Partha Nandi, MD - Amazon S3...perhaps even using half of the insulin that you have, and your body...

Partha Nandi, MD Understanding The Factors That Affect Blood Sugar

Brian Mowll: Hey everybody, Dr. Brian Mowll, the Diabetes Coach. I want to welcome you back to the Diabetes Summit 2019. This is our sixth annual Diabetes Summit, and my next interview is with someone really special. He's a gastroenterologist, and his name is Dr. Partha Nandi. Dr. Partha Nandi is a full-time practicing gastroenterologist and internal medicine physician. As an active holistic health practitioner in the field, Dr. Nandi is also the chief health editor at WXYZ ABC Detroit.

Brian Mowll: Dr. Nandi practices gastroenterology in the suburbs of Detroit, Michigan. He's the author of several publications and peer reviewed journals. He is a national speaker, educating physicians on various topics within medicine. He's a patient advocate, emphasizing empathy in patient care and treatment of the entire patient, both body and mind. Dr. Nandi is also the creator and host of The Dr. Nandi Show. His medical lifestyle talk show, Ask Dr. Nandi, has won National Academy of Television Arts and Sciences Michigan Emmy awards. So enjoy this powerful and informative interview with Dr. Partha Nandi.

Brian Mowll: All right. So here with Dr. Partha Nandi. Doc, welcome, and great to be with you here today. Excited to dive in and share some important information about the gut and metabolic health.

Partha Nandi: That's awesome, Dr. Mowll. Thank you for having me. It's a privilege. I love everything that you're doing to help people to really manage this unbelievable, ... I call it an epidemic. It's unbelievable how much it's affecting the planet. So yeah, it's my pleasure.

Brian Mowll: Yeah, it really is an epidemic, and it's an interesting problem because I think there's ... it shows up in a little bit of a different way in different places, right? In the US here, we have most people with type 2 diabetes are overweight. It's 80, 85%, but then there's other countries, like Asian countries, where the numbers look a lot different. I think we're scratching our head. We have to realize that it's more than just being fat or having too much body fat. There's a lot more to it than that. That's one of the things that I try to do is shed some light on all the different factors that can influence blood sugar and metabolic health, and the gut is a big one, which I know we're going to dive in and talk about today.

Partha Nandi, MD - Diabetes Summit 2019 (Completed 04/26/19) Transcript by Rev.com Page ! of ! 1 14

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Partha Nandi: Yeah, it's awesome.

Partha Nandi: I know you asked me, and said, “Is it something you're interested in?” I'll tell you, in my family, I've got a bunch of people that have had diabetes. I'm originally from India, and as you know, India has an... If we have an epidemic in the US, they have a severe epidemic in India. I think a lot of it has to do with the changing of how we eat and all of the benefits of Western civilization. The US alone, and you know these statistics really well, but I'll tell you, 30 million people with diabetes. It says it's the seventh leading cause of death, and it's rising; and of that 84 million people with pre-diabetes, so what's really going on?

Partha Nandi: I love the fact that we call the whole idea of being your own healthier, which means that you can actually do something about it. A lot of my patients think, 'My uncle got sugar, my dad's got sugar, I got sugar, and that's it.' And really, the paradigm's shifting. That's what I love about gut health.

Partha Nandi: Some people say, 'Well, what does the gut have to do with diabetes?' Your pancreas is kind of connected to the intestinal tract. You got a duct that basically puts the pancreas juice into the intestine to digest stuff, but what's the connection?

Partha Nandi: Well, I think that, as you know, a lot of people may not know that are listening, a landmark study came out. This was almost 12 years ago now. In nature it showed that the kind of bugs that people who are obese, people overweight and obese, are completely different than people who are not.

Partha Nandi: People say, 'Wait a minute. I thought it was all about just what you eat and if you move.' Absolutely, what you eat and how you move is very, very important. But when people realized that the microbiome, which is the trillions of bugs that are in your system, in your intestinal tract, not just bacteria, but protozoa and organisms such as fungi, all these come together and somehow create this environment. That really got people thinking to say, 'Is this have to do with anything about metabolism and also about something called insulin resistance?'

Partha Nandi: I think that was the beginning. So we then started thinking, how can we then approach diseases like diabetes and obesity, ... and some even have gone as far as saying that it's really part of the same syndrome, that diabesity. You pointed out, there are places all over the world that patients may not be obese. But in the United States, we have an epidemic of obesity.

Partha Nandi: The whole idea is that your gut can actually change something tremendous, which is your insulin resistance. The insulin resistance in in English means that you may have a certain amount of insulin, Dr. Mowll may have a certain amount of insulin, I may have a certain amount of insulin, but a person who's got insulin resistance may have the same amount, but it's just not acting in the way that you want it to. Meaning that it's not acting in the way your body needs. It's, you're basically


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perhaps even using half of the insulin that you have, and your body develops resistance.

Partha Nandi: We know that actually the bugs in your intestinal tract may affect that. So for example, if you have a certain type of bacteria, certain type of microbiome, you may actually be more prone to having worsen control diabetes, no matter what you're doing with your medicine. This is the cool thing about it. You go to your doctor, your diabetaologist, endocrinologist, primary care doctor, whoever it is that's managing it, nurse practitioner.

Partha Nandi: They say, 'Well, you know your blood sugar's up. Here's more insulin, and here's more medicine.' And the fact is, and you know this, Dr. Mowll and those of you who are watching, is that now we may say, 'Well, what's your gut doing? How can we then change the paradigm, and say instead of more medicines, more procedures, more this, more that, let's keep on adding something else. Well, what about going back to the basics? How can we then have your body fix what it already has, and basically fix it so that you can use what you already have, rather, so you may not need as much.'

Partha Nandi: Now, I'm not saying that if you change your gut microbiome that everyone is going to be okay, stop your insulin, absolutely not. You've got to still take your medicines, still do everything the way you're supposed to, but perhaps you can better manage it if you really look at your gut health.

Partha Nandi: Gut health can be central to what you're doing for every type of disease. We're talking about diabetes today, but I talk about heart health, I talk about people who are getting Alzheimer's, people who are getting diseases of autoimmune type, for example, Lupus, or Crohn's Disease. I talk about how the gut can really change that. The gut's really at the center. But with diabetes, if you do some simple, simple maneuvers, I call them, you can be your own health hero and really control your diabetes. Again, to make that part of your armamentarium.

Partha Nandi: More and more, we're not just ... This is not just like, 'Oh well, Dr. Mowll and Dr. Nandi are talking about it, it's a nice theory.' We now have studies to show it. It's all over the Western literature. There used to be alternative doctors or people with functional medicine that talked about this. Now, we have world microbiome day. In my field, we talk about the American gastroenterology association, and the American College of Gastroenterology. Western traditional medicine now is looking at the gut microbiome and gut health.

Partha Nandi: This is the key. So what really happens? [crosstalk 00:08:57] ...

Brian Mowll: Exactly. I wanted to see if you could dive into that, because the ... This is exciting. The idea is that it's not just bad genes. There's something there that you can do something about. For the people who are listening right now, or watching this, who have made some changes to their diet, but they haven't necessarily seen their blood sugar respond the way they thought it might, or perhaps they have been taking


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medications, and their blood sugar just hasn't been coming down low enough into the normal range. They're wondering what else is going on here? This is an area that I really think you need to look at is gut health.

Brian Mowll: So could you maybe shed some more light on what exactly is happening? Because it's interesting, but I don't think it's an obvious connection for people. It's not like, 'Oh, yeah. That makes sense.' So what is it about the gut and these bugs that are living in our gut right now, that are actually helping to contribute to our health in many ways? Like the symbiotic relationship, we help them, they help us. What is it about the different types of bugs that ultimately lead to diabetes? There's a couple steps in there in between, but maybe you can shed some light on that.

Partha Nandi: Those are good questions. What is it exactly that really happens? The combination of the trillions of bugs in your intestinal system, what it does is some help, and some don't help. What does that mean? It means that for over thousands and thousands of years, our gut has developed good relationships with, like Dr. Mowll talked about, symbiotic relationships with the bugs.

Partha Nandi: When you have an imbalance, for example, you go in with the ... You go to the doctor and you have an upper respiratory tract infection. They give you this, and 'Oh, well you're ... I think it's a bacteria. I'm not sure, but here's a prescription for a medicine called Z-pak.' Powerful antibiotic. You take that. It's a nuclear bomb for your microbiome, which is your trillions of bugs.

Partha Nandi: All of a sudden, you're ... a bunch of the good bacteria could die. You do that a few times, you could really change the paradigm, and the good and the bad bacteria. So what then happens when you don't have enough good bacteria, or the ratio of good to bad bacteria and organisms change? Well, then you can begin the whole prospect of inflammation.

Partha Nandi: So everybody talks about this leaky gut, right? My patients say, 'I don't know what the means. You have big holes in your gut?' When you do my endoscopy, the colonoscopies, you don't see holes. Well, these are microscopic holes, right? There's a one cell layer thick between here's blood and here's poop. So that is how little protection we have. It's incredibly strong, though when you have the appropriate environment.

Partha Nandi: When you don't have the appropriate environment, for example, if you don't have the right combination of the microbiome, one of the factors, then you can start having little tiny openings; and that, over time, if you continue to have that, those leaks, little part of the stuff that's not supposed to go in your blood goes in your blood. That begins your immune system sees those as attacks, and they start responding to it. That's the beginning of inflammation.

Partha Nandi: When you have inflammation in the gut, they're very good at talking the rest of the body, right? So it just doesn't happen in the gut. THere's


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communication, there's inflammation that really spreads throughout your body.

Partha Nandi: When you think about what exactly does happen in type two diabetes. It's an autoimmune condition where your body is actually ... The inflammation is not allowing your body to use the insulin, and perhaps in certain cases, not even giving you the appropriate amount of insulin that you need. It's not just insulin and other factors. When you don't have appropriate gut health, you don't have the proper protection, and then your body develops inflammation.

Partha Nandi: Moreover, what can happen is that if you then give it another atomic weapon, after you get your Z-pak, you go down to your local fast food restaurant and then you have yourself a big juicy burger with lots of toppings, nice, big juicy bun. Those simple carbohydrates, along with all the processing, then goes inside and guess what? That is the food, the simple carbs, the bun, all the sauce, and everything else, are great foods for the bad stuff that worsen the bad part of your microbiome.

Partha Nandi: The way to really to make your gut as unhealthy as possible is to give yourself a whole environment of stuff that goes in that's unhealthy. I tell my patients if you put crap in, you are going to get crap out. When you have a situation like diabetes and insulin resistance, when you eat those kinds of foods, it's not just a problem with the fact that you're giving yourself simple, bad sugars, but it also devastates your gut microbiome. If you do this once in a while, it may be tolerable, but if you do it every day, like a lot of us do, along with antibiotics, along with eating the wrong food ... And guess what? We also sit in our couches and not move. Another way to change your microbiome. Now we have studies that show that if you don't move and move with purpose, and get the right amount of movement and exercise, your microbiome will also be unhealthy.

Partha Nandi: We don't talk about another big factor, right? So you're working at your job, and you have a horrible boss. They yell at you. They scream at you. Then, if it happens once in a while, maybe you can tolerate it. But some people are in relationships with their work, with their personal life, with people around them that are toxic. Guess what that does? That also changes the entire balance of your gut and your microbiome. Why? Because it secretes hormones and substances like cortisol, epinephrine, all of which that creates an environment, creates an entire place where your gut cannot be healthy. When your gut's not healthy, and it doesn't have the right amount of protection that it needs for the rest of the body, everything goes haywire.

Partha Nandi: Your gut has the most sophisticated immune system because it has to protect itself from all the stuff that's coming through. When you eat a piece of food, it's not sterile. Your gut has to really be ready. However, if you don't have an intact barrier, meaning you have leaks there, that powerful immune system can actually affect you in an adverse way, worsening inflammation. Inflammation is the beginning of all disease, including diabetes, worsening insulin resistance.


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Partha Nandi: Then, we talk about this whole metabolic syndrome where you're not only diabetic, but you also could have obesity. Your cholesterol goes up. So lots of bad things can happen. That's the understanding, but this is revolutionary. I didn't see this in medical school, wasn't even a subject or a thought in people's minds. This is all groundbreaking stuff that Dr. Mowll is introducing to us. We're talking about this. So simple things you can do, we'll talk about that. How can you then take this and actually move in the right direction?

Brian Mowll: There has been research, and they've described these various [intero 00:16:23] types. I'm not sure if that's overly simplistic, or if it's pretty accurate; but, there's the bacteroides, and prevotella strains. They have described how certain people, based on certain diets, will have more of one type of bacteria versus something else, or a microorganism. Do you think that is clinically useful, or do you think it's overly simplistic? Does it give us a framework to kind of build on?

Partha Nandi: I think that's a great question. So what happens is that you see certain types of bugs in people that are not having good control, and using certain types of bugs that people who have good control or bad control. Then you don't know if it's an association, or is it cause and effect?

Partha Nandi: What I like to tell people is, to keep it simple, is that if you look at the entire picture instead of going into the weeds. Say, 'Oh, I want a not have [variicola microbio 00:17:23] in my gut, lactobacillus, and this type is good.' You really get in the weeds, and I just don't know if we have the evidence to prove that, but I do know this: that we have evidence to prove that if you fundamentally change your diet to not have processed foods, have complex carbohydrates, fruits and veggies, include movement in your life, include spirituality, and have tribe, ... You know this, Dr. Mowll, because I've talked to you about this before. We call it the five pillars of being your own health hero.

Partha Nandi: So to me, instead of making it overly complex and people remembering, is this bacteria or organism bad or good? Let's look at the biggest picture. The big picture is that if you can then do something fundamentally different, don't take antibiotics unless you absolutely have to, right? Huge, huge issue in our country. I just came from the hospital today, and there's somebody with resistant bacteria that we don't know what to do with. That didn't just come out of nowhere. I mean, that's a completely different topic than we're talking about, but we are overusing antibiotics.

Partha Nandi: Pertinent to diabetes, that kills your chances of having good gut health. It doesn't matter if you're looking and seeing if you want to take a probiotic with certain strains, or give yourself a certain type of vegetables. If you wipe yourself out with taking these antibiotics, you're done, because you don't really have a chance for your gut to be able to have the health.

Partha Nandi: So number one, take all your antibiotics. Be purposeful in what you do. When you go to the doctor, don't say, 'I just want an antibiotic.' You wouldn't believe how many people come to me and say, 'Doc, I need an


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antibiotic.' That's not a complaint, that's just like, 'Here it is. Give me an antibiotic, and I'll be out of your way.' It's easy for me to just write an antibiotic. I don't, but many people do. So I really implore so many of us who are watching that be your health hero, be your own advocate. Don't ask for an antibiotic.

Partha Nandi: Secondly, fruits and vegetables, right? Fruits and ... Even if you're a diabetic. People think, 'Well, I can't eat ... I can't have any fruit.' No. If you have it in moderate portions, you can have fruits and vegetables. These complex carbohydrates are going to build your great microbiome. Those trillion member army is going to help you. So that is my second pillar, which is nutrition.

Partha Nandi: Third is what? Movement. Not just movement, going to the gym for 20 minutes three times a week, and then sit on the couch every single minute of the day after that. No, purposeful movement. Go out there and run with your dog, with your kids, walk the stairs, do things that incorporate movement in your life. Why is that great for diabetes? Well first of all, movement will help you with insulin resistance just by itself. But with gut health, we now know if you have movement in your body, you change the type of your gut microbiome, you change the species that you have. It goes towards favorable types. Now again, I want to let you know that there's a lot more information we need, but these are the trends we're getting.

Partha Nandi: I talked about the toxic relationships, and your mental anguish. I mean in this nation, in this world, we're getting people that are just unbelievably being stressed by environment. If you have spirituality, what happens is diseases like diabetes change tremendously. Why/ Because when you have stress from everybody around you, and it's continuing ... If you could have it just once or twice a day, that's fine, but if it's continuous, like so many of us.

Partha Nandi: I had a patient that came in yesterday, Dr. Mowll, that basically at work, she didn't have any way to be able to reach her milestones. She was constantly under stress. She couldn't finish lunch. She has no movement, then goes home to a toxic relationship, and then she goes to bed, and can't sleep. I mean it is, ... and that's not an unusual story. So if you have that, you have a barrage of this complete emotional stress. If you have spirituality in your life, and by that, I don't mean necessarily prayer. If prayer is a thing for you, it's okay, but I'm talking about doing yoga, being mindful, even walking in the garden. Anything that tells you that you are ... that somebody in the universe has got your back, and that you can use your body to able to calm those stressors down. What does that do for your diabetes? Less cortisol, less epinephrine, and improves your environment for having gut health.

Partha Nandi: The last thing is tribe. This is what Dr. Mowll has created in this summit, right? We're all working together to try to beat diabetes. Whatever disease you have, whatever disease, whatever type of health, but you have a tribe that's working together. We know that the levels of all the bad hormones, all the bad products actually go down. Why? Because unrest and disease is decreased. Not only does it help your gut health


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and every other part of your body, but it actually can help you with actually managing diseases that are chronic and inflammatory, like diabetes.

Partha Nandi: So simple steps that you can really do. To me, in order to be effective, it has to be simple. People have to be able to not memorize stuff, but really do things that they can put their arms around, and do it every day. I guarantee if people that are watching do those just simple, those five steps, they will go a long way towards managing not only their diabetes, but their overall health.

Brian Mowll: Wow, that's amazing. You know, it's one thing that I think you really get from being in clinical practice is the need and the art of simplifying. Because when you're talking with patients all day long, every day, you really have to be able to convey that information quickly and easily, and in a way that people can understand it, and walk away with some action steps.

Brian Mowll: Sometimes, like you said, we get too far in the weeds with even some of the testing that's done, and trying to get a deep level of understanding of exactly what's going on. The truth is, it's really hard to know but we do know that there are strong links and connections between gut health, and metabolic health, and diabetes, and insulin resistance. The healthier you lead, ... the healthier lifestyle you lead, including all the factors that you mentioned, the better off your gut's going to be, and the better off your blood sugar's going to be. So I love the message, very simple and clear.

Brian Mowll: Now, if someone has taken antibiotics, or perhaps they've had other factors that have led them to a position where their gut is just not in a healthy way. They've maybe got some conditions like [SIBO 00:24:12], or they're just having some GI symptoms. They've ruled out anything serious, and they're looking at ... trying to just rebuild the health of their gut.

Brian Mowll: You mentioned these steps, but is there anything specific nutritionally that they should be eating or should not be eating? Is there anything like a probiotic that they should be taking? How should they look at rebuilding their gut health over time?

Partha Nandi: That's a great question. The idea is that you've got this system where everything is out of equilibrium. What's the first thing that you do? You want to find how you can pour the good organisms back. The one difficulty is that everybody's a little different. Let's put that aside. Let's say, 'Okay, what ... some general things that you can do?'

Partha Nandi: Number one, I would say avoid. I tell my patients this. Avoid all processed foods completely. For some patients, I tell them that if they can, try to avoid gluten and sugar completely; and also if they can, avoid dairy. This is not for everybody, but people who are really debilitated, meaning that they have taken antibiotics, and they really have ravaged their entire body by eating processed foods for possibly


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most of their life. So for them, I tell them to avoid processed foods, number one, avoid simple sugars. Then, pour more good stuff.

Partha Nandi: So what does that mean? I think you can give yourself a probiotic, but I love to tell patients, give yourself probiotics that have existed for a long time. So what does that mean? Throughout all of history, every culture has got something, right? If you like sauerkraut, great source of probiotic, right? If you like Greek yogurt, great source of probiotic, right? Kimchi, great source of a probiotic. There's all kinds of fermented foods that you can give that really then increase the amount of good stuff that's been there.

Partha Nandi: I'll tell you it's your body for thousands of years has developed a relationship between the stuff that's in those foods like I talked about, sauerkraut or kimchi. Whatever these ancient foods are that people have had for a long time, and your body has developed a relationship that's positive. So put that stuff back in there.

Partha Nandi: Now, it's going to take a long time if you just do that. We take the probiotic that we talked about, then add a prebiotic. What I do is then ... what the prebiotic does is it's almost like a growth factor. You take these probiotics, and you get millions and millions of bugs, and then you give them food so they can just get multiplied, and get more and more in your body.

Partha Nandi: So what are prebiotics? The best type of prebiotics is just fiber I your body. So again, we go back to veggies. If you like celery, right? If you like cabbage, if you like cauliflower, all those foods will then do this, proliferate, and make those amazing bugs then become plentiful. Then, what does that do to your intestinal system that's damaged? Then you replace or replenish that gut lining that's been damaged. Your body already has the ability to do that. You just have to accelerate it and move it in the right direction.

Partha Nandi: I'll give you the example. The analogy is that we treat gastric ulcers all the time, ulcers in the stomach that you can see. They look like big canker sores. I had one this morning when I did a procedure. I did an endoscopy on a patient, and she was having discomfort and bloating. She had a big ulcer about a centimeter, which is what? About a little bit less than a half an inch. We gave her medicine to help to decrease the damaging factor, but the body is actually healing it. It's the same with when your gut has lost its integrity. Lost its way, almost, because of what you've done to it. Your body will repair it, but you just have to help it by not continuing to give it the factors that made it bad. So what you eat, antibiotics, lack of movement, lack of spirituality, increasing stress. If you take those factors out, put good stuff in there, your body will repair itself.

Partha Nandi: In addition, what I would also say is that you want to make sure that you minimize every other medicine that you can. Because what happens is remember, what's the first place that these medicines actually go into? It's in your gut. So you may not think that if you're not taking an antibiotic, but I'm taking something else, that's going in your intestinal


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system. You are giving your body so many ways to be able to say, what is this? Is this something foreign? That then begins the immune system.

Partha Nandi: So what I mean by that is give yourself as few foreign stuff that your body doesn't know. Every little substance that goes in you body is going to be ... the body has to deal with. So if it feels it's foreign, it's going to start ... If you're the right person that's in that category, it's going to start developing an immune response. So it's going to see this foreign, start that whole immune process going. Minimize as many of the medications. Don't say, 'Oh, I've got a headache. Let me take a Motrin.' 'I've got this, let me do that.' That's the reaction. Instead, practice spirituality. Practice yoga. Move with purpose. Lots of times, you can get rid of some of those aches and pains.

Partha Nandi: That's the approach I give my patients who have problems with gut integrity. I'll tell you, most of the time, this actually works. You have to be committed, though. It's very difficult to resist. You go to a party, have a big piece of cake. Or, you go somewhere else, and ... When your gut's ravaged, and you want to repair it, you can't really do that until you really have a place where you've achieved that gut integrity. That's the approach I take to them. I try to keep it very simple, and I try to give them ways that they can actually do it in a meaningful way. What I mean is go to a regular grocery store. I don't want them to travel 120 miles, or have to go through Amazon, or some retailer to get it. There are ways you can do it, and do it successfully.

Partha Nandi: The blue zones, and you know about this, Dr. Mowll, the blue zones where people are actually ... around the world that have done incredibly well. Part of the reason why they've done well is because their gut health is incredible. They do very simple things to make that happen. That is why I really wanted to stick with those types of principles, and that really works for a lot of my patients.

Brian Mowll: Wow. Very, very cool. Yeah, I think with leaky gut, a lot of people are, again, going down the path of over complicating things, trying to figure out exactly what magical supplement they need to take to heal their gut. Really, I think it's all the things that you just mentioned, and giving the body time and space to do that healing. It can repair itself, just like a cut on the skin can heal, and you can have brand new skin, the gut lining can heal as well; but you'd have to stop the onslaught of negative factors. I think that's a lot of what you discussed. That's great.

Brian Mowll: Now, what's the connection then that you've talked about the immune system several times. What's the link between that and then autoimmune disease, like type one diabetes, or LADA, which is basically adult onset autoimmune diabetes, or other autoimmune diseases like celiac, rheumatoid arthritis, lupus, MS, and so forth?

Partha Nandi: Oh, that's a great question. So the gut is lined with the most complicated immune system; because here's the thing: it's the last place really where you have to encounter mother nature, which is not sterile. So what I mean is that when you put something in your mouth and it goes in your gut, it's really full of anything that the world has. Your body


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has to be incredibly sophisticated. You've got the CIA, the FBI, the local police, sheriff, everybody's in that place because you've got to not let anybody in. If you do, you have a consequence of death. I mean, if you get the wrong bug or the wrong particle into your bloodstream, you could die. It's Fort Knox in your gut, which is great, right? It's what's kept us alive.

Partha Nandi: However, in the last 50 to 75 years, we have dramatically changed what we put in our mouth because for thousands and thousands of years, your body knew that there are plants, there's vegetables. If you ate meat, you had certain types of meat that you ate. But we've dramatically changed everything. The food scientists, and the people that know how to make food efficient have introduced stuff that your body has never seen.

Partha Nandi: Now, if this happened over maybe a thousand years, I don't think we'd have a problem. What's happened is that you've taken all of humanity's history, and then now in 50 to 75 years, completely changed what, how we affect our immune system and the gut. So when you basically put in a hamburger that's made of processed material, the bond, and everything else within it is nothing the bodies has seen, your body doesn't know what to do about that. It's sitting there thinking, 'Okay, now I'm seeing this. It looks abnormal. What should I do?' They start reacting to it. The guns come out. They're waiting for something bad to happen. Then, if nothing happens, it basically goes to rest.

Partha Nandi: But let's say you do that not just once, not just twice, but thousands and thousands of times. The immune system is going to be at an alert, and start attacking these particles. Not in a macroscopic way, which means that you can't see all the inflammation. But on a microscopic, cellular level, the immune system becomes up-regulated. It starts attacking. We've talked about that gut health, the leaky gut. So what happens? Those immune cells then create these tiny little crevices, the beginnings of inflammation. When that happens, those inflammatory cells, the CIA, the FBI, the local police, then tell the rest of the body as well. They communicate that there's inflammation that's happening, and then your body becomes in ready position, not just in your gut. But in the right person, the susceptibility's also there. There's another factor that says, 'are you going to be affected in your joints? Are you going to be affected in your heart? Are you going to be affected in your intestinal tract, or perhaps your brain?'

Partha Nandi: All diseases, when you boil it down, it's from inflammation. People are wondering how is this all happening? Well, it begins in your gut because what you're giving your gut is the beginnings of how to get attacked. When your body starts to attack in that gut, then that attack, on a microscopic level, our technology is not sophisticated enough yet to find that. But then that inflammation goes, and can create the right [inaudible 00:35:44] or the environment for diabetes, or lupus, and everything else we talked about. That's how you really start with inflammation.


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Partha Nandi: So I tell my patients who have Crohn's Disease, I say, "The first thing you have to do is get rid of all the crap you're eating, and get rid of all the stuff we talked about, the emotional stress, the lack of of movement, the lack of any support and tribe. Because until you do that, we can continue to escalate the steroids, escalate the biologic therapy, but you've got to go back to the root cause of what is happening. That is that you are not giving your gut the right environment to maintain equilibrium. It is in ... this equilibrium, and that's the beginning of disease."

Partha Nandi: It's a connection between saying the microbiome, the stuff that you put in your body, and the leakiness or the lack of integrity. We now have electron microscopes that you actually are showing where the gut is not actually together. Those little leaks, stuff goes into the bloodstream. The inflammatory process begins and spreads everywhere. That's the connection.

Partha Nandi: What I love about it, Dr. Mowll, is that we can do something about it. It used to be that you're helpless, right? You're like, 'I've got lupus. My gosh, all I have to do is take steroids,' or something else, but now you can do something as simple as change your gut, and you could really fight it, and possibly prevent that from happening.

Brian Mowll: Wow, what an inspiring message. I absolutely love that. You may have just answered the first of my three questions that I like to end each interview with; but I'll go ahead and ask anyway. Maybe you have something else to share. Just curious what quote or thought, or idea would you like people to walk away from this interview with, or even as you speak and share information with people in your clinic, and on other interviews, and around the world, what is the main thought? It could be a quote, or just an idea that you want to really convey to people.

Partha Nandi: The main idea or quote is that you are in charge of your life. You are your own health hero, which means that you have the power to change your health in a dramatic way like you've never had before. Like I've said, this is not from medical school. This is from learning and understanding the current environment. What's exciting is that you have research now that shows that you have the power of health in your hands, and that to me is exciting. That takes away all of this passive behavior, like this is happening to me. No, you are in control, and you can change it. Less than 10% of your disease is through your genes. The rest is all the stuff we talked about. Man, if you could change 90% of your health, why not?

Brian Mowll: Yeah, yeah. Absolutely. Powerful. Second question: is there a book that you've read that you feel like really changed your life, or changed the direction of perhaps the way you practice today, or the way you teach and share information?

Partha Nandi: I don't think it's one particular book, but here's what I love is that I love all the books that talk about really self empowerment, and not just about health, but in life and in general. When you can give the power of


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changing your behavior, changing what you can do in your life to affect change for others and yourself, that, to me, is the most critical step.

Partha Nandi: I love the fact that there's so much work out there. If you look at the 'End of Alzheimer's, just as an example, I think it was last year that it was published. We talked about now the change of disease that's devastating this country. It's not like some voodoo, and you got to like buy some potions from the top of mount something. It's really fundamentally changing things in your life that you can do.

Partha Nandi: That's an example, but there are many, many books out there. The idea is that you know what? You can actually do something in your life to affect others. There are books now that show that you know what? It's not about who your parents are, or what your genes are that really can make you an NFL star or a ballerina. It's really about your 10,000 hours of experience. How about that? Meaning that if you start off and say, 'I'm going to be able to do that,' and really put in the time, it doesn't matter if people said, 'Well, you're not good at that.' You can actually develop skills to make that happen. That's what I love about the movement. I think the next decade is going to be tremendous, especially for health, but in general because exponentially, people are changing the way they think and paradigm shifting is going to elevate all of humanity.

Brian Mowll: Yeah, yeah. Well said. I love that book, by the way, the 'End of Alzheimer's.' We actually interviewed Dr. Bredesen recently, and he's going to be on the summit here as well; so sharing that information firsthand. So make sure you guys, if you're watching that, tune in and watch that interview as well.

Brian Mowll: So last question here for you today is if you had ... I know you have patients who probably come to you with this. But if you had a friend or family member who was recently diagnosed with type two diabetes, and they came to you, and just asked you for some advice ... if you had just a couple of minutes to kind of give them your best advice, 'Here's what I think you should do.' What would you tell them?

Partha Nandi: What I'd tell them is that make your gut health the center of your universe. Really take every step you can to make sure that you treat your gut like template, because ... Listen, I'm a gastroenterologist, so to me, it's the center of the world, but now we know for so many diseases, including diabetes, it's really the centerpiece. If you do not manage your gut health, you're not going to be successful in managing diabetes the right way. You can keep elevating your insulin and do other things to try to mask really what it is, but really look at your gut health. Understand that, that blood sugar number is just a symbol of what's going on. It's not the only thing. It's the only thing we can easily look at, but that blood sugar is just a little snippet. If you could look into a tiny hole where everything is happening behind that tiny hole, that tiny hole is your blood sugar. Man, everything else behind it is so much more complex and powerful. Use your gut to be able to fight not just that blood sugar number, but everything else that goes along with it.


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Brian Mowll: Fantastic. Okay, so a lot of information today. There's so much more to cover. There's a hundred other questions I'd like to ask you, but I think that you have a lot of great information and resources that you can share with people if they do want more information. What is the best place for people to go? Do you have a resource for people to look at? What do you recommend for people who want to get more information about this topic?

Partha Nandi: I think if you go to AskDrNandi.com, so A-S-K-D-R-N-A-N-D-I dot com, we have blog recipes, also information ... I have a television show that airs in every city in the country, so you can get information from all of that. But all of it's really information that's to help you empower your life, and be your own health hero, to manage your disease and give yourself and your loved ones the best life they can lead.

Brian Mowll: Fantastic. Dr. Nandi, thank you so much for spending this time with me today. I appreciate your time and your passion dedicated to what you do to help people. Thank you.

Partha Nandi: Hey, thanks for having me, and thanks for all you do to empower people as well. I appreciate it.

Brian Mowll: Okay, fantastic. That was Dr. Partha Nandi. I'm sure you absolutely love that interview. You can learn more about Dr. Nandi by going to AskDrNandi.com. That's Ask D-R Nandi dot com.

Brian Mowll: This is Dr. Brian Mowll, the Diabetes Coach. I want to thank you again for being part of the Diabetes Summit 2019. I'll be back with another expert interview very soon. Take care.


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Partha Nandi, MD - Amazon S3...perhaps even using half of the insulin that you have, and your body...

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