Digestive Care Expert Brenda Watson

Every Friday for six weeks I am sharing with you a recipe from my new book, The Skinny Gut Diet. If you have tried it all, but you still can’t lose weight, then this book is for you. You are not entirely to blame for your extra pounds. As it turns out, the bacteria in your gut play a major role in whether or not you will lose weight—and keep it off—for good.

Athenian-Meatballs

These delicious meatballs make a delicious snack, appetizer, or, when paired with a side salad, a nice lunch. Prepare them ahead of time so that you can heat them up them whenever you need to quell your appetite. These meatballs have only 0.6 teaspoons of sugar (that includes sugar that breaks down from starchy carbohydrates), as calculated using my sugar tracker calculation:teaspoon-tracker

0.6 teaspoons of sugar
55 minutes to prepare and cook
Serves 6

1 white onion, quartered
¼ cup fresh dill sprigs
¼ cup fresh mint leaves
2 garlic cloves
½ cup grated zucchini
1 pound ground lamb
1 large egg, beaten
¼ cup crumbled feta cheese
¼ teaspoon freshly ground black pepper
2 tablespoons water or milk

  1. Preheat the oven to 375°F. Place the onion, dill, mint, and garlic in a food processor and pulse 8 to 12 times, until chopped and well mixed. Add the zucchini and pulse 2 or 3 times more to combine. Transfer the mixture to a large bowl.
  2. Add the lamb, egg, cheese, and pepper and mix with your hands until well combined. Wet your hands with water or milk and form the mixture into balls slightly larger than a gold ball.
  3. Heat a large skillet over medium-high heat. Brown the meatballs for 5 minutes all around, then place on an ovenproof dish or pan. Place in the oven on the center rack and bake for about 30 minutes.

appetite, appetizer, Athenian meatballs, lunch, Skinny Gut Diet, snack

The intestinal tract is a main source of health-care associated pathogenic infections, not surprisingly due to the high concentration of microbes residing there.1 The GI tract is also considered to the primary reservoir for the emergence of antibiotic resistance of such infections.2 In patients with prolonged critical illness, the risk of developing a gut-derived sepsis (blood infection) is increased.

In a recent study published in the journal mBio, researchers analyzed the gut microbial composition of 14 critically ill patients under prolonged stay in an intensive care unit.3 They found ultra-low-diversity communities of bacteria consisting of only one to four species in 30 percent of the patients. This ultra-low diversity is the result of harsh conditions in the gut during critical illness, including multiple antibiotic exposure, reduced nutrition, physiological stress, and additional medications, some of which also affect gut microbes (acid-suppressors and opioids, in particular).

The most common bacteria in these patients detected by 16S rRNA sequencing were Enterococcus and Streptococcus as well as microbes under the family Enterobacteriaceae. Culture-based analyses also revealed the presence of Candida albicans and Candida glabrata in about 75 percent of the ICU patients. Four patients harbored a 2-member pathogen community consisting of one Candida and one bacterial organism.

“Here we demonstrate that the intestinal microbiome in critically ill patients can be considered a “damaged organ” given that its main cellular mass, the normal microbiota, is disrupted and dominated by pathobiota which may be an ever-threatening source for disseminating pathogens,” concluded the researchers.

In further experiments, the researchers determined that the ultra-low-diversity communities showed low virulence (pathogenicity) when they were grouped together, or living commensally as “friendly” organisms. The bacteria were able to keep the fungal Candida species in check, reducing their ability to become pathogenic. The researchers also tested the use of phosphate-polyethylene glycol (an anti-virulence compound) and found that it helped to reduce the pathogenicity of the microbes, suggesting that it might be a useful compound for critically ill patients with an ultra-low diversity of antibiotic-resistant gut microbes.

“A major challenge in treating critically ill patients is the overuse of antibiotics, a practice that is often unavoidable with patients exposed to multiple invasive procedures and extreme physiologic stress,” noted the researchers.

Further study of compounds that positively affect gut microbe composition in this vulnerable population is needed.

Many critically ill patients are now getting a slow, continuous drip of liquid food fortified with gut supportive supplements such as zinc, glutamine, arginine, vitamin C, omega-3s, and many more. These feedings are administered either via a thin nasogastric tube or an endoscopically placed gastric feeding tube.

I personally think it is high time that prebiotics and probiotics be added to the feeding tube line. Many of these tubes have an extra opening to administer meds. The prebiotics could be administered with the continuous liquid feedings and the probiotics be injected via side port, ideally between antibiotic dosages. This allows for maintenance of microbial diversity and repopulation of probiotic species that diminish with chronic stress, which allows pathogenic bacteria and fungi to multiply out of control.

It has been well documented that probiotics ingest prebiotic fibers, creating short-chain fatty acids (SCFAs) such as butyrate, acetate, and propionate. All three of these have been shown to bind to GPR43, and GPR41 receptors in the gut lining and on the surface of white blood cells. This action majorly helps to balance the immune system so that it can appropriately deal with pathogenic bacteria and fungi without overdoing it and leading to autoimmune disease.

This is only one action of SCFAs, and only one of many ways immunity is balanced when supported by good nutrition and beneficial bacteria such as Lactobacillus and Bifidobacteria, and fungi such as Saccharomyces boulardii, signaling through many different pathways. The optimum situation is to provide the nutrients, supplements, and probiotics that support our “damaged organ”—the gut lining and beneficial microbes.

This article provides a good picture of what happens when our normal microbiome, which normally consists of several hundred microbial species, is reduced to 2 to 4 pathogenic bacteria and fungi while everything else has been starved or killed by antimicrobials. It makes perfect sense to replenish that which has been lost, a practice that should be, and is slowly becoming, standard of care today.

References

  1. Alverdy JC and Chang EB, “The re-emerging role of the intestinal microflora in critical illness and inflammation: why the gut hypothesis of sepsis syndrome will not go away.” J Leukoc Biol. 2008 Mar;83(3):461-6.
  2. Salyers AA, Gupta A, and Wang Y, “Human intestinal bacteria as reservoirs for antibiotic resistance genes.” Trends Microbiol. 2004 Sep;12(9):412-6.
  3. Zaborin A, Smith D, Garfield K, et al., “Membership and behavior of ultra-low-diversity pathogen communities present in the gut of humans during prolonged critical illness.” mBio. 23 2014 Sep;5(5):e01361–14.

antibiotics, bacteria, Candida, gut microbes, intestinal tract, microbes, ultra-low-diversity

Artificial sweeteners—the likes of saccharine (the pink packets), aspartame (the blue packets), and sucralose (the yellow packets)—were created as an alternative to caloric sweeteners like sugar and honey, which contribute to raised blood sugar and the development of metabolic syndrome and type 2 diabetes. Artificial sweeteners are added to a wide range of commonly consumed foods such as diet sodas, cereals, and sugar-free desserts, which are often recommended for people with, or at risk of, type 2 diabetes.

Artificial sweeteners are not absorbed by the body, but are instead passed through the digestive tract largely intact. Due to the 100 trillion bacteria inhabiting the gut, however, they may have more of an effect on metabolism than experts previously realized. In a recent study published in the journal Nature, researchers found that artificial sweeteners trigger an imbalance of gut bacteria that leads to an increase in glucose intolerance (an inability of the body to deal with excess sugar in the bloodstream—in other words, high blood sugar and insulin resistance).

In an elegant collection of experiments, the scientists found that artificial sweeteners are likely not the safe sugar alternative that we are led to believe.

“Together with other major shifts that occurred in human nutrition, this increase in non-caloric artificial sweetener (NAS) consumption coincides with the dramatic increase in the obesity and diabetes epidemics,” noted the researchers. “Our findings suggest that NAS may have directly contributed to enhancing the exact epidemic that they themselves were intended to fight.”

The scientists began by adding saccharine, sucralose, aspartame, sucrose (table sugar), glucose (the basic sugar molecule that makes up table sugar and is found in the bloodstream), or nothing to the drinking water of mice. Those mice drinking water with an added artificial sweetener were found to have increased glucose intolerance when compared to mice given sugar or plain water. Of the three artificial sweeteners tested, saccharine had the most pronounced effect.

Next, the mice were given antibiotics while continuing to consume the saccharine, sugar, or plain water. The antibiotic treatment induced a reversal of the glucose intolerance in those mice consuming artificial sweeteners, a finding that suggests that gut bacteria play a role in the alterations of glucose tolerance. When the gut bacteria were diminished by antibiotics, the glucose intolerance disappeared, so we know the bacteria were involved. In addition, the stool of mice consuming saccharine (before antibiotics) was tested and found to exhibit dysbiosis, or bacterial imbalance when compared to the control groups consuming sugar or plain water. This also implicates the bacteria as playing a role.

To test the idea that gut bacteria might be the cause of the glucose intolerance, the researchers transplanted stool from the saccharine-consuming mice into germ-free mice, or mice without gut bacteria. After only six days, the germ-free mice began to exhibit impaired glucose tolerance. This demonstrates that not only is saccharine responsible for triggering gut bacteria imbalance, but that the imbalance is directly responsible for impairing glucose tolerance after consumption of saccharine.

Think about that. Bacteria inside the gut are altered by saccharine, and they trigger the body to have a faulty response to dietary sugar, leading to increases in blood sugar. I don’t know about you, but I’ll hold off on the pink stuff (and all artificial sweeteners, for that matter.)

“Collectively, these results demonstrate that saccharine directly modulates the composition and function of the microbiome and induces dysbiosis, accounting for the downstream glucose intolerance…” noted the scientists.

Next the researchers took their investigation to the next level by studying these effects in humans. They first found a link between consumption of artificial sweeteners and several parameters related to the metabolic syndrome, including increased weight and waist-to-hip ratio, higher fasting blood sugar and glucose intolerance as well as elevated levels of HbA1C (a measure of long-term blood sugar control).

To determine whether these links may be more than a coincidence—that is, that consumption of artificial sweeteners causes these abnormalities rather than occurring alongside them—the scientists followed seven healthy individuals who do not normally consume artificial sweeteners. For six days, the participants consumed saccharine at the highest allowable daily intake level, and for even this short period of time, four of the seven participants developed glucose intolerance. Stool tests of these individuals showed that their gut bacteria differed from those who did not have an abnormal glucose response, showing that an imbalance of gut bacteria plays a role in the abnormal blood sugar response to saccharine in humans, as well.

To test this idea out and determine whether gut bacteria causes the glucose intolerance rather than occurs alongside it, they transplanted stool from two people who exhibited abnormal blood sugar response after consuming saccharine and two people who did not into germ-free mice. As predicted, those mice who received stool from people who exhibited abnormal glucose response went on to exhibit the same abnormal glucose response as well as a gut bacterial imbalance.

This is quite an impressive and eye-opening study. If you regularly consume artificial sweeteners, you may want to think twice. While more studies will be needed to replicate these results and to determine whether the other artificial sweeteners sucralose and aspartame have the same effects in humans, taking the precautionary measure and avoiding these sweeteners is a good idea. Even the study’s lead author, Eran Elinav, MD, PhD, has made the personal decision to stop using them. I, myself do not eat them, and I have recommended against them for many years now. Opt instead for natural non-caloric sweeteners like stevia, lo han (monkfruit), erythritol, or xylitol.

artificial sweeteners, aspartame, blood sugar, dysbiosis, glucose intolerance, gut bacteria, gut bacteria imbalance, high blood sugar, insulin resistance, saccharine, sucralose

Every Friday for six weeks I am sharing with you a recipe from my new book, The Skinny Gut Diet. If you have tried it all, but you still can’t lose weight, then this book is for you. You are not entirely to blame for your extra pounds. As it turns out, the bacteria in your gut play a major role in whether or not you will lose weight—and keep it off—for good.

healthy-greens-drink

For a refreshing and healthy boost, this green juice will be sure to invigorate your detoxification pathways. I recommend this drink at any time, any day (every day would be great!). Pair it with a high-protein snack and look out world! You’ll be ready to tackle any task. This green juice has only 2.9 teaspoons of sugar (that includes sugar that breaks down from starchy carbohydrates), as calculated using my sugar tracker calculation:

teaspoon tracker

 

2.9 teaspoons of sugar
10 minutes to prepare and cook
Serves 1

⅓ small cucumber
2 ribs celery
1 cup trimmed kale
1 cup baby spinach
3 sprigs parsley
Juice from 1 lemon wedge
¼ Granny Smith apple

Place ingredients in Ninja or Vitamix blender and blend until smooth. Enjoy.

detoxification, green juice, healthy, sugar

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Watch Me Today on the Dr. Oz Show!

I’m so excited to announce that I’ll be on the Dr. Oz show today discussing the importance of the trillions of bacteria that reside in your gut and how the composition of those bacteria determines whether or not you will gain weight. That’s right—your extra pounds are not entirely your fault. If you have been on the diet roller coaster for years yet you still struggle to keep the weight off, this show is for you.

Dr. Oz and I discuss the two main groups of bacteria in your gut—what I call the “Fat bacteria” and the “Be Skinny bacteria.” When your level of “Fat bacteria” increase and your “Be Skinny bacteria” go down, you are more likely to gain weight. The good news is you can reverse that balance and achieve your ideal weight. In my new book, The Skinny Gut Diet, I give you four simple rules that will help you balance your gut for permanent weight loss.

My Skinny Gut Diet will help you get a daily fiber flush that feeds the good “Be Skinny bacteria” in your gut while starving the bad “Fat bacteria.” But that’s not all—by eating at least 35 grams of fiber each day, you will eliminate 245 calories from your diet on a daily basis.

Dr. Oz and I will discuss why you should be eating more of what I call living foods—those foods that contain good bacteria (like fermented foods) and those foods that feed the good bacteria in your gut (prebiotic fibers that are found in foods like onions, leeks, asparagus, Jerusalem artichokes, and in soluble fiber supplements like acacia fiber).

Check your local listings for viewing times, or go to the Dr. Oz website to find out what time the show airs in your region.

acacia fiber, bacteria, daily fiber flush, diet, Dr. Oz, fermented foods, good bacteria, gut, ideal weight, living foods, soluble fiber, The Skinny Gut Diet, Weight Loss

The diversity of your gut bacteria refers to the abundance of different types of microbes. As a rule, the more diverse your gut microbes, the healthier you are. A recent study published in the Journal of Clinical Endocrinology & Metabolism further supports this idea. Researchers from the National Institutes of Health National Cancer Institute discovered that gut bacterial diversity may play a role in the eventual development of breast cancer.

“In women who had more diverse communities of gut bacteria, higher levels of estrogen fragments were left after the body metabolized the hormone, compared to women with less diverse intestinal bacteria,” noted James Goedert, MD, one of the researchers. “This pattern suggests that these women may have a lower risk of developing breast cancer.”

Could it be that our bacteria take over our living environments as a protective measure over our health? I would certainly not be surprised. I like the idea of having an arThe researchers collected fecal and urine samples from 60 postmenopausal women aged 55 to 69 and analyzed them for the ratio of estrogen fragments to estrogen, which is a known predictor of breast cancer. my of beneficial bacteria surrounding me at all times.

What does gut bacterial diversity have to do with estrogen and breast cancer, you might ask? Well, bacteria in the gut actually metabolize estrogen that is excreted into the digestive tract, affecting the balance of estrogen and estrogen metabolites. Some estrogen is even reabsorbed from the gut into circulation, which can affect overall estrogen levels in the body. This new research suggests that gut bacterial diversity may play an important role on estrogen levels and breast cancer risk.

The best way to improve gut bacterial diversity is to eat a diet high in foods that replenish gut bacteria (fermented foods) and foods that feed good bacteria (those foods high in prebiotic fibers). Adding probiotic and fiber supplements will also help. As we see here, optimizing gut health is the key to better total-body health.

diet, diversity, estrogen, fermented foods, foods, good bacteria, gut bacteria, gut health, intestinal bacteria, microbes, prebiotic fibers, women

I recently had the opportunity to discuss the connection between weight loss and gut bacterial balance with Dr. Oz for an upcoming segment that will air on his show on October 23.

Inside your digestive tract live 100 trillion bacteria that play a vital role in maintaining your digestive and overall health. As it turns out, the balance of these bacteria determines whether or not you will gain weight. You see, bacteria in your gut may be the cause of your food cravings.

There are two main groups of bacteria in your gut—what I call the “Fat bacteria” and the “Be Skinny bacteria.” When your level of “Fat bacteria” increase and your “Be Skinny bacteria” go down, you are more likely to gain weight. Even if you ate the same food as your best friend, if she had more “Be Skinny bacteria” and less “Fat bacteria” than you, guess who would pack on the pounds? You!

Fortunately, you have the power to bring your gut bacteria back into balance. In my new book, The Skinny Gut Diet, I give you four simple rules that will help you balance your gut for permanent weight loss. With a 14-day start-up food guide, 75+ recipes, and plenty of tips and tools to keep you on track, The Skinny Gut Diet will help you get to the root of your inability to lose weight, and help you shed those pounds for good.

My Skinny Gut Diet will help you get a daily fiber flush that feeds the good “Be Skinny bacteria” in your gut while starving the bad “Fat bacteria.” But that’s not all—by eating at least 35 grams of fiber each day, you will eliminate 245 calories from your diet on a daily basis.

You will also learn how to eat what I call living foods—those foods that contain good bacteria (like fermented foods) and those foods that feed the good bacteria in your gut (prebiotic fibers that are found in foods like onions, leeks, asparagus, Jerusalem artichokes, and in soluble fiber supplements like acacia fiber). Living foods will help replenish your good bacteria.

If you are tired of restricting calories and following diets that leave you hungry and craving sweets and snacks, look no further. A daily fiber flush with The Skinny Gut Diet will help you address your true cause of weight loss and get you off the dieting roller coaster—for good.

Tune in to The Dr. Oz Show on Thursday to learn more about how you can balance your gut for permanent weight loss.

bacteria, Be Skinny bacteria, calories, craving, daily fiber flush, Dr. Oz, Fat bacteria, living foods, prebiotic, The Dr. Oz Show, The Skinny Gut Diet, Weight Loss

Every Friday for six weeks I am sharing with you a recipe from my new book, The Skinny Gut Diet. If you have tried it all, but you still can’t lose weight, then this book is for you. You are not entirely to blame for your extra pounds. As it turns out, the bacteria in your gut play a major role in whether or not you will lose weight—and keep it off—for good.

Chicken-Lime-Cobb

Lunch is an important meal that can sometimes get minimized when we are too busy to eat a good meal. Whether your tendency is to stop by the drive-thru or just get by on snacks while you’re working, please realize that you are doing a disservice to your digestion (not to mention, your appetite later!). This Chicken Lime Cobb is a hearty and tasty way to make sure you are eating enough veggies while also getting a protein boost to keep you going strong through the afternoon. This salad has only 2 teaspoons of sugar (that includes sugar that breaks down from starchy carbohydrates), as calculated using my sugar tracker calculation:

teaspoon tracker2 teaspoons of sugar
15 minutes to prepare and cook
Serves 2

Dressing
2 teaspoons extra-virgin olive oil
¼ cup buttermilk
2 teaspoons minced jarred pickled jalapeño pepper
Juice of 1 lime
2 teaspoons Dijon-style mustard

Salad
8 ounces cooked chicken breast, chopped
½ red bell pepper, chopped
½ green bell pepper, chopped
¼ red onion, chopped
1 ripe tomato, chopped
½ avocado, scooped out and chopped
¼ cup blue cheese crumbles
1 hard-boiled egg, sliced in quarters
2 cups mixed salad green

  1. For the dressing: In a small bowl, whisk together all the ingredients.
  2. For the salad: In a large bowl, combine all the salad ingredients. Drizzle on the dressing and serve. Garnish with egg slices.

chicken lime cobb, digestion, lunch, protein, starchy carbohydrates, sugar, veggies

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Probiotics for Fatty Liver Disease

The liver is the body’s powerhouse of detoxification. The main function of the liver is to filter blood that comes directly from the intestines to the liver via the portal vein. The health of the liver, therefore, is very much dependent on the health of the gut. The intestinal lining is the main interface between the immune system and the external environment, and the health of the intestinal lining is determined by its balance of bacteria. When gut bacteria are out of balance, the intestinal lining can become damaged. As a result, a higher amount of toxins are able to pass through the lining and into the bloodstream, accessing the immune system as they travel directly to the liver for processing.

Because of the close proximity and intimate relationship between the gut and the liver, conditions that affect the liver are being increasingly linked to gut bacterial disturbances. There are two main ways in which researchers believe that gut bacteria contribute to non-alcoholic fatty liver disease (NAFLD), as discussed in a recent review paper published in the Journal of Functional Foods:

  1. Increased production of ethanol (alcohol) by gut bacteria2
  2. Increased absorption of bacterial toxins (such as lipopolysaccharide, or LPS)3

These toxins trigger inflammation in the liver via upregulation (increase) of immune function, which initiates the development of NAFLD. These toxins more readily flow to the liver under three main conditions, all known to be contributing risk factors of NAFLD:

  1. Leaky gut (increased intestinal permeability)
  2. Small-intestinal bacterial overgrowth (SIBO), a form of dysbiosis in which bacteria from the colon back up into the small intestine and overgrow.
  3. Bacterial translocation, or the migration of bacteria from the gut through the intestinal lining and into the mesenteric lymph nodes, where they trigger inflammation that reaches the liver.

To reverse or prevent the harmful effects of gut bacterial disturbances on the liver, probiotic administration has been suggested. The researchers note the following possible mechanisms by which probiotics can improve NAFLD:

  1. Decreased inflammation
  2. Decreased SIBO
  3. Immune system regulation
  4. Decreased LPS production
  5. Decreased bacterial translocation

An important function of probiotics is the protection of the intestinal lining. This function explains the protective functions of these beneficial bacteria. In a human clinical trial, patients with non-alcoholic steatohepatitis (NASH)—a condition that often follows NAFLD—received a multi-strain, high-dose probiotic and were found to have significant decreases in inflammation and improvements in levels of the liver enzyme aminotransferase.4 In another uncontrolled trial on the same probiotic formula, NAFLD and alcoholic cirrhosis patients experienced decreased inflammation and lipid peroxidation.5 In another clinical trial, the probiotics Lactobacillus bulgaricus and Streptococcus thermophilus supplementation resulted in improved liver aminotransferase levels in people with NAFLD.6

“Probiotics, as safe and effective compounds, have the potential to influence gut barrier functions and immune cell regulations resulting in liver health improvements,” noted the researchers.

Due to the scarcity of treatments available for NAFLD, probiotics are a promising option. More studies are needed to further pinpoint just how the probiotics exert their benefits in people with fatty liver disease.

References

  1. Mohammedmoradi S, Javidan A, and Kordi J, “Boom of probiotics: This time non-alcoholic fatty liver disease—A mini review.” J Functional Foods. 2014 Nov;11:30–35.
  2. Compare D, Coccoli P, Rocco A, et al., “Gut—liver axis: the impact of gut microbiota on non alcoholic fatty liver disease.” Nutr Metab Cardiovasc Dis. 2012 Jun;22(6):471–6.
  3. Vanni E and Bugianesi E, “The gut-liver axis in nonalcoholic fatty liver disease: Another pathway to insulin resistance?” Hepatology. 2009 Jun;49(6):1790–2.
  4. Loquicercio C, De Simone T, Fe3derico A, et al., “Gut-liver axis: a new point of attack to treat chronic liver damage?” Am J Gastroenterol. 2002 Aug;97(8):2144–6.
  5. Loquicercio C, Federico A, Tuccillo C, et al., “Beneficial effects of a probiotic VSL#3 on parameters of liver dysfunction in chronic liver diseases.” J Clin Gastroenterol. 2005 Jul;39(6):540–3.
  6. Aller R, DeLuis DA, Izaola O, et al., “Effect of a probiotic on liver aminotransferases in nonalcoholic fatty liver disease patients: a double blind randomized clinical trial.” Eur Rev Med Pharmacol Sci. 2011 Sep;15(9):1090–5.

bacterial toxins, beneficial bacteria, Fatty Liver Disease, gut, gut bacteria, immune system, inflammation, intestines, leaky gut, lipopolysaccharide, liver, NAFLD, non-alcoholic Fatty Liver Disease, Probiotics, small intestinal bacterial overgrowth

Since I announced the launch of my new book The Skinny Gut Diet last week, many of you have already told me you are living a Skinny Gut lifestyle and loving it. Exciting news! By eating the right foods for a balanced gut, you are one step closer to losing weight and keeping it off for good.

Since the book was released one of the questions I have been asked most often is “Why did you write The Skinny Gut Diet?” and of course I love sharing the answer. In fact, I made a video about the journey from inspiration to print.

Click on the image below to watch my video:

Why Did You Write the Skinny Gut Diet?

I have always been passionate about digestive care, and to me this book symbolizes the next step in a lifelong journey to help millions of people live healthier every day. Thank you for sharing that journey with me—and be sure to join the Skinny Gut Diet online community to interact with other Skinny Gut dieters and hear their stories.

digestive care, lifestyle, losing weight, Skinny Gut Diet

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