Eat right and get a good night’s rest… we’ve heard it since we were kids.  But modern medicine is now discovering that digestive health and sleep cycles may be far more critical to our aging parents mood and cognition than we ever could have suspected.

This week on Parents Are Hard To Raise…Guest medical expert Dr Felice Gersh reveals the truth about the amazing gut-brain connection.

Dr. Gersh is a true pioneer in her field… a rare combination of an award winning physician— Double-Board Certified, both in OB/GYN and Integrative Medicine— and a tireless champion of woman’s health… focusing her knowledge and skills on those aspects of women’s health that are unique, under-appreciated, and poorly managed.

She holds degrees from:

  • Princeton University,
  • the University of Southern California, School of Medicine, and
  • the University of Arizona, School of Medicine.

Dr. Gersh serves as Medical Director of the Integrative Medical Group of Irvine, California, where she leads a team of skilled holistic practitioners.

She writes and speaks internationally on integrative medicine and woman’s health, and is a favorite guest expert on numerous radio programs and web summits.

You can also hear her weekly broadcast, A Healthy Perspective, on KRLA Radio—AM 870— in Los Angeles…

Here Are Some Handy Links To Items We Discussed On This Episode 

Show Transcript

Parents Are Hard To Raise S02 E64  Transcripts

[00:00:00] The world’s becoming a dangerous place for us women. Lipstick bodyguard looks just like an innocent little lipstick. But it will instantly drop any attacker to his knees so you can get away unharmed. Lipstick bodyguard fear no evil. Get yours today only at lipstick bodyguard dot com

Announcer: [00:00:38] Eat right and get a good night’s rest. We’ve heard it since we were kids. But modern medicine is now discovering that digestive health and sleep cycles may be far more critical to a long and healthy life than we ever could have suspected.

[00:00:53] This week on Parents Are Hard to Raise… Renowned medical expert Dr. Felice Gersh discusses the shocking link between circadian rhythms, poor digestive health and mood problems as we age.

Diane: [00:01:21] Welcome to Parents Are Hard to Raise. Helping families grow old together without losing their minds. I’m Elder care expert Diane Berardi.

[00:01:30] When doctors talk about a healthy gut they’re not necessarily referring to a trim waistline, although that could play a part. And when your doctor asked you how you slept, it’s more than an attempt at polite conversation. Modern medical science is discovering the critical roles digestive health and sleep cycles play in our health and well-being as we age.

[00:01:51] My very special guest this week is Dr. Felice Gersch. Dr. Gersh is a true pioneer in her field. A rare combination of an award winning physician.. Doubled board certified both in OG/GYN and Integrative medicine. And a tireless champion of women’s health, focusing her knowledge and skills on those aspects of women’s health that are unique underappreciated and poorly managed.

[00:02:15] She holds degrees from Princeton University, the University of Southern California School of Medicine, and the University of Arizona School of Medicine.

[00:02:24] Dr. Gersch serves as medical director of the integrative medical group of Irvine California, where she leads a team of skilled holistic practitioners.

[00:02:33] She writes and speaks internationally on integrative medicine and women’s health, and is a favorite guest expert on numerous radio programs and web summits.

[00:02:43] You can also hear her weekly broadcast a healthy perspective on KRLA Radio AM 870 in, Los Angeles.

[00:02:52] And rumor has it her first book on women’s health is due out this fall which I definitely want to hear more about.

[00:02:59] Dr. Felice Gersh… Welcome to Parents Are Hard to Raise.

Dr. Gersh: [00:03:03] Well, thank you so much for inviting me. I’m so excited to be here and have the opportunity to talk about this wonderful topic of the circadian rhythm, the gut, and emotional and cognitive well-being.

Diane: [00:03:16] Well this is a great topic for us. This is something that we haven’t heard any information on. So, I know our listeners are really going to eat this up.

[00:03:28] But first could you tell us… For people in our audience that may not be familiar with the field of integrative medicine. What exactly is that.

Dr. Gersh: [00:03:39] Well that’s a great question. It should be what all medicine is we shouldn’t have to call it integrative just call it medicine. But unfortunately, the standard care that’s given is not really addressing a lot of the issues that are facing people. So integrative medicine takes into account the entire person, their environment their relationships, their activity.

[00:04:01] So we look at the emotions and the environmental toxin exposures, their sleep, their habits, their fitness, their diet, their their stage in life. So we look at everyone in their entirety… The context and everything about them.

[00:04:17] So we use a much greater tool box to help people. We don’t just use pharmaceuticals and surgical procedures. We do things involving mind body energy medicine. We use meditation and guided imagery and emotional freedom technique. We use herbal Essential oils. Homeopathy. Different forms of massage. So we look at lifestyle medicine, fitness and exercise and nutrition. So we have a really expensive therapeutic toolbox to help people to really reach their optimal state of health.

Diane: [00:04:52] So I would imagine if someone, I guess comes, into you and is saying they have certain problems… So you look at the whole person environment… Everything about them. So that must be a very initial assessment?

Dr. Gersh: [00:13:35] It is. Because what we’re doing is the opposite of what conventional medicine does, which is really trying to do what we call “ill to the Pill”… You know, rather than “pill to the ill.”.

[00:13:44] They are trying to just suppress symptoms and we’re trying to look at root causes. So we’re trying to look at really pealing the layers of the onion what’s going on.

[00:13:52] So when we have our first appointment, they are very long, because we can’t manage it like 5 or even 15 minutes. We have a timeline. We have to look at what’s been going on in this entire person’s life going back very very far to find out what their exposures are and emotional issues and traumas and you know all the different illnesses that they may have experienced.

[00:14:12] So we have to look at many many different aspects that could contribute to a person’s state of being at this moment in time. And then weave together… You know we do a lot of functional medicine testing, we look at not just the standard tests, but we look at inflammation markers, advanced Lipid testing, nutritional markers.

[00:14:31] So we look at the gut microbiome. We actually test different microbiomes. All these tests are by labs that are CLEA certified.

[00:14:39] They really will soon be mainstream, because in fact, just this week in the Journal of the American Medical Association they had a whole big section on the link between the gut microbiomes and cardiovascular health. So we know this is turning around and everything that we do in integrative medicine will soon become the standard. It’s just it’s just it takes time. Everything is slow going. And to implement it, and the problem of course is that we integrated and functional medicine recognize the uniqueness of every individual. You know like like a snowflake. And a lot of conventional medicine like to people into protocols, you know, like everyone’s the same. And everyone is really unique and different.

[00:15:17] And of course it’s so conflicting in the way that medicine approaches things. Because we know that everyone has their unique set of genes, and how they’re epigenetically expressed– how genes express themselves– can vary depending on environmental exposures. So we know everyone is unique in their way that their genes express themselves and the genes that they even have. And yet we don’t necessarily use that as much as we should in terms of creating treatment plants for people. But all that is going to change that we’re just at the forefront of this.

Diane: [00:15:45] Yeah my gosh. Because it’s true.

[00:15:47] I deal, obviously, with the elderly. And everybody just kind of groups them into “they’re old.”. You know, this is the elderly and you just expect this. So this is unbelievable because we’re dealing with so many issues with them… Urinary Tract infections, dementia et cetera. I don’t think anyone… I can’t say anyone but… Not most. You know, you go to the physician, they don’t look at the whole person in the environment and everything, and go back, from what you’re saying.

Dr. Gersh: [00:16:27] Well it’s it takes a lot to learn a lot of the different elements that go into that, but it really is very doable. And I really see it changing. I really hope that I’m right about that, that people will be looked at in the bigger context of their environment. And, you know, that’s one of the things that is really missed in most of the medical treatment, is looking at the the role of environmental toxicants and we live in… I hate to call it what it is… But it is kind of like “poison world.” You see it in the news, you know, the air pollution and what goes into the water and the chemicals they put into our food. And, you know, with the processing, and you know, fracking and the diesel fuels, and all the things that we breathe all the time.

[00:17:07] So we definitely have a ways to go to bring awareness. But little by little, I think it’s made… It’s really breaking into the mainstream. And programs like yours are really helping to move things along at a faster pace.

Diane: [00:17:21] Thank you. We try.

[00:17:22] And now… What Are some of the functions of the gut which relate to maintaining a healthy mood?

Dr. Gersh: [00:17:27] Oh, it’s so amazing. They now have what is referred to… And sometimes it’s expanded… But at the minimum it’s called the [00:17:34] gut brain axis. [1.3] [00:17:36] It’s the incredible link between the gut and the brain and it’s bi-directional.

[00:17:41] So for example, if someone eats a very poor diet, they have lack of fiber. And Polyphenols… Those magic ingredients that are in fruits and vegetables called polyphenols.

[00:17:50] If it doesn’t have the right ingredients in it, to nurture and feed that bacteria… And there’s even more complex, but we’ll talk about the bacteria that live in our gut. And the massive numbers that live in the colon in the trillions.

[00:18:03] There is bacteria that live everywhere. I mean, we don’t have any sterile parts of us.

[00:18:07] I was taught in medical school and you probably heard the same thing… That there are parts of us that are sterile. But there are no parts that are sterile. It’s all a question of how many bacteria are are in that area.

[00:18:17] Well there’s trillions in our gut and there’s lots in our mouth and there’s less in our stomach and there’s some in the small intestine. And these are all different specific microbiomes.

[00:18:26] Well, it turns out that the bacteria that live in our colon are a special microbiome– that they ferment the food that we eat. And of course, we have to eat the right foods that are fermentable… Types of fibers that are found in complex carbohydrates like whole grains and also into fibrous vegetables like root vegetables and so forth.

[00:18:46] And then the other things… Those magic things I mentioned the polyphenols that you find in the fruits and the vegetables, they all combine to nurture the microbes that we call the microbiomes. Because they need to be healthy. It’s actually now viewed as a unique origin that these microbes create within us like an advanced civilization that we didn’t really know lived there.

Diane: [00:19:06] Wow.

[00:19:06] And when we come back we’re going to hear more about this…

Lipstick Bodyguard: [00:19:08] I want to tell you about my friend Katie. Katie is a nurse and she was attacked on her way home from work. She was totally taken by surprise. And although Katie is only 5 feet tall and 106 pounds, she was easily able to drop her 6 foot 4, 250-pound attacker to his knees and get away unharmed.

[00:19:24] Katie wasn’t just lucky that day. She was prepared. In her pocketbook… A harmless looking lipstick, which really contained a powerful man-stopping aerosol propellant. It’s not like it was in our grandmother’s day. Today just going to and from work or to the mall can have tragic consequences.

[00:19:39] The FBI says, a violent crime is committed every 15 seconds in the United States. And a forcible rape happens every five minutes. And chances are, when something happens, no one will be around to help.

[00:19:50] It looks just like a lipstick. So no one will suspect the thing. Which is important since experts say, getting the jump on your attacker is all about the element of surprise.

[00:19:59] Inside this innocent looking lipstick… Is the same powerful stuff used by police and the military, to disarm even the most powerful armed aggressor.

[00:20:06] In fact, National Park rangers use the very same formula that’s inside this little lipstick to stop two-thousand pound vicious grizzly bears dead in their tracks.

[00:20:15] It’s like carrying a personal bodyguard with you in your purse or your pocket.

[00:20:18] Darkness brings danger. Muggers and rapists use darkness to their advantage. We all know what it’s like to be walking at night and hear footsteps coming at us from behind. Who’s there? If it’s somebody bad will you be protected? Your life may depend on it.

[00:20:32] My friend Katie’s close call needs to be a wakeup call for all of us, myself included.

[00:20:36] Pick up a lipstick bodyguard and keep it with you always.

Announcer: [00:20:38] You’re istening to Parents Are Hard to Raise. Now, thanks to you, the number one eldercare talkshow on planet earth… Listen to this and other episodes on iTunes, Google Play, And on demand… Using the iHeart Radio app.

Diane: [5160:09:01] We’re back with our very special guest, Dr. Felice Gersh.

[5160:09:07] And so, Dr. Gersh… Before the break we were talking about the functions of the gut that relate to maintaining a healthy mood.

[5160:09:17] Absolutely. So what I was mentioning is that we we have this unbelievable community of microbes that live inside our gut and are concentrated in trillions of numbers in terms of different colonies of bacteria in our colon. And we did not know they were there but they are incredibly important to our mood.

[5160:09:35] It turns out that when we feed them the right foods like the fibers and the polyphenols they ferment and they create these intermediates that are called short chain fatty acids. And these actually act as both food to the gut and signaling agents to our livers and to other organs and actually to the brain itself.

[5160:09:54] One of the short chain fatty acids which is the fermentable product is called butyrate. And Butyrtae actually can transfer into the bloodstream and to the brain directly. It can also trigger signaling agents in the Vegus nerve, which is a piece of the brain which is called a nerve. It’s almost like a piece of the brain that comes down and it innervates with nervous signaling to the gut, to the heart, to the bladder, to the skin, and to the blood vessels. And it can control a great deal of mood. It makes you feel stressed or it makes you feel calm. And there is this incredible interaction between the products that are created by the gut bacteria–the microbes– and the actual brain health and function itself.

[5160:10:41] And so, we know that by changing the diet and giving the microbes the right foods and helping to nurture and create the proper microbiomes to have diversity… Actually you need a lot of different types of bacteria, so we call it diversity. So you have to have the right numbers and the right diversity… The right types. You can actually completely impact directly how the brain works both in terms of mood and cognitive function. It’s an amazing new connection that until just a few years ago we had no clue that this existed.

Diane: [5160:11:10] Yeah. This Is amazing. So now, this is very individual as well? I mean, what a person would eat or…

Dr. Gersh: [5160:11:23] Well, it turns out that there are definitely different microbiomes in different people and they are labs that have actually accumulated data, so we’re learning. And it’s still really at the infancy. But there are certain microbes that we find are more beneficial and tend to be really important certain lactobacillus and different other bacteria in the grand positive and gram negative families. The bacillus and so on, that are really important but, you definitely need to have a huge variety. So we say Eat across the colors of the rainbow.

[5160:11:54] So your unique status… And there’s actually differences between males and females. So everyone is going to have their own little footprint of their microbiomes. But to keep the healthiest one for you, you need to eat a diverse diet of lots of different fibers and different types of plants and different fruits, but different definitely lots of vegetables and whole grains. All of these wonderful foods help to nurture and grow the right microbiomes that will be the right one for you.

Diane: [5160:12:19] I see. And does age play a part at all?

Dr. Gersh: [5160:12:23] Absolutely. It turns out that there are several things that come into play with aging. So one is, of course, hormone changes. It turns out that estrogen is very key to gut health and to the microbiome itself. Now, it turns out that the estrogen is so important to the gut that it actually is made in the gut. There are actually tissues in the in the intestinal tract that make their own estrogen. And of course for women it’s also compounded by the estrogen that’s made by the ovaries. But unfortunately of course for women with menopause, the ovaries ceased to make estrogen and the gut does not pick up the slack. It does not.

[5160:12:58] That’s one of the reasons why after menopause women have so many more gut problems, and they tend to have much higher… Before menopause women have lower rates of GERD or gastroesophageal reflux problem with the heartburn…women have less. But after menopause, women have more than men. After Menopause women have more colon cancers of course and more problems with their intestinal tract. And that’s because the estrogen levels in the gut decline. And then along with that we have other issues that are somewhat related and somewhat independent that have to do with making digestive enzymes and proper amounts of stomach acid.

[5160:13:34] So they pool that into what they call now the [5160:13:37] “aging gut.” [0.7] Isn’t that a lovely term?

[5160:13:39] So… the Aging Gut. So, it changes. So with aging, the microbiome changes, the ability to digest changes, an appetite tends to change. And people sometimes don’t eat the right foods. As you probably talked about many times. So the dietary choices are often very bad, you know, lots of sugars or processed foods. And people are tired they don’t want to cook things from scratch. And unfortunately, the nutritional status can suffer greatly and nutrition for the whole body and the nutrition for the gut microbiomes.

[5160:14:04] So what happens is that with aging, there tends to be less of a mucus production that is very coating and protective in the colon. And you get what’s called impaired gut barrier function also known as “leaky gut.” I know you’ve heard that term before.

[5160:14:19] But what happens in elderly people… And it can happen at any age, but much more common in elderly, is that the microbial population changes it becomes more hostile it’s not the good healthy, happy type of bacteria, and these unfortunately you know negative guys that are growing they make toxins. The official name is [5160:14:41] Lipopolysaccharides, [1.6] but they’re also known as Endotoxins… Toxins from within.

[5160:14:45] And the barrier to keep these toxins within the gut becomes impaired. That’s what we call leaky gut. And these can actually cross out into the body itself. And where the immune system lies, right around surrounding the gut. And the immune system sees what’s going on–all this inflammatory toxic endotoxin coming into that area, and it creates inflammatory products… it creates inflammation. And this inflammation goes into the brain. It travels through the body. It also impacts on the Vegus nerve. So it’s a very complex thing, but it creates inflammation in the brain.

[5160:15:21] So we now know that inflammation in the gut can actually lead to inflammation in the brain. And we now know that psychiatric issues whether it’s anxiety or depression and also cognitive issues all related to inflammation.

[5160:15:35] And so when you have an unhealthy gut you get an unhealthy brain. And with that comes mood changes and cognitive changes and a lot of this is really very very responsible for what’s happening in elderly people.

Diane: [5160:15:46] Right. Yeah…

Dr. Gersh: [5160:15:46] And we’re not taking… so there are things that we can do to help them. And you know a lot of times these are not being done. But we can help. We we can’t turn the clock back and there’s things that we can’t do. But we can do everything we can to provide the healthiest diet. To encourage elderly people to eat more fruits and vegetables and whole grains.

[5160:16:05] And the other thing that’s been shown is that it’s… It’s two pronged. One thing is you need to eat the right food. The other is that if you eat the wrong food– they’ve shown how a really crappy diet full of chemicals, processed foods, and bad fats actually actively destroys the microbiome. So then you’re not only not nurturing but you’re actually destroying. So you know it can be very very terrible for elderly people when they eat a terrible diet and it just completely decimates the gut microbiomes. And that has a huge impact on the brain.

[5160:16:35] And so, by helping them to eat the right foods and make the right choices and then most elderly people will benefit from getting some digestive enzymes and some extra stomach acid. A lot of people think that people get acid reflux because they have too much stomach acid actually as people age it’s too little, and they don’t have enough to close sphincter at the top of the stomach, and they can’t digest their food properly, because they need stomach acid.

[5160:16:59] So giving them some a little bit… And this is all over-the-counter products that you can use. So it’s always best to do it with a doctor’s supervision, of course we know, but these are things that can really make a difference.

[5160:17:09] And you know, somebody came up with– how long ago– the idea like the route to a man’s heart is through the stomach. How about…”The route to the brain is through the stomach.” What you eat dramatically impacts on how the brain is going to work.

Diane: [5160:17:24] And you know, I know a lot of children I will say to me– children of aging parents– “I can’t get my mom to eat or I can’t get my dad to eat… I can’t get anything in them.”

[5160:17:35] And I know you know a product a lot of people use Ensure or things like that. Do you have any suggestions… what we can do you?

Dr. Gersh: [5160:17:45] Absolutely. Well number one, start with a good breakfast. OK… That’s another very important point. And you know we can touch on the whole circadian rhythm. It starts with the time that you eat as well. That helps tremendously. So we want to get a good breakfast a lot of people, any age, they skip breakfast. It turns out that it really is important and it affects the way that the body works, the way the GI tract works, and the appetite for the rest of the day. So try to get a nice breakfast.

[5160:18:11] Now, you’ve right. As people age there is aging of the taste buds. Right? And of scent.

Diane: [5160:18:16] Right.

Dr. Gersh: [5160:18:17] You know the sense of smell. And so the food just doesn’t appeal. So you know, what I say is OK then if you need to sweeten it then you need to sweeten it if that’s what makes it appealing. So, as much as you can use fruit, right. So fruit is naturally sweet, but fruit has in it all the polyphenols and the fiber. So if you can use fruit to sweeten things up like if you make a big bowl of a whole grain cereal, and then you put in pieces of fruit, you know that would be great.

[5160:18:43] And if you have to do something else to sweeten it, use something that actually has medicinal purpose, like a very high quality honey or a high quality natural maple syrup. They actually have antioxidants in it. And there’s actually some data that really high quality… So this is really high quality stuff… Not the stuff that you get that may be in a plastic bottle… But Really high quality honey can actually help heal an injured gut.

Diane: [5160:19:06] Really?

Dr. Gersh: [5160:19:06] They use it in wound healing all the time.

Diane: [5160:19:09] Yes.

[5160:19:09] Like the Manuka honey from New Zealand which has incredible healing properties. So it’s ok if you use small amounts of like really high quality honey. If that makes it more palatable. And also maple syrup real maple syrup has in it all kinds of amazing properties for healing as well and nutrients. So a little bit of that is actually not a bad thing if that helps to eat those foods.

Diane: [5160:19:32] Dr. Gersch we need to have you back. Because there’s so much more. And I’m sure everyone is very interested, as I am. So will you be able to come back? And I have so many more questions to talk to you about.

Dr. Gersh: [5160:19:47] Oh. I would love to, because I have so many more answers. Absolutely!

Diane: [5160:19:47] That’s perfect. Could you just I know my listeners they want to learn more. How can they reach you?

Dr. Gersh: [5160:19:52] Well I have a Web site it has my name FeliceLGershMD.com And you can certainly go to my Web site. You can sign up… I’m going to be putting out a weekly newsletter. So please sign up and you’ll get my newsletter. And you can access through the Website, a lot of my previous blogs and reports and other kinds of interesting information.

Diane: [5160:20:12] Perfect.

[5160:20:12] I hope this episode helped you with something you may be dealing with. Please keep emailing your questions and comments and share as much detail as you can, because listeners come here each week for insight and inspiration, and your story can also help someone else.

[5160:20:25] If you found something helpful in this episode subscribe to our show on iTunes and iHeart Radio. And I’d be so grateful if you’d share this episode with your family and friends.

[5160:20:34] Parents Are Hard to Raise as Counterthink Media production. The music used in this broadcast was managed by Cosmo Music, New York, New York.

[5160:20:40] Thank you so much for listening and I look forward to reading your comments and can’t wait till we meet up again on the next episode of Parents Are Hard to Raise.

[5160:20:48] Till then… May you forget everything you don’t want to remember and remember everything you don’t want to forget.

[5160:20:52] See you again next week.

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