Tell me why people should trust their ‘gut’

Gulf News

Finding the right health and nutrition tips can be overwhelming, which is why Dietitian and Founder of A-Z Nutrition, Sandra Mikhail, advises people to trust their ‘gut’ on the latest Tell Me Why podcast episode.   Sandra: People often wait for someone to tell them what to do when it comes to nutrition  I teach my clients how to reconnect and listen to their bodies, says Sandra  Sandra: I have found that many of my clients have felt unheard, dismissed and have struggled for more than 10 years The most challenging cases are those who’ve developed a fear of eating, says Sandra  Sandra: Eliminating certain foods is never lifelong, it’s only temporary because gut health is about inclusion not exclusion  See more videos at https://gulfnews.com/videos Read more Gulf News stories here: https://bit.ly/2HLJ2km  Subscribe to Gulf News on YouTube and watch more of our videos: https://www.youtube.com/user/GulfNewsTV  #UAEnews #podcast #guthealth

Transcript

00:00Hold on what? Yeah, people look at like seed oils are bad. Yes, you know, you shouldn't look

00:05I think at the end of the day if something sounds off look at who's I mean

00:11Look at where you're getting your information from right?

00:14I'm not gonna say look. Yes, look at their qualifications

00:17But even you know people with an MD title have as I said spewed a lot of misinformation and pseudoscience

00:22but at the end of the day, I think you know one of

00:27One of the things that I get my clients to relearn is to be connected with their bodies

00:31We've become so disconnected that we wait for people to tell us what to do and I should ask my clients

00:37How does it feel if I tell you at one point?

00:40Don't come and see me for two months. I just want you to do I want you to listen here

00:44What is your body telling you? When should you eat? You know, that's another experiment

00:49I get my clients to do don't look at the clock. Oh, yeah, when should you eat? When should you stop?

00:53What what's your body signals, you know

00:55Yeah, we're so disconnected from our internal body cues that we wait for all these external messages. Yeah to tell us what to do exactly

01:08Going back to food intolerance tests and food allergy tests to be honest

01:14even though I did go through the journey and I did omit, you know a

01:17Bunch of the foods and I felt better for a very short while

01:21After a while I managed to feel better on my own

01:26Without having to take out these foods and I did actually reintroduce a lot of the foods that you know

01:31They said I couldn't have

01:33eventually

01:35Exactly and to be honest after a while. I felt like okay

01:39Maybe I don't believe in them as much as I thought I would these food intolerance tests or these food allergy tests

01:46So it's important to define like the two and to maybe point out the difference between the two

01:52And then just to give me your take because I honestly felt like okay, maybe it wasn't so much

01:58Omitting the foods. It was maybe just you know, sort of like restarting my system or trying to find like, you know

02:04What aggravates you know certain symptoms, but it isn't so much about like a whole category of food

02:12absolutely

02:14Food allergies and food intolerance. The terms are always used interchangeably, right?

02:19So a lot of people would say I'm allergic to gluten and actually

02:23You probably have a sensitivity to maybe other components of meat not necessarily gluten

02:27But when we're talking about a food allergy, we're talking about your immune system being involved

02:31so what happens is your immune system reacts to a specific food protein and

02:36It identifies it as being harmful. So

02:40Once it does it just goes. Oh, let's start producing these compounds to deal with it. And these are allergy antibodies

02:48Called IgE antibodies. Okay. So basically once you start producing these specific compounds

02:55Allergic reactions will follow and they can manifest from things like a rash. So skin rash hives urticaria

03:03But also vomiting and diarrhea

03:05Breathing difficulties and in very, you know, serious cases anaphylaxis where basically you get swelling in your throat

03:12Exactly, and you start breathing. Allergies, food allergies are fatal. They can be fatal

03:18now

03:20the most common food allergy look I'll give you the

03:24Basic ones like you get eggs, wheat, nuts, soy, nuts, nuts, right

03:30a cow's milk protein, right

03:32And a lot of the times if you've been diagnosed with a food allergy as a child you tend to outgrow them

03:38Also, it is very unusual or rare. I'm not gonna say impossible to develop a food allergy as an adult

03:44We are seeing more and more right now. We don't know the exact reason why

03:49We can go back to leaky gut then

03:52I

03:53Always say when it comes to food allergies, you can actually test for those

03:57But there's specific tests that you need to go for so there's an IGE panel that you can do tests a RAS

04:02So through the blood work or a skin prick test, okay, and your specialists there are a food allergist

04:08So they're allergist or a clinical immunologist and a gastroenterologist. So they're the ones if you do suspect a food allergy

04:14You need to see them and also a clinical dietitian or a clinical nutritionist who specializes in this area, right?

04:21food intolerance

04:23Your immune system is not necessarily involved directly. Okay. So basically what happens is

04:30By definition a food intolerance is a non

04:33Immunological response to a food component or an amount that's normally tolerated by a normal person

04:39Mm-hmm

04:39So what happens is you've probably consumed a food product and then if it doesn't sit well with you a chemical reaction happens

04:47Potentially impacting your gut but also the nerve endings and your nervous system and involve is involved

04:53so what tends to happen with a food intolerance and why is it so tricky to diagnose is because your gut is not the

04:59Only system impacted. Okay skin

05:03respiratory

05:05Neurological symptoms. So with a food intolerance you get a whole range of symptoms

05:11You know making my life more difficult, but that's the beauty about it. Yeah, and it really takes this whole, you know, no one-size-fits-all

05:18It's all approach for another level. Mm-hmm now when it comes to food intolerance

05:25There are different types of food intolerance and we group them into three main ones

05:29One is called an enzymatic intolerance and actually one of the most common intolerances if you want to talk about it is lactose intolerance

05:36So basically this is where you don't produce lactase, which is the enzyme you need it to break down the milk

05:43Sugars which is lactose. This is very very common as we get older we produce less and less lactase

05:49So a lot of people say dairy doesn't sit well with me. It doesn't mean you're allergic to it, right?

05:53You're probably intolerant lactose intolerance actually very lactose intolerance is

05:59Actually normal lactose tolerance is a genetic mutation

06:05Interesting. Yeah, so basically a lot, you know looking at cultural backgrounds and ethnicities

06:11we do see a lot of people that's in this region and

06:14Let's say in Asia and Southeast Asia develop lactose intolerance because we are not

06:19You know exposed to the farms or you know, and then the cows

06:24Natural in their natural form, of course, but you see a lot of lactose tolerance and more

06:30Let's say the the northern European countries, right?

06:32But by saying that though still that is just an example of a food intolerance or an enzymatic food intolerance

06:38another type which is very tricky is

06:41a food chemical intolerance also called a

06:44pharmacological sensitivity

06:46So basically you develop the sensitivity to either natural chemicals and food like amines

06:52I'm sure you've heard of maybe histamines or

06:55food additives like sulfites

06:57okay, so that is a food chemical intolerance and the last type of let's say intolerance is a

07:03Sensitivity to a group of foods called FODMAPs and these are fermentable sugars found in lots of healthy stuff, right?

07:10So they're found in things like your wheat your breads and your cereals are found in things like your onion your garlic your avocado

07:16Asparagus, so a lot of these are good foods that we need to have but some people let's say especially those that were diagnosed with irritable

07:23bowel syndrome

07:24Developed the sensitivity to FODMAPs because what these specific foods do is they cause your intestines to purge your to basically absorb so much

07:32liquid and gas causing

07:34Distention the bloating. Yeah the bloat

07:37And then causing a regular bowel movement stomach pain, etc

07:43Now there is no blood test

07:45That can diagnose a food intolerance. We can diagnose food intolerance with lactose and potentially fructose

07:52but

07:55The issue that I have with these commercial food intolerance testing is actually it is the biggest

08:01wellness scam of our generation, okay

08:05Specifically talking about

08:08Food intolerance tests that look at these IgG antibodies. So basically these are compounds that we produce in

08:15exposure to things like food

08:17viruses

08:19Pollen toxins in our environment and these compounds are present whether a person has symptoms or not

08:27So we still produce these compounds even if we're healthy

08:30So if anything these antibodies when they test you they just actually indicate

08:35Tolerance because you've been exposed to it rather than intolerance because you've been consuming it basically exactly

08:41So this is why when a lot of my clients would come in with this massive list of foods

08:44I was like look at the traffic light system. I know the red the green the yellow

08:48I can tell you without even looking at your blood work what you're apparently intolerant to oh, man, so I

08:57I

08:58Know a lot of people are listening or watching going watch me. I've invested so much money in these

09:06Look, and I'm being completely honest with you because I have been approached by these companies and I've even had discussions with these companies

09:14It's a money-making industry, right? And then it's not regulated when I was I know went back when I was living here years ago

09:21It's been a while. I've moved actually I moved out of Dubai a long time ago now

09:25I was part of a group that were working with the DHA

09:29So that's to buy health authorities here to actually start regulation or regulating these food intolerance testing

09:36Problem is is it's it's incentivized so they would go to doctors or dietitians and say look if you sell this amount

09:42This is how much money you can make

09:45And when you talk to these companies and this is quite unfortunate is that they always say look the Middle East is fantastic

09:51These are a clientele base because they don't question it. They have the money

09:54You know, they're uneducated

09:56Hmm and they'll pay for it and that just infuriates me

09:59So it's like you are taking advantage of the most vulnerable people and why do people resort to food intolerance tests?

10:06They want answers

10:08So the only way to diagnose a food intolerance is to work with a clinical dietitian who has worked in this field for a while

10:14But to do an elimination diet, but again, you need to know what sort of elimination diet am I doing?

10:18Is it a food chemical intolerance are we looking at an enzyme intolerance for an enzymatic food intolerance?

10:25Or are we looking at a FODMAP sensitivity, right?

10:28So a lot of the people who would say look, I think I'm intolerant to gluten

10:31Actually, it's potentially not gluten that you're sensitive to it's maybe the FODMAPs found in wheat called fructans

10:36Mm-hmm. So this is where you know, you have to start educating the public to know. Okay, hold on

10:43This is a scam cost a lot of money and it's unnecessary. Yeah. Yeah

10:48So it just goes back to essentially what you said in the beginning is start questioning

10:53Question be critical always look for answers

10:56Do not just believe everything you hear and I think a lot of people have become

11:01More and more aware of that and I think that's why they've become more skeptical of everything they hear you were skeptical

11:07I was I was even at the very beginning and

11:10Again my father told me from the very beginning. He was like, trust me. These things won't do you any good?

11:15I was like no, no, no. No, I'm just gonna give it a shot

11:17And you know, I I have grown more and more skeptical of these tests and I know that it's always good to question

11:24But then it just makes your life so difficult

11:26You just don't know what to believe and and trying to look for answers. I mean simplest way on the internet

11:32I mean you always find contradict here, right?

11:36Everything but you'll find contradicting opinions and and contradicting research and and contradicting, you know

11:43I don't I mean, I don't even know information just regular information one website will tell you. Yeah, sure

11:50I mean red meat is good for you. Another website will tell you no, it's not

11:53I mean, it's always it's always been the case

11:56So it's just it makes our lives so much and I understand that even as a dietitian. I even question

12:01I was like, hold on what? Yeah, people look at like seed oils are bad

12:06Yes, you know you shouldn't look I think at the end of the day if something sounds off look at who's I mean

12:13Look at where you're getting your information from, right?

12:16I'm not gonna say look

12:17Yes

12:18Look at their qualifications

12:19But even you know people with an MD title have as I said spewed a lot of misinformation and pseudoscience

12:24but at the end of the day, I think you know one of

12:29One of the things that I get my clients to relearn is to be connected with their bodies

12:33We've become so disconnected that we wait for people to tell us what to do and I should ask my clients

12:39How does it feel if I tell you at one point?

12:42Don't come and see me for two months. I just want you to do I want you to listen your what is your body telling?

12:48You when should you eat? You know, that's another experiment. I get my clients to do don't look at the clock

12:52Oh, yeah, when should you eat? When should you stop?

12:55What what's your body signals, you know

12:57We are so disconnected from our internal body cues that we wait for all these external messages. Yeah to tell us what to do

13:04Exactly. Oh, it's it's funny that you mentioned timing and just you know, it just reminded me of the whole intermittent fasting, you know

13:12Dilemma should you do it? Should you not women it affects your hormones?

13:16No, it's actually good for you. And it's just you never know what's actually good for you. But anyway, that's it

13:22Yeah, that's a different topic and that's a whole new day and a whole new episode

13:27But you did mention as you were talking that it makes your life so much more difficult with clients

13:33You know when you when you hear these things tell us about some of the difficult cases and like the challenging cases

13:38Obviously without mentioning any names or anything to preserve their look again

13:42I don't want to mention specific cases, but you do see let's say the common denominator exactly. They haven't felt heard

13:49They felt dismissed they've been struggling for 10 years plus so literally my clients are coming with a portfolio

13:57Information and I think you know, my role there is to start to put I would say that they're there the pieces of the gut

14:03Puzzle together. Mm-hmm. It's about listening sometimes about really going way back. When did it all start, right?

14:10So we really go about 10 15 even 20 years before could be part of their upbringing

14:15Maybe or something be a stressful event that caused a glitch, you know and how that gut-brain axis is working

14:21Perhaps they haven't worked on that specific pillar

14:24They were too focused just on the nutrition side of things, but they probably neglected the mind

14:29So the ones that I find the most difficult are the ones that have struggled for a very very long time

14:35Have been eliminating for a very very long time and have actually developed a fear of eating because of that

14:42So this is where when it you know, when it comes to gut health gut health is not about exclusion

14:47It's about inclusion. Mm-hmm. And this is something that I remind my clients like if we do have to go on an elimination

14:53It's never lifelong. It's only temporary unless it's medically justified

14:57Of course

14:57so the complicated cases are ones that are potentially developing either a turbulent relationship with food a specific eating disorder or just fear of

15:05Eating because it just takes them back to that time where they've completely reacted that to that specific

15:11So my role there is sometimes to refer them to get a second opinion or a third opinion

15:15So all the doctors that I've actually hand-picked I've built my network. I know I trust these people and

15:23They're very you know

15:25Empathy goes a long way. Let's just put it. Of course. Yes

15:27So all they want is for someone to sit and listen to them again going back to how the health care system is made

15:34Sometimes it doesn't allow for that. Oh, yeah, you don't have I mean in Switzerland, for example

15:39You have 15 minutes with a GP and sometimes that's your first point of contact. It takes me 15 minutes to say hello

15:45Yes, exactly. I get to know you to exactly know how you are

15:49So then here you go with all the other, you know wellness woo-woo's coming in and say, you know

15:55I've got you for 90 minutes

15:56You're here these all the tests that you need to get done and you pay out of pocket insurance doesn't pay for it

16:03So they feel like okay, I'm being heard but at the end of the day, you know

16:07These are also the clients that come back to me and said tried it three four months felt

16:11Okay, but here I am and look at how much money I have spent on supplements XYZ

16:16so these tend to be the most challenging cases and as I said

16:19A lot of the time is that they haven't worked on a specific pillar long enough. Mm-hmm

16:26So that tends to be kind of the common picture that I see with a challenge

16:29Okay, I love that you mentioned empathy because most of the time if I'm going to a doctor

16:35Let's just keep it general just a doctor someone in the medical field

16:38I want to feel like I'm interacting with a human being

16:41I don't want you to just give me the the science jargon and tell me what's wrong with me

16:46But I want you to either tell me like give me the solution and you know, give me that

16:51Human factor with it. I'm not asking you to give me hope but false hope but at the same time

16:56I want you to know me as a person to be able to give me the solution that fits me because again

17:01It's not a one-size-fits-all like you need to know me to know exactly what to address and how to fix it

17:07So I love that. Okay, you did mention that you have a client waiting and that you have a bunch of appointments

17:13Which is always the case with it with our with our wonderful guests, you know, we get carried away my last last question

17:20What's your advice? I'm a frustrated client. I come to you and I'm like listen

17:25Nothing's working. I'm done. Like I'm on the brink of giving up

17:30Nothing's working. I've done all these tests. I come in with the 10-year portfolio that you were mentioning. I'm done

17:36Like I you're gonna tell me to do something but it's sort of like in the back of my mind

17:41I know that it's gonna fail because everything else has failed. What's your advice?

17:46One of the first things that I actually get to do with my clients even in that first session is setting

17:51Expectations what has worked and what hasn't worked and a lot of the time it's really about redefining your why why are you doing this?

17:57Again depending what you go irrespective of gut health

18:02Whether it's

18:04Struggles with weight whether it's struggles with fertility whether it's struggles

18:09I said with your gut a lot of the times I get my clients to just ask themselves. Why do you move?

18:15Find out your why if you're moving just to change that number on the scale or for aesthetic reasons

18:20You're bound to fail might work short-term, but you're bound to fail

18:23The other thing that I'm always interested in is the psychology around why do you eat the way you eat?

18:27So there's a whole bunch of exercise that I get my clients to do because a lot of the times people

18:31Neglect the psychology around eating. Why do we eat the way we eat?

18:36There's a ton of different factors that influence that of course. So again, it's it's redefining your why so

18:43yes, we do work with a lot of goal-setting and it really goes back to I

18:48mean, I

18:49Want to empower my clients to take charge of their own health

18:52So the most important thing is right if we have to work with these four pillars

18:56And one thing that I get my clients to do is I want you to think of these four pillars mind movement nutrition and sleep

19:03And I mentioned that in the book as well

19:04And I give a few examples that I just want you to set one goal under every pillar

19:09That you potentially want to work on for the next three months. No, don't set for the year. It can be three months

19:14It can be for the year, but just pick one goal a maximum of three if you're very optimistic

19:18Be specific and the thing is you need to make sure that it works for your reality. What is your reality?

19:24so this is one of the things that we you know, I

19:27I'm gonna say I'm proud of but one of our slogans is that we work with your reality

19:32We have people that don't cook

19:33I'm not gonna send them a shopping list and expect them to be Jamie Oliver in the kitchen

19:37So there's a lot of things that I feel there are gaps within this industry that

19:42They haven't found the right support system yet

19:44And it might take you 15 years until you find people like me who are out there doctors

19:49Like the ones we work with who are out there

19:52and

19:54This is where we you know where we start

19:58The I say getting your engines revved up. The other thing that I do is I always take my clients back

20:03I was like remember that feeling you had

20:05that

20:07Where you felt good physically?

20:10Mentally right and also redefine what success means to you

20:14What are your KPIs if your body composition and your weight are KPIs forget about it?

20:18You're these are not good enough anymore

20:21So whether it's about strength whether it's about mental clarity whether it's about not having diarrhea anymore whether it's that you know

20:27We celebrate a good poo

20:31So there are lots of different KPIs that you can start to

20:36Work towards and a lot of the times people just say look you're so unconventional, you know, why?

20:42You know, this is not what I expected a lot of people expecting a dietitian. Here's a meal plan

20:46This is a diet that I'm on go and follow it, but it doesn't work. We know it doesn't work this way anymore

20:51Yeah, it's it's long gone. So find out your why which is perfect because they're here to tell you why

20:58Sandra thank you so much. We've taken up so much of your time and this has been pleasant

21:02Please if you're ever back in Dubai stop by and we'll talk about talk. Yes more food talk

21:08We'll talk about whatever else that we didn't get to talk about today. And I know there's always something to discuss

21:14Thank you so much

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