The gut does more than just digest food… but as we age, it’s Katy Bar the Door!
Doctor Felice Gersh discusses the link between the aging gut and chronic disease, and how we as children of aging parents can choose between sickness and health as we age.
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Parents Are Hard To Raise S02 E85 Transcript
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Announcer: [00:00:37] This week on parents are hard to raise health and wellness expert Dr. Felice Gersh is back with more great advice to keep our aging parents and us living our lives to the fullest. Parents are hard to raise is now available on Spotify and it’s 180 million monthly subscribers.
[00:01:08] Welcome to Parents are Hard to Raise. Helping families grow old together without losing their minds. I’m elder care expert Diane Berardi.
[00:01:18] Longtime listeners will recognize my next guest. Mostly, because she’s among my favorite guest medical experts.
[00:01:24] Dr. Felice Gersh she’s a true pioneer in her field, a rare combination of an award winning physician double board certified both in G Y N and integrative medicine, and a tireless champion of women’s health. She holds degrees from Princeton University, the University of Southern California School of Medicine and the University of Arizona School of Medicine. Gersh serves as medical director of the integrative medical group of Irvine California. She also writes and speaks internationally on integrative medicine and women’s health. You can hear her weekly broadcast, a healthy perspective, on KRLA Radio AM 870 in Los Angeles. Felice…. Welcome back to Parents are Hard to Raise.
Dr. Gersh: [00:02:13] It’s such a pleasure to be back.
Diane: [00:02:15] Well I’m so glad to have you. And you’re always an amazing wealth of cutting edge information. So tell us what have you got for us this week?
Dr. Gersh: [00:02:25] I thought we would talk about a problem that is so prevalent among people as they age. And that is what we call the “aging gut.”
It’s central to all of health of course is the intestinal tract. And it starts everywhere from the mouth all the way to the anus. And we have troubles as we age, as hormones change and the whole environment changes, the microbiome the enteric nervous system. So I thought we could start literally at the top work our way down and maybe anywhere in between.
Diane: [00:02:57] I think that’s perfect. So I guess the gut actually does something other than digest food.
Dr. Gersh: [00:03:06] Well that is a major job, but we have discovered over the last oh maybe decade or so, that it is more like the control center of the body. I think of it as the Trojan horse. And people look at the outside and think oh that’s what it is. But no. It’s what’s going on inside. These little critters just like advanced mysterious complex civilization of microbes that lives within the gut and it’s varied from every little level of the gut, it changes and it changes with the time of the day and it changes with the seasons and travel. It’s amazing. And it really controls our immune system and our immune system ultimately now we understand.. we’ll have to talk about that another day… Is really what triggers how everything in our body works together. And it really starts with the gut which ages as everything else does.
Diane: [00:04:04] I guess yeah everything has to age doesn’t it.
[00:04:09] And our job as medical professionals is to slow the process. We can’t stop it, but we want to control and slow it.
Diane: [00:04:17] So I guess start from the top. Right.
Dr. Gersh: [00:04:22] Start with the mouth. I know you’ve heard this that people lose their teeth. Things change in the mouth. Well it turns out that the mouth itself is key to digestion. Will focus on that, because it’s actually key to cardiovascular health. We can talk about that another time too. But if you think about just the digestion part and what happens in the mouth, you have special mouth bacteria we call it the oral microbiome. And these bacteria work synergistically with our body to make things right. So they make certain enzymes called Reductase that actually break down the nitrates, which are so important.
Nitrates are found in green leafy vegetables and beets, the beet roots. And people you probably heard drink a lot of beet juice. Like why is that. Because it has these nitrates. But the nitrates by themselves are not useful. They have to be broken down into nitrites and that can only be done by mouth bacteria.
[00:05:24] So if you like don’t have the right mouth environment, you have inflammation of your gums, your teeth are falling out, you know you have chemicals in all these different appliances… And these are the things that happen, you know, people have all these different foreign materials in their mouth… They’re going to impact on the microbiome.
[00:05:43] And if you can’t create the nitrites then ultimately down in your stomach and down even further you convert the nitrates into nitric oxide which is a gas. It’s one of the few things in our bodies that we want to be a gas that actually acts as an antioxidant in a signaling agent that is really essential for the health of our cardiovascular system and our brain and everything.
[00:06:07] So that’s why we have to work very hard to go to the dentist and keep a really healthy mouth not use chemicals as much as possible don’t use chemical mouthwashes and chemical toothpaste and really try to keep the healthiest mouth you can have.
[00:06:23] And then as well, you got to put in the nitrates you’ve got to eat those green leafys and the kale and such and the beets. And I know I myself eat beets every day.
Diane: [00:06:36] Do you, really?
Dr. Gersh: [00:06:36] I Do. And they’re wonderful. And you can always buy beet powders now and beet juices. It’s really popular because you don’t know why they’re why they’re buying beet juice. And it’s really that you know it has other nutrients, polyphenols, but it’s primarily this nitrate that is going to really help your body stay in in metabolic health.
[00:06:58] So we start with the mouth. That’s really important, of course. So then, if we jump down to the stomach.We’ll kind of bypass the esophagus for the moment…
What happens as we age, and people don’t realize that, they just think it’s just the exact opposite is that our stomachs make less stomach acid not more. And it takes stomach acid to cause the sphincter, that’s at the top of the stomach where the stomach joins the esophagus, it’s to close off so you don’t have acid regurgitating into your esophagus. But you need to have enough acid for that to happen. And as people age they make less stomach acid and that’s why after menopause, for example, for women they have to dramatic escalations in the incidence of gastro esophageal reflux and terrible heartburn.
[00:07:47] And then the doctors think, a lot of them, that oh you’re making too much acid and then they give them drugs to suppress acid production. But actually the problem is they’re not making enough stomach acid. And when you suppress the acid production you increase cardiovascular risk many other problems and you do not suppress the reflux. All you do is you take the acid reflux. So fully one third of people continue to have very bad symptoms. But now you’re not going to digest your food even more. You have more trouble. And the acid in your stomach kills bad bacteria so that you don’t end up with overgrowth of bacteria in your small intestine and also very toxic bacteria like Clostridium which is really harmful especially for the aging population people over 60 have some terrible problems when they get C. difficile. That particular bacteria. If you don’t have enough stomach acid you’re more likely to acquire it.
[00:08:46] You can see how important the stomach is just for the stomach acid. It’s such a big deal. And that’s pretty universal that stomach acid production goes down as we age, particularly for females. It’s pretty abrupt sometimes as menopause takes hold and for men it’s more a gradual.
[00:09:05] That’s a big deal with the stomach. And then as we work our way down you know we start having changes in the enteric nervous system. That’s the muscular system that works with the nervous system to keep things “moving” at the right pace. That’s that people have a lot of trouble with that. You know it’s just it’s a very complex neurological system to keep things right. That’s why sometimes people call it the second brain. There’s more neurons in the G.I. tract than in the brain. And they change. They age as well. Like the brain ages. The G.I. neurological system the enteric nervous system ages and you get problems with Peristalsis. And it can be very very helpful if you eat lots of fiber. And one of the problems is as people age they tend to eat more processed food, because it’s easy, it’s less expensive and sometimes that’s where they get it. You know where they live or things like that. You know it’s just easy and cheap. And that’s like not what they should eat. They should eat lots of root vegetables and whole grains and lots and lots of vegetables again and lots and lots of vegetables and hydrate.
[00:10:15] That’s another problem as people age they often don’t drink enough and you need all of that because you need extra help when you’re nervous system of your gut is troubled.
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Diane: [00:13:03] Remember there are so many new ways to listen to our show.
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[00:13:30] So we’re here with Dr. Felice Gersh and we’re talking about the aging gut.
[00:13:36] So you were talking about fiber and that we need to eat fiber and hydrate.
Dr. Gersh: [00:13:43] Yes I definitely don’t want to be all doom and gloom.
[00:13:46] So glad we got we got the bad news out of the way. And now we can talk about some solutions.
[00:13:52] So, if we start by getting the right diet and the other thing that is so you know you want to eat lots of natural foods. Of course we talked about this for everything and it relates to everything right. You want to eat real food try to get organic. They just had an article that came out last week which was hardly a shocker that if you eat organic foods your chances of cancer go down. And after menopause and with aging men and women of course gut cancer, colon cancer, stomach cancer is all these really escalate and we want to keep those down. We want to keep that under control. So you’re eating the right food is very helpful, trying to go organic.
[00:14:34] And then there’s some herbal teas and supplements that can also help. Some of the best teas to drink as we age are ginger tea. Ginger really can help with as an anti-inflammatory and also it helps with the gut motility. It helps. Yes. And so it’s very nice. And if you like to drink a little bit of these flavored vinegars, like you know, you have strawberry vinegar and blueberry vinegar… as like an aperitif. If you put like a couple of tablespoons and you can put it even in like some Pellegrino which by the way is very good because it actually has a lot of the minerals in it like lithium which are so good for our brains.
[00:15:14] And you can have a couple of teaspoons start with and even work up to a couple of tablespoons if you like the flavor of these vinegars and it acts to really help stimulate some of the stomach acid. So that will help. And it really helps us an aperitif. So that would be a nice thing to start at the beginning of the meal and work your way up even just start with a teaspoon if you don’t like the flavor of vinegar.
[00:15:36] And chamomile tea is also another wonderful and it’s calming. It also helps with the GI tract. And then some of the herbals are coating. Like if you get acid reflux we don’t want know if we really want to try to avoid those acid-suppressing drugs would be Slippery Elm. And you can buy them as lozenges. That’s actually the first herbal that was ever approved by the FDA it was Slippery Elm.
Diane: [00:16:02] Oh really?
Dr. Gersh: [00:16:03] Yes. And you can get it as capsules. You can actually open capsules dissolve the powder into teas and drink it you can get it as a lozenge and that’s nice. And you can buy a special form of licorice called D G L. And you can chew it. And it also coats and soothes the entire esophagus and it goes into the stomach and it’s very very good if you get that acid reflux kind of a problem. So those are very very helpful as well.
Diane: [00:16:34] You know those flavored vinegars is that’s a great idea. I went to buy natural honey and they had a stand of flavored vinegars and I think I got a lemon flavor and it’s really good, but I never thought you know OK put that in some Pellegrino. That’s great.
Dr. Gersh: [00:16:52] It’s wonderful. I’m glad you mentioned the honey. A lot of you get really low brow you know really mass produce honey that is no better than drinking high fructose corn syrup, it’s not any better. But if you get really high quality honey, it’s actually very very healthy for the gut. It has anti-microbial properties. It’s coating. it’s Soothing. So actually that is a very good thing for elderly everybody. Know it would benefit. You just don’t do it if you’re under the age of one. But I don’t think that’s our target audience.
[00:17:26] Yes really high quality. I was just in New Zealand not long ago giving some lectures and I got some of the Manuka Honey. It’s you know very very powerful as a medicinal and health aide.
Diane: [00:17:42] Yeah. I keep reading, some hot water honey and lemon.
Dr. Gersh: [00:17:50] Yes. That is that is actually… You know a lot of these old we’ll call them old fashioned rather than, I’m not gonna call them wives’ tales, ’cause they’re not, they’re actually legit.
[00:18:02] And for example, this is another really good one. If you get bloating and sort of indigestion chew on fennel seeds and anise seeds. Yes, it’s really helpful. Very very helpful. And if you get, if you tend more the opposite and you get more like diarrhea, ’cause a lot of people get constipation, but encapsulated peppermint oil works as well as the pharmaceutical Lomotil which has other toxic effects. So you can have some encapsulated peppermint oil, and that works really well for a diarrhea kind of a situation. So yeah we’re trying. We’re getting more and more back to more natural things as we really see the full picture of what some of the side effects are the pharmaceuticals, for a long-term use especially.
Diane: [00:18:49] Yeah. You know we used to always eat fennel. You know… Holidays. My family always just had that at the end of a meal. But actually it’s probably a good idea.
Dr. Gersh: [00:18:59] Well it somehow became a family tradition and it was based in scientific medical fact. That is great. And the other things I just want to make sure people know is that they should be taking probiotics.
Diane: [00:19:14] OK.
Dr. Gersh: [00:19:14] You can also eat probiotics. And you know there are some wonderful probiotic foods and one of the ones that almost no one in the United States eats is called natto which is a fermented soy product which you get the probiotics. You also get vitamin K 2 which is at the unheralded vitamin that is important not only for bones, a lot of people do know that that’s really critical for bones and one day you know we’ll talk more about bones because how big a deal is that. But it’s also found to be important for the cardiovascular system. So you can do stuff with supplements, which I do use a lot of supplements, but of course you want to foundationally start with these foods which have your everything plus, so you get the probiotics plus. And then I’ll give almost all my patients over 65 some digestive enzymes. That can really really help a lot, because our digestive enzyme system really also goes a little kaput and so we don’t make the digestive enzymes. And that gets back to the foundational point of the gut you know the one that you started with, digesting food.
Diane: [00:20:20] Right.
Dr. Gersh: [00:20:21] Your you can’t run any of the machinery if you don’t have the nutrients and that becomes malnutrition in the elderly is such a huge deal. And often choose the wrong foods. And but then when they eat it if they don’t absorb it what good is it.
Diane: [00:20:34] Right.
Dr. Gersh: [00:20:35] You know so digestive enzymes can really help.
Diane: [00:20:38] Now that natto is it N.A.T.O?
Dr. Gersh: [00:20:42] two “t’s”.
Diane: [00:20:42] Two t’s. OK. And where would you find that?
Dr. Gersh: [00:20:46] You know, I am in Southern California. We have lots of Asian food stores. How can you know I think you can buy everything online. So you don’t… If you’re in an area that isn’t packed with Asian food stores like my area then I think you could probably go online and somebody will ship it to you.
Diane: [00:21:04] Now, that contains a lot of vitamin K 2. Now what about people on blood thinners?
Dr. Gersh: [00:21:12] That’s a very interesting story.
[00:21:14] So the biggest problem for them is actually Vitamin K1. And so the Vitamin K 2 has far less. The other thing you can do is get a supplement which is called M.K.4. So vitamin K is a family of vitamins just like Vitamin E is actually a family of vitamins and B is. So people think it’s one but it’s not one and it’s vitamin K 1 that can affect the blood thinning drugs. And the vitamin K 2 has minimal effect. And if you want to do it as a supplement and as a supplement it usually is not a problem if you get MK4. There’s a little bit with MK 7. But any time anyone is on Coumadin something like that more and more the doctors are using the other blood thinners that don’t have the the issues that Coumadin has, you know that the warfarin the more we want. Of course you have warfarin, Coumadin the same. So we want definitely everyone to get checked. And anytime you make any dietary changes that are significant when you’re on Coumadin you really have to watch because it interacts with just about everything.
Diane: [00:22:26] Yeah exactly. And that’s what I was thinking of.
Dr. Gersh: [00:22:29] Yes. So you have to be you have to be careful with any kind of dietary change when you are on those drugs. You know that’s that is a very unique situation for sure.
Diane: [00:22:39] I have to tell you my father he’ll say and I don’t know he just turned 90 and…
[00:22:47] Oh! Congratulations.
[00:22:47] I Know. Thank you. And he’ll say… Yeah, I’m always thirsty. And I say, well Dad are you drinking? “No.” [laughing].
[00:22:57] So maybe… You know he goes, “well, water.” And I guess because it’s boring. Right?
Dr. Gersh: [00:23:06] It’s boring. And I definitely want more and more studies actually have shown that it’s hard to believe as it is that artificially sweetened beverages are even worse for your metabolic situation your cardiovascular health and diabetes. It’s actually worse than drinking high fructose corn syrup soda, which I am not encouraging. I’m just saying, don’t drink either one. And that’s we’re actually getting back to a little sweetener like a really high quality honey if they really want something a little sweetened, high quality honey or the real maple syrup not the phony baloney. Real maple syrup has actually quite a bit of polyphenols and antioxidants in it. And a little bit of sweetener with that type of sweetener into a drink because we got to get them drinking and you’re right they just will sit and they’ll dehydrate.
Diane: [00:23:58] I know.
Dr. Gersh: [00:23:59] ‘Cause it’s too much trouble and it’s boring. And one of the teas that I think is naturally sweet. I think it’s really good actually two. One is Rooibos. I think that’s an herbal tea ,has no caffeine, and it has sort of a natural sweet taste to it. Oh hibiscus tea a lot of hibiscus which is a form of flour, also it’s kind of naturally sweet. And Kava Kava which is great for anxiety is also naturally sweet.
[00:24:26] So some of these teas they might like and you can actually make them hot you can make them cold. And that will go a long way to feeling better.
[00:24:34] You know in terms of hydration, the brain needs that fluid they’re going to get you know blurry brain fog and everything you know just from getting dehydrated and of course the gut will be in big trouble. And we just can’t afford constipation and it’s such a big problem in the elderly.
Diane: [00:24:56] It is.
Dr. Gersh: [00:24:56] And the bloating and all that. Then they don’t want to eat it. And it’s a terrible downward spiral.
[00:25:02] The other thing that can be healthful, and some of them may need a little help with this, is to do castor oil tummy packs.
[00:25:09] So you take castor oil… You’re not drinking it. Do not drink it. No don’t drink it. [laughing] [00:25:14] You rub a thin film over the abdomen. Then you put flannel over the abdomen on top of the castor oil and then you put heat on that. And it is so wonderful and so soothing for them. And it actually is very anti inflammatory and it absorbs right through and it can be very very soothing for elderly people.
[00:25:37] Of course any age you know if they get like stomach cramps and they have indigestion. It just doesn’t they feel worse after they eat and then they don’t want to eat. And this can be very very helpful.
[00:25:47] The other thing is to try to get them to have a nice big breakfast. Because that’s when their body is most designed to accept food.
Diane: [00:25:55] OK.
Dr. Gersh: [00:25:56] Most elderly people sort of know, don’t eat late at night. That’s why they have the early bird specials and such. [laughing].
[00:26:02] But they often for breakfast they just have some kind of processed carb. You know some box cereal or toast or English muffin or something. Put like jelly on it or something. That is not the best breakfast for them. They’re not getting any nitrates they need to make the nitric oxide. They’re not getting any anything. You know that’s like nothing.
Diane: [00:26:23] Yeah.
Dr. Gersh: [00:26:24] You know try to get… I wish people would do something like vegetable soup or bean vegetable soup things like that for breakfast or…
Diane: [00:26:33] You know that’s a great idea. And I bet though it’s hard to get the elderly to say they’ll have that. [laughing].
Dr. Gersh: [00:26:40] [laughing] It’s hard at any age. But we have to be open to change.
Diane: [00:26:43] Oh my gosh. I can’t believe we’re out of time. I hope you got something out of this episode. I know I did. I love getting your e-mails and questions so please keep sending them to me.
[00:26:56] You can reach me at Diane a Parents are Hard to Raise dot org or just click the green button on our home page.
[00:27:02] Parents are Hard to Raise is a CounterThink media production. The music used in this broadcast was managed by Cosmo Music, New York, New York.
[00:27:10] Our New York producer is Joshua Green. Our broadcast engineer as Well Gambino. And from our London studios, the melodic voice of our announcer, Miss Dolly D.
[00:27:19] And I have two favors to ask, as I ask every week. Please help someone else find the show. Show them how to find it. And if you like the show please give it a five star rating, because that will help other people find our show as well.
[00:27:34] Thank you so much for listening. Till next time…
[00:27:35] May you forget everything you don’t want to remember and remember everything you don’t want to forget.
[00:27:40] And we thank you so much Dr. Felice Gersh and you’ll be back. See you again next week.
Dr. Gersh: [00:27:46] My pleasure.
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