make that as robust as possible. so, you know, it, it's fantastic that you're looking at this and that you're covering all of these challenges, in this paper. Cause it's not just about what we eat. It's about the impact of what we eat has on our gut health, on our microbiome. And that's possibly why children have a much better microbiome because they just haven't been around long enough to do the damage yet really <laugh> they just haven't been around long enough that they're generally fairly active.
Beverley 00:11:09 They're on the go and that's good for the microbiome. Yeah. they're, they're eating, you know, reasonable amount of food until they reach older age and they become stressed, which damages the microbiome and then the, the vicious circle of carb craving and all those things that are imbalancing and not good for the microbiome. So, they just haven't reached that point yet in their history. And so, you know, maybe that has a lot to do with why there got much better, but also, you know, if we want to continue into longevity, it's so interesting what you said about the, these older people. Mm-hmm Arians, who, who are, you know, reaching old age with a much more robust microbiome. And I think that's, that's really exciting and really encouraging and really motivating. I think for people that, you know, a lot of people say, oh, the damage is already done. You know, there's no point it's all in the genes, what will happen will happen. But actually, you know, from an epigenetic point of view, we can influence these changes if, and improve our health. If we, start thinking about our microbiome. So,
Dr. Bishara 00:12:11 With you mm-hmm, <affirmative> sorry.
Beverley 00:12:13 Didn't. So, so yeah, no, absolutely. I'm looking, thinking about my next, my next question on my list of things. Cause, things that I discuss with you. So, let's, first of all, I want to think a little bit about why it is that people with these chronic inflammatory issues, are actually struggling with, with COVID. So, we just go a little bit more into that.
Dr. Bishara 00:12:38 Sure. so, I think many people have heard that term, she has, or he has inflammation, or they're inflamed, right. And it was kind of this just general term that we've used. And a lot of people probably don't even understand what that means exactly. But find what we have found is that people actually are inflamed this specific subset of people. and what happens is that the way I see it as like a traffic light, so individuals who are not obese or, you know, are, are fairly healthy, they're at green and, an obese individual or someone with diabetes or insulin resistance is at yellow. And the reason why they're at yellow is because they have higher levels than normal of a specific pro-inflammatory cytokine called interleukin six mm-hmm <affirmative> and interleukin six is one of those things where, it's, it's great and small doses.
Dr. Bishara 00:13:28 and you know, there's not, we don't know everything about it yet, but what we've seen is that Intelex is a pro-inflammatory marker. And so, what it is it's something that's released, as a result of some kind of, injury to the body infection intruder. And so, it's, it's basically there to help us to protect us, unfortunately, in those, in this specific subset of, people that I spoke about have higher than level subclinical, levels of interleukin six already circulating in their body. So, they're at yellow already, and this is where we see that term in flame mm-hmm, it's because their body, for whatever reason, and it's probably due to the fact that they don't have as healthy of a gut, microbiome, they have other conditions that are causing their body to react. And so those levels of interleukin six are higher than normal individuals.
Dr. Bishara 00:14:18 And so what we've seen is when these patients have been infected with COVID 19, what happens is their body's on already kind of hyper alert, they're at yellow, right? And so, you get this intruder. And so, they stimulate this hyper exaggerated response to the intruder in a way to kind of fight for their, for their body. but this hyper exaggerated response initiates something called a cytokine storm. And unfortunately the cytokine storm, even though it's meant to help the body, it's actually causing more damage mm-hmm <affirmative>, cause then you're having an influx of all these anti-inflammatory, markers and you're, and you're trying to migrate antibodies and white blood cells and all these, natural killer cells that are really trying their best attack the virus. But unfortunately, you know, they're also damaging tissue, and this is exactly what we're seeing. And, interestingly enough, in the ICU, they have been giving medications, which are interleukin six inhibitors mm-hmm <affirmative> and those have been successful in, kind of diminishing the response.
Dr. Bishara 00:15:24 And so this is really where we find that link. these people do have a higher, the normal level of Interleukin six, which is what's causing that pro inflammation. Yeah. And it's present in adipose tissue and believe it or not, this is something that's reversible because we have found that with, administration, there were some studies done a few years back administration of, this bifido bacterium that we've written the article about mm-hmm <affirmative>, specifically bacterium breve, which is one of the, more common types of bifido bacterium in children guts, in infants guts actually. And even more abundant in breastfed infants. We found that patients, we had, we had one study where they were given to obese individuals and their BMI decreased after eight to 12 weeks of administration. we had another, bifido, species called bifido infantis, which, also was found to decrease pro-inflammatory cytokines, such as interleukin six.
Dr. Bishara 00:16:25 And that's actually also been one where they get to premature infants who have necrotizing enterocolitis. Mm. and it's, it's been found to be, be helpful. So, we have all this evidence of our gut playing such a major role. And it's definitely something reversible because we've seen with, with diet with, with weight loss, these levels have gone down. So, I'm really excited about the findings that we have. And I'm hoping that we can start, some form of clinical trials. as soon as where we're checking patients’ guts, mm-hmm, <affirmative>, we're correlating, you know, the results with who's high risk who's being treated, et cetera. Mm-hmm
Beverley 00:17:01 <affirmative> yeah, no, that's all very exciting. And I love your analogy there of the traffic lights, because a lot of people don't understand what we mean by this idea of, of inflammation and this expression, the site account storm people have no idea what that means. It's just a phrase that's been banded around in the media. We just know it's something nasty and it has something to do with the virus mm-hmm <affirmative>. and if you, have it, you're in big trouble, but what's interesting in these high-risk groups, is that in, in their situation regarding the immune system, it would seem that their immune system, I liken it to being otherwise engaged, otherwise busy. So, if your immune system's already busy tackling information, which comes from, and along with these other inflammatory conditions, like heart disease, diabetes, obesity, et cetera, then you know, it it's understandable how and why it could, would have difficulty coping with yet another immune threat, which is, from a virus.
Beverley 00:18:03 Because what we don't realize is that the immune system is involved when we have any of these inflammatory conditions, these are chronic immune mediated conditions. And that's the part that the public wouldn't understand. They wouldn't understand that their diabetes had anything to do with their immune health or their gut health, that these connections there. And that's where the kind of work that we do in this sort of wellness and functional, approach. Then what we're looking at, these, the interconnectedness of these disease pathways, and it's these chronic inflammatory pathways that obviously driven by, the presence of, or not, these bacteria. So yeah, I really, really like that, that approach, and fantastic that there's a possibility there of clinical trials follow on from this review paper as well.
Dr. Bishara 00:18:54 I, I'm hoping that we build some traction and do get interest in this so that we can see if there's a correlation. unfortunately, and I don't know how it is in the UK, but unfortunately in the us, wellness medicine is not really covered by insurance. So, so many people, are not able to have proper wellness exams and get access to all these measures that we think are so vital. and so, the way I see it is, a small investment in your health, eventually will, will lead to, I guess, a bigger payback when you're older, right. To prevent illness. and that to me is something that also I'd like to really focus on is why, why is in wellness covered by insurance? I mean, maybe this is somewhere where we now have the opportunity to actually show that the immune system is so linked and what we eat really, really does affect, our health. I am not sure how it is in the UK. Is it similar?
Beverley 00:19:55 I mean, obviously it's very different here because we have a free system of the NHS, but, you know, the NHS system is, is basically brought by primary care GPS at the bottom end, who are seeing people face to face and running those very short 10 minute or slightly more if you're lucky conversations, but there isn't the time there isn't the, the funding there, isn't the training, to support people with, some of these chronic conditions in the way that they should be. Because basically when you've only got a few minutes to see someone, it it's very much a case of, well, here's the pill.
Dr. Bishara 00:20:28 Absolutely.
Beverley 00:20:29 There's no time to actually look at the underlying, challenges, but that's where people like us nutritional therapists come in, because that's what we do. And interestingly, within the UK, there are a growing number of, doctors who are studying the functional medicine approach, study nutritional therapy. so, you know, year on year, those numbers are going up and, in the UK, we've also got a great, GP, who's a real ambassador for this. Who's called, ring and strategy. And he has had a TV program actually talking about, his lifestyle medicine and, and showing how we need to be, bringing this approach into mainstream. But it's, I mean, I'm sure there are those doctors out there who bless them or trying to do this and trying to introduce it in their own quiet way, but the system at the top, isn't allowing space for that and allowing proper funding for that.
Beverley 00:21:22 So, so in some ways, you know, we, we'd be pretty similar in the way that people operate in this country. And that's why there is a frustration among people with these conditions. And they're looking for answers elsewhere. He, they come to people like us, of course. because they want to get to the root of the problem. They don't want to just throw a pill. They want to find out, well, what can I do? And what's not working, what am I doing wrong? Why am I still overweight? Or why have I still got high blood pressure? what can I do differently that will influence that? So that's really, yeah. What we're about and where we come in. Fortunately. so yeah, and, and again, it's, it's, it's crazy because it's very costly. you know, whether it's NHS or whether it's, you know, private funding or whatever it is, doesn't matter at the end of the day, somebody someone has to pay, for this, this crazy approach.
Beverley 00:22:10 And so it has to change. We have to have, you know, medicine is going through a bit of an evolution now and is changing. and it, it has to, because this is, it's an INCOM, it's a common sense, intelligent approach. And if you think about the situation, we're in, just now, it's all more ridiculous because here we are facing this immune threat and yet the immune system is never thought about or discussed, among, you know, those government leaders, it's almost as if we don't have the immune system. but of course, you know, 70% of our immune system is in the gut and that's why we need to be considering a microbiome. and it's absolutely fundamental. Now recently on that topic, actually couple weeks ago, we did have, a report in the national press saying that 120 or more than 120 scientists in the UK have actually put forward a proposal to the government to, to suggest that we do just that we are, you know, we need to look at gut health.
Beverley 00:23:09 So obviously people behind closed doors are starting to make those connections and have those discussions. So that's a good thing. That's a positive that's coming outta this, but it's taken weeks and weeks, for people to come forward and all that, you know, the only suggestion has been stay at home. Don't go anywhere, wash your hands, you know, all practical stuff, but it's, it's not doing anything. It's not serving any purpose at all regarding the immune system. And that's, doesn't make any sense. Cause we, we have to tackle the immune system where we're going nowhere where fast,
Dr. Bishara 00:23:39 I agree with you. I mean, I, I feel like this was probably a wakeup call and we are making progress in, holistic medicine. So, I'm happy about that, but we definitely need a little bit more, attention to, the gut, like, as you said, which is so linked to the immune system and not only linked to our immune system but linked to our mental health as well. I don't know if many people know that serotonin is 90% of serotonin is made in the gut mm-hmm <affirmative> and there's a direct feedback loop from the gut to the brain and our neurotransmitters, you know, that affect our mood are, are linked. And, you know, I tell people this all the time, but I, I, I truly believe this. I think hopefully, this will be the case, but I, I believe that gut analysis really is the routine blood work of the future.
Dr. Bishara 00:24:27 Mm-hmm <affirmative>, I think all of us really need to assess our guts. And so many conditions have, have occurred as a result of leaky gut and of just that dysbiosis that's going on. Mm-hmm <affirmative> for whatever reason. I mean, you know, it's funny, I tell my kids all the time, there's good and evil in the world, right? Mm-hmm <affirmative> that good? Always overpowers evil, well, the same thing's going on in your gut. Mm-hmm, <affirmative>, you know, bad bacteria and there's good bacteria, and you definitely want to hire ratio of that good bacteria yeah. To help with the integrity of gut health mm-hmm <affirmative> with membrane support. I mean, this is all, you know, these are all prerequisites to the development of leaky gut, which again, I mean, you're releasing all these toxins into the body and causing inflammation and I think this is really what's going on. and so, I'm glad that we're kind of making some traction and there's some attention. I just feel like we really need to, to, to bring a lot more attention to the gut mind and the gut, body.
Beverley 00:25:25 Mm-hmm <affirmative> absolutely. And of course, and another aspect to that is the fact that stress itself suppresses the immune system. Absolutely. so that's another factor that, is important and we've, we've created actually a lot of stress in the last few weeks and months because, you know, we're, we're creating stress by a creating this social isolation. but also, a lot of the fear mongering as well around the condition itself. and a lot of the things that have been said that have been appropriate and, you know, we've been around suggestions that young fit people have got this and have died. Whereas actually we don't know the truth about those young people. We don’t know anything about their immune health. We don't know their vitamin D status. We don't know what their microbiome was like. We know nothing. And we certainly don't know about their mental health or their stress, which is we know suppress is immunity.
Beverley 00:26:16 So they're, it's all of these factors. You you'd have to understand an awful lot about an individual to know whether they were high risk or not the fact that they don't have a, a condition diagnosed. Doesn't actually tell you anything because health is so much more than the absence of disease. And, and again, that's, that's where we come in with our work. Cause we meet those people who don't actually have a label. Don't actually have a diagnosis maybe, but, or they have the wrong diagnosis and then they appear, and they're trying to get to the root of something and trying to understand, you know, again, what they could be doing wrong or what it is about their history that's brought are very keen to those and very motivated to do so about it. But
Dr. Bishara 00:27:03 I, I agree with you and I'm really glad that you brought that up because there are so many people out there that, quote unquote, look fit and healthy. And in essence, we don't know, we don't know what's going on with their gut. I mean, I'll give you an example. there are so many people, like you said that have vitamin D deficiency, vitamin D plays a significant role in the gut. There are many people that are magnesium deficient. magnesium is, you know, a mineral that is present in almost all functions of the cells. So many, nutritional deficiencies that we're seeing in young people and older people that definitely affect, our health. And interestingly enough, for my, my practice, I, I have incorporated something called antioxidant, a scanner mm-hmm <affirmative> and what that scanner does. It's a non-invasive scanner where you put your hands on and it actually checks the level of carotenoids in your skin to determine how high your antioxidant level is in the body.
Dr. Bishara 00:27:58 And I've checked many individuals who appear very fit and healthy, who actually have very low levels, suboptimal levels. And this is another thing where, you know, we have these people who appear healthy, but are not. And, and like you said, there's so many different factors that go in and, and we don't know whether or not these people have, an adequate, a gut, antioxidant levels, which, which might be suboptimal that are contributing. And, and, you know, we can speak a little bit more about that, but we need antioxidants to fight free radicals. And without those free radicals or free to cause Oxid cells, and this is a whole another issue that we have. So, I think we need to start looking at, you know, different options of how we are viewing health. it's not just from blood work and, you know, diagnosis of disease. I mean, these are all the end factors, but we need to look at the, you know, pre factors that are causing all of this.
Beverley 00:28:56 Yeah, absolutely. Absolutely. And actually, it's funny, I mean, a big part of my work of course, is, is doing stool analysis, which is a part that always raises a laugh from people because it's such, sounds like such an awful thing to have to do, but it's funny because I'm always so excited when the results come back for anyone. Cause it tells you so much about what's going on. And I always think what a huge privilege to do something like that, especially when you're young, you know, I, I came to all of this later on and I wish I'd known about these things 30 years ago. Cause I would've solved a lot of problems with my own health with having I for years and years and years and assuming I would just always have it, but you know, it, it's great when you learn these things.
Beverley 00:29:34 And I always think these young people who do come along and do still tests, they learn about their health from day one. And then they, they do something about that. They're able to influence changes, which are going to carry them long into the future and have implications for all sorts of things in terms of disease prevention and supporting their immune system and their mental health and everything else because they, they about these things and they how to manage them and how to support them. So, yeah, it's a great thing. And you know what you were saying, it's interesting about antioxidants, but I also think there's a bit of a, another thing going on there because, with food not being organic, most people are not buying organic and therefore they're going to have much level levels of antioxidants and if they were buying organic and again, there's, there's a bit of a public health issue there because really all foods should be organic. We shouldn't have to make that choice. It should justly organic. cause we do know there's a high number of nutrients and a high number of antioxidants for meat, wheat, organic. And you know, that comes from huge Metro analysis from Newcastle university. If you want to look up that reference, but you know, we, we know that it does make a difference and, and I suspect that that's why you're seeing those differences in otherwise healthy-looking individuals because the food is just not the same mm-hmm <affirmative> farmers changed. Yeah.
Dr. Bishara 00:30:52 Unfortunately there's so many people that can't afford organic and that I think organic should be, ubiquitous. Uh that's
Beverley 00:31:00 Right.
Dr. Bishara 00:31:00 Not something that you know, is a privilege to buy. That's true. and so, I, I really hope that I I'm so glad that you, as a nutritional therapist as well is someone that can coach people and to, to train them and to give them that knowledge and power that they need. we need more people like you, we need more people to educate because I do truly believe that education and knowledge is, is the, the power given to a patient to take control of their own life mm-hmm <affirmative> and in life. Mm. and, it's true. Like you said, organic is very important, but, we have, we, we have, we have our work cut out for us. We have a lot of, mm-hmm <affirmative>, work that we need to do to educate, those, I mean, we don't have to buy everything organic there, you know, there's certain foods, like certain fruits and vegetables that are the clean 15 that, you know, that that's okay. And, and, and the dirty doesn't, I, I, I recommends goes up cause, you know, for example, like an orange, it has a thick, thick, covering, you might not necessarily need to buy that. organic. Yeah. Yeah. but it definitely, everyone should really look up the clean 15, every year, and the dirty dozen, I think it's, it's important to, you know, but I'm so glad that we were able to connect and, discuss this across the pond. <laugh>
Beverley 00:32:23 Yeah, no, it's great. And actually, the dirty dozen and the clean 15 people always laugh about that one as well. When I tell them to look that one up, they wonder who the dirty does now, but it sounds like characters in a movie, but, but yeah, it comes from the environmental working group. If you look on the environmental working group website, you will actually find not just food, but you'll find all your cosmetics, your toiletries, everything you use in your personal care products. and you'll find out which ones are the NAS and which ones are OK. So do have a look at that really good resource,
Dr. Bishara 00:32:53 App as well. So, you can, just look at it directly from your phone, the EWG. Yeah, yeah,
Beverley 00:32:58 Yeah. So, so yeah. Now talking about, going back to some of the, the studies that you mentioned in your review, and of course, one of the things I do a lot of work with fertility and I love it when couples come to me to talk about preconceptual planning, because really we think about true preventive medicine happens before we're even born. It happens getting hold of couples, talking about diet, talking about gut health, immune health, and talking about the home in which the environment in which you're going to place that growing child, in Ute. So, we need to get things right then. And I did notice that you had a study on, the role of Al bacteria, right from pregnancy and then in the early days of infancy as well. So, do you want to say a little bit about that?
Dr. Bishara 00:33:46 Sure. it's funny because we found that, certain impacts to the levels of bacteria in, as of D and, and infants, are related to the mother's, the mother's health mm-hmm <affirmative> mm-hmm, <affirmative>, what the mother's eating. I mean, they, they now are focusing on, you know, in our nutritional, history and physical we're focusing on whether or not your mom, you know, eat healthy, was her diet healthy, whether or not you were breastfed, whether or not you were born vaginally or caesarean section mm-hmm <affirmative>, there's so many different factors that are affecting, a child's, gut, perspective. And we found that babies with, you know, who, who receive breast milk. I mean, this is why they call it liquid gold is babies who receive breast milk. definitely had higher levels of DFI bacterium, and I'm not, I'm not here to shame anyone, or any mother that, you know, was not able to breastfeed for whatever reason.
Dr. Bishara 00:34:42 And, and, you know, personally, having three children with all three of my children, I had problems with latch on, and I was not able to actually physically breast all of them, but I did pump, breast milk for about three to six months for each one. just because I knew the importance. So, I, I'm not definitely not here to shame. And also, if, you know, if you're listening to this and you're older and you're saying, well, I never get breastfed, it's never too late to change. It's never too late to take your diet <affirmative> that's right. And, and eat the right food and, and, and eat fruits and vegetables. I mean, the, the servings that they recommend, which are three to five fruits and vegetables is, is too low. I mean, we definitely need to eat at six to eight servings of fruits and vegetables, mm-hmm <affirmative> daily to improve our gut gut integrity. Mm-hmm <affirmative> so those are the things that we did find that, were variables in the levels of, IFI in children And I don't know why certain children got, this Kawasaki, type, condition that we are seeing with a very small mm-hmm <affirmative> set of children, but it would be interesting to see those children and see what factors they had that may have impacted, the role of their gut.
Beverley 00:35:53 Yeah. Yeah. And I did notice one of the studies that you included in the review article was on the fact that, taking probiotics during pregnancy and then the babies, in the first six months of life, mm-hmm <affirmative>, would have an impact on prevention of the atopic conditions. So, eczema, asthma, et cetera.
Dr. Bishara 00:36:12 Yes. We've seen that as well. There was a, another study that we, we looked at where, they gave, bifidum to, children with apathy and, asthma. And they did a control group where they didn't receive it. And they found that the, the subset that received B bacterium, their symptoms actually improved their asthma symptom. which, I don't think is a coincidence as, as you know, as
Beverley 00:36:38 No. And actually, similar studies being done in the UK from the university of Swansea medical school, where they again gave the moms probiotic pregnancy, and then the baby's prob first six months of, and they found a significant reduction in symptoms of eczema, and also in, food intolerance issues as well. later on just by doing that, which is a very simple intervention, very cheap intervention, but my goodness, the cost of steroids, for example, you know, to the NHS for kids, with eczema and asthma and all these things are just growing exponentially in recent years and have to go back to issues around our gut health, our microbiome, cause you think, well, why are we seeing all those cases now that we didn't have 30, 40 years ago? and now it's literally outta control, but it's, it's unpleasant for those going through it, but it's also a huge cost, to the NHS here.
Dr. Bishara 00:37:32 I agree. I do want to stress though that, probiotics are great obviously for administration, but I think more importantly is we really need to change our diet.
Beverley 00:37:41 Absolutely. Absolutely. That's the bottom line,
Dr. Bishara 00:37:44 The best probiotic comes from prebiotic. Yeah. what a prebiotic is, as you know, is, what you're eating, certain specific vegetables and fruits and foods do provide that prebiotic for your gut. absolutely. And so that is, I mean, I don't want people to just start taking probiotics because yes, they're great, but we don't know how much of that is actually absorbed. What percentage is actually going up? I think just changing your diet and lifestyle is I think the priority and also probiotics is a secondary.
Beverley 00:38:19 Yeah, that's right. And I mean, we, the same here and we always tell people, there is no point in spending money on expensive probiotics and then feeding it all the wrong things. You have to create the environment. And actually, you know what, right now, actually, in where we are, we're just about to open garden centres, which is exciting, because we can go out and get our bedding plants. But the thing is that if you're planting bedding plants and you want it all look pretty, you start with the, we, you start with the mulching, you start preparing the grant and we need to think about our guts in the same way that we
Dr. Bishara 00:38:48 Very good analogy
Beverley 00:38:49 Thinking, thinking about what we're putting in, but also thinking about the things we really don't want to be putting in or things we want to be removing. And it's, it's taking the time out to think, well, what are the things in my life right now, which are not supporting, my gut health? You know, is it the diet drinks that I'm drinking every day routinely make that your first start, if you can start simple with something like that, because again, those sweeteners are massively disrupting your microbiome and they're creating the wrong environment. so, it's the sugars, it's the sweeteners, it's the processed food. all of these things that we need to be removing. and the things that, you know, we talk about prebiotics, and we talk about probiotics, which could be fermented foods and things. But at the end of the day, if we just eat what our great grandparents ate, we wouldn't have a problem.
Beverley 00:39:36 you know, they didn't have probiotics in those days. They had real food mm-hmm <affirmative> and, they didn't have a problem. They didn't have the chronic inflammatory immune conditions that we have now. so, we can see how modern living has created this complete mess, that we're now in. And so we need to be thinking about that and changing, the choices that we make in the shopping trolley on a weekly basis, and basically go into a supermarket, buy your fruit and nuts and seed, toll grains, lagoons, quality meat, quality fish, lots of mega three, and then get out and do not buy anything else in that building unless it's toilet roll, leave, cause everything else is bad. Everything else is bad for you. I mean, even the cereal aisle is a disgrace. It literally is a disgrace because there's only a few things that you could buy that are actually healthy. A handful of products from decent companies that are producing nice things, but otherwise, just leave, get out there before you reach these would, you know, wish you hadn't bought, we microbiome's taking care of anyway.
Dr. Bishara 00:40:46 Absolutely. It's that good and evil again, right? I mean, you can't start a microbiome, journey with, more evil, bacteria in your gut and good. It's just, it's going to act the good and, and you're done. So, you really have to start, like you said, from our foods and interestingly enough, that you mentioned that, you know, they've done studies on, children in third world countries and in industrial nation and we have a higher rate of inflammatory bowel disease in industrial nations. And I think it's process foods, but that's right.
We have such high levels of allergies, not allergies, in our children where you're not really seeing that in a lot of third world countries. And that's because we're eating fresh, real food. I mean they have, you know, an issue with quantity, but what they are eating. I mean, they're, they're much healthier. I don't, I don't think they have a high nut allergy ratio in third world countries as we do in, industrial industrialized nations. Yeah. Something to look at as well. And I know it's again, it's the gut, it's the immune
Beverley 00:41:48 It's. It is. It is. But it's also back to that hygiene hypothesis as well. Of course, about us being too clean. And you know, in these countries, they're just going to pick stuff off the ground. They're going to eat it. They're not going to wash it first. you know, we've become too clean and actually potentially now we've become ironically even cleaner, which is not necessarily benefiting us. So, there's a bit of a double edge sword that one with the advice by governments to, you know, scrub everything and clean everything to within an inch of its life. And actually, I would say within, within clients, that's that over cleaning is creating a lot of anxiety, a lot of anxiety in people
Dr. Bishara 00:42:23 And the overuse of antibiotics is also, getting rid of all your, your good gut bacteria too. That's right. there are significant studies relating, antibiotic use as well, even in, in infancy, in childhood. I mean it limit as much as you can, antibiotic use and less absolutely necessary because that does your bacterial flora, your good flora. so, we really need to just go back to the basics and I'm so glad that we're having this conversation. Cause I think it's so important.
Beverley 00:42:55 Yeah, yeah, yeah. I know. And I think as well, it's, you know, it's nice what you said before about not, not judging people and giving your own experience because I think you and I both like that as practitioners anyway, that we would be very much sharing our own observations and our own experience. And you know, I think that, with, with all of these things and with weight management issues as well, there are lots of things that contribute to, to weight management issues. And unfortunately, these aren't being addressed in mainstream as you and I both know, the misinformation is, is going out. And of course, inevitably these BOS can't manage their weight. Can't get outta that trap, but that's because they haven't dealt with all the underlying factors, which might be emotional around cravings. Or they might be again, infections in the gut around yeast infections that driving them to eat more sugars, or it might be food intolerance, due to the leaky gut and that's driving them to eat more of that food that they are intolerant to.
Beverley 00:43:48 And so then they start with weight management, and it just goes on and on and on. It's just endless and again, with nutrient deficiencies that creates problems. And especially those macronutrients, not enough protein, not enough good fat, you know, the low-fat movement that makes people, remove good fat from the diet. And of course, then they're not promoting satiety. So then inevitably of course they're going to be hungry for something else. It's, you know, we create these traps, we create these, these vicious cycles because we don't have enough of an understanding about how to support ourselves. And, and of course, by learning all these things, we don't just support our microbiome, but we also support our, immune health, our blood sugar, you name it, we do it
Dr. Bishara 00:44:28 Mental health.
Beverley 00:44:30 Yeah. Yeah. And, and a lot of the things, you know, I was thinking before our conversation today about, you know, prebiotics and probiotics and thinking, I don't usually say to people what I do mention sometimes prebiotics, but I don't go into whole lists of which foods they are, because actually if you're eating legumes and you're eating lots and seed and you're eating all grains and vegetables, you're going to be hitting your, your preloads anyway, it's, it's, it's nothing more complex than eating, real food. So, we don't need to get homework about the terms. It's just eat real food and, prepare it yourself from scratch. And I think one of the biggest things we can do for our health right now is learn to prepare food, learn to cook, and just develop a few staples that, are easy enough to do, and kind of go from there and really help each other with cooking.
Dr. Bishara 00:45:17 I agree. I think we're, we're in an advantage right now that many people are home and have access to fresh food. You know, the restaurants, many restaurants are closed, and people are resorting to making their own foods. Well, this is a perfect time to start that, where you're eating fresh food, but you're also, if you have children, you're teaching your children proper eating habits as well. Mm-hmm, <affirmative>, you know, our family, for example, my children’s antioxidant levels weren't as high as I thought, and they're all thin and, you know, very active and very healthy and they all do sports. And so, it was interesting to see that. And we've now been making daily smoothies where we're putting in, you know, three or four different fruits and we sometimes will throw, usually we do throw, like organic spinach leaves or celery in there.
Dr. Bishara 00:46:02 And so they're getting like four servings just in one cup of a smoothie in the morning. And then it kind of sets their day and I'm happy to say they they've all increased their antioxidant levels. And, it's not something that, you know, even if you don't have a scanner, I mean, you know, if you're eating, like you said, fresh food, mm-hmm <affirmative> and you're incorporating, you know, six to eight servings of fruits and vegetables daily, you're going to have that gut diversity automatically, you're healing you're going to heal from within.
Beverley 00:46:32 Absolutely, absolutely. And I think with, with children as well, they like being involved in cooking and preparing food. So, I think involving them is important. And my, granddaughter at the moment she's for, and she has been planting lots of things and lots of herbs because they're easy to grow. So right now, she's picking Parley from the garden and eating that direct, which my girls used to do as well. And they were small. and it's so nice because of course that's packed with antioxidants. It's just what you need. It's ideal. Something like Parley, it's all nutrient dense. but encouraging children to just pick things straight from the pot, straight out of the garden and eat it.
Dr. Bishara 00:47:11 I agree with you. Yes. When you involve, they definitely, are more, prone to improving their health. Again, it just goes back to education. Knowledge is power.
Beverley 00:47:22 It does, it does.
Dr. Bishara 00:47:23 And they will. They, you know, people, people want that. They want the guidance. So
Beverley 00:47:29 That's nice. That's nice. And one final thing on gut health is that, and again, I was thinking about having this conversation with you and thinking about the tips that we'd give. But I think what I would say to people is that when you are making these changes and you, you read somewhere, oh, I need to eat more onions and I need to make more garlic. It's good for my gut. And then you start eating more of those things. And what happens, you end up with tummy pains, you end up with other problems. Yeah. Cause then there's something else going on. And sometimes people with IBS, or sometimes people with small intestinal bacteria growth and these kind of things for a while anyway, just can't tolerate, some of these vegetables or can only have them in small amounts. I can only have them cooked versus raw.
Beverley 00:48:09 And so there's all these caveats we have to think about. And that's where the work of people like us comes in, because then you can help people navigate some of the complexities out there and some of the traps, because otherwise what worries me is that, and I've experienced this in practice that you meet people who say, oh, I tried that, but it didn't agree with me. So, I didn't eat it anymore. And they actually end up eating a very narrow diet because they don't tolerate something. Whereas actually if they learn about foods and learn how to navigate some of these challenges with working, like people like myself and you then, you know, we, we, we can help them on their way so that they can achieve good gut health. Like those centenarians that you mentioned right in the beginning mm-hmm <affirmative> and yeah, make those improvements over time, but just take it slow as what I'd say, you know, don't go by a huge jar sour and have it half the jar eaten by the weekend because you'd probably be doubled up with a, to of pain if you did that. So, it's take it slow, take whatever you do really slow and listen to your own body and just gradually start to incorporate these sorts of changes.
Dr. Bishara 00:49:10 I'm so glad you brought that up because it's, it's true. I see so many patients with similar symptoms where they want to start eating healthy and then they go all out and unfortunately, you know, either due to leaky gut or maybe SIBO, they're not able to tolerate. And so, you kind of have to, again, just start from the beginning and do an elimination and, and, and consider maybe doing a low fodmap, diet and just, and looking at the source and they need to have their blood work checked and they need to make sure that yeah, their gut integrity is intact. And if it's not, you know, so to, to get on the right path, that's
Beverley 00:49:46 It, that's it. So, all roads lead back to individualized medicine, it's the only way to do it. And absolutely. and, and it's the only way to keep people on track really and keep them motivated and empower them to understand their own health and their own bodies and, what they need to do and, and why, when things go wrong. Well, that's okay. It only went wrong because of X, Y, Z, but it'll come right again. And that's where we can encourage people. So, so that's great. So, I think that we'll leave it there, but thank you for, joining us today for our very first podcast, which has been just amazing to have you all the way from Manhattan. And I hope that, our listeners and your listeners will enjoy this and, take on board some of those tips and be encouraged by it.
Dr. Bishara 00:50:34 I thank you so much for having me. I'm so glad we were able to have this conversation and I hope, we have, more future conversations related to this and that more people hear this and are inspired to change their health. And it's, it's doable for anyone and everyone, and it's never too late. So that's the beauty of it. and so, I thank you again.
Beverley 00:50:59 Thank you.
Beverley 00:51:02 Thank you for joining the nourishing insights podcast. We do hope that you've enjoyed it, and if you'd like to follow us, you will find us on Instagram, Facebook, and YouTube. You'll also find our website, nourishinginsights.com. Look forward to seeing you next time. And in the meantime, stay nourished and let food be your medicine.
WHAT OUR CLIENTS ARE SAYING
“I did Nutritional Therapy with Beverley and it was life changing. I highly recommend it!” Allison Blakely (Glasgow)
Want to speak to us by phone? Book a call back here.