Constipation and Diarrhea in Children

February 18, 2017

Learn what parents can do to establish normal bowel function for children and eliminate constipation and diarrhea.

Constipation is difficult for an adult to figure out and deal with, so imagine how a child feels when faced with the same issues. Special guest, Dr. Struble, a practicing pediatrician and author of How To Be a Poop Detective joins us this week to help field listener calls, explain some causes of constipation and what parents can do to establish normal bowel function for their children.

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DAR: Welcome to Dishing Up Nutrition. I'm Darlene Kvist, licensed nutritionist and certified nutrition specialist and hosts of Dishing Up Nutrition. Dishing Up Nutrition is brought to you by Nutritional Weight & Wellness, a company providing life-changing nutrition education, and also life-changing nutrition constantly. Our co-host today is Carolyn Hudson, who has had many years of experience as a licensed and registered Dietitian. She teaches several of our Nutrition 4 Weight Loss classes at a variety of business locations. In the office she helps individual clients meet their health goals and when she's not working at Nutritional Weight & Wellness she is a wonderful caregiver to her father. Because of Caroline's extensive experience, she has really a good grasp on how to guide clients to make better food choices. These choices are often life-changing. So, Carolyn, it is so nice to work with someone who understands how difficult it can be for clients to make food changes. You know, we know some people just, they get the information, they make the change. And you really break it down so it's doable for every client. That's an art.

CAROLYN: Thank you, Dar. That’s a wonderful compliment. Yes. You know, I do think that one of my biggest assets as a dietician is really being able to understand that most people need to take those baby steps. Really, really small steps when they're trying to change a habit, an eating habit. Those seem to be one of the hardest to change.  And let me ask the listeners, do you have an eating habit that you want to change? Perhaps you want to stop drinking pop or soda because maybe you ache all over, but you're not really sure how to do it successfully.

DAR: That one pop keeps sneaking in for people.

CAROLYN: Yeah. I run into that all the time in my individual counseling as well as in the classes. So, I suggest switching to ice tea. It's cold. It has flavor. So, tea is sometimes an easy change for soda. Maybe you could even substitute green mango tea. Green mango iced tea. It's cold. It's got wonderful flavor. And did you know that green tea has been listed as a cancer preventative? While chemicals and sugar in that soda you're drinking encourage cancer growth. So, if you have that daily six can habit of Coke or mountain dew, you are practicing some really risky behavior.

DAR: So, if you have a problem with constipation or diarrhea, yes, we're saying those words, this is a show for you. If you have a child or grandchild with constipation or diarrhea, this is the show for you. And I think, Carolyn, you actually were going to share a story.

CAROLYN: Yes. Just the other day, I was talking to a friend, I was telling him that I was going to be on the show and we're going to be talking about constipation and diarrhea, and he told me kind of a frightening story. His son, who was in sixth grade, had been throwing up and losing weight and in awful pain and the doctors could not figure out what was wrong with him. This went on for weeks. He finally ended up down at the U and they did an upper GI and they discovered he was constipated. He was totally blocked up. That poor child had no way of knowing that that was what was wrong with him.

DAR: Right. And I think we have a lot of parents listening that may have a child or adult with special needs. And I know from working with those children before that they struggle with constipation and diarrhea. So, this really is the show for all of you listeners that may have this issue.

CAROLYN: And we are so lucky today to have Dr. Kristin Struble joining us by phone from Phoenix, Arizona today. Doctor Struble is a practicing pediatrician and author of a fun book called How to Be a Poop Detective.

DAR: Welcome to Dishing Up Nutrition, Doctor Struble. I bet kids love reading your book because kids love to talk about poop and tooting and honestly that put a picture in my brain. A bunch of little boys giggling about this topic until they personally experience constipation or diarrhea. And then suddenly no one is giggling. They're in pain. Welcome to you.

DR. STRUBLE: Thank you. Thanks for having me on. I'm really delighted to be on. Thank you.

CAROLYN: Great. Well, Dr. Struble, what inspired you to write a book which helps kids understand that their poop comes from what they eat and so does their toots.

DR. STRUBLE: Well, as you said, kids do really find it to be a fun topic and it is a funny topic. It's funny because most people are not super comfortable about talking about poop, but boy does it really help give me insight as a doctor about what's going on in their body. What really inspired me is the story you just spoke about. I can't tell you the number of patients who end up in emergency room. Parents’ first thought is, “Oh my gosh, my kid’s having severe belly pain or vomiting. They must have appendicitis.” And then they end up going into the ER having tons of studies and then they end up with a $5,000 bill to be told that their kid is full of poop. And, really, my ultimate goal is to really help encourage families to talk about, it's kind of gross, but making certain that their child’s poop is normal because oftentimes when a kid goes into the bathroom and is potty trained, parents don't know if they have an issue. And quite frankly, kids don't know what normal is. So, my inspiration was really to try to help those families make certain that they know what's going on in there because if there is an issue, as you all know, being dieticians, there's just simple things that you can do to change a child’s tummy, to change their intestinal track, and to really help their body be healthy because healthy poop means a healthy body for sure.

DAR: Since we have you on today as our expert, we want to kind of have people think if they are really ever struggling with constipation or if they have a toddler and that toddler's struggling with constipation, what do we really do? We also know that it's painful, it's even scary and it's fairly common, isn't it?

DR. STRUBLE: Yes. I guess that's a big reason I wrote the book because it comes up probably in every well-check I see. And more oftentimes than not, in every sick visit I see. Because one of the most common reasons to come to the doctor for sick visit is abdominal pain, chronic belly pain. Mommy, my tummy hurts. And then, well-checks a lot of times, we always ask about bowel movements and we ask, “Are they going every day?” “Oh, yes, doctor they are, but they complain about belly aches.” And then I use my book as tool and I draw out the shapes and ask the child to identify which one is theirs. It never ceases to amaze me, you find out they have little pellets or they have baseball tubes. And so anyway, the real cause of this is diet and the number one trigger is dairy. Number one trigger. And so, nutrition education is my passion. I really try to help kids learn what moderation is with regards to dairy. I personally don't recommend cow's milk. I don't think we should be drinking it. I think they should drink water. And they instinctually know how much water they need to drink. But it's very important that they really just drink water. They don't need cow’s milk for their bones. And then cheese and yogurt, they can have a little bit, but if they're constipated, they definitely need to limit it and make certain that all the while they're making sure that their poop comes out easy. It shoots out like the book talks about. That it’s soft, that it is shaped like a log and that it sinks and then and all those five characteristics I talk about my book.

So, in a nutshell, really watch what is going into the body and try to figure out what is causing the issue. And again, the number one trigger is dairy. So, I encourage them to try taking what they think is the cause out. What is triggering it, which oftentimes is dairy, out for about six weeks and all the while increasing good fiber products and drinking a ton of water and then seeing what happens. And it's very rare that they don't find their kids’ tummy aches to go away and their stools become perfect and they just feel better. And most adults will tell you they try it and they feel better, too. So, I'm not saying they can't have any, but my message is it's not what it's cracked up to be. It's not the food that you need for protein or calcium or all the things as advertised.

DAR:  So, we have to take a little break here, but stay with us.

CAROLYN: You're listening to Dishing Up Nutrition, brought to you by Nutritional Weight & Wellness. Today, we're pleased to have pediatrician, Dr. Kristin Struble join us today via phone from Phoenix, Arizona. We're discussing the causes and solutions for both constipation and diarrhea. And both constipation and diarrhea are common problems for adults, common problems for young children and very common problems for children with special needs. I encourage you to stay tuned for some real simple solutions that might be life solutions.


DAR: Well, welcome back to Dishing Up Nutrition here. A few questions for you, our listeners today. Did you notice how advertisers are trying to get you off your healthy eating plan this month? And we had February, so I think you probably noticed all the chocolates that were advertised to tempt you. Of course, they were heart shaped and since they were in the shape of a heart, they must be healthy. Well, maybe not. Or did you notice all the bakeries advertising heart-shaped cookies and cupcakes decorated with trans fats and high fructose corn syrup. Some of the Trans fats were soybean oil, and that was a refined oil, corn oils were some of the refined oils. Then there were those heart-shaped suckers with high fructose corn syrup and bad fats to tempt your kids. As parents, it's difficult to keep your kids and even yourself sometimes away from those foods that the marketers have tried to entice us to eat. And as nutritionists and dieticians, we really understand how challenging it can be during these special holidays to stay with a healthy plan. You have to be thinking all the time.

CAROLYN: You do. And you have to be prepared. So, we know that this issue about constipation is difficult, not just for kids, but for an adult to figure out and deal with. So, just imagine how a child feels when they try to go to the bathroom and it's painful and it just won't come out. So today, Dar and Dr. Struble and I are going to try to give you some real quick, practical, concrete suggestions to help solve that issue. So, Dar, what are some of your thoughts on this?

DAR: Well, Dr. Struble talked about we need to drink water. And, really, kids need to drink water. So, how do you go about getting them to drink water? And we're kind of wired to like to have something that tastes sweet. So, one of the tricks that I do sometimes to get my grandchildren to drink more water or other children that are visiting is to take water and dilute it with just a little bit of juice. Maybe, if you've got a cup of water, maybe put a fourth of a cup of juice in there. There is still that sweet taste, but suddenly they like it better and it's interesting if you put it in a cute little bottle that they can hold on to, they like to drink it then.

CAROLYN:  Their favorite sippy cup.

DAR: Yes. Or maybe it's got an animal on it, or something that is going to entice them to carry that water bottle around and drink out of it. And then they're getting more water into their system. And people keep thinking, well how much water does my kid need? Not a couple of sips here and there. They need about four cups of water a day, depending on how much they weigh and how old they are and how big they are and all those things. But, if you take, kind of like you were mentioning, maybe just take their weight and divide it in two, so half of their weight in ounces every day. It probably would be about the right amount. And I know from my experience working with children with special needs, for some reason, they really like sweet things better than they do plain things. And so, you really have to kind of have the tricks of the trade to get them to drink enough water so that they don't have constipation as one thing.

CAROLYN: Right. Well, I think that's a great track. So, diluting juice or, really, just putting a little bit of juice in water, right? Just to give it that little teeny sugar content that will be more appealing to them. So, we know that a lot of parents give their children full-strength juice. We know that's not good for them. Or worse yet, they even give them soda. So, it really surprises me when I talk to parents and I try to get them to please give your children a water. If you have to put a strawberry in it for that little bit of sweetness, that's okay.

DAR:  Or even a straw. It's interesting, these little tricks that make a difference. And I know, Dr. Struble, when you're seeing clients, you don't have time to go through all those little tricks with the parents. But that's our job to help people do that. So, what are some other things, Carolyn, that we use that we should really talk about here?

CAROLYN: Well, I'll go back a little bit to that cheese and crackers. That seems to be a real easy snack for parents or grandparents to give our children, but we do know that that can lead to constipation, and I know that Dar, I know you've probably seen this a lot of times, that whole bread and pasta thing.

DAR: Yes, definitely. I think that's the other thing is you talked about cheese and yogurt and milk. Dr. Struble, you talked about that milk is probably not the drink of choice. Do you want to expand on that just a little bit? Because I think that's new information for a lot of listeners.

DR. STRUBLE: Well, and of course you have to talk to your own pediatrician, but milk has been promoted as a necessity from the time a child turns one year of age and there are definitely a lot of practitioners out there that still promote that, but there are a lot of them out there that definitely don't feel that's the case. I mean, to be frank, that cow's milk is meant to make a calf grow to 400 pounds and it's not intended for human consumption, but we've been taught that it's a necessity and it's really, it's just not good for us. Um, if you process it and make it into cheese and yogurt, it's easier to digest. But in its whole form, I see a lot of kids who have, especially in a year when they start consuming it, they start getting constipated, they start having eczema, they start having more allergies and ear infections. The body really does talk to us. I mean, it gives us an idea of what's going on and our gut health really is kind of the epicenter of what is going on in the rest of our body. So, we're having constipation, diarrhea, bloating, gas. A lot of times we're seeing that reflected in the other organ systems. Do we have sinus infections? Are we getting ear infections? Do we have eczema? Do we have a lot of the signs our bodies are really shouting at us saying something's going in and it's upsetting the colon, upsetting the intestinal tract? And it's really just leading to poor health.

DAR: One of the interesting things is that 70 percent of the whole world's population cannot really digest dairy products and that's an awful lot of people. So, when we think about it, we only have maybe 30 percent of the population that is okay with dairy products. It's sort of amazing. I think one of the things maybe we should talk a little bit more about is yogurt because I don't think people think in terms of yogurt as being something that's got a lot of sugar in it or artificial sweeteners. And we as nutritionists and you as a pediatrician, when you think yogurt, you think plain yogurt, full fat yogurt without sweeteners and corn syrup and all those things. But that's not what kids are eating.

DR. STRUBLE: No. It's kind of like the water to them if they were to eat that. They want the sweet. Unfortunately, the sweet is really not so good. The Gogurts and all the brilliantly marketed products out there just really aren't that good. That sugar is just feeding the gut in a bad way. But, I definitely think probiotics are good. But not from a really sugary yogurt drink or junk. So many of these kids are drinking them. They're drinkable yogurts because they’re drinking them fast. Get a spoon out to eat it, for goodness sake! No, but I definitely think, if they want it as a treat, it's okay. But, I don't think yogurt in general, unless it's plain like you said and it’s full fat and you sweeten it with a little honey and put some fresh fruit in there.

CAROLYN: Yeah, exactly. So, if we could get all of our clients eating plain, full-fat yogurt. In some cases, it's even hard to find that. You gotta kinda really look through that area in that whole big yogurt case in the grocery store.

DR. SHUBLE: Cheeses, too, aren't all the same. There are some cheeses that are easier to digest. The cheese sticks, those are definitely a big cause of constipation, as you said. They're easy snacks. But, the harder cheeses, the cheddars, even the swiss, don't seem to be as hard on the gut. The body digests them easier. But, the Mac and Cheeses, a lot of the common fast, quick foods are definitely constipating.

CAROLYN:  So, unfortunately, we have to take another break here.

DAR: And when we come back from that, let's talk a little bit more about cheese because that's a new area for people. They don't know that. Because cheese sticks, like you said, are so easy. But they’re so constipating

CAROLYN: You are listening to Dishing Up Nutrition, brought to you by Nutritional Weight & Wellness. You might be asking yourself, how can I tell if my child or I am constipated? Here's some physical body signs of constipation:

#1: Bowel movements that are hard, dry, and difficult to pass.

#2: Pain while having a bowel movement.

#3: Blood on the surface of a hard stool.

DAR: None of those sound like fun.

CAROLYN: No, not at all.


DAR:  Well, welcome back to Dishing Up Nutrition. I have a question for you. Have you heard the ads on TV that say you can eat anything you want and still lose weight? Well, I know that is not true for sure. Not for weight loss. You can eat real protein, real fat, vegetables and fruits and lose weight, but not just anything. We work with and have great success with veteran dieters. Listeners, if you're a veteran dieter, you can't eat brownies and have weight loss, unless of course those terrible cardboard tasting brownies at some weight loss companies sell to their clients. Yeah, because they don't really get eaten. And as veteran dieters, you also know you can't lose weight eating chips every day. Unless, of course, they're fried in oils that you have you running to the bathroom. And I think maybe those that are off the market. Our Nutrition 4 Weight Loss plan helps you lose weight and restore your health. It's not a quick fix. It's not a fad plan. But it will put you on a lifelong path of good health and it's practical and easy to follow. It's not a starvation plan.

CAROLYN: And that’s what our clients love. They're not hungry and they get rid of those cravings.

DAR: And they get real fat, but not bad fat.

CAROLYN:  Butter! So, before the break we were talking about cheese. So, let's go into a little more detail about that. I'll just say one thing before we move on. I worked for the dairy farmers here in the state of Minnesota for many years and I learned a lot about dairy products. We do know that the harder cheeses have very little lactose in them. And so, I think that's the reason most of them are much easier to digest in many cases. But we still don't want to give children a lot of cheese at any one time.

DAR: But, how about these cheese sticks. They're so easy and you see it all the time. Parents giving cheese sticks. When I see it, I think constipation.

CAROLYN: Unfortunately, it does constipate a lot of children. And in the story I told earlier, the father told me that it was cheese that was doing it and so they did have to monitor how much the child was eating. And I think that's the other thing. We tend to think it's a healthy food, so two, three cheese sticks are okay. And that's probably not a good source of protein for that child.

DAR: So, Carolyn, another question. I think we had a caller that was asking about a snack. Let's do a dairy snack for her.

CAROLYN: Okay. Well for me, like one of my kids and even my dad loves this one. How about some strawberries and whipped cream? Dip the strawberries in the whipped cream. Or even do frozen strawberries and whip it all together.

DAR: So, that’s good. If you use real whipped cream, heavy cream, that's got a perfect fat in it and it's easy to digest.

CAROLYN: Yes. People are still scared of fats. Even for kids. They need that fat.

DAR: Dr. Struble, maybe address that, because we have so many parents that are afraid of giving their kids fat. What's your take on that?

DR. STRUBLE: Well, there's so many mixed messages. At a year old, when you're told your child needs milk, it's because of the fat. The fat for the brain, but it's the quality of the fat. And so, fat is good. Avocados are great. That's great fat. That helps to fill them up in a good way. Not just fill them up with a protein or a fat that's not good for them. So, nuts for the older kids that won't choke on them, nuts are a great source of fat. I love that you talk about whipped cream because it actually is not a terrible fat. It's much better than a lot of other dairy sources. So, you mentioned the lactose. Lactose is really hard for many of us to digest, but it's really the protein in the dairy that's the hardest. And I love your Cookbook because one of the things you do talk about is that that component of the dairy that is tough to digest, the casein. I love that you're dispelling the fat rumor because we need that to help us feel full.

DAR:  It's always nice to have a doctor that sells it, though.

CAROLYN: Clients who come in and say, “But my doctor, but my friends, and what I hear, I shouldn't eat any fat. Fat's bad for you.”

DR STRUBLE: But you all are doing great things. I mean, I wish you were in Phoenix. I actually send patients to you all the time. I love that you have your online option.

You're just so different. You're so unique in how you personally approach nutrition and dieting. I wouldn't even call it dieting. It's a lifestyle modification and the foods you talk about, they're good. We don't need to lose taste when we eat, right ladies? I just commend you so much for what you're doing. I’ve told you that many times.

DAR: Thank you. I think that one of the things when I think in terms of, like that good fat, and this is one of the things that I always try to tell my clients, that you have to hydrate your tissues with both water, but you also have to hydrate them with good fat. So, if you think about your intestinal tract being lots of cells and lots of tissue, all that has to be hydrated with good fat and good water so that you can avoid that constipation. So, it's taking it to another level of how those fats really work for people.

DR. STRUBLE: Well, and the good carbohydrates, too. Carbs are a big source of hydration. And if they are complex carbohydrates, that's actually good. Our body has to break that down. But if they're simple carbohydrates like sugar, those are just trigger inflammation and they're not hydrating.

CAROLYN:  Yeah, and that word carbohydrate. That one kind of throws a lot of people out there. So, to us, when we're talking about a really good carbohydrate, we're talking about vegetables, green vegetables, broccoli, cauliflower or asparagus, green beans. All of those great sources of fiber. And you get to put butter on that. And it tastes great!

DAR:   I have a great story about a carbohydrate that's not so good is that I have a little dog, a little poodle mix, bichon, kind of a little dog and we don't really have bread and rolls at my house unless it's like Thanksgiving and then I might buy a few, but otherwise we don't have any and she's really never had anything like a piece of bread or a roll, but somebody brought me a salad and it had a roll with it and I just set it aside and my little Bella decided that she would like to eat that and she did and I didn't realize it and a couple of days later Bella was so constipated that she was just struggling and crying and whimpering because she couldn't get it through. And that was the first time that that had ever happened in three years that I've had her. Because that's not what she eats. She eats vegetables and organic meat and organic dog food, but she's healthy. And because of my experience working with kids with special needs, I think, what do you think of a down syndrome child or a child with autism going through that struggle with digestive issues? It's sad. And they are picky eaters. I understand that parents need a lot of help and support to get them past being picky eaters and into eating some vegetables. One of my tricks is to take pieces of watermelon, put them on a toothpick or, I have kids put black olives on their fingers. You have to be creative to get some kids into healthy eating. Even cherry tomatoes. I mean, they taste good. On a toothpick, they're even better!

CAROLYN:  Yeah, that's true. I can't believe it, but we are ready for our third break. We're going to need a longer show. You are listening to Dishing Up Nutrition. I'm Carolyn Hudson, licensed dietitian, and I'm here with Darlene Kvist, licensed nutritionist, and our special guest Dr. Kristin Struble, pediatrician and author of a very popular children's book, How to Be a Poop Detective, and we're discussing the causes and solutions for constipation and diarrhea. So, Dr. Struble, as you know, we have listeners from all over the world. Many, even in Phoenix, Arizona, where you see your patients, so if our listeners want to reach you, what is the best way for them to contact you?

DR. STRUBLE: They can just go to my website and there's lots of information there as well.


DAR:  Welcome back to Dishing Up Nutrition. We will be starting several Nutrition 4 Weight Loss classes in the Minneapolis-Saint Paul area. If you sign up for this 12-week series, here are some things that you can expect. You will lose weight. Some people lose four pounds, some people lose 24 to 30 pounds. It's different for each person, but everyone reports that they feel better. They have fewer aches and pains, they are in better moods and their clothes fit better. So, here's a question for you. Can you accomplish all your life goals in 12 weeks? Of course not. Losing weight is a very complex issue and a problem. Let's face it. There are no quick fixes in life. In weight loss, quick fixes have a way of putting more weight on our bodies. Kristy from North Oaks has lost 40 pounds after taking the Nutrition 4 Weight Loss series twice. Yet, the most important news is that this is the very first time in her life that her sugar cravings are gone.

CAROLYN: That is so wonderful. I love it when I hear that from my clients.

DAR:  To sign up call 651-699-3438 today. We want it to be the best fit for you. The best time, the best location. And we talk price. We have nothing to hide. So, we'll answer all and any of your questions. So, we're back to our discussion on constipation and diarrhea, mostly on constipation today.

CAROLYN:  But, Dar, I’d really like to suggest to parents and all our listeners out there another tip. Breakfast is a great time to be giving them fruit, but not just any fruit, right? So, like blueberries, strawberries, raspberries, they’re great choices for relieving constipation. But, bananas are definitely not a good choice, especially if you're constipated. So, I tell parents over and over that bananas are constipating, so don't feed them to your children if they're constipated. However, if they have diarrhea, that might be a good fruit to give them to firm up their stool. So, other things like apples. People are not aware that apples are constipating. Yeah, that's really interesting. I think a lot of my clients, even adults say, “Oh, I had no idea that apples are constipating.” But oranges and grapefruit, cantaloupe, honeydew melon, they all relieve constipation.

DAR: So, Dr. Struble, you started talking a little bit about bread and pasta and the gluten products. Do you feel comfortable talking a little bit more about that as far as how that could either give people diarrhea or it could be constipating for some people?

DR. STRUBLE: Well, absolutely. So, a lot of us tolerate gluten just fine. But, even if we tolerate it, it's still something that obviously we should limit. There are people who have a disease commonly known as Celiac disease. It’s much more readily diagnosed nowadays. Those kids will actually present with chronic constipation. So, if you have a child who's chronically constipated and you try to modify their diet and they're still constipated, it's definitely something we will test for. Alternatively, a lot of those kids will present with chronic diarrhea. So, to summarize, again, gluten isn't an absolute enemy. We just have to pay attention to, again, what are our kids saying? Does their stomach hurt? Does their poop look okay? If they do have stomach aches, if their poop is off, then they might even want to try eliminating gluten or really limiting it and see what happens. Again, our body will talk to us; the bloating, abdominal pain, constipation, alternatively diarrhea, those are all signals. So, just doing an elimination diet sometimes helps to be a detective and to detect what food is triggering that and it very well could be gluten.

DAR: So, one of the things that I hear from a lot of parents is that their child maybe hits first or second grade and suddenly they don't want to go to school because their tummy is hurting all the time. Immediately they say it's the stress, it's the stress of going to school. And I bet you take a different look about that. And I know we do.

DR STRUBLE: Definitely, because oftentimes they have tummy aches and they’re stressed, they don't wanna have to feel that they have to go poop at school or they have tummy aches because they do have constipation or, generally speaking, some of them are stressed. But you definitely have to look at the whole picture. And that's where going to see a practitioner comes in and they’ll dive into all that and decide if it is just truly stress, or if there's something going on in their GI tract. Just getting a really good history helps to pinpoint exactly what's going on.

DAR: Well, I think a lot of times what they’re eating at home is cereal and milk. And then by the time they get to school, they have gas pains and constipation and they feel miserable and they're not stressed, but their body is.

DR. STRUBLE: But you said it best. A lot of your clients that do follow your protocol, when you feel good because you're eating well, your mental health definitely is better. Your gut makes neurotransmitters, the chemicals that help your brain feel better. And if your gut’s off, you're not going to feel as good. If you're heavier, if your body’s achy, that’s just so impactful. So, I love that that's a focus of yours as well. All of this does begin in the gut.

DAR: My dad used to say that and I used to think, “Oh my heavens, what do you know?” But he knew so much, I realized. And then I'm saying the same thing. You’re saying the same thing. That's kind of neat.

DR. STRUBLE:   Hippocrates said that so I can't take credit for it. Hippocrates is the father of modern medicine, and he really was very, very amazingly fortuitous in the sense that I think we're all trying to come back to that very simple concept that if you have a healthy gut, you are healthy.

DAR: So, thank you so much for joining us this morning. I think people learned a lot and that's our goal, so thank you again everyone. Have a great day.

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