In this episode, I’m speaking with gut health expert, Dr. Partha Nandi on why gut health is the key to brain health.
Partha Nandi, M.D., F.A.C.P is the creator and host of the internationally syndicated medical lifestyle television show, Ask Dr. Nandi. Dr. Nandi is the Chief Health Editor at WXYZ ABC Detroit, a practicing physician, and a renowned international speaker.
His latest book, Heal Your Gut, Save Your Brain, published by Mayo Clinic Press, delves into the crucial connection between gut health and cognitive function, offering practical advice and insights drawn from his extensive medical expertise and personal experiences.
Sign up for Dr. Nandi’s FREE Heal Your Gut Save Your Brain webinar and learn more about how you can prevent Alzheimer’s disease and dementia.
Table of Contents
In this podcast, you’ll hear:
- What inspired Dr. Nandi to write “Heal Your Gut, Save Your Brain” and the novel insights it brings to the table
- Why drugs that target mechanisms of diseases often fail to get results and what the better approach is
- How the gut communicates with the brain and influences brain health
- Do neurotransmitters in the gut (e.g. serotonin) affect brain function and mood, like many people claim they do
- Why the key to getting healthy is addressing true root causes
- Keys to microbiome health and the most effective ways to improve gut health
- How to prevent dementia and Alzheimer’s disease
- Dr. Nandi’s approach to nutrition for gut and brain health
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Transcript
Ari Whitten: Hey, this is Ari, welcome back to the Energy Blueprint podcast. With me today is Dr. Partha Nandi, who’s on the show for the second time. He’s the creator and host of the internationally syndicated medical lifestyle television show, Ask Dr. Nandi. He’s the Chief Health Editor at WXYZ ABC Detroit. He’s a practicing physician and he’s a renowned international speaker. He delivers passionate and inspiring talks to diverse audiences and continues to travel to international conferences and symposia, meeting with global health leaders on his quest to improve healthcare quality, access, and advocacy.
His mission is, “To be your own health hero.” This is at the heart of his work and he empowers individuals worldwide to take charge of their health. His latest book is, Heal Your Gut, Save Your Brain, which is published by Mayo Clinic Press. This delves into the crucial connection between gut health and cognitive function and brain health. It offers practical advice and insights drawn from his extensive medical expertise and personal experiences. That is the subject of today’s podcast, his new book, which is all about gut health and brain health and the gut-brain axis. With no further ado, enjoy this conversation with Dr. Partha Nandi. Dr. Nandi, welcome to the show.
Dr. Partha S Nandi: Hey, thanks for having me again, Ari. It’s great to see you. Appreciate it.
What inspired Dr. Nandi to write “Heal Your Gut Save Your Brain”
Ari: Likewise. The topic this time is your new book, which is Heal Your Gut, Save Your Brain. This is really all about the gut-brain axis, the link between gut health and brain health. Given that the gut and microbiome has been a very hot topic for probably a decade or maybe a bit more at this point, there’s been lots of books that have come out on this subject. What made you want to write another book on this topic? Not another book in the sense that you’ve written books before on this, but another book contributing to the sort of many books on this topic. What insights did you feel needed to be brought to the table at this point?
Dr. Nandi: I’ll tell you, I’ll go back a little bit. I’m a practicing doc and I see patients. I straddle both traditional medicine and holistic or what’s called alternative medicine. What’s startling is this, despite the fact that there are books that may have been written, it’s not translating to going into mainstream practice, for example. If you have a neurologist that you see because perhaps, your memory is fading. Or, you see your gastroenterologist because you have bloating or discomfort. Neither doctor is asking you about the other, meaning that the neurologist is not saying, “Hey, what do you eat? What are your bowel movements like? Do you have any approach in how you eat or how you live?”
Vice versa, the gastroenterologist is not asking about, “Have you had any problems with brain fog? Are you having problems with any symptoms attributable to neurological disease?” I found this personally when my dad, and you know this, my dad had a devastating stroke when I was a practicing physician. When that happened, I said to myself, this, “My dad was never hospitalized, a very healthy guy.” I said, “What, as a physician, what could I have done differently? What could I have, how could I have instructed him?”
At the time, when– This is 2000, I would say seven, 2008, I didn’t have any information that I could give him, I struggled. Now, as you alluded to, there’s information that we can allude to, that we can approach and talk about, “Hey, this is what you can do.” If I knew then what I know now, I could tell my dad, “This is what you would do.” The insights are this, that we now know, and some of your audience already know this, maybe some don’t, about the basic connections between the gut. We talked about the information superhighway, from the gut to the brain, the vagal nerve. The vagus is a bidirectional superhighway. You’re not just sending stuff from the gut to the brain, but vice versa.
We talk about the most sophisticated immune system that the body has, which is in the gut. We talk about also the neurotransmitters that actually can not only affect your thinking, but sometimes even control the way you think. When you talk about, “Am I having a good day or a bad day? Am I approaching life the right way?” How you look at the gut can make a difference. It’s with that background that I approach this, that I feel that we still have to give actionable steps to folks, because they don’t know what to do. When you have statistics like this, Ari, that every three seconds someone is diagnosed with dementia, every six seconds someone’s diagnosed with Alzheimer’s, every four minutes someone dies of a stroke.
We really have to make a difference, and it– Clearly, we’re not translating. That’s why I felt a book, and this book is published by the Mayo Clinic, and so what that means is you have neurologists, gastroenterologists, internists, all looking at this and making sure that this is evidence-based. I was happy and proud of doing that to be able to reach folks.
The main mechanisms that link the gut and the brain
Ari: Yes, that’s wonderful. As far as the gut-brain axis, specifically the physiology, the biochemistry of the link between what’s going on in the gut and the brain, how do you conceptualize that? What do you see as sort of the main mechanisms or pathways that link the gut and the brain?
Dr. Nandi: Three, great question. There are three main pathways. Number one is, as I talked about, the direct relationship is with the vagus nerve, and you have transmission of signals back and forth. To me, I attribute it or I actually compare it to teenagers that just went to a Taylor Swift concert. They’re constantly talking to each other. Now, the gut talks to everybody, but it talks to the brain more than any other organ. What it’s transmitting are basically signals back and forth.
The brain is letting the gut know what the state of the body is, so the gut can then function the correct way. For example, if there is a state of unrest, right? You’re not at ease. The gut is told by the brain so it can actually function the way you need to in a survival mode rather than in a mode of thriving. For example, blood flow to the gut is now taken away and given to the vital organs. If you have nutrients and the whole energy homeostasis has changed in the gut to be able to support the rest of the body.
If you’re in a state like we are right now, we’re talking and we’re in a state of ease. The gut is told, “Hey, you know what? Everything is great.” You take the nutrients, you digest it. Peristalsis works well. It also lets the trillion member plus army that’s in your gut function well. That’s the second method in which the brain and the gut connect. The microorganisms are called the gut microbiome. We use that term loosely. The gut microbiome is made of, as I said, trillions of bacteria, fungi, protozoa, viruses all coming together.
When you have the correct signals from the brain into your gut, what happens is that microbiome can thrive, meaning that you’re giving it the food that it needs, the energy it needs, and the environment that it needs to be able to thrive. If you’re in a state of unrest, so for example, if we are running for our lives, if we are hunting and gathering like we used to thousands of years ago, then the gut is in a state of unrest, let’s say. It’s not thriving the way you want to. It’s important to know that the gut microbiome, those microorganisms are responsible for some of the transmissions that we actually give to the brain via the vagus nerve.
It’s also very important to produce products, which we call postbiotics. We call probiotics the actual bugs in the intestinal system. The prebiotics are the food for the probiotics. The postbiotics are the products. We really are, when you look at the research, we’re really interested in the postbiotics. Very simple things like short-chain fatty acids, which can contribute to the wall of the gut to be whole and the integrity to be strong. You also look for the right microbiome to produce, for example, the neurotransmitters, which is the third way you can contribute to the function between the gut and the brain.
The gut microbiome is producing, along with the gut, 95%, for example, of serotonin. It’s producing a ton of GABA. These are neurotransmitters that can change your approach and the way you think. I tell my patients, one of the things that we think are fundamental are our thoughts, the most intimate, most personal parts of our body in our being, our thoughts. If I tell them that, “Listen, if I change the concentration of the neurotransmitters in your body and your brain, you think differently.” What is the thought? There are two neurons firing a signal and that produces a thought. Having great gut health and really supporting not only your gut health, but the microbiome, the trillions of bugs in your intestinal system allows you to be able to give the best brain health.
Leaky gut is not recognized in conventional medicine
The last thing I’ll tell you, and we’ve talked about this in non-traditional medicine for a long time, which is called leaky gut. In gastroenterology, which I’m a gastroenterologist, I still practice traditional medicine. When people came, a lot of my colleagues, when people came and said, “I have leaky gut,” the eye roll began, “Oh my gosh, what is that? That’s just, it’s hokey.” It’s nothing to-
Ari: Meaning among, in conventional medicine, among allopathic doctors in the past, there tended to be an eye roll when people said, “I have leaky gut.”
Dr. Nandi: Unbelievable, and even the present. I will tell you, even in the present.
Ari: Oh, really? Still now, the allopathic doctors are resistant to the same thing.
Dr. Nandi: There’s an acceptable term called intestinal permeability. Now-
Ari: [laughs] As long as we talk about it with different words, then it’s okay.
Dr. Nandi: Yes, because, for many, many years, decades, we talked about leaky gut, and we knew that existed. Now, in traditional medicine, in MDs, DOs, allopathic medicine, so when you talk about traditional medicine, in at least the West, you can show, electron micrography that shows that you have spaces. Remember, the gut wall is one cell layer thick between having, poop on one side and blood on the other. You can see on electron microscopy, tiny little crevices, tiny openings that then erode some of the protection we have from the gut to the rest of the body. When you erode that, we call it leaky gut, or increased intestinal permeability, you can then begin inflammation that can go to any part of your body.
The one I’m interested, and I talk about it in my book, Clear Your Gut, Save Your Brain, is that this inflammation can then disrupt the blood-brain barrier. When it disrupts the blood-brain barrier, then you begin unabated or unopposed inflammation that then can lead to diseases like Alzheimer’s, like Parkinson’s, like multiple sclerosis, and also put you at increased risk for stroke. This is why it’s important. We felt for a long time that diseases like Alzheimer’s, for example, are inevitable. You’re just getting too old. Many times, folks went to see their physician or their practitioner, and they were told in traditional medicine, you just feels, it’s kind of a consequence of older age and just wear and tear. Now we know it’s an inflammatory condition. In the gut is where we feel now more and more– Even evidence in Western medicine showing that the beginnings of inflammation for these devastating diseases lie in the gut.
That’s why, to me, this is so important to talk to folks because I want people not to suffer the same fate as I did and my family did and my dad. The disease of stroke robbed him for the last 10 years of his life. He couldn’t play with his grandkids and we could not share the wisdom. Ari, my dad was one of a kind. To me, he was my first hero. If you ever drive down the road, even if you’re in the US or outside, when you drive down the road and it’s dark, you see these reflective tape that’s on the side of the road. That was my dad. He’s the one who invented that and saved countless lives.
With this book, I’m hoping that we can save a few lives and hopefully be able to at least address the problems before they become clinically evident, which I think that if you can take care of your gut in simple ways, then you can also then prevent these problems when, even before they come. When they come, you can still decrease the significance or the severity of them, but I would propose that if you watch some of the principles we talk about for your gut health, then you can prevent these symptoms from coming and even prevent the disease altogether.
Ari: I’d like you to indulge me in a certain line of questioning here that I believe, my current understanding, it’s been maybe two or three years since I explored this in depth, but so maybe the information landscape has evolved since then, but I’d like to ask you about neurotransmitters in the gut and the relationship between that and neurotransmitters in the brain. For many years now, there’s been discussions of, well, one aspect of it is GABA. There are certain question marks around GABA in the gut and can GABA actually be taken up through the vagus nerve and transmitted into the brain? There’s sort of this discussion, last I checked on this literature, there was this sort of controversy around to the extent that GABA in the gut translates into GABA in the brain. GABA for listeners is a neurotransmitter that relates mostly to sort of relaxation and calmness, but it’s an important, what’s called inhibitory neurotransmitter in the brain.
I think most commonly is this discussion around serotonin. For decades, we’ve had this whole narrative around serotonin and depression. Depression has been the narrative from the medical community and pharma, I would say, is that depression is driven by, “a chemical imbalance.” That chemical imbalance, for the most part, we’re told is essentially a serotonin deficiency. You have low serotonin levels in your brain and that translates into depression. We’ll sort of bracket that right now because as I’m sure there’s been a lot of controversy around just that subject. Recent research has shown that whole narrative that we’ve been told for decades really has very weak evidence to support it. Let’s– So that’s existed in our minds, this link between serotonin and depression.
Then we hear some people talking about gut health in the last five or 10 years and who bring forth this idea of, well, did you know that 80% or 85% or whatever the number is of your whole body serotonin is actually in your gut, not in your brain? With the– Basically implying that that serotonin does the same thing as the serotonin in your brain, which is this thing that relates to depression. I think the story, my understanding is that the story is quite a bit more complex than that. In one, the layer I already explained, the serotonin-depression link is questionable, but I’m also curious about to what extent the serotonin that’s in the gut is actually relevant or doing something at the level of the brain versus it’s just doing different roles, performing other functions that are more relevant to gut health that don’t really impact on our sort of moods and that sort of things and brain function.
Dr. Nandi: Yes, it’s an important question. I think what you’re asking is that, “Hey, you know what? It’s great to tell us that you see these neurotransmitters in the gut, but does it have any relationship with a completely different organ in the body?” The answer is, it’s a difficult one because what you have to show is that the same GABA or serotonin is acting on the brain. I think it’s about receptors. These neurotransmitters are not simple, meaning that they’re not just doing one thing. For example, in the GI tract, right, it’s helping with motility. It helps to let the intestines move in a certain way, to be able to rapidly clear out things when it’s needed. The same molecule, when you have it in the brain has receptors that then trigger certain reactions and they’re perceived for us as joy or feeling good.
I think that talking about that, depression is simply a relative lack of one neurotransmitter or a hormone. It’s, I think it’s a simplistic one, right? We don’t seem to understand all the factors that go into depression. Here’s what we do know though. If you don’t, and these are associations, right? We’re not talking about randomized control trials that you hear about in the highest of scientific articles and scientific meetings. The associations are this, that if you don’t have the right milieu, the right environment in your gut to be able to produce these hormones, you seem to have also associations of folks that don’t have great [unintelligible 00:18:08], great moods. You don’t have people that are, thriving in their mental state. It’s not just your physical state, but your mental state.
Furthermore, so again, it’s never about just one thing happened in isolation. Your body’s complex. For example, if you take cortisol in one part of the body it does something very different in other parts of the body. We, for patients and for people who are trying to get a, “Hey, here’s what I think I can glean from this.” We try to make it simplistic, but you’re right. The conversation, the story is much more complex, but I’ll leave it with this, that if you don’t have the right microbiome, still 2020, ’24, if you don’t have the right microbiome, if you don’t have the right gut milieu, you’re seeing associations of diseases that are neuropsychiatric and neurodegenerative. Making the connection of cause and effect is incredibly difficult because what you have to show is that same time that neurotransmitter is actually affecting. You have to tag these molecules, et cetera.
It’s very sophisticated, but we’re seeing is that when you have a lack of the right microbiome, you’re seeing a preponderance of diseases of neurodegeneration. I’ll give you an example. In Alzheimer’s disease, we actually now can call something an Alzheimer’s gut, meaning that you have certain types of organisms, for example, Prevotella, which may be increased in some patients with Alzheimer’s that you don’t have in patients who don’t have it. Let’s talk about Parkinson’s disease. You’re looking in Parkinson’s disease that you not only have a certain level of microbiome and gut health, but you’re seeing the actual same inflammatory markers that you see in the brain, which are called
Lewy bodies, which are just, folded proteins that are misshapen in the enteric nervous system, so in the nervous system of the gut, so in the tiny little walls.
Imagine the wall of the gut is like layers of an onion, except much smaller. In those walls, you’re seeing the same evidence, the same misshapen proteins that you’re seeing now in the brain, for example, in Parkinson’s disease that we call Lewy bodies. Furthermore, not human studies, but in mouse, mice studies, when you sever the vagus nerve, you no longer are seeing the same pattern of misshapen proteins that you see both in the enteric nervous system and the brain. Last example I’ll give you is that in stroke patients, the concentration of certain types of microbiome is related to the post-stroke survival. For my dad, the stroke was severe. His recovery after the stroke really was the devastating part. When you look at the gut health, and we talk about microbiome a lot because it’s such a huge mediator in gut health, that when you have the right microbiome, you can actually thrive.
In mice studies, again, I’ll give you one last mouse study. When you take young mice and subject them to the stroke and then transplant the microbiome of an older mice, their post-stroke survival– Most of them die or have horrific post-stroke outcomes. If you take an older mice and have them in a stroke model and transplant the microbiome of a young mouse, their stroke survival is far better than what their age would suggest. What I’m trying to point out is not just neurotransmitters, but the integrity of the gut wall, the barrier you talk about.
The composition of the microbiome all together are now pointing to the fact that if we can then optimize this environment in your gut, it’s associated with better health. When you look at all of the centenarians that you see in multiple places around the world, and you see patterns of what they eat, what they do, and their gut health. Again, these are associations. These are not where we can talk about cause and effect. When you see pattern after pattern that are similar, I think it’s really promising to show folks that you may be able to make a dent in your future, that it’s not predestined, that you can actually change the way your body and your mind works. I gave you a much longer answer than your question warranted, but I wanted to give you a perspective of how I think about that.
Amyloid plaques and Alzheimer’s
Ari: Yes. It’s a great answer. I want to try to poke holes a little bit. With your permission. I want you to rebut me in a way where you convince me why this perspective is inaccurate. We often, especially I would say in allopathic medicine, talk about what I would frame as confusing mediators or physiological mechanisms or physiological correlates of something with the “causes” of that thing. You’ve mentioned and, I’ve done, geez, I think over 500 podcasts with experts over the last eight years or so. I’ve seen a lot of different kinds of physiological explanations and mechanisms discussed for different diseases.
Let’s say some people say, “Well, it’s all about inflammation,” or, “It’s all about hormones, thyroid hormones and cortisol and the HPA axis is really important.” Or, “The vagus nerve and parasympathetic versus sympathetic, the autonomic nervous system is really critical.” Or, “The microbiome and gut permeability.” Or, “Neurotransmitters.” There’s lots of different mechanisms we can point to for different things. I think it’s always important to ask the question, Well, okay, so if it’s inflammation, that’s, let’s say, causing XYZ disease, well, what caused the inflammation? Is it right to talk about the inflammation as “the cause” of that thing? Should we go upstream of that and examine what are the factors, the underlying causes of why the body is creating this inflammation and talk about those things as the causes?
In the context of this discussion, to what extent is it correct to talk about the XYZ change in the gut or in the microbiome and the proportions of this bacteria versus this other bacteria or gut permeability as “the causes” of these conditions in the brain versus examining what are the factors that are leading to those changes in the gut and calling those the causes?
Dr. Nandi: Yes, it’s a great question. It’s basically saying, “Listen, you come, you arrive to an accident late and you see all of these debris everywhere. The question to ask is that, did the debris cause the accident or was the accident then resulting in all this debris that’s occurring?” It’s an excellent question. I’ll give you an example that I talk about in my book, Heal your Gut, Save Your Brain. I talk about amyloid bodies, right? We know that. I’m sure some of your experts have talked about that with Alzheimer’s disease. For years, the pharmaceutical industry said, “We’ve got to get rid of the amyloid bodies.” Something amazing happened is that folks got not better, it got worse when they tried to just turn-
Ari: They had drugs that succeeded in blocking the progression of these amyloid plaques, but it didn’t reverse the Alzheimer’s. It actually accelerated the progression of it.
Dr. Nandi: Correct. They said, “Wait a minute, we see these, the debris, the metaphor for debris. We see these amyloid plaques. We see these amyloid bodies all over these brains. What gives?” Again, then you have to go back and say, “Do we now have to go back and say, what is it that’s causing these folks to have amyloid plaques for bodies?” The question you’re asking is, so, what is it? These are just, they just happen to be there and depends on which side you’re coming from or what your perspective is. All these multiple factors are [unintelligible 00:26:57]. Really, you brought up to be the ultimate factor. I think we can put them all together in a relatively, I think, depends on what your level of understanding of this is, right?
If you look at a practical matter, see, inflammation is the reason for at least all these neurological diseases that I’m seeing, most of them. It’s a matter of inflammation. Where the inflammation comes from, why does it happen? It is my belief that it begins in the gastrointestinal tract, that it starts there and then it begins to really affect the rest of the body, whether it’s your joints, whether it’s your heart, whether it’s causing autoimmune disease, or in this case, I’m talking about unabated or unbalanced inflammation that’s now in your brain.
Is it the vagus nerve? Is it the microbiome? Is it the wall of the gut? My answer is, I love these answers on multiple choice questions, it’s all of the above, because what happens is that when your gut, the environment of your gut, whether it’s– I’ll go back to what I talk about, my five pillars of health. When your gut is not healthy and your brain and your body is not healthy, because you’re really not following to me some very simple principles. I’ll talk about, I’ll answer your question in a minute. Tangentially, I talk about my five-pillar method, which is purposeful living, right? Then food as medicine, nutrition, and then number three is movement with purpose. Number four is community, and number five, spirituality. I feel these factors, and there may be more subtypes, but these factors, if you follow them well, you really, you can achieve not just good health, but vibrant health and joyful lives.
If you follow those, you really try to get the best in your food intake, which means just eat whole foods, nothing complex, no diets, just eat whole foods. Try to prevent having simple carbohydrates, bad fats, and you can still go to your kid’s birthday party. It doesn’t mean that you have to give a list of your menu when you go to visit your kid’s friends, but I call it the 80-20 rule. 80% of the time, you’re trying to follow very simple principles of a good food plan. Move, but move with purpose, have a community, and I’m sure in your podcast, you talked about the Roseto effect, where people who have communities that are close-knit have great health, and they also have great gut health.
Movement also increases the variety and the amount of positive microbiome contents that you have, and we know that because the gut is a muscular organ. When you move, it’s moving. There’s better homeostasis of energy I talked about. The last thing is spirituality. If you do those, and you’re giving the gut the right environment and the right input, if you have those, then you’re optimizing your gut microbiome. You’re creating great wall integrity. All these are not cause and effect, but they’re associations that we see in [unintelligible 00:30:17] models. Very little human studies, but you’re talking about better microbiome, better wall integrity, and then what you’re transmitting via the vagus nerve, and you talked about the sympathetic-parasympathetic stimulus, to me it’s a fight or flight, right?
When your body is at ease, when you’re living like you are purposeful living in a community setting, the transmission that you’re giving from your brain to your gut and elsewhere is balanced, right? Your life is in balance. When you do that, then you are not creating disarray. When you don’t create disarray, you don’t activate all of your reticular activating system, all of your hormones that tell you to be able to be active and ready, and part of that is the beginning of inflammation. If you do it once a day, twice a day when the situation warrants it, but if it happens all the time, if you have unrest all the time and you don’t have a purposeful life, if you are constantly under duress, you begin this constant unopposed fight or flight mechanism, which increases cortisol, which increases your inflammatory pathway.
It’s hard to show that every time somebody is upset 5,000 times a day that you’re actually at a microscopic level showing inflammation, but we see associations of that. When you live a life that way and your gut is in balance, you’re creating the right environment for, through the vagus nerve, your microbiome is thriving, your gut walls and integrity is stable, and you’re not creating inflammation, which I feel the beginning of inflammation through the gut wall, through having intestinal permeability and leaky gut. All of those, everything you said was correct, but there’s a unifying thesis in the sense that they all work together to be able to create harmonious and I think, healthy living. I don’t think they’re isolated and one does not affect the other, I think they all work in concert. I hope that answers your question.
Ari: Absolutely it does. I’m really glad you explained it that way. I thought the example of the approach to Alzheimer’s using drugs to attack or to interrupt the development of amyloid plaques is a perfect example to illustrate the point that I was getting at. What you ended up explaining, which is your paradigm of how you treat this is essentially the opposite direction of what I was getting at, which is you’re looking at it through a holistic lens. You’re looking at it, you’re saying, “Let’s go deep and sort of analyze the mechanisms of how this disease develops and then let’s track that upstream to these root causes at the level of how a person lives, what they’re putting into their bodies, what they’re putting into their minds, how they’re sleeping, their stress levels, all these different dimensions, their spirituality, their community,” and so on.
You are doing the thing that I think very strongly is the right thing, which is tracking these physiological mechanisms upstream to the actual root causes. I think the danger of historically, and I would say what is the dominant way of thinking, particularly within conventional medicine, but also shockingly in a lot of alternative circles as well, is to do the opposite, right? You gain all this knowledge and insight into the cellular and the biochemical mechanisms of a particular pathology or disease. Based on that, you essentially use a sort of hacking mindset where you say, “Okay, now that we have this knowledge of this or that mechanism at the cellular, at the biochemical level, we’re going to develop this, we’re going to go to the chemistry lab, we’re going to synthesize a man-made synthetic chemical that blocks or suppresses or inhibits or interrupts this particular mechanism in the hopes that will block or cure this disease process.”
Why pharmaceuticals might not be the final solution
If, and like in the context of serotonin, it’s like, “Hey, we looked at all these depressed people,” in the context of depression, I should say, “We looked at all these depressed people and we found that, they have lower levels of serotonin in their brain. Therefore, what we’re going to do is we’re going to create a drug that they can take every day that alters levels of serotonin in their brain.” If the reason that person is, but I would argue this is generally, and in most contexts, not just depression, a grave misunderstanding of what’s going on is really a reductionist and myopic way of looking at physiology in the sense of, well, let’s look at the broader landscape of what that depressed person’s life is like.
They’re eating a terrible diet, they’re sedentary. They have no purpose, they’re working a job they hate. They’re in a toxic relationship, or they’re lonely and isolated and they have no relationship, right? Really, they have a terrible circadian rhythm and sleep habits. They’re stressed out of their mind, right? Really nothing is being done well in terms of how they’re living to take that person and say, “Oh, well, we did this really sophisticated sciency brain scan and blood tests and we found your serotonin levels are low, so here, take this drug that’s going to fix your serotonin levels in your brain.” This is something that has the illusion of being really cutting edge and really scientific, but when you look at it that way, you realize how often it is really simplistic and really a very foolish way of thinking and a foolish approach to try to heal pathology. I think, again, what you’re doing is you’re moving the opposite direction. Instead of the hacking with drugs mindset, we’re saying, let’s track these back upstream to the real root causes of these physiological changes, which I think is the right approach to solving illness.
Dr. Nandi: We’re not Petri dishes and test tubes and these isolated organisms that people are looking at where we’re complex creatures and the body functions. We just have to look to our past. I look forward, but we have to look to our past to find how did we not have, these problems. We’ve created clean water, and to me, some of the diseases that killed folks that were in their teenage years or 20s and 30s, we’ve solved those problems. Now we go back and say, “Well, why were not half the population depressed or why were people, trying to find some purpose in their life?” We go back and find out what people did to thrive.
If you look at those ancient principles, you can learn a lot. Then you can apply as much as possible scientific principles to say, “Hey, how can we reproduce those in a modern world to say, okay, we don’t want to do X, but if we do Y and do it in a way that’s, and you said it well, holistically, so it meets your life.” My third pillar I talked about was movement. It’s not just movement going to a gym for one hour a day, three days a week and you’re done. Then you sit on your butt the rest of the week and order, a door dash or somebody to come and deliver the meal and never even enter your kitchen. That doesn’t work. I think that’s what you’re suggesting is that even when you’re quote unquote “holistic,” you’re still saying, “Aha, if I had to do this, I’m going to produce the postbiotics, I can just skip the rest of it. I don’t have to eat well. I don’t have to do anything.”
Ari: We see a lot of that same type of thinking with supplements, replacing synthetic drugs.
Dr. Nandi: Yes. I’ll just take butyrate. Forget all these microbiome crap. I’m just going to take the butyrate. I’ll be good to go. What they find is, it doesn’t work, right? It doesn’t work because it’s in isolation and that’s, and that’s, and you’re– This is what I talk about in my book is that, these five principles, a lot of people just simplistically say gut health is just about what you eat. I would propose that it really is much more complex than that. That if you look at spirituality in isolation, community in isolation, that you can see overall health thrives, and, but if you look at the gut, it, and you look at just some of the surrogates, right? How are they having any symptoms on a very big level? Are they bloated, discomfort? I’m a gastroenterologist.
We see bloating, discomfort, abdominal pain, diarrhea, constipation, the works at a very basic level of having any of those symptoms and then if you go down the line, you look at how healthy is your gut and you can actually do some diagnostic testing now. It’s not perfect, but you can see patterns developing in these folks that follow this. When you look at, people that are somewhat isolated in the Amazon, you look at their microbiome and you compare it to the microbiome in folks that are in frozen environments and still, even though their environments are completely different outside, the internal environments are startlingly similar. What’s happening is that they are living the same lives in the sense, the same principles. I think that’s, really important.
When you look at the gut, we will have more sophisticated tests to look at gut wall integrity. We’re just getting started, but I think on a very basic 35,000-foot level, what your microbiome looks like, what’s your symptomatology, having normal bowel movements, things like that on a very high level. On a very 35,000-foot level, you can see that the folks that follow these five principles I talk about actually have those in common in very different environments when they follow those same principles, which to me is exciting.
The reason it’s exciting is because it doesn’t require some crazy hack or plan or it doesn’t require wealth. It doesn’t require a specific place on the planet. You can be anywhere and really follow this to a great degree. If you’re in a highly polluted environment and you can’t get out of it, well, that’s a difficult scenario. Most places on the planet, what I try to do in the book is talk about ways in which wherever you live, whatever your economic status is, whatever your social status is that you can actually do this. Even if you’re not married, right, or if you don’t have a large family, you can still have community and you can still have connections that you can develop that can really make your life better, including your gut health. I like the fact that you brought that question, even though I didn’t expect it, but it was great the way it worked out.
How making healthy lifestyle choices make a difference
Ari: I think paradigm, the lens in which we look at problems is really important. I think that when we start to look at it through a lens like what you’re describing is the way that you look at these problems. When we start to gather much more knowledge about what’s going on, what’s actually affecting our gut and our brain and many other systems in the body down to our mitochondria, we start to develop all this insight into, okay, the food, nutrition is playing a big role in shaping the microbiome and shaping gut health. It turns out physical activity plays a role in shaping the microbiome. Turns out circadian rhythm and sleep plays a role. Turns out our mind, our psychology plays a role, our stress levels play a role in shaping our microbiome. You start to– Our toxin exposure and things like that, the quality of the water you’re drinking and the air you’re breathing, so many different factors in the way we live down even to the level of community and spirituality, as you’ve described, impact our gut health, impact our microbiome.
I think the more you accumulate knowledge from that perspective, the more you realize how silly it is to try to reduce things down to a purely biochemical perspective or cellular perspective and say, “Here’s what’s happening at the biochemical level. Therefore out of this, we’re going to take a drug or a supplement that modifies the microbiome to be like this, like these healthy people over here, and that’s going to cure this disease.” If you take the person who isn’t living well in terms of their nutrition, in terms of their circadian rhythm and sleep, in terms of their stress management, in terms of their diet, their exercise habits, and all these other dimensions, even, exposure to nature, getting out and being exposed to nature has a big impact on the microbiome.
If you take somebody who is doing all those things wrong, and you just say, “Well, we’re going to give you this drug or this supplement that’s going to create the right microbiome, and that’s going to lead to all these beneficial changes.” It’s just absurd. It’s a really foolish way of thinking, in my opinion. The only real way to get the right change, to get meaningful change and meaningful health benefits is the way that you’re describing. You have to address things at that root because level.
Dr. Nandi: I appreciate that. I think that also, for your listeners, and I talk about it in my book, is that you have to have actionable steps. I break it down that, people feel like, “Listen, I’ve lived 50 years of my life a certain way, and how am I going to change this?” This seems insurmountable. it looks like you’re in Mount Everest, right? You’re basically, you are climbing a mountain that can’t be, that you can’t possibly get on top of. What I suggest is that you take actionable steps in each of those five pillars.
Purposeful living, figure out in your day, just in one day today, what things, what items in your life, that activities that you had, that you felt were meaningful. What can you then take away from your life that you felt were not really helpful or not creating meaning, that doesn’t give you joy, like looking at your phone for an hour and looking at a social media app. Was that really helpful? Was that meaningful? If you do that one step and you say, “I’m going to do one thing in my life today that achieves more purpose.”
Same thing with nutrition. Say, what? I’m going to add fermented foods to my diet starting today. Movement. I’m going to walk my dog or play with my kids instead of just sitting there and watching television as your kids run around, run around with them. One activity of movement, one activity in community. I’m going to find a group of people that have similar beliefs that I do or similar thoughts that I have and then work with them and just make a commitment. Spirituality, like I meditate every day, even if I’m traveling at least five minutes a day. You don’t have to meditate. You can do things. If you like prayer, if you like Tai Chi, if you like yoga, whatever it is, do one activity.
When you can do one actionable item in each of these pillars every day, within weeks you’ll see transformations in your life. I’m talking about gut and brain health in my book, but really it doesn’t, it’s not isolated to just that. The rest of your body thrives because when your gut health is thriving and your brain is thriving, the rest of your body will. I think that it’s also important for folks who are listening or watching, that they feel often that they need a hack because what we’re talking about is so difficult, so just such an insurmountable task that they can’t, they can’t achieve it. I think that we have to give them actionable steps every day.
I talk about, I talk about that in the book. I give them recipes in Heal your Gut. If you’re thinking about Alzheimer’s or Parkinson’s, well, here’s some activities, here’s some foods that may be helpful that have been shown to be associated with great outcomes or prevention. Again, it’s not that it’s so difficult, it’s the fact that you have to be consistent. I don’t know if you’re a fan of American football, but I love Tom Brady. Tom Brady said, he said, “I’m not any more talented than anybody else, but I’m consistent. I do this activity every single day.” I offer to use, if you can take each of these five pillars and every day create an activity for yourself, I promise you in weeks and in months and years, you’ll transform your body and your brain. It’s, I’ve seen that myself and I’m sure you’ll be able to do the same thing.
Dr. Nandi’s approach to nutrition
Ari: Yes. Dr. Nandi, I have one last question for you, which is, I’m just out of curiosity since I haven’t read the book yet. I’m excited to. There’s all this, “Look, we’ve been in the diet [unintelligible 00:47:45] for, I don’t know, 40 years at this point. At this point we have, every conceivable food has been demonized even down to berries and green vegetables. We have everything from veganism to carnivore diets being promoted as the big thing within the space of brain health. I know there’s been a lot of focus on keto diets historically, forgive if there’s some background noise coming through, I have some gardeners outside, unfortunately.
Keto diets have been a big focus and they’ve been promoted by, for example, Dale Bredesen and other people, Dr. Perlmutter. I think some people have shifted their tune on this in recent years. Some people have sort of talked about more of the importance of reincorporating carbohydrates. There’s lots of different views out there. I’m just out of curiosity, is there any particular diet that you promote in the book and maybe you can give some insight into sort of the key dietary pattern that you’re recommending for optimizing brain health?
Dr. Nandi: I respect Dale and David, I think that they’re great people. I think any extreme of, excluding foods or just having a preponderance of a certain type of food is just not, first of all, realistic, nor is it what allowed us to thrive, right? In no part of our history could we be on an absolute carbohydrate-restricted diet, right? It just didn’t happen. Nor could you just say, “I’m going to just eat, these berries and these vegetables.” What did we do? We ate what was available and we had a variety of foods. To me, I don’t like the word diet because to me it’s a word for failure. Outside of the scientific community and people who write books, nobody else can follow this stuff, right?
You struggle every day, you’re looking at books. I’m sure somebody can follow this, but for maybe a few weeks, maybe months and then you drop off. A 100% of my patients, and I’ve been doing this for two decades, have not been able to follow a diet. I talk about very simplistic [unintelligible 00:49:59],
simplistic ideas, right? Try to have a rainbow of fruits and veggies that you can tolerate. If you notice that a certain vegetable or a certain fruit gives you problems or digestive distress, or you feel like it’s not something that your body tolerates, just avoid it.
In general, whole foods, right? Fruits and vegetables. If you’re going to eat meat, probably not more than once a day. If you can, it’s pasture-raised and hopefully, from the wild. Some people can’t, they can’t afford that or they can’t access that. You do your best and minimize it. If there is one diet that I like to support, it’s the Mediterranean diet. To me, it’s not really a diet. It’s a plan. It’s a food plan that you eat a bunch of vegetables and fruits. You eat very little red meat. You eat some fish, drink a little wine. It’s like your life here, Ari. That’s what he does. You drink a little wine.
Ari: I would say that approximates my dietary pattern pretty closely.
Dr. Nandi: It’s called the Ari diet, right? It’s the Mediterranean diet and we’ve seen it forever. You eat a bunch of whole grains and not the way we do it in America where everything is, the grains are processed. I’ve had so many stories of my patients who are intolerant of so many bread products and grains in the US. They go abroad to even Europe and they say, “Nothing happened.” It’s because of the way we process it. Back to your question. I think that you can always find evidence of taking something in isolation, just like we talked about. In an isolated situation, say if you give this organism, this type of nutrient, you see a decreased inflammation or decreased effect. I think it’s a very unrealistic way of thinking about what life is about because a human being with all of its input, right? It actually matters if you’re sitting down with your family or sitting down alone and how your body accepts the food, right?
It matters if you actually participated in the cooking and how your body accepts the food and all the factors in your mind and your gut that then says, “Okay, this is what we need to do with the food.” It’s a complex interaction that cannot be simplistically said, “If you follow a keto diet or if you follow a vegan diet, you’re going to be the healthiest person alive.” It’s really looking at even food in a holistic way. Follow some basic principles, but then get your butt in the kitchen and actually cut the vegetables, see the food, feel the food when you drink the water. Then, you’re talking to your family or you’re playing music and then you sit down at the table.
It is taking all those pillars I talk about and then moving it into the meal. That’s the real food plan. That’s the real diet. If we just did that, it’d be great. We did that for centuries, right? We stopped doing that when we felt like we were far more advanced, right? The wealthier you are, it should mean that you don’t have to prepare your food. Everything has to be very efficient and done in the smallest period of time. Your body has not adjusted to that, right? This idea that the surrogate feeling of success is very, very short. It’s been the last 50 to 75 years max.
Your body, your mind and your gut has not caught up yet. They’re thinking, “What the heck is this giant creature doing? Why are they sitting there and having just food given to them that they’re not creating?” I’m talking about it as a third person because I feel like when you talk about the microbiome and I’m being tangential here, you have to know that the microbiome predates us by millions of years. You see the same organisms that are in our gut were present 15 million years ago before there were eukaryotes. These tiny little organisms figured out a way to communicate with other organisms. They somehow got into us.
They said, “Well, this is fantastic. We’ve got these lumbering creatures that feed us and move us around and poop us out so we can go everywhere and thrive.” When you then give them a bowl of pasta that’s made somewhere and just plopped in front of you, it’s not acceptable. When you think, “Why am I feeling this way? Why is it that I’m not being able to concentrate?” I had an executive who said, “Dr. Nandi, I want to crawl in a ball every single day and disappear. I can’t concentrate in meetings.” I asked him a question that [unintelligible 00:54:39] nobody had, “Tell me about how you eat?”
To answer your question, I just think these simplistic dietary plans are ineffective because of the fact they’re basically unrealistic. They don’t incorporate what your body is really going through when they ingest a meal. That’s why it’s unsuccessful. If we can follow some basic principles and I’ll offer my five pillars in your food plan and when you’re sitting down to eat, I think it could be very successful.
Dr. Nandi’s final words of hope
Ari: I think that’s a wonderful message. Dr. Nandi, is there any final thought that you want to leave people with or final message, final words that you want to leave people with? Also, please let people know where they can follow you and where they can find your book.
Dr. Nandi: Absolutely. Thank you for that. The final message to me would be that, the erosion of your brain health, meaning that having diseases of neurodegeneration like Alzheimer’s or Parkinson’s or MS or having strokes, they’re not inevitable. They’re not a consequence of just living. You can thrive. You can live a joyful life. You can play with your grandkids and really live a meaningful life. If you take, make some actionable steps way before the time when you actually have symptoms, I think you can really prevent. I feel you can prevent these diseases that are ravaging our society.
Again, I’ll repeat every three seconds, somebody is diagnosed with dementia every six seconds. Someone’s diagnosed with Alzheimer’s in every four minutes. Someone dies with a stroke. We call folks that look at these diseases and health in general as a way to be able to be proactive and prevent it, as health heroes. Be a health hero and look at your body and your gut as a way to be able to achieve these wonderful ideals, which is living a joyful life that includes great brain health.
You asked me about the book. It’s Heal Your Gut, Save Your Brain. You can get it anywhere books are sold. Amazon, Barnes and Noble, your local bookstore. You can go to our website, which is askdrnandi.com. A-S-K-D-R-N-A-N-D-I.com. I’m sure we can give you a link. You can find us there, but this has been great because Ari always asks very challenging questions that are introspective. I love the fact that you go deep and beyond just the superficial. I appreciate your time and having me on.
Ari: Yes, thank you so much for coming on the show, Dr. Nandi. I appreciate the kind words as well. Right back at you, you did very, very well. I love the message that you’re bringing to the table here. It sounds like an amazing book. I’m really excited to read it myself and I highly recommend everybody does the same. Thank you so much for coming on the show and sharing your wisdom with my audience. I appreciate it.
Dr. Nandi: Thank you, appreciate the opportunity.
Ari: Hey, this is Ari. I hope you enjoyed the show and I hope that you will go out and grab Dr. Partha Nandi’s new book. Sounds wonderful. I haven’t had a chance to read it yet but I absolutely love the message that he communicated here today. I strongly agree with the paradigm as I hope you gathered that he is communicating about how to optimize your brain health. It sounds like a great work and I strongly encourage you to check that out. Go on Amazon, Barnes and Noble, wherever you buy books and grab a copy.
One more thing, which is that about a year ago I partnered with another gut health expert who I consider one of the top microbiome experts in the world. That is Dr. Jason Hawrelak. He is a clinician and a professor and an author of medical textbooks on the subject of the microbiome. I partnered with him for my human optimization brand to create the gut optimization course. If you’re interested in optimizing your gut health and healing, resolving any gut symptoms you have going on, this is, in my opinion, certainly I’m biased. The whole reason that I went out and partnered with Dr. Hawrelak and created this gut optimization course was to create the best online course for optimizing your gut health available. I believe that we’ve accomplished that and I strongly encourage you if you’re dealing with any gut health issues or if you’re just looking to have the best gut health possible to go grab yourself that course. It’s phenomenal, it’s extremely well done. I think you’re going to learn a lot and benefit tremendously from it.
Thanks so much for joining me. If you’re interested in grabbing that course we’ve got links below on YouTube. You can also go to the website humanoptimization.com and get it there. I hope to see you on the podcast next week.
Show Notes
00:00 – Intro
00:12 – Guest intro: Dr. Partha Nandi
01:38 – What inspired Dr. Nandi to write “Heal Your Gut Save Your Brain”
05:29 – The main mechanisms that link the gut and the brain
09:53 – Leaky gut is not recognized in conventional medicine
22:59 – Amyloid plaques and Alzheimer’s
34:44 – Why pharmaceuticals might not be the final solution
41:36 – How making healthy lifestyle choices make a difference
47:39 – Dr. Nandi’s approach to nutrition
55:20 – Dr. Nandi’s final words of hope
Links
Gut health is very important in preventing dementia and many other diseases. If you want to optimize your gut and lower your risk of disease, click here to check out our very popular Gut Health Optimization program that I put together with renowned gut expert Dr. Jason Hawrelak.
Click here to sign up for Dr. Nandi’s FREE Heal Your Gut Save Your Brain webinar and learn more about how you can prevent Alzheimer’s disease and dementia.
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