7 Health benefits of fibremaxxing and how to build a high fibre diet | Dr Karan Rajan

Dr Rupy: I'm Dr Rupy and on this show, I help you feel more in control of your health through food and lifestyle medicine. Fibromaxing is everywhere right now, but it could be a trend that actually is doing some good. However, like most things in nutrition, it's not simple. There are different types of fibres doing different things, and more of one type isn't necessarily better. So today, we're doing a deep dive into fibre and the benefits to your brain, inflammation, menstrual health, and even fertility. Why fermentability and solubility should be on your radar and which foods to focus on. And there's no one better to have this conversation with than Dr Karan Rajan, surgeon, author, and one of the most trusted voices online when it comes to gut health. If you're listening to this and thinking you're getting enough fibre, this might inspire you to mix it up. And if you struggle with bloating when you eat more, we've got some tips for you too. Alongside Karan's top tip for the best time to eat fibre in the day.

Dr Rupy: Dr Karan, why is everyone fibremaxing right now and what can it supposedly do for your health?

Dr Karan: I think the question is what can't it do for your health? You know, I'm maybe a bit biased here, but I'm firmly of the belief that there is not much that fibre can't do directly or indirectly in terms of pathways in the body to improve your health. So, why is everyone fibremaxing? You know, it's trending, it's going viral on social media platforms, but I think this is one of the few trends that actually is rooted in evidence and is probably one of the few social media trends that won't send you to the hospital.

Dr Rupy: Yeah. I mean, in terms of fibremaxing, what do people mean by it?

Dr Karan: Yeah, I mean, we as humans and on social media, we like to be very polarized and binary in our outputs. You know, it's extremes always. Extreme restrictions, extreme add-ons, you know, let's get 200 grams of protein or no protein. You know, there's no middle ground or nuance. Fibremaxing, the connotation of that on social media is just how much fibre can you pack in in one day. And a lot of it I see seems to be based around chia seeds. Let's just ram the chia seeds in our chia seed pudding. There's some problems with fibremaxing the way it is now because people are focusing so much on the total number of grams of fibre and not focusing on a diversity of different fibre types, which in my opinion is arguably as important because it gives you different types of fibre. But also, if you're coming from a low fibre baseline, you are putting yourself at risk of some gut symptoms, bloating, cramps, constipation if you don't have enough water with it. So there is a microbiome and colon adjustment that's needed if you're starting from basically no or little fibre and fibremaxing.

Dr Rupy: Yeah, got you. I mean, I guess this fibremaxing trend is addressing a very clearly recognized deficit in our diets, particularly in the UK and the US, right? I think I'm right in saying that most of us, 96% of us aren't reaching the NHS 30 grams of fibre a day target.

Dr Karan: Yeah, a lot of these government guidelines, they say 30 grams a day, but I feel that's based on quite outdated epidemiology. I think it's good baseline to aim for, but I feel that should be the minimum. So yeah, I mean, 95, 96% of people are not getting the the current recommended guidelines. And they're also just not getting the different sources of fibre and different types of fibre that ferment in different areas. And you know, that paired with the fact that we're seeing colorectal cancer rates, specifically in under 50s, go up for the first time in a while. So that's also quite worrying. And we know that one of the biggest, easiest levers we've got to reduce our colon cancer risk is not being fibre deficient. So that's also why there's more hype and focus on fibre.

Dr Rupy: We've mentioned fibre a number of times now. How would you describe fibre to to a noob? Like what what is the actual definition of it?

Dr Karan: Well, the definition would be that it's a non-digestible carbohydrate, right? So this is why people shouldn't demonize or be worried about carbs, because in this instance, this is the best form of carbohydrate you can get. And it's a non-digestible carbohydrate, so it isn't broken down or digested in the small intestine, and it's not absorbed in the body in any way, shape or form. We also don't have the enzymes to break it down, but we have this entire population of gut bacteria which can break down fibre. They've got fibre-digesting enzymes, different types of fibre-digesting enzymes that can break down different fibre types. That all happens in the large intestine or the colon. That is used as a substrate or as a fuel for them to then break that down into different things and produce different compounds in the body. Short-chain fatty acids, which have an anti-inflammatory, antioxidant effect. So you don't technically need fibre to survive. If we were literally talking about survival, we don't need many things to survive. You technically don't need vitamin D to survive for a period of time. You know, you don't need fresh air or sunlight to survive for a very long time. Same with fibre. You don't actually need it to survive, but if you want a life worth living, you need it.

Dr Rupy: Yeah, this is a common rhetoric I find on social media, some of these like hooks like fibre's not necessary, there's no essential need for fibre, and it's a way to sort of like, you know, bring you into a, not to, you know, pound on the low carbs here, but you know, a low carb way of living or a carnivorous way of living. Whereas actually fibre is is relevant for thriving, not just surviving, and you'd want to increase fibre in your diet.

Dr Karan: Yeah, I think if you look beyond the poop and the gut aspect of fibre, it's actually remarkable how much of a role it plays, just because those molecules that are produced as a byproduct of bacteria digesting fibre, they go throughout the body. They exert their effects on pretty much every organ physiological system you can think of. They're involved in neurotransmitter and neurochemical interplay and interface, so has cognitive benefits potentially. They directly help to reduce inflammation in the colon, and long-term inflammation in the colon, in the colonic lining, can raise the risk of cancer because inflammation can cause gene mutations. They can have an impact on the liver health, you know, they can have an impact on the immune system and actually train the immune system, both the microbes and the compounds they produce. They can have an impact on appetite signalling and hunger pathways. Those are just a few things I've mentioned, you know, even more weird things that people are not used to, they can have an impact on your skin health. You know, if your gut health is in disarray because you're currently low fibre, you can actually have exacerbations and breakouts of chronic inflammatory skin conditions like rosacea, acne, eczema, psoriasis, you know.

Dr Rupy: This is incredible. I mean, I can understand why people are fibremaxing because if it's going to help with this array of things, plus a whole bunch of others, like, you know, reducing cholesterol and improving your cardiovascular health, it's it's no wonder people are interested in increasing fibre. And I mean, these are just some things, just to replay it back, you know, brain health, inflammation, immunity, liver health, skin health. I mean, it doesn't seem like there's nothing that fibre doesn't touch.

Dr Karan: Yeah, and call me crazy and maybe you think I'm lying, but actually it can even impact fertility.

Dr Rupy: Really?

Dr Karan: Yeah, both in men and women.

Dr Rupy: Let's talk about that. I mean, you're expecting a child and you're the fibre king, so.

Dr Karan: Got the liver king and then the fibre king. So, yeah, I mean, so we know both in men and women, so let's start with women first. You know, the the colon has estrogen receptors, first of all. And we know at various stages of the menstrual cycle, there are, you know, ebbs and flows and peaks and troughs of estrogen. So directly it has a role to play in like period poops and kind of GI issues during menstruation, right, at various stages of the cycle. Also, we know that via the hormone liver colon axis, that three-way axis, there's a feedback loop called enterohepatic recirculation of hormones. You know, now this is digging back to our physiology in med school, you know. So I knew this really well back then and I had to relearn it as I got interested in this kind of fibre rabbit hole. So what happens is, you know, our bodies excrete estrogen. And how that happens is it's packaged up in the liver to make it water soluble, and then it's dissolved into bile, which is then released into the colon, and then that is excreted. Some of the estrogen, it is reabsorbed by the colon and goes back into systemic circulation via the portal vein, and it's recirculated. We don't sometimes want all of that estrogen to be reabsorbed back into systemic circulation because then you can have a higher amount of estrogen in the bloodstream. The role of fibre, especially soluble fibre, that can increase GI speed, so the sort of reduces GI transit time, so more of that can be shoved away. So if you've got a shorter GI transit time, there's less time for that estrogen to be reabsorbed in the colon lining. Okay, that's one route. The other route is soluble fibre can actually form a net and mesh around the bile acids in which cholesterol is dissolved, in which estrogen is contained. So it can bind to it and chuck it out and prevent it being reabsorbed as well. The final thing is that soluble fibres can also help to regulate the populations of a subset of bacteria in the microbiome called the estrobolome. The estrobolome is a subset of bacteria which has these enzymes called beta-glucuronidase. They can actually help to deconjugate or uncouple estrogen to make it less well absorbed and less absorbed into the colon. So there's multiple mechanisms there, how in women, fibre can directly play a role in fertility. And in men, we know that inflammation can actually worsen fertility and sperm production. So if you've got high cortisol, high adrenaline, chronically, due to whatever mechanism, whether it's like the diet you're having, poor sleep, alcohol, other toxins, that can directly dunk testosterone production, sperm production, affect sperm motility, DNA fragmentation, all the bad stuff with male fertility. Fibre, due to its production of anti-inflammatory compounds, can actually help to regulate and improve fertility that way. So even fertility doesn't escape the powers of fibre.

Dr Rupy: If I'm listening to this and and I'm a woman, just talk me through some of the potential diagnoses that fibre could help with. So I'm thinking menorrhagia or painful periods, PMS, like can fibre have a role with those given some of the mechanisms that you just described now?

Dr Karan: Yeah, absolutely. I mean, what we were talking about with regards to regulating the balance and recirculation of estrogen, I don't want someone to think that fibre directly reduces estrogen. So I need to keep more estrogen, especially in perimenopause and menopause. No. What fibre does, it helps to regulate it. When it's too much, it can bring it down. If it's too low, it can help to regulate it. Think of it as a controller of estrogen balance and that the enzymes and the bacteria it it sort of helps with. So directly it can help with estrogen dominant symptoms. You know, things like you described, dysmenorrhea, menorrhagia, heavy periods, cramps, all those things, plus the GI symptoms associated with periods and other women's health conditions, fibre can help with that. But specifically here, it's more about the soluble fibre, the soluble fibre which is fermented, has a role on the microbiome, because we know at certain life stages, whether it's menstruation, pregnancy, perimenopause, menopause, because of the hormonal fluctuations that happens in various stages of a woman's life, hormonal fluctuations leads to GI symptoms as well often, you know, diarrhoea, constipation, bloating, all those things. Fibre, soluble fibre can help to regulate that. But also, we've seen in a lot of epidemiological studies, like for example, you know, in the UK we've got biobank studies, in America they've got the NHANES database, which they look at epidemiological study, long-term. In some of those studies, when they looked at the highest quartile of fibre intake, that was associated with the lowest amount of GI symptoms in endometriosis, for example. We also have some studies suggesting, newer review studies suggesting that low FODMAP dietary intakes can also help with some endometriosis GI symptoms being relieved as well. So in those specific conditions, we know that fibre has a role. And I think as a dietary adjunct, it's great for a whole host of inflammatory driven conditions, of which we know endometriosis and other similar ones, inflammation is a huge component of that. And you know, I don't like the phrase anti-inflammatory diet because what does that mean? It just means a diet that's rich in plant foods and antioxidants, of which fibre is core.

Dr Rupy: Yeah, yeah. I love that clarification actually. We don't want to think of fibre as a binary thing that can reduce estrogen in the same way you might have a medication that can increase or reduce hormones. You want to think about fibre as a, you know, a modulator rather than something that's going to have a direct effect on on your hormones.

Dr Karan: Yeah, absolutely. And I think different fibres have different roles. You know, you mentioned earlier cholesterol. Fibre in general, soluble fibre has a huge role to play in the cholesterol through one of the mechanisms we mentioned, the bile acid binding and excreting it. But also, certain fibres have a direct role to play in the liver with lipid metabolism as well. They can upregulate and downregulate certain genes and enzymes and pathways in the body to actually get rid of more cholesterol and suck it out of the bloodstream as well. So huge.

Dr Rupy: Yeah, it's it's incredible when you go down this rabbit hole of fibre. You mentioned a couple of times soluble fibre here. A lot of people talk about variety, yourself included. I've had a few friends of mine, some of which have just been diagnosed actually with diverticular disease and other conditions that could be associated with low fibre, about how they've been taught, okay, I just need to have like a fibre one supplement in America. It's just like a monofibre or like wheat bran and that's about it. Why do why do we need to also concern ourselves with variety of fibre and what what varieties are there?

Dr Karan: Yeah, I think a lot of people are beginning to understand soluble versus insoluble fibre, right? But again, that is slightly archaic thinking. The conversation needs to progress to the point of we think about viscosity of fibres, the fermentability of fibres, the actual pharmacokinetics of how it's broken down, how it's metabolized, where in the colon it's broken down. You know, if we go back to first principles of human anatomy, right? The colon is roughly divided into three parts. You've got the first part of the colon, or the ascending colon. You've got the second part of the colon, which is the transverse colon, and the third final part of the colon, which is the descending colon or the distal colon that joins onto the rectum.

Dr Rupy: So it's like a U-shape if you're drawing it on your abdomen at home. Up one side, across and then down.

Dr Karan: Perfect. And in each of those areas, I mean, this is slightly simplified still, there are different pH gradients, there are different populations of bacteria which live in different places. Those different bacterial populations like to feast on different fibre types. The first part of the colon, you get the fast fermenting fibres which are digested there. Middle, you've got the medium fermenting fibres, and at the end, you've got the slow fermenting fibres. They have different roles in the body. You need a mix of those fibres to produce different short-chain fatty acids, different metabolites and compounds, so you feed it different things. And so that is why you need a variety, so you actually feed all the different communities of microbes that live in your body to then produce different things, right? It's almost like, imagine it's a company and you've got different floors, HR, accounts, like the C-suite, whatever, right? And the food delivery needs to reach all those places. If you just have one fibre type, so for example, you mentioned like a a fibre one bar, a lot of supplements out there, a lot of foods and snacks which are fortified with high fibre labels, they usually contain like a cheap, fast fermenting fibre like inulin, chicory root inulin, right? If you get chicory root inulin or just inulin in your diet from like garlic or whatever, it's okay because it's in the food matrix. But as an isolated supplement, it's very potent and that can cause gas and bloating because it's a fast fermenting fibre which ferments in the ascending colon. So you can get a lot of gas, bloating and cramps. And then you're not feeding the rest of the microbiome because these early birds catch it all. There's nothing else for the stuff afterwards.

Dr Rupy: Got you. Okay, so variety is very important. The fermentability of these different fibres will determine in some way where it's going to get to in your colon. Talk to us a bit about some of the foods that might be classified in some of those different areas, if we can actually, because from my understanding, most whole food will have a mixture of all these different types.

Dr Karan: Yeah, so yes, mostly, like we can say that for example, apples, right? Apples have a bunch of different fibres. They'll have the kind of like soluble components, insoluble components, but one of the sort of main prebiotics that it contains would be something like a pectin. And that's a fast fermenting fibre. Even berries, you know, it'll have soluble, insoluble components. It's the soluble which is going to actually make a difference to the microbiome. Things like that will have fast fermenting fibres, and that's fine in moderation because you're not going to get a huge dose of fast fermenting fibres from just apples, unless you plan to eat 10 apples a day. So it's not a huge problem. That is like a fast fermenting fibre. Something which is maybe a medium fermenting fibre would be something like a oat potentially, certain types of vegetables like carrots would be medium fermenting fibres, which ferment in kind of the middle colon, produce different types of compounds. And then the slow fermenting fibres would be the root vegetables, cassava, sweet potato, beans as well, legumes, lentils, those are like the slow fermenting fibres which ferment over hours, give you a more sustained fermentation and feed those butyrate producing bacteria in the end of the colon. So a mix of those in your diet is pretty good and most of our modern diets lean heavily towards the fast fermenting fibres.

Dr Rupy: Yeah, yeah. I guess like, so what I'm hearing is, if someone's listening to this and they've heard from NHS guidelines or another podcast, you know, you need to hit 30 grams of fibre, great. It's not the best move to just get it from a cereal or like a bar or, you know, isolated inulin or chicory root powder that you just add to water in the morning and then just drink. You've really got it going to get it from a mixture of foods so you get all those different subtypes.

Dr Karan: Yeah, you need diversity in anything you're doing. So, you know, I have no problem with someone having their fibre from like a a bar which has fibre to it or a fibre supplement which is giving you extra thing. The thing is, you should just be doing your due diligence, look at the label, what does it have, which type of fibre does it have? Is it a monofibre? Like, you know, psyllium husk is great for one thing, basically helping you poop, but it's a relatively non-fermentable, non-prebiotic or low prebiotic activity type of fibre. So if you're adding psyllium husk to help your microbiome, it's the wrong type of fibre. If you're eating fibre bars or chips or whatever to upgrade your fibre, it's not the best because you could do better. So just be mindful of what you're consuming and try to diversify even those snacks and supplements that you're taking for fibre.

Dr Rupy: Yeah, makes sense. In terms of some of the things, some of the words you mentioned here, like prebiotic, how does that fit and you know, resistant starch as well. How does that all fit in this picture of this classification of the different fermentability of fibres? Is it, do we classify them in there or do we classify them as separate? Like how I want people to get an idea of the categorization.

Dr Karan: So if you're thinking soluble fibres, chances are that most soluble fibres will be rich in prebiotic activity. And a prebiotic is something specifically, a subset of fibre that has a direct influence on the microbiome that can actually feed your gut bacteria. Okay? So another fibre type would be cellulose. You'd find it in plant cell walls. That is an insoluble fibre that has no prebiotic prebiotic activity. It does not feed the microbiome. It just adds bulk and it can help to speed up transit time and, you know, kind of bulk up your stool. But so think of prebiotic as a subset of fibre that feeds your microbiome. And even within prebiotics, we have different kind of activities of prebiotics, something which can make it all the way to the end of the colon, like the resistant starches, has a powerful prebiotic activity versus kind of low activity as well.

Dr Rupy: And there are some hacks that you can do to like change the sort of properties of the same ingredient, right? To create more of these resistant starches. I know you've you've you've done some of these on on Instagram and TikTok. Like what what are what are some sort of practical ways in which we can we can do that?

Dr Karan: So one of my favourite ways would be, you know, in bananas. You know, like if you look at the full rainbow of bananas, you go from like kind of green, which is like super under ripe, all the way through to almost black, like, you know, almost black with a bit of yellow. That's like super ripe, which maybe you'd use for like cakes or, you know, banana bread or whatever.

Dr Rupy: Smoothies and stuff.

Dr Karan: Smoothies, exactly. So in that spectrum, the sort of blackish overripe ones are high in starch, low in fibre, but also high in antioxidants because the blackness is actually correlated with antioxidant content. And the other end, the super green ones, very low sugar starch content and high resistant starch content. Resistant starch is technically not a fibre, it's a pseudo-fibre. So it acts like a fibre for all intents and purposes and acts like a prebiotic. Right? It's not actually a fibre. And what happens is, as the banana ripens, it begins to lose its resistant starch content and the starch content and the sugar content goes up. So kind of the sweet spot for me that I like is like that sort of type three, four banana and that can help helps give you the type three, four stool as well. It's like just slightly green. You know, it's not quite got any black to it as well. That is pretty good. But also with any carbohydrates, whether it's pasta, rice, potatoes, they all have starches. And if you cook them, allow them to cool down, the crystalline structure of the starch begins to change and it reorganizes to resistant starch, which again is that type of pseudo-fibre. And that process of starch going to resistant starch, which then breaks down in the colon, not in the small intestine, it's called retrogradation, that chemical process that happens. And that resistant starch content, you can do it with beans, you can do it with carbohydrates, pasta, water, potatoes, any type of potatoes. You can even freeze them and heat them again and that resistant starch content will remain. It's hardy and it's heat stable as well.

Dr Rupy: Amazing. I always have cold potatoes now in my salad every every ever since I heard about this retrogradation process. And for anyone that missed it, Karan just made a Bristol stool chart joke in the middle of that exploration, which I thought was pretty funny. If someone if someone's listening to this and they think, I'm good. I'm I'm getting enough fibre. I'm, you know, I eat my salads every time I I have my meals. Are there any signs that people can pay attention to that might signal to them that they're not actually getting enough fibre?

Dr Karan: Yeah, I would say they're pretty vague signs once we get into it because it could be overlapping with a bunch of other stuff. But if we look at what fibre can do for body systems, we can then look at the flip side of what happens if it doesn't, right? We know that there's a timeline in which you get short, medium and long-term benefits with fibre. And by the flip side, you'll suffer the consequence of these if you're not getting enough fibre. So shorter term benefits of fibre, like almost immediate benefits, would be help with bloating and regularity of stool. So you might find yourself irregular with your stool, feeling more bloated and just gassy if you've got a low fibre intake. Medium term benefits of more fibre would be things like, you know, you're starting to feel more satiated and full with your meals, right? Because fibre doesn't just work for the meal you eat. It has something called the second meal effect, which is if I have fibre now, it's going to give me sustained fullness and appetite signalling throughout the day. So you'll start to feel more full generally throughout the day. You'd get a more stable blood sugar response as well. You might over days and weeks of eating more fibre, find yourself with more energy, more clarity, more focus. Similarly on the flip side, you might struggle with that sort of midday slump if you're not having enough fibre. And then the longer term benefits of disease risk reduction, lower cholesterol, LDL, apoB reduction. You have better control of blood sugar, the HbA1c longer term, the long-term blood sugar control, especially useful for pre-diabetics and diabetics. And then even the longer term over months and years, risk reduction in type two diabetes risk, cardiovascular disease, colorectal cancer, in fact a bunch of cancers. So all of those things, if you flip it, you're going to raise your risk for all those things and symptoms if you're not fibre sufficient.

Dr Rupy: Totally, yeah. I mean, just as you were going through some of those signs and diagnoses, you had your own personal story with health and I imagine this is how you got into fibre in in such a big way. What what was your sort of wake up call to what was perhaps deficient in your diet and your and your lifestyle?

Dr Karan: Yeah, so I think as doctors, sometimes we're our own worst enemy, you know, and it's often a culture of, you know, do what I say, not what I do. And I was living that lie for a long time where, you know, I was a gut surgeon, I was like so involved in the gut and like dealing with cancers. And I could see it at the coalface, like what is the consequence of a low fibre diet? I could see it, I was operating on it, right? But I wasn't paying heed to that. And in 2018, I was 28 years old, going to the gym, eating lots of protein. Most of my protein was coming from meat, animal sources as well. So I was having a high saturated fat diet, a high salt diet as well, lots of like deli meat, bacon, things like that. And also, importantly, low fibre. That's like the unholy trinity for your microbiome. High fat, high salt, low fibre, right? Which is, you know, often what we find in ultra-processed foods. You know, that's kind of like the sort of demon effect. And in 2018, I had a random blood test and I thought it'll be fine. Turned out I had really high for my age cholesterol. My LDL cholesterol was high, my apoB was high, and I was shocked. And I worked with a dietitian to look at my food diary and it was just low in fibre, like maybe 10, 12 grams of fibre a day, mainly from like toast and bread, which is not like the best fibre source you can get. And I worked with her over a couple of years to raise my dietary fibre intake, reduce my saturated fat intake from meat, more plant proteins to sub that in. But also she recommended that I try fibre supplements as well. And that was like a two-year long journey to reduce my cholesterol. And actually that high cholesterol led also to fat deposition in my liver. I had an ultrasound scan, a fibroscan for my liver, and that showed early signs of liver stiffness and fat deposition in the hepatocytes. So it was at the stage where it was reversible.

Dr Rupy: You were 28?

Dr Karan: I was 28. So 28 I had the high cholesterol, which was a shock in itself. Six months later, I still had the high cholesterol, it was going down, and actually my GP recommended and my mum recommended as well, you should just get a fibroscan for your liver because, you know, as part of this metabolic syndrome and people these days having high cholesterol, we forget about the non-alcoholic fatty liver disease or MAFLD as we like to call it now instead of that. It's a thing that one in five people have these days and it's asymptomatic. And it was important for me to look at that because eventually that non-alcoholic fatty liver disease will progress to cirrhosis if it's kind of like, you know, untreated. And cirrhosis can raise your risk of other things including hepatocellular carcinoma, liver cancer. So I mean, that's a long-term thing if it's untreated, but I wanted to nip it in the bud. So for me, it was at a stage of that early fatty liver disease, you know, stage one, where with a few months of solid diet, taking care of my diet and lifestyle, I could reverse it. And I managed to reverse it over two years. So it's not a quick fix, I reversed it. And fibre was core to that.

Dr Rupy: Yeah, yeah, yeah. I mean it's amazing, man. I mean, I think sometimes you need to have that personal experience for you to recognize, particularly at such an early stage in your medical career, that the penny dropped with fibre and and food in general. And I think, you know, doing a seven-day food diary is a really good way of becoming a lot more cognizant of actually what you are putting into your body because I imagine as a a surgeon in the NHS, you would have been just downing sandwiches and hospital canteen food. Like I was as well. I mean, every it's a standard junior doctor diet. It's, you know, what we're exposed to.

Dr Karan: Yeah, the the the random non-descript meat, Moroccan lamb stew. Which was cooked by someone who is neither Moroccan nor has ever seen any Moroccan food. So, yeah, there was a lot of slop that I ate. And yeah, just the pressures, there's so many different lifestyle factors, but I think if I didn't have that experience, because I didn't, in medical school, I actually don't think I had the word microbiome in my lexicon, in my vocabulary. And it actually took that experience for me to dive into the microbiome, fibre, and become a better doctor, but also become better at knowing how to look after myself and then educate others about what I learn as well.

Dr Rupy: Yeah, yeah. I love that, man. I think, you know, just those moments of self-reflection where you realize that, I mean, 28 is an early time as well. 28 is a very early stage to have that high cholesterol and those changes on your liver. But, you know, I look back at my own medical experience and I'm like, I look back at it with gratitude now because had I not had that moment, I wouldn't have learned so much about the microbiota. I wouldn't have done my masters in nutrition. I wouldn't have, you know, gone down this rabbit hole of food and lifestyle medicine. So it's, I think it's like a a blessing, but at the time it was probably, you know, really overwhelming.

Dr Karan: You know, in, so 2018 when this happened to me, most people kind of like, either online, colleagues of mine, even my bosses, no one was ever talking about the microbiome. It was still relatively fringe in, you know, like public discourse. And microbiome scientists were never kind of like given the limelight. Now they're they're the gods. They're the guys, you know, you go to. And, yeah, so I think thankful that we're at the stage right now where actually we are now invoking what Hippocrates was saying all along. All diseases start in the gut. You know, we're just a couple of thousand years too late.

Dr Rupy: Totally, yeah. Yeah. I had an Ayurvedic doctor on recently who's a public health researcher as well, and it's just incredible actually what traditional medicine says about gut health. And like that was like 3,000 years ago. Like, wow, how on earth did they recognize all these core features of diversity and fibre? And you look at it now and you're like, okay, this is the kind of stuff that we should have known all along. And we can look at it now with the, you know, with the benefit of modern science.

Dr Rupy: Guidelines are say 30 grams, but I'm an optimizer, right? Is there an upper limit that there is for fibre and, you know, is it possible to perhaps eat too much fibre?

Dr Karan: So if we look at some of the epidemiological research that's been done, the trials that have been done on fibre in populations and looking at the health benefits, you get a lot of health benefits at that 30 gram mark. And it's an easy way for people to say, okay, aim for 30 grams a day. But actually, if you look at the dose response curves within those studies, there is ongoing benefit and yield conferred to your health beyond 30 grams a day.

Dr Rupy: Can you just explain to the listeners, sorry, what a dose response curve is? So.

Dr Karan: So, like it's a simple XY axis graph, right? So, X would be your total number of grams of fibre, which keeps increasing on the bottom line, and on the Y axis, it's the health benefit. It could be, you know, reduction in mortality or some other benefit, right? And you think about it as like a kind of gentle curve which goes up. So if you're having zero grams, you're at the kind of like lowest benefit. And then as you keep increasing your fibre intake, the benefits increase. You expect it not to be a linear curve like one to one. Like, you know, if you have a thousand grams of fibre, you're going to live forever. No. We wish that was the case, but, you know, I would like to wish that was the case too. But it's like a curve which will go up and then slightly level off, you know, it kind of like troughs. But if we look at the cutoffs, and the dose response is bigger dose, better response, like better health benefits. And we've stopped that kind of arbitrarily at 30 grams. 30 grams is going to give you all your benefits. No. If we look beyond that 30 gram, 40 gram, 50 gram, you still get benefits. And it's not such a hard thing to eke out an extra 10 grams a day. Why not? Because that's one thing in the studies, but there's other studies looking at these microbiome hotspots around the world, as I like to call them, right? Where we look at these non-industrial populations where they're eating more fibre. In South America, the Kitava tribe, the Hadza tribe in Tanzania. We've mapped their microbiomes. They have more diversity in the bacterial species, and they also have the lowest index of chronic disease, lowest index of Alzheimer's, type two diabetes, cardiovascular disease. Why is that? Because their microbiome is more diverse, and they're also, surprise, surprise, eating over 100 grams of fibre a day.

Dr Rupy: Over 100 grams.

Dr Karan: Over 100 grams. So not telling that you need to eat 100 gram. I am personally trying to get there, right? So I can be an honorary non-industrial population member. But there is something there. Why don't we aim for that? And you know, your second question about can you eat too much fibre? The caveat is most people are not at the point where that's a concern, right? It's like asking the question, can you exercise too much? Most people are nowhere near there. Yeah, of course you can. You can exercise so much that it thickens your heart and you're at a higher risk of mortality. But that is ultra marathon runners, Iron Man runners who are doing one Iron Man a week, which is insane, right? You're not at that level. Let's get to baseline and table stakes first. Same with fibre. I don't think we're at risk of doing that. And I personally do not think if you're slowly increasing, there seems to be an upper limit because you can also get foods which are high in fibre and high in protein. So you're not focusing so much on one thing that you're cutting out another food group if you're having a diversity of things. And I think the final thing would be, you can have too much fibre too quickly, right? If you don't drink enough water, if you have one type of fibre, and and even then, the worst case scenario would be like you have maybe a bit of constipation, gas and bloating. You're not going to worsen some disease risk by having too much fibre.

Dr Rupy: Totally, yeah. And let's just double click on that for a second actually, because I'm sure you've had comments online from people saying, you know, Dr. Karan, I tried fibre, it's not for me, I can't tolerate it. What are the common pitfalls that you see people falling into when they try and increase fibre content in their diet?

Dr Karan: So I like to think of this thing that I I made up a couple of weeks ago called the fibre fart curve.

Dr Rupy: The fibre fart curve. All right, I'm intrigued.

Dr Karan: So it's like a bell-shaped curve, right? Like a population bell-shaped curve where there's like two flat ends and then the peak in the middle. That's the bell. So if you're either at a low fibre baseline, like you're having sub 15 grams of fibre a day, or you're like an elite fibre maxer having 30 grams or more, you might not experience much gas or bloating eating fibre, right? But if you're at the lower end, you're just not giving your body enough fibre to ferment anything. And because of that chronicity of not having any fibre, your bacteria are just chilling there and they're like, we don't need to ferment much and there's not much gas and bloating and activity happening, right? Then you start increasing your fibre intake. Suddenly, you are now dumping a load of fibre on your gut bacteria and they're like, whoa, there's all this work we have to do fermenting. And you know, they're having to work more, there's gas and bloating. And that's when there's like a fork in the road. There's a fork in the road where someone adds more fibre, gets gas and bloating, and they're like, fibre's not for me. Carnival pipeline, here I go. They become carnival. But actually, if you push past that, keep steadily, slowly increasing your fibre intake, you start to train your microbes. You start to exert an evolutionary pressure on them to upregulate the number of fibre-digesting enzymes they need to produce in their in themselves. So there's that microbiome adaptation where your microbes, because of the increasing fibre load, become more efficient at fermenting fibre, and then you get past the peak and then now you're into fibremaxing territory where you've got efficient fermentation and less bloating for the same amount of fibre. And then you level off the gas and bloating. So that is a fibre fart curve. Go slow with your uptitration of fibre and drink plenty of water to mitigate any side effects.

Dr Rupy: I love that. So drinking more water, making sure that you get over that fart curve. And it's sort of like exercising, right? So when you go to the gym for the first time, if you're not used to training, you're going to feel sore the first time. But making sure that you go slow, you titrate up your weights, those DOMS, those delayed muscle fatigue, like that's going to get better over time. And it sounds like it's similar with your your microbiota as well.

Dr Karan: Yeah, you know, I think when most people think about fibre, they think, oh, I need to stick to it for, you know, a long time to notice any changes. We know from research that within 24 to 48 hours, you see rapid alterations in microbiome composition. Within just 24 to 48 hours after eating a fibre rich meal, you see increases in beneficial bacterial populations. You see increases in alpha diversity, which is like, you know, one of the sort of markers of gut health in general in, you know, the microbiome world. So I think that is pretty telling that even though you may not be able to feel something in a few hours, you there's invisible changes happening in your gut. Now, having said that, the caveat there is, if you don't stick to those changes, those changes disappear. You need to be consistent with those changes. And you know, like when a lot of people talk about, you know, and I used to be there as well, like, oh no, you have to get fibre only from food, right? You can actually still, like, you know, fake fibre people like to call it from like foods and supplements. You see changes in those as well. Like, you know, I don't know if I told you, but like we did some clinical studies for for Loam. In our preclinical studies, we saw short-chain fatty acid production within six hours. Wow. So there was increased acetate production in six hours in both normal and ulcerative colitis microbiomes. And within 24 hours, 48 hours, we had the full range. So with any fibre, you see microbiome changes pretty rapidly.

Dr Rupy: And can you extrapolate that increase in short-chain fatty acids to benefits down the line?

Dr Karan: Yeah, so you that increased short-chain fatty acid production, we know it's an anti-inflammatory and antioxidant compound. So that will perform different things. So you've got three short-chain fatty acids, acetate, propionate and butyrate, the three main ones. Butyrate is generally one that fuels the colon cells, the colonocytes, and has an anti-inflammatory effect right on the colon, can help to reduce colon cancer risk. Propionate has impacts on appetite, on metabolism, on cholesterol, works with the liver as well to improve liver antioxidant pathways. Acetate has a role to play in gut-brain signalling, appetite signalling as well. And it's one of those early short-chain fatty acids that's produced in the early colon. So all of those have overlapping roles, but also distinct roles in human health.

Dr Rupy: Got you. I want to talk about supplements in a minute, but I want to talk a bit about, okay, I'm sold, right? I'm listening to this and I want to practically start consuming more fibre. Talk to me about some ingredients that you think are like all-star fibre, you know, they get the five stars on the on the fibre leaderboard, and about how we look to get that diversity and balance.

Dr Karan: So the absolute S-tier goat of fibre is beans.

Dr Rupy: Beans.

Dr Karan: Yeah, absolutely. Like, I should not need to convince anyone of this because if you just look at the macros for a second and the sort of fibre chemistry of it, beans, even within beans, you get different fibre types. So beans are rich in, if we break it down simply, soluble fibres, insoluble fibres, as well as resistant starches. You know, they've got multiple fibre types within that, which have different roles. And they've got a specific type of prebiotic called galacto-oligosaccharides, which are a type of slow fermenting fibre. So beans have slow fermenting fibres, which make it way all the way to the end of the colon. Just a quarter cup, a quarter can of beans is 9 grams of fibre.

Dr Rupy: 9 grams, wow.

Dr Karan: And a quarter can is not much. Like in a meal, I would have half a can of beans, which is 18 grams of fibre right then. 18 grams of fibre with a mix of different fibre sources, also slow fermenting, which is hard to get in, well, which most of our modern diets are missing. So that's like the number one. And it's also protein rich as well. Plant protein friendly, which is zero saturated fat rated. So amazing, keeps you satiated and so versatile. Pinto beans, navy beans, kidney beans, chickpeas, take your pick, right? And they're cheap. To actually buy canned, so cheap. And you can even use them in anything, whether you want to make like a hummus dip type thing, whether you want to add it to pasta with soups, or just have it as a salad, so, you know, as a meat replacement, so versatile. Then below that, I think berries are just excellent because they combine prebiotics and polyphenols, which are another type of antioxidant. A lot of people don't realize this, but even polyphenols, which are antioxidant plant chemicals, which give a lot of these fruits their colour. So raspberries contain anthocyanins, which are this kind of give it the red colour. Anthocyanins are a prebiotic. It's a polyphenol, which also feeds the gut bacteria. And they're usually very low in calorie. Like, I don't know, maybe a cup full of raspberries is 5 grams of fibre and very low calorie, whether you're on a diet, on a GLP-1, whatever, fantastic. Another sneaky way I like to get fibre in is like a guilty pleasure of mine would be dark chocolate. A couple of squares of dark chocolate, which is maybe 50 grams of dark chocolate, make sure it's at least 70% cocoa, is...

Dr Rupy: What's your number?

Dr Karan: I like 75%, 80%. The higher the cocoa concentration, the more fibre you can get for the same grammage, right? So 3, 4 grams of fibre from that. And actually just raw cacao powder, one tablespoon of cacao powder is a couple of grams of fibre, right? A couple of tablespoons of that into like a smoothie or whatever, boom, 4 grams of fibre.

Dr Rupy: I love that.

Dr Karan: Popcorn as well. A portion of popcorn, probably about 3, 4 grams of fibre.

Dr Rupy: Popcorn, really?

Dr Karan: Wow. I think a lot of people when they think of fibre, they think of just like salads and whatever.

Dr Rupy: Absolutely. Yeah.

Dr Karan: Avocado, I love avocados. Half an avocado is 5 grams of fibre. A whole avocado, if you wanted to have guac and chips, is 10 grams of fibre. That's insane.

Dr Rupy: Yeah, yeah, yeah.

Dr Karan: Right?

Dr Rupy: Yeah. And salads themselves. So let's talk a bit about spinach and lettuce leaves and rocket. You know, a lot of people are like, I get a fibre, get a salad, you know, I've got some fibre in there, surely. No?

Dr Karan: Yeah, I was I was one of those many, many moons ago where rocket, lettuce, spinach, kale, all these things are great foods to consume for health in general, packed with micronutrients and other things. And in bulk volume, they may contribute somewhat to fibre load. But two things, they're not high in fibre themselves individually per 100 grams. Like I think, you know, cucumber per 100 grams is about 1 gram or less of fibre. It's mainly water and other nutrients. So, and also the types of fibre they have are generally not prebiotic. So they're not going to feed your gut bacteria. It's insoluble bulk-forming fibre, if that moves the needle at all. So, yeah, if you have your green leafy salad, add in some seeds, add in some nuts, maybe some beans, and then you've got high fibre salad.

Dr Rupy: Yeah, yeah. Actually, I was going to ask you about nuts and seeds as to whether you you regard them as good sources of fibre as well.

Dr Karan: Yeah, I do. Like, it depends what you're trying to do, right? I think for diversity, they contain so many different types of, you know, compounds like lignans and insoluble fibre types. Great. And they have other, you know, plant compounds which are beneficial, the plant alpha-linolenic acid, the omega-3s, healthy fats, the, you know, the monounsaturated and polyunsaturated fats, all great. For a lot of people who are trying to eat more fibre as well, they are a lot of fibre, but they're also high in calorie for a certain fibre type. So I think as a mix, as a daily portion of nuts, I think it's great. Yeah. But if you're trying to really whack in a lot of fibre, you don't want to maximize your fibre from nuts and seeds, I would say. Certain seeds, yes. Like, you know, people love chia seeds, right? Flax seeds, basil seeds, which is very underrated. You know, I'm a big fan.

Dr Rupy: Basil seeds. Yeah. Indian cooking has a lot of basil seeds.

Dr Karan: Yeah, the sabja seeds, right? They they dunk on chia seeds. Right? Most people don't know that.

Dr Rupy: And they have the same effect when you put them in water, they become gelatinous, right?

Dr Karan: Even better effect. For the same grammage, they're a higher fibre amount. They swell slightly less. They have a more even fermentation profile than chia seeds. So pound for pound, basil seeds are way better than chia seeds.

Dr Rupy: Oh, so they have a, so in terms of the mixture of those different fermentability, fibres that ferment at different parts of the colon, they actually have a better mix, a spread across those.

Dr Karan: It has a greater component of the soluble fibre and less insoluble fibre, but just the way it gels and hydrates itself, it allows for a more even fermentation for your gut bacteria. So there's not an explosion of fermentation that's uneven across the colon. And going one step beyond that, you should actually grind any seeds because whilst it does remove some of the hard coating and remove some of that mucilaginous component, which a lot of people desire, maybe if they're trying to like make some, you know, egg-free batters or cakes, you do get more even fermentation and less gas and bloating because there's more bioavailability and more access to the gut bacteria to ferment them and metabolize them. And I think you actually unlock some of the compounds even more, like some of those omega-3 acids you get in chia seeds and basil seeds, you unlock them more and make them more bioavailable if they're ground. And if you've got a sensitive stomach, 100% grind them.

Dr Rupy: Yeah, that's such a good tip. I mean, we make a jam where we actually mill chia seeds because they're more accessible than basil seeds, but you can definitely get them from Asian stores and online. We mill it and then we add frozen raspberries, a touch of honey and a little bit of water and it turns into a jam. You put that on your toast. Honestly, it's so good.

Dr Karan: Yeah, I I inconsistently make that, definitely in the summer, and yeah, I don't buy jam anymore. You know, what's the point when you've got this fantastic availability at home?

Dr Rupy: Yeah, phenomenal, phenomenal.

Dr Rupy: Let's talk a bit about supplements. You mentioned Loam, so this is your supplement that you come out with. Talk us through the process because as an NHS doctor, you know, coming out with a product, going on social media, like there would have been a lot of soul searching, like, do I believe in this product? How do I, you know, take people along the journey? Like talk to us about how it even came about to to come up with a product.

Dr Karan: So as an extension as an extension of my health journey, the dietitian I was working with also recommended I add on fibre supplements to really have that consistent intake. So whilst I'm figuring out my diet, make sure you've got a baseline of this fibre supplement. And as I researched more about fibre, prebiotics and the microbiome, I thought, hang on, even when I got to a point where I was eating around 30 grams a day, I enjoyed having this fibre supplement to give me 40 and that bit of extra. Because there are so many use cases for that. I know people say, oh, I'm eating 30 grams, I don't need a fibre supplement. Sure. You know, you don't need anything, but I want to try and get more and more and more. And just as like an insurance for my gut, in the morning to have that fibre supplement with my coffee, just add it to my coffee or whatever, it's a great feeling and that's sort of extra 10 grams, you know, helps. And when I was experimenting with different fibre supplements, I found problems at every stage. Either the dosage wasn't high, you know, most fibre supplements right now are anywhere from 4 grams to 7 grams per serving per dose, which I think is low for a fibre supplement because you can get 4 grams from a pear. You know, you can't get 10 grams easily from just one single food source, right? Like even one avocado is a lot to get your 10 grams. So that was a use case and I didn't find that. A lot of fibre supplements were monofibres, just had one fibre type and didn't have the range and diversity of fibres which we're trying to mirror. We're trying to mirror the supplement to someone's diet, which has a range of things. That was another problem. A lot of supplements weren't using clinically backed ingredients or they weren't dosing it properly, or they were adding fillers like maltodextrin to them, which can actually spike your blood glucose, which if you're taking a fibre and improving your gut health, why you have maltodextrin? You know, they use this as binders and to make the flow more smooth. Or, you know, it just had an awful solubility and mixability, like psyllium husk is gloopy, or they didn't have the prebiotic activity that we're searching for. They had insoluble fibre components, or they were just formulated by some random hack who'd either done a ChatGPT formulation or some manufacturers just churn something together, copycat things, right? And I started buying different fibres that I was using that had high quality and was like almost doing like a kitchen experiment, like dosing and weighing out in a scale different fibres and then mixing it in a powder, blending it, and I had the thing. That was not only expensive, but just cumbersome and not scalable. But I was doing that and I was taking it myself. Then I was actually spending a lot of money sampling different things and making like a small batch run for myself. Giving it to myself, giving it to my dad, and I was like, wow, this is really cool. Because my dad also, I wanted to like take care of him. And he hated psyllium husk. You know, as Indian households know, isabgol, it's like the classic thing. Awful. He couldn't tolerate that. Like, I don't want to be taking a supplement that I'm literally having to pinch my nose and swallow. So it started like that, and for all the problems I saw that I mentioned, you know, the dosing, the quality, the science, I made Loam to solve for all of that. And the one thing I was really proud of is the thing I was talking about before, something I like to call fermentation geography, having different fibres which ferment all across the colon, a mix of fast, medium and slow fermenting fibres. I literally couldn't find a fibre supplement which was built on those first principles of colonic anatomy and fibre science. So I made this and I think you've tried it before as well. It goes invisible.

Dr Rupy: It it literally turns into, I mean, this this could actually have Loam in it right now. It's it's pretty phenomenal.

Dr Karan: And so I wanted that to be able to add to anything. You can cook with it. I formulated so it's heat stable as well. You can bake with it. My wife makes like high fibre brownies and banana bread with it as well. And I just wanted like a one of one product which doesn't exist. And you know, there we go.

Dr Rupy: That's amazing, man. I mean, I think one of the things that I've experienced certainly during my career being, you know, on social media is criticism from other medics in the field, you know, should you be in front of a camera? Should you be talking to the masses and all that kind of stuff? I think majority of it is positive. But I think when it comes to creating products, whether it's books or, you know, I've got a tech product, you've got a physical product now, in the UK at least, it's not as well received as it is perhaps in the US. I think in the US it's kind of like, you know, a bit more expected to be a bit more entrepreneurial and like, you know, do something good in the world with good intentions and actually be celebrated for it. But in the UK, it's not, I don't get the culture is is as receptive. Is that been your experience?

Dr Karan: Yeah, I definitely know what you're speaking of in terms of the reception and maybe the lack of entrepreneurship. But I think that's like something to do with the system in general, like the sort of, you know, the medical system we have here where it's primarily like a government-led system. Whereas in the US, there's a lot of private doctors who have their own private practices, they may have their own products, their courses, all these different things, right? And so I think fundamentally there's like that difference in mindset between the two things. However, both you and I, we always do things with credibility, science and evidence behind whatever it is we do to provide value. And I know from the feedback I've got from both the books that I've published, from the podcast that I do, from even Loam that I created, I'm getting thousands of people message me or message like the customer support email and like email me saying, Loam has literally changed my life, or what this book or this video has changed my life. I wouldn't have gotten this far, do what I'm doing if I wasn't, you know, trying to make an impact. And ultimately, I'll be completely honest, I have had so many opportunities over the years to make six figures or more from random companies offering me one-time deals to do stuff. Even with when I was creating this product, I had so many companies say, hey, we will do everything for you. We'll do the supply chain, we'll source the ingredients, we'll do the formulation, we'll do the branding, create any product you want, just slap your face on and we'll take it from there. That is terrible because they even gave a list of creators they've done this for. I won't name their names, but I just thought, I want to make this. At every step, because creating a physical product, there's like a complex supply chain there. Where do we source the ingredients from? How do we test for it? How do we assure quality? Because in the supplement world, there is no mandate for manufacturing standards, for raw ingredient sourcing, for formulation, nor for third-party contamination testing. There's no third party, there's no mandatory requirement for you to do that, either in the US or in the UK or any part of the world. So I did those same standards for Loam. I self-imposed them to the point of we tested against the most stringent third-party standards in the world, which is even more stringent than the European Food Safety Authority, the WHO or the FDA, which is something specific to California called Prop 65. I don't know if you've heard of that. Which is crazy. There's like foods in the supermarket in California which are Prop 65 non-compliant because they are higher than the heavy metal amount for that, right? We tested Loam against those crazy ludicrous standards. And like, for example, Loam has tested to have one dose has less lead than a tomato. Has less cadmium and arsenic than a carrot and a potato. And even the trials that we're doing, human trials, preclinical trials, these are things which cost me insane amounts of money that I don't even need to do. And I'm never going to tell my wife how much they cost because we're trying to start a family right now. She would kill me if she knew how much money I was spending on doing testing and trials. But to your point, if I'm going to do something well, I need to build it for the skeptic, but also build it for myself because I'm the biggest skeptic of all of these things. I'm building it so my wife can take it every day during her pregnancy. I'm building it so my dad can take it and I'm confident my dad can take it. So that is the standard and that's why we're both here because we have unreasonable standards for ourselves.

Dr Rupy: Yeah, yeah. I love that, man. I I think because a lot of people might associate supplement with scam straight away because of the lack of rigor that there is within the supplement industry. And I think part of what your content is doing around Loam is re-educating the public on how you can actually introduce standards even though they're not enforced in this industry and how you're doing it and and showing the way in which it should be done because you're right, there are some great supplements out there, there's some great supplement brands out there, but the vast majority of them are not doing the due diligence that you are doing for for Loam.

Dr Karan: I think, you know, one thing when I set out to create Loam was, how do I raise the floor of the wellness industry, right? Can the halo effect of what I'm doing actually be other companies thinking like, hang on, we need to catch up with this guy because this guy's come out of nowhere as a startup with no backing, no millions and millions of pounds and revenue or whatever, and he's doing third-party testing. He's doing trials in humans and actually can that competition breed competition where everyone's like, okay, this is now table stakes, we need to do this. And actually you've got the entire industry now doing these things and raising up the standard so everyone benefits. Like, you know, I don't make multivitamins, I don't make omega-3, I don't make creatine, but can the offshoot be that all these other companies being like, okay, let's do this. And then everyone benefits. Even I benefit. If I'm buying from a company for my creatine, now I know that their creatine is third-party tested or whatever. That's what we need where you've got to sheriff and police yourself.

Dr Rupy: Yeah, I totally agree. I mean, it's the same kind of standards that we have for the app as well. Like every recipe is rigorously tested. We did our own nutrition calculator, like I was telling you about before, because I didn't trust the the ones available off the shelf. We did our own ratings, like all that kind of stuff. But no one sees that. No one sees how the sausage is made.

Dr Karan: You've got to shout about it sometimes, man.

Dr Rupy: I know, I know. We should, we should definitely do more of that. This has been awesome. I want to bring this to a close, but I want to ask you about a fibre habit that you never skip.

Dr Karan: So one thing I've started doing now is front loading my fibre. And what I mean by that is it's nothing to do with the orifice of insertion, but it's to do with maximizing your fibre intake earlier in the day. Because your body's clock is very closely aligned with your digestive clock and your digestive function. Your colonic contractions, your digestive enzymes, your GI function is at its peak prowess earlier in the day, you know, like mid-morning, 10, 11 a.m. then it starts to wane away and decline as you get closer to bedtime. You know, bile acid secretion, enzyme secretion, GI motility all slows down towards the end of the day, which is why you shouldn't be having big meals close to bedtime. So if you have a lot of your fibre early in the day, like, you know, breakfast and lunch, you get more of that fibre deeper into the colon earlier in the day as well. So you get that full fermentation support throughout the day. You get this kind of appetite support, metabolic support, and general boost of energy the earlier in the day you have your fibre. And then I was talking about the second meal effect where you get this kind of waterfall and the domino effect to your metabolic control throughout the day. You get that the earlier in the day you have it. So if you have, like for example, this morning at around 9, 9:30, I had like a pot of beans for breakfast. I've had the beans for breakfast. It is now, you know, just past 2 o'clock. So it's been almost 5 hours. I feel full. I feel really full right now.

Dr Rupy: Yeah, you wouldn't have lunch with us before we started.

Dr Karan: I know. If I hadn't had that, I would have gobbled up that fish curry like nothing. But, you know, I just all I had was a coffee and I actually still feel full and I'll have like an early dinner when I go home. So that is the second meal effect and the power of early fibre in the day.

Dr Rupy: Yeah, I love that. I'm definitely going to start consciously thinking about that. I mean, I tend to have quite a bit of fibre at most meals, but particularly anchoring my day in the morning with fibre, I'm definitely going to remember that. Karan, you're awesome, man. We will link to all your socials and everything else, but pleasure having you in the studio. Real, real pleasure having you here.

Dr Karan: Beautiful studio and great conversation.

Dr Rupy: Thanks, man. Thanks. Thanks so much for listening to this episode of The Doctor's Kitchen podcast. Remember, you can support the pod by rating on Apple, follow along by hitting the subscribe button on Spotify, and you can catch all of our podcasts on YouTube if you enjoy seeing our smiley faces. Review show notes on the doctorskitchen.com website and sign up to our free weekly newsletters where we do deep dives into ingredients, the latest nutrition news, and of course, lots of recipes by subscribing to the Eat, Listen, Read newsletter by going to thedoctorskitchen.com/newsletter. And if you're looking to take your health further, why not download the Doctor's Kitchen app for free from the App Store. I will see you here next time.