# Sea Moss, Leaky Gut and Probiotics: Separating Gut Health Facts from Hype

An episode of [Health vs Hype with the American Medical Association](https://invisiblenetwork.ai/podcast/1891080741), 27 Oct 2026, 36 min.

Audio: https://pdrl.fm/b28604/prefix.up.audio/s/podtrac.com/pts/redirect.mp3/traffic.omny.fm/d/clips/e73c998e-6e60-432f-8610-ae210140c5b1/bb78c430-6171-45f8-8428-b41700fda214/c505d174-55ed-4510-9d85-b4ef015c546b/audio.mp3?utm_source=Podcast&in_playlist=439e7012-8c6c-4e4d-86c6-b41700fda646

Can probiotics, prebiotics, sea moss, and fermented foods really improve your gut health? And what does the science actually say about your gut microbiome? On this episode of Health vs. Hype from the American Medical Association, host Trace Dominguez explores the science behind gut health trends with Danielle Brown, holistic nutritionist and New York Times bestselling cookbook author behind Healthy Girl Kitchen, and Dr. Mohamed Mokadem, gastroenterologist and professor of medicine at the University of Iowa. From sea moss gel and probiotic supplements to postbiotics, prebiotics, fermented foods, and so-called “leaky gut,” we examine which wellness claims have scientific support and where the evidence is still developing. Dr. Mokadem explains what the gut microbiome does, how diet and antibiotics can affect it, and what researchers know about the gut-brain connection and its relationship to digestion, stress, and mental health. We also explore whether everyone needs a probiotic, how prebiotics differ from probiotics, what postbiotics actually are, and why there’s no single ideal microbiome for everyone. Plus, Danielle shares her personal journey with plant-based eating and gut health, while Dr. Mokadem explains why restrictive elimination diets and expensive supplements may not be the answer for everyone. Learn what the evidence supports, which warning signs deserve medical attention, and how a varied, balanced diet can help support digestive health. See omnystudio.com/listener for privacy information.

## Transcript

[0:07] Speaker 1: You know, I'm 30 now when I was 16. We
[0:09] Speaker 1: didn't have TikTok. We didn't have Instagram. We didn't have
[0:13] Speaker 1: access to social media and the health information that we
[0:16] Speaker 1: have on social media today. The term gut health wasn't
[0:19] Speaker 1: even a thing.
[0:21] Speaker 2: So gut health to me isn't a single medical diagnosis.
[0:25] Speaker 2: And there is no one blood test or stool test
[0:28] Speaker 2: that gives you like a gut health score.
[0:32] Speaker 3: Gut health is a topic that pops up regularly in
[0:35] Speaker 3: social media feeds. You'll find influencers talking about everything from
[0:39] Speaker 3: bloating and gut resets to probiotics, prebiotics, and the secret
[0:43] Speaker 3: to a healthier microbiome. Some swear that fixing your gut
[0:47] Speaker 3: can transform everything from your skin to your mood to
[0:51] Speaker 3: your immune system. Like Danielle Brown, a holistic nutritionist and
[0:55] Speaker 3: New York Times bestselling cookbook author who focuses on her
[0:58] Speaker 3: healthy girl diet in a pursuit of a healthy gut.
[1:02] Speaker 1: Once I started college, I actually discovered a plant-based diet.
[1:06] Speaker 1: I had heartburn, but I was also fatigued. I was
[1:09] Speaker 1: always bloated. I had acne. I just wasn't my healthiest self,
[1:14] Speaker 1: and I realized that. I was gaining the freshman 15
[1:17] Speaker 1: that everyone gains. I knew I had to get healthier.
[1:20] Speaker 3: Here to help us sort through all the information out
[1:23] Speaker 3: there about gut health is Dr. Mohamed Mokadem, a gastroenterologist
[1:27] Speaker 3: and professor of medicine at the University of Iowa. He
[1:30] Speaker 3: also serves as the chief section of gastroenterology at the
[1:33] Speaker 3: Iowa City VA Hospital.
[1:35] Speaker 2: Gut health pretty much sits at an intersection of like food, digestion,
[1:39] Speaker 2: immunity and the brain. But it's also an area with
[1:42] Speaker 2: a lot of hype, you know.
[1:44] Speaker 3: Welcome back to Health vs. Hype with the American Medical Association.
[1:48] Speaker 3: I'm your host, Trace Dominguez. So what does a healthy
[1:51] Speaker 3: gut actually look like? And when it comes to your microbiome,
[1:54] Speaker 3: are you helping your body or chasing the latest wellness trend?
[1:58] Speaker 3: I have a gut feeling you're going to want to
[2:00] Speaker 3: hear what the science says your gut actually needs. So
[2:04] Speaker 3: join me as we find out whether gut health trends
[2:06] Speaker 3: are all health or just hype. Danielle, when you hear
[2:24] Speaker 3: that phrase, gut health, what does that mean to you?
[2:27] Speaker 1: So to me, it really means, is the gut working properly?
[2:32] Speaker 1: And to put it in simple terms, are you pooping regularly?
[2:37] Speaker 1: Are you uncomfortable when eliminating waste? Is your gut bacteria
[2:43] Speaker 1: in proper balance? When you eat, do you get super
[2:48] Speaker 1: bloated or do you feel comfortable after? Is your gut
[2:52] Speaker 1: in harmony. And that means something different for everyone. I
[2:55] Speaker 1: had eliminated meat, dairy, eggs, fish, but replaced it with beans,
[3:00] Speaker 1: whole grains, fruits, vegetables, nuts, seeds, potatoes, everything unprocessed from
[3:05] Speaker 1: the earth, from the plant kingdom. After four months, my
[3:09] Speaker 1: heartburn went away, never came back. I was very regular,
[3:13] Speaker 1: like eliminating waste properly. I wasn't bloated. I felt so
[3:18] Speaker 1: much energy. I had a pep in my step. I
[3:20] Speaker 1: felt lighter. I could get through the day without having
[3:23] Speaker 1: to take a nap because I truly used to have
[3:26] Speaker 1: to take a nap every single day. I had no energy.
[3:29] Speaker 1: My skin cleared up. When you are eating properly, fixing
[3:34] Speaker 1: your gut health, that also shines outside as well. Fixing
[3:38] Speaker 1: that heartburn, fixing my gut, fueling my body properly, that
[3:41] Speaker 1: also showed up in my skin and my hormone health.
[3:45] Speaker 3: What process did you go through to figure out what
[3:47] Speaker 3: was helping you versus what might have been just a
[3:51] Speaker 3: trend in the gut health community. How did you test
[3:54] Speaker 3: these trends or did you?
[3:55] Speaker 1: I think once I had the foundation of a plant-based
[3:58] Speaker 1: diet and, you know, now it's been over a decade
[4:01] Speaker 1: and we have social media and there's always something new
[4:04] Speaker 1: coming out, like sea moss is this new thing. Everyone's
[4:08] Speaker 1: talking about sea moss gel and sea moss gummies. And
[4:11] Speaker 1: so now that I have my foundation and I know
[4:13] Speaker 1: that eating plant-based works really well, That way I can
[4:18] Speaker 1: try other things and see if they help. Now, I
[4:21] Speaker 1: think people, they might eat a terrible diet and then
[4:25] Speaker 1: they think, you know, eating the sea moss will outshine
[4:29] Speaker 1: their bad diet. No, like you have to have a
[4:31] Speaker 1: healthy diet, whatever that means for you and your body.
[4:33] Speaker 1: Not everyone's going to be plant-based vegan. I totally understand that.
[4:38] Speaker 1: You can't eat badly and then take a probiotic or
[4:41] Speaker 1: eat poorly and just eat, you know, sea moss gummies
[4:44] Speaker 1: and And eat fermented foods. It's really like, eat your
[4:48] Speaker 1: healthy lunch, put fermented foods on top. Take your probiotic
[4:51] Speaker 1: every single day.
[4:54] Speaker 3: For those of you who haven't heard of sea moss
[4:57] Speaker 3: or sea moss gel, it's being touted as a nutrient-packed
[5:00] Speaker 3: superfood to improve gut health. This edible seaweed contains minerals
[5:05] Speaker 3: like folate, iodine, calcium, and zinc, along with fiber. But
[5:08] Speaker 3: does that mean you need to add a spoonful of
[5:11] Speaker 3: sea moss gel to your daily routine? Not so fast.
[5:14] Speaker 3: Research supporting many of its biggest health claims is limited,
[5:18] Speaker 3: and CMOS is not FDA approved. So without knowing exactly
[5:22] Speaker 3: what's in your supplement, it's hard to know whether it's
[5:25] Speaker 3: providing the benefits you're looking for or even potentially exposing
[5:29] Speaker 3: you to unwanted risks. So there is a lot of
[5:32] Speaker 3: advice online. You know this as somebody who works online,
[5:35] Speaker 3: that there's a lot of people coming at everybody all
[5:37] Speaker 3: the time with different perspectives, different advice about probiotics and
[5:42] Speaker 3: fermented foods. elimination diets, supplements, healing foods. How is it
[5:47] Speaker 3: that you sort through it or help your audience sort
[5:50] Speaker 3: through it?
[5:51] Speaker 1: I think it's really sticking to the basics and sticking
[5:57] Speaker 1: to what has research behind it. We know and every,
[6:00] Speaker 1: you know, gastroenterologist and doctors will say fiber is essential
[6:05] Speaker 1: to a healthy gut and a healthy lifestyle. and to
[6:10] Speaker 1: have your system functioning correctly. That amount of fiber will
[6:13] Speaker 1: vary on the person. Some people can tolerate more, some
[6:17] Speaker 1: people can tolerate less, but getting it in at some
[6:19] Speaker 1: point is very important. Obviously fiber, a lot of research
[6:23] Speaker 1: behind it. Something like taking a probiotic has a lot
[6:25] Speaker 1: of research behind it. Anything new, you know, don't buy
[6:30] Speaker 1: random parasite cleanses on TikTok is all I can say.
[6:34] Speaker 3: Parasite cleanses, right. That is a can of worms that
[6:38] Speaker 3: I don't think we want to open right now. Maybe
[6:39] Speaker 3: that'll be a whole other episode. Dr. Mokadem, I'm really
[6:43] Speaker 3: glad that you're joining us today. Our guest, Danielle, said
[6:45] Speaker 3: that her definition of gut health is pooping regularly, not
[6:49] Speaker 3: feeling bloated after meals, gut bacteria in proper balance. Is
[6:53] Speaker 3: that how you would define it?
[6:55] Speaker 2: I agree with much of what Danielle is describing. I mean,
[6:58] Speaker 2: comfortable digestion, regular bowel movements. And not having persistent pain
[7:03] Speaker 2: or bloating are important signs that the digestive system is
[7:05] Speaker 2: functionally well.
[7:06] Speaker 4: I mean, that's how you gauge it. I would add
[7:08] Speaker 4: two qualifications.
[7:09] Speaker 2: First, being regular does not necessarily mean having a bowel
[7:13] Speaker 2: movement every day. Normal frequencies varies among even healthy people. Second,
[7:17] Speaker 2: we currently have no clinical test that can tell us
[7:19] Speaker 2: whether someone's gut bacteria is healthy or balanced or not balanced.
[7:22] Speaker 2: We know the concept, but we don't have the test
[7:24] Speaker 2: to just kind of label that as a yes or no.
[7:27] Speaker 2: Medical gut health means to me that the digestive system
[7:29] Speaker 2: is moving food normally. absorbing nutrients and maintaining its protective
[7:34] Speaker 2: barrier from harmful exposure to the environment.
[7:37] Speaker 4: So briefly, I would define.
[7:39] Speaker 2: Gut health less as achieving a perfect function or perfect
[7:43] Speaker 2: microbiome environment, that's what probably most of the people think,
[7:47] Speaker 2: and more as having a comfortable, dependable digestive function, a
[7:52] Speaker 2: good nutrition, and no background warning signs of disease.
[7:57] Speaker 3: She also attributes her gut health to a plant-based vegan diet,
[8:00] Speaker 3: Is there anything to that?
[8:02] Speaker 2: Danielle's experience is certainly plausible. A well-planned, plant-forward diet can
[8:07] Speaker 2: provide more fiber, improve bowel regularity, support, even there's some
[8:11] Speaker 2: data that supports the cardiovascular and metabolic health. If she
[8:15] Speaker 2: also ate fewer higher fat or highly processed food and
[8:19] Speaker 2: experienced weight loss, that might have helped for heartburn, for example,
[8:23] Speaker 2: and energy level. But we cannot assume that every change
[8:26] Speaker 2: in her skin hormone or immune function resulted directly from
[8:30] Speaker 2: fixing the gut. And not everyone will have the same response. Again,
[8:34] Speaker 2: even if it's worked for her or for somebody specific,
[8:37] Speaker 2: it might not work for somebody else. Maybe even having
[8:39] Speaker 2: the same description as her symptoms. Healthy pattern can include vegetables, fruits, legumes,
[8:45] Speaker 2: whole grains overall, depending on the individual's needs and preferences,
[8:49] Speaker 2: I would say.
[8:50] Speaker 4: You can shape it.
[8:51] Speaker 2: The key message is that You do not have to
[8:53] Speaker 2: eliminate all animal food, but most people who would benefit
[8:56] Speaker 2: from eating more varied, minimally processed plant food is being supported.
[9:01] Speaker 3: Your microbiome is something that you hear talked about a
[9:04] Speaker 3: lot in the context of gut health. So what exactly
[9:07] Speaker 3: is it? Your microbiome is the community of tiny organisms,
[9:11] Speaker 3: including bacteria, fungi, and viruses that live in and on
[9:15] Speaker 3: your body. Your gut microbiome, or microflora in particular, plays
[9:20] Speaker 3: an important role in digestion and immune function. And these
[9:23] Speaker 3: microbes can be influenced by things like your diet, medications,
[9:27] Speaker 3: and your environment. But, Dr. Mokadam, is there an ideal
[9:31] Speaker 3: microbiome we should all be striving for?
[9:34] Speaker 2: So there's no single ideal microbiome that everyone should have.
[9:38] Speaker 2: I like to think of the gut microbiome as a
[9:41] Speaker 2: living ecosystem. It contains many different microorganisms that interact with
[9:46] Speaker 2: one another and with our own body parts. So that
[9:49] Speaker 2: ecosystem is highly personal. It is shaped by a person's
[9:52] Speaker 2: age and diet and genetics and geography, what medication they take,
[9:56] Speaker 2: especially antibiotics and similar medications. and how quickly food moves
[10:02] Speaker 2: through the digestive tracts. It also changes over time. Two
[10:05] Speaker 2: healthy people can have very different microbiome, both completely healthy
[10:09] Speaker 2: and still be equally functionally healthy from the gut standpoint.
[10:12] Speaker 2: NIH research actually has shown that microbial composition can vary
[10:17] Speaker 2: among two healthy individuals yet their function might still be similar.
[10:21] Speaker 3: So it's funny because it seems like we didn't really
[10:25] Speaker 3: know about the gut microbiome. We haven't known about it
[10:28] Speaker 3: for that long. Is that true?
[10:30] Speaker 2: In terms of like how much it's important to communicating
[10:34] Speaker 2: to us as a host. So they've been living with
[10:37] Speaker 2: us as long as humans or our ancestors has ever
[10:40] Speaker 2: existed or documented.
[10:42] Speaker 4: And we were aware that our gut has bacteria.
[10:46] Speaker 2: And then we had few ideas that some of them
[10:49] Speaker 2: that resides in the distal part of the guts are
[10:51] Speaker 2: probably helping shape some of our specific digestion process. But
[10:57] Speaker 2: there was so much variability of the microbiome that we
[10:59] Speaker 2: thought that we just evolved to coexist together with certain
[11:03] Speaker 2: populations of them that helps us. what's new to the community,
[11:06] Speaker 2: what's making it exciting for the past few years, they're
[11:09] Speaker 2: actually playing a role. Because not actually that different people,
[11:12] Speaker 2: different disease, different conditions have different microbiome, changing or manipulating that,
[11:17] Speaker 2: that's now as research is showing, can change and manipulate
[11:21] Speaker 2: the host's response, like our bodies to certain conditions or disease,
[11:25] Speaker 2: and not just general gut-related issues, even brain and depression
[11:29] Speaker 2: and liver disease. And it looks like they're talking to
[11:32] Speaker 2: the body parts through the gut and the brain, but
[11:37] Speaker 2: the message is being received by all other body organs.
[11:40] Speaker 2: That's why we have probably much more longer road to learn.
[11:45] Speaker 3: Take a second to digest what Dr. Mokadam is saying here.
[11:48] Speaker 3: Your gut microbiome communicates with you, its host, through the
[11:52] Speaker 3: gut-brain connection. Your gut microbes help produce chemicals that send
[11:56] Speaker 3: signals between your gut and your brain. They are in
[11:58] Speaker 3: constant communication. Your gut also contains millions of nerve cells,
[12:03] Speaker 3: more than anywhere else in your body outside of your brain.
[12:05] Speaker 3: The gut-brain connection helps your body recognize which foods provide
[12:10] Speaker 3: nutrients that you need and which ones might be harmful.
[12:12] Speaker 3: Your brain and gut communicate to regulate digestion and alert
[12:15] Speaker 3: you to potential problems. They also influence each other emotionally.
[12:20] Speaker 3: For example, stress can make gut symptoms feel worse. while
[12:24] Speaker 3: uncomfortable digestive sensations can increase stress and anxiety. This is
[12:29] Speaker 3: why you sometimes hear your gut referred to as your
[12:32] Speaker 3: second brain.
[12:33] Speaker 2: I mean, we know for sure. So they reside within
[12:37] Speaker 2: our gut. So they also are exposed to whatever we're
[12:39] Speaker 2: exposed to. So some of them, our function is to
[12:42] Speaker 2: protect from some of the toxins or the ingestions that
[12:45] Speaker 2: we accidentally get. Some of them help with the process
[12:47] Speaker 2: of our own regular digestion to get the nutrients and
[12:50] Speaker 2: the energy we need to survive. Some of them help
[12:53] Speaker 2: send signals to the brain that maybe we need to
[12:55] Speaker 2: change the behavior to see certain subtypes of nutrients that
[12:59] Speaker 2: could be deficient.
[13:00] Speaker 3: Yeah, and that makes sense. You mentioned that then when
[13:04] Speaker 3: we talk about microbiomes, antibiotics come up often. How resilient
[13:09] Speaker 3: is the microbiome? What does an antibiotic do when you
[13:13] Speaker 3: take one to a microbiome?
[13:15] Speaker 2: Our gut microbiome, like any other bacteria or microbiome that's
[13:18] Speaker 2: not even living with our gut, are very sensitive to
[13:20] Speaker 2: any drug that can affect their replication or their division. Antibiotics,
[13:25] Speaker 2: with all their variable mechanisms of working, they're still, you know,
[13:30] Speaker 2: very effective in disturbing microbial communities, much more to certain
[13:34] Speaker 2: bacteria that are called sensitive than other ones that might
[13:36] Speaker 2: be a little bit more resistant.
[13:38] Speaker 4: But here's the interesting part.
[13:39] Speaker 2: The shape of the current gut microbiota that we have
[13:42] Speaker 2: right now has been exposed to a lot of changes
[13:45] Speaker 2: throughout our lifetime, especially the first five years, probably of
[13:48] Speaker 2: our time, based on like how you were born and
[13:50] Speaker 2: where you lived and what you eat the first few
[13:51] Speaker 2: years of your life.
[13:52] Speaker 4: It goes through a lot of change.
[13:54] Speaker 2: And usually that, that number start to significantly stabilize in
[13:57] Speaker 2: general around the age of five or more. And that composition,
[14:01] Speaker 2: that ecosystem with all its variability remains more or less stable.
[14:05] Speaker 2: Every time you get exposed to antibiotics, they get disturbed.
[14:09] Speaker 2: The antibiotics affects certain bacteria and types more than the other,
[14:13] Speaker 2: but it's definitely disturbed. And the purpose of what the
[14:15] Speaker 2: antibiotics is supposed to treat, hopefully it's supposed to treat
[14:19] Speaker 2: an unwanted bacteria that's causing an infection, the throat, pneumonia,
[14:23] Speaker 2: skin infection, something that the antibiotic is taking care of.
[14:26] Speaker 2: But meanwhile, it's going to go through the gut, and
[14:28] Speaker 2: that's why the gut microbiota is going to be affected
[14:30] Speaker 2: by it. But the interesting part is that after whatever
[14:34] Speaker 2: incident has passed, they always tend to reprogram and rearrange
[14:38] Speaker 2: themselves to the composition it was before. Before the age
[14:41] Speaker 2: of five, that's why we have variable. But unless we
[14:43] Speaker 2: have major surgeries or cancer or something like really big,
[14:47] Speaker 2: a lot of stress, traveling, or exposure to antibiotics can
[14:50] Speaker 2: actually affect the composition. But it's interesting that they have
[14:53] Speaker 2: a certain fingerprint that our body, there is this understanding
[14:56] Speaker 2: between us and them. And after that injurious part goes away,
[15:00] Speaker 2: that balance seems to restore itself. We still don't understand how,
[15:04] Speaker 2: but it's amazingly consistent.
[15:06] Speaker 3: That is incredible, actually, to think about, that it's like, okay, guys,
[15:11] Speaker 3: we've lost some of our microbes here. We've got our list.
[15:14] Speaker 3: Let's go to the list.
[15:16] Speaker 4: Let's bump up this, or this population is by too much.
[15:19] Speaker 4: Let's try to trim some of this down, and they
[15:21] Speaker 4: go back, give them enough time.
[15:22] Speaker 3: Yeah, that's so interesting. So I guess let's back up
[15:26] Speaker 3: a little bit and say, like, how many... microbes are
[15:29] Speaker 3: in there, you know, thousands, millions, billions.
[15:32] Speaker 4: Oh, we're talking billions.
[15:33] Speaker 3: Wow.
[15:34] Speaker 4: Billions.
[15:34] Speaker 3: You mentioned that it's sort of, I'm going to use
[15:36] Speaker 3: the term self-healing, but I don't know if that's really
[15:38] Speaker 3: what it is, you know, to kind of self-reorganizing after damage.
[15:41] Speaker 3: Is there anything we can do to assist that process?
[15:44] Speaker 3: How much can we actually change how our gut microbiome
[15:48] Speaker 3: is made up?
[15:49] Speaker 2: At this point, I wouldn't focus much on changing the
[15:52] Speaker 2: microbiome before we understand actually, you know, maybe the healthy
[15:56] Speaker 2: microbiome for your body specifically would at one point be known.
[16:00] Speaker 2: And then we can probably target a personalized medicine when
[16:04] Speaker 2: we understand for certain people with a certain specific associations
[16:07] Speaker 2: and conditions, that is the ideal healthy microbiome. At this point,
[16:12] Speaker 2: I would probably much more focus on getting like a
[16:14] Speaker 2: healthy gut because if we follow symptoms and signs that
[16:18] Speaker 2: your body's telling you that there's something wrong, We'll try
[16:20] Speaker 2: to address that. And if there are an association of
[16:23] Speaker 2: something wrong happening, including an unwanted gut microbiome, we address
[16:28] Speaker 2: that appropriately. So common symptoms such as occasional gas or
[16:31] Speaker 2: bloating are often harmless. But for example, certain warning signs
[16:35] Speaker 2: should not be blamed on vague gut imbalance or just
[16:38] Speaker 2: treat only with supplements. I think people should seek medical
[16:42] Speaker 2: evaluation with tests recommended by their provider. If they have
[16:46] Speaker 2: warning signs like unexplained weight loss, persistent vomiting, intractable, long,
[16:51] Speaker 2: unexplainable pain, difficulty swallowing, turning yellow or having what's called jaundice,
[16:56] Speaker 2: having fevers. And we call those associated alarming signs. Your
[17:00] Speaker 2: body's trying to tell you, well, there is something abnormal.
[17:02] Speaker 2: At this point, identifying the cause, irrespective of this is
[17:06] Speaker 2: directly confirmed a microbiome caused or associated result or none,
[17:11] Speaker 2: that would be the most appropriate. So supporting it is
[17:14] Speaker 2: mostly supporting when you're not having symptoms is just eating
[17:17] Speaker 2: the right healthy variable diet and doing your age appropriate
[17:21] Speaker 2: screening for cancers and conditions that now we know about.
[17:25] Speaker 2: You should at least talk with your provider of like
[17:27] Speaker 2: when and how you should get tested, even when you're
[17:30] Speaker 2: not having any symptoms at all.
[17:32] Speaker 3: You mentioned appropriate diet, and I want to play a
[17:34] Speaker 3: clip from Danielle about that so we can get a
[17:37] Speaker 3: gut check about it. Here's Danielle.
[17:40] Speaker 1: So first and foremost, look at that ingredient list. If
[17:42] Speaker 1: you can't pronounce it or it has something that you
[17:45] Speaker 1: wouldn't cook within your own kitchen, don't pick it up.
[17:48] Speaker 1: Look at the grams of total sugar in the nutrition
[17:51] Speaker 1: panel or added sugar. It's really important to look at
[17:54] Speaker 1: that added sugar. Because let's say the product has strawberries
[17:58] Speaker 1: and dates, whole natural foods from the earth. They're going
[18:01] Speaker 1: to contain some natural sugar and that's going to show
[18:03] Speaker 1: up on the nutrition label. But if you look at
[18:06] Speaker 1: added sugar, that means they added extra sugar in. We
[18:09] Speaker 1: don't want added sugar. If you can completely eliminate eating
[18:12] Speaker 1: added sugar in your diet, you will see so many
[18:15] Speaker 1: benefits in your gut and your immune system.
[18:18] Speaker 3: So, Dr. Mokadam, is she on to something here? You know,
[18:22] Speaker 3: added sugars and ingredients with names you can't pronounce. How
[18:25] Speaker 3: much does that impact our gut health?
[18:28] Speaker 4: There are two important issues here.
[18:30] Speaker 2: So first, diets and high added sugar, especially sugar-sweetened beverages
[18:34] Speaker 2: and highly processed foods and sugar foods, can add excess
[18:38] Speaker 2: calories and display fiber-rich, nutrient-dense food.
[18:41] Speaker 4: There has been.
[18:42] Speaker 2: Very well-known or documented association with multiple confirmed gut conditions.
[18:48] Speaker 2: Limiting added sugar is definitely sensible, but sugar is not
[18:51] Speaker 2: a toxin. I just want to clarify that must be
[18:53] Speaker 2: completely eliminated, just the word sugar. I mean, there are
[18:56] Speaker 2: definitely certain subtypes of sugar and definitely excessive sugar, but
[19:00] Speaker 2: just making sure that it's still part of a balanced diet.
[19:03] Speaker 2: I mean, being on a zero sugar diet obviously does
[19:06] Speaker 2: not go with our own biology where we have cells
[19:09] Speaker 2: and mechanism enzymes to digest and process carbohydrates.
[19:13] Speaker 4: Including sugars.
[19:14] Speaker 2: And normally, occurring sugar in whole fruits comes packaged with fiber.
[19:19] Speaker 2: But second, I want to also commend that whether you
[19:22] Speaker 2: can pronounce an ingredient is not a scientific measure of safety.
[19:25] Speaker 2: So for example, ascorbic acid is what? I mean, it's
[19:28] Speaker 2: simply vitamin C. Check the serving size. Set what exactly
[19:32] Speaker 2: types of sugar, the amount of sugars. And the ingredients
[19:35] Speaker 2: are listed from the greatest to the smallest amount by weight.
[19:38] Speaker 2: So pay particular attention to the first few. So you
[19:41] Speaker 2: know where you're, highest density of the micronutrients coming from fat,
[19:45] Speaker 2: especially saturated fat, sugar and how much, and make judgment according.
[19:50] Speaker 4: To that.
[19:50] Speaker 2: A practical message for me is just choose mostly minimally processed,
[19:55] Speaker 2: nutrient-rich foods, but judge a product by its overall nutritional value,
[20:00] Speaker 2: not by how difficult ingredients are pronounced or what you
[20:03] Speaker 2: probably heard even from one or two sources.
[20:07] Speaker 3: Okay, that makes sense. Can we talk about probiotics? This
[20:11] Speaker 3: is something Danielle talked about, but also something we see
[20:13] Speaker 3: promoted online all the time. So what is a probiotic?
[20:17] Speaker 3: Does everyone need a probiotic? Should I be taking a
[20:20] Speaker 3: probiotic right now? Should I be pro-probiotics?
[20:24] Speaker 2: So the short answer is no. Most people do not
[20:26] Speaker 2: need to take a probiotic routinely. A probiotic is a
[20:29] Speaker 2: life microorganism. You know, it's like a mimicker of a
[20:32] Speaker 2: microbiome that we want it to be, like a super microbiome.
[20:35] Speaker 2: that has been shown to provide a health benefit when
[20:38] Speaker 2: taken in an adequate amount. But probiotic, in general, is
[20:42] Speaker 2: a broad category. It's not a single treatment. Its effect
[20:46] Speaker 2: depends on the specific strain or combination of strains of
[20:50] Speaker 2: certain bacteria, the dose, and the condition being treated. So far,
[20:54] Speaker 2: we have very few conditions that have been reliably confident
[20:57] Speaker 2: that there are specific strains of probiotic or engineered microorganisms
[21:02] Speaker 2: that can help with it. So a product that helps
[21:05] Speaker 2: in one situation may have no benefit in another. So
[21:08] Speaker 2: if you don't have that condition, just taking a presumably
[21:11] Speaker 2: just a healthy type of a microbiome, we don't have
[21:14] Speaker 2: a reliable evidence that actually it does anything. It might
[21:16] Speaker 2: not harm, but we don't have a reliable information that
[21:19] Speaker 2: does help. My main message is that probiotics can be
[21:22] Speaker 2: useful for the right person, the right condition, and using
[21:26] Speaker 2: the right strain, but they are not universally beneficial for everyone.
[21:31] Speaker 3: And I think it's important to mention here, many probiotics
[21:33] Speaker 3: are sold as dietary supplements, which means they don't need
[21:37] Speaker 3: FDA approval before they hit store shelves. Companies can make
[21:41] Speaker 3: certain claims about how a product supports the body, but
[21:44] Speaker 3: they can't claim it prevents or treats a disease without
[21:47] Speaker 3: meeting additional FDA requirements. If a probiotic is marketed as
[21:52] Speaker 3: a treatment for a specific disease or condition, the rules
[21:55] Speaker 3: are stricter. the manufacturer must demonstrate that it's safe and
[21:59] Speaker 3: effective for that intended use through clinical trials and get
[22:03] Speaker 3: FDA approval before selling it as a drug. So, Dr. Mokhtar,
[22:07] Speaker 3: what do you think about prebiotics? They're different than probiotics,
[22:11] Speaker 3: I'm assuming.
[22:13] Speaker 2: So prebiotics are fibers in general. So fiber is a
[22:15] Speaker 2: type of carbohydrate that our body does not fully digest.
[22:19] Speaker 2: Some fibers act as prebiotics, meaning that they are selectively digested.
[22:23] Speaker 2: used to target our gut microbiota because we know specifically
[22:27] Speaker 2: that it's their main source of energy. And by that,
[22:30] Speaker 2: we try to flourish our own healthy gut by giving
[22:33] Speaker 2: them their favorite food, you know, their preferred types of
[22:37] Speaker 2: diet to flourish and expand. So the terms overlap, but
[22:41] Speaker 2: they're not identical. You can favor a probiotic that's already
[22:44] Speaker 2: naturally in you, which is your gut microbiota, by supporting
[22:49] Speaker 2: or giving the right prebiotic. Yeah.
[22:51] Speaker 3: Just to kind of make sure I have my head
[22:53] Speaker 3: around it. A prebiotic is like what you're giving to
[22:56] Speaker 3: the gut microbiome to help it. And a probiotic is
[22:59] Speaker 3: sort of a boost. It's either there's other gut microbiota
[23:03] Speaker 3: in there that you're adding or you're supporting stuff that's
[23:06] Speaker 3: already there.
[23:06] Speaker 4: Correct.
[23:07] Speaker 3: Okay. Correct. Got it. Is there really a big meaningful
[23:10] Speaker 3: difference between prebiotics and fiber? Like if you're taking a supplement,
[23:14] Speaker 3: does it matter or?
[23:16] Speaker 2: All prebiotics are fibers, but not all fibers are prebiotics,
[23:19] Speaker 2: if that makes sense. So fibers, even multiple types of fibers,
[23:23] Speaker 2: can be healthy as prebiotics because they might, you know,
[23:26] Speaker 2: selectively flourish certain good microbiota, but they're also maybe healthy
[23:31] Speaker 2: for the gut itself because they're undigestible types of carbohydrates.
[23:35] Speaker 2: So if they're not absorbed after being digested or undigested
[23:39] Speaker 2: or partially digested, they draw water into the lumen of
[23:41] Speaker 2: the gut or the pipe, making... end waste much more
[23:45] Speaker 2: easier to pass the waste or the stools ultimately. So
[23:48] Speaker 2: they might have multiple benefits in how our gut moves
[23:51] Speaker 2: the waste, how our gut supports the gut microbiome that
[23:54] Speaker 2: actually helps boost certain types of our body function, like
[23:58] Speaker 2: our own immune system, our own gut nervous system. There
[24:02] Speaker 2: are combinations of fibers that would help as a collective,
[24:06] Speaker 2: but the ones that are being sold or advertised as prebiotic,
[24:09] Speaker 2: they're mostly the one boosting certain specific types of gut microbiome,
[24:15] Speaker 2: while the other ones, the other common types of fibers
[24:18] Speaker 2: available in the market are supplements like selium that your
[24:22] Speaker 2: GI doctor might prescribe to help softening the bowels, managing
[24:26] Speaker 2: or co-managing constipation, treating irritable bowel syndrome, adding to the
[24:30] Speaker 2: motility or to the digestive motility of your gut.
[24:34] Speaker 3: Got it. All right. So, Dr. Moghadam, we've got prebiotics,
[24:39] Speaker 3: we've got probiotics, but there's also now postbiotics. So is
[24:45] Speaker 3: this actually a thing or is this a new buzzword?
[24:47] Speaker 3: You know, where's the health and hype on that one?
[24:51] Speaker 3: I see.
[24:51] Speaker 2: No, no, actually, actually, postbiotics are a legitimate area of science,
[24:56] Speaker 2: but the marketing is moving faster than the clinical evidence.
[25:00] Speaker 4: So the term is there.
[25:01] Speaker 2: A scientific consensus defines a postbiotic as a preparation of
[25:06] Speaker 2: a non-living microorganism or their components that has demonstrated some
[25:12] Speaker 2: form of a health benefit, even if they're not strong,
[25:14] Speaker 2: but some form.
[25:16] Speaker 3: Okay, so they are made from inanimate microorganisms or components
[25:21] Speaker 3: of those microorganisms that may offer health benefits. So instead
[25:25] Speaker 3: of introducing live bacteria into your gut, you're introducing something
[25:28] Speaker 3: derived from those microbes in the hope of getting some
[25:32] Speaker 3: of the same benefits. The big question is whether those
[25:35] Speaker 3: benefits have actually been demonstrated, and that depends on the
[25:39] Speaker 3: specific postbiotic and what it is supposed to do.
[25:43] Speaker 2: But the word postbiotic on a label does not prove
[25:46] Speaker 2: that a particular product works. The biological concept is there,
[25:50] Speaker 2: but we're still a little bit even more behind the pre-
[25:53] Speaker 2: and the probiotic. We don't have even stronger evidence that
[25:57] Speaker 2: even those products, if ingested, that they withstand the harshness
[26:01] Speaker 2: of this complex digestive system. And we'll just go and
[26:05] Speaker 2: reach that target where a living organism in our gut
[26:08] Speaker 2: is making it down there in direct proximity to the
[26:12] Speaker 2: cells of our body that they need to communicate with.
[26:15] Speaker 2: We're just assuming it's going to go travel and find
[26:17] Speaker 2: whatever it needs to go and does what it's supposed
[26:20] Speaker 2: to do.
[26:21] Speaker 3: Yeah, I think that's something a lot of people don't
[26:23] Speaker 3: always understand. But it's like, imagine you're a country and
[26:26] Speaker 3: what we're doing is we're putting something in New York
[26:29] Speaker 3: and hoping it gets to L.A., right? Or like on
[26:31] Speaker 3: its own.
[26:32] Speaker 2: Right.
[26:32] Speaker 3: Whereas like the microbiome is already there doing what it
[26:34] Speaker 3: needs to do in L.A. or wherever.
[26:36] Speaker 4: Right.
[26:36] Speaker 3: But it's like you were trying to make sure that
[26:39] Speaker 3: it gets there without really knowing if it does.
[26:41] Speaker 4: Yeah, it's a very nice analogy.
[26:44] Speaker 3: So there are claims online that connect gut health microbiomes
[26:48] Speaker 3: to everything. Inflammation. immunity, anxiety, depression, weight loss, brain health.
[26:54] Speaker 3: Where is the science the strongest in these areas and
[26:57] Speaker 3: where is it more speculation and hype?
[27:00] Speaker 2: The strongest science shows that the gut is connected to
[27:04] Speaker 2: the rest of the body. That has been definitely a
[27:07] Speaker 2: concept older than the concept of the microbiome and its role. Now,
[27:11] Speaker 2: the intestinal lining and the immune system interact continuously with
[27:15] Speaker 2: the brain through gut hormones, nerves, sensory nerves. We know
[27:19] Speaker 2: the connection is there. Now, understanding the details of how
[27:23] Speaker 2: the signaling happens between what's inside of the lumen gut,
[27:27] Speaker 2: between nutrients and microbiome, and how that signals reaches all
[27:32] Speaker 2: the complexity of the barrier and beyond, including the brain,
[27:36] Speaker 2: there is still a lot to learn about the pathway,
[27:39] Speaker 2: the actual small roads and routes to get there. But
[27:43] Speaker 2: the concept is there. The big picture has been very
[27:47] Speaker 2: well suggested and supported by scientific data.
[27:51] Speaker 4: Yeah.
[27:51] Speaker 3: So we know it's affecting, but we don't necessarily know
[27:54] Speaker 3: that like, okay, if we do this, we'll affect inflammation.
[27:56] Speaker 4: Correct.
[27:56] Speaker 3: If we do this, we'll affect anxiety.
[27:58] Speaker 4: We're in the midst of this learning curve.
[28:01] Speaker 2: The gut-brain connection is real, but the claim that one
[28:04] Speaker 2: specific manipulation by one molecule or one item and one
[28:08] Speaker 2: bacteria or one whatever intervention can treat a disease is
[28:12] Speaker 2: still too early to claim. Yeah.
[28:15] Speaker 3: What about some other things that we see on social media,
[28:17] Speaker 3: like the idea of Leaky gut, which I have to say,
[28:21] Speaker 3: sounds awful. That sounds like something nobody really wants. But
[28:25] Speaker 3: they say it's responsible for a whole bunch of different
[28:28] Speaker 3: health problems. How does leaky gut work? What is it?
[28:31] Speaker 3: Intestinal permeability? What does that mean?
[28:34] Speaker 2: Leaky gut is a popular term, increased intestinal permeability. Maybe
[28:38] Speaker 2: some people might confuse the leakiness as happening through the
[28:41] Speaker 2: wall of the intestine. But those two phrases are not
[28:44] Speaker 2: always used accurately or interchangeably in the medium. The intestinal
[28:47] Speaker 2: lining is not meant to be a solid, just like
[28:50] Speaker 2: impenetrable wall. It's there to allow to pass certain things
[28:54] Speaker 2: and to block pathogen of certain things.
[28:56] Speaker 4: And when it's injured and it's diseased and it's.
[28:59] Speaker 2: Broken for whatever reason, that function of selective filtering, allowing
[29:04] Speaker 2: certain types of nutrients or micronutrients or water or minerals
[29:09] Speaker 2: to enter and block pathogen, certain bacterial toxins or harmful
[29:14] Speaker 2: materials from the environment to get to our body through
[29:16] Speaker 2: the intestines get disrupted.
[29:18] Speaker 4: The concept is there.
[29:19] Speaker 2: It's much more consistent with people who is known to
[29:22] Speaker 2: have a very specific condition that disrupt that permeability in details,
[29:26] Speaker 2: like in people have Crohn's disease or certain inflammatory bowel disease.
[29:30] Speaker 2: The assumption that there is some level of permeability that's
[29:33] Speaker 2: not visual and it can be associated with a bigger,
[29:38] Speaker 2: non-specific symptomatic of gut health like symptoms of like bloating
[29:43] Speaker 2: that's excessive or non-specific vomiting or change in bowel habits
[29:49] Speaker 2: is not at least completely true or reliable or.
[29:51] Speaker 3: Confirmed got it yeah and i think that makes sense
[29:54] Speaker 3: i think it's a very um a visual term so
[29:58] Speaker 3: I can see why it would catch on whether or
[30:00] Speaker 3: not they're talking about it the way that it's meant.
[30:03] Speaker 3: They also talk a lot online and when talking about
[30:06] Speaker 3: gut health about fermented foods like yogurts, kefir, kimchi, sauerkraut,
[30:11] Speaker 3: and they're promoted as these kind of gut health superfoods.
[30:15] Speaker 3: What do we know about the benefits of fermented foods
[30:18] Speaker 3: and how they interact with our gut?
[30:20] Speaker 2: Fermented foods can be a healthy part of our diet,
[30:23] Speaker 2: no question, but I would call them Useful foods, not superfoods.
[30:27] Speaker 2: For example, like yogurt with live cultures that has a
[30:29] Speaker 2: naturally healthier type of a biome that we know about. Kefir, kimchi,
[30:34] Speaker 2: and similar foods may provide life, either direct life microbes
[30:39] Speaker 2: that we know about their health association, not specifically conditioned,
[30:43] Speaker 2: but associations. And some of them have like direct nutritional usefulness.
[30:47] Speaker 2: But I would say choose food that you enjoy and tolerate.
[30:50] Speaker 2: Read the label because not every fermented product contains live organism.
[30:55] Speaker 4: So people, also people who are pregnant or.
[30:57] Speaker 2: Have problems with immunity or called immunocompromised should be especially
[31:01] Speaker 2: careful when consuming those products because they're more prone for
[31:04] Speaker 2: some of their possible down adverse effect or more prone
[31:08] Speaker 2: to their gut symptoms specifically. So yes, fermented foods can
[31:13] Speaker 2: contribute to a varied nutrient-rich diet, but they are optional.
[31:17] Speaker 4: I've said them useful.
[31:18] Speaker 2: They are not a substitute for medical treatment, the most
[31:21] Speaker 2: important part, or an overall healthy eating pattern. If you
[31:24] Speaker 2: have a medical condition that's diagnosed, you should seek the appropriate,
[31:27] Speaker 2: you know, route to address that with a professional.
[31:31] Speaker 3: Yeah, yeah, and I get that. There's also recommendations of, like,
[31:34] Speaker 3: eliminating gluten, eliminating dairy. You mentioned sugar, like, looking for
[31:37] Speaker 3: added sugar, and sugar in general, seed oils, alcohol, entire
[31:41] Speaker 3: categories of food, which will heal your gut, which was
[31:44] Speaker 3: somehow broken.
[31:45] Speaker 4: Huh.
[31:46] Speaker 3: When is that counterproductive versus helpful?
[31:50] Speaker 2: Elimination diets can be valuable once you want to answer
[31:52] Speaker 2: a specific clinical question. So, for example, a strict gluten-free
[31:56] Speaker 2: diet is very essential for somebody, for example, have confirmed
[32:00] Speaker 2: celiac disease, not suggested based on certain commercial tests, like
[32:04] Speaker 2: confirmed medically by a professional, because there's a lot of
[32:07] Speaker 2: overdiagnosis based on those attribute commercial tests. Avoiding lactose may
[32:12] Speaker 2: help someone with lactose intolerance. Eliminating lactose like certain specific
[32:15] Speaker 2: food allergens in somebody who has been documented to have
[32:17] Speaker 2: food allergy testing. So elimination for a specific confirmed diagnosis
[32:23] Speaker 2: by a medical professional is actually very helpful and some
[32:26] Speaker 2: of the solid evidence has been repetitively reproduced over the
[32:29] Speaker 2: past decades. The problem is just indefinite restriction without a
[32:33] Speaker 2: diagnosis or plan. If you don't have a condition for
[32:36] Speaker 2: which that elimination has been attributed, a blind elimination so
[32:41] Speaker 2: far has not been supported by science evidence that it
[32:44] Speaker 2: would help something in terms of symptomatology even by itself.
[32:49] Speaker 4: My rule in general is simple.
[32:50] Speaker 2: Eliminate with a purpose for a defined period and then
[32:55] Speaker 2: reintroduce when you safely can.
[32:58] Speaker 4: So then you can test it again.
[32:59] Speaker 2: A broader variety diet is usually healthier than just a
[33:02] Speaker 2: progressively shrinking one.
[33:04] Speaker 4: That's my theory overall.
[33:06] Speaker 3: Love that. What is something that you wish people would
[33:10] Speaker 3: not worry about?
[33:11] Speaker 2: Well, I wish people would stop worrying about every digestive
[33:16] Speaker 2: sensation that means their microbiome is damaged. As I mentioned initially, gas, bloating,
[33:21] Speaker 2: you know, changes after travel. You do not need a
[33:23] Speaker 2: perfect bowel movement every day. You do not need to
[33:26] Speaker 2: keep buying tests or supplements to chase an ideal microbiome
[33:29] Speaker 2: or preventive health measure. What I wish people would take
[33:33] Speaker 2: more seriously, honestly, is persistent changes, especially, you know, alarming
[33:38] Speaker 2: Symptoms that we mentioned like, you know, unexplained weight loss,
[33:40] Speaker 2: difficulty swallowing, etc.
[33:42] Speaker 4: etc.
[33:43] Speaker 2: And those symptoms deserve evaluation, even if it's a younger
[33:45] Speaker 2: person or even if they have attributed before to certain
[33:48] Speaker 2: lifestyle stresses or conditions. If it becomes persistent or, you know,
[33:53] Speaker 2: recurrent or like it has a repetitive movement, it's definitely
[33:55] Speaker 2: everything is worth appropriate evaluation. People should take recommended colorectal
[34:00] Speaker 2: screening seriously. It's one of the third most common cancers
[34:03] Speaker 2: now in the world. Because screening matters and it can
[34:06] Speaker 2: change lives. This is one of the preventive measures that people,
[34:09] Speaker 2: even without symptoms, should be aware of, discuss with their provider.
[34:12] Speaker 2: The larger message is reassuring. I would say support your
[34:15] Speaker 2: gut health in a varied, well-balanced diet. Non-process as much
[34:19] Speaker 2: as possible. Continuous movement. Appropriate sleep and medical check-up and
[34:24] Speaker 2: care routinely. Be curious about new science, but do not
[34:29] Speaker 2: let marketing turn your normal.
[34:31] Speaker 4: Digestion into a disease.
[34:33] Speaker 2: Just... Be mindful, but also don't be distracted by social
[34:38] Speaker 2: medias or product advertisers of certain conditions and issues.
[34:44] Speaker 3: I like that. Yeah. Be curious.
[34:47] Speaker 4: Great.
[34:48] Speaker 3: And don't let marketing cause your regular digestion to feel
[34:52] Speaker 3: like a disease. I think that's really important. Right.
[34:55] Speaker 4: It will be the source of your unhealthy gut.
[34:58] Speaker 3: All right. You heard it. Don't let the stress of
[35:00] Speaker 3: worrying about your gut health be the source of an
[35:03] Speaker 3: unhealthy gut. Remember, your gut microbiome plays an important role
[35:08] Speaker 3: in your health, but there's no magic supplement, sea moss gel,
[35:12] Speaker 3: or gut reset that can improve what your body naturally
[35:15] Speaker 3: handles itself. Definitely trust your gut. If something feels off,
[35:21] Speaker 3: have a conversation with your physician. Thank you to Danielle
[35:24] Speaker 3: Brown for having the guts to join us on Health vs. Hype,
[35:28] Speaker 3: and thanks to Dr. Mokadam for helping us get to
[35:30] Speaker 3: the bottom of our gut health. If you haven't already,
[35:34] Speaker 3: please hit the subscribe or the follow button and join
[35:36] Speaker 3: us next time on Health vs. Hype with the American
[35:38] Speaker 3: Medical Association. For more information on all the topics we're covering,
[35:42] Speaker 3: visit amahealthvshype.org. That's A-M-A-Health-V-S-Hype.org. Health vs. Hype is a production
[35:51] Speaker 3: of Ruby Studio from iHeartMedia and the American Medical Association.
[35:56] Speaker 3: I'm Trace Dominguez. Our producer is Pamela Lawrence. The show
[35:59] Speaker 3: is engineered and features original music by Matthew Ernest Filler.
[36:03] Speaker 3: Health vs. Hype is intended for educational and informational purposes
[36:06] Speaker 3: only and does not constitute medical advice, diagnosis, or treatment.
[36:10] Speaker 3: Always seek the advice of your physician with any questions
[36:13] Speaker 3: you may have regarding a medical condition.

Shows are listed from Apple Podcasts' charts and directory, and Podcast Index where it is used. Every show and episode belongs to its publisher and plays from the publisher's own feed; this site hosts none of them.