The Gut-Brain Connection Explained by Dr. Christine Bishara, Author of The Gut Revolution
Dr. Christine Bishara says that over 70% of your immune system lives in your gut, and that what we eat has a lot to do with how we think, feel and sleep. In this conversation, the New York City physician and author of The Gut Revolution explains the gut-brain connection, why time outdoors and a variety of fiber matter for kids, how gut health begins in the womb, and one toddler mealtime tip every parent can use.
What you'll learn in this episode
The gut and brain talk to each other. Dr. Bishara says the two are linked by the vagus nerve, and that this connection helps the body produce neurotransmitters such as serotonin, dopamine and acetylcholine.
Food provides the building blocks for mood and sleep. Dr. Bishara says serotonin and melatonin are made from tryptophan, which the body cannot make on its own, so it has to come from food.
Gut inflammation may affect the brain. Dr. Bishara says inflammation in the gut can travel to the brain, and that researchers are seeing links between an imbalanced gut and conditions such as Alzheimer's and Parkinson's. Her advice is to start by preventing gut inflammation through what we eat.
A gut feeling is real. Dr. Bishara says receptors in the gut sense things in the environment and send warning signals to the brain. She notes that children and animals are very in tune with this, and suggests parents have some faith in a child's gut sense.
Get kids outside. Dr. Bishara says sunshine helps us make vitamin D, which she links to gut and immune health, and that outdoor time exposes children to helpful bacteria. She describes a study in which children who spent 12 weeks outdoors had greater gut microbiome diversity with no change in diet.
Feed the good bacteria with a variety of plant fibers. Dr. Bishara says inulin, found in asparagus, onions and chicory root, and pectin, found in apples, feed helpful gut bacteria. She adds that about 70% of the immune system is housed in the gut.
Bifidobacterium is a key gut bacterium for children. Dr. Bishara says 60 to 80% of a child's gut bacteria is bifidobacterium, and that levels decline with age. She and her husband, a critical care physician, wrote a study suggesting this may help explain why kids did not get as sick from COVID-19. She says foods like yogurt, kefir, asparagus and blueberries can help.
Gut health begins in the womb. Dr. Bishara says a baby's gut starts developing around the same time as the nervous system, at about six weeks. She recommends that women who are pregnant or planning to be eat more plant-based, fiber-rich foods and try to maintain their weight during pregnancy.
Breastfeeding and birth can support a baby's gut. Dr. Bishara says milk oligosaccharides in breast milk feed a type of bifidobacterium, and that studies suggest delaying a baby's first bath by 24 hours may help. If a baby is born by C-section, she encourages breastfeeding or giving pumped milk, even for a week or two.
Keep offering new foods. Dr. Bishara says it can take 14 tries for a toddler to like a new food, especially a vegetable. Keep putting it in front of them and eat it yourself, because children usually copy what they see you do.
About the guest: Dr. Christine Bishara
Dr. Christine Bishara, MD, is the New York City-based founder of From Within Medical, a medical wellness practice that places emphasis on the mind-body and gut-brain axis to prevent and manage disease, as well as the author of the book The Gut Revolution: Change Your Gut, Change Your Life.
With over 20 years of clinical experience, Dr. Bishara has discovered that the connection between the mind-body and gut-brain axis systems plays a significant role in disease prevention and management, but it has not been adequately addressed. She also has research that helps explain why kids did not suffer as much from COVID-19.
Website: fromwithinmedical.com
Book: The Gut Revolution: Change Your Gut, Change Your Life (Amazon)
Instagram: @doctorchristineb
Facebook: facebook.com/doctorchristineb
This episode is for general information only and is not medical advice. The health claims, research and opinions described are those of the guest. Talk with your own doctor or health provider before making changes to your health, diet, supplements or your child's routine.
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Full episode transcript
Read the full transcript
Intro (recorded)
Did you know that over 70% of your immune system literally lives in your gut? Today's episode is going to help you understand more about that and so much more. Hi, I'm Marijo Tinlin from the Teaching Your Toddler Show. Our guest today has a ton of fascinating information to share. So, make sure you listen to the whole show and check out more information about Dr. Christine Bishara. Dr. Bishara, MD, is the New York City-based founder of From Within Medical, a medical wellness practice that places emphasis on the mind, body, and gut-brain axis to prevent and manage disease. She's also the author of the book, The Gut Revolution: Change Your Gut, Change Your Life.
With over 20 years of clinical experience, time and again, Dr. Bishara has discovered that the connection between the mind, body, and gut-brain axis systems play a significant role in disease prevention and management, but it has not been adequately addressed. She even has some research that helps explain why kids didn't suffer as much from the COVID-19 illness. You're not going to want to miss this episode. It's packed with amazing information to help support gut health for you and your family. Welcome to the show.
Marijo: Hello, this is Marijo Tinlin from the Teaching Your Toddler podcast. I am so excited to welcome this guest to the show because I think this is a topic that we maybe hear about but we don't know a lot about. So, please welcome Dr. Christine Bishara to the show. Please introduce yourself and tell us a little bit about yourself and about what you'd like the listeners to know.
Dr. Bishara: Sure. Thank you so much for having me. Number one. Number two, so I'm a traditionally trained MD. However, the system kind of frustrated me a little bit because I personally am very passionate about nutrition and how to teach our my patients how to make their body the best doctor because ultimately I think our bodies are really amazing healing machines. But I think society now has focused more on treating the symptom and the end result of what we're feeling instead of the root cause. So, I kind of stepped away from traditional medicine and opened a practice a few years ago called From Within Medical, which really helps me do that.
Helps me spend time with my patients, talk to them about nutrition, talk to them about everything that is in their body and is amazing and allows us to heal naturally.
Marijo: That is awesome. I'm I'm all about that. I think that's great. I think it I think it is. I mean that's personally my philosophy as well that I think our body is the best doctor and that we can tell tell we can tell when things are going on. So I think one of the things that in your book then the book that you wrote last in 2024 the gut revolution you're talking about things like immune health mood weight control things like that.
So I guess maybe the first thing to start with is that gut-brain axis like what is what is that first of all and then how does that sort of manifest itself in our bodies or in our in what we're like what we just said you know if you're your best doctor how do you kind of know what's going on there?
Dr. Bishara: Yeah. And that's something that is phenomenally linked together the gut and the brain. And a lot of people say the gut is the second brain and what does that mean? Well, we have a large communication system between the gut and the brain. It's called the vagus nerve. And believe it or not, we have two main functions of the gut brain connection. Number one, it's to help us produce neurotransmitters that basically help us function cognitively. Neurotransmitters like serotonin, dopamine, acetylcholine, which is our neurotransmitter that helps with how neurons travel. And all of these are based on a lot of times amino acid precursors in the foods we eat.
So, for example, a lot of people know serotonin, that's always the one I talk about because it's one that people know and can familiarize with. So, serotonin and melatonin actually, which we know is what helps us sleep. They're made of protein building blocks. One of the main ones is called tryptophan. And tryptophan, without it, we can't produce these two neurotransmitters like melatonin and serotonin. So, tryptophan unfortunately is not made by our body. We just aren't able to produce it and we have to get it from an external source such as food. So, I always teach my patients if you're not eating foods that have that tryptophan precursor in it, your body is just not going to be able to make as much of the serotonin and melatonin that you need.
So, part of my practice is we kind of go through all these symptoms. We go through neuro questions, sorry, neurotransmitter questionnaires and we figure out what is your body needing? What is it trying to tell you? And so that's one way that the gut and the brain connect. But another way that the gut and the brain connect is if you have inflammation in your gut. Again, we have these nerve impulses that travel everywhere. The vagus nerve is a huge conduit to the brain. And if you have inflammation in the gut, well, that inflammation will actually travel to your brain and deposit there, believe it or not.
And they're starting to see a lot of neurological conditions such as Alzheimer's for example and Parkinson's which are the two that we're definitely seeing a link to actually are caused by a gut dysbiosis and that means that we have an inflammation in the gut it's lowering the diversity of the microbes in there which is really important that's one of the main features of a gut dysbiosis is just a lower diversity and that inflammation travels to the brain deposits there So how do we prevent that? Well, we prevent the gut inflammation first, which is again through what we eat, what we put in our body. And we help that way.
Another way that the gut and the brain connect is through nerve impulses where have you ever heard that saying it's a gut feeling, right? When you have gut feeling and you don't know what it is, but it's so strong. Well, it's actually these receptors in your gut, crazy enough, right? There receptors in your gut that sense things in the environment that you may have not even remembered. It may have just been something that you'd seen before, something that's kind of causing the gut to be a little bit cautious. And it sends these signals to the brain to warn the brain. And so if we're really in tune with our gut sense, then a lot of times it turns out to be right.
Like you know how sometimes people say, you know what, I had this gut feeling about that person or that thing and I didn't listen to it. And the reason sometimes we don't listen to it is you know our brain is kind of built to produce patterns because it doesn't do it doesn't want to do as much work as it should and so it'll produce this pattern like hey you know what I've seen this before and I'm just going to ignore it because I think I've I've I've gotten this in my database and I'm going to ignore it. And that's kind of sad because the brain shouldn't ignore it, right?
It just it just wants to build a pattern and make you feel safe. But sometimes when your gut is saying, "No, no, don't ignore this. This is something I'm warning you about, just be in a little bit more tune with it. And we see this a lot in animals and children, right? Children are very in tune to their gut sense because they haven't been conditioned by society yet to kind of not judge that person or this thing. Their their instinct is to just go with their gut. Or animals, same thing.
So, I think as adults, we need to be more in tune with not only what our gut tells us, but a lot of times with our kids, if your child doesn't want to do anything and they're just not feeling it, maybe have a little faith in their in their in their gut sense.
Marijo: So, wow, that's interesting. Is that is that tied to peptides at all? Is that is that something is that the same thing or is that different?
Dr. Bishara: The human body has so many intricate things that are going on. So, peptides definitely play a role. We you know we make these neurotransmitters that really just kind of help us be alert function like dopamine is another one where if we're not making enough dopamine we're kind of not going to be able to focus and we're not going to be as driven so a lot of times I tell people tell your tell your kids to go outside you know back in the day we used to go outside our kids used to go outside and smell the air in the environment and be exposed to bacteria in the environment which helps develop their immune system, but also exposed to the sun, which helps us make vitamin D, which plays a large role in our immune health in our gut.
So definitely a lot of factors that play a role. Peptides are definitely one of them as well.
Marijo: That's interesting, the tie of vitamin D. I hadn't put that together before. Because I've been reading a lot lately about how important it is. I've been reading Casey Mean's book about going outside and like how much brighter the light is outside and how important it is to have it go into your eyes versus coming in through the window or whatever. And and so that idea of getting the kids out, but then what you just said about the vitamin D that it's actually physically helping us process things in our bodies, like that's there's just so many good things about being outside, right? And I think one of the things that I think a lot of parents, especially new parents, they're trying to clean everything.
They're trying to make sure it's all like no bacteria and all the things, but we actually need that, right?
Dr. Bishara: Absolutely. And if you look at countries like the US and Europe, they have a much higher incidence of childhood allergies than third world countries. And part of it is that germ theory, right, where in other countries kids are being exposed, they're outside more. And believe it or not, if you look at like the continent of Africa for example, subsaharan Africa has the lowest incidence of colon cancer. And part of the reason why I think it is number one, they're in the sun, right? They have a much more exposure to vitamin D. And you know, as I mentioned, vitamin D not only helps with strong bones, it actually helps with the gut bacteria immune function.
This is why it played a big role in COVID too because the immune system is in the gut. But they also eat a lot more vegetables and a lot more tuber type of fiber in countries like Africa. But even then there there was another study that showed that kids who spent out time outdoors like even 12 weeks they did a study on children who spent 12 weeks outdoor and they found that their gut microbiome diversity had increased just from that 12 weeks of being outside.
Marijo: Nothing else.
Dr. Bishara: Yes, exactly. No change in diet, nothing else. And it's partly because of that vitamin D that plays such an important role in the gut. But also, you know, the trees that are surrounding us, they actually release these substances which help them. But we are passive, you know, absorbers of these substances. Some of them are called fightes and they actually help to kill harmful bacteria and they help to develop our immune system, our tea killer cells. So there's a lot going on when we're outside. It's not just, you know, Yeah. Other studies have shown people who are near water or in nature tend to be more calm and more relaxed.
So there's definitely something in the air.
Marijo: There is. I've heard that like ocean air actually is charged with different what is it?
Dr. Bishara: Electrons.
Marijo: Yeah, exactly. Ions and that the ocean air is actually good for you. And that kind of reminds me of like forest bathing, right? That whole idea of being in the in the forest and having that around you. I mean that's just it's just so amazing how everything is so connected. Two things that you mentioned, you mentioned like the veggies and the tubers. I would assume that because when we eat this processed food, it does not have that that rich biome in it. And so by eating different vegetables and fruits, that's what's going to bring it in. What what are some of those things that we can en enrich our biodiversity in our guts with?
Dr. Bishara: Yeah. Well, so as much as we do know about the gut, there's so much that we don't know. But the little that we do know is we have our obviously harmful bacteria in our gut that produce these toxins like lipotoxins that release into the system that aren't good for us. But we also have these really good bacteria like bifidobacterium, which is the one that we discovered was what protected children from more severe COVID infections because they have so much more of it. And also like Lactobacillus. So those two bacteria we know are really, really good for us. Both of them love to feed on certain types of fibers called inulin.
And so inulin is a fiber that's present in certain vegetables and it's vegetables like for example asparagus or onions or like chory root like a lot of tuber type vegetables you know the asparagus like the stock of it sometimes tastes a little woody well that's like a really rich source of inulin and I know a lot of people don't like to eat that but all of the asparagus has but that part really has a lot of inulin and we can't digest inulin. So we eat it for them. So I always say feed them and you in turn feed yourself. So when they're full they actually send signals to our brain satiety center to say hey we don't need any more food.
So this is why a lot of times when we eat more vegetables we're not as hungry because they are actively sending signals to our brain to certain receptors. So inulinrich foods are very important. We also want to and there's different types of fibers. There's pectin fiber for example which is rich in apples and we've seen that apples feed a certain type of bacteria called Akkermansia which actually helps us with weight management. So the more variety of plant-based fibers that we're eating, the more variety of good bacteria we're feeding and they in turn do these things for us like support our immune health, support our weight.
So there's a lot of intricacies that are going on in the gut and we have to pay attention to it because it believe it or not 70% of our gut is what houses our immune system.
Marijo: So 70% that's I think a lot of people don't realize that it's so important that that your immune system really does live in your gut a lot, right?
Dr. Bishara: Yes.
Marijo: I've never heard of the word Akkermansia. That's pretty interesting about weight control. But the second thing I wanted to ask you about was you've mentioned it twice now is COVID and so I understand that you did some studies around that and then and then you mentioned like we did hear just kids just didn't get it for whatever reason and so you have you have a study that you did that that may explain that.
Dr. Bishara: Right. Yeah. It was kind of a study that we weren't planning on writing and I'm not a researcher. I it was my first study but I felt that it was so important to get it out there and the way that it actually happened was interesting. So I live in New York City and my husband's also a doctor. He's a pulmonologist critical care physician. So he's always in the ICU treating really really sick patients. And so when COVID first hit New York in March of 2020, I don't know if you remember like a lot of medical practices were considered non-essential and everything was shut down. So I had a little extra time on my hands because my practice was mostly you know outpatient weight loss.
But my husband on the other hand had the opposite effect. So he and his colleagues were all kind of like the frontline critical care workers where they were seeing all these really really sick patients in the ICU and every night he would come home and we'd have discussions about what his patient demographics look like. And it was interesting because on the news we were seeing that you know it's it's it affects people who are elderly and people who you know are more prone to getting illness just from a weakened immune system. But then he was telling me that, you know, I have like a 90 yearear-old little lady who you would think would get really sick from COVID and she did fine.
And then I have somebody who has no medical problems but maybe just a higher than normal BMI, so a little bit overweight and they're very sick in the ICU. And what he was finding was they were starting to give these medications that affect certain immune pathways that the body releases like immune markers. One of them, and I'm not going to get into too detailed, but it's called interleukin 6, which is a very potent immune regulator that our body releases when we when we sense that we need to make an inflammatory response. And he was saying that all of those patients were very high, the really sick patients had very high interleukin 6 levels.
And one day he came home and he said, do patients who are overweight in your clinic have high IL6 interleukin 6? And I said, "Yeah, actually they do. And he said, "I think there's a link between the interleukin 6 that's really high in my patients and COVID. And I said, "That's really interesting. And I and we started to see kids weren't really getting affected as much. So we started kind of digging into just kind of comparing the gut microbiome of children versus adults. And we found something really interesting. We found that children have a majority of their gut bacteria, this one bacteria called bifidobacterium.
And about 60 to 80% of their gut has this just this one bacteria and the levels slowly start to decrease as we get old and it's actually very low in elderly people but it's also very low in people who are overweight obese and certain medical conditions and these are the same conditions that affect affected by COVID so we kind of started digging a little bit more into bifidobacterium and the interesting thing is once we started digging we found that it actually works on downregulating the same inflammatory path ways that we were finding which was interleukin 6. So kids don't get sick because bifidobacterium downregulates interleukin 6 and interleukin 6 is what causes that inflammation.
So we published our study. We started giving our patients very high dose probiotics with bifidobacterium, very high dose vitamin D whenever they got sick. Like all of my patients that were sick, they got a protocol of that and nobody needed to go to the hospital and we kept doing it over and over and we were trying to share the study and unfortunately it was like very frustrating because we sent the study to so many news outlets and everybody was very excited and then as soon as they said they were going to send it to the science department, we never heard from them again. Interestingly enough, at some point I connected with another doctor who also does studies on the gut and she was doing studies on ivermectin and the mechanism of action of ivermectin.
And a lot of people think ivermectin works because it downregulates inflammation which it does indirectly but part of the reason why ivermectin works so well is it actually increases this bacteria in the gut. So when people take ivermectin the bifidobacterium levels increase in their gut and that kind of helps them and protects them. So all roads lead back to this one bacteria. And now 5 years later there have been so many more studies kind of confirming this hypothesis that we put together and it's actually one of the main treatment protocols that critical care doctors now who see patients with COVID use. It's on their It's on their website.
You know, probiotics containing bifidobacterium, but we can get them naturally through food. Like yogurt for example, kefir. Some food help to feed bifidobacterium more than other foods like what we mentioned, asparagus, blueberries, all these fibrous rich foods. Sorry, I hope that wasn't a long runon sentence.
Marijo: Oh no, that was that was that's fascinating. I wondered that so because I feel like is it ivermectin or is it a different one that they use for malaria? Is that hydroxychloroquine?
Dr. Bishara: Oh, hydroxychloroquine.
Marijo: That was it.
Dr. Bishara: Yeah. Yeah. It's actually probably the same mechanism of action. And when we published our study, we put in hydroxychloroquine. At the time of our study, we looked at hydroxychloroquine and we found that it also downregulated interleukin 6. So we at the time we knew that the factor that was causing the severe infections was interleukin 6 and other inflammatory markers but we knew that bifidobacterium downregulated and hydro hydroxychloroquine we just didn't know the mechanism of how and I don't know I haven't done studies but I would bet that hydroxychloroquine also increases bifidobacterium in the gut because it's also a very similar type of medicine than ivermectin.
They're both antimmalarial, antiarasitic medications. And those medications have been around for many years. And in the gut, they're killing off parasites and they're helping increase bacteria. So, it's almost like they're giving this bacteria like a boost.
Marijo: A boost, right? Wow. I've I've heard the parasite connection, but now I've not heard this the bacteria connection. That's pretty that is just fascinating.
Dr. Bishara: I know. That is really fascinating in my opinion.
Marijo: Oh, yeah. Oh my goodness. That is that's so cool. It even says, and I know the blurb on your on the Amazon page for your book, and we'll of course make sure that we have lots of links for everybody to find you and everything, but it actually you say that it starts in the womb. Like, so what what would parents need to know about this if they're expecting or if they have young children?
Dr. Bishara: That's a really good question. I'm glad you brought it up. So as soon as you get pregnant, you know, a lot of moms know that they need to take folic acid, right, when they're pregnant because folic acid plays a role in their development of their nervous system. And it's very early on. At six weeks, the nervous system starts to develop. Well, the gut also starts to develop around the same time. And so I always tell moms, what you eat really does matter because if you're eating a lot of foods that are enriching your microbiome, that in turn is going to enrich your children's microbiome. So if you're planning on getting pregnant, really focus on eating more plant-based foods, especially with the fibers that we talked about.
And I mention this a lot in the book. I have a whole chapter on like moms and how to kind of prime your baby's health. But it really does start in the womb and it starts early on. And so a lot of times women don't even know they're pregnant until they're about six, six or eight weeks. And at that point, your baby's gut microbiome is already being developed. So you want your baby to have a lot of bifidobacterium because now we know bifidobacterium is God or nature's gift to children. And it's to protect them from the harms of the environment early on when they don't have that developed immune system yet.
And so if you want to build up your child's immune system with bifidobacterium, you want to eat the foods that feed your gut and increase it because then it translates to your child. Another really important thing to do is try to maintain your weight during pregnancy as best you can. A big big one is breastfeeding when you have your baby. Again, we've done all these studies on breastfeeding from years ago, right? And we know it's helpful, but how is it helpful? Well, believe it or not, the milk particles in breast milk, they're called milk oligosaccharides. Those feed a certain strain of bifidobacterium in the gut.
Yeah, there's a there's a there's a lot of strains of bifidobacterium. One of them is called bifidobacterium breve and that actually is present in children who are breastfed. And we've found that it's very potent in getting that immune system when a baby's born strengthened. And really the if you think about the way our gut bacteria function is like think of them as soldiers kind of on the front line of a baby's gut. And the more you have there the stronger the lining and the less likely you are to compromise that lining. So the more bifidobacterium we have lining up in a child's gut and in our own gut the stronger it is.
So breast milk definitely helps with that.
Marijo: Wow, that's I love that you said that it's God's gift to children. That's so cool. And I just recently did an interview actually along that line with nursing where she's actually a therapist for like your mouth and your and all all the things and Yeah. Yeah. And that it actually helps with the development of your pallet and your sinuses and like as a baby and so like the design of all of that. And so then to tie that with what you just said, I mean it's just like such a perfect argument for nursing. Oh my goodness. Well, that's that's fascinating.
Dr. Bishara: And the other thing, and I mentioned this in the book, too. I mentioned all these things, but, don't give your baby a bath for about the first 24 hours, after they're born because we have bifidobacterium all, you know, in our in our vaginal tract, too. We have a lot of really beneficial bacteria. And again, it's it's just it's God's way of ensuring that our children are kind of primed, right, early on. And so, especially when a baby's born vaginally, they're kind of baptized with all these bacteria.
Marijo: I've heard that, but I didn't know the connection. That's so that is so cool. Wow.
Dr. Bishara: Right. What do we do? We give them a bath right away. And so now studies are showing that maybe we should delay a baby's bath for 24 hours so that we can help them kind of build. I mean, there are harmful bacterias also present in the mom's vaginal tract like strep B is a common one. So, it's definitely important to have that checked before obviously, which most most hospitals do anyway. But, you know, I get a lot of moms who, have their baby by cesarean section, and unfortunately, that's not something that you can control. But I do tell those moms, if you do, and you don't have any of that harmful bacteria that is in your vaginal tract, maybe get a swab and swab your baby, you know, after they're born.
But definitely try to breastfeed if you can because as a as a C-section born baby, your baby's already kind of not as primed. And so, you know, if you can even breastfeed for a week or two weeks, or if your baby's in the NICU or for whatever reason you can't, just even pump the milk and save it and give it to your baby because that first few weeks of milk is amazing. It has all these Yeah. Antibacterial properties. So yeah.
Marijo: Oh man, that's amazing. All these all these great things. Goodness goodness. Well, thank you so much, Dr. Bishara. It's been such a pleasure. What are your parting words? What would you like the listeners to know?
Dr. Bishara: Before I let you go, it takes 14 tries for a toddler to actually like eating something, especially like if it's a vegetable or or any, you know, food that's not pasta. So keep putting it in front of them and eat it yourself because when they see you eating it and you talk about how healthy it is, your children will usually model what you do.
Marijo: So that is great advice. Wow. Because yeah, picky eating, but that but if you kind of stick with it, that's that is a gem right there. That's a mom hack. Thank you so much. Well, we'll make sure again that we link to your website and to your book and all of the things, but it's been such a wonderful discussion today. I really appreciate your time.
Dr. Bishara: Thank you so much for having me.
Marijo: Thank you.
Outro (recorded)
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