The Surprising Science of Pooping: Why Most Americans Get Fiber Wrong

Good morning, Hank. It's Tuesday. Every now and again, you read a book that truly changes your life. I always say that books can be like mirrors or windows. They can be mirrors that reflect your own experience back to you and help you understand it in a new or deeper way. And they can also be windows into other people's experiences or Hank, they can be windows into your own digestive system. Like this book, You've Been Pooping All Wrong That Changed My Life. This is not an ad or anything. This book just permanently changed my life and the way I engage with my own pooping. So several months ago I saw Dr. Trisha Pasicha give a talk and afterwards I came up to her and I was like that was very impressive and interesting and I learned a lot and she

was like thanks do you want to read my book and I was like uh yeah I mean a lot of people asked me to read a lot of books Hank and honestly I came home from the talk and I was like I'll read five pages of this and then uh you know move on with my life. Except I didn't read five pages. I read the whole dang book and I've read it again because like I said, it changed my life. So, first off, it turns out I have been pooping all wrong because like 95% of Americans, I don't get enough fiber. And I know Hank, you've been prattling on about fiber supplementation for years and years. But when Dr. Trisha Price makes the case, I don't know, it's more compelling to me than when my little brother does. So,

now I'm getting more fiber, which has dramatically improved my pooping. But also, secondly, Dr. Pasichia isn't just a gastronurologist. She's actually a neurogastroinerologist. She studies like the relationship between the brain and the gut and the gut brain information axis. And that is of some interest to me as readers of my book Turtles All the Way Down might know. Like I have long been troubled by the fact that about half the cells inside my body are not in fact me, but are bacteria and other organisms that colonize me and that those bacteria release like chemicals into my gut that change the way that I think. And in this

book, Dr. Preser writes about the relationship between the gut and the brain and how the gut does some thinking. And that fascinates me. But then finally, Hank, the third way this book has changed my life is that it has destigmatized pooping. Now, Hank, on some level, you've always had to destigmatize pooping a little bit because you have ulcerative colitis and so it's just like a part of your life to poop a lot. But for me, it has always been a deep well of shame. Like over the last 19 and a half years on Vlog Brothers, I have discussed almost everything that you can discuss, but you can go back. I don't talk about pooping much. And in a way, the stigmatization of poop makes sense, right? Like it's dirty. It often happens in private, etc.

But it also leads to delays in care and very real actual health problems. Like a lot of health rellated stigma, it is a social problem that becomes a biomedical problem. So anyway, after I read the book, I asked Dr. Pricia, hey, will you come on my YouTube channel and talk to me about poop? And she said yes. I had a couple questions for her, but one big one. Is it possible that my OCD is in fact caused on some level by the bacteria that colonize me and is a problem of my gut as much as it's a problem of my head. Let's talk about gut brain research real quick if we can because longtime viewers of my channel know that I'm obsessed with the gutbrain information axis. And this is actually

what you study when you're not writing the book. You've been pooping all along. You are a researcher who studies the conversations that our guts have with our brains. Yeah, that's right. I have been studying how the gut and the brain communicate with each other for about 20 years. But it's an old field. It's not something that just popped up in the last couple decades. People have known how impactfully the brain influences the gut for like more than hundred years. It's within the last couple decades that we're realizing how much the gut influences the brain. And that's really where I think the excitement is.

This is a question that I've been wondering for many, many years. Is my OCD caused by my bacteria or is it caused by my brain? Yeah, that's a fantastic question. It's like the question that keeps us up at night. And I think the short answer is that it's not as simple as like the gut microbes acting like this puppeteer pulling the strings. But I do think it's safe to say that the gut microbes and other aspects of your GI tract, they're creating this neurochemical weather in which our thoughts are formed, in which our moods are formed, and that can influence our OCD and other disorders. So, it's not that they're

thinking for you and like our thoughts are formed in our cortex and they're not directly causing behaviors without a lot of other inputs, but they're definitely a big part of the conversation. It's kind of a relief to me to know that my bacteria are not actually having thoughts for me because that's the way that I've always constructed it. That it's a little more complex than that. That's sort of helpful to me. But there is an extent to which my microbiome and my gut is informing what happens in my brain. Yeah. And you're using brain to mean brain in your head. But when I use brain, I think about the brain and our guts. Like I think about the fact that our gut is its own brain. And I say that

because it has 500 million neurons that are doing a lot of the same things that brain and our heads do. Like it's producing most of your body's serotonin, most of your body's dopamine. And then those microbes are also producing those same neurotransmitters. And how those neurotransmitters are broken down, whether they go up to your brain or whether they stay in the gut is all being influenced by those microbes. And so in a human like you and I, it's not always so onetoone about like, okay, this exact microbe is the exact one that's producing the dopamine that's making you feel this way. But, you know, it might be interesting to learn that if we look at mice, like there have been these mice studies of OCD, um, and if

you took healthy mice, you wiped out their microbiome with really strong antibiotics, and then you gave them a fecal transplant of people who have OCD and then another group who doesn't, a control group, mice who get the fecal microbes of somebody who has OCD, will start to mimic behaviors that we think of as being consistent with OCD. like they'll start to engage in maybe repetitive grooming behaviors. They'll start to show more signs of anxiety. And in a mouse, that actually does tell us that yeah, there is this one to one almost causal link between the microbes and this behavior and this kind of actions and thoughts and mood in a human. And that's true of a lot of microbiome studies is that in mice and

these translational studies, the mechanism feels really clear-cut. Then when we take a step back and look at humans, it doesn't quite pan out that way because it's so complicated the world in which we live and all the other factors that go in there. But you know, we do know that in humans, now we're just talking about humans, in humans who have OCD, there is a kind of consistent demonstration that they have increased intestinal permeability, meaning like those tight junctions lining the gut are a little bit more open. We don't know if that's a cause or effect. Um, and we do also know that the people with OCD tend to eat less fiber. I don't know, I don't think that's the cause of per se of

of it, but when you eat less fiber, you are producing your gut microbiome. Those microbes produce fewer short- chain fatty acids, which can be anti-inflammatory, which can influence all of these neurotransmitters production. So there are changes that we know even in a human can link back to those microbes and how we fix that is not a probiotic despite what you know sometimes you might hear but it could be through diet and diet could play a role in so far as how the microbes are processing that and then that can affect our thoughts and our mood and eventually. Yeah. So I want to ask you about fiber.

My brother has been whining and whining about Metamucil for like 20 years and telling me to take a fiber supplement. And then I read your book and I was like, "Oh, I should actually take a fiber supplement." And so now I do. So your book has done two important things for me. One, it has changed how I poop, which is great. It's also changed how I talk about poop, my like my ability to talk about poop and not be not have such stigma around it and such embarrassment and shame around it because the book is so wondrously dstigmatizing. And I wonder if you can talk I mean is fiber kind of the number one thing that most of us should be doing uh in terms of improving our gut health?

Oh my gosh. Well, first of all, you've just like warmed my I was going to say heart, but you've warmed my gut all over. Um but thank you for taking fiber. Yeah. Fiber is the number one thing that is like obviously the most boring thing any doctor could ever tell you and like what people want me to usually tell them about the number one thing I want them to do as a gastronologist is take my supplement or take this it's just fiber it's always going to just be fiber and the reason fiber is so important is one we're not getting enough right Americans we get we meet like 95% of us are not meeting our fiber goals and fiber does

two things like it does immediately it will impact the shape and consist consistency of your poop that will change your life overnight. Like it will really make that better. But the long-term effects of it are that it supports the lining of your gut. It feeds your microbes that can then start to change into the species that produce more anti-inflammatory compounds. And that's linked to just endless long-term health benefits. So, it's good for you. You're going to feel those benefits pretty quickly, but you're also doing something good not just for your gut health, but for your brain health. So, usually if I can do one thing for anyone, I assume you're in the 95%. Which is not getting enough fiber. And

then I tell you, yeah, eat more fiber. Hank, I will put a link in the doobly-doo below to Dr. Pasich's incredible book, You've Been Pooping All Wrong. I will see you on Friday. Good luck with your pooping.