O:H header
Welcome to the Shit Show! We start off with a discussion of fiber - is it the essential part of the diet the "experts" tell us it is? Fiber appears to have benefits, but there are a number of examples of people doing fine, even thriving, eschewing it completely. Some health issues even seem to be markedly improved by eliminating fiber, while increasing it worsens conditions. Maybe fiber isn't the amazing non-nutrient it's assumed to be!

Dr. Gaby brings us a health alert with important new information about fluoroquinalones.

We then move into other poopy areas, discussing the emerging research on fecal transplants among other poop-related topics.

Finally, Zoya's Pet Health Segment brings us some fascinating information about animal poop - why do some animals eat their own poop and why do dogs prefer to poop along the north-south axis of the earth?

Join us for our poopy parley - everything you didn't know you wanted to know about poop!

Time stamps: For more health-related news and more, you can find us on:
♥Twitter: https://twitter.com/objecthealth
♥Facebook: https://www.facebook.com/objecthealth/

Running Time: 01:07:05

Download: MP3 - 61 MB

Here's the transcript of the show:

Tiffany: Hello and welcome to Objective: Health. My name is Tiffany and I'll be your host today. Joining me are Erica, Elliot and Doug.


Tiffany: So welcome to the shit show {laughter} we like to call it. Today we're going to be talking about poop. We won't say it's one of my favourite topics but it's up in the top 5 hit list. I'm not quite sure if I'm exaggerating or not but I guess we'll find out as the show progresses. Today we're going to talk about fiber and we're going to talk about poop and things that are poop and fiber-related.

I guess we can just start off with fiber and usually when we think of fiber we think of the foods that contain fiber like vegetables, fruits, grains, legumes, nuts, those sorts of things. Sometimes, depending on how involved you are with the medical system, you think of something like Metamucil. I think they use psyllium husks in Metamucil. It's basically indigestible matter. The body can't break it down. It also can't produce it on its own and yet it's still touted as something that we have to consume in order to have good gut health. Eat your fiber, eat your fiber, eat your fiber.

Does anyone want to talk about exactly what fiber is and different types of fiber?

Doug: Well, first of all I want to point out that today I have Uranus in the background because of the topic of our show. {laughter} So if anybody was wondering...

Tiffany: Whose anus?.

Doug: What's that?

Tiffany: Whose anus? {laughter}

Doug: The solar system's anus.

Tiffany: Okay. Why did they even pick that name? Out of all the names in the world, they call it Uranus.

Doug: I know that some people pronounce it Ur-anus just to maybe take away from that whole anus part of it. {laughter} But anyway, fiber. Like you described it, that basically is what it is. But I guess it's a carbohydrate for one thing and it's just chains of carbohydrate that are indigestible by us because they contains bonds that our digestive system can't break. So we don't produce the enzymes that actually break the bonds on those carbohydrate chains so we don't digest it. It stays in its same form as it goes through our digestive tract.

The two major forms of it are soluble and insoluble. Insoluble fiber is roughage, the hard core stuff that really goes through the entire digestive system without being altered in any way. Soluble fiber on the other hand will actually draw water to it. It's generally considered the good fiber because it draws water to it but it also is fermentable meaning that the bacteria in our guts will actually eat it and produce other things, things that we will actually be able to use, one of the major ones being butyrate which I think we'll get into a little bit later, but also different things that we're able to use because we re-absorb them.

Tiffany: Excellent. If we can't produce it and we can't digest it, why do they say we need it? Why do we eat anything that we can't digest?

Doug: I think that's a good question. Generally if you look into the history of how fiber actually started to get recommended, it's a bit of a shit show. A lot of it came from misrepresentation of fiber. When they were first looking at the diseases of civilization, back in the early 1900s or late 1800s, they were looking at people who were still maintaining their traditional diets and comparing them to people from the same genetic pool who had transitioned to more modern diets. They were saying the people who transitioned to more modern diets are getting all these diseases. So what's the reasoning behind that?

Some scientists came forward and said, "It probably has a lot to do with this refined carbohydrate". But some people actually took that and said, "Well yeah, but it's because the fiber's missing. It's because we took all the fiber out. So it's not the sugar, it's the fact that the sugar doesn't have the fiber present." A lot of people jumped on that because they didn't want to get rid of these refined carbohydrates. "Oh, it's the fiber so we just have to make sure we're eating lots of fiber."

But really, as time has gone on and more and more studies have been done, all these supposed benefits of eating fiber have fallen by the wayside. There's not a lot of evidence for fiber being beneficial. There's exceptions to that, but in a lot of cases it doesn't seem like it serves that important a purpose at all.

Elliot: When you isolate fiber you provide fiber-based supplements, the expected result was that you would see significant clinical benefit in using these kinds of supplements if the fiber was the beneficial aspect of the food. But if you actually look at the data, there's very poor benefit, very poor outcomes. It's not the expected benefit that you would see.

There are certain things that have been shown about fiber. For instance, fiber does marginally decrease the rate that glucose is absorbed. So if you eat a really high carbohydrate meal and it's got lots of fiber in it, then it's going to somewhat reduce your blood glucose response. You're going to absorb the glucose into your bloodstream at a slightly decreased rate. So that's one thing.

Another thing that it can do, by various mechanisms, is can reduce cholesterol. That's another thing. Whether that's good or not is highly debatable. But that is one established thing that certain types of fiber do such as those in oats. Apart from that, there's not actually that many things the fiber does do. {laughter}

Tiffany: I've read of a study where they had people eat fiber and they wanted to test the effect that it had on their blood pressure and it lowered their blood pressure a measly two points which is really not significant at all and just could have been the normal variation in blood pressure that you see as the day progresses. So no big deal there.

Doug: So many of the benefits that are supposedly happening from fiber, a lot of times it might just be from the fact that it does slow down the speed at which glucose or sugar is absorbed. I was reading an article by Dr. Georgia Ede and she was talking about the fact that you can't find studies where they actually compare a fiber-eating group to a non-fiber-eating group, where you actually have them eat the same diet but one has fiber and one doesn't. She says it doesn't exist. Now mind you her article was from back in 2014 so that might have changed.

One thing she was pointing out is that in a lot of these studies, they'll have a fiber group and a non-fiber group but they aren't eating the same diet otherwise. What they'll do is feed the other group a whole bunch of refined carbohydrates. Well, the difference between the two groups might just be the refined carbohydrate, not the fiber. So it's not that the fiber is improving things, it's that the refined carbohydrate are making things a lot worse.

Elliot: Typically when you look at so many of the supposed benefits of fiber, is when you gather a pool of data from the population and you're asking them what kind of foods that they eat. You're saying, "How much fiber do you eat? How much of this food do you eat?" And then they gather the data and they say, "Okay, so the people who report that they eat the most fiber actually have the lowest disease risk for certain things." But if you look at what those people are eating - and I think it comes back to what you just said Doug.

So let's say that people are eating whole foods. So instead of eating refined pasta, like white pasta which is practically devoid of fiber, they might be having quinoa. While quinoa's not great, it's better than white pasta.

Doug: Exactly.

Elliot: The fact is, since we're told that fiber is healthy, I'm not sure what phenomenon it's referred to as, but there's a specific word for this kind of thing that I'm talking about. Essentially, the people who make the choices toward conventionally healthy decisions are often the people who make other lifestyle choices which are considered to be healthy and the people who do things which are considered not to be healthy also do lots of other things which are meant to be healthy.

I'll give you an example. If we're told that fiber is healthy, the people who eat lots of fiber are also probably going to be doing exercise. They're probably going to make sure that they have good sleeping rhythms. They're probably going to be making many other health-conscious decisions in their life whereas on the other hand if you have people who, despite being told that fiber is healthy, still don't eat that much of it and actually also live a sedentary lifestyle, eat loads of other junk food, sugar and generally drink lots of alcohol and things like that, then you've got the one person who's trying to be healthy and the other person who doesn't really care about their health.

So it's so difficult to be able to reduce the healthier person or the lower disease risk simply to eating more fiber. It could be any number of factors that they do in their lifestyle which is actually making them more healthy.

Doug: Yeah, I think that's called the healthy user bias.

Elliot: That's the one.

Tiffany: Another thing to point out is that a lot of these studies that they are using are observational studies where somebody will just report what they eat where you have to rely on your memory which is not always reliable and then they make a correlation based on the data that they collect which is not always reliable. But based on those faulty studies, most dietary associations still recommend that the average person consume about 25-30 grams of fiber a day in order to maintain their health.

Doug: Yeah.

Tiffany: And there is a slight reason for this because if you do eat fiber it will cause some bacterial fermentation in your gut and it will produce short-chain fatty acids in the gut and these short-chain fatty acids include something called butyrate and it's good for colon health that actually feeds the cells that line the gut and it can balance the ratio between dying cells and the new cells that are being formed. So it essentially adds energy for the cells in your gut and butyrate has also been found to be anti-inflammatory and beneficial for the immune system.

So when people recommend fiber, hopefully that is one of the reasons why fiber is recommended because there is that one benefit.

Doug: They think that that might be the mechanism because they say that fiber prevents colon cancer. But studies haven't really borne that out too well. So what they suspect is - or what some researchers suspect - is that the reason for it is actually because of that butyrate production because butyrate, like you said, does protect the cells. There's epigenetic qualities to the butyrate. It actually will bind to a receptor that inhibits an enzyme called histone deacetylase and it helps with the regulation of genes. Basically it stops unwanted cell proliferation.

They suspect that that's the reason that fiber is protective. They come up with all kinds of stories for why it does because, 'oh it helps to move the food through your digestive tract more quickly' or some people say slower and it stops toxins from building up. There's all kinds of crazy things. Or it increases the bulk of the stool therefore that's better because it helps with motility and you move the stool through in a more smooth manner, but really what's probably going on is that it's because of the butyrate.

Elliot: It's undeniable that butyrate is a really cool thing. Just butyrate supplementation, this short-chain fatty acid, you find it in small amounts in certain types of foods like butter. That contains some butyrate and some other things like fresh cream I think. But just even supplementation with it has actually found very good results in certain gastrointestinal disorders. So the butyrate definitely seems to be cool and it's not only just having an effect on the cells lining the gut but it's actually theorized to be almost a system effect as well. So the butyrate, this special kind of fat, is actually getting into the bloodstream, having various signalling effects to the immune cells in the gut but also potentially to the brain, to the neurological system and to various other systems like the cardiovascular system. There are all of these postulated really beneficial effects from this fat.

Doug: Well one thing that's interesting is that all of us here are doing low carb diets in some respect. A low carbohydrate diet is going to be lower in fiber than a standard or high fiber carbohydrate diet just because where you get your fiber from is from fruits, vegetables, all these things that happen to be high in carbohydrates. So one thing that experts will often warn you against low carbohydrate diets such as the ketogenic, carnivore or paleo, is that you won't be getting enough fiber and then you're going to get colon cancer and you're going to die. {laughter}

But interestingly, there was an article recently. Let me see if I can pull it up here. Damian, it was called Fiber and Colon Health on a Well-Formulated Ketogenic Diet. It's by some fairly well-known researchers in ketogenic diets. They wrote a couple of books, one of which was...

Erica: Stephen Finney.

Doug: ...yeah, Stephen Finney, Jeff Volek and there was another PhD with them as well, Brooke Bailey. What they were pointing out is that on a ketogenic diet you actually are forming ketone bodies. So you drop your carbohydrate, your liver starts to produce ketone bodies as an energy source and one of them is called beta hydroxybutyrate and it actually is only one molecule away from butyrate and can actually be used in pretty much all the same processes that butyrate is used in only in a lot of cases it's actually better.

I was talking about that de-inhibit of histone deacytelase. It actually does that better. It can be used as an energy source and it gets used in all the same places that butyrate gets used in the body. So in other words, despite the fact that you're lowering your fiber and the bacteria in your gut aren't fermenting it and producing butyrate, you're producing your own, more or less the same thing, that does all the same kind of stuff only some of it, it actually does better.

So if pretty much all of the benefit of fiber is coming from butyrate production, which chances are is the case, there might be other things involved, but certainly the vast majority of benefit is coming from this butyrate, then you don't really need to worry about lowering your fiber because you're producing all those benefits by a different mechanism.

Tiffany: And not only are you getting the benefits of butyrate, if you're following a well-formulated ketogenic diet, you're actually producing more butyrate than you would be producing if you were eating a high fiber diet. So say you consider 25-30 grams a high fiber diet, if you are in ketosis, your liver is going to be producing 75-150 grams of beta-hydroxybutyrate. We already talked about the benefits of butyrate so you're getting even more benefit by following a ketogenic diet.

Elliot: Now someone might come along and say, "Okay, on that diagram just then, it said 'with an optimized microbiome' you're producing butyrate. You're never going to be producing as much butyrate as you are beta-hydroxybutyrate but the amount of butyrate that you supposedly produce by dietary fiber is still supposedly beneficial. But you notice on the diagram it says 'optimized microbiome'. What we're doing is we're assuming that dietary fiber is beneficial for everyone. We're assuming that everyone's gut can produce a bunch of butyrate.

But quite frankly, if you look at people's stool tests, there's various tests which measure the stool and actually measure the various types of fatty acid. You've got three primary fatty acids that are produced by the bacteria. You've got proprionate, acetate and butyrate. So if you run a stool test on someone you can get a rough idea as to how many of these fatty acids are actually in the stool. From looking at quite a few stool tests in the past, I can tell you that the amount of butyrate produced or with regard to the reference ranges, I haven't seen many people with a microbiome that is producing significant amounts of butyrate. These people are usually people who have digestive issues.

So while someone with what you might call a robust digestive system might actually be able to derive benefit from dietary fiber, there are lots of people who actually it seems to cause more problems for than benefits. There are many different kinds of gasses that you can produce. For instance one is called hydrogen sulphide gas and this is a gas that's produced in the gut and this actually degrades butyrate as well. So many people who've got any kind of digestive issues are producing lots of this kind of gas and this is actually degrading the butyrate and the gas is usually produced by dietary fiber.

The point I'm trying to get across is that some people might tell you that eating dietary fiber is going to produce butyrate, it's a really healthy thing to do, but I question whether dietary fiber is even going to produce butyrate in every person because it seems that some people might be able to make use of dietary fiber, some people might be able to adapt to it, but many of the people that I speak to actually tend to find it exacerbates many of the issues that they have in terms of their digestion.

Tiffany: So if you're fairly young and healthy and your gut functions well, fiber at least won't be damaging to your gut and can actually produce some benefits, but if you have something like small intestinal bacterial overgrowth or Crohn's or ulcerative colitis or any other gut issue, then fiber can be a detriment.

Elliot: Yeah. Let's put it this way. One of the primary recommendations for people who are constipated is to eat more fiber. They're told to eat more fiber. Does this work? Actually usually it has the opposite effect. There are so many people you speak to who have had chronic constipation, they've been put on fiber supplements or they've been told to eat more bran flakes and things like that, more insoluble fiber, roughage and it actually makes it work.

I think there's probably several reasons for this but just to give a brief overview, when you consume this fiber, what it's doing is going into the gut and it's becoming lodged. It's binding with water or if it's a soluble type it's not but it's forming a bolus. Let's call it a bolus, a thick, gloopy bolus and as that is passing through the intestine, it's squeezing the intestine. It's causing the intestine to stretch and you've got cells in the intestine which contain very high levels of serotonin. When the fiber pushes against the intestinal cells they release all of this serotonin and it's the serotonin which is actually excitatory which initiates a cascade of events which causes the intestine to actually squeeze. It's called intestinal peristalsis. So this is what is initiating motility.

So the idea is that by providing more fiber you're going to be initiating that peristaltic reflex to be able to initiate a storm. The problem is, I think is that it seems that this mechanism may actually only be temporarily useful. It seems that with so much fiber it actually has the opposite effect whereby what you're essentially doing is clogging up the intestine. You're clogging up the intestine and sometimes it's so difficult and it seems like this peristaltic action can actually become dysfunctional. By providing more fiber, what you're potentially doing is just blocking up the hole even more.

If someone comes to me and they're chronically constipated, the best recommendation that I could make is actually to reduce all fiber immediately. You would be amazed because they start going to the toilet within a couple of days.

Doug: There was a study actually in World Journal of Gastroenterology - Damian I think I actually sent that one to you. The name of the study was Stopping Or Reducing Dietary Fiber Intake Reduces Constipation and its Associated Symptoms. I'll just read you a little bit from the discussion on it. It says,

"Dietary fiber is also associated with increased bloatedness and abdominal discomfort. Insoluble fiber was reported to worsen the clinical outcome of abdominal pain and constipation. In a recent study patients who followed a diet with no or less dietary fiber intake showed significant improvement, not just in constipation but also their bloatedness. Patients who completely stopped consuming dietary fiber no longer suffered from abdominal bloatedness and pain. These symptoms are caused by the fermentation of dietary fiber by colonic bacteria which produces hydrogen, carbon dioxide and methane. Gases that are trapped by a peristaltic colon exert pressure on the walls causing abdominal pain experienced by patients."

In their study they had different groups eating different amounts of fiber and there were people who had chronic constipation and the group that stopped fiber altogether had the best result. The group that lowered their fiber had pretty good results although not as good and the people who continued on their normal fiber diet had no results whatsoever. They continued to have the problem.

It just goes to show you, the whole idea that fiber helps with constipation is based on nothing! It's not in fact the case. It is the opposite of what is true.

Tiffany: Yet doctors keep pushing it. I've seen this quite frequently in my work, especially working with little old ladies in nursing homes. If they're in a nursing home they're not well in the first place so you would assume that there is something going wrong with their guts. Sometimes their guts look a little distended and bloated and the doctors will prescribe them fiber because they complain of being constipated. I've had to manually or digitally dis-impact several little old ladies in nursing homes. They have huge amounts of stool trapped in their guts and fiber is on their med sheet as what they get every day. It just makes everything worse and they have these large masses of stool that you have to use the jaws of life to get out of there.

They have great relief after I do it, but it's bad that they have to actually go through that and their doctors don't have enough sense to stop prescribing fiber supplements for them.

Doug: We should probably point out that Tiff is a nurse.

Tiffany: Yeah.

Doug: In case...

Tiffany: I have a reason for putting my fingers up people's butts. {laughter}

Doug: Yeah. So anyway, I think fiber is all hype from what I can tell, the whole thing about the weight loss too. People said that fiber actually helps with weight loss. That was a thing for a long time and all these people were loading up on fiber as a means of trying to lose weight. But in studies that just doesn't bear out. The thing was they were saying it helped because it would make you feel more full. It's like eating a rock basically. It takes up space in your stomach so you won't be as hungry because you'll feel more full.

Well this doesn't play out because you can't fool the body that easily. The idea that the body's going to think "Well I guess I'm full" meanwhile it's getting no nutrition from any of that. I think a lot of the reason for the obesity epidemic is that people are eating nutrient deficient food. The body keeps on telling you to eat more because what you're eating isn't giving it what it needs. It's not getting the vitamins, the minerals, the macronutrients, any of the stuff that it actually needs so it's giving hunger signals.

I think the same thing would happen with fiber. Just because you have a physically full feeling, your body is still going to be signalling "I'm not getting the nutrition I need so please keep eating. Anyway, whether or not that's actually what' happening, the fiber for weight loss thing never played out. It doesn't work.

Tiffany: Well there are some articles that said that it can increase stool frequency so I guess that depends on what it means by stool frequency. How frequent do you want it to be? Do you want a bowel movement every day? I've got people who said that they poop once a week which is not good either. I don't think that fiber is the answer to it. I think that you must address the diet first before you start throwing fiber supplements at people.

Elliot: I think there are cases of people who have chronic fiber use and then they all of a sudden cut out fiber and I think it's theorized that the intestine actually becomes a bit stretched out and so it can take a bit of a while for the intestine to re-normalize in terms of its diameter. So in cases like that, if someone has been on a very high fiber diet for a long time, immediately cutting out fiber may worsen constipation temporarily and in those cases you may want to use some kind of laxative, like a magnesium citrate or magnesium sulphate or alternatively gradually reducing fiber because if you think it's that stimulus against the intestinal wall which is kind of like the trigger for the peristalsis.

So if your intestines are so used to having this really thick bolus coming down of fiber and it's all of a sudden gone, that could trigger a temporary constipation. I read about that quite often.

Tiffany: Because people complain when they first start a carnivore or a ketogenic diet that they go through this period of constipation.

Doug: Yeah. I think that particularly fibrous supplements do cause a dependency. People are taking it and then they get so used to it and they have to start increasing it, probably because of that stretched out increased diameter that you were talking about Elliot.

But I think also when somebody goes on a keto or carnivore diet, a lot of the times they think they're constipated when they aren't necessarily, particularly with carnivore because I think people just go a lot less when they're not eating fiber and when they're eating primarily or all animal products. I think you just don't have to go as often and people might think that that is constipation but really it's just that they don't have to go as often.

So I think you need to actually analyse and look at what you're doing. Are you actually constipated? Do you feel like you have to go but you can't go? That's constipated. If you just haven't gone in a while, that's probably not constipation. That's just not having to go as often.

Tiffany: Yeah, that's less waste in your colon that needs to be pushed.

Erica: And more absorption of the nutrients from the food that you're actually eating instead of all the refuse.

Doug: Exactly.

Elliot: Just on the topic of the fiber, going to the toilet and whatnot, I think it probably can be useful in some specific contexts like say if you were doing a very specific detoxification regime and your potentially going to be dumping things into the gut and you want them bound up, you might usually use an activated charcoal or a bentonite clay, but there are some other kinds of fiber which actually have quite a good binding capacity for certain toxins. If you look at mycotoxins which are released by mould species, I think modified citrus pectin, which is kind of like a fiber, and then you've also got acacia gum and that's like a fiber as well and these are very useful binders. But they're not foods, so don't get me wrong. I'm not saying that these are foods but in certain contexts, a dietary fiber supplement for a short period of time with this specific aim in mind, might be useful.

But to market these things as foods or as permanent supplements I think is quite dangerous. I just want to add as well, as it was mentioned earlier, a lot of the backlash against the ketogenic or animal-based dietary approach is the lack of fiber. It's often coming from people who have high level qualifications in science like PhDs or masters degrees or MDs, usually people who've already established an authority and already have made numerous recommendations about the importance of fiber in the past, in their books or in their talks or in resources where they praise fiber, I think it's fairly difficult for them to move away from that because they've already kind of nailed their foot to the stone, so to speak.

Doug: Yeah.

Elliot: We've spoken about butyrate and the argument is, "If you don't have fiber then you're not going to have butyrate." So there's a counterpoint to that which is that if you're on a ketogenic diet then you're probably going to have either beta hydroxybutyrate which is just as good as butyrate theoretically, but then there's also the fact that when you're on an animal-based diet you are getting a bunch of protein. That is without a doubt. You're going to be eating lots of protein and protein can actually form butyrate as well.

So I was looking at a couple of studies earlier and there's one that comes to mind here. It was talking about how you have various species of gut microbes and they can take dietary protein, dietary amino acids and not only do they take these amino acids and they can produce something called methylbutyrate and they can produce something called isobutyrate. These things are not very different from butyrate. They're all very similar. What I'm trying to say is that you can get this really beneficial short-chain fatty acid from protein fermentation. It's been shown that the gut microbiota, the gut bacteria are so fluid that they change with your mood. They change all times of day. They change based on what you're eating.

So if you change your diet from a diet which is really high in carbohydrates and fiber and you move over to a diet which is really low in fiber and predominantly animal-based, it's likely that your gut microbes are also going to dramatically shift and it's therefore possible - I would say likely, I would tend to guess that this would be the case - that your gut microbes would shift to a population which was more able to ferment proteins to make butyrate.

The problem is it hasn't been studied because no one eats a no fiber diet. It's so uncommon. But the backlash against these animal-based diets are all based on foundational assumptions, on limited amounts of data and they treat this as if it's the be-all and end-all when actually it's just the tip of the iceberg that we are only learning about.

Tiffany: I don't think that science or medicine knows enough to make any statements with absolute, 100% guarantee at this point. I don't think we know enough about the gut, how it works or about the gut microbiome at all. We can only make estimations, guesses and experiment on ourselves and see.

Erica: And report back.

Tiffany: Yeah.

Dr. Gaby: Hello, this is Dr. Gaby and I'm here with yet another alert about Cipro. This one comes from Medscape and it pretty much recapitulates what has been said before. You should never prescribe fluoroquinolones, either Cipro, Levofloxacin, Moxifloxacin, Norfloxacin, when there is a urinary infection that is not complicated, when there is an exacerbation of bronchitis and when there is simple sinusitis. Search for another antibiotic. Don't prescribe fluoroquinolones because the adverse effects don't compensate for the possible benefits of treating the infections with these antibiotics.

The interesting thing about this particular alert is that it also specifies that there has apparently been more retinal detachment, hallucinations, epilepsy, ruptured tendons, severe neuropathy, severe fatigue and so forth. The alert does seem to admit that there is a genetic predisposition, that is, people who seem to have genetic mutations that affect the syntheses and production of collagen are more vulnerable to fluoroquinolones and the obvious example is the Marfan syndrome where they have an elastic type of collagen, several congenital diseases that are like that, but also very simple genetic mutations that don't necessarily show in specific congenital syndromes. You could be a carrier of a mutation for the glycosylation pathway which is something that is burgeoning. There are books written about it but they're all academic and I think it's going to be a new branch of the medical field in a few decades.

There is a lot of research being done and discoveries being made about the glycosylation pathway and it's apparently not that uncommon to have mutations in these pathways as well, especially Caucasian people which coincides with my experience that there seems to be more adverse effects to fluoroquinolones in people of Caucasian descent. These people that typically see are roundish and even though I've seen reported cases of all ethnicities, it does strike my attention that Caucasian people seem to be particularly affected by Cipro and fluoroquinolones in general.

So that's another thing you can do. You can order genetic tests just so you know because fluoroquinolones are prescribed when there is a complicated infection. They have their indications but if you have some sort of medical report that makes you not an ideal candidate for fluoroquinolones I would think that health care providers will go an extra mile to see that they prescribe another antibiotic that is not fluoroquinolones that may be more pricey or more inconvenient but you might be a candidate for that antibiotic so that's a new step. Good-bye.

Tiffany: Well thanks Dr. Gaby. She kind of just busted in out of the blue! {laughter}

Doug: It was a health alert.

Tiffany: Yeah, it was an alert. We have to keep that in mind. That was some good information on Cipro and fluoroquinolones. Do your research because those are some very strong antibiotics and you just don't want to take them for anything.

So to further our discussion, how about we get down and dirty and just talk about straight up poop? {laughter}

Doug: Okay.

Erica: I have an interesting tidbit of information, adding to what Elliot was talking about with the gut microbiome and how we don't know a lot about it and our topic today being poop, Last year in November Science Magazine released an article about a poop vault that is being built which is focusing on preserving gut microbiome diversity from all over the world and yes, they do collect stool samples. It's called the Global Microbiome Conservancy and it's efforts are focused on identifying and preserving gut bacteria from different people around the world for study. There are a few studies of traditional people and they have much more diverse gut microbiomes and this is leading to a lack of certain diseases.

As folks were sharing earlier in the show, they're not eating the standard American diet so they have more diversity in their guts. So this organization is actually rescuing and preserving these microbes and paving the way for new treatments. One of these treatments is the faecal matter transplant.

Tiffany: Yeah, faecal transplant.

Erica: Just this last month the FDA is all up in the shit with trying to control how this is going to be regulated. When the faecal matter transplants were first developed, they came out of people from MIT, microbiologists and they proposed this idea of using faecal transplants to help with c-difficile - is that how you say it?...

Tiffany: Clostridium difficile also known as C-diff, which is a really bad infection that mostly old people get if they're in hospitals or nursing homes and it can be really hard to treat and really hard to get rid of.

Erica: So they take healthy poop from donors and they transfer it to these people who are suffering, with an 80% success rate. That's pretty impressive.

Tiffany: One of the interesting things though when I was reading about that, there's a traditional route of transplanting it. I guess you'd give them the sample of the faecal matter in an enema but they can also do it through a nasogastric tube which is a tube you put down your nostril. It goes down your throat and it ends in your stomach. {laughter} I don't know if we were going to have to have a faecal transplant I would not want to take that route because just imagine if you burped after that.

Doug: Uuggghhhh. {laughter}

Erica: So right now the FDA is trying to decide how to regulate these faecal transplants and the two questions are, are they going to regulate it as a new drug which would be extremely costly and again, providing this service to elderly people that may need it, would be very cost prohibitive; or if they regulate it like they do organs, tissues and blood. So if anyone's interested in reading the article it's called Big Pharma's Next Gold Mine: Poop.

Doug: It's really interesting. I've heard a lot of anecdotal accounts on the faecal transplants. I even know a naturopath who was doing them for her patients despite the fact that it wasn't regulated. There was no company out there that was providing faecal transplants or anything like that so she was just doing it because it was in situation where - obviously I'm not going to give her name - it was a dire situation with IBD or colitis, some kind of severe disorder. She found somebody who was healthy and had a healthy diet, that sort of thing, got them to donate it, did it up in a blender, did the old enema and the person improved.

I actually remember reading a story of a woman who did it herself as well, actually took a sample from I think her husband, because nobody would do it for her but she had been reading about it. She just did it herself and ended up having a huge improvement. So I think this is the future in a lot of ways.

Tiffany: Yeah, just make sure you have a second blender. {laughter}

Doug: Don't do it in your butter coffee blender.

Tiffany: Right. But if you want to make money doing it, there's also a place - I think it's in Massachusetts - where they are collecting faecal samples from people in order to use for the transplants and they do testing on people. You have to be relatively young and you can't have a BMI over 30 I believe and your poop has to be healthy. So they run tests on your poop. I think you get $40.00 for the initial testing and then if you want to come at least four times a week and donate a sample you can get $40.00 per sample.

Doug: That's not bad money, really.

Tiffany: I think the article said that over the course of the year you can make something like $13,000 in a year just donating your poop to science.

Doug: That's a pretty good part-time job, really.

Tiffany: Yeah. {laughter}

Tiffany: I think that I've also read other articles or studies that said that a faecal transplant from a healthy donor who has a healthy weight transferred over to someone who is obese, that they can actually lose weight because of the healthier bacteria that they get from the transplant.

Erica: Well it's interesting because healthy poop has over 1,000 different types of bacteria and viruses in it so it acts as a probiotic to help stabilize the gut. So if people have serious gut issues and they're not getting any relief from it, this might be something to consider.

Tiffany: Would the NHS cover something like that Elliot? A faecal transplant? {laughter} Or is that considered a fringe treatment?

Elliot: I think in some places they're starting to consider it, especially for C-diff and then there's a couple of other things. It's still relatively fringe. I think you've got to pay big money at the moment. It costs thousands of pounds. You would think that the health services would want to make use of something like that because it's completely free, so cheap.

Doug: Yeah. In fact if they're charging thousands of pounds for it, what's the justification there? It's poop? Where's the cost. You pay the guy $40 apparently. Done. Where's the other $9,660 coming from?

Tiffany: Well you have to pay the person who's going to administer it, overseeing it. But I can't imagine that it should cost any exorbitant rate.

Elliot: I was reading about someone who did it herself. She paid one of her friends and she just started doing it herself. I think she blended it up herself and then either put it in as an enema or she might have made capsules out of it, frozen it or something and made it into capsules and then just did it herself and she said that it was completely free. It cleared her up of C-diff I think. I don't know about the practicalities of that.

Erica: Desperate situations call for desperate measures.

Elliot: Indeed.

Doug: And the potential for this is pretty big too. Tiff you were talking about taking a faecal transplant from a thinner person would actually help them lose weight. Apparently in rat studies and mouse studies they've done a number of different things with faecal transplants and found some pretty amazing things; getting rid of psychological types of disorders. I don't remember the specifics now but I think it was depression or anxiety. There were actual behavioural differences where there was a behaviour in one mouse group, they gave them a faecal transplant from a group that had normal behaviour and that behaviour cleared up. And if I'm not mistaken, vice versa. They were actually able to create an anxiety disorder in a mouse just through faecal transplant. So the potential for these things I think is really huge.

Erica: Yeah! They've used it for autistic children and it has helped with symptoms.

Doug: Right now I think Mikaila Peterson released a video recently about how she is exploring that possibility for her issue. If that works for her great because the fact of the matter is she's in a situation where she reacts to absolutely everything except beef. So even though she said she plans on sticking to a carnivore or carnivore-like diet even if she does get better, just to be able to have a little bit of variety, something, would be great for her.

Tiffany: Well you can imagine that if she actually did have the faecal transplant and wrote about it or posted a video about it, there would be people lined up to have one.

Doug: Yeah. I think that would probably boost the popularity because she has a huge following.

Tiffany: So that's our next investment opportunity. {laughter}

Doug: Yeah. Sell your poop.

Tiffany: Or invest in poop-selling companies. Get ahead of the curve.

Doug: Yeah, there you go.

Tiffany: So have we talked enough about poop and fiber in the diet?

Doug: I didn't have anything else.

Tiffany: We can look at that Bristol stool chart just to close things out. We can talk about what is a healthy poop and what isn't a healthy poop. I'm assuming that whoever created this chart was named Bristol but I could be wrong.

Doug: It's a hell of a thing to be named after.

Tiffany: One through seven. I think most people can say they've had all of them at different points in their life. But the type that is most desirable is types 3 through 5 with type number 4 being deemed as the perfect poop. So if it's smooth and soft and snake-like - I like to say it's like the width of one of your fingers. That's how big your poo should be.

Doug: That's thin!

Tiffany: Yeah. But it happens.

Doug: I'm definitely not there.

Tiffany: I'm not going to say who it's happened to or anything {laughter} but yes.

Doug: Maybe I'm wrong about this but I think that most people should have an instinct of what is a good poop and what's not a good poop. When you're in there and you're having some problems I would think anyway - maybe people do need this chart because they might look at it and think, "Oh really? That's not a good thing?"

Tiffany: There should be no straining involved, no blood and you shouldn't stink up the entire bathroom, not to say that poop shouldn't stink. It does have a distinct smell, but if you have to open up all the windows and spray a whole can of air freshener, then something's probably not right.

Doug: Yeah, because you're a vegan. {laughter} That's one thing that I noticed when I went carnivore. The odour just was no longer there. This is probably getting into way too much detail. We'll leave it there.

Tiffany: So everybody aim for a type 4. If you hit a type 3 or type 5 I guess that's okay too. But maybe you'll get there one day.

Doug: It's a worthy goal.

Tiffany: So I guess since we talked about human poop, now we can move on to Zoya's pet health segment where she talks about dog poop.


Zoya: Hello and welcome to the Pet Health segment of Objective:Health. This week's topic is going to be poop. Don't laugh! Apparently some scientists take this issue very seriously, especially when it comes to the direction dogs assume when they unload the said poop. So watch the following two videos in order to learn more about the two most important issues - why some animals eat their poop and why dogs take a while before they poop. Have a great weekend and good-bye.

Emily: Hi. This is Emily from Minute Earth. Humans eat lots of weird stuff but one thing we almost never eat is poop either because we're naturally grossed out by it or because we've learned that poop contains nasty pathogens. But for lots of animals, faeces is a regular part of the menu. That's partly because poop isn't necessarily as dangerous as we think. While poop from sick individuals can contain disease-causing bacteria, viruses and parasites and contaminate anything they touch, healthy poops are usually just water, harmless bacteria, undigested food and some metabolic waste and dead cells.

Poison control centres consider accidental ingesting of poop, human or otherwise, to be minimally toxic and doctors even prescribe poop pills from healthy people to combat hard-to-treat gut infections. And because the digestive process doesn't usually manage to suck all of the nutrients out of food, poop is nutrition. Herbivores for example, leave a third of food nutrients in their poop. As a result, animals like dung beetles and flies subsist almost entirely on nutrients from the poop of other animals and for thousands of years humans have built toilets over pig sties because pigs can get almost all of their nutrition from human poop.

And while some dogs will scarf down pretty much any poop they come across, many dogs will actually use their keen noses to sniff out fresh poop that has specific vitamins or enzymes they're craving. Some animals regularly extract leftover nutrients from their own poop.

For example, when gorillas feed on the piece of the dialium tree, their gut bacteria soften the tough seeds but don't extract many nutrients so when times are tough, gorillas will often eat their excrement to extract the seeds' full complement of fat and sodium. And when the southern cassowary eats southern cassowary plums the fruits are so big and the bird's digestive tract so short that the cassowary poops out whole chunks of the fruit. He then turns around and picks them out to eat and digest again.

Other animals absolutely have to eat their own poop. For example, rabbits eat lots of the same foods that ruminants like cows do but while cows have long, complex digestive tracts to give the microbes inside time to break down the tough plant cells, rabbits have much shorter guts. So after a yummy plant meal, they poop a soft mucous-covered cluster that contains the partially digested food and the microbes in charge of digesting it then then gobble the whole package back up in order to recover the nutrients and bring the microbes back into their gut. Finally the rabbit poops real rabbit poop.

Koalas too must eat their own poop, or at least their own mom's poop. They have a specialized diet of eucalyptus leaves which are both fibrous and toxic and koala babies aren't born with the specialized bacteria needed to break it down. So for several week the baby just eats pap, a soft green poop chocked full of those bacteria that the mom makes special for her little one. Pap both supplies nutrients and gives the baby the microbes it needs to digest its future food. As baby food goes, this number two is second to none.


Watch where you're walking! If it's on the north/south access of the earth's magnetic field, you might be more likely to step in dog doo. According to a study from researchers in Germany and the Czech Republic, when dogs are looking for a place to poop, they align themselves with the earth's magnetic field before doing their business. The study lasted two years during which time the researchers looked at nearly 2,000 dog poops from 70 different dogs. They eliminated several factors that could influence the dog's preferred locations like the wind, the angle of the sun and the time of day. The dogs were kept off-leash and allowed to find their own place to defecate and they often chose the north/south axis of the earth's magnetic field and reported avoided the east/west axis.

Researchers aren't sure of the reasons behind the orientation but they noted that when there was instability in the earth's magnetic field caused by a shift in the earth's magnetic field and solar wind, the dogs didn't stick with the pattern and ignored the north/south axis.

Tiffany: Wow, thanks for that Zoya. I never thought I would learn so much about animal poo and dogs lining up with the axes.

Doug: That is just bizarre.

Tiffany: Well I can say my life has been enriched. {laughter} Okay, I guess that brings us to the end of our shit show. We will be back next week with another show on a topic that is yet to be determined. So thanks for watching. Remember to hit the like and subscribe buttons and we'll see you next time.