The Crunchy Allergist 0:05
Are you sick of the fatigue and fog fed up with unpredictable flares hangry from the super restrictive diets. Hello, and welcome to success with sjogrens a podcast empowering naturally minded and scientifically grounded women looking to reduce or even eliminate their sjogrens symptoms. Hi, I'm your host Dr. Kara wata, a fellow sjogrens spoony triple board certified allergy immunology and lifestyle medicine physician, coach, medical educator, and mom. As a reminder, although I am a physician, I'm not your physician, and this podcast is for educational purposes only.
Hi, everyone, thanks for joining us for this episode of the Success with Sjogren's Podcast. I am super excited to welcome another one of my esteemed colleagues today Dr. Parastook Janouk who is dual board certified in internal medicine, and gastroenterology. She practices medically in Austin, Texas, and she's also a gut health expert and a certified life coach. So she does all the things. One of the things that I have really loved about following you is all of your awesome Instagram posts. They're so incredibly rich with just great information, especially on gut health that I have sent countless patients to Instagram. But super excited to have you here. And I'd love for you to introduce yourself. And we can kind of jump on into things.
Dr. Parastook Janouk, MD 1:52
Thanks so much, Kara. I'm so excited to be here. Thanks for having me on your great show. And thanks for the great introduction. So I think the introduction was complete. I'm a practicing gastroenterologist certified life coach and gut health experts currently living in Austin, Texas. And I love bringing in life coaching to gut health and links our minds to our guts. So that's basically the angle that I see things from most of the time.
The Crunchy Allergist 2:34
So when we talk about gut health, what what does that mean? And like, how do you talk to patients about that in the office.
Dr. Parastook Janouk, MD 2:44
So as you probably know, gut health these days is a buzzword. But beyond, you know the buzzword, I think there are a lot that we can talk about. So traditionally gut health. We know gut refers to our digestive system. So when we talked about gut health, it was all about having a basically functioning GI system or digestive system. But the last 10 years, I think what we learned with our expanding knowledge about gut microbiome, the definition of gut health has changed tremendously. And it's going to be evolving from here on and I'm sure in the next 10 years, you're going to have great data that gut health. It's not only referring when we say gut health, we do not only refer to the health of our digestive system, but we are referring to the health as you know, has a holistic meaning here, the health of our body or other organs. Because now we know that our gut microbiome, it's essential in basically working with other organs in our body. It's not only our digestive system, our gut microbiome is constantly in communication with our brain, with our endocrine system. And without immune system. I'm sure we are going to come back to this on this episode. And with our cardiovascular system, and the health of our gut microbiome is something that we need if you want to have a healthy mind and healthy body. We really need to have a healthy gut.
The Crunchy Allergist 4:36
And what sorts of things do you tend to recommend that people think about when they maybe want to make some improvements in their gut health?
Dr. Parastook Janouk, MD 4:49
Great questions. I always get this question in the office. My patients come to me and asked me, they always ask about different kinds of stuff. And they asked about different kinds of probiotics, prebiotics, vitamins, and a lot of commercial stuff out there. And I always tell them, and I would really love for people to know that we, you know, our knowledge about gut microbiome is really in its infancy. We know a lot, but it's not really that much. I'm sure we are going to learn more in the next 10 years, as I said, but for now, we don't really know much, we only know one fact, we know that our gut microbiome is thriving on fiber on dietary fiber. And this is the fact that has been consistently shown in the data. And if you really want to have a healthy gut microbiome, you really have to change your diet, you really have to increase a diverse diet, a diet diverse in fibers, which we find fibers mainly in plants, that means fresh fruits, vegetables, whole grains. And you name it legumes, and all these seeds and nuts. So that's the what the data says, the rest of fat probiotics and so forth. So we don't know we really, this is an unregulated business, we don't know what happens to probiotic, it rarely even gets into our colon, where the majority of our gut microbiome lives passing through all these different kinds of digestive enzymes or stomach acid. So that's to be determined. But for now, I would say, you know, this is very powerful. By changing our diet, we really can change our gut microbiome. And I think this is something that is under valued. And I'm very happy that you're doing this. And also, you're a proponent of plant based diet.
The Crunchy Allergist 7:02
Ah, yeah. And I think that's what's been, I read another article this morning on, you know, one of this celebrity podcasters is doing a month of current carnivorous eating again, and I was like, oh, gosh, that again, like, and just one of the quotes that they said was that he had terrible digestive distress, like, you know, diarrhea and things? And I'm like, Well, yeah, because your poor microbiome isn't getting any probably nutrients, you know, to speak of, you know, minimal fiber, if you're essentially eating steak, and, and all those things, you know, three times a day.
Dr. Parastook Janouk, MD 7:46
It's just crazy, you know, right. As you said, I wasn't aware of this carnivorous diet to be honest, up until a few months ago, and that was when on Instagram, one of my followers, who is an acquaintance, started posting that she went on this amazing diet, carnivorous and I thought, initially, this is a joke or something. And but I started falling, and no, she was serious. And she was just like, saying, that's just amazing. And, you know, like, it blew my mind. And actually, so I know that we are talking, I was really thinking, a lot of things that, you know, as physicians, it's very obvious to us. And it's an no brainer. And we think, okay, people know this, and we don't need to educate people on this topic. But you see, it's so confusing for majority of people out there, did all these different fat diets that are out there, and even up until to be honest with you up until a few years ago, myself, even as a physician, because there wasn't really a you know, they don't teach us this. No, yeah, no, right. I was just like, I thought that a high protein high in I'm sorry, a diet high in animal protein is the way to go if you want to be fat and build muscle. So I was working out and I had just crazy high protein diet with minimal fiber was a physician and I was smart. And I think it takes something more to research on your own and just go through the data to understand between fad and real and I want to say plant based diet diet as you know, it's not a fad. It's not going to go away. It's the future of medicine.
The Crunchy Allergist 9:35
Yeah, no and I agree in it's interesting. So in in my my route to kind of eating a more plant forward diet has been a long and winding road. But along the way, stopped and tried some different paleo type approaches. And one of the things that came up in conversation with my husband who's a cardiology He's like, this is too much meat, he's like, you know, we know that this is bad for cardiovascular health. So he kind of came from that lens. And I've dealt with more constipation predominant IBS type symptoms off and on. And so I've kind of realized too, when I cut out oatmeal, which is my favorite grain, I don't do so well, like I do much better when those gut bugs are fed with, with more fiber. And so it's, it has not been a direct path, but it's been kind of, you know, these different bread crumbs, or cookie crumbs, whatever you want to say that I've kind of left along the way, you know, and kind of culminated with, with everything I learned kind of through lifestyle medicine, which really promotes you know, all of the the data behind a plant based, you know, whole food plant based diet. Have you found anything to be helpful in your own day to day life to help you kind of with making that transition from, you know, kind of a more animal protein heavy diet to a plant based diet?
Dr. Parastook Janouk, MD 11:14
Yes, you know, what I realized since last year, when we decided to become plan forward, more plant forward, we basically what we do, we are not completely plant based. We eat plant based completely plant based the whole week. And also, you know, I still have a here and there. I replaced my milk with oatmeal, which I love. Yeah, me too. And I highly, highly recommend. Actually, I think it tastes somehow better than milk. It's still having cheese. So I love cheese. But, and no, sometimes they treat ourselves to seafood, chicken, sometimes even meat, but it's just very, very now sort of like, you know, occasional, and did the things that I figured help me is just become curious around our plans and around the diversity of plans. Because I know people have this basically mindsets, let's call it that they think, Oh, we know if you go plant based, there's no diversity is boring, you have to eat the same thing over and over, which is completely not true. I think when I go grocery shopping, I'm always thinking, what else can I try? What new vegetable? What new fruits? What new grains, you know, what is out there? And that's really, I think, helping sort of like me to explore and figure out because when you ask these questions constantly, then you go after ways that you can bring diversity to your food. And diversity of plants matters. Obviously, you know, that's what I think I forgot to tell people during the last question. That's when diversity of plants is what our microbiome really thrives on the more diverse plants and the microbiome is introduced to the more diverse our gut microbiome becomes. And diversity of gut microbiome is the sign of resilience. That means you have a resilient, healthy gut microbiome. The other thing, I think it's very important, just along mindset is to also think that this is not from when you want to try change and become plant forward plan based, this is not coming from limitation, but it's coming from abundance, you're exploring your whole new world around you, and you can try it and see if you like it or not. And I think if you go there, you don't come back, that's my experience, because you start feeling better physically. And also, I have some ethical concerns or, you know, sort of like with animal eating animals as well. And I feel like becoming plant based, I help environment better. So some sort of like, you know, motivations beyond, you know, self that I think, you know, might work for some people.
The Crunchy Allergist 14:30
Absolutely. And I think you know, what I'm hearing you say too, and it has been really instrumental kind of in our family is having that flexibility of not being you know, say you know, necessarily putting a full label on it like Oh, I'm 100% vegan or what have you that you know, that if there is a wedding you're going to or you know, or going out with friends or something that there's some flexibility, in, in our approaches, which is, I think, for me has been helpful. Because I've tended to go more towards restriction, which is totally, you know, counter to what we know now with diversity and wanting to expand our diet to get kind of all of those different things. And you were talking about some of the aspects to mindset, how have you found mindset and coaching to be helpful kind of with, with the gut and with GI health.
Dr. Parastook Janouk, MD 15:37
So you know, our mind and body, not separate. That's, that's, I think, the first thing that always comes to my mind, when I'm sort of like approaching a client's a patient, you know, it's all interconnected. So we think that they're separate, but actually, they're both part of the whole. And as a part of that is gut, which is part of our body, I would like to sort of like separate say, Mind Body gods, in a sense not to separate them and say that they're, you know, different entities. But to say that basically just like a triad, I introduce a triad of mind by Mind, Body gut. And that's a basically, a health triad or a model that I talked to my patients like clients about, as if it's a triad is a triangle, you see that Mind, Body cards are constantly talking to each other. And, you know, we cannot really be healthy, if you know if one of these muscles are not flexing. So we need in order to be healthy, we have to have a healthy mind, healthy body, healthy gut. And we know that specifically I've got in mind are connected through pathways of nerves and hormones here. And this is science, this is facts. They're constantly communicating, it's a bi directional pathway. And now with the role of gut microbiome, also, this communication becomes more sophisticated. It's a different layer. So basically, it's again, my body gut connection. So what happens is that our nervous system, our brain is constantly sending signals to our gut. And vice versa. Our gut is constantly sending signals to our brain, if there is any disruption, or if there is an impairment anyway, throughout this pathway, that then basically, irritable bowel syndrome happens. Certainly the last, I would say few years, we now tend to call IBS or irritable bowel syndrome, more like diseases of gut brain connection, because of all these knowledge that we have. And we know now that there is a connection and there is an impairment in this connection. So if you can repeat your question for me, because I think I may
The Crunchy Allergist 18:18
know, this is all great. Just the, you know, this role of coaching or mindset kind of in the approach to, to the symptoms. And in particular, I'm, of course curious with irritable bowel.
Dr. Parastook Janouk, MD 18:32
Okay, exactly. If I wanted to get to this point, exactly. I was like, Oh, I wanted to get to coaching. I don't know what happened. So with coaching, what happens? Basically, I think, the role of mindset, or let's say, coaching of mindset, is that when you know how to even you know, your nervous system when you know your brain, so you really can sort of like modulate the effect of your mind on your body, or even vice versa, when you know, how your nervous system really communicates with your gut or with your body. Because if you see, you know, trauma response, what happens when we are really in trauma response is the response of our sympathetic nervous system, which is our autonomic nervous system that makes us go into this response that we fight or flight, exactly fight, flight, spawn, freeze, and that's a trauma response. That's the response that has basically played a great role in our evolution and got us here. And now when we feel threatened. When we feel that you're under attack this system sympathetic nervous system gets activated. That's when our blood pressure goes up. Heart rate goes What's up, our breathing gets fast, our digestion slows down, and to help us deal with this trauma and deal with the stress or the acute stress. So that's the way that our mind communicates with our body, whatever happens in our mind, if we feel threatened, interprets interpret something as a trick, you know, we start our body starts responding accordingly. So, where coaching comes into play is that to help our nervous system interprets tread, or triggers, because necessarily not everything that happens outside and be perceived as threats are real threats. And that's the role of coaching, I would say, that's when we have the power to calm our nervous system down. Or if the going, sorry, that dial, yeah, right, exactly,
to dial it down. Or if we go even to trauma response, which happens multiple times throughout the day for each of us, we can even just like, you know, call ourselves done down and go to our body and see, you know, face the effects of trauma on our body, and can fine tune that dial, like back as you said,
The Crunchy Allergist 21:24
it's always um, I recall, like being very young, and my mom always explaining like this idea of like, Oh, I get this nervous stomach or, you know, like the butterflies in your stomach and kind of this gut feeling. And so that's kind of the the analogy or kind of the story I shared with patients just to kind of explain or, you know, this idea of the mind gut connection, but it really is incredibly powerful to see how we can actually use that to our advantage, when we're dealing with some of these different conditions that are related to, to mind body, and that we are to be more empowered through some of these coaching techniques, which is really awesome.
Dr. Parastook Janouk, MD 22:14
Exactly. So you know, just to add, here, I have an analogy that I use a lot. So just to open up for our listeners who are not in medical field, a big part of our nervous system is responsible for our bodily functions behind the scenes. And that's then everything happens subconsciously without our input without our you know, it's just like, we really don't have any say into how our heart is beating, right, we are not aware of our breathing most of the time, we don't tell our lungs Okay, breathe at this grade, or our heart to pump up the street, or our digestion we don't, we cannot dictate anything to our digestive system. These are happening behind the scene by autonomic nervous system, which is made of two main three, but here just for the sake of it to say two main, a nervous system sympathetic. And parasympathetic. Sympathetic is the trauma response, or we call it fight or flight. Parasympathetic is rest or digest. So basically, when we are stressed out, sympathetic nervous system comes to play, and parasympathetic nervous system comes later to clean up after the storm to bring things back to normal. So we always want really to be living in parasympathetic nervous system, if you want to be healthy, right? That's where you want to be because that's where your digestion is optimal. Your heart rate is at the rate that it should be, everything is quiet. And that's interesting. I say all these great things, but you hear they tell us to do meditation, yoga, belly breathing, coaching, and mindset that I think some people may say, Okay, I'm just tired of people telling me do this, do that. What the heck, what is meditation? What does yoga do? That's there? You know, it just basically, without doing those, you're going to be in parasympathetic nervous system. So you are going to be distancing yourself from your trauma response. That's where your mind and body should. I would say, it's not possible but we should try to be living there more often.
The Crunchy Allergist 24:43
Because we're not being chased around by tigers all day long. We feel like
Dr. Parastook Janouk, MD 24:50
Yeah, really. So you know, exactly. As you said, I don't think we need our sympathetic nervous system, right because we have to respond to stress. If we see the tiger as you said, if you see a car In front of us in the highway, slamming on the brakes, we need our sympathetic nervous system to slam on the brake and, you know, respond accordingly. And that's an evolution evolutionary response. But, you know, now with this modern life, we are constantly in sympathetic nervous system, we are constantly in stress response, because somebody says something because somebody does something because traffic is, you know, heavy because we get later a lot of things, you know, our kid is doing other parents are doing this is exactly the same response that you do when you see the tiger, then you get stressed out, right. That's where coaching comes to play.
The Crunchy Allergist 25:45
Yeah, as I hear my little one crying in the background, it's like, that's a response. I learned to now as it's the third, like with the first one, you know, on hyper alert all the time. And now it's like, Oh, fine. That's got it. No problems at all
Dr. Parastook Janouk, MD 26:03
way. Yeah, exactly. Exactly.
The Crunchy Allergist 26:09
So thinking of take home messages for our, our listeners, it sounds like, you know, basic things are really trying for diversity of fiber in our diet, trying to get more plants in our diet, and tapping into the rest and digest kind of mode, as I've kind of thought about it to any other take home messages you'd love to share.
Dr. Parastook Janouk, MD 26:35
So, yes, exactly. As you said, you know, I, I would like for people to, you know, remember from this episode, I think that our mind, body and guts are interconnected. And you're constantly in communication. And it takes, you know, awareness, to basically have some control and try to basically make things go the direction that you want, if you want to be healthy, we have to really pay attention to our gut, as you said, we have to have a diet diverse in plants, and stay away from red meat, processed meat and, you know, eating a lot of meat, and that by by itself, and you'll have a healthy gut microbiome, so your other organs are going to be functioning better healthier, your mind is going to be much more at ease. And then then, you know, during the day, I would say it's very important when you're in that stress response. And you know, you know, your heart rate goes up, you're upset, you're angry, you're mad, try to sort of like really calm down and get that response. tune down that response. I think that's very important, because the detrimental effects of leaving chronically in that stress response, that's when we see all these diseases coming up.
The Crunchy Allergist 28:09
Including autoimmune, which is, you know, kind of a circle ourselves back.
Dr. Parastook Janouk, MD 28:15
Exactly. So I think yeah, that's, as you said, I just I forgot to say this, but because I know we are short in time, but just in one minute. So interestingly, we've also during the last 10 years, we also discovered that greater than 70% of our immune system lives in our guts, and it's separated from our gut microbiome by a very thin layer of cells and the polio cells. So they're constantly communicating by molecules, that the gut microbiome secretes immune cell secrets to do is this connection. So the role of gut microbiome in autoimmune diseases in cancer is now really getting more and more becoming more and more topic of sort of like people are trying to figure out, really, there is that link, which makes sense because we know that autoimmune diseases, we think there's some genetic role, but it's not obviously 100% linked environmental role. Yes. But we don't know what I think that missing link is really gut microbiome. What I
The Crunchy Allergist 29:26
find so fascinating, it you know, my training, I finished up my allergy immunology training around 2016. So, you know, it's relatively recent, there was only one chapter in my basic immunology textbook, which is like, gets into the nitty gritty of the immune system that we kind of have to know for our boards, one chapter that talked about immune system in the gut out of like, you know, dozens of chapters, so I I'll be curious to see how that that book, and all those others resources involved over the next 10 years, and just how much information we're seeing, develop in that area. I'm like, I wanted to be here already. But, you know.
Dr. Parastook Janouk, MD 30:14
It will be fascinating. Yeah I know.
The Crunchy Allergist 30:17
Well thank you so much. Where can people find you so that they can follow you on social media or kind of or maybe work with you or if we have people who are in Austin who want to come see you um how can they find you?
Dr. Parastook Janouk, MD 30:30
I think the easiest way is my instagram account is mindgutfitmd and my website is https://mindgutfitmd.com/. So yep anytime they want, if they want to message me on instagram, happy to answer any questions. Yes and I think you have facebook also I am on facebook, Mind Gut fits MD but more active on instagram awesome.
The Crunchy Allergist 31:03
And yeah especially going back to some of those posts right in the middle of the pandemic, those. I was just totally like learning so much from and always have beautiful pictures to. I'm hoping one of these days I'll be able to get down to Austin or maybe we'll be able to meet up at one of the conferences would be fantastic.
Dr. Parastook Janouk, MD 31:24
Yes, for sure. No, thanks so much. I also enjoy following you on instagram. Thanks for doing this. Thanks for educating people. I think we really need this as many physicians as they can get out and spread the fact and data. I think I really love that and hopefully we can meet soon.
The Crunchy Allergist 31:50
Yeah. Well thank you so much and take care and be well.
